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For the week of February 21 through 27, 2001

State cites St. Luke’s for violation

Emergency room procedures deficient

Express Staff Writer

The Idaho Department of Health has found St. Luke’s Wood River Medical Center in violation of state licensing requirements for written procedures in its emergency room.

Hospital administrator Jon Moses was advised in a letter Friday that St. Luke’s has failed to "formulate and implement complete policies and procedures for emergency medical services to address patients with psychiatric illness."

The letter also informed Moses the information the state had gathered on the violation had been forwarded to a federal agency in a separate investigation for possible federal law violations.

Hospital spokeswoman Kerry George confirmed St. Luke’s had received the letter.

"We are currently developing a plan of correction that will address the state’s findings which is to document the procedure in writing," George said in a written statement.

"It is important to note for your readers that St. Luke’s was not found to be deficient in the care we provided to the patient identified in their report or any other patient prior to or since the case at hand."

Theresa Bush, director of nursing services for St. Luke’s, said it is common to have deficiencies in emergency room procedures.

Attached to the letter was a Statement of Deficiencies and Plan of Correction that described the violation. The statement also includes testimony from the emergency room physician, the director of nursing services, and the director of emergency services.

The investigations were initiated after Health and Welfare received a complaint from a Ketchum woman who said her daughter was in a suicidal state but was turned away from treatment in November.

The letter to Moses, which accompanied the Statement of Deficiency, gave him until March 1 to address how the hospital will correct the problem.

The findings show the hospital was aware it did not have a written procedure for treating the mentally ill in its emergency room at the time of the incident.

The ER physician who treated the girl told Health and Welfare that "she was unaware of a policy that provided direction to staff regarding psychiatric patients who were not under an involuntary hold by law enforcement."

Dr. Keith Sivertson, the director of emergency services, and Bush told Health and Welfare that there was "no policy in place to provide direction to staff regarding how to handle patients at ER with acute psychiatric illnesses."

But the findings also show the mother and patient refused advice from two family physicians for the girl to go to a psychiatric facility. One was the girl’s psychiatrist and the other was her pediatrician.

Meanwhile, St. Luke’s is still being investigated for allegedly refusing emergency treatment to a patient, a violation of federal law.

The matter is being investigated by the Health Care Financing Administration (HCFA) at its Region X Office in Seattle.

Bill Collins, special assistant to Region X administrator Linda Ruiz, said the report from Idaho Health and Welfare arrived at the Seattle office on Friday. HCFA began processing the complaint on Tuesday.

HCFA is the federal agency that finances, runs and oversees the Medicare and Medicaid programs and the hospitals that participate in them.

The Emergency Medical Treatment and Active Labor Act (EMTALA) is the federal law that prohibits participating hospitals from refusing treatment to patients.

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