S.C. hos­pi­tal to pay $1.3 mil­lion in EMTALA set­tle­ment

Modern Healthcare - - REGIONAL NEWS - —Har­ris Meyer

A South Carolina hos­pi­tal last month agreed to pay nearly $1.3 mil­lion in the largest-ever set­tle­ment for al­leged vi­o­la­tions of the Emer­gency Med­i­cal Treat­ment and La­bor Act.

AnMed Health, based in An­der­son, S.C., and serv­ing up­state South Carolina and north­east Ge­or­gia, reached a set­tle­ment with HHS’ Of­fice of In­spec­tor Gen­eral over al­le­ga­tions that in 2012 and 2013 it held pa­tients with un­sta­ble psy­chi­atric con­di­tions in its emer­gency de­part­ment with­out pro­vid­ing ap­pro­pri­ate psy­chi­atric treat­ment in 36 in­ci­dents.

“In­stead of be­ing ex­am­ined and treated by on-call psy­chi­a­trists, pa­tients were in­vol­un­tar­ily com­mit­ted, treated by ED physi­cians and kept in AnMed’s ED for days or weeks in­stead of be­ing ad­mit­ted to AnMed’s psy­chi­atric unit for sta­bi­liz­ing treat­ment,” ac­cord­ing to the set­tle­ment agree­ment.

The pa­tients—most of whom were sui­ci­dal and/or homi­ci­dal and suf­fered from se­ri­ous men­tal ill­ness—were held in the ED from six to 38 days. In each of th­ese in­ci­dents, AnMed had on-call psy­chi­a­trists and beds avail­able in its psy­chi­atric unit to eval­u­ate and sta­bi­lize the pa­tients.

But it did not pro­vide ex­am­i­na­tion or treat­ment by a psy­chi­a­trist, ac­cord­ing to the set­tle­ment agree­ment.

AnMed did not ad­mit to li­a­bil­ity un­der the set­tle­ment deal. In a writ­ten state­ment, AnMed said it had been a long­stand­ing pol­icy for its be­hav­ioral health unit to ac­cept only vol­un­tar­ily ad­mit­ted pa­tients, while pa­tients who were to be in­vol­un­tar­ily ad­mit­ted were held in the ED un­til they could be trans­ported to the state men­tal hos­pi­tal.

The short­age of space in that fa­cil­ity often pro­longed psy­chi­atric pa­tients’ stays in the AnMed ED, the state­ment said.

AnMed has en­gaged in sig­nif­i­cant cor­rec­tive ac­tion, in­clud­ing adding more train­ing for staff and se­cu­rity to pro­tect other pa­tients and plans to ex­pand its psy­chi­atric in­pa­tient unit from 15 to 34 beds by yearend.

“That’s one of the rea­sons why the penalty was not even higher,” said San­dra Sands, a se­nior at­tor­ney with the OIG who has been han­dling EMTALA cases since 1989. “They were very co­op­er­a­tive with the OIG dur­ing the in­ves­ti­ga­tion, and it ap­pears they did things that went be­yond what was re­quired.”

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