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Critical requirements that must be met to not violate EMTALA 1. Provide an appropriate medical screening examinations (MSE) within the capability of the emergency department, including ancillary services routinely available to the emergency department. 2. If an emergency medical condition (EMC) is determined to exist, provide treatment to stabilize the EMC or facilitate an appropriate transfer. 3. Accept appropriate transfers. EMTALA applies when: • An individual presents at a dedicated emergency department (ED). • An individual or someone on their behalf requests examination or treatment for a possible EMC. • An individual's appearance or behavior suggests a need for examination or treatment. • An individual is on hospital property (including parking lots, sidewalks and hospital-owned buildings within 250 yards of the hospital) under the same conditions. • An individual is in a hospital-owned or operated ambulance for the purpose of examination and treatment at the ED unless directed otherwise by non-affiliated physicians or EMS protocols EXCEPTION: Outpatients already receiving a scheduled course of treatment are not obligated to receive an MSE if they do not present at the dedicated ED. The Safety of the Patient is ALWAYS our Priority In emergency situations with ERD implications such as pregnancy, focus should be on saving the life you can. That is, provide such treatment when: 1. No Discharge Before MSE: Patients cannot be asked to leave the grounds prior to completing a MSE. 2. EMTALA Log Requirements: All patients arriving for emergency medical services must be recorded on the EMTALA log. 3. Appropriate MSE Completed: Needs to be completed by Qualified Medical Professional (QMP) that is approved by medical staff bylaws/ rules and by the governing body. • Be aware of limitations of scope of MSE that can be performed (e.g. L&D RN that has been approved is limited to scope per policy). • May require MSE to be completed by multiple individuals depending on chief complaint (e.g. ED and L&D). What is a Medical Screening Examination (MSE)? • Definition: An MSE is tailored to the patient's presenting signs, symptoms, medical history, and the hospital's capabilities. • Process: Ongoing until it is determined whether an EMC exists and, if so, the patient is stabilized or appropriately transferred. • Personnel: Must be performed by Qualified Medical Personnel (QMP) as determined by the hospital's governing body. • Special Cases: Patients sent to L&D for MSE who have other conditions must return to the ED for completion of the MSE. NOTE: Triage is not equivalent to a Medical Screening Examination. Provider Education Training Manual 21 |

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