DQ1-2

DQ 1-2 RESPONSES

1.

Yes, EMTALA can be a massive problem for any hospital, which accepts any payment from the Department of Health and Human Services (Medicare/Medicaid); all of the hospitals, except Shriners and some other military hospitals. But understanding that not every patient that shows up in the hospital or Emergency Room will automatically apply it can help ease the managerial minds.

EMTALA or "Emergency Medical Treatment and Labor Act is a statute which governs when and how a patient must be (1) examined and offered treatment or (2) transferred from one hospital to another when he is in an unstable medical condition" (EMTALA, 1986.) In other words, It guarantees patient the no refusal or rejection of care from hospitals, due to the lack of payment at the time of any emergency situation, complains of pain included.

How do emergency departments remain solvent, nowadays? They design a cost model that applies efficiency with accuracy, charging patients for tasks, while being strictly monitored by their managers. Involving workers and leaders of the unit in discussing prices and costs of the items and procedures will allow them to explore more cost-efficient alternatives. Leaders should also monitor the tools and activities recently implemented to make sure the plan is moving in the right direction. Being able to recognize that changes take time is essential, but establishing a timeline to analyze the data and then come with a solution is recommended. Finally, assign accountability to leaders and staff will help to accelerate all the learning process to make a place more stable and profitable. (Spence, 2013)

Thanks

References Overview. (2012, March 26). Retrieved from https://www.cms.gov/regulations-and-guidance/legislation/emtala/ Spence, J. (2013). Five ways to make cost accounting a strategic function in hospitals. Healthcare Financial Management, 67(3), 40.

2.

In terms of departmental solvency, it is dependent on whether EMTALA is valid. EMTALA does not apply to doctor offices, clinics and inpatient departments unless it is an emergency situation which is defined as, “A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in — placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part, or With respect to a pregnant woman who is having contractions — that there is inadequate time to effect a safe transfer to another hospital before delivery, or that the transfer may pose a threat to the health or safety of the woman or her unborn child (FAQ on EMTALA 2011)."

In the case of an emergency, it is important to consider resources because it may come down that the department will have a deficit. One thing that providers can do to aid in the departmental solvency is when they put it orders for the patient that it relates to their plan of care. Not over ordering tests that may not be necessary. For example, when a patient is coming in for a broken arm, we would use radiology diagnostics rather than a blood and urine test to determine the cause of break or fracture and how to continue with providing care. Clinical staff and nurses can also assist with saving the department money by opening only necessary supplies needed for procedures, anything opened and unused gets thrown away and more supplies would have to be ordered to ensure that our department is properly stocked.

 

FAQ on EMTALA - Frequently Asked Questions. (n.d.). Retrieved from http://www.emtala.com/faq.html

3.

To maintain solvency in a hospital it is vital to know and understand the laws and our obligation. The law referred to in this post is the "Emergency Medical Treatment and Labor Act," (EMTALA) this law was passed in response to the patient dumping whereby hospitals refused to treat patients that either had no insurance or just the inability to pay. It was also to combat the early discharge from the hospital because the hospitals saw the potential for anticipated high costs.

The law only refers to real emergent cases. Physicians in the ER are not educated to treat chronic illness or prevention, chronic illnesses such as diabetes, high blood pressure, asthma, heart disease and such. These physicians are trained in treating acute emergent illnesses. Not in maintenance or disease prevention, therefore many of the people coming into the ER cannot be treated under the EMTALA. (Bitterman) So, while this law requires all to be seen in the ER, what is not explained well is that treatment of all on-emergent conditions is not required and that uninsured patients will receive bills. (Why the EMTALA Mandate for Emergency Care Does not Equal Healthcare "Coverage" 2017)

Other pertinent things to know about the law is that it applies to only participating hospitals those that accept Medicaid and Medicare. The other important fact is that the law does not mean that

Non-emergent cases be treated. It merely says that a screening exam blood tests, imaging, consultations be administered in determining whether an emergency really exists. Things that fall under emergency medical conditions are things like; severe pain, health of an unborn child in jeopardy, if the patient is reasonably expected to have impairment of bodily functions without immediate treatment, things like a heart attack in other words anything that impairs health if not immediately treated.

Basically, for solvency, know the laws, have strict guidelines that your staff knows and understands so as not to get involved in treating chronic illness that there will be no reimbursement for.

Why the EMTALA Mandate for Emergency Care Does not Equal Healthcare "Coverage". (2017, June 29). Retrieved May 18, 2019, from https://westjem.com/editorial/why-the-emtala-mandate-for-emergency-care-does-not-equal-healthcare-coverage.html

Bitterman, R. A. (n.d.).