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 670068 (X3) Date Survey Completed 06/25/2024
Name of Provider or Supplier Texas Health Presbyterian Hospital Flower Mound Street Address, City, State 4400 Long Prairie Road, Flower Mound, TX
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)
A0000 . An on-site unannounced EMTALA complaint survey was conducted beginning on the afternoon of June 24, 2024. An entrance conference was held in a conference room with Texas Health Presbyterian - Flower Mound's administrative staff members on June 24, 2024, at 1315 PM. A survey investigation was conducted to determine the hospital's compliance with the Medicare Conditions of Participation set forth at 42 CFR Part 482 using the applicable survey report form. It was explained that the complaint survey would be conducted according to 42 CFR 489.24 and 42 CFR 489.20 (l), (m), (q), and (r) of the Emergency Medical Treatment and Labor Act, and section 5400, appendix V of the State Operations Manual. . 06/25/2024: EMTALA Complaint TX00501547 will be referred to CMS Regional Office for final compliance determination. . An exit conference was held with Texas Health Presbyterian - Flower Mound's administrative staff members at 1530 PM and they were informed that CMS would make the final determination for complaint TX00501547. .