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.
|MELBOURNE REGIONAL MEDICAL CENTER||250 NORTH WICKHAM ROAD MELBOURNE, FL 32935||Oct. 16, 2020|
|VIOLATION: EMERGENCY ROOM LOG||Tag No: A2405|
|**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on observation and interview, the facility failed to ensure the maintenance of an accurate central log on each individual who comes to the Emergency Department seeking assistance, but then left on their own before all requested registration demographic information can be obtained by the facility.
During an interview of the Administrator of the Steward Melbourne hospital on [DATE] at approximately 3:05 PM, he stated that a patient would not be able to see a nurse to perform triage or see any other nursing or physician staff unless they had first been registered. He stated that the Registrar is the only staff member positioned to await walk-in patients in the Emergency Department (ED) lobby. This arrangement was observed during a tour of the ED on 10/15/2020 at 2:20 PM.
During an interview of the Registration Manager on 10/15/2020 at 2:35 PM, she stated that when a person enters the ED, the first person they would encounter is a registrar at the front desk. She stated that the registrar would enter the patient's name, social security number, date of birth, and chief complaint into the computer system.
During an interview of the Administrator of Steward Melbourne hospital on [DATE] at approximately 1:44 PM, he stated that if a patient presented in the ED to the registrar, reported symptoms, did not disclose their name and then left the ED, that encounter would not be entered by the registrar in any form into the computer system which generates the ED log. He indicated that if a person had presented in the ED, provided a name and nothing more, and then left, the encounter would not be entered by the registrar in any form into the computer system which generates the ED log. He confirmed that this would mean there would not be any notation in the ED log regarding any such encounters. He stated that there are no policies requiring such entries.
Telephone interviews of registrars of Steward Melbourne Hospital were performed on 10/16/2020 from approximately 1:50 PM to 2:07 PM. The interviewees were: Registrar C at 2:02 PM, Registrar A at 1:50 PM, and Registrar B at 1:55 PM. During these interviews, all the registrars indicated that if a person presented to them in the ED but did not give their name and other demographic information, and then left, an entry would not be made in the computer system which generates the ED log. In addition, if only a name was given, an entry would still not be made in the computer system as described above.
The process of receiving people in the ED who may provide limited demographic information at the registration counter and then depart the ED before registration can be finalized does not allow for the incorporation of such visits into the ED log.
During an interview of the Administrator at approximately 5:00 PM on 10/16/2020, he confirmed the findings.