EMTALA: ED transfer documentation goes digital

All Asante employees should be familiar with the federal Emergency Medical Treatment and Active Labor Act, or EMTALA. Enacted in 1986, the law requires Medicare-participating hospitals to evaluate and, if necessary, stabilize any patient who comes to the hospital with a potential emergency condition regardless of the person’s ability to pay.

To streamline the documentation for transfers, Epic now has a digital version of the patient transfer form, largely eliminating the need for paper forms. The electronic form, which went live today, June 30, also allows quick access to the refusal-of-transfer form, if needed. (To access all forms, you need to be logged into the Asante network.)

Asante takes its EMTALA obligations seriously and is committed to providing ongoing education to employees and providers about their responsibilities under the law.

EMTALA obligations apply when:

• A person or someone speaking on their behalf comes to an Asante hospital property seeking an evaluation and treatment for an emergency medical condition or a reasonably prudent (i.e., average) person would perceive that the person needs examination and treatment for an emergency medical condition; or
• Anyone comes to an Asante hospital emergency department, Labor and Delivery Unit/Family Birth Center or Psychiatric Care Unit seeking an evaluation and treatment for any condition, or a reasonably prudent person would perceive that the person needs examination and treatment for a medical condition.
• An emergency patient is transferred to a hospital with specialized services from another hospital that lacks the capability or capacity to treat the patient’s emergency medical condition.

As part of Asante’s obligations:

• A qualified medical professional must provide a medical screening exam. (Triage does not qualify as a medical screening exam.)
• The exam can’t be delayed for inquiry about methods of payment or insurance coverage.
• If an emergency medical condition exists, stabilizing treatment must be provided until the patient is admitted or the emergency medical condition is resolved. If Asante does not have the present capability or capacity to resolve the emergency medical condition, an “appropriate” transfer of the patient to another hospital must be done in accordance with EMTALA provisions.
• Asante must accept a patient with an emergency medical condition from a referring hospital if Asante has the present capacity and capability to treat the condition. Emergency patients who are transferred to Asante hospitals also require the provision of a medical screening examination similar to any other emergency patient who presents to the hospital in need of emergency services.
• Signs explaining patient and visitor rights under EMTALA must be visible in the Emergency Department, Family Birth Center and the Psychiatric Care Unit.
• Asante must maintain a “central log” that records the name and disposition of each person who comes to the emergency department, Labor and Delivery Unit/Family Birth Center and Psychiatric Care Unit for medical or emergency services. The patient’s electronic medical record does not qualify as a central log.

Employees should be familiar with Asante’s EMTALA Policy, the Against Medical Advice, Left Without Being Seen and Elopement Policy and the Transfer Admits Center and Nursing Supervisors Operational Plan. Additional policies and forms that should be reviewed include the ARRMC and ATRMC Emergency Department On-Call Policy and AACH Emergency On-Call Policy.

Any EMTALA-related questions or concerns can be directed to co********@as****.org.