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February 17, 2021

We have a patient who is being held in the ED awaiting a stepdown bed (she has rib fractures from a fall and admit orders for stepdown care inpatient). She is signing out AMA from the ED without ever actually making it to the stepdown. Technically she was a stepdown admit with a mechanism and an injury…which would make her a PTOS patient. However she is leaving the ED (after 14 hours) without ever going to the floor so she will look like an ED discharge to Collector. Are we NOT to be capturing her as PTOS since she never technically got admitted to an inpatient bed?

That’s correct. The patient was discharged home from the ED. She went home and did not meet LOS and so does not qualify as PTOS.
In order for Stepdown or ICU to be qualifying criteria, the patient actually has to go to the unit.

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