State Operations Manual - CMS

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State Operations Manual Appendix V Interpretive Guidelines Responsibilities of Medicare Participating Hospitals in Emergency Cases ________________________________________ _______________________________ (Rev. 60, 07-16-10) Transmittals for Appendix V Part I- Investigative Procedures I. General Information II. Principal Focus of Investigation III. Task 1 - Entrance Conference IV. Task 2 - Case Selection Methodology V. Task 3- Record Review VI. Task 4- Interviews VII. Task 5-Exit Conference VIII. Task 6- Professional Medical Review IX. Task 7- Assessment of Compliance and Completion of the Deficiency Report X. Additional Survey Report Documentation ________________________________________ ______________________________ Part II - Interpretive Guidelines - Responsibilities of Medicare Participating Hospitals in Emergency Cases Basic Section 1866 Commitments Relevant to Section 1867 Responsibilities (l) (m) (q) (r) (j) Availability of On-Call physicians Special Responsibilities of Medicare Hospitals in Emergency Cases (a) Applicability of Provisions of this Section (c) Use of Dedicated Emergency Department for Nonemergency Services (d) Necessary Stabilizing Treatment for Emergency Medical Conditions (e) Restricting Transfer Until the Individual Is Stabilized (f) Recipient Hospital Responsibilities ________________________________________ ________________________________ Part I- Investi

Investigate for compliance with the regulations in 42 CFR §489.24 and the related requirements in 42 CFR §489.20(l), (m), (q), and (r). All investigations are to be unannounced. The investigation is based on an allegation of noncompliance. The purpose of the investigation is to ascertain whether a violation took place, to determine

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