Under EMTALA, when is transfer accepted?

• A. Only when the patient is stable and consent is provided.
• B. Transfers are always at the discretion of the receiving facility with no consent needed.
• C. 1) if patient needs higher level of service/medically necessary (stable or unstable) AFTER an MSE is completed and consent from patient/proxy is obtained; 2) per patient or proxy's request (regardless of stability); the accepting physician is obligated to accept the transfer; all pertinent records must accompany the patient.
• D. Only if the patient signs a transfer waiver.

Answer: (C)

Under EMTALA, a transfer is acceptable when the patient needs a higher level of service or a medically necessary transfer after a medical screening exam (MSE) has been completed, and consent from the patient or a proxy has been obtained; or when the patient or proxy requests the transfer (regardless of stability). In either scenario, the accepting physician at the receiving facility is obligated to accept the transfer, and all pertinent medical records must accompany the patient.

This reflects EMTALA’s aim to ensure appropriate care and prevent unwarranted refusals, combining patient autonomy with the receiving facility’s obligation to admit if capable of providing the needed care.