ER Inspector MARSHFIELD MEDICAL CENTER - RICE LAKEMARSHFIELD MEDICAL CENTER - RICE LAKE

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Updated September 19, 2019

This database was last updated in September 2019. It should only be used as a historical snapshot.Researchers can find more recent data on timely and effective care in the Centers for Medicare and Medicaid Services’ hospitals datasets and guidance about hospital regulations.

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ER Inspector » Wisconsin » MARSHFIELD MEDICAL CENTER - RICE LAKE

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MARSHFIELD MEDICAL CENTER - RICE LAKE

1700 west stout street, rice lake, Wis. 54868

(715) 234-1515

79% of Patients Would "Definitely Recommend" this Hospital
(Wis. Avg: 76%)

2 violations related to ER care since 2015

Hospital Type

Acute Care Hospitals

Hospital Owner

Voluntary non-profit - Private

ER Volume

Low (0 - 20K patients a year)

See this hospital's CMS profile page or inspection reports.

Patient Pathways Through This ER

After a patient arrives at the emergency room, they are typically seen by a doctor or medical practitioner and then either sent home or admitted to the hospital and taken to a room. A small percentage of patients leave without being seen. The chart below shows on average how long each of these pathways take. Lower numbers are better, and all times refer to the average length of time people waited.

Arrives at ER
2% of patients leave without being seen
3hrs 36min Admitted to hospital
4hrs 32min Taken to room
2hrs 24min Sent home

All wait times are average.

Detailed Quality Measures

Here is a more in depth look at each quality measure, compared to state and national averages for hospitals with low ER volumes. Experts caution that very small differences between hospitals for a given measure are unlikely to correspond to noticeable differences in the real world.

Measure
Average for this Hospital
How this Hospital Compares

(to other hospitals with similar
ER volumes, when available)

Discharged Patients
Time Until Sent Home

Average time patients spent in the emergency room before being sent home (if not admitted).

2hrs 24min
National Avg.
1hr 53min
Wis. Avg.
1hr 58min
This Hospital
2hrs 24min
Impatient Patients
Left Without
Being Seen

Percentage of patients who left the emergency room without being seen by a doctor or medical practitioner.

2%
Avg. U.S. Hospital
2%
Avg. Wis. Hospital
1%
This Hospital
2%
Admitted Patients
Time Before Admission

Average time patients spent in the emergency room before being admitted to the hospital.

3hrs 36min

Data submitted were based on a sample of cases/patients.

National Avg.
3hrs 30min
Wis. Avg.
3hrs 16min
This Hospital
3hrs 36min
Admitted Patients
Transfer Time

Among patients admitted, additional time they spent waiting before being taken to their room (sometimes referred to as "boarding time.")

56min

Data submitted were based on a sample of cases/patients.

National Avg.
57min
Wis. Avg.
54min
This Hospital
56min
Special Patients
CT Scan

Percentage of patients who arrived with stroke symptoms and did not receive brain scan results within 45 mins.

38%
National Avg.
27%
Wis. Avg.
25%
This Hospital
38%

Violations Related to ER Care

Problems found in emergency rooms at this hospital since 2015, as identified during the investigation of a complaint. About This Data →

Violation
Full Text
COMPLIANCE WITH 489.24

Jan 15, 2019

Based on record review and interview, facility staff failed to complete transfer forms per the guidance on the form, regulatory guidance, and/or facility policy in 17 of 20 medical records reviewed (Patient # 1, 2, 4, 5, 6, 7, 8, 9, 11, 12,13,15,16,17,18,19, and 20). Findings include: Facility staff failed to complete transfer forms per the guidance on the form and/or facility policy.

See More ↓

Based on record review and interview, facility staff failed to complete transfer forms per the guidance on the form, regulatory guidance, and/or facility policy in 17 of 20 medical records reviewed (Patient # 1, 2, 4, 5, 6, 7, 8, 9, 11, 12,13,15,16,17,18,19, and 20). Findings include: Facility staff failed to complete transfer forms per the guidance on the form and/or facility policy. See tag A2409.

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APPROPRIATE TRANSFER

Jan 15, 2019

Based on record review and interview, staff failed to accurately complete the patient transfer form information in 17 of 20 medical records reviewed of patients transferred to other facilities (Patient # 1, 2, 4, 5, 6, 7, 8, 9, 11, 12,13,15,16,17,18,19, and 20) and failed to obtain physician co-signatures on the transfer form for 4 of 4 patients transferred by mid-level providers (Patient #2, 6, 8, and 11) out of a total of 20 medical records reviewed. Findings include: The facility Physician Certification for Transfer form was reviewed on 1/16/2019 at 9:00 AM.

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Based on record review and interview, staff failed to accurately complete the patient transfer form information in 17 of 20 medical records reviewed of patients transferred to other facilities (Patient # 1, 2, 4, 5, 6, 7, 8, 9, 11, 12,13,15,16,17,18,19, and 20) and failed to obtain physician co-signatures on the transfer form for 4 of 4 patients transferred by mid-level providers (Patient #2, 6, 8, and 11) out of a total of 20 medical records reviewed. Findings include: The facility Physician Certification for Transfer form was reviewed on 1/16/2019 at 9:00 AM. The form had 5 sections. Section I, titled Medical Condition, asked for diagnosis, and had check boxes for if the patient had an emergent condition, if the patient was stable or unstable. Section II, titled "Risk and benefit for Transfer," revealed, "(Required: Check all that apply and add case-specific information.)" Section III, titled Mode/Support/Treatment during transfer as determined by physician, asked for transport information. Section IV, titled Receiving facility and individual, asked for the name of the receiving facility, receiving facility representative accepting the transfer and the time, the name of the accepting physician and the time, and the transferring physician's name, date and time. Section V, titled Patient consent to :Medically Indicated" or "Patient Requested" transfer, had check boxes for if the transfer was medically indicated or if it was a patient request, and an area for the patient and witnesses to sign. The facility policy titled, "[Acronym for facility] EMTALA (emergency medical treatment and labor act): Screening, Stabilization, and Transfer," dated October 5, 2017, was reviewed on 1/15/2019 at 9:00 AM. The policy revealed in part, "D. Transfer or Discharge 1. Stable Patient Transfer Only a physician may transfer a stable patient from [acronym for facility] to a receiving facility for ongoing care if ALL of the following requirements are met:..." The policy goes on to reveal the requirements for facility staff to transfer a patient. On 1/15/2019 at 10:45 AM a policy or protocol for completion of the Physician Certificating for Transfer form was requested. Per interview with Emergency Department Manager C at the time of the request, Manager C stated that there was no separate policy, only the EMTALA policy. A review of Patient #1's medical record was conducted on 1/15/2019 at 10:30 AM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #1 was transferred to an alternate acute care facility on 1/5/2019. In section V of the Physician Certification for Transfer form, the physician/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #2's medical record was conducted on 1/15/2019 at 10:52 AM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #2 was transferred to an alternate acute care facility on 1/2/2019. In section II the Physician Certification for Transfer form does not specify what the medical benefits or risks are, specific to Patient #2's needs. Also in section II the form does not identify specialty resources required. In section IV the transfer form was signed by a Nurse Practitioner and not co-signed by a physician indicating there was a consultation and agreement prior to the transfer. A review of Patient #4's medical record was conducted on 1/15/2019 at 11:23 AM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #4 was transferred to an alternate acute care facility on 1/3/2019. In section II of the Physician Certification for Transfer form, the specific benefits and risks for Patient #4 were not listed. In section IV of the form there was no time that the receiving facility was contacted/accepted Patient #4, and there was no time the physician signed the form. In section V the physician/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #5's medical record was conducted on 1/15/2019 at 11:40 AM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #5 was transferred to an alternate acute care facility on 1/3/2019. Section II of the Physician Certification for Transfer form was incomplete with unchecked applicable boxes. The specific medical risks for Patient #5 were entered as "transfer." A review of Patient #6's medical record was conducted on 1/15/2019 at 11:47 AM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #6 was transferred to an alternate acute care facility on 1/4/2019. Section II of the Physician Certification for Transfer form does not specify the medical risks of transfer specific to Patient #6. There was no mode of transportation indicated in section III of the form. In section IV of the form there was no time that the physician assistant signed the form and there was no co-signature from a physician. In section V the physician assistant/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #7's medical record was conducted on 1/15/2019 at 12:07 PM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #7 was transferred to an alternate acute care facility on 1/4/2019. In section I of the Physician Certification for Transfer form, there are no medical benefits or risks indicated for Patient #7's specific needs. In section IV there was no time the receiving facility was contacted/accepted the transfer, and there was no date or time the physician signed the form. In section V the physician/nurse did not check if the transfer was medically indicated or patient request and there was no relationship of the responsible person who signed the form (Patient #7 was unable to sign). In an interview with Manager C during the time of the record review regarding dates and times of signatures, Manager C stated, "Yes, it does have to have a date and time." A review of Patient #8's medical record was conducted on 1/15/2019 at 12:20 PM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #8 was transferred to an alternate acute care facility on 1/5/2019. In section II of the Physician Certification for Transfer form, specialty resources needed were not listed. The mode of transportation in section III was not indicated. In section IV of the form there was no time that the physician assistant signed the form and there was no co-signature from a physician. In section V the physician assistant/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #9's medical record was conducted on 1/15/2019 at 12:33 PM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #9 was transferred to an alternate acute care facility on 1/5/2019. In section II of the Physician Certification for Transfer form, the medical benefits and risks for transfer specific to Patient #9's needs were not listed. In section IV of the form there was name of a receiving physician. In section V the physician/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #11's medical record was conducted on 1/15/2019 at 12:48 PM accompanied by Emergency Department Manager C who confirmed the following findings per interview: Patient #11 was transferred to an alternate acute care facility on 1/10/2019. In section II of the Physician Certification for Transfer form the medical risks for transfer specific to Patient #11's needs were not listed. The mode of transportation in section III was not indicated. In section IV of the form there was no time that the physician assistant signed the form and there was no co-signature from a physician. In section V the physician assistant/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #12's medical record was conducted on 1/15/2019 at 11:02 AM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #12 was transferred to an alternate acute care facility on 10/04/2018. In section II of the Physician Certification for Transfer form the box indicating that benefits outweigh risks of transfer was not checked. In Section V of the same form the physician/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #13's medical record was conducted on 1/15/2019 at 11:19 AM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #13 was transferred to an alternate acute care facility on 10/15/2018. In section II of the Physician Certification for Transfer form the box indicating that benefits outweigh risks of transfer was not checked. In Section V of the same form, the physician/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #15's medical record was conducted on 1/15/2019 at 11:39 AM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #15 was transferred to an alternate acute care facility on 11/13/2018. In section II of the Physician Certification for Transfer form the box indicating that benefits outweigh risks of transfer was not checked. In Section V of the same form the physician/nurse did not check if the transfer was medically indicated or patient request nor was there a signature/name for patient or responsible person for consent to transfer. A review of Patient #16's medical record was conducted on 1/15/2019 at 11:50 AM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #16 was transferred to an alternate acute care facility on 11/23/2018. In section V of the Physician Certification for Transfer form the physician/nurse did not check if the transfer was medically indicated or patient request. Also in Section V of the same form there was not a witness signature. A review of Patient #17's medical record was conducted on 1/15/2019 at 11:59 AM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #17 was transferred to an alternate acute care facility on 11/29/2018. In section II of the Physician Certification for Transfer form the box indicating that benefits outweigh risks of transfer was not checked. Section V of the same form, the physician/nurse did not check if the transfer was medically indicated or patient request. A review of Patient #18's medical record was conducted on 1/15/2019 at 12:35 PM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #18 was transferred to an alternate acute care facility on 12/17/2018. In section II of the Physician Certification for Transfer form the box indicating that benefits outweigh risks of transfer was not checked. A review of Patient #19's medical record was conducted on 1/15/2019 at 12:45 PM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #19 was transferred to an alternate acute care facility on 12/23/2018. In section II of the Physician Certification for Transfer form the box indicating that benefits outweigh risks of transfer was not checked. In Section V of the same form the box indicating if the signature is that of the patient or responsible person is not checked. A review of Patient #20's medical record was conducted on 1/15/2019 at 12:55 PM accompanied by Quality Manager B who confirmed the following findings per interview: Patient #20 was transferred to an alternate acute care facility on 12/28/2018. In section II of the Physician Certification for Transfer form the box indicating that benefits outweigh risks of transfer was not checked.

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Notes

“Average time” refers to the median wait time (the midpoint of all patients' wait times). References to “doctor or medical practitioner” indicate a doctor, nurse practitioner or physician's assistant. CMS reports the CT scan quality measure as the percentage of patients who received a scan within 45 minutes. We have reversed that measure so that all measures follow a “lower is better” pattern.

Additional design and development by Mike Tigas and Sisi Wei.

Sources

All data comes from the Centers for Medicare and Medicaid Services. Detailed quality measures at the hospital, state and national level were last updated September 2019. Most data was collected between October 2017 and October 2018. Data on ER-related violations is from January 2015 to June 2019.

Additional Info

How We've Updated ER Inspector | Download ProPublica's Emergency Room Planning Toolkit | About This Data

Don’t See Your ER?

In some cases we aren’t able to identify the exact location of a hospital, so it doesn’t appear on our mapped search results. However, it may still be in our database – try looking for it in the list of hospitals on each state's page.

In other cases, the hospital is missing from our database because it doesn't have an emergency department.

In other cases, the hospital is missing from the federal government’s Centers for Medicare and Medicaid Services (CMS) data. There are a couple of reasons why a hospital isn’t included in CMS data: it may not participate in Medicare, or it may share a certification number with another hospital (common across large hospital systems).

If you notice a hospital missing from our database, please first check if you can find it on CMS' website, and that it is listed as having an ER. If so, please email us with the hospital name and address.