When EMTALA site reviewers started pulling cases from the log to review, they found 5 of 33 entries were wrong and cited the hospital for EMTALA violations of tag A2405.
- Patient #2 was listed as “Left Without Being Seen” (LWOBS) but the medical record showed the patient was discharged home.
- Patient #3 was also listed as LWOBS but the record showed the patient eloped from the hospital.
- Patient 21 was logged as having been discharged at 3:32 p.m., while the record showed the patient was discharged at 10:51 a.m.
- Similarly, Patient 22 was logged as discharged at 10:00 a.m., when they were actually discharged at 6:49 a.m.
- The log failed to show the time #23 was seen, leaving a gap in log entry, while the medical record showed the patient was seen at 8:33 a.m.
On the face of it, these might not appear to be a “bid deal”, but from the enforcement perspective, these errors are frustrating for surveyors. The main purpose of the log is not really for the hospital, but is intended for use by the site surveyors to identify charts for their specific issues for review. The disposition of the patient or times involved in the visit may be the reason a chart is selected, and then it turns out the chart is not really relevant. It wastes surveyor time and puts them into a bad mood which never helps the hospital.
Logs need to be sequential, complete, and accurate. Out of order entries, gaps in information, or errors in information are a definite “hot button” for triggering a citation. When it comes to logs in separate departments such as OB, it is important to note that the log is a “presentation log” not an “admissions” log. Everyone who “presents” must be captured in the log.
For more information, see PP 207-211 EMTALA Field Guide 3rd Edition.
A2405-NJ-2013-4-11