Emergency Medical Treatment & Restraints

CMS published new EMTALA guidelines in memo QSO 19-14, issued on June 4, 2019. It details complaint investigation timelines for potential EMTALA violations and restraint related deaths. These timelines are expectations for the state agencies to conduct their investigation. They are not a timeline for hospitals to act. But, they are a signal to be ready should the state come to investigate an EMTALA or restraint death issue.

CMS EMTALA Guidelines

CMS considers these violations serious, potentially reaching immediate jeopardy thresholds. Plus, they may seek to have the state on site to investigate restraint deaths within two business days of receipt.

Potential EMTALA violations require the state to engage the CMS regional office for triage as either potential IJ or not potential IJ. If triaged as a potential IJ High, CMS will notify the state and expect an investigation within two business days. If not a potential IJ High situation, the regional office will notify the state and expect an investigation within 45 days.

Since much of the QSO memo discusses state and regional office responsibilities this may be of little importance to most readers. But, there is noteworthy information in Appendix V.  The CMS details the investigative procedures state surveyors follow in conducting an EMTALA investigation. This includes a CMS definition of when a hospital department acts like an emergency department. One example is a labor and delivery unit. If unscheduled ambulatory patients visits are more than one third of the total, it is considered an emergency department.

Patton Healthcare Consulting

Patton Healthcare Consulting provides CMS Survey Support. In fact, we have a thorough knowledge of CMS regulations, conditions of participation and the interpretative guidelines.

Contact our office at 888-742-4621, via email or through our website contact page to schedule a discussion of your needs and learn more about our compliance and readiness expertise. Patton Healthcare Consulting provides Joint Commission Compliance Assistance and a full range of pre-survey and post survey services including patient suicide prevention.