A new question came up today on whether Flu Shots in the Emergency Department trigger EMTALA.
My “lawyeresque” answer is “No — except…”
We actually have some guidance that appears relevant: The guideline for determining whether an area should be considered a “Dedicated Emergency Department” refers to the number of unscheduled presentations for emergency department type care, but expressly mentions immunizations as not being within that category.
Additionally, immunization requests would not be generally construed as a request for emergency medical care, even under the rather broad interpretation applied by EMTALA.
The “Except…” part comes into play on scheduled visits and non-emergency presentations to the hospital, where CMS regulations and site review guidelines indicate that EMTALA does not apply unless the patient requests a medical assessment or care or under the prudent lay person standard it appears that patient care or assessment is required prior to the commencement of the outpatient or scheduled procedure. ERGO, if the patient complains of a medical condition, requests assessment or care, or appears to the prudent lay person to require emergency care or assessment, even a person presenting for an immunization might trigger EMTALA.
As a general precaution for EMTALA compliance, log the folks presenting in the ED even for immunizations, and note the reason for the visit as “outpatient flu immunization”.