Health Economics Assignment

5

EMTALA Scenario Analysis

Adetutu Adeparusi
HLT-520-Legal and Ethics Issues in Health Care
Grand Canyon University
Karen Rice
Running head: ASSIGNMENT TITLE HERE

1

March 10th, 2021.

EMTALA Scenario Analysis

According to (Zibulewsky 2001) in Baylor University Medical Centre Proceedings. EMTALA is a health act instituted back in 1986 as a section of the consolidated omnibus budget reconciliation act. Originally, the law intended to facilitate access to health facilities for patients and minimize patient dumping risk. As argued by (Tammy_RN 2019) in AJN, American Journal of , patient dumping is the act of transferring a patient from a hospital of a higher standard in the form of equipment and services to a lower standard facility due to financial inadequacy. Before forming EMTALA, patients in private hospitals who could not afford the billing cost would be transferred to public hospitals. However, the medical staff knew the patients would not get any medical assistance in that facility.
EMTALA demands that the emergency response team provide medical examinations to anyone who enters the facility. Equality is championed in the act since medical screening is performed on anyone regardless of their citizenship, race, gender, and financial status. A hospital is expected to stabilize a patient in the facility without requesting a transfer to another health facility. The law allows for interhospital transfers only when their independent consent from the patient or the hospital lacks the specific equipment required for the s stabilization of the patient. The refusal to provide healthcare for people who are capable of raising the hospital bills is highly discouraged. (Zibulewsky, 2001) as outlined in Baylor University Medical Centre Proceedings. It is illegal to deny a patient the request for an examination or treatment in a health facility.
In the assignment scenario case, the patient had checked in hospital B with a severed ear. Since the health facility is not equipped with an ENT physician, the emergency department physician could only stabilize the injury. At the same time, the patient waits for specialized health care from an ENT physician. (Zibulewsky, 2001), as argued in Baylor University Medical Centre Proceedings, on-call medical staff are responsible for providing emergency care as

EMTALA Scenario Analysis
requested by the emergency department physician. The ED send a recording of the patient, whereby on analysis, the ENT physician ascertained that the injury was salvageable and could be easily sutured. In my opinion, the hospital administrator would not have violated the EMTALA by rejecting the transfer of the patient to hospital A. (Zibulewsky, 2001) as outlined in Baylor University Medical Centre Proceedings. The HCFA has a rule that if the on-call physicians are less than three, the hospital can call them intermittently.
Most on-call physicians are not aware of the responsibility as outlined in EMTALA. When hospital administrators receive emergency transfer calls from the ED and the on-call physician is not available, the administrator has to make the tough decision whether to authorize or decline the emergency transfer request. Since the ENT physician won’t be available to perform the service for up to six hours, the hospital administrator declined the transfer. Since the ENT physician had analyzed the situation and ascertained that the emergency department physician could stabilize, the patient had to continue receiving health care from hospital B. If, after six hours, and the ED is yet to stabilize the patient, I would advise the emergency department to request the transfer again.
To prevent a recurrence of the situation where a patient has a requested a transfer and denied, I would explain to the on-call physicians the magnitude of failing to upload to the EMTALA laws and regulations. Physicians on call not only represent themselves but the entire hospital. An on-call physician’s incapacity not responding to a request to perform medical health services to patients paints a bad picture of the hospital in public. If there is an emergency and the on-call physician is not in a position to respond to the call, they should find another medical staff who will be able to fill in and perform the required task. (Zibulewsky, 2001) as outlined in BaylorUniversity Medical Centre Proceedings.EMTALA regulations require the on-call physicians to report to the hospital in less than thirty minutes. Since the penalties implied on non-responsive physicians stand even if the injury did not result in complications, on-call physicians must be on high alert of any emergency occurrence. The ED physicians should receive additional training on how to stabilize emergencies and perform general health care on patients.
The on-call physician in the hospital would be concerned about violating the EMTALA code if he had analyzed the patient’s condition to require specialized health and declined the call request. Since the ENT specialist had analyzed the situation and ascertained that the energy department could stabilize the condition, the call’s neglect didn’t violate the EMTALA regulations. If the ED physician insisted on transferring the patient to hospital A despite the decline, he/she would have violated the regulations under the dumping clause. If the ENT specialists were more than three, failure of either of them to respond to the call could have a lead regulation violation. (Zibulewsky, 2001) as outlined in Baylor University Medical Centre Proceedings. ‘if there are more than three specialists in a specific hospital, the call list must include them each day. If the ED physician could not stabilize the patient and the on-call fail to respond to the call even after six hours, the ENT would have violated both the HCGA and EMTALA laws and regulations.
EMTALA regulations were developed with the intent of eradicating discrimination in health care facilities due to financial issues. Since the emergency department is concerned with the stabilization of patients involved in freak accidents, the ED physicians must stabilize the patients without any form of discrimination based on nationality, race, gender, and financial stability. After stabilizing the patient, EMTALA stipulates the ED physician to request on-
EMTALA Scenario Analysis
callspecialists if the patient needs health care beyond their capacity. After the on-call specialist is informed of the need for their services, a timely response is demanded. ED physicians who don’t stabilize patients and request on-call specialists risks penalizations of up to fifty thousand dollars per patient from the HCFA. The penalization is similar to on-call physicians who don’t respond on time.

References
Staffel, G. (2011). Primary Care Otolaryngology. (M. K. Wax, Ed.) Alexandria, VA: American Academy of Otolaryngology-Head and Neck Surgery Foundation.
Tammy_RN, C. (2019, March). Patient Dumping. AJN, American Journal of , 119(3), 1. doi:10.1097/01.NAJ.0000554012.77906.74
Zibulewsky, J. (2001, October 14). The Emergency Medical Treatment and Active Labor Act (EMTALA): what it is and what it means for physicians. Baylor University Medical Centre Proceedings, 339-346. doi:10.1080/08998280.2001.11927785