Title: What Does EMTALA Really Mean For The Hospital – The Hospital Medical Director
Headings: What Does EMTALA Really Mean For The Hospital
What Does EMTALA Really Mean For The Hospital
Why did EMTALA come to be?
What about free-standing emergency rooms?
What are the implications for physicians?
By James Allen, MD

Content: There are 3 obligations that hospitals have under EMTALA: The emergency department must provide a medical screening exam to any patient who requests emergency care, regardless of their health insurance status, their ability to pay, or their citizenship. If the medical screening exam indicates that the patient has an emergency medical condition, then the hospital must provide treatment until the condition resolves or stabilizes and the patient can provide self-care after discharge. If the hospital does not have the capability to treat the patient’s condition, then it must make an appropriate transfer to another hospital that has the capability of treating the patient’s condition and provide medical records to the accepting hospital. Hospitals with specialized capabilities must accept these transfers and provide treatment. Why did EMTALA come to be? In the 1980’s, some hospitals and doctors flat out refused to treat patients in their emergency departments if the patients could not pay. Other hospitals would transfer unstable patients to public hospitals without doing even a basic medical assessment or providing initial treatment to stabilize patients. Physicians at Cook County Hospital in Chicago reported that 87% of patients transferred to their hospital were sent because they lacked health insurance, only 6% of those patients actually gave written consent for transfer, and 24% were transferred in medically unstable condition. Thus emerged the term “patient dumping”.