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This page contains the regulations pertinent to EMTALA
 other than those under section 489.24:
Selections from 42 CFR 413.65
Selections from 42 CFR 489.20
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Selections from 42 CFR 413.65

[NOTE - sections 413.65(a) and (d) provide detailed definitions of "provider-based" entities: departments of a hospital which are treated as integrated with the hospital for purposes of cost reporting and for purposes of determining the need to comply with EMTALA requirements.  Section 413.65(g) imposes duties on such facilities, as does Section 489.24.]

(a) Scope and definitions.

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(2) Definitions. In this subpart E, unless the context indicates otherwise—

Campus means the physical area immediately adjacent to the provider’s main buildings, other areas and structures that are not strictly contiguous to the main buildings but are located within 250 yards of the main buildings, and any other areas determined on an individual case basis, by the HCFA regional office, to be part of the provider’s campus.

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Provider-based entity means a provider of health care services, or an RHC or an FQHC as defined in § 405.2401(b) of this chapter, that is either created by, or acquired by, a main provider for the purpose of furnishing health care services of a different type from those of the main provider under the name, ownership, and administrative and financial control of the main provider, in accordance with the provisions of this section.

Provider-based status means the relationship between a main provider and a provider-based entity or a department of a provider, remote location of a hospital, or satellite facility, that complies with the provisions of this section.

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(g) Obligations of hospital outpatient departments and hospital-based entities.

(1) Hospital outpatient departments located either on or off the campus of the hospital that is the main provider must comply with the anti-dumping rules in §§ 489.20(l), (m), (q), and (r) and § 489.24 of this chapter. If any individual comes to any hospital-based entity (including an RHC) located on the main hospital campus, and a request is made on the individual’s behalf for examination or treatment of a medical condition, as described in § 489.24 of this chapter, the hospital must comply with the anti-dumping rules in § 489.24 of this chapter. . .

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Selections from 42 CFR 489.20

489.20 -- Basic Section 1866 commitments relevant to Section 1867 responsibilities.

The provider agrees to the following:

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(d) In the case of a hospital or a CAH that furnishes services to Medicare beneficiaries, either to furnish directly or to make arrangements (as defined in § 409.3 of this chapter) for all Medicare covered services to inpatients and outpatients of a hospital or a CAH except the following:

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(3) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act.  

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(l) In the case of a hospital as defined in Sec. 489.24(b), to comply with Sec. 489.24.

(m) In the case of a hospital as defined in 489.24(b), to report to CMS or the State survey agency any time it has reason to believe it may have received an individual who has been transferred in an unstable emergency medical condition from another hospital in violation of the requirements of 489.24(e).

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(q) In the case of a hospital as defined in 489.24(b)--

          (1) To post conspicuously in any emergency department or in a place or places likely to be noticed by all individuals entering the emergency department, as well as those individuals waiting for examination and treatment in areas other than traditional emergency departments (that is, entrance, admitting area, waiting room, treatment area) a sign (in a form specified by the Secretary) specifying the rights of individuals under section 1867 of the Act with respect to examination and treatment for emergency medical conditions and women in labor; and

          (2) To post conspicuously (in a form specified by the Secretary) information indicating whether or not the hospital or rural primary care hospital participates in the Medicaid program under a State plan approved under Title XIX;

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(r) In the case of a hospital as defined in 489.24(b) (including both the transferring and receiving hospitals), to maintain--

        (1) Medical and other records related to individuals transferred to or from the hospital for a period of 5 years from the date of the transfer;

        (2) An on-call list of physicians who are on the hospital's medical staff or who have privileges at the hospital, or who are on the staff or have privileges at another hospital participating in a formal community call plan, in accordance with Sec. 489.24(j)(2)(iii), available to provide treatment necessary after the initial examination to stabilize individuals with emergency medical conditions who are receiving services required under Sec. 489.24 in accordance with the resources available to the hospital;  and

          (3) A central log on each individual who "comes to the emergency department," as defined in 489.24(b), seeking assistance and whether he or she refused treatment, was refused treatment, or whether he or she was transferred, admitted and treated, stabilized and transferred, or discharged.

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(w) In the case of a hospital as defined in § 489.24(b), to furnish written notice to all patients at the beginning of their hospital stay or outpatient visit if a doctor of medicine or a doctor of osteopathy is not present in the hospital 24 hours per day, 7 days per week, in order to assist the patients in making informed decisions regarding their care, in accordance with § 482.13(b)(2) of this subchapter. The notice must indicate how the hospital will meet the medical needs of any patient who develops an emergency medical condition, as defined in § 489.24(b), at a time when there is no physician present in the hospital. For purposes of this paragraph, the hospital stay or outpatient visit begins with the provision of a package of information regarding scheduled preadmission testing and registration for a planned hospital admission for inpatient care or outpatient service.