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Thu, 17 Oct 2002 20:23:43 -0500

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Not true, Rick.  The term reverse-EMTALA is frequently used to describe 
the situation in which a hospital with limited facilities legitimately 
attempts to transfer a patient to a hospital with specialized 
capabilities.   The receiving hospital could face liability if it 
refuses to accept the transfer. The on-call physician cannot refuse to 
accept a patient while awaiting "finanical" authorization.

42 CFR 489.24(e) states:
 A participating hospital that has specialized capabilities or 
facilities (including, but not limited to, 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 from a referring hospital within the boundaries of the United 
States an appropriate transfer of an individual who requires such 
specialized capabilities or facilities if the receiving hospital has the 
capacity to treat the individual.

59 FR 32101 states:
We believe that after assessing an individual's medical condition and 
weighing the risks versus benefits of effectuating an appropriate 
transfer to another facility, the amount of travel time required to 
transport the individual should be considered.  Situations will occur 
where an individual's condition requires a hospital to effectuate a 
transfer to the nearest appropriate facility that has the capability and 
capacity to treat in order to minimize the risks to the individual by 
reducing the transportation time as much as possible.  Transfer of an 
unstabilized patient to a hospital with which there is a prior transfer 
agreement can be justified when the condition of the unstabilized 
individual is such that the additional travel time would not increase 
the danger to the patient.

Tom Scaletta, MD FAAEM

> DocRickFry@aol.com wrote:
>
> EMTALA puts the onus on the original institution seeking to 
> transfer--if they transfer an emergency case for which they have the 
> capability to care for (i.e. if there is a thoracic surgeon there in 
> the first institution), then THEY are liable--and, that is regardless 
> of another surgeon willing to accept elsewhere--liability does not 
> apply to a possible receiving institution under either EMTALA or 
> COBRA--you have no legal obligation or are under no urgency to accept 
> such a patient.

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Not true, Rick.&nbsp; The term reverse-EMTALA is frequently used to describe
the situation in which a hospital with limited facilities legitimately attempts
to transfer a patient to a hospital with specialized capabilities.&nbsp;&nbsp; The
receiving hospital could face liability if it refuses to accept the transfer.
The on-call physician cannot refuse to accept a patient while awaiting "finanical"
authorization.<big> 
</big> 
42 CFR 489.24(e) states: 
&nbsp;A participating hospital that has specialized capabilities or facilities
(including, but not limited to, 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 from a referring hospital within
the boundaries of the United States an appropriate transfer of an individual
who requires such specialized capabilities or facilities if the receiving
hospital has the capacity to treat the individual. 
 
59 FR 32101 states: 
We believe that after assessing an individual&#8217;s medical condition and weighing
the risks versus benefits of effectuating an appropriate transfer to another
facility, the amount of travel time required to transport the individual
should be considered.&nbsp; Situations will occur where an individual&#8217;s condition
requires a hospital to effectuate a transfer to the nearest appropriate facility
that has the capability and capacity to treat in order to minimize the risks
to the individual by reducing the transportation time as much as possible.&nbsp;
Transfer of an unstabilized patient to a hospital with which there is a prior
transfer agreement can be justified when the condition of the unstabilized
individual is such that the additional travel time would not increase the
danger to the patient. 
 
Tom Scaletta, MD FAAEM 
 
<blockquote type="cite"><a class="moz-txt-link-abbreviated" href="mailto:DocRickFry@aol.com">DocRickFry@aol.com</a> wrote: 
 
 EMTALA puts the onus on the original institution seeking to transfer--if 
they transfer an emergency case for which they have the capability to care 
for (i.e. if there is a thoracic surgeon there in the first institution), 
then THEY are liable--and, that is regardless of another surgeon willing to
accept elsewhere--liability does not apply to a possible receiving institution 
under either EMTALA or COBRA--you have no legal obligation or are under no 
urgency to accept such a patient.</blockquote>
 
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