EMTALA question

[HiddencatBSN, BSN]

Would refusing to treat a pediatric patient because the parent brought a non-patient sibling constitute an EMTALA violation? We have a very strict visitor policy in place but we allow siblings in the ED with the patient and caregiver when there are no childcare options for the family, but I've heard other EDs are not allowing this. I tried to see if there was any specific guidance on this and haven't been able to find anything.

[Mebzone05, BSN]

My ED would never do this. Sounds horrible.

[HiddencatBSN, BSN]

5 hours ago, Mebzone05 said:

My ED would never do this. Sounds horrible.

Do what, allow siblings or refuse treatment to families without anyone to care for siblings?

[JKL33]

In general: A waiver for section 1135 of the SSA has been issued by CMS during the Covid-19 disaster response. And some of that waiver relates to hospitals' ability to redirect patients to receive their medical screening (MSE) exam at alternative locations. What they specifically must not do is discriminate based on ability to pay. Read here.

Also, during this time they are allowed to direct people elsewhere without an MSE if the person is simply requesting asymptomatic covid screening and is not requesting treatment for an emergency medical condition.

The other thing that has always been the case is that patients have never been required to be brought to a room/bed/whatever. What is required specifically is that patients must receive a medical screening exam if they present requesting treatment for an emergency medical condition; they must be screened by appropriate personnel to see if an EMC exists. And there is more than one way to make that happen. Hospitals have never been required under EMTALA to provide further care/treatments if the medical screening exam doesn't indicate that an EMC exists. Under normal circumstances we do provide further care and treatment without the existence of a strict EMC, but that is a service to the community and a business decision, not a mandate of EMTALA.

The reason I wrote all this ^ is to say that it's possible people are being sent elsewhere for reasons that are legal but of which the staff aren't fully aware. What I mean is, say a parent brings in two kids who have no symptoms or complaints and wants one of them tested for covid for whatever reason. They may legally be directed elsewhere, and the reason would not be because of the sibling's presence.

I would find it really odd for them to turn away someone in the scenario you posted in the OP for the rumored reason specifically (presence of sibling). They could violate EMTALA that way if the parent has presented with a concern for a medical emergency with the one child, and an MSE is not provided and they are simply told to leave because reasons (covid visitor policy, etc.). Surely if that child does indeed have a condition that a normal lay person would think might be an emergency, it is still a violation to not make any attempt to evaluate the situation. As far as I know. And it is probably risky to blindly turn people away because reasons (visitor policy); I really don't think they would do that. I think there's probably more to it that the staff doesn't know about.