Based on document review and interview the facility#1 failed to investigate the events that led to an eleven year old child being turned away from the facility's emergency room by a Registered Nurse after a complaint of sexual molestation was made on behalf of the child. This child did not receive a medical screening. The staff member scheduled to provide the medical screening examination (MSE) on or about 2/11/2016, had not received MSE training. A review of staff #5's education file revealed the staff member had not received the required MSE training and was providing MSE screenings on or about 2/11/2016. A review of the document titled Medical Screening and Referral in the Emergency Department revealed: "All individuals presenting to be seen in the Emergency Department will be provided an appropriate medical screening examination by a Qualified Medical Person (QMP). A QMP includes qualified physician members of the Medical Staff, and, within the limits established by the Board of Directors, the Medical Staff, the Texas Medical Board, and the Texas Board of Nursing - including the scope of licensure, certification, education and experience - physician assistants, nurse practitioners, or Emergency Department Registered Nurses (RN5) who have received specialized training, demonstrated appropriate competence for performing appropriate MSEs, have been approved to conduct MSEs, and are functioning under standardized protocols approved by the Medical Staff Executive Committee." A review of a document titled Social Work Progress Note provided by facility #2 revealed once the patient made this outcry of sexual assault last evening (02/11/2016), the caregiver took patient to a hospital in Pittsburg, TX and she was told they don't do exams on children. The care giver called the police, who came to the home and interviewed the patient. A review of a document provided by facility #1 revealed a doctor from facility #2 had placed a call to the Risk Manager at facility #1. The doctor reported a minor child had come to facility #1 twice with a chief complaint of sexual assault and the child was turned away both times. An interview on 4/20/2016, at approximately 2:30pm with staff #1, #2, #3 and staff #4 of facility #1 confirmed the survey findings that staff #5 had not been trained to provide MSE. Staff #1, #2, #3 and staff #4 confirmed staff #5 had seen a minor child in facility #1's ER twice on or about 2/11/2016 with a chief complaint of sexual assault and the child was turned away both times. Staff #1, #2, #3 and staff #4 confirmed staff had not provided a MSE to the minor patient.

Based on document review and interview the facility #1 failed to investigate the events that lead to an eleven year old child being turned away from the facility's emergency room by a Registered Nurse after a complaint of sexual molestation was made on behalf of the child. This child did not receive a medical screening. The staff member scheduled to provide the medical screening examination (MSE) on or about 2/11/2016, had not received MSE training. A review of staff #5's education file revealed the staff member had not received the required MSE training and was providing MSE screenings on or about 2/11/2016. A review of the document titled Medical Screening and Referral in the Emergency Department revealed: "All individuals presenting to be seen in the Emergency Department will be provided an appropriate medical screening examination by a Qualified Medical Person (QMP). A QMP includes qualified physician members of the Medical Staff, and, within the limits established by the Board of Directors, the Medical Staff, the Texas Medical Board, and the Texas Board of Nursing - including the scope of licensure, certification, education and experience - physician assistants, nurse practitioners, or Emergency Department Registered Nurses (RNs) who have received specialized training, demonstrated appropriate competence for performing appropriate MSEs, have been approved to conduct MSEs, and are functioning under standardized protocols approved by the Medical Staff Executive Committee." A review of a document titled Social Work Progress Note provided by facility #2 revealed once the patient made this outcry of sexual assault last evening (02/11/2016), the caregiver took patient to a hospital in Pittsburg, TX and she was told they don't do exams on children. The care giver called the police, who came to the home and interviewed the patient. A review of a document provided by facility #1 revealed a doctor from facility #2 had placed a call to the Risk Manager at facility #1. The doctor reported a minor child had come to facility #1 twice with a chief complaint of sexual assault and the child was turned away both times. An interview on 4/20/2016, at approximately 2:30pm with staff #1, #2, #3 and staff #4 of facility #1 confirmed the survey findings that staff #5 had not been trained to provide MSE. Staff #1, #2, #3 and staff #4 confirmed staff #5 seen a minor child in the facility #1's ER twice on or about 2/11/2014, with a chief complaint of sexual assault and the child was turned away both times. Staff #1, #2, #3 and staff #4 confirmed staff had not provided a MSE to the minor patient.