HHS-OIG Fines Two Healthcare Providers for EMTALA Violations
The Department of Health and Human Services Office of Inspector General (HHS-OIG) has entered into settlement agreements with two healthcare providers to resolve alleged violations of the Emergency Medical Treatment and Labor Act (EMTALA), commonly known as the patient dumping statute.
EMTALA requires hospitals to provide emergency care to anyone seeking treatment, regardless of their ability to pay. When a patient presents at a hospital emergency department, they must undergo an appropriate medical screening examination by a qualified medical professional to determine if they have an emergency medical condition, and stabilizing care must be provided. Organizations found to have violated EMTALA can face stiff financial penalties and, potentially, exclusion from federally funded healthcare programs.
Baptist Medical Center South (Baptist), in Montgomery, Alabama, was alleged to have failed to provide an appropriate medical screening examination and/or stabilizing treatment on three occasions. The first instance was in October 2020 when a patient was brought in by ambulance after being found by law enforcement preparing to jump off a bridge. The patient had a history of bipolar disorder, depression, anxiety, and schizophrenia. Baptist ordered a psychiatric consultation, and staff performed a suicide risk assessment and categorized the patient as high risk. Suicide interventions were initiated, including 1:1 observation, and without having received the ordered the psychiatric consultation, the patient eloped.
In May 2021, a patient presented at the Baptist ED via ambulance after being found unresponsive in a parking lot. A physician diagnosed the patient with acute psychosis and ordered a psychiatric consultation. Prior to receiving a psychiatric examination, the patient left the ED Against Medical Advice (AMA), but was not informed of the risks and consequences of leaving AMA nor did the staff take steps to determine the patient’s mental capacity.
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In May 2021, a third patient presented to the ED who had plans to overdose. She was diagnosed with suicidal ideations and depression, had a history of bipolar disorder and alcohol abuse, and had attempted suicide in the past. The patient was categorized as high risk after a suicide risk assessment and a drug screen returned a positive result for a controlled substance. The on-call psychiatrist recommended inpatient treatment, and the patient was given Celexa around 24 hours later and left the hospital 90 minutes later AMA before any stabilizing treatment could be provided. Staff did not determine if the patient had the capacity to decide to leave AMA. HHS-OIG determined that each case violated EMTALA and settled the alleged violations with Baptist for $290,000.
Presence Chicago Hospitals Network dba Ascension Resurrection in Chicago, Illinois, was investigated over an incident in April 2023. A patient presented to the Emergency Department with chest pain, nausea, and vomiting. The patient’s insurance information was obtained; however, Resurrection failed to obtain an EKG, perform a pain assessment, and obtain a medical history. The patient was triaged and sent to the waiting area, waited an hour, then left without having received a medical screening examination to seek care at a different hospital. At the second hospital he was diagnosed with a ST-elevation myocardial infarction, an emergency medical condition. The settlement agreement included a $133,420 penalty.
