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Based on observation, policy review and staff interview it was determined the emergency room failed to post the Emergency Medical Treatment and Labor Act (EMTALA) federal requirements for individuals entering the emergency room as well as those individuals waiting for examination and treatment. The emergency room census was 14.

Findings include:

Review of the EMTALA Medical Screening and Stabilization Policy Number AD430 ( Approved 03/02/17) states the hospital is required to provide the care for emergency medical conditions under the Emergency Medical Treatment and Labor Act (EMTALA). The purpose of the policy is to provide care for emergency medical conditions to individuals regardless of their ability to pay, and regardless of whether they are eligible for assistance under the hospital's financial assistance policy.

On 08/12/19 at 11:45 AM a tour was conducted in the emergency department with the Staff C and D. During the tour it was determined there was no EMTALA signage posted informing patients without discrimination, an appropriate medical screening exam within the capability of the emergency department must be completed to determine whether or not an emergency medical condition exists.

During the tour Staff D was unable to locate the EMTALA signage required to be posted in the emergency department. Staff D reported no patients are turned away for treatment. Patients are treated and stabilized and/or transferred to a higher level of care.

Staff C reported during an interview on 08/12/19 at 12:15 PM the signage was posted in the emergency room, however, it may have been moved and/or removed for an unknown reason. Staff C reported all staff receive mandatory EMTALA training upon hire and annually thereafter.

Staff B reported in an interview on 08/13/19 at 1:29 PM the individual assigned to marketing in the emergency room may have removed the EMTALA signage.

On 08/15/19 at 2:15 PM an interview was conducted with the Emergency room Medical Director who reported not seeing the EMTALA signage in the Emergency Department. The emergency room has fourteen beds and is not a trauma designated hospital. All patients are assessed by a physician and if necessary are transferred to a higher level of care. All physicians are contracted and are aware of the EMTALA requirements.

On 08/15/19 at 2:40 PM the Emergency Room registration staff was interviewed who reported not seeing an EMTALA sign in the emergency room. The EMTALA training is provided upon hire and mandated annually thereafter. No patients are turned away for services. The medical insurance information is not collected until after the patient is triaged and in a bed where the demographics are then collected. Medically unstable patients are transferred to a higher level of care based on the decision of the physician.