Hospitals are being cited for violating the federal emergency-care law more often than at any point in more than a decade, according to a Becker’s analysis of CMS inspection data.
Deficiencies under the Emergency Medical Treatment and Labor Act — the law requiring hospitals to screen and stabilize anyone who arrives at the emergency department, regardless of ability to pay — appeared in 422 hospital inspections in 2024, up from 222 in 2019.
As a share of all inspections, EMTALA citations rose from about 4% in 2019 to 6.9% in 2024, the highest in a dataset spanning 2010 to 2026. They eased only slightly in 2025, to 6.6%.
The share of inspections citing at least one EMTALA deficiency by year:
| Year | Inspections with an EMTALA citation | Share of all inspections |
| 2019 | 222 | 4.1% |
| 2020 | 140 | 3.2% |
| 2021 | 225 | 4.9% |
| 2022 | 281 | 5.7% |
| 2023 | 339 | 6.3% |
| 2024 | 422 | 6.9% |
| 2025 | 403 | 6.6% |
Two requirements drove the increase. Citations for failing to perform an appropriate medical screening exam nearly doubled, from 133 inspections in 2019 to 264 in 2024. Citations for general compliance with EMTALA’s core obligations more than doubled over the same span, from 162 to 354.
The most frequently cited EMTALA deficiencies in 2025:
1. Compliance with 489.24 (general EMTALA obligations) — 360 citations
2. Medical screening exam — 260 citations
3. Appropriate transfer — 111 citations
4. Emergency room log — 68 citations
5. Stabilizing treatment — 59 citations
The rise coincides with mounting strain on hospital emergency departments, where crowding and the boarding of admitted and behavioral health patients have drawn growing regulatory and clinical attention.
Through Aug. 24, 2026, EMTALA deficiencies had appeared in 130 inspections, or 3.6% of the total — a lower share than recent full years. Figures for the most recent months are likely incomplete, as statements of deficiency continue to be posted after surveys close.
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