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Based on observation, interview, and document review, the hospital failed to ensure appropriate signage was displayed, as required, in all areas of patient entrance and awaiting and/or receiving treatment for the Emergency Medical Treatment and Labor Act (EMTALA). The lack of signage had potential to affect anyone arriving to the ED via emergency response (i.e., EMS) or receiving care within the ED.

Findings include:

On 9/16/24 at 11:15 a.m., a tour was completed of the Mercy Hospital - Coon Rapids emergency department (ED) with the ED patient care director (PCD)-A present who explained the ED consisted of 48 rooms and included both stabilization (i.e., STAB) rooms and mental health dedicated (i.e., seclusion, monitored) rooms. The main entrance to the ED was observed and opened to the outside with a large awning above the double set of sliding doors which displayed to the public, red-colored lettering reading, "EMERGENCY." Inside the entrance, a set of sliding doors opened to the waiting area and reception desk which had multiple persons seated and, on the left side of this entrance, was signage for EMTALA and the associated rights thereof. The tour continued, and access to the ED corridor required security badge access. Inside, the ambulance garage was toured which PCD-A verified was where EMS presenting patients would enter the ED. However, the entire space and corridor attaching it to the ED lacked any EMTALA signage. PCD-A verified the lack of signage and expressed the area had been re-modeled months prior and the signage must not have been replaced yet. The tour continued and no further EMTALA signage was located in the treatment area hallways or corridors which PCD-A verified adding no such signage was displayed or posted, at least to their knowledge, adding aloud, "We don't [have posted] in the ED proper."

During subsequent interview, on 9/16/24 at 2:45 p.m., PCD-A clarified the ambulance garage area was re-modeled back in July 2024 and they believed a work-ticket had been submitted then to replace the EMTALA signage. PCD-A stated they would locate and, if able, provide the work-order ticket.

However, during the onsite abbreviated survey from 9/16/24 to 9/18/24, it was not provided or received.

A hospital' provided Emergency Medical Treatment and Labor Act (EMTALA) policy, dated 1/2024, identified the policy applied to the hospital campus under survey and included a section labeled, "Signs," which directed EMTALA signage was to be conspicuously posted in any entrances, emergency department and place likely to be noticed by persons waiting examination. The policy continued, "This would include but is not limited to entrances, admitting areas, waiting rooms, ambulance bays, and labor and delivery triage areas." The policy directed the signage must display the rights of persons with emergency conditions seeking care and indicate if the hospital participates in the Medicaid program.