EMTALA - Conditions Of Participation For Hospitals 2022

Every hospital that has an emergency department and accepts Medicare and Medicaid patients must follow the federal law and the Center for Medicare and Medicaid Services (CMS) Conditions of Participation Interpretive Guidelines on the Emergency Medical Treatment and Labor Act (EMTALA).

Hospitals without emergency departments but have specialized capabilities must comply with EMTALA. EMTALA can impact obstetrical patients and behavioral health patients. CMS made changes to include the Born-Alive Infant Protection Act with an updated survey memo on the issue. 

This webinar will discuss a recent case against a hospital that was the largest EMTALA settlement of 1.2 million dollars. It is anticipated that healthcare will see larger EMTALA fines and more activity because of the higher fines and the OIG final changes. These changes are not in the CMS CoPs and will be discussed.

This 3-hour webinar will include the regulations and interpretive guidelines. It will include all 12 sections of the EMTALA manual – Appendix V – and an expanded section for on-call physicians and the shared and community care plan process. 

This webinar will include a discussion of a 6th Circuit Court case that has created an enormous expansion of hospital and practitioner liability under federal law. The case, Moses v. Providence Hospital and Medical Centers, Inc., No. 07-2111 (6th Cir. April 2009), overruled the CMS regulation that EMTALA obligations end when the hospital admits the patient in good faith. Those states in the 6th Circuit (Ohio, Kentucky, Tennessee, and Michigan) must now follow this case as precedent. The case illustrates the importance of understanding the role that case law has on the outcome of EMTALA litigation. Patients can complain to CMS and request an investigation, or they have the option of going and directly filing a lawsuit.

• Recognize EMTALA as a frequently cited deficiency for hospitals. 
• Recall that CMS has a manual on EMTALA that all hospitals that accept Medicare must follow. 
• Describe that the hospital must maintain a central log.
• Discuss the hospital's requirement to maintain a list of the specific names of physicians who are on call to evaluate emergency department patients. 
• Describe the CMS requirements on what must be in the EMTALA sign. 
• Describe the hospital's requirements regarding a minor who is brought to the ED by the babysitter for a medical screening exam. 
• Discuss when the hospital must complete a certification of false labor.

This program will cover the following 

• OIG changes that every hospital should be aware of
• Two-day visit with immediate jeopardy 
• Common deficiency report by CMS
• The basic concept of EMTALA
• Revised manual
• EMTALA survey memos
• OCR memo and EMTALA investigations
• OIG advisory opinions on EMTALA
• Compliance program
• CMS Survey memos regarding EMTALA
• Impact of COVID-19 on EMTALA
• EMTALA definitions and requirements 
• The Joint Commission standards
• EMTALA sign requirements
• To whom EMTALA applies
• Reasonable registration process
• Financial questions from patients
• Patients who sign out for AMA
• Specialized capability
• Policies and procedures required
• Hospital recommendations
• On-call physician issues
• Dedicated emergency department
• Central log
• Special responsibilities
• Meaning of “comes to the ED”
• Definition of hospital property
• EMTALA and outpatients
• Capacity
• Dedicated emergency department
• Inpatients and observation patients
• Medical screening exam
• Certification of false labor
• Born alive law and EMTALA 
• Minor child request for treatment
• Telemetry
• When diversion is allowed
• Parking of patients
• Helipad
• State plans and EMTALA
• Who can be a QMP
• Waiver of sanctions
• Requests for medications
• Blood alcohol tests
• Emergency medical condition
• Stabilization
• OB patients
• Born-Alive Infant Protection Act and MLN clarification
• Transfer and transfer forms
• Behavioral health patients
• QIO role with EMTALA

• Emergency Department Managers
• Emergency Department Physicians
• Emergency Department Nurses
• ED Medical Director
• Risk Managers
• OB Managers and Nurses
• Behavioral Health Director and Staff
• Chief Nursing Officer
• Nurse Supervisors
• Nurse Educators
• Staff Nurses
• Outpatient Directors
• Compliance Officers
• Legal Counsel
• Directors of Hospital-Based Ambulance Services
• Director of registration
• Registration staff and director
• ED education staff
• On-call physicians
• Chief Medical Officer (CMO)
• Chief Nursing Officer (CNO)
• Chief Operating Officer (COO)
• Chief Financial Officer
• Patient Safety Officer
• Joint Commission Coordinator