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Obstetric triage & EMTALA regulations. Practice strategies for labor and delivery nursing units.

The purpose of EMTALA (a component of the Consolidated Omnibus Budget Reconciliation Act of 1986 [COBRA]) is to ensure that patients receive emergency or active labor care when they seek it. The EMTALA regulations seek to prevent situations that might result in injuries or deterioration of a condition, such as an institution or provider refusing to treat a client who is not able to pay for care, unnecessary transfers to another hospital or neglect by health care providers when timely care is needed. Since 1996, the Office of the Inspector General (OIG) has made enforcing EMTALA a high priority, fining institutions up to $250,000 and individuals up to $50,000 per violation. EMTALA regulations apply to all hospitals that participate in Medicare and to all patients, whether or not they are eligible for Medicare. This includes women presenting to an L&D, as well as all pregnant women seeking care at a hospital for any reason. L&D nurses need pertinent information about EMTALA and how it relates to obstetric triage. This information will allow the obstetric triage nurse to provide care that is safe, efficient and in compliance with federal regulations.