| (ii) The response time may be extended before the expiration
of the initial 30 minutes period by agreement among the parties to
the transfer. If the transfer is accepted, the agreed extension shall
be documented in the memorandum of transfer.
(E) The policy shall recognize and comply with the
requirements of the Indigent Health Care and Treatment Act, HSC, §§61.030-61.032
and §§61.057-61.059 (relating to Mandated Providers) since
those requirements may apply to a patient.
(F) The policy shall acknowledge contractual obligations
and comply with statutory or regulatory obligations which may exist
concerning a patient and a designated provider.
(G) The policy shall require that all reasonable
steps are taken to secure the informed refusal of a patient refusing
a transfer or a related examination and treatment or of a person acting
on a patient's behalf refusing a transfer or a related examination
and treatment. Reasonable steps include:
(i) a factual explanation of the increased medical
risks to the patient reasonably expected from not being transferred,
examined, or treated at the transferring facility;
(ii) a factual explanation of any increased risks to
the patient from not effecting the transfer; and
(iii) a factual explanation of the medical benefits
reasonably expected from the provision of appropriate treatment at
a receiving facility.
(H) The informed refusal of a patient, or of a person
acting on a patient's behalf, to examination, evaluation or transfer
shall be documented and signed if possible by the patient or by a
person acting on the patient's behalf, dated and witnessed by the
attending physician or facility employee, and placed in the patient's
medical record.
(I) Transfer of patients may occur routinely or as
part of a regionalized plan for obtaining optimal care for patients
at a more appropriate or specialized health care entity.
(6) Transfer of patients who do not have emergency
medical conditions.
(A) The policy shall recognize and comply with the
requirements of the Indigent Health Care and Treatment Act, HSC, §§61.030-61.032
and §§61.057-61.059 (relating to Mandated Providers) as
those requirements may apply to a patient.
(B) The policy shall acknowledge contractual obligations
and comply with statutory or regulatory obligations which may exist
concerning a patient and a designated provider.
(C) The policy shall require that all reasonable steps
are taken to secure the informed refusal of a patient refusing a transfer
or a related examination and treatment or of a person acting on a
patient's behalf refusing a transfer or a related examination and
treatment. Reasonable steps include:
(i) a factual explanation of the increased medical
risks to the patient reasonably expected from not being transferred,
examined, or treated at the transferring facility;
(ii) a factual explanation of any increased risks to
the patient from not effecting the transfer; and
(iii) a factual explanation of the medical benefits
reasonably expected from the provision of appropriate treatment at
a receiving facility.
(D) The informed refusal of a patient, or of a person
acting on a patient's behalf, to examination, evaluation or transfer
shall be documented and signed if possible by the patient or by a
person acting on the patient's behalf, dated and witnessed by the
attending physician or facility employee, and placed in the patient's
medical record.
(E) Transfer of patients may occur routinely or as
part of a regionalized plan for obtaining optimal care for patients
at a more appropriate or specialized health care entity.
(F) The policy shall recognize the right of an individual
to request a transfer into the care of a physician and a receiving
facility of the individual's own choosing.
(7) Physician's duties and standard of care.
(A) The policy shall provide that the transferring
physician shall determine and order life support measures which are
medically appropriate to stabilize the patient prior to transfer and
to sustain the patient during transfer.
(B) The policy shall provide that the transferring
physician shall determine and order the utilization of appropriate
personnel and equipment for the transfer.
(C) The policy shall provide that in determining the
use of medically appropriate life support measures, personnel, and
equipment, the transferring physician shall exercise that degree of
care which a reasonable and prudent physician exercising ordinary
care in the same or similar locality would use for the transfer.
(D) The policy shall provide that except as allowed
under paragraph (3)(B) of this subsection, prior to each patient transfer,
the physician who authorizes the transfer shall personally examine
and evaluate the patient to determine the patient's medical needs
and to ensure that the proper transfer procedures are used.
(E) The policy shall provide that prior to transfer,
the transferring physician shall secure a receiving physician and
a receiving facility that are appropriate to the medical needs of
the patient and that will accept responsibility for the patient's
medical treatment and care.
(8) Record review for standard of care. The policy
shall provide that the medical staff review appropriate records of
patients transferred to determine that the appropriate standard of
care has been met.
(9) Medical record.
(A) The policy shall provide that a copy of those portions
of the patient's medical record which are available and relevant to
the transfer and to the continuing care of the patient be forwarded
to the receiving physician and receiving facility with the patient.
If all necessary medical records for the continued care of the patient
are not available at the time the patient is transferred, the records
shall be forwarded to the receiving physician and receiving facility
as soon as possible.
(B) The medical record shall contain at a minimum:
(i) a brief description of the patient's medical history
and physical examination;
(ii) a working diagnosis and recorded observations
of physical assessment of the patient's condition at the time of transfer;
(iii) the reason for the transfer;
(iv) the results of all diagnostic tests, such as laboratory
tests;
(v) pertinent X-ray films and reports; and
(vi) any other pertinent information.
(10) Memorandum of transfer.
(A) The policy shall provide that a memorandum of transfer
be completed for every patient who is transferred.
(B) The memorandum shall contain the following information:
(i) the patient's full name, if known;
(ii) the patient's race, religion, national origin,
age, sex, physical handicap, if known;
(iii) the patient's address and next of kin, address,
and phone number if known;
(iv) the names, telephone numbers and addresses of
the transferring and receiving physicians;
(v) the names, addresses, and telephone numbers of
the transferring and receiving facilities;
(vi) the time and date on which the patient first presented
or was presented to the transferring physician and transferring facility;
(vii) the time and date on which the transferring physician
secured a receiving physician;
(viii) the name, date, and time administration was
contacted in the receiving facility;
(ix) signature, time, and title of the transferring
facility administration who contacted the receiving facility;
(x) the certification required by paragraph (5)(B)(ii)
of this subsection, if applicable (the certification may be part of
the memorandum of transfer form or may be on a separate form attached
to the memorandum of transfer form);
(xi) the time and date on which the receiving physician
assumed responsibility for the patient;
(xii) the time and date on which the patient arrived
at the receiving facility;
(xiii) signature and date of receiving administration;
(xiv) type of vehicle and company used;
(xv) type of equipment and personnel needed in transfers;
(xvi) name and city of facility to which patient was
transported;
(xvii) diagnosis by transferring physician; and
Cont'd... |
