Requirements for medical facilities:
(1) provide for any patient who enters or is brought to hospital property (including ambulances owned by the hospital) seeking care
(2) perform an "appropriate" screening examination to determine if an emergency condition exists for the patient. The examination must follow standard procedures used in all patients regardless of their ability to pay.
(3) treat and stabilize (within the capabilities of the institution) an emergency condition if it exists, prior to discharge or transfer
An emergency medical condition:
(1) condition that without immediate treatment could place the patient in serious danger or cause significant impairment of bodily or organ function
(2) condition during pregnancy that could cause harm to the woman or unborn child
Stabilization:
(1) no significant medical deterioration will occur after the patient is discharged or transferred
(2) based on criteria determined by professional standards
Risk points:
(1) differences in care received by patients was determined by the patient's ability to pay
(2) inconsistent behavior towards or treatment of patients
(3) failure to stabilize prior to discharge or transfer
(4) failure of on-call physicians to provide emergency care required to stabilize a patient
(5) failure of a medical facility to maintain a list of physicians who are on call
Criteria for patient transfer:
(1) medical benefits of transfer outweigh the risks
(2) the patient or family requests the transfer and/or give informed consent
(3) the transferring facility provides medical treatment to minimize the risk during transfer
(4) the receiving facility agrees to the transfer
(5) all medical records (or copies of the medical records) are sent with the patient. The documentation must be clear, especially when the patient transfer is performed before stabilization.
(6) the transfer is performed by qualified personnel with proper equipment
If the receiving facility has reason to believe that a transfer may have been inappropriate, then they must notify HCFA (Health Care Financing Administration) or the state agency within 72 hours.
NOTE: An algorithm for patient management under EMTALA has been developed by Denise Causaubon which is included in the contributor section. She also made recommendations for the above text.
