Based on medical record review and staff interview, the facility failed to provide the care and services needed by inappropriately transferring a patient when the facility had the capability and capacity to provide the needed services. This affected one of nine medical records reviewed for transferred patients in the emergency department (Patient #9). Twenty medical records were reviewed. The emergency department averages 2,796 patients per month and 198 transfers per month. Findings include: Review of the medical record for Patient #9 revealed arrival to the ED (Emergency Department) on 03/18/16 at 4:53 PM for a psychiatric evaluation. The patient was seen and examined at 5:10 PM by the ED physician, including the medical screening examination. The patient was suicidal with a plan, but had very limited mobility. The patient was [AGE] years old and was received from an assisted living facility. The ED nurse noted at 11:03 PM the patient was sleeping and they were awaiting placement as the Geri-Psych unit had denied the patient admission. At 1:05 AM on 03/19/16 the patient was transferred by ambulance in stable condition to another facility for admission. At 11:05 AM on 07/15/16, Staff E stated the facility's Geri-Psych unit has 14 beds. For Patient #9, the Crisis Center mental health worker called the hospital's Geri-Psych unit for admission and the psychiatrist requested additional information. The Crisis Center mental health worker did not want to bother the family to get the information and told Geri-Psych that he/she would just call another hospital. The Director of Behavioral Health provided documentation that the Geri-Psych unit had not made a decision to admit or decline because they requested additional information which was not provided. On 03/18/16 the census on the Geri-Psych unit was three.

Based on medical record review and staff interview, the facility failed to admit the patient to the hospital's psychiatric unit when the facility had the capability and capacity to provide the needed services. This affected one of nine medical records reviewed for transferred patients in the emergency department (Patient #9). Twenty medical records were reviewed. The emergency department averages 2,796 patients per month and 198 transfers per month. Findings include: Review of the medical record for Patient #9 revealed arrival to the ED (Emergency Department) on 03/18/16 at 4:53 PM for a psychiatric evaluation. The patient was seen and examined at 5:10 PM by the ED physician, including the medical screening examination. The patient was suicidal with a plan, but had very limited mobility. The patient was [AGE] years old and was received from an assisted living facility. The ED nurse noted at 11:03 PM the patient was sleeping and they were awaiting placement as the Geri-Psych unit had denied the patient admission. At 1:05 AM on 03/19/16 the patient was transferred by ambulance in stable condition to another facility for admission. At 11:05 AM on 07/15/16, Staff E stated the facility's Geri-Psych unit has 14 beds. For Patient #9, the Crisis Center mental health worker called the hospital's Geri-Psych unit for admission and the psychiatrist requested additional information. The Crisis Center mental health worker did not want to bother the family to get the information and told Geri-Psych that he/she would just call another hospital. The Director of Behavioral Health provided documentation that the Geri-Psych unit had not made a decision to admit or decline because they requested additional information which was not provided. On 03/18/16 the census on the Geri-Psych unit was three.