ER Inspector BAPTIST HEALTH RICHMONDBAPTIST HEALTH RICHMOND

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Updated September 19, 2019

This database was last updated in September 2019. It should only be used as a historical snapshot.Researchers can find more recent data on timely and effective care in the Centers for Medicare and Medicaid Services’ hospitals datasets and guidance about hospital regulations.

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ER Inspector » Kentucky » BAPTIST HEALTH RICHMOND

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BAPTIST HEALTH RICHMOND

801 eastern bypass, richmond, Ky. 40475

(859) 623-3131

76% of Patients Would "Definitely Recommend" this Hospital
(Ky. Avg: 70%)

2 violations related to ER care since 2015

Hospital Type

Acute Care Hospitals

Hospital Owner

Voluntary non-profit - Private

ER Volume

Medium (20K - 40K patients a year)

See this hospital's CMS profile page or inspection reports.

Patient Pathways Through This ER

After a patient arrives at the emergency room, they are typically seen by a doctor or medical practitioner and then either sent home or admitted to the hospital and taken to a room. A small percentage of patients leave without being seen. The chart below shows on average how long each of these pathways take. Lower numbers are better, and all times refer to the average length of time people waited.

Arrives at ER
2% of patients leave without being seen
3hrs 55min Admitted to hospital
4hrs 51min Taken to room
2hrs 26min Sent home

All wait times are average.

Detailed Quality Measures

Here is a more in depth look at each quality measure, compared to state and national averages for hospitals with medium ER volumes. Experts caution that very small differences between hospitals for a given measure are unlikely to correspond to noticeable differences in the real world.

Measure
Average for this Hospital
How this Hospital Compares

(to other hospitals with similar
ER volumes, when available)

Discharged Patients
Time Until Sent Home

Average time patients spent in the emergency room before being sent home (if not admitted).

2hrs 26min
National Avg.
2hrs 23min
Ky. Avg.
2hrs 26min
This Hospital
2hrs 26min
Impatient Patients
Left Without
Being Seen

Percentage of patients who left the emergency room without being seen by a doctor or medical practitioner.

2%
Avg. U.S. Hospital
2%
Avg. Ky. Hospital
2%
This Hospital
2%
Admitted Patients
Time Before Admission

Average time patients spent in the emergency room before being admitted to the hospital.

3hrs 55min

Data submitted were based on a sample of cases/patients.

National Avg.
4hrs 21min
Ky. Avg.
4hrs 18min
This Hospital
3hrs 55min
Admitted Patients
Transfer Time

Among patients admitted, additional time they spent waiting before being taken to their room (sometimes referred to as "boarding time.")

56min

Data submitted were based on a sample of cases/patients.

National Avg.
1hr 33min
Ky. Avg.
1hr 28min
This Hospital
56min
Special Patients
CT Scan

Percentage of patients who arrived with stroke symptoms and did not receive brain scan results within 45 mins.

9%
National Avg.
27%
Ky. Avg.
29%
This Hospital
9%

Violations Related to ER Care

Problems found in emergency rooms at this hospital since 2015, as identified during the investigation of a complaint. About This Data →

Violation
Full Text
COMPLIANCE WITH 489.24

Oct 13, 2016

Based on interviews and review of the facility's Labor and Delivery Logbook, medical records, and facility policies, it was determined the facility failed to ensure stabilizing medical treatment was provided for one (1) of twenty (20) sampled patients (Patient #1) that presented to the facility's Labor and Delivery (L&D) Department for an Emergency Medical Condition.

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Based on interviews and review of the facility's Labor and Delivery Logbook, medical records, and facility policies, it was determined the facility failed to ensure stabilizing medical treatment was provided for one (1) of twenty (20) sampled patients (Patient #1) that presented to the facility's Labor and Delivery (L&D) Department for an Emergency Medical Condition. Interviews revealed Patient #1 presented to the L&D on 09/11/16 with a complaint of active labor. Patient #1 was taken to a room and provided with a medical screening by Registered Nurse (RN) #1 and informed she was dilated to one (1) centimeter. Patient #1's family member stated RN #1 informed her that the patient's Obstetrician (OB) (Physician #1) did not deliver at Facility #1 and RN #1 would contact the OB on call (Physician #2). Physician #2 did not return RN #1's calls and Advanced Practice Registered Nurse (APRN) #1 was contacted. APRN #1 gave RN #1 an order to "discharge [Patient #1] to [Facility #2]" (23 miles away) where Physician #1 would deliver the baby. At approximately 11:15 AM, RN #3 assessed Patient #1 and found the patient to be "dilated to 3." RN #1 and RN #3 failed to contact APRN #1 with the change in Patient #1's condition. Patient #1 left Facility #1 in a privately owned vehicle and arrived at Facility #2 at 12:14 PM. Patient #1 delivered by Caesarean section at 1:38 PM due to fetal intolerance of labor. Refer to 42 CFR 489.24 (d)(1-3) Stabilizing Treatment (A2407).

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STABILIZING TREATMENT

Oct 13, 2016

Based on interviews and review of the facility's Labor and Delivery Logbook, medical records, and facility policies, it was determined the facility failed to ensure stabilizing medical treatment was provided for one (1) of twenty (20) sampled patients (Patient #1) that presented to the facility's Labor and Delivery (L&D) Department for an Emergency Medical Condition.

See More ↓

Based on interviews and review of the facility's Labor and Delivery Logbook, medical records, and facility policies, it was determined the facility failed to ensure stabilizing medical treatment was provided for one (1) of twenty (20) sampled patients (Patient #1) that presented to the facility's Labor and Delivery (L&D) Department for an Emergency Medical Condition. Interviews revealed Patient #1 presented to the L&D on 09/11/16 with a complaint of active labor. Patient #1 was taken to a room and provided with a medical screening by Registered Nurse (RN) #1 and informed she was dilated to one (1) centimeter. Patient #1's family member stated RN #1 informed her that the patient's Obstetrician (OB) (Physician #1) did not deliver at Facility #1 and RN #1 would contact the OB on call (Physician #2). Physician #2 did not return RN #1's calls and Advanced Practice Registered Nurse (APRN) #1 was contacted. APRN #1 gave RN #1 an order to discharge Patient #1 to Facility #2 (23 miles away) where Physician #1 would deliver the baby. At approximately 11:15 AM, RN #3 assessed Patient #1 and found the patient to be dilated to three (3). RN #1 and RN #3 failed to contact APRN #1 with the change in Patient #1's condition. Patient #1 left Facility #1 in a privately owned vehicle and arrived at Facility #2 at 12:14 PM. Patient #1's baby was delivered by Caesarean section at 1:38 PM due to fetal intolerance of labor. The findings include: Review of the facility's policy titled, "Emergency Medical Treatment and Labor Act (EMTALA)," revised and effective 07/25/16, revealed the facility will provide a medical screening examination to any individual who comes seeking examination or treatment for an emergency medical condition. Further review of the policy revealed if it is determined that the patient has an emergency medical condition, the facility will provide the patient with such further medical examination and treatment required to stabilize the emergency medical condition. Review of the facility's policy titled, "Emergency Medical Screening for Labor & Delivery," effective 08/08/16, revealed after an initial assessment is conducted by qualified medical personnel, the provider should be notified by the RN. Further review of the policy revealed Registered Nurses designated as qualified medical personnel to provide care for obstetric patients during the initial assessment and triage period of an emergency medical exam had the following competencies: completion of unit based orientation; minimum of six (6) month labor and delivery experience; completion of AWHONN (The Association of Women's Health, Obstetric and Neonatal Nurses) intermediate fetal monitoring; and completion of EMTALA (Emergency Medical Treatment and Active Labor Act) Education. Continued review of the policy revealed the provider would be notified after the initial assessment, unless earlier notification is warranted by the Registered Nurse and/or requested by the provider. The decision of the existence of an emergency medical condition is determined by the provider and a false labor diagnosis must be certified by the provider. Review of the Labor and Delivery Logbook revealed Patient #1 (MDS) dated [DATE] at 9:27 AM with a chief complaint of "labor." Continued review of the Logbook revealed Patient #1 was discharged on [DATE] at 11:15 AM with a disposition of "discharge to go to [Facility #2]." Review of Patient #1's medical record revealed the facility admitted Patient #1 on 09/11/16 with a diagnosis of "active labor." Continued review of the record revealed at 9:30 AM, RN #1 assessed Patient #1 to be "Station: 0; Position: vertex; Dilation: 1; Effacement: 70; Position: posterior; Consistency: soft." RN #1 documented at 9:45 AM "contraction intensity to be mild-strong; activity: breathing with contractions; position: semi-fowlers; pain: 4." Further review of the medical record revealed RN #1 documented at 10:15 AM "contractions were every 3 to 6 minutes lasting 60-80 seconds." RN #1 contacted Physician #2 at 10:15 AM and left a message for a return call. A second call for orders to Physician #2 was documented at 10:38 AM with a message left. RN #1 contacted APRN #1 at 10:52 AM and notified her of "patient arrival with SROM [Spontaneous Rupture of Membranes], VE [Vaginal Exam] 1-/70/0. Contraction pattern of 3-6 minutes reviewed, reactive NST [Non-Stress Test]." RN #1 documented an order to "discharge [Patient #1] to [Facility #2]." RN #3 documented at 10:58 AM "[Patient #1] was dilated to 3 with effacement of 70 in the posterior position." RN #1 entered into the record at 12:48 PM "patient discharged to [Facility #2]." Interview with RN #1 on 10/10/16 at 3:35 PM revealed she was working in Labor & Delivery on 09/11/16 and recalled Patient #1. RN #1 stated Patient #1 presented with her "water broke" and in labor. RN #1 stated she informed APRN #1 that Patient #1 was dilated to one (1) centimeter and APRN #1 felt Patient #1 was ok to "discharge to [Facility #2]." RN #1 stated that she did not think this was a "transfer" so she did not fill out the EMTALA forms. RN #1 stated she did not contact APRN #1 with the change in Patient #1's condition after RN #3 had assessed the patient and found her to be dilated to three (3) because she already received the order for discharge and did not think it was necessary to notify APRN #1 again. RN #1 stated she did contact Facility #2 and give report to a Labor and Delivery nurse. Interview with RN #3 on 10/11/16 at 10:30 AM revealed that she was working in Labor & Delivery on 09/11/16 and assisted RN #1 with Patient #1. RN #3 stated she checked Patient #1 when she first arrived and the patient was dilated to one (1) centimeter at that time. RN #3 stated she checked Patient #1 right before discharge and the patient was then dilated to three (3) centimeters; however, she did not contact APRN #1 nor did she think RN #1 did. RN #3 stated that Patient #1 was not her patient and she did not think it was her responsibility to contact APRN #1. Interview with Patient #1's family member on 10/10/16 at 12:24 PM revealed she was with Patient #1 at Facility #1 on 09/11/16. The Family Member of Patient #1 stated she overheard nurses stating "that [Physician #2] likes to do the easy part then let us do the hard part." Patient #1's family member stated Patient #1 wanted to remain at Facility #1 but was never given the option. Further interview with the Family Member of Patient #1 revealed that Facility #1 never offered Patient #1 Emergency Transportation to Facility #2, and just discharged Patient #1 to go to Facility #2 in their personal vehicle, wearing a hospital gown. Patient #1's Family Member stated that upon arrival at Facility #2 Patient #1 was immediately taken to the floor and then it was decided the baby was in distress and the baby was taken by Caesarean section at approximately 1:38 PM. Interview with Physician #2 on 10/11/16 at 9:40 AM revealed he was the on-call OB on 09/11/16 for Facility #1. Physician #2 stated that he contacted Facility #1 after APRN #1 had given the order to discharge Patient #1. Physician #2 stated that labor is considered active when a patient is dilated to three (3) or four (4) centimeters. Physician #2 stated he agreed with APRN #1's medical decisions based on the information she had been given by the nursing staff. Interview with Physician #1 on 10/11/16 at 11:00 AM revealed he was Patient #1's Obstetrician. Physician #1 stated that he did not receive any call from Facility #1 to inform him that his patient was in labor and on the way to Facility #2. Physician #1 stated that if Facility #1 had contacted him, he would have accepted transfer of his patient as long as the patient was transported by Emergency Medical Services; or he would have been in agreement with the patient remaining at Facility #1 and delivering the baby. Physician #1 stated Patient #1 delivered by Caesarean section at 1:38 PM due to fetal intolerance to labor. Review of Patient #1's medical record from Facility #2 revealed the facility admitted Patient #1 on 09/11/16 at 12:09 PM with a diagnosis of "active labor." Continued review of the medical record revealed Physician #1 documented Patient #1 "recently arrived to L&D as transfer from [Facility #1]. On auscultation fetal heart rate in 60's per nursing, recovered with reassuring pattern." Continued review of the medical record revealed Physician #1 was called and "[Patient #1] was contracting irregularly and had epidural in place." Further review of the record revealed Physician #1 was contacted by nursing staff after completing his evaluation and was informed Patient #1 had a "prolonged decel." Physician #1 called an emergent Caesarean section and Patient #1 delivered at 1:38 PM. The facility discharged Patient #1 on 09/13/16.

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Notes

“Average time” refers to the median wait time (the midpoint of all patients' wait times). References to “doctor or medical practitioner” indicate a doctor, nurse practitioner or physician's assistant. CMS reports the CT scan quality measure as the percentage of patients who received a scan within 45 minutes. We have reversed that measure so that all measures follow a “lower is better” pattern.

Additional design and development by Mike Tigas and Sisi Wei.

Sources

All data comes from the Centers for Medicare and Medicaid Services. Detailed quality measures at the hospital, state and national level were last updated September 2019. Most data was collected between October 2017 and October 2018. Data on ER-related violations is from January 2015 to June 2019.

Additional Info

How We've Updated ER Inspector | Download ProPublica's Emergency Room Planning Toolkit | About This Data

Don’t See Your ER?

In some cases we aren’t able to identify the exact location of a hospital, so it doesn’t appear on our mapped search results. However, it may still be in our database – try looking for it in the list of hospitals on each state's page.

In other cases, the hospital is missing from our database because it doesn't have an emergency department.

In other cases, the hospital is missing from the federal government’s Centers for Medicare and Medicaid Services (CMS) data. There are a couple of reasons why a hospital isn’t included in CMS data: it may not participate in Medicare, or it may share a certification number with another hospital (common across large hospital systems).

If you notice a hospital missing from our database, please first check if you can find it on CMS' website, and that it is listed as having an ER. If so, please email us with the hospital name and address.