An overworked ER Nurse who just can't take it anymore may decide to not update a patient's medical record when a patient is in decline and instead will simply discharge the patient. If the Patient dies at home, the medical records will not indicate a decline, therefore no EMTALA violation. That is how my Mother was basically manslaughtered by West Hills, CA ER back in March of 2018, right in front of my own eyes. I still have PTSD from the incident. After Mom died at home in my arms without ever having been treated for her pre-pnemonia, NOBODY would investigate. How cruel and complicit is that?