Crucial EMTALA phrases clarified
Here are more of the clarifications of the EMTALA rule that providers must now follow to avoid patient-dumping charges. The interpretations of the revised EMTALA rules are provided by Mark Kadzielski, JD, head of the West Coast health practice for the law firm of Akin Gump in Chicago.
• "Comes to the emergency department" means that the individual is on hospital property, which means the entire main hospital campus including the parking lot, sidewalk, and driveway, as well as any facility that is located off the main hospital but has been determined to be a department of the hospital.
• "Property" also includes ambulances owned and operated by the hospital even if the ambulance is not on hospital grounds. An individual in a nonhospital-owned ambulance on hospital property is considered to have "come to the hospital’s emergency department." An individual in a nonhospital-owned ambulance off hospital property is not considered to have come to the hospital’s emergency department even if a member of the ambulance staff contacts the hospital by phone or telemetry and informs the hospital that the patient will be delivered for treatment.
• The capability of the hospital includes that of the hospital as a whole, not just the capability of the off-campus department. With a few exceptions, the obligation of a hospital must be discharged within the hospital as a whole. However, the hospital is not required to locate additional personnel or staff for off-campus departments to be on standby for possible emergencies.
• The hospital must establish protocols for handling potential emergency conditions at off-campus departments. These protocols must provide for direct contact between personnel at the main hospital campus and may provide for dispatch of practitioners, when appropriate, from the main hospital campus to the off-campus department to provide screening or stabilization services.
• If an off-campus department is an urgent care center, primary care center or other facility routinely staffed by physicians, RNs, or LPNs, they must be trained and given appropriate protocols for handling emergency cases. At least one person on duty during regular hours of operation must be designated as a qualified medical person. If that person is not a physician, Kadzielski says you should be especially careful to meet the requirements for nonphysician screening.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content