Case Study: Emergency Department Treatment and Transfer Background Hope General Hospital is a medium-sized facility with a busy emergency department (ED). It serves a diverse community, including a large uninsured population. The hospital has a transfer agreement with a larger, specialized trauma center located 30 miles away, which often receives patients requiring advanced care that Hope General cannot provide. Case Summary On a busy Saturday night, a 40-year-old male patient, Mr. Johnson, arrives at Hope General's ED with severe abdominal pain and symptoms of potential internal bleeding. The triage nurse quickly assesses the patient, noting that he appears to be in significant distress. However, due to high patient volume and a shortage of ED staff, the medical screening examination is delayed for over an hour. During the delay, Mr. Johnson's condition deteriorates, exhibiting signs of hypovolemic shock. The attending emergency physician, Dr. Smith, orders additional tests to confirm the source of the bleeding. Meanwhile, Dr. Smith realizes Hope General lacks the resources to provide definitive care for this patient's condition and contacts the trauma center for a possible transfer. What are some issues and alleged violations in this case? What steps should Hope General have taken to avoid a delay