Strategic And Experienced Defense Against EMTALA Violations

Hospitals face plenty of hurdles in their day-to-day operations - especially in emergency rooms, which are among the highest-risk areas in terms of legal liability. Not only is malpractice a significant issue; so, too, is maintaining compliance with a complex web of federal regulations, including the Emergency Medical and Labor Treatment Act (EMTALA).

EMTALA violations can result in steep fines (up to $50,000 per incident). They also lead to consequences that can't be measured in dollars: publicity nightmares, lasting reputational damage and potential exclusion from Medicare/Medicaid, to name a few. Individual physicians can be held accountable for violations - and incur costly fines that malpractice insurance won't cover.

Dealing with potential EMTALA violations requires swift and strategic legal intervention.

At the Roberts Law Group in North Carolina, we help hospitals and emergency departments address compliance violations - including EMTALA - in a thorough and proactive manner. Our lawyers can assist you in conducting a thorough investigation. We can work quickly to put protections into place that both limit the fallout and avoid further legal troubles. Our lawyers also represent individual physicians, nurses and other practitioners facing EMTALA violations (and the disciplinary proceedings that may follow).

The 3 Most Important Components Of EMTALA

EMTALA (also called the "patient anti-dumping law") prevents hospital emergency departments from improperly transferring or turning away patients due to their inability to pay. All hospitals and emergency rooms that participate in Medicare/Medicaid must comply with its detailed regulations.

The law has three major components:

1. Medical Screening Exam

Emergency departments must conduct a prompt medical screening exam of every patient seeking emergency medical treatment. This EMTALA screening differs from triage in that it must be performed by qualified medical personnel (as designated in the hospital's bylaws), though not necessarily by emergency room physicians.

The goal of the medical screening is not to provide medical treatment, but rather to determine whether the patient is suffering from an emergency medical condition that could cause serious harm or seriously jeopardize their health. Pregnant women in labor are deemed to have an emergency medical condition, even if it's a healthy and normal pregnancy.

2. Duty To Stabilize

Emergency departments must make reasonable attempts to treat or stabilize patients without regard to their ability to pay. As part of this requirement, hospitals must have on-call physicians available to provide emergency care and written policies addressing the availability of specialists. Individual physicians can face liability if they fail to respond when on call.

3. Restrictions On Transfers

Hospitals can't simply transfer away undesirable patients who are suffering from emergency medical conditions. Under EMTALA regulations, emergency department transfers may only be done when medically necessary. Additionally, the hospital must make reasonable attempts to stabilize patients before transferring them away. Unstable patients can still be transferred so long as the benefits of the transfer outweigh the risks, as certified by a physician.

EMTALA regulations also impose these obligations on the receiving hospitals. Specifically, they can't turn away proper transfers, and they must promptly report any improper transfers.

Common Violations

When violations of EMTALA requirements occur, they often involve:

  • Patients getting turned away once on hospital grounds (for example, by a security guard at the front entrance)
  • Patients leaving before they get a timely medical screening examination
  • Patients receiving incompetent medical screenings (for example, by a triage nurse or LPN rather than an RN, physician or nurse practitioner)
  • Patients getting improperly transferred to other facilities
  • Psychiatric patients getting turned away by emergency departments that don't provide psychiatric services (but nonetheless have a duty to conduct a medical screening and stabilize the patient)

EMTALA investigations are frequently triggered by patient complaints. Sound patient care policies are thus one important aspect of avoiding violations.

Undergoing Review For A Possible Violation?

By the time the Centers for Medicare & Medicaid Services (CMS) initiates a review, the stakes are high. It's far better to address the problem from a proactive rather than reactive standpoint.

Our lawyers can work with you to investigate what happened and take the right corrective action - for example, disciplining the responsible parties, modifying hospital policies and retraining medical staff. These measures can help mitigate sanctions, ensure ongoing EMTALA compliance and avoid further violations down the road.

For more information, contact our firm at 866-630-2389. We have convenient offices throughout North Carolina, including Raleigh and Charlotte.