EMTALA Update 2023 — Two-Part Virtual Series

Audience

chief medical officers, chief nursing officers, compliance officers, emergency department personnel, TJC coordinators, medical records staff, quality improvement personnel, risk managers and legal counsel

The following program content was provided by the speaker.

Overview

Every hospital that has an emergency department and accepts Medicare and Medicaid payment must follow the federal law and the Centers for Medicare and Medicaid Services Conditions of Participation Interpretive Guidelines on the Emergency Medical Treatment and Labor Act.

Hospitals without EDs must comply with EMTALA if they have specialized capabilities. For example, 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 two-part series will cover the regulations and interpretive guidelines regarding EMTALA, as well as all 12 sections and tag numbers. It also will offer an additional section for on-call physicians and the shared and community care plan process.

The series also will include a discussion on two EMTALA cases. The first — Moses v. Providence Hospital and Medical Centers, Inc., No. 07-2111 (6th Cir. April 2009) — created an enormous expansion of hospital and practitioner liability under federal law. The case overruled the CMS regulation that EMTALA obligations end when the hospital admits the patient in good faith, which illustrates the importance of understanding the role that case law has in the outcome of EMTALA litigation. The second is a recent case against a hospital, which was the largest EMTALA settlement of $1.2 million. Health care is anticipated to see larger EMTALA fines and more activity because of the higher fines and the Office of Inspector General final changes. These changes are not in the CMS CoPs and will be reviewed in this series.

Objectives

Upon completion of this program, participants will be able to:

• 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
• recite the requirement that hospitals 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 ED patients
• describe the CMS requirements on what must be in the EMTALA sign
• recall the hospital's requirements regarding a minor who is brought to the ED by a nonparent for a medical screening exam
• discuss when the hospital must complete a certification of false labor

Speaker

Laura A. Dixon, J.D., RN, CPHRM, most recently served as the Director of Risk Management and Patient Safety for the Colorado Region of Kaiser Permanente. Before joining Kaiser, she served as the Director, Facility Patient Safety and Risk Management and Operations for COPIC from 2014 to 2020. In her role, Dixon provided patient safety and risk management consultation and training to facilities, practitioners and staff in multiple states.

Dixon has more than 20 years of clinical experience in acute care facilities, including critical care, coronary care, perioperative services and pain management. Before joining COPIC, she served as the Director, Western Region, Patient Safety and Risk Management for The Doctors Company in Napa, Calif. In this capacity, she provided patient safety and risk management consultation to the physicians and staff for the western U.S. As a registered nurse and attorney, Dixon holds a Bachelor of Science from Regis University in Denver; a Doctor of Jurisprudence from Drake University College of Law in Des Moines, Iowa; and a registered nurse diploma from Saint Luke’s School Professional Nursing in Cedar Rapids, Iowa. She is licensed to practice law in Colorado and California.

This educational activity is provided by MHA Health Institute in collaboration with the Georgia Hospital Association.