Psych-related EMTALA Violations

Mary C. Malone, JD, a partner in the Richmond, VA-based healthcare law firm of Hancock, Daniel, Johnson & Nagle, has represented hospitals cited for these EMTALA violations involving psychiatric patients:

  • Labeling behavioral health patients who are repeat visitors to the ED as “frequent fliers,” and failing to provide a full and appropriate medical screening examination as a result.
  • Inappropriate delay in treatment for behavioral health patients who remained in the ED for days awaiting admission to a psychiatric facility, receiving no stabilizing treatment in the interim.

“Consider whether your hospital could benefit from creating a psychiatric ED, which is designed in a manner that helps to better manage behavioral health patients — particularly for purposes of short-term observation,” Malone says.

  • Failure to provide appropriate transportation for the patient, such as allowing transport by private car for a patient with assaultive behaviors.
  • Arranging inappropriate transfers to other facilities for psychiatric admission, such as sending a patient with a concurrent complex medical condition to a psychiatric facility that does not have the resources to manage the medical condition.
  • Refusal to accept transfers of psychiatric patients based on inappropriate admissions limitations, such as refusal to accept transfer of patient more than 50 miles from the receiving facility.

If your facility has behavioral health inpatient services and capacity to treat the patient, Malone says, do not refuse to accept the patient based on criteria such as geographic proximity of the sending and receiving facilities.

“Remember: If you have the capacity and capability, you must agree to receive the transfer,” Malone says.