Emergency Transfers—EMTALA

Brodus Franklin and Jaime Gasco

What is EMTALA?

Emergency Medical Treatment and Active Labor Act, also known as the patient antidumping law 1,2

Under the EMTALA mandate, when is a patient considered “stable for transfer”?

A patient is considered “stable for transfer” if the treating physician determines that no material deterioration will occur during the transfer between facilities.^1,2

Does EMTALA apply to the transfer of stable patients?

No. EMTALA does not apply to the transfer of stable patients, but instead to unstable patients.^1,2

If the patient is unstable, under what two conditions may the hospital transfer the patient?

Normally if the patient is unstable, then the hospital may not transfer the patient unless:

1. The physician substantiates that the medical benefits expected from the transfer outweigh the risks; or

2. A patient formulates a transfer request in writing after being informed of the hospital’s obligations under EMTALA and the potential risks of transfer.

Is transfer of unstable patients automatic under EMTALA?

No. The transfer of unstable patients must be “appropriate” under the EMTALA mandate.^1,2

For the transfer of unstable patients to be “appropriate” under EMTALA, what four things must the transferring hospital do?

“Appropriate” transfer under EMTALA requires that the transferring hospital:

1. Provide continuing care within its capabilities until a transfer can be made to minimize transfer risks.

2. Provide copies of medical records.

3. Confirm that the receiving facility has adequate space and qualified staff members to treat the condition and has agreed to accept the transfer.

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