Hospitals Settle EMTALA Violations after Failing to Screen and Treat Patients with Emergency Mental Health Conditions
The Department of Health and Human Services Office for Inspector General (HHS-OIG) has announced two settlements with healthcare providers to resolve alleged violations of the Emergency Medical Treatment and Labor Act (EMTALA) due to the failure to provide adequate medical screening examinations and stabilizing treatment to patients with emergency mental health complaints.
EMTALA requires Medicare-participating hospitals to provide a medical screening examination to anyone seeking treatment for a potential emergency medical condition, regardless of their ability to pay. Stabilizing treatment must be provided to the patient, or the patient may be transferred to another facility if the hospital is unable to provide stabilizing treatment within its capabilities.
North Carolina Baptist Hospital (NCBH) was investigated by HHS-OIG and was found to have violated EMTALA on two occasions in August 2021. A patient presented at the Emergency Department requesting a psychiatric evaluation, a psychotropic medication refill, and complained of back pain at an 8/10 level. The patient was triaged and found to have abnormal vital signs. Around four hours later, NCHB’s records showed that the patient left the facility without being seen. Two days later, the patient returned to the ED two days after jumping off a bridge and being hit by a truck, and later died from the injuries.
The same month, a patient with a history of schizoaffective disorder, bipolar disorder, and depression presented to the hospital with psychological issues, having arrived by ambulance due to a psychiatric disturbance. In the ED, the patient experienced auditory hallucinations and made bizarre, illogical statements. The patient was given intravenous fluids and was discharged home the following day, without having been given a detailed psychiatric evaluation. At the time of discharge, the patient refused to leave and claimed she could not walk or see. After speaking with a doctor, she was given a bus token and was escorted off the premises by a security guard. After her mother called the hospital to inquire about her whereabouts, the patient was found in a hospital robe at a bus stop. Around one week later, the patient was involuntarily committed to a psychiatric facility. NCBH settled the alleged EMTALA violations and paid a $200,000 financial penalty.
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Swedish American Hospital (SAH) in Rockford, Illinois, was investigated over an alleged EMTALA violation in 2024 when a patient was not provided with appropriate medical screening after presenting at the hospital’s Emergency Department, complaining of suicidal ideation. The previous day, SAH referred the patient to a mental health professional at an outpatient facility, who signed a petition for involuntary admission. The patient presented at the hospital with the petition; however, the patient did not receive an appropriate medical screening examination, was not provided with stabilizing treatment, and was discharged two hours after presenting at the hospital. SAH settled the alleged violation with HHS-OIG and paid a $100,000 financial penalty.
