Corporate Compliance

Tip: Maintaining on-call obligations under EMTALA

Compliance Monitor, February 25, 2004

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Hospitals must maintain their on-call lists to best meet the needs of patients who receive services required under EMTALA. As part of the Medicare Conditions of Participation, CMS requires hospitals to provide consultative services to emergency patients for services routinely available in the hospital.

The on-call list must include every specialty privileged in the hospital, unless too few physicians exist in a specialty to provide on-call coverage. Hospitals should consider their capabilities, including the availability of on-call physicians, when they make the on-call list.

CMS does not require a lone specialist to be on call at all times, but it does require hospitals to have a policy that addresses how to care for emergency patients who need specialty treatment when a specialist is unavailable. That policy could include a formal or informal transfer agreement with another facility.

CMS considers all relevant factors to determine EMTALA compliance, including the following:

  • the number of physicians on staff
  • other demands on these physicians
  • the frequency with which the hospital's patients typically require on-call services
  • the provisions the hospital has made for situations when the physicians in a particular specialty are not available for on-call coverage

    Hospitals that cannot maintain full-time on-call coverage in specific medical or surgical specialties should keep local EMS staff advised of the times in which certain specialties will not be available. This will help minimize the number of cases in which individuals must be transferred due to lack of complete on-call coverage.

    This column was excerpted from A Practical Guide to EMTALA Compliance. Copyright 2004 by HCPro Inc.

    The guide includes a comparison of the old rule and CMS' 2003 changes, step-by-step advice on how to respond to an EMTALA violation, realistic scenarios that illustrate how to comply with EMTALA in various situations, and a Q&A section to help you meet EMTALA's on-call requirements and ensure that your facility complies with the rules.

    For more information on A Practical Guide to EMTALA Compliance, click here.



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