Signing out AMA

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    OKAY here's the question....a patient signed out AMA 2 days ago...all well documented that we told her she wasn't ready to go and was at risk....she left anyway. She is now back in the ER wanting to come back. I said NO. I've never worked in a place that took someone back after signing out against medical advice. My administrator wants to take her to make nice with the docs. I am outraged and know I will be over ruled (another story altogether)..what do all y'all think.?
  2. 24 Comments so far...

  3. 0
    Quote from CapeCodMermaid
    OKAY here's the question....a patient signed out AMA 2 days ago...all well documented that we told her she wasn't ready to go and was at risk....she left anyway. She is now back in the ER wanting to come back. I said NO. I've never worked in a place that took someone back after signing out against medical advice. My administrator wants to take her to make nice with the docs. I am outraged and know I will be over ruled (another story altogether)..what do all y'all think.?
    Whenever we had someone sign out AMA, we had the Admin behind us. We always made sure we had them involved from the start. As far as taking them back, we have, but not under many circumstances. .....they usually went back to hospital or another SNF.

    Best to you!!!

    ~ear
  4. 0
    Our hospital allows them to come back. There's more liability with turning them away.
  5. 0
    I did not think hospitals could turn pts away even if they do sign out AMA then come back.
  6. 0
    In our ER when we have a pt leave AMA we generally mention to them that signing out AMA does not mean they are not welcome back and we encourage them to return should they change their mind.
  7. 0
    Quote from auntiern
    i did not think hospitals could turn pts away even if they do sign out ama then come back.


    baring a court order, hospitals can't.

    ltc facilities, however, are a different story.

    i'd think it would depend on why the patient left ama, and how the whole situation went.

    doesn't sound like it went well. does your facility have a policy? if not, it is probably up to the admin to decide.
  8. 0
    I'm sure that LTC is different, but in my experience with hospitals, it's like Jabra posted - the patient is encouraged to come back if he feels that he needs/wants to...

    =^..^=
  9. 0
    Is payment an issue? I thought that if a Medicare or insurance patient signed himself out AMA that payment would be denied to the facility.

    If the patient is self-pay or covered by Medicaid that may not be an issue, though.
  10. 0
    Quote from CapeCodMermaid
    OKAY here's the question....a patient signed out AMA 2 days ago...all well documented that we told her she wasn't ready to go and was at risk....she left anyway. She is now back in the ER wanting to come back. I said NO. I've never worked in a place that took someone back after signing out against medical advice. My administrator wants to take her to make nice with the docs. I am outraged and know I will be over ruled (another story altogether)..what do all y'all think.?

    here in nj refusing care to ANYONE who seeks it is an emtala(sp?) violation.

    amas have to start right back at triage and wait all over again though.
  11. 0
    I agree capecod... admin will take them back. Happens all to frequently.. anything to fill a bed.


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