Questions for Dr. Stern
About Your Urgent Care Center
38. In reading your Q & A answer in the Feb. 2007 JUCM the criteria you listed for type B emergency depts is also the criteria definition as to whether UCC meet EMTALA requirements. Would you say based on your comments that unless an UCC is treating 1/3 emergency conditions it would not fall under EMTALA regs either? We are hospital owned, are NOT licensed as an ED, and do not advertise to treat EMERGENCY conditions. I would have to run numbers but do not believe 1/3 of our pts are "emergency medical conditions" and have been trying to get that defined. We lose a portion of our revenue due to referral denials yet do not turn these patients away due to EMTALA regs. Your thoughts would be greatly appreciated. ps. thanks for the magazine - great articles!!!!!
Thanks for the encouraging note. Yes. It does seem to make perfect sense that you should not have to follow EMTALA regulations if less than 1/3 of your patients suffer from emergency conditions. I suppose you would want to do a formal survey of 100 or more consecutive visits to demonstrate the actual percentage of patients with emergency conditions.
In addition, if you are off campus, the rule also makes it clear that, while the law defines "hospital property" as "the entire main hospital campus . . . including the parking lot, sidewalk, and driveway," EMTALA does not apply to other entities that participate separately in Medicare, such as doctors' offices, rural health clinics, nursing homes, or other "nonhospital entities," even if they are next to the main hospital building and are owned or operated by the hospital. Of course, some hospital systems will tend to err on the safe side, even if it is very clear that the urgent care center does not reach the formal requirements for application of EMTALA. Take care. We hope to see you in Daytona (May 9-12, 2007) at UCAOA-2007.
PS: If you docs are not signed up, encourage them to go to www.jucm.com and sign up for a free subscription to JUCM.
