BP Checks Under EMTALA

Howard Eikenberry, Assistant Administrator at Boone County Hospital in Boone, IA, discovered this in the Interpretive Guidelines, and I believe that constructing the policy and support documents could solve one of the more frustrating aspects of EMTALA compliance, dealing with requests for blood pressure checks.

(Emphasis added)

Interpretive Guidelines – Responsibilities of Medicare Participating Hospitals In Emergency Cases

Interpretive Guidelines §489.24(c)

Any individual with a medical condition that presents to a hospital’s ED must receive an MSE that is appropriate for their medical condition. The objective of the MSE is to determine whether or not an emergency medical condition exists. This does not mean that all EMTALA screenings must be equally extensive. If the nature of the individual’s request makes clear that the medical condition is not of an emergency nature, the MSE is reflective of the individual presenting complaints or symptoms. A hospital may, if it chooses, have protocols that permit a QMP (e.g., registered nurse) to conduct specific MSE(s) if the nature of the individual’s request for examination and treatment is within the scope of practice of the QMP (e.g., a request for a blood pressure check and that check reveals that the patient’s blood pressure is within normal range). Once the individual is screened and it is determined the individual has only presented to the ED for a non-emergency purpose, the hospital’s EMTALA obligation ends for that individual at the completion of the MSE. Hospitals are not obligated under EMTALA to provide screening services beyond those needed to determine that there is no EMC.