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.
|ALLEGIANCE BEHAVIORAL HEALTH CENTER OF PLAINVIEW||2601 DIMMITT ROAD, SUITE 400 PLAINVIEW, TX 79072||Aug. 7, 2014|
|VIOLATION: CHIEF EXECUTIVE OFFICER||Tag No: A0057|
|Based on record review and interview, it was determined that the facility failed to ensure that appropriate documentation was completed for the transfer of a patient with an emergency medical condition, which had not been stabilized, in accordance with the facility's policies and procedures, and transfer agreement between the transferring facility and receiving facility.
Review of the medical record for patient #1 on 8/7/14, revealed that the patient was transferred to another hospital's emergency room for treatment after the patient was found unresponsive, and there was no certification of transfer signed by a physician or a qualified medical personnel. Nurses notes from 7/25/14 stated that the following occurred from 6:30 am to 6:45 am: "pt found on floor face down, unresponsive breathing Rapid Response, Dr ... called. Patient immobilized placed on stretcher and then to ER ..."
Facility policy Patient Transfers, Policy :435 stated the following:
C. Transfer of patients who have emergency medical conditions:
2. The hospital may not transfer a patient with an emergency medical condition which has not been stabilized unless:
a. the patient, or a legally responsible person acting on the patient's behalf, after being informed of the hospital's obligations under this section and of the risks and benefits of transfer, in writing requests transfer to another hospital and indicates the reasons for the request, was well as that he or she is aware of the risks and benefits of the transfer;
b. a physician has signed a certification, which includes a summary of the risks and benefits, that, based on the information available at the time of transfer, the medical benefits reasonably expected from the provision of appropriate medical treatment at another hospital outweigh the increased risks to the patient; or
c. if the physician who made the determination to transfer a patient with an emergency condition is not physically present in the treatment area at the time of transfer, a qualified medical person may sign a certification described in clause b. of this subparagraph after consultation with the physician. The physician shall countersign the certification within a reasonable period of time.
The facility's "Transfer Agreement Medical, Surgical & Emergency Services" with Covenant Hospital Plainview, stated the following:
3.2 The hospitals will not transfer a patient with an emergency medical condition which has not been stabilized unless:
a. the patient, or a legally responsible person acting on the patient's behalf, after being informed of the hospital's obligations to stabilize and of the risk of transfer, in writing, requests transfer to another hospital;
b. a licensed physician has signed a certification which includes a summary of the risks and benefits, that, based on the information available at the time of transfer, the medical benefits reasonably expected from the promise of appropriate medical treatment at another facility outweigh the increased risks to the patient and, in the case of labor, to the unborn child from effecting the transfer; or
c. if a licensed physician is not physically present at the time a patient is transferred, a qualified medical person has signed a certification described above, after consultation with a physician who makes the determination that the transfer without stabilization is necessary. The physician must countersign the certification within a reasonable period of time.
The above was confirmed in an interview with the facility's CEO and CNO on 8/7/14.