Presents to the Dedicated ED

Any person who comes to the hospital’s dedicated ED requesting an evalua­tion or a treatment must be given an MSE. The request can be made on the patient’s behalf (eg, a minor). A dedicated ED is any department of the hos­pital (1) licensed by the state as an ED; (2) held out to the public as a place for emergency or unscheduled care; or (3) in which at least one third of the outpatient visits were for emergency care during the previous calendar year.

The “250-yard” rule has also been modified. The request for care, using the aforementioned criteria, may still occur anywhere on the hos­pital property (including driveways and sidewalks). However, the CMS uses other Medicare rules (42 CFR §413.65) to define the hospital campus. Areas such as physician offices, skilled nursing facilities (and similar separate Medicare-participating units), and nonmedical facilities are not included in the hospital’s zone of responsibility. Non-EDs off the main hospital cam­pus no longer fall under EMTALA. They still must have written policies for dealing with emergencies.