HospitalInspections.org

Based on document review, audio recording and interview, it was determined that for 1 of 20 patients the hospital failed to ensure compliance with 489.24 in that the hospital failed to perform a medical screening examination.

Findings include;

1. See findings cited at 489.24 (a) and (c).

Based on document review, audio recording and interview, the facility failed to provide a medical screening exam for 1 of 20 patients (patient #20).

Findings include:

1. Facility policy titled "Treatment of Patients with Emergency Medical Condition" last updated 9/30/15 states under purpose: "It is the purpose of Kentuckiana Medical Center that all patients presenting for examination or treatment, including women in labor, shall be given an appropriate medical screening examination by a physician to determine if an emergency medical condition exists."

2. Facility policy titled "Patient Assessment" last updated 9/30/15 states under policy: "All patients will be assessed by the ED physician."

3. Review of patient #20 medical record at facility #2 indicated the following:
(A) He/she presented to facility #2 via ambulance at 1642 hours on 9/8/16 in cardiopulmonary arrest and a code was continued per ED staff.
(B) The ambulance run sheet indicated they were on location at 1627 hours on 9/8/16 and were enroute to facility #1 at 1633 hours when they were advised by facility #1 that they had no beds. They diverted to facility #2.

4. Review of diversion log indicated that facility #1 was not on diversion 9/8/16.

5. Review of daily census sheets for 9/8/16 indicated there were four (4) ICU beds vacant (rooms 5, 6, 7, and 10 and one (1) medical/surgical bed vacant.

6. Audio recording provided by EMS service #1 indicated a voice answered the phone stating "Emergency Department". A second voice stated "We are enroute, full arrest......". The first voice stated "I have no where to put that patient...... All our monitored rooms are full."

7. Staff member #3 indicated in interview beginning at 10:20 a.m. on 9/21/16 that the facility was not on diversion on 9/8/16 and all Intensive Care Unit beds are monitored beds.

8. Staff member #9 (Dispatch supervisor at Emergency Medical Services [EMS] #1) indicated in phone interview beginning at 11:00 a.m. on 9/21/16 that he/she was the employee that was attempting to give report to facility #1 about a patient on 9/8/16 and was told there were no monitored beds. He/she indicated that the facility was not on diversion status at the time.

9. Staff member #6 (Supervisor of EMS service #1) indicated in phone interview beginning at 3:15 p.m. on 9/21/16 that he/she has tape indicating facility #1 turned a patient away.

10. Staff member #10 (Emergency Medical Technician with EMS service #1) verified in phone interview at 7:20 p.m. on 9/22/16 that he/she worked with patient #20 on 9/8/16 and the ambulance was informed that facility #1 could not take the patient and they took the patient to facility #2. He/she indicated that the patient was on the side of Interstate 65 and that facility #1 was in line of site and definitely the closest facility.