Assessing the Regulatory Burden on Inpatient Psychiatric Facilities

Commissioned by the National Association for Behavioral Healthcare

Inpatient psychiatric facilities operate under a heavy burden of federal regulatory requirements. In a new report commissioned by the National Association for Behavioral Healthcare, Manatt Health assesses the burden that certain federal laws and regulations impose on inpatient psychiatric facilities. The report focuses on three federal regulatory domains that attach to participating in the Medicare program:

  1. The so-called “B-tag requirements,” a detailed set of standards for patient evaluations, medical records and staffing in inpatient psychiatric facilities
  2. The requirement to address “ligature risk points,” meaning aspects of the physical environment that a patient could use to attempt self-strangulation
  3. The Emergency Medical Treatment and Labor Act (EMTALA), which obligates a hospital to screen all patients for emergency medical conditions and, if an emergency condition is identified, to stabilize the patient before he or she may be discharged or transferred 

These rules are intended to serve the important goals of patient safety and quality care. Some, however, are outdated, and many are applied inconsistently, exposing providers to unpredictable citations and requiring costly alterations to procedures, equipment and facilities.

Based on our survey of 62 inpatient psychiatric facilities, we estimate that these three regulatory areas, taken together, impose $1.7 billion in compliance costs each year nationwide. Put another way, these burdens represent 4.8% of an average facility’s annual revenue for all inpatient psychiatric services from all sources.

Click here to read the full report.

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