The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

THOMAS H BOYD MEMORIAL HOSPITAL 800 SCHOOL ST CARROLLTON, IL 62016 Sept. 5, 2017
VIOLATION: RESPONSIBILITIES OF MD OR DO Tag No: C0261
Based on document review and staff interview, it was determined for 7 of 10 patients (Pt #3, Pt #5 thru Pt #10) receiving care in the Emergency Department, the Critical Access Hospital (CAH) failed to ensure a medical doctor (MD) was immediately available to examine patients, potentially affecting all patients receiving care in the Emergency Department (ED).

Findings include:

1. From 09/05/17 to 09/06/17, at various times, the medical records for Pt #3, Pt #5 thru Pt #10 were reviewed. The following information was documented:

Pt #3 - Arrived in the Emergency Department on 09/05/17 at 11:05 PM, with abdominal pain. The ED physician (E #5) examined the patient at 11:55 PM. (More than 30 minutes after arrival) There was no documentation indicating why there was a delay the examination.

Pt #5 - Arrived in the Emergency Department on 07/05/16 at 3:25 AM, with abdominal cramping. E #5 examined the patient at 4:25 AM. (More than 30 minutes after arrival) There was no documentation indicating why there was a delay in the examination.

Pt #6 - Arrived in the Emergency Department on 07/05/16 at 3:25 AM, with abdominal cramping. E #5 examined the patient at 4:25 AM. (More than 30 minutes after arrival) There was no documentation indicating why there was a delay in the examination.

Pt #7 - Arrived in the Emergency Department on 03/28/16 at 11:00 PM, with abdominal pain.
E #5 examined the patient at 11:50 PM. (More than 30 minutes after arrival) There was no documentation indicating why there was a delay in the examination.

Pt #8 - Arrived in the Emergency Department on 03/08/16 at 1:06 PM, with bladder spasms. E #5 examined the patient at 2:02 PM. (More than 30 minutes after arrival) There was no documentation indicating why there was a delay in the examination.

Pt #9 - Arrived in the Emergency Department on 07/26/16 at 12:50 PM, with foot laceration. E #5 examined the patient at 1:45 PM. (More than 30 minutes after arrival) There was no documentation indicating why there was a delay in the examination.

Pt #10 - Arrived in the Emergency Department on 07/25/16 at 12:47 PM. E #5 examined the patient at 1:40 PM. (More than 30 minutes after arrival) There was no documentation indicating why there was a delay in the examination.

2. On 09/06/17 at 11:30 AM, an interview with the Chief Executive Officer (E #1) was conducted. E #1 was aware of the Nursing staff having difficulty, at times, locating the Emergency Department physician (E #5) when he leaves the CAH for short periods of time. E #1 explained that ED physicians may leave the hospital as long as they immediately return when contacted by nursing staff. E #1 confirmed that only a physician was allowed to perform medical screenings in the Emergency Department. E #1 indicated she informed all nursing staff to report to her if they ever have difficulty locating E #5 or E #5 was not responding within a reasonable length of time. E #1 indicated she had not received any complaints about E #5 from the nursing staff in the last 6 months.

3. On 09/05/17 at 9:15 AM, another interview with the Chief Executive Officer (E #1) was conducted. E #1 confirmed that the Emergency Department, physician (E #5) was very hard to wake up when sleeping, and indicated she had made staff aware of the expectation to have emergency room patients examined by a physician within 30 minutes upon arrival. E #1 verbalized "The physician is not allowed to give orders over then phone, then wait for the results of those orders, prior to examining the patient." E #1 also indicated there was no hospital policy, just a verbal agreement for the 30 minute time frame.