Based on interview and record review, during a complaint investigation (NY 328), the hospital failed to maintain an accurate schedule of specialists who are on call for duty to provide further evaluation and treatment. Findings: On 12/3/15 the schedules of specialists on call to the Emergency Department (ED) were requested. The hospital provided schedules for June-December 2015. The schedules included the specialties of general surgery, orthopedic surgery, ophthamology and urology. The general surgery schedule has initials for each day of the week. The Quality Management Coordinator was interviewed on 12/4/15 at 8:30 am. Surveyors were told that surgeons initials, not names, are used to identify which surgeon is on call. The orthopedic surgery schedule has a name for each day of the week. On 12/4/15 at 9:00 am the ED Medical Director stated that the ED does not have access to orthopedic surgeons. The surgeons on the schedule are available at another hospital, or for patient follow up after discharge. The ophthalmology and urology lists include the name of another hospital. On 12/4/15 at 9:00 am the ED Director stated specialists were not on call when the other hospital is on the schedule. On 12/4/15 at 8:30 am the Quality Management Coordinator confirmed the hospital did not participate in a Community Call Plan.

Based on interview and record review, during a complaint investigation (NY 328), the hospital failed to provide a medical screening examination to a patient who presented to the Emergency Department (ED). Findings: On 11/21/15 Patient #1 was brought by ambulance to the hospital for hip pain. The ambulance Patient Care Report (PCR) documented the patient requested evaluation at the hospital. The ambulance arrived at the hospital ED entrance. A physician from the hospital ED met the ambulance outside the ED. The physician told the patient and ambulance crew the hospital didn't have orthopedic services, and the patient would need to go to another hospital. The PCR documents the patient was taken to another hospital. The ED Medical Director was interviewed on 12/3/15 at 9:00 am. The ED Medical Director confirmed a patient arrived at the hospital on [DATE] via ambulance. The ED physician did not perform a medical screening examination and directed the ambulance to take the patient to another hospital.