HospitalInspections.org

West Jersey Hospital Voorhees

Based on observation and staff interviews, it was determined that the facility failed to conspicuously post signage, specifying the rights of individuals under section 1866 of the Act with respect to examination and treatment of emergency medical conditions and women in labor.

Findings include:

1. A tour of the West Jersey Hospital Voorhees Adult Emergency Department (ED) area, conducted on 3/12/20, revealed the following:

a. The EMTALA sign posted in the Adult ED Waiting Room was not visible to all patients and visitors.

b. One (1) ED treatment room (Room #18) was observed. This room did not have an EMTALA sign.

c. During interview on 3/12/20 at 10:15 AM, Staff #WJ7 confirmed the above findings and stated that none of the West Jersey Hospital Voorhees ED treatment rooms have EMTALA signs posted.

2. A tour of the West Jersey Hospital Voorhees Pediatric ED treatment area, conducted on 3/12/20, revealed the following:

a. There were no EMTALA signs posted in the Pediatric ED treatment area.

b. During interview on 3/12/20 at 10:25 AM, Staff #WJ1 confirmed the above finding.

c. The EMTALA sign posted in the Pediatric ED Waiting Room was not visible to all patients and visitors.

3. A tour of the West Jersey Hospital Voorhees Obstetrics (OB) triage area, conducted on 3/12/20, revealed the following:

a. Two (2) OB Triage Treatment Rooms were observed (Room #4 and #5). There were no EMTALA signs posted in either room.

b. During interview on 3/12/20 at 10:50 AM, Staff #WJ8 confirmed the above findings and stated that none of the OB triage rooms have EMTALA signs posted.

2. A tour of the West Jersey Hospital Voorhees facility, conducted on 3/12/20, revealed that there were no EMTALA signs posted at the hospital entrance, ambulance entrance, and in the Hospital Main Lobby.

a. During interview on 3/12/20 at 11:00 AM, Staff #WJ3 confirmed the above findings.

West Jersey Hospital Voorhees

Based on a review of the Emergency Department on-call physician lists for services provided at Voorhees for January, February, and March 2020, it was determined that the facility failed to ensure that some lists do not include individual physician names.

Findings include:

1. Gastroenterology:

a. The "WEST JERSEY Gastroenterology" on-call list for March stated: "All GI (Gastrointestinal) patients should be referred to Internal Medicine on call for referral." The log sheet was undated and included no other information.

b. The "WEST JERSEY Gastroenterology" on-call list for February stated: "All GI (Gastrointestinal) patients should be referred to Internal Medicine on call for referral." The log sheet was undated and included no other information.

2. The WEST JERSEY OB/GYN (Obstetrics/Gynecology) CALL SCHEDULE included the entry for March 27: "______ (surname) 8a-5p ______ 5p-8p." There was no evidence on the schedule of a physician being on-call between 12:00am and 8:00am nor between 8:00pm and 12:00am.

3. Neurology:

a. The NEUROLOGY ON-CALL SCHEDULE for March 2020 included the entry "SOC" (Specialist on Call) for "Urgent" consults between 5:00pm and 7:00am for every day of the month.

b. The NEUROLOGY ON-CALL SCHEDULE for February 2020 included the entry "SOC" for "Urgent" consults between 5:00pm and 7:00am for every day of the month.

c. The NEUROLOGY ON-CALL SCHEDULE for January 2020 included the entry "SOC" for "Urgent" consults between 5:00pm and 7:00am for every day of the month.

4. The WEST JERSEY Orthopedics Call Schedule for March, February, and January listed the name of an Orthopedic Group, not the name of a physician or physicians.

5. The WEST JERSEY Gastroenterology on-call schedule for March, February, and January stated: "All GI (Gastrointestinal) patients should be referred to Internal Medicine on call for referral."

6. Neurosurgery:

a. An on-call schedule for March was not provided to the surveyor.

b. The "Live Consult" section of the WEST JERSEY Neurosurgery Call Schedule for January only included the name of a physician for 1/9, 1/11, 1/12, 1/14, 1/23, 1/28 and 1/30/20. There were no entries for any of the other dates.

c. The "Live Consult" section of the WEST JERSEY Neurosurgery Call Schedule for February only included the name of a physician for 2/2, 2/11, 2/13, 2/22, 2/23, 2/25 and 2/27/20. There were no entries for any of the other dates.

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West Jersey Hospital Voorhees

A. Based on staff interview, medical record review, and review facility documentation, it was determined that the facility failed to ensure that an accurate and complete Emergency Obstetrics (OB) triage log is maintained for one (1) out of two (2) patients in the West Jersey emergency OB triage area (Medical Record #WJ6).

Findings include:

1. Two (2) medical records were reviewed and it was noted that in one (1) of two (2) medical records, there were discrepancies between the medical record and the associated West Jersey OB triage log.

2. A review of Medical Record #WJ6 on 3/12/20, in the presence of Staff #WJ8, revealed the following:

a. The patient arrived to the West Jersey OB triage area on 3/11/20 at 0728 with a complaint of vomiting during pregnancy. The patient was triaged at 0738 and a medical screening exam (MSE) was initiated at 0856.

b. The OB triage log indicated that the patient was not admitted. The section titled, "Admitted?" stated "No"
The section titled, "Discharge Disposition" was left blank.

c. There was documentation in the medical record that the patient was admitted to the West Jersey Intensive Care Unit on 3/11/20 at 1634.

3. Upon interview on 3/12/20 at 1:43 PM, Staff #WJ8 confirmed the above findings.


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Berlin

B. Based on review of two (2) out of twenty (20) medical records (Medical Record #B3 and #B4), staff interview, and review of the Emergency Department (ED) Central Log, it was determined that the facility failed to ensure that an accurate and complete Emergency Department (ED) central log is maintained.

Findings include:

1. On 3/12/20 at 12:15 PM, review of Medical Record #B3 revealed that the patient was discharged home. Discharge disposition was documented as "treat and release."

a. Review of the ED central log indicated that the patient left Against Medical Advice (AMA).

b. This finding was confirmed by Staff #B1 and Staff #B2 at the time of discovery.

2. Review of Medical Record #B4 on 3/12/20 revealed the following:

a. The patient arrived to the ED via ambulance on 3/3/20 at 8:14 PM with complaints of chest pain. The patient was triaged and a medical screening exam (MSE) was initiated at 8:24 PM.

b. The ED Central Log indicated the patient was treated and released to home. There was no documentation in the medical record that indicated the patient was a treat and release to home.

c. The above findings were confirmed by Staff #B2.


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