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.

TRI COUNTY HOSPITAL - WILLISTON 125 SW 7TH ST WILLISTON, FL Oct. 12, 2011
VIOLATION: INTEGRATION OF EMERGENCY SERVICES Tag No: A1103
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on staff interviews and record review the facility failed for 3 of 3 patients, (#2, #3, and #4), to ensure that standard diagnostic laboratory tests are available to evaluate and treat patients with acute cardiovascular events and that facility failed for 1 of 1 patient, (#1), to provide for the administration of medical examination and the gathering of evidence required for investigation and the prosecution of sexual assault victims.


Findings:


1. Interview with the Laboratory Supervisor on 10/12/2011 at 9:15 AM revealed that facility had switched vendors for reagents and the reagents for performing CKMB and Troponin I had been on backorder for the past couple of weeks.

The supervisor stated that the facility was not able to perform these cardiac tests and if the physician ordered the blood would be sent to another named hospital for analysis. The supervisor stated that it could take a several hours to get the results. The supervisor further stated that if the physician suspected that a cardiac event is occurring that the patient would be transferred to Gainesville or Ocala for treatment.

Review of a FAX form Fisher Scientific dated 10/04/2011 revealed that the reagents were backordered and expected deliver date, "Promise date" would be 10/11/2011. As of 10/12/2011 at 4:00 PM the reagents had not been delivered.

Review of the emergency room (ER) Log Book for 10/01/2011-10/11/2011 revealed three patients presented to the ER with the complaint of chest pain. All three had CKMB and Troponin levels ordered and the blood was sent out for analysis. For all three patients the medical records revealed that the patients were transferred to the hospital that performed the laboratory test on the blood, for a Cardiac workup and possible cardiac catheterization.

2. Interview with the ER registered nurse on duty on 10/12/2011 at 9:45 AM revealed that the facility does not have "Rape Kits" in the ER and if a possible sexual assault victim presents at the ER the patient would be transferred to a different named hospital to have rape protocol performed.

Review of the ER log revealed that a patient (MDS) dated [DATE] at 4:00 AM with the complaint of "Thinks was sexually assaulted". Review of the patient's medical record revealed that after law enforcement was notified, she was transferred to the other named hospital for a sexual assault workup.