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.

LONG ISLAND COMMUNITY HOSPITAL 101 HOSPITAL ROAD PATCHOGUE, NY 11772 Feb. 6, 2019
VIOLATION: APPROPRIATE TRANSFER Tag No: A2409
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

.
Based on medical record (MR) review, document review and interview, the facility failed to confirm the receiving facility had agreed to accept a transfer in one (1) of eight (8) MRs.

Findings included:

Review of Patient #5's MR identified the following information: This [AGE]-year-old (MDS) dated [DATE] at 5:56AM with a complaint of vaginal bleeding at twenty-two (22) weeks of pregnancy. Patient #5 was examined by a physician who documented the medical necessity to transfer the patient.

The facility's Authorization for Transfer Form, dated 08/18/18, did not contain documented evidence that a physician at the receiving facility had been contacted and had accepted Patient #5 for admission.

Per interview of Staff E (Medical Director) on 02/06/19 at 11:05AM, Staff E stated, "Our policy is for our physician to contact the receiving hospital and get a physician to accept the patient. This is done doctor to doctor. It should be documented in the medical record."

The facility policy and procedure (P&P) titled, "Transfer of the Emergency Department Patient to Another Facility," dated 02/17/17 stated, "...the receiving hospital must give acceptance in advance and acceptance must be made physician to physician. The acceptance must be documented in the medical record along with the receiving hospital physician name..."

The facility failed to confirm that the receiving hospital had agreed to accept the transfer.