The Centers for Medicare & Medicaid Services (CMS) has instructed state survey agencies that they must conduct onsite complaint investigations related to Emergency Medical Treatment and Labor Act (EMTALA) complaints and surveys of death in restraint or seclusion in hospitals and critical access hospitals within two business days instead of five.  This change brings these two categories of complaint investigations in line with other potential immediate jeopardy investigations in Medicare-participating non-long term care facilities.  The June 4, 2019 guidance to states also updates how CMS Regional Offices may triage EMTALA complaints and makes other revisions to the survey process.  The changes are effective immediately.