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There are no court findings. I'm guessing you are a psychiatrist. EMTALA violations are almost always settled with CMS/OIG/DOJ and rarely enter into the courts. Most health systems do not want to lose participation in Medicare while it makes its way through the courts.@southerndoc while EMTALA applies to psychiatric hospitals and preempts state law, it's application is not simple since commitment involves curtailment of liberty and attendant constitutional protections. Do you have citations for EMTALA applying in cases involuntary treatment and transfer? Specifically, court findings that "refuses to consent" to treatment or transfer does not include when such refusal is product of mental illness or incapacitated?
I am unclear what you are asking. Most mental health-related EMTALA violations are due to involuntary treatment or inadequate stabilization/screening examinations. Here are some psychiatric cases from a database I keep. There have been more recent cases, but I have not transferred them over. I can look them up this weekend. Will try to more appropriately answer your question when I fully understand what you are asking. Sorry, still having some brain fog.
05-06-2019
Florida Hospital Settles Case Involving Patient Dumping Allegation
On May 6, 2019, Park Royal Hospital (Park Royal), Fort Meyers, Florida, entered into a $52,414 settlement agreement with OIG. The settlement agreement resolves allegations that, based on OIG's investigation, Park Royal violated the Emergency Medical Treatment and Labor Act (EMTALA) when it failed to accept a transfer of a patient with an unstablilized emergency medical condition, from the emergency department of another hospital. The patient presented to that hospital's emergency department following a suicide attempt and was diagnosed with lacerations to the wrist and an emergency psychiatric condition. Park Royal is a hospital with specialized psychiatric capabilities. OIG alleged that Park Royal refused to accept a transfer of the patient, despite having the specialized capabilities to stabilize the patient and the capacity at the time of transfer, because the patient's insurance was out of network. Senior Counsel Geeta Taylor represented OIG.
10-17-2017
Missouri Hospital Settles Case Involving Patient Dumping Allegations
On October 17, 2017, Southeast Missouri Hospital (SEM), Cape Girardeau, Missouri, entered into a $100,000 settlement agreement with OIG. The settlement agreement resolves allegations that SEM violated the Emergency Medical Treatment and Labor Act when it failed to provide an adequate medical screening examination and stabilizing treatment for two patients who presented to SEM's Emergency Department (ED) in 2011. OIG alleged that instead of being properly evaluated and treated, the patients were discharged with unstabilized emergency medical conditions to the custody of police pursuant to a hospital policy: if a patient had a blood alcohol level (BAL) above 100, the patient was given to local law enforcement and taken to jail. The first patient was 25 years old when she called a crisis hotline and an ambulance was dispatched to her residence. She was transported to SEM's ED for evaluation of a possible suicide attempt by overdose. The patient's BAL was 422 and the ED physician discharged her into the custody of local law enforcement where she was detained in jail and expected to see a counselor. The second patient was 41 years old when he presented to SEM after attempting suicide by overdose. The patient was depressed, had a history of psychiatric problems, and had recently been admitted for electroconvulsive therapy. The patient's BAL was 288 and he was discharged into the custody of local law enforcement and taken to jail. The next day the patient was seen by a counselor in jail and then released from custody. The patient returned to SEM that evening after again attempting suicide by overdose. The patient had slurred speech, was lethargic and had a flat affect and was admitted to the intensive care unit in guarded condition. Senior Counsel Sandra Sands represented OIG.
06-23-2017
South Carolina Hospital Settles Case Involving Patient Dumping Allegations
On June 23, 2017, AnMed Health (AnMed), in Anderson, South Carolina, entered into a $1,295,000 settlement agreement with OIG. The settlement agreement resolves allegations that, in 36 incidents investigated by OIG, AnMed violated the Emergency Medical Treatment and Labor Act (EMTALA). In these incidents, individuals presented to AnMed's Emergency Department (ED) with unstable psychiatric emergency medical conditions. Instead of being examined and treated by an on-call psychiatrist, and despite empty beds in its psychiatric unit to which the patients could have been admitted for stabilizing treatment, the patients were involuntarily committed and kept in AnMed's ED for between 6 and 38 days each. The following is an example of one such incident. A patient presented to AnMed's ED via law enforcement with psychosis and homicidal ideation and was involuntarily committed. The patient did not receive psychiatric examination or treatment by available AnMed psychiatrists and was not admitted to the psychiatric unit for stabilizing treatment. Instead, the patient was kept in the ED for 38 days and at one point was seen by a psychiatrist from another facility that was familiar with her condition. The psychiatrist prescribed a variety of medications for agitation. The patient eventually was discharged home. Senior Counsel Sandra Sands represented OIG.
11-28-2016
Missouri Hospital Settles Case Involving Patient Dumping Allegations
On November 28, 2016, Research Medical Center (RMC) in Kansas City, Missouri, entered into a $360,000 settlement agreement with OIG. The settlement agreement resolves allegations that RMC violated the Emergency Medical Treatment and Labor Act (EMTALA) when it failed to provide an adequate medical screening examination and improperly transferred a patient. The patient presented to RMC's Emergency Department (ED) with a psychiatric emergency medical condition. Without providing stabilizing treatment, RMC transferred the patient to a nearby facility by private vehicle; en route, the patient exited the vehicle and was struck by another vehicle. RMC self-disclosed the incident involving this patient. Based on its investigation, OIG concluded that RMC implemented a transfer policy applicable to patients who presented to RMC's ED with psychiatric emergency medical conditions that also resulted in multiple violations of EMTALA. Specifically, OIG found seventeen occasions where RMC failed to provide adequate medical screening examinations and improperly transferred or discharged, without providing stabilizing treatment, patients who presented to RMC's ED with psychiatric emergency medical conditions. At the time each patient presented, RMC had the capacity to treat, stabilize, or admit each patient. Senior Counsel Geeta Taylor represented OIG.
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