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Complying with the Emergency Treatment and Labor Act (EMTALA) can be hard enough before court rulings give the rule a longer reach. Courts in Kentucky, Ohio, Michigan, and Tennessee have passed laws that make EMTALA applicable even after admission.
The EMTLA rule usually has been interpreted as being in effect only up to admission, explains Sara H. Shanti, JD, an attorney with the law firm of Drinker Biddle & Reath in Chicago.
"Courts in those states found that inpatient admission does not terminate your EMTALA obligation, so hospitals still have to either stabilize or transfer the patient according to EMTALA," she says. "That means hospitals in those states have to meet all the inpatient requirements but also the EMTALA requirements for these inpatients. That may sound like the same thing, but it’s not."
For example, stabilization under EMTALA has a different meaning than stabilization for an inpatient, Shanti explains. Under EMTALA, stabilization means the patients can be discharged and leave on their own, and there is no threat of an emergency medical condition. Transfer also meets the definition of stabilization.
"It can get confusing for people on the frontlines who think that if they are providing good, quality care then they must be in compliance with EMTALA," she says. "There are pitfalls, especially in these states."