EMTALA Compliance in Microhospitals Requires Contingency Planning for Emergencies

In emergency situations, microhospitals' "more limited scope" can leave staff scrambling to provide compliant care.

The following is an excerpt from an article that originally appeared on the Credentialing Resource Center, September 13, 2017.

Because microhospitals are subject to regulations developed with larger acute care institutions in mind, in an emergency, they can run into compliance obstacles that their traditional counterparts don’t often encounter or are better equipped to handle.

Compared to a tertiary hospital, resources can be tight and clinical expertise narrowly concentrated in a scaled-down facility. “In the acute care setting, in most cases, you presume you’re going to have a full-fledged medical staff and most of the ancillary support services to get you through whatever condition rolls in,” says John A. Gillean, MD, executive vice president and chief clinical officer at CHRISTUS Health.

Microhospitals' “more limited scope” can leave staff scrambling to provide compliant care in unanticipated situations.

Requirements for Providers of Emergency Services

For example, microhospitals that offer emergency services are subject to EMTALA, a federal law requiring hospitals to stabilize and treat any patient who visits an ED, regardless of his or her insurance status and ability to pay, or the hospital’s typical service focus. 

The Emergency Medical Treatment & Labor Act (EMTALA) was enacted by Congress in 1986 to ensure public access to emergency services regardless of ability to pay.

For facilities with limited staffing and equipment, this requirement can prove especially burdensome, says Gillean, who urges organizations to ensure that their microhospital can handle patients with emergent needs beyond the facility’s typical scope of service.

During the planning process, account for high-risk scenarios that could play out in the real world, like a walk-in patient who’s having a heart attack and requires immediate stabilization before he or she can be safely transferred to a tertiary hospital.

“You want to be able to have enough support services there so that you can manage that patient and truly stabilize them,” says Gillean. “Think through the types of patients who might show up and what you would need to have available for that immediate scope of care to manage them and stabilize them before you transfer them.”