Current regulations do not protect those people who are held in an emergency room and have not been declared incapacitated or incompetent, but are nonetheless unable to protect themselves due to ECO status.  DBHDS and the CSB's claim they have no regulatory authority in hospitals, VDH claims they have no regulatory authority unless the person is a medicare/medicaid recipient.   APS has no authority unless the person meets definition of elderly or disabled/incapacitated.  This leaves those adults who are otherwise capable, vulnerable to mistreatment (in emrgency departments or general hospitals) which they can neither prevent nor escape and for which they have little to no legal recourse.  The CMS CoP's are very specific about the rights of all patients regarding safe environments and conditions of treatment, especially the definitions of abuse, but if an adult in Virginia does not meet specific definitions, then these CoP's have no authority.