On November 1, 2016 the U.S. District Court for the District of Rhode Island denied a hospital-owned urgent care center’s summary judgment motion, contending that the federal Emergency Medical Treatment and Active Labor Act (EMTALA) did not apply to urgent care centers, even if owned by hospitals.  The court disagreed, holding that EMTALA does apply to urgent care centers because they are held out to the public as facilities that provide treatment for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment – which is precisely how the EMTALA regulations define a dedicated emergency department subject to its obligations. 

The facts of the case are as follows: A patient presented to the South County Hospital Medical & Wellness Center’s Urgent/Walk-in Care (the “Urgent Care”) on September 9, 2013, complaining of severe pain and burning in her chest and right arm.  The patient was seen by a physician.  After undergoing several tests, she was diagnosed with gastroesophageal reflux disease, given a “GI cocktail,” and discharged with no follow-up ordered.  The next day, the patient was found unresponsive at home and was pronounced dead at South County Hospital.  The autopsy showed cause of death as atherosclerotic and hypertensive cardiovascular disease.

The threshold question in the case, according to the court, was whether the Urgent Care, which was owned by South County Hospital,  is a “dedicated emergency department” of South County Hospital under EMTALA and therefore required to conduct a full medical screening examination and to transfer a patient to a hospital if necessary.  The court noted that CMS has made no distinction between urgent care and emergency care and that CMS has stated emergency departments can encompass those off-campus hospital departments that would be perceived by an individual as appropriate places to go for emergency care.

The court found that the Urgent Care’s website stating it can “treat virtually any non-emergency need” was not sufficient evidence of non-emergency services when “urgent” was part of the name and could be easily misconstrued by an ill patient.  The court distinguished the case from other cases where an independent facility that was not affiliated with a hospital was exempt from EMTALA obligations.

The court denied the summary judgment motion, finding that EMTALA applied because the Urgent Care held itself out “as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment.”  The opinion is available here.