you cannot transfer a patient to another facility if you have the ability to care for them. this does not mean bedspace, it means specialties (burns, neuro, etc). i've been doing this a long time. you would never find a physician to accept an established pt just due to "bed problems". THAT would be an emtala violation. Emtala addresses inappropriate transfers, started out as an "anti-dumping" legislation to prevent sending self-pays to other facilities. For example: we send out all our OB's because we do not offer, or have OB physicians on staff. This would be even if the entire hospital was empty. the closest facility that offers OB and has bed space is obligated to take the pt, insurance or not. THAT is emtala in a nutshell. Someone above said it "emtala ends when the pt leaves the ER". It does not cover in house patients at all. If the powers to be think that the pt would be safest in the ER, then that's where they go, like it or not. The patient still has their admitting orders, physicians, etc the same. The only way the ER doc gets involved is if the pt codes. Which would be the same if the patient was upstairs.