{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:09:30Z","timestamp":1781068170121,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T00:00:00Z","timestamp":1555459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["F32 HS022402\u201001"],"award-info":[{"award-number":["F32 HS022402\u201001"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R03 HS 25281\u201001A1"],"award-info":[{"award-number":["R03 HS 25281\u201001A1"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective was to describe characteristics of civil monetary penalties levied by the Office of the Inspector General (<jats:styled-content style=\"fixed-case\">OIG<\/jats:styled-content>) related to violations of the Emergency Medical Treatment and Labor Act (<jats:styled-content style=\"fixed-case\">EMTALA<\/jats:styled-content>) involving psychiatric emergencies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Descriptions of <jats:styled-content style=\"fixed-case\">EMTALA<\/jats:styled-content>\u2010related civil monetary penalty settlements from 2002 to 2018 were obtained from the <jats:styled-content style=\"fixed-case\">OIG<\/jats:styled-content>. Cases related to psychiatric emergencies were identified by inclusion of key words in settlement descriptions. Characteristics of settlements involving <jats:styled-content style=\"fixed-case\">EMTALA<\/jats:styled-content> violations related to psychiatric emergencies including date, amount, and nature of the allegation were described and compared with settlements not involving psychiatric emergencies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 230 civil monetary penalty settlements related to <jats:styled-content style=\"fixed-case\">EMTALA<\/jats:styled-content> during the study period, 44 (19%) were related to psychiatric emergencies. The average settlement for psychiatric\u2010related cases was $85,488, compared with $32,004 for non\u2013psychiatric\u2010related cases (p\u00a0&lt;\u00a00.001). Five (83%) of the six largest settlements during the study period were related to cases involving psychiatric emergencies. The most commonly cited deficiencies for settlements involving psychiatric patients were failure to provide appropriate medical screening examination (84%) or stabilizing treatment (68%) or arrange appropriate transfer (30%). Failure to provide stabilizing treatment was more common among cases involving psychiatric emergencies (68% vs. 51%, p\u00a0=\u00a00.041). Among psychiatric\u2010related settlements, 18 (41%) occurred in <jats:styled-content style=\"fixed-case\">CMS<\/jats:styled-content> Region <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> (Southeast) and nine (20%) in Region <jats:styled-content style=\"fixed-case\">VII<\/jats:styled-content> (Central).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nearly one in five civil monetary penalty settlements related to <jats:styled-content style=\"fixed-case\">EMTALA<\/jats:styled-content> violations involved psychiatric emergencies. Settlements related to psychiatric emergencies were more costly and more often associated with failure to stabilize than for nonpsychiatric emergencies. Administrators should evaluate and strengthen policies and procedures related to psychiatric screening examinations, stabilizing care of psychiatric patients boarding in <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>s, and transfer policies. Recent large, notable settlements related to <jats:styled-content style=\"fixed-case\">EMTALA<\/jats:styled-content> violations suggest that there is considerable room to improve access to and quality of care for patients with psychiatric emergencies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13710","type":"journal-article","created":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T09:08:15Z","timestamp":1555492095000},"page":"470-478","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Civil Monetary Penalties Resulting From Violations of the Emergency Medical Treatment and Labor Act (<scp>EMTALA<\/scp>) Involving Psychiatric Emergencies, 2002 to 2018"],"prefix":"10.1111","volume":"26","author":[{"given":"Sophie","family":"Terp","sequence":"first","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA"},{"name":"Schaeffer Center for Health Policy &amp; Economics, University of Southern California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Wang","sequence":"additional","affiliation":[{"name":"New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Burner","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denton","family":"Connor","sequence":"additional","affiliation":[{"name":"Creighton University School of Medicine Omaha NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth A.","family":"Seabury","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA"},{"name":"Schaeffer Center for Health Policy &amp; Economics, University of Southern California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Menchine","sequence":"additional","affiliation":[{"name":"Keck School of Medicine University of Southern California Los Angeles CA"},{"name":"Schaeffer Center for Health Policy &amp; Economics, University of Southern California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.0517"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198602273140905"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.257.11.1500"},{"key":"e_1_2_11_5_1","volume-title":"Examination and treatment for emergency medical conditions and women in labor","author":"U.S. Code \u00a7 1395dd","year":"2010"},{"key":"e_1_2_11_6_1","unstructured":"CMS.Appendix\u00a0V. 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Bloomberg News July 17 2013."},{"key":"e_1_2_11_25_1","unstructured":"CMS.CMS Region IV investigation report and related correspondence related to EMTALA investigation SC00023639.Baltimore MD:Centers for Medicare & Medicaid Services. Obtained via Freedom of Information Act."},{"key":"e_1_2_11_26_1","unstructured":"AnMed Health. Available at:http:\/\/anmedhealth.org\/About. Accessed August 1 2018."},{"key":"e_1_2_11_27_1","unstructured":"QuickFacts.Anderson County South Carolina. Available at:https:\/\/www.census.gov\/quickfacts\/fact\/table\/andersoncountysouthcarolina\/PST045217. Accessed September 1 2018."},{"key":"e_1_2_11_28_1","unstructured":"Meyer H. S.C. Hospital to Pay $1.3 Million for Not Properly Treating Emergency Psych Patients. 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