Biomedical Engineering Reference
In-Depth Information
Treatment and Active Labor Act (EMTALA)
22
in
incoming patients
as
the
result of
an
the event of a major public health emergency.
emergency?
7. Has the organization identified all parties
who need to receive notice of any closure,
including other providers, ambulance compa-
nies, agencies responsible for triage and
patient allocation in an emergency,
1. How will the determination be made that
the organization's emergency-response plan
(or the community emergency-response plan)
should be implemented (e.g., whether an offi-
cial declaration is necessary)? Has a threshold
number of cases been established to require the
triggering of the plan? What occurs if the plan
appears to conflict with an organization's own
legal or other obligations? What happens if the
community has not developed an emergency-
response plan? Does the institution have its
own plan?
2. Does the organization have in place a full
range of transfer agreements to provide for the
emergency transfer of patients whose medical
conditions are beyond the scope of its services?
If the organization is a tertiary care facility,
does it have in place transfer agreements with
other community providers under which the
tertiary care facility will receive patients in an
emergency?
3. Do the organization's transfer agreements with
any long term care facilities address the imme-
diate return of hospitalized residents in the
event of an emergency situation requiring an
evacuation of patients?
4. Do the organization's routine files, as well
as its Command Center records, include (in
readily accessible locations) the list of such
community and affiliate resources, including
a description of the potential resources and
appropriate contact information, for easy refer-
ence by the incident-command staff in an
emergency?
5. Has the organization planned for partial or
complete closure (including partial or complete
evacuation) of the facility in the event of an
emergency?
6. Does the organization have an established
protocol
first
responders,
and regulatory or
licensing
authorities?
8.
Is the organization a participant in the
National Disaster Medical System (NDMS),
under which hospital beds are made avail-
able to the Department of Homeland Security
for use in the federal medical response to
major emergencies and declared disasters? If
so, what are the organization's responsibili-
ties within the NDMS program?
9.
Is the organization's process for closure or
diversion compliant with the organization's
obligations under EMTALA, and with state
or local rules and orders of public health
officials? Will the organization continue
to provide for screening examinations and
required stabilizing care within its avail-
able resources at all
times it remains in
operation?
10. Has the Centers for Medicare & Medi-
caid Services (CMS) issued any emergency
guidance? What should hospitals do in the
interim between the arrival of patients and the
issuance of CMS guidance, as this could lead
to treatment differences before and subse-
quent to such an issuance?
11. May patients be directed to the organiza-
tion by a governmental authority, including
a public health, police, or military offi-
cial, overriding the organization's EMTALA
duties? If so, is the Command Center
equipped to receive documentation of the
order or direction? In the alternative, has
the Incident Commander created appropriate
records of the directions received?
for
closure of
the
facility to
22
See generally
Emergency Medical Treatment and Active Labor Act, 42 U.S.C. ยง 1395dd (2004).
