1. CSOs must not have a written transfer or hospital planning agreement for all physicians. Centers must provide hospitals with a document containing information about their operation and patient population. The active terms of a hospital transfer agreement vary from case to case and must be set out in the written document. A transfer contract may have an expiry date or indicate that it remains in effect until a party terminates the contract. Many of the transfer agreements that I have reviewed have not taken these three elements into account. Can a critical access hospital that has transferred a patient to a higher level of care put a patient back in hospital or does it have to return to a swing-bed status? We have a transfer-back agreement, but they always came back to us in a swing bed, and just recently the care hospital wanted to send patients back because they solved the heart problem and they wanted to send them back to the hospital so we could take care of the first admission for cellulite. Is this eligible? An effective emergency transfer depends on the existence of an established procedure, which is why it is strongly recommended to put in place a written agreement between the CSA and its designated local hospital, even if this is not mandatory by state rules or accreditation agencies. Florida is dealing with the issue from the point of view of medical qualifications. If a physician does not have staffing privileges to perform their ASC procedures in a hospital at a reasonable distance, a transfer agreement must be made in advance.
And Georgia notes that hospitals “must not unduly refuse a transfer agreement to the [CSA].” transfer agreements should clearly define the respective responsibilities of the CSA and the hospital in a number of areas, including the provision of patient information; the provision of means of transport; sharing of services, equipment and personnel; the provision of care with regard to the establishment and capacity of the Agency; and confidentiality of medical records. While 43 states require ASD to be granted, only 30 require them to consider the possibility of outpatient emergency care. Fifteen of them are demanding that they have a hospital transfer agreement. The others require either an agreement or hospital admission privileges for CSA surgeons. (See the “Situation” sidebar. For billing, collection and insurance obligations, the particularities are usually essentially to protect oneself and each for himself. A robust hospital transfer agreement should require each party to maintain professional liability insurance or equivalent insurance, in order to insure its facilities and staff against claims that are made during and after the termination of the agreement. In addition, each party should be responsible for collecting its own fees for the services provided and not be held responsible for the provision of the services provided by the other party.
Hospitals all over the country have been contacting me in recent days with the same question – the hospitals that receive require us to sign sketched transfer agreements. How is it going with EMTALA? Unfortunately, the answer is not clearly mentioned in EMTALA, but over the years, WSC representatives have expressed their views on the implementation of this issue, most often referring to the limitations of these agreements when it comes to EMTALA. 1. A participating hospital with which the SNSF has entered into an agreement pursuant to Article 483.70(j) of this Chapter on the transfer of patients and the exchange of medical records; or sketched retrocessions may result in citations for violation of cmS participation conditions, but EMTALA is unlikely to apply to a retrocession situation in most cases. . . .