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Based on observation and interview, it was determined the facility failed to post a sign specifying the rights of the individual with respect to examination and treatment of emergency medical conditions and women in labor in an area easily visible by patients presenting to the Emergency Department. The failed practice did not assure all individuals were aware of their rights for treatment of emergency medical conditions and treatment of women in labor. The failed practice had the likeliness to affect all individuals seen in the Emergency Department. The findings follow:

A. Observation of the Emergency Department on 08/15/13 at 1015 revealed the rights were not posted where all individuals that presented to the Emergency Department could easily observe the sign. The sign identified by the Emergency Department Director as the patient notification of rights was enclosed in a glass cabinet behind the glass enclosed triage area.

B. The findings were confirmed by interview with the Emergency Department Director on 08/15/13 at 1015.

Based on clinical record review and interview, it was determined the facility failed to inform eight of eight (#3, #8, #9, #10, #12, #14, #17 and #25) patients the risks and benefits of being transferred to another facility. The failed practice did not ensure the patients were aware of or accepted the risks or the benefits of the transfer. The failed practice had the potential to affect all patients being transferred to another facility form the Emergency Department. The findings follow:

A. Review of Patient #3, #8, #9, #10, #12, #14, #17 and #25's clinical records on 08/15/13 revealed the patients were transferred to other care facilities. There was no evidence the patients or guardians were informed of the risks and benefits of the transfer.
B. The findings were confirmed in an interview with the Emergency Department Director on 08/15/13 at 1430.