The Most Cited Deficiencies and How to Avoid Them
EMTALA is a hot topic and should now be on the radar screen for every hospital. There have been a recent increased number of deficiencies and intense CMS and OIG activity. With a recent CMS deficiency memo showing over 4,000 hospitals receiving deficiencies for non-compliance with EMTALA (most of whom were unprepared!), this is now the most frequent area of noncompliance.
What would you do if a CMS surveyor shows up at your hospital today to investigate an EMTALA complaint? You are required to report a potential EMTALA violation. Do you know when? If you are a hospital with over 100 beds, you may have to shell out almost $105,000 for each violation.
In this three-part EMTALA webinar series presented by industry veteran, Sue Dill Calloway, you will learn all you need to know about the EMTALA regulations and interpretive guidelines. It will include all 12 sections and an expanded section for on-call physicians, and the shared and community care plan process.
We will also discuss an important recent case against a South Carolina hospital which was the largest EMTALA settlement of 1.2 million dollars. We see this as a precedent for larger EMTALA fines and stricter enforcement by the OIG. Though these are not covered in the CMS CoPs, we will discuss these topics so that you are not caught off guard when enforcement actions intensify.
We will also discuss one very crucial case that has created an enormous expansion of hospital and practitioner liability under federal law. This case illustrates the importance of understanding the role case law on the outcome of EMTALA litigation. Patients can now complain to CMS and request an investigation or they have the option of going and directly filing a lawsuit.
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 must comply with EMTALA if they have specialized capabilities. EMTALA can also impact obstetrical patients and behavioral health patients.
Failure to comply and follow the federal EMTALA for all hospitals, including critical access hospitals, could result in loss of Medicare and Medicaid payments. Financial penalties can be assessed against hospitals and physicians who negligently violate the EMTALA law.
The federal EMTALA law and the accompanying regulations are complex and the purpose of this 3-part webinar series is to simplify these regulations and statutes in a structured way to make it understandable and fit for consumption with a liberal use of practical examples and case scenarios.
- Understand why EMTALA is the most frequent cited deficiency for hospitals
- Comprehend CMS manual on EMTALA for Medicare accepting hospitals
- Know how hospitals must maintain a central log
- Learn about the hospital's requirement to maintain a list of the specific names of physicians who are on call to evaluate emergency department patients
- Decipher CMS’ requirements on what must be in the EMTALA sign
- Understand the hospital's requirements regarding a minor who is brought to the ED by the babysitter for a medical screening exam
- Know when the hospital must complete a certification of false labor
Part 1 : May 2nd | 1:00 PM ET | 12:00 PM CT | 10:00 AM PT | 120 Minutes
- OIG changes that every hospital should be aware of
- BFCC QIOs process
- Common deficiency report by CMS
- Basic concept of EMTALA
- Who are the players?
- CMS EMTALA website
- Detail on the penalties that have more than doubled
- Case law: AmHealth 1.3 million dollar settlement
- How to locate copy of the EMTALA regulations
- OCR memo and EMTALA investigations
- OIG advisory opinions on EMTALA
- CMS Deficiency memo
- Compliance program
- CMS Survey memos
- EMBOLA and EMTALA memo
- CMS Memo on EMTALA and telemedicine
- CMS memo on payment and collections
- EMTALA definitions and requirements
- The Joint Commission standards
- EMTALA sign requirements
- Who does EMTALA apply?
Part-2 : May 7th | 1:00 PM ET | 12:00 PM CT | 10:00 AM PT | 120 Minutes
Session Highlights :
- Payment issues
- Reasonable registration process
- Financial questions from patients
- Patients who sign out AMA
- Specialized capability
- Policies and procedures required
- On-call physicians issues
- Hospital recommendations
- Dedicated emergency department
- Central log
- Special responsibilities
- Meaning of “comes to the ED”
- Definition of hospital property
- EMTALA and outpatients
- Dedicated emergency department
- Inpatients and observation patients
Part-3 : May 23rd | 1:00 PM ET | 12:00 PM CT | 10:00 AM PT | 120 Minutes
- Medical screening exam
- Certification of false labor
- Born alive law and EMTALA
- Minor child request for treatment
- When can you be on diversion?
- Parking of patients
- State plans and EMTALA
- Who can be a QMP?
- The Moses case
- Waiver of sanctions
- Requests for medications
- Blood alcohol tests
- Emergency medical condition
- OB patients
- Transfer and transfer forms
- Behavioral health patients
- QIO role with EMTALA
Who Will Benefit?
- ED managers, physicians and nurses
- ED medical directors
- OB managers and nurses
- Behavioral health director and staff
- Chief nursing officer
- Nurse supervisors and educators
- Staff nurses
- Outpatient directors
- Compliance officers
- Legal counsel
- Risk managers
- Directors of hospital-based ambulance services
- Director of registration
- Registration staff and director
- ED education staff
- On-call physicians
- Chief medical officer (CMO)
- Chief operating officer (COO)
- Chief financial officer
- Patient safety officer
- Joint commission coordinator