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Based on review of facility policies, facility documents and interviews with staff (EMP), it was determined that the provider failed to ensure that the Emergency Medical Treatment and Labor Act (EMTALA) policies that the facility adopted were followed by staff.

Findings include:

A review on April 17, 2014, of the facility's policy entitled "Emergency Medical Treatment & Active Labor Act (EMTALA) Screening, Stabilization and Transfer of Patient to Other Facilities," last reviewed January 2015 revealed, "Policy It is the policy of Mercy Catholic Medical Center (MCMC) to provide appropriate medical screening examination to individuals presenting at the ...Mercy Philadelphia Hospital Emergency Department requesting examination or treatment of a medical condition, and to individuals presenting at either hospital's main campus requesting examination or treatment of an emergency medical condition...either to stabilize an emergency medical condition if one exists, or to transfer the individual appropriately and in conformity with legal and regulatory requirements....

A review on April 17, 2014, of the facility's policy entitled "Management of Psychiatric Patients in the Emergency Department" last reviewed January 2015 revealed, "It is the policy of Mercy Health System-Mercy Hospital of Philadelphia ...to establish therapeutic guidelines in assessing and caring for patients who exhibit psychiatric dysfunction and to protect staff, visitors and patients themselves from harm. Purpose ...Hospital of Philadelphia ... to provide appropriate, therapeutic guidelines to the Emergency Department personnel when caring for an emotionally disturbed patient, and to ensure the safety of staff, visitors and patients... Procedures. 1. The role of nursing and physician staff is to be available, understanding, comforting and supportive the patient through his/her crisis"

A review on April 17, 2015, of facility documents revealed, the patient entered the Crisis Response Center voluntarily for treatment on April 7, 2015, at 9:57PM. Further review revealed, the patient repeatedly tried to regain entry to the Crisis Response Center at 10:02PM and the Emergency Department at 10:05PM but was denied access by facility personnel.

A review on April 17, 2015, of facility documents revealed, a written statement by EMP21 denying the patient access to the Emergency Department to receive treatment.

An interview conducted on April 17, 2015, at 2:50PM with EMP17 and EMP18 confirmed that the patient presented to the Crisis Response Center and the Emergency Department attempting to receive treatment.

An interview conducted on April 17, at 3:00PM,with EMP20, confirmed that the patient displayed disturbing behavior "kicking and banging" on the Intake Department door inside of the Crisis Response Center and was not evaluated due to this disturbing behavior.

An interview conducted on April 17, 2015, at 3:15PM with EMP14 and EMP19 revealed the facility failed to allow the patient access to treatment and the facility failed to follow their policy.

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Based on a review of facility policies, facility documents and interviews with staff (EMP), it was determined that Mercy Philadelphia Hospital failed to provide an appropriate medical screening examination (MSE) for one of one psychiatric patients.

Findings include:

A review on April 7, 2015, of the Mercy Philadelphia Hospital-MCMC policy entitled "Emergency Medical Treatment & Active Labor Act (EMTALA) Screening, Stabilization and Transfer of Patient to Other Facilities," last reviewed January 2015, revealed, " ... II. Definitions: ... Medical Screening and Stabilization 1. Individuals who present to ..Mercy Philadelphia Hospital Emergency Department, or at any other on-campus MCMC department and who require an examination or treatment for a medical condition must be provided an appropriate medical screening examination by an emergency department physician or physician's designee in order to determine whether an emergency medical condition exists...An individual is considered to have made a request for examination or treatment for a medical condition if a request is made on his or her behalf, or if a prudent layperson observer would believe, based upon the individual's appearance or behavior, that the individual needs emergency examination or treatment.

A review on April 7, 2015, of the Mercy Philadelphia Hospital-MCMC policy entitled "Management of Psychiatric Patient in the Emergency Department," last reviewed January 2015, revealed, " Procedures 11. The role of nursing and physician staff is to be available, comforting and supportive the patient through his/her crisis. 2. Obtain history of the presenting problem which brought the patient to the Emergency Department. This should be obtained from the patient..In appropriate situation, additional information may be obtained from others such as family, friends, police, medics or crisis worker...5. The Emergency Department Physician performs a pertinent physical examination. 6. Ascertain whether or not the disturbed behavior may be secondary to toxic substances and if this is judged so, see the policy on Alcohol and/or Drugs....If the patient is agitated or assaultive, and intoxicated, the patient should be observed and treated (or medicated if appropriate) in the ED until patient is calm and deemed appropriate for Psychiatric Crisis Unit..."

A review on April 17, 2015, of the Mercy Philadelphia Hospital Emergency Department Log revealed, the patient was not listed on the log for April 7, 2015. Therefore, there was no medical record created for the patient.

An interview conducted on April 17, 2015, at 11:30AM, with EMP4, and EMP19 revealed that the patient presented to the Emergency Department on April 7, 2015 at 10:03PM. Further interview with EMP4 and EMP19 confirmed that the facility did not perform a MSE for this patient.

An interview conducted on April 17, 2015, at 3:00PM with EMP20 confirmed that the patient presented to Crisis Response Center 9:57PM. Further interview revealed the patient displayed disturbing behavior "kicking and banging" on the Crisis Response Center intake door and was not evaluated because of the disturbing behavior. EMP20 confirmed that she did not intervene to establish therapeutic interventions to assess and evaluate the patient's behavior.

An interview conducted on April 17, 2015, at 3:15PM with EMP19 confirmed that the facility failed to follow their policy.