HospitalInspections.org

Based on review of documentation the facility failed to ensure patients presenting to the Emergency Department (ED) recieved an appropriate medical screening exam, in 1 of 21 sampled patients (Patient #1) (A-2406). The facility failed to provide evidence a Medical Screening Exam was completed for Patient #1 who was transported to the hospital by the police and presented to the rear entrance of the emergency department on 6/22/2024.

Cross reference:

§489.24(a); §489.24(c) Appropriate Medical Screening Examination

Based on review of documentation and interviews, it was determined the facility failed to provided Patient #1, an appropriate medical screening exam at the facility's Emergency Department (ED) on 06/22/2024.

Findings:

Facility policy titled "EMTALA" last revised 01/24/2024, states in part:

"2. All persons presenting to the Hospital main campus requesting emergency care must be accepted and evaluated by a qualified medical provider, regardless of ability to pay."

"3. In the absence of an actual request for services, if a 'prudent layperson' observer would believe, based on the individual's appearance or behavior, that the individual needs an examination or treatment for a medical condition, EMTALA still applies and the person must be accepted and evaluated for treatment."

"DEFINITIONS:
Hospital Property: The entire main Millinocket Regional Hospital (Hospital) campus including the parking lot, sidewalk, driveway, Hospital departments, Hospital clinics, and any building owned by the Hospital that is within 250 yards of the Hospital."

Review of facility documentation dated 06/22/2024 indicated that the facility had received a call from a police officer about Patient #1 who was "in a manic state" and "heightened state of arousal" who had been speeding. The document further indicated that Patient #1 was recently discharged from another hospital for "similar behavior" and has a "history of "Bipolar II/Schizophrenia and has not been compliant with [Patient #1's] medications for a while."

The document further revealed (name of police officer) "arrived at the rear entrance of the emergency department and asked if we were able to receive (Patient #1)." Staff Member #1, a nurse, consulted with Staff Member #2, a provider, to inquire about the possibility of the police department to exercise their ability to direct transport this person to a more appropriate facility that could meet [Patient #1's] needs.

An interview with Staff Member #3, CNO revealed Staff Member #1 did suggest that Police Officer take Patient #1 to another facility. Patient #1 was transported by police to another hospital and #1 did not receive a medical screening evaluation.