EMTALA: Hospital compliance improves over 10-year period

The number of hospitals penalized or investigated for violations of emergency treatment rules dropped several percentage points over the past 10 years.

Under the Emergency Medical Treatment and Labor Act (EMTALA), emergency departments must give all patients screenings and whatever treatment is necessary to stabilize their conditions, independent of ability to pay. In 2005, 10.8 percent of hospitals were the target of investigations for violating the EMTALA, but by 2014 it had dropped to 7.2 percent, according to a recent study published in the Annals of Emergency Medicine.

The number of hospitals cited after the investigations concluded fell as well, according to the study; in 2005, 5.3 percent of hospitals were cited, compared to 3.2 percent as of 2014.

While the most obvious--and encouraging--interpretation of the data is that hospitals have simply become more vigilant in adhering to EMTALA, it’s also possible hospitals simply improved at meeting the law’s administrative requirements, according to lead author Sophie Terp, M.D., of the Keck School of Medicine at the University of Southern California in Los Angeles.

Although penalties for lapses, such as lack of a central log, fell during the study period, hospitals actually saw more citations for clinical violations, such as improper screening or transfer protocols, Terp told Reuters Health.

“This raises questions about whether EMTALA actually accomplished its original goals of reducing patient dumping or improving access to quality emergency care,” she said.

Moreover, if hospitals still turn some patients away but technically fulfill the law’s requirements, the statistics won’t reflect that, David Kao, M.D. of the University of Colorado School of Medicine, who wasn’t involved in the research, told the publication. For example, hospitals could transfer uninsured patients to another hospital better-suited to their condition without legally violating the law.