Recipient Hospitals Must Accept the Patient Only If He/She Requires the Specialized Capabilities
PAGE:1 of 2 / REPLACES POLICY DATED:
APPROVED: November 12, 1998 / RETIRED:
EFFECTIVE DATE: January 1, 1999 / REFERENCE NUMBER: RI.006
SCOPE: All Company facilities including hospitals and any entities operating under the hospital’s Medicare Provider Number including, but not limited to, the following:
All Clinical Departments Administration
Ancillary Services Quality Management
Admitting/Registration Risk Management
Employed Physicians Emergency Department
Hospital owned Medical Office Buildings Urgent Care Centers/clinics
Hospital owned emergency vehicles Ambulatory Care Facilities
Nursing
PURPOSE:
To ensure that appropriate transfers are accepted by the hospital and medical staff on-call.
POLICY:
Facilities that have specialized capabilities or facilities (such as burn units, shock-trauma units, neonatal intensive care units, or with respect to rural areas, regional referral centers) may not refuse to accept an appropriate transfer of an individual with an emergency medical condition who requires specialized capabilities or facilities if the receiving facility has the capacity to treat the individual. The referring hospital must be within the boundaries of the United States.
Some states have separate emergency services laws that may apply additional legal requirements to the Medical Screening Examination, diagnostic testing, or stabilizing emergency medical treatment. Consult with your Operations Counsel to identify and comply with any such additional legal mandates.
PROCEDURE:
Please refer to the EMTALA - Medical Screening Policy, RI.001, for a complete list of definitions pertaining to this policy.
- Recipient hospitals must accept the patient only if he/she requires the specialized capabilities or facilities of the hospital.
3. Lateral transfers between facilities of comparable resources are not supported by EMTALA, because they do not offer enhanced care benefits to the patient except where there is a mechanical failure of equipment, no ICU beds available, or similar circumstances. However, if the sending hospital has the capability, but not the capacity, the individual would most likely benefit from the transfer.
If a hospital has accommodated additional patients by whatever means in the past, it has demonstrated the ability to provide services to patients in excess of its occupancy limit. The number of patients that may be occupying a specialized unit, the number of staff on duty or the amount of equipment on the hospital’s premises do not in and of themselves reflect the capacity of the hospital to care for additional patients.
REFERENCES:
Social Security Act, Section 1867, 42 U.S.C. 1395dd, Examination and Treatment for Emergency Medical Conditions and Women In Labor
HCFA Site Review Guidelines, State Operations Manual
42 Federal Register 489.24(e), Special Responsibilities of Medicare Hospitals in Emergency
Cases
EMTALA Medical Screening Policy, RI.001
EMTALA Stabilization Policy, RI.002
EMTALA Transfer Policy, RI.003
EMTALA Signage Policy, RI.004
EMTALA Central Log Policy, RI.005
EMTALA Provision of On-Call Coverage Policy, RI.007