Avoiding EMTALA (...and Crossposted)

[Krin135 at aol.com]

In a message dated 25-Aug-07 11:54:00 Central Daylight Time,  KMATTOX at aol.com 
writes:

I  encountered for the first time a very  interesting mechanism for  
transfer. 
The patient with the acute abdomen who  I readily accepted  in transfer, was 
checked out by the sending doctor, and  then the  registration area of the 
emergency room arranged the   transfer.   They gave him a printed copy of a 
MapQuest route to  get to  our hospital


 
While we've discussed the problem of 'no specialists on call due to limited  
resources' in Louisiana before, I'm flabbergasted at this one.
 
My understanding from working in both Louisiana and Missouri is that the  
SENDING hospital has an affirmative responsibility to provide transportation TO  
the RECEIVING hospital no matter the ability to pay....and I've been 
criticized  in the past for allowing a patient to sign out against medical advice when 
the  patient refused a transport because they had no way to return from the 
receiving  hospital if they were not admitted (in the case of something like a 
complex  facial laceration or the need for an ophthalmologic consult).
 
I've even had administrators tell me that they'd rather have a relatively  
non urgent transfer transported on the hospital's nickel rather than risk that  
said patient would get lost in the shuffle of a busy admissions department (in 
 this case, where we didn't have any inpatient non psych beds, and the 
patient  needed a short stay admission for a pneumonia failed outpatient  treatment).
 
ck
Charles S. Krin, DO FAAFP



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