Length of Program: 120 minutes.


Course Description:

This program will include the 5 new updates on EMTALA occurring in the year 2001. A recent survey indicated a significant knowledge deficit on EMTALA among Nurses and Physicians. In fact, only 27% know about the 1999 CMS/OIG advisory bulletin and only 65% knew of the CMS 1998 interruptive guidelines. Because of this there is an increased awareness of EMTALA by CMS and an increased number of complaints being filed against hospitals based on EMTALA. This program will also cover the legal requirements of EMTALA, case law update, and how to respond to an EMTALA complaint survey.


Content for the program will include the following:

Case Law and Problematic Areas of Medical Screening Exam

  • Performance by QMP

  • Difference between triage and medical screening exam

  • CMS reservation to second guess

Patients Who Want to Sign Out AMA

  • Refusal of treatment

  • Documentation requirements

  • Attempt to obtain written refusal

  • Long waits in emergency departments

  • Informing patients of risks

  • Offering further medical exam and treatment

Case Law and Problematic Areas of Stabilization

  • Application to inpatients

  • Documentation

  • Court cases

Case Law and Problematic Areas of Transfer

  • Definition

  • Discharges from the emergency department

  • Inpatient discharges

  • Transfer certification

  • Appropriate transfer guidelines

  • Transfer of psychiatric patients

  • Medical record documentation

On-Call Physician Issues

  • List of on-call physicians/specialists

  • What is a reasonable time?

  • Medical staff bylaws

  • Policies and procedures

  • Failure to show up

  • Notification of doctor’s name and address to receiving hospital

Penalties for Violating EMTALA

  • Loss of Medicare/Medicaid reimbursement

  • Fines

  • Private right of action

  • Receiving facility claims

  • Licensure and accreditation

  • Plan of correction

Responding to an EMTALA Survey/Investigation

  • The complaint

  • Reporting violations

  • HHS timeline to do survey

  • Team

  • Entrance/exit conferences

  • Documents requested

  • The survey process

  • Post-survey activities

Incorporating EMTALA Into the Hospital’s Compliance Program

  • The interpretive guidelines

  • Compliance officers

  • Policies and procedures

  • 25 tips to reduce your risks

New HIPAA law relationship to EMTALA

  • Consent requirements under HIPAA

  • Requirement of EMTALA to do a MSE on all patients.

Target Audience:

CEOs, COOs, emergency department managers, OB managers, emergency department physicians, emergency department nurses, compliance officers, legal counsel, risk managers, and nurse managers. Also any other clinics or facilities that are classified as a provider based organization.


At the conclusion of this program, participants will be able to:

1. Document what EMTALA requires of a patient who wants to sign out against medical advice?

2. Define what is meant, “come to the emergence department” for a patient requesting medical care.

3. Describe what would be an adequate medical screening exam.


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