Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 010005 (X3) Date Survey Completed 09/29/2022
Name of Provider or Supplier Marshall Medical Centers South Campus Street Address, City, State 2505 U S Highway 431 North, Boaz, AL
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
A2400 COMPLIANCE WITH 489.24
CFR(s): 489.20(l)

[The provider agrees,] in the case of a hospital as defined in §489.24(b), to comply with §489.24.


This STANDARD is not met as evidenced by:
Based on review of Medical Records (MR), facility policy and definitions, Medical Staff Rules and Regulations, and interviews with staff, it was determined the facility failed to: 1. Provide a Medical Screening Exam (MSE) for a patient presenting to the Emergency Department (ED). 2. Provide stabilizing treatment for all patients presenting to the ED. These deficient findings did affect one of two MR's reviewed with a disposition of left without being seen (LWBS), including Patient Identifier (PI) # 1, and had the potential to affect all patients served by the facility ED. Findings Include: Refer to findings in tag A 2406.