Based on interview and review of hospital documents the hospital transferred a patient (Patient #1) without first notifying the accepting facility of the transfer. Failure to notify the accepting facility prior to transfer puts patients at risk for possible delays in receiving the appropriate medical care. Findings include: 1. On 01/14/2019 at 12:27 PM a contact not associated with the hospital was interviewed. The contact stated the hospital sent the patient by ambulance without first talking to the receiving hospital emergency room physician about the patient's medical condition. This caused a delay in Patient #1 getting their cardiac inteventions upon arrival to the receiving hospital's emergency room . 2. On 01/15/2019 a review of the hospital policy titled "Medical Evaluation Prior To Transfer" revised 06/27/2002 read in part "Appropriate Transfer", "2. The receiving medical facility has available space and qualified personnel for the treatment of the patient, and has agreed to accept transfer of the patient and to provide appropriate medical treatment". 3. Review of Patient 1's medical record revealed they were transferred on 12/27/2018 to another hospital emergency room for the care of a cardiac condition. Report was not called to the receiving hospital until after the patient was enroute to the receiving hospital. 4. On 01/15/2019 at 11:00 AM, Staff #2 was interviewed. Staff #2 stated before a patient is sent to another hospital the RN (registered nurse) needs to verify that the hospital has accepted the patient and report must be given before sending the patient by ambulance. 5. On 01/15/2019 at 12:00 PM, Staff #4 verified the above information.