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Based on review of the Emergency Department Log, Medical Staff Rules and Regulations, Policy and Procedure GO18 EMTALA (Emergency Medical Treatment and Labor Act) Medical Screening/Stabilization and interview, it was determined the facility failed to ensure every patient presenting to the Emergency Department for treatment was entered into the Emergency Department Log. The failed practice allowed a person seeking medical treatment to not receive a medical screening exam by a physician and had the potential to affect all patients presenting to the Emergency Department.

A. There was no documentation in the Emergency Department Log October 21 and 22, 2010, of the patient's name, date, time of presentation, chief complaint, or disposition.
B. Review of the Policy and Procedure GO18 EMTALA (Emergency Medical Treatment and Labor Act) Medical Screening/Stabilization stated the name and disposition of all patients requesting emergency treatment would be entered into the Emergency Department Log.
C. An interview was conducted at 1400 on 01/24/11 with the Director of Regulatory Compliance. She verified the names of the employee identified in the occupational health file were not entered into the Emergency Department Log.

Based on review of the Medical Staff Rules and Regulations, Emergency Services Policy and Procedure #20 Medical Screening Exam, Policy and Procedure GO18 EMTALA (Emergency Medical Treatment and Labor Act) Medical Screening/Stabilization and interview, it was determined patient #1 requested to be seen by a physician for an on the job injury and Emergency Department staff declined services until payment was made. Therefore a medical screening was not provided to determine if an emergency medical condition existed. The failed practice allowed a person seeking medical treatment to not receive a medical screening exam by a physician and had the potential to affect all patients presenting to the Emergency Department.
A. Review of the Medical Staff Rules and Regulations 6.1 Screening, Treatment and Transfer stated "All patients who present to the Emergency Room shall be assessed by qualified medical personnel, i.e., a physician trained in emergency medicine".
B. Review of the Emergency Services Policy and Procedure #20 Medical Screening Exam revealed all patients presenting to the Emergency Department will receive a Medical Screening Exam.
C. Review of the Policy and Procedure GO18 EMTALA (Emergency Medical Treatment and Labor Act) Medical Screening/Stabilization stated all patients requesting treatment would receive a Medical Screening Exam.
D. An interview was conducted at 1045 on 01/24/11 with the ED Nurse Manager. She stated in October 2010, an employee was told by an Emergency Department Clerk that the employee would have to pay $100.00 to file a workman's compensation claim.
E. An interview was conducted at 1530 on 01/24/11 with the Patient Access Director. She stated in October 2010 an Emergency Department Clerk told an employee they would have to pay a deposit before they could be seen in the Emergency Department.