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.

AUSTIN LAKES HOSPITAL 1025 EAST 32ND STREET AUSTIN, TX Sept. 21, 2016
VIOLATION: MEDICAL SCREENING EXAM Tag No: A2406
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on a review of clinical records and an interview with staff, the hospital failed to provide an appropriate medical screening exam by a qualified medical person to determine whether or not an emergency medical condition existed for Patients #1 through 23.

Findings were:

During a review of 23 clinical records (Patients #1 through #23), none of the records contained documentation of a medical screening exam by a qualified medical person. The patients were evaluated by a nurse and the care was discussed with a physician. The physician did not perform a medical screening examination. The patients were either transferred to another facility or discharged .

Patient #1 presented on [DATE] with a complaint of suicidal ideation. Patient #1 was assessed by a registered nurse and transferred to an area psychiatric hospital due to the lack of an available bed.
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Patient #2 presented on [DATE] with a complaint of suicidal ideation. Patient #2 also complained of chest pain. Patient #2 was assessed by a registered nurse and transferred to a nearby medical hospital for clearance.

Patient #3 presented on [DATE], requesting substance abuse treatment. Patient #3 was assessed by a registered nurse and transferred to a nearby medical hospital for symptoms of heroin withdrawal.

Patient #4 presented on [DATE] with a complaint of depression. Patient #4 was assessed by a registered nurse and was transferred to a nearby medical hospital due to a blood pressure of 180/107.

Patient #5 presented on [DATE] with a request for housing, as [patient #5] was homeless. Patient #5 was assessed by a registered nurse and transferred to a nearby group home.

Patient #6 presented on [DATE] with a complaint of suicidal ideation. Patient #6 was assessed by a registered nurse and transferred to an area psychiatric hospital due to the lack of an available bed.

Patient #7 presented on [DATE] with a complaint of depression and cocaine abuse. Patient #7 was assessed by a registered nurse and transferred to an area psychiatric hospital due the lack of an available bed.

Patient #8 presented on [DATE] with a complaint of depression and stated that she had ingested 3 bottles of blood thinner tablets and 1 bottle of blood pressure medication prior to her arrival. Patient #8 was assessed by a registered nurse and transferred to a nearby medical hospital for treatment of her overdose.

Patient #9 presented on [DATE] with a complaint of depression. Patient #9 was assessed by a registered nurse and advised to go to a nearby hospital for medical clearance, as the patient appeared to be intoxicated on alcohol.

Patient #10 presented on [DATE] with a complaint of having relapsed on heroin. Patient #10 was assessed by a registered nurse and advised to go to a nearby hospital for medical clearance.

Patient #11 presented on [DATE] with complaints of being intoxicated. Patient #11 was assessed by a registered nurse and sent to a nearby hospital for medical clearance, accompanied by friends.

Patient #12 presented on [DATE] with complaints of dementia. Patient #12 was assessed by a licensed professional counselor and transferred to a nearby medical hospital.

Patient #13 presented on [DATE] with complaints of psychotic symptoms and grandiose delusions. Patient #13 was assessed by a registered nurse and transferred to a nearby psychiatric hospital due to legal issues with the physician.

Patient #14 presented on [DATE] with complaints of slight paranoia and epigastric pain. Patient #14 was assessed by a registered nurse and transferred to a nearby medical hospital for treatment of her epigastric pain.

Patient #15 presented on [DATE]. No reason is documented. Patient #15 was assessed by a social worker and advised to seek treatment at an outpatient psychiatric facility.

Patient #16 presented on [DATE] with complaints of visual hallucinations. Patient #16 was assessed by a registered nurse and advised to seek treatment at an outpatient psychiatric facility.

Patient #17 presented on [DATE]. No reason is documented. Patient #17 was assessed by a social worker and admitted .

Patient #18 presented on [DATE] with complaints of depression. Patient #18 was assessed by a registered nurse and determined to not meet criteria for inpatient admission.

Patient #19 presented on [DATE]. No reason is documented. Patient #19 was assessed by a registered nurse and determined to not meet criteria for inpatient admission.

Patient #20 presented on [DATE]. No reason is documented. Patient #20 was assessed by a registered nurse and determined to not meet criteria for inpatient admission.

Patient #21 presented on [DATE] requesting shelter and medical management of his delirium tremens. Patient #21 was assessed by a registered nurse and advised to seek medical treatment for his delirium tremens.

Patient #22 presented on [DATE]. No reason is documented. Patient #22 was assessed by a registered nurse and determined to not meet criteria for inpatient admission.

Patient #23 presented with complaints of major depression. Patient #23 was assessed by a licensed professional counselor and transferred to a nearby medical hospital for medical clearance.

In an interview with staff #13 on 09-21-16, staff #13 confirmed that no medical screening exam had been performed or documented on any of the 23 patients.

The above was confirmed in an interview with staff #13 on the afternoon of 09-21-16.