HospitalInspections.org

Based on review of facility documents, staff interview (EMP), and security surveillance it was determined the facility failed to provide a medical screening exam for a patient who arrived at the facility via ambulance for one of one observation made.

Findings include:

Review on June 5, 2023, of the facility policy, " EMTALA (Emergency Medical Treatment And Active Labor Act) - Administrative, " last reviewed January 2023 revealed " ... I. Policy: 1. Medical Screening Examination A. The Hospital must provide an appropriate medical screening examination within its capability to all persons who present themselves to a dedicated emergency department and who request, or have a request made on his or her behalf, for an examination or treatment of a medical condition. The Hospital must also provide a medical screening examination when persons on hospital property other than a dedicated emergency department request or appear to require emergency medical care. If an emergency medical condition is determined to exist, the Hospital must provide any necessary stabilizing treatment within the capabilities of the staff and facilities available at the Hospital or an appropriate transfer..."

"II. Definitions... Hospital Property (HP): Buildings on the hospital that participate in the same Medicare license. Buildings that are immediately adjacent to the main buildings and other areas and structures that are not strictly contiguous to the main buildings but are located within 250 yards of the main building including parking lots, sidewalks and driveway. Medical Screening Examination (MSE): A medical screening examination is the process required to reach, with reasonable clinical confidence, the point at which it can be determined whether or not an emergency medical condition exists or an individual is in labor. Such screening must be done within the facility ' s capability and available personnel, including on-call providers and be applied in a non-discriminatory manner (i.e., a different level of care must not exist based upon age, sex, race, ethnic origin, religion, sexual preference, medical condition, insurance, or ability to pay). Screening is to be conducted to the extent necessary, by providers and/or other qualified medical personnel, to determine whether an emergency medical condition exists. With respect to a person with psychiatric symptoms, an MSE consists of both a medical and psychiatric screening. The MSE is an ongoing process and the medical records must reflect continued monitoring based on the person ' s needs and must continue until the individual is either stabilized or appropriately transferred. ... Person Presenting to Emergency Department: Any individual who is not already a " patient " who requests an examination or treatment. A person who presents anywhere on the hospital campus and requests emergency services or who would appear to a prudent layperson observer to be in need of medical attention shall be evaluated by the DED for an emergency medical condition. This includes a person in an ambulance on hospital property. ... "

Review on June 5, 2023, of security camera footage revealed at approximately 3:17 PM on May 22, 2023, MR22 arrived to Muhlenberg Campus Emergency Department accompanied by a male and a young child. MR22 approached EMP18 at the registrar desk. EMP18 handed the patient an IPAD device for communication purposes. Communication on the IPAD ends and EMP18 motions for the patient to go around the building. The patient is then seen leaving the emergency department.

Interview on June 5, 2023 at approximatley 10:45 AM with EMP1 confirmed the reviewed security camera footage was of the patient in MR22.

Review on June 2, 2023, of security camera footage revealed at approximately 4:00 PM, on May 22, 2023, MR22 approached the guest services desk located in the South Entrance of the hospital. The patient handed EMP11 documents which were then reviewed. EMP11 returned the documents to the patient, and the patient leaves the hospital.

Interview on June 2, 2023 at 1:45 PM with EMP4 confirmed the security camera footage reviewed on June 2, 2023 was of the patient in MR22

Interview on June 2, 2023 with EMP11 at 1:55 PM confirmed s/he did not utilize interpreter services to communicate with MR22.

Interview on June 2, 2023, with EMP2 at approximately 10:45 AM confirmed MR22 in the security footage predominantly spoke Spanish and was 29 weeks pregnant. The patient was expected to be seen in the Labor and Delivery Department for hypertension and required interpreter services. The patient did not received a medical screening exam and was directed to drive around the building to the South entrance where the Labor and Delivery Department was located.