HospitalInspections.org

Based on record reviews and staff interviews, it was determined the hospital failed to enforce policies and procedures that comply with the requirements of 42CFR §489.20 and 42 CFR §489.24, responsibilities of Medicare participating hospitals in emergency cases.

Findings Include:

Hospital Policy titled, "EMTALA- Medical Screening Examination and Stabilization Treatment", revealed: " ...appropriate MSE will be offered to individuals in the Hospital ' s Dedicated Emergency Department who request emergency medical services, on whose behalf such services are requested, or, in the absence of such a request, whose appearance behavior would cause a prudent layperson observer to believe that such individuals need examination or treatment for a medical condition...an EMS provider brings an individual to the Hospital with a Dedicated Emergency Department and the Hospital does not have the capacity or capability to provide an immediate medical screening exam and if needed, stabilizing or an appropriate transfer, the Hospital must still assess the individual upon arrival to ensure that the individual is appropriately prioritized based on presenting signs and symptoms...An MSE will be conducted to determine whether the Patient has an Emergency Medical Condition [sic]EMC. The Hospital will conduct a consistent MSE, in nondiscriminatory matter, for all Patients with similar medical conditions. The MSE is an ongoing process requiring continuing monitoring based upon the Patient ' s needs and must continue until the EMC is stabilized or the Patient is admitted or appropriately transferred...An MSE and Stabilizing Treatment, within the capabilities of the Hospital, will be provided to all individuals regardless of their ability to pay. Medical screening and stabilizing treatment will not be delayed to obtain payment or insurance information...."

The hospital failed to provided to medical screening exam for to 6 patients prior to the patients leaving.

Employee #6 confirmed that medical screening exams were not provided to the patients that were not treated.

Based on review of documents and staff interview, it was determined the hospital failed to provide medical screening exam to 6 patients out of 20 patients prior to them leaving the Emergency department. (patient #1, Patient #3, Patient #5, Patient #6, Patient #9, and Patient #10).

Findings Include:

Hospital Policy titled, "EMTALA- Medical Screening Examination and Stabilization Treatment", revealed: " ...appropriate MSE will be offered to individuals in the Hospital ' s Dedicated Emergency Department who request emergency medical services, on whose behalf such services are requested, or, in the absence of such a request, whose appearance behavior would cause a prudent layperson observer to believe that such individuals need examination or treatment for a medical condition...an EMS provider brings an individual to the Hospital with a Dedicated Emergency Department and the Hospital does not have the capacity or capability to provide an immediate medical screening exam and if needed, stabilizing or an appropriate transfer, the Hospital must still assess the individual upon arrival to ensure that the individual is appropriately prioritized based on presenting signs and symptoms...An MSE will be conducted to determine whether the Patient has an Emergency Medical Condition [sic]EMC. The Hospital will conduct a consistent MSE, in nondiscriminatory matter, for all Patients with similar medical conditions. The MSE is an ongoing process requiring continuing monitoring based upon the Patient ' s needs and must continue until the EMC is stabilized or the Patient is admitted or appropriately transferred...An MSE and Stabilizing Treatment, within the capabilities of the Hospital, will be provided to all individuals regardless of their ability to pay. Medical screening and stabilizing treatment will not be delayed to obtain payment or insurance information...."

Review of six (6) out of twenty (20) patient emergency medical records randomly selected from the hospital emergency logs for the months of December 2024, January 2025 and February 2025 revealed there was over five (5) hour delays and patients Left without Triage/Treatment.

Patient #1 Registered at 1617 on 12/01/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 10 hours and 37 minutes.

Patient #3 Registered at 2018 on 12/02/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 4 hours and 57 minutes.

Patient #5 Registered at 2009 on 12/06/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 7 hours and 02 minutes.

Patient #6 Registered at 2009 on 12/014/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 9 hours and 22 minutes.

Patient #9 Registered at 1921 on 12/21/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 6 hours and 02 minutes.

Patient #10 Registered at 2132 on 12/23/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 5 hours and 18 minutes.

Employee #5 stated the hospital and ED "have made changes in the ED, dramatic changes that has diminished the LWOT times drastically".

Employee #5 and #6 confirmed on 03/24/2025 the hospital had identified in February the long MSE times and implemented a new process on 2/26/2025.

Based on review of policies and procedures, clinical records, hospital documents, and staff interviews, it was determined the facility failed to provide a Medical Screening Examination (MSE) and treatment to six (6) out of (20) patients (Patients #1,3,5,6,9,and 10)who left without treatment (LWOT) and delayed an MSE and treatment for two (2) out of twenty (20) patients (Patients #7, #11).

Findings include:

Hospital Policy titled, "EMTALA- Medical Screening Examination and Stabilization Treatment", revealed: " ...appropriate MSE will be offered to individuals in the Hospital ' s Dedicated Emergency Department who request emergency medical services, on whose behalf such services are requested, or, in the absence of such a request, whose appearance behavior would cause a prudent layperson observer to believe that such individuals need examination or treatment for a medical condition...an EMS provider brings an individual to the Hospital with a Dedicated Emergency Department and the Hospital does not have the capacity or capability to provide an immediate medical screening exam and if needed, stabilizing or an appropriate transfer, the Hospital must still assess the individual upon arrival to ensure that the individual is appropriately prioritized based on presenting signs and symptoms...An MSE will be conducted to determine whether the Patient has an Emergency Medical Condition [sic]EMC. The Hospital will conduct a consistent MSE, in nondiscriminatory matter, for all Patients with similar medical conditions. The MSE is an ongoing process requiring continuing monitoring based upon the Patient ' s needs and must continue until the EMC is stabilized or the Patient is admitted or appropriately transferred...An MSE and Stabilizing Treatment, within the capabilities of the Hospital, will be provided to all individuals regardless of their ability to pay. Medical screening and stabilizing treatment will not be delayed to obtain payment or insurance information...."

Review of the medical records of 20 randomly selected patients from the ED logs revealed the following:
The hospital failed to provide a medical screening exam to 6 of 20 patient s before the patients left without treatment.

Patient #1 Registered at 1617 on 12/01/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 10 hours and 37 minutes.

Patient #3 Registered at 2018 on 12/02/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 4 hours and 57 minutes.

Patient #5 Registered at 2009 on 12/06/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 7 hours and 02 minutes.

Patient #6 Registered at 2009 on 12/014/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 9 hours and 22 minutes.

Patient #9 Registered at 1921 on 12/21/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 6 hours and 02 minutes.

Patient #10 Registered at 2132 on 12/23/2024 and Left before medical screening Exam (MSE), with an MSE elapsed time of 5 hours and 18 minutes.

Further review reviewed the hospital delayed an MSE and treatment for 2 of the 20 patients.

Patient #7 Registered at 1040 on 12/16/2024 and had an MSE of 1 hour and 54 minutes.

Patient #11 Registered at 1735 on 02/27/2025 and had an MSE of 3 hours and 23 minutes.

Employee #5 confirmed the hospital had identified the long MSE times and implemented a new process on 2/26/2025.