Based on interview and record review, the receiving hospital (H2) failed to accept and provide care for Patient #1 even though the receiving hospital (H2) had the specialized capabilities to provide treatment for Patient #1. This failed practice resulted in delayed care/surgery for Patient #1 who suffered from an open fracture on the right knee. Patient #1 was then transferred to an Acute Care Hospital (H3) where surgery was performed on Patient #1. The findings are: A. On 01/04/18 at 9:45 am during an interview, Staff #1 from H2 stated that he should have accepted Patient #1 from H1. He further stated he did not know how old the knee surgery was on Patient #1 and assumed that it was a recent surgery. B. On 01/04/18 at 10:15 am, during an interview, Staff #2 from H2 stated that she informed the receiving surgeon at H2 about the patient but did not know how old the knee replacement was. She further stated that the receiving surgeon at H2 did not speak directly with the sending surgeon from H1. Staff #2 stated that receiving surgeon was "busy and had a full caseload" and this was possibly another reason why the patient was not accepted because they didn't want the patient to wait for treatment. C. On 01/04/18 at 10:25 am during an interview, Staff #3 from H2 stated that "99% of the times, there is a direct physician to physician communication between hospital providers". He also stated that this did not occur with this patient [Patient #1]. D. On 01/04/18 at 11:05 am during a telephonic interview, Staff #4 from H2 stated that he did not accept the patient because he felt that Patient #1 would benefit from being seen by the surgeon who performed her knee replacement. E. Record review of Patient #1's chart [from H3's records] reveals that the patient had received knee replacement surgery over 10 years ago. Record review also reveals that the patient sustained an open fracture to her right knee and was taken to H1 on 12/27/17. H1 did not have a surgeon on staff and attempted to transfer Patient #1 to H2 on the same date. H2 refused to take Patient #1 which delayed care/surgery for Patient #1. Record further reveals that Patient #1 presented at H1 at 7:09 am on 12/27/17, was accepted [via telephone] by H3 at 10:34 am on 12/27/17 and was discharged by H1 at 12:12 pm on 12/27/17. There was no written evidence of time(s) when H2 staff received or made phone calls to H1 staff/surgeon regarding Patient #1.