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CMS Revises Investigation Timelines for EMTALA and Deaths Associated With Seclusion, Restraint

For Licensing and Certification Staff, Quality & Patient Safety Staff

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The Centers for Medicare & Medicaid Services (CMS) has released revisions to the State Operations Manual, Appendix V, effective June 4, on complaint investigation timelines for Emergency Medical Treatment and Labor Act (EMTALA) and deaths associated with seclusion or restraint for hospitals and critical access hospitals.

Previously, CMS regional office and state survey agency surveyors were required to complete these investigations within five working days.

Surveyors have been able to triage EMTALA complaints as immediate jeopardy, and now can also triage them as non-immediate jeopardy high. For EMTALA immediate jeopardy complaints, the surveyors must be onsite within two business days. For EMTALA non-immediate jeopardy complaints, the survey activity must be initiated within 45 calendar days.

All deaths associated with seclusion or restraint will be categorized like immediate jeopardy complaints, and surveyors must be onsite within two business days.

The changes bring these two categories of complaint investigations in line with other potential immediate jeopardy investigations in Medicare-participating, non-long-term care facilities. The revisions also include other minor clarifications to the survey process.