|(a) General provisions.
(1) Transfer agreements between transferring facilities
and receiving facilities as those terms are defined in §134.43
of this title (relating to Patient Transfer Policy) are voluntary.
(2) If transfer agreements are executed that are consistent
with the requirements of subsection (b) of this section, any patient
transfers shall be governed by the agreement. The memorandum of transfer
described in §134.43(d)(10) of this title is not required for
transfers governed by an agreement.
(3) Multiple transfer agreements may be entered into
based upon the type or level of medical services available at other
(b) Rules for patient transfer agreements.
(1) A patient transfer agreement shall contain the
(A) Except as specifically provided in paragraph (4)
of this subsection, relating to mandated providers, the transfer of
a patient shall not be predicated upon arbitrary, capricious, or unreasonable
discrimination based upon race, religion, national origin, age, sex,
physical condition, or economic status.
(B) The transfer or receipt of patients in need of
emergency care shall not be based upon the individual's inability
to pay for the services rendered.
(2) The patient transfer agreement shall require that
patient transfers be accomplished in a medically appropriate manner
by determining the availability of appropriate facilities, services,
and staff for providing care to the patient and by providing:
(A) medically appropriate life support measures which
a reasonable and prudent physician in the same or similar locality
exercising ordinary care would use to stabilize the patient prior
to transfer and to sustain the patient during the transfer;
(B) appropriate personnel and equipment which a reasonable
and prudent physician in the same or similar locality exercising ordinary
care would use for the transfer; and
(C) all necessary records for continuing the care for
(3) The facility shall recognize the right of an individual
to request transfer into the care of a physician and facility of
the individual's own choosing.
(4) The facility shall recognize and comply with the
requirements of the Indigent Health Care and Treatment Act, Health
and Safety Code, Chapter 61 (relating to the Transfer of Patients
to Mandated Providers).
(5) The patient transfer agreement shall provide that
a patient with an emergency medical condition which has not been stabilized
shall not be transferred unless the following occurs.
(A) The patient, or a legally responsible person acting
on the patient's behalf, after being informed of the facility's obligations
under this section and of the risk of transfer, has requested transfer
to another facility in writing.
(B) A physician has signed a certification, which
includes a summary of the risks and benefits, that, based on the information
available at the time of transfer, the medical benefits reasonably
expected from the provision of appropriate medical treatment at another
facility outweigh the increased risks to the patient and, in the case
of labor, to the unborn child from effecting the transfer.
(C) If a physician is not physically present at the
time a patient is transferred, a qualified medical person has signed
a certification described in subparagraph (B) of this paragraph after
consultation with a physician who has made the determination described
in subparagraph (B) of this paragraph and who will subsequently countersign
the certification within a reasonable period of time.
|Source Note: The provisions of this §510.61 adopted to be effective January 1, 2004, 28 TexReg 5154; transferred effective June 1, 2019, as published in the Texas Register May 17, 2019, 44 TexReg 2469