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Based on observations, interview and document review, the facility failed to ensure a central log of all patients who presented to the facility for treatment was maintained.

Findings include:

Facility policies:

The policy, Emergency Medical Treatment and Labor Act (EMTALA), read a central log will be maintained that includes information on each patient requesting emergency treatment at the hospital (regardless of whether the patient requested such treatment through the ED). The log will document the date, time, patient name, medical record number or social security number, chief complaint, and whether the patient refused treatment or was refused treatment, was transferred, was admitted or treated, or was stabilized and transferred. The ED shall maintain the log for all patients who present or are treated in the ED. If a patient presents or is treated in a department or facility of the hospital other than the ED, such other department or facility shall maintain a log with the necessary information on such patient and shall provide such information to the ED upon request. The ED log shall reference the logs maintained by other departments or facilities.

1. The facility failed to include all patients who presented to the hospital for emergency treatment on the central log.

a. On 6/6/22 at 9:36 a.m., observations were conducted at the main hospital entrance. Observations revealed a patient entered the facility main entrance and walked up to the main hospital reception area and spoke with Receptionist #1. The patient stated he had shortness of breath and his oxygen was low. The receptionist did not take any patient information and stated to the patient that low oxygen saturations in the mountains wasn't good. Receptionist #1 then told the patient to go to the "walk-in clinic" to be seen. The receptionist was observed to point the patient towards the clinic and the patient then walked to the walk-in clinic.

This was in contract to facility policy which identified any person who presents to the hospital requesting treatment for a medical condition will be maintained on a central log.

b. On 6/6/22 at 2:42 p.m., an interview was conducted with Chief Nursing Officer (CNO) #2. CNO #2 stated any person who presented to the hospital for care was to be seen at the hospital. CNO #2 then stated if the patient did not have an appointment, the patient could receive care in the emergency department as this was an EMTALA obligation. A review of the morning observations were done with CNO #2 in which the patient presented to the main hospital entrance with shortness of breath and was instructed to go to the walk-in clinic. CNO #2 confirmed the patient from the observation was not logged on the central log as required.