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.

Based on interviews, review of policies and procedures, review of medical records and review of documents, it was determined that the hospital failed to comply with all requirements of 489.24.

Refer to citation and examples at:

A 2406 - Medical Screening Exam

Based on interview, review of hospital policies and procedures, review of medical records and review of documents, the hospital failed to provide a medical screening examination (MSE) for 1 of 26 patients who presented to the ED during the period of 08/01/19 through 10/02/19.

Failure to ensure that patients receive a MSE by a qualified medical professional and stabilizing treatment risks negative health care outcomes, injury or death.

Findings included:

1. Review of hospital policies and procedures showed the following:

a. The hospital's policy and procedure titled "Emergency Patients, Screening and Mental Health Patient Transfer (EMTALA)", # , effective date of 10/02/19, showed that all persons presenting to Skagit Regional Health Emergency Department with symptoms or complaints that may indicate a medical emergency will receive an emergency medical screening examination and stabilizing medical care.

b. The policy showed that the definition of presenting to the emergency department included patients who presented elsewhere on the hospitals property in order to gain access to the hospital for emergency care.

2. Hospital staff interview showed the following:

a. On 10/02/19 at 2:40 PM, the Registered Nurse (RN) (Staff #3) who had been in charge in the Emergency Department (ED) on the date in question, stated that she recalled Patient #26 and the circumstances about the patient's presentation to the ED. She stated that the patient had been brought to the ED by a Skagit County Sheriff's Deputy who stated that he had a restrained and delusional patient.

Staff #3 stated that she asked the deputy if he had stopped by [another hospital] before coming to Skagit Valley Hospital, and the deputy stated that he had not.

Staff #3 stated that the patient was not evaluated by Skagit Valley Hospital staff, and the deputy left the hospital grounds with the patient.

3. Review of medical records showed the following:

a. Medical records from an outside hospital showed that Patient #26 had been taken by the Sheriff's deputy to the ED of the outside hospital where the patient received a MSE. The ED physician at hospital #2 documented that the patient had been brought in by the police after she had initially been taken to Skagit Valley Hospital. The ED physician documented that the patient was in a mental health crisis.

4. Review of documents showed the following:

a. Review of a document titled "Skagit County Sheriff Incident Report" showed that a Skagit County Sheriff's Deputy had filed a report dated 08/26/19, regarding the transport of Patient #26, on 08/21/19. The report showed that the deputy had initially taken the patient to Skagit Valley Hospital where she was not evaluated. The patient was subsequently transported to another hospital where she was evaluated.