This form is not mandated by EMTALA or CMS.

It is a sample variation of a system that we have successfully implemented in many plans of correction with CMS. The system must be adapted to the individual hospital capabilities and state law, and must achieve the goal of assuring that no patient who should receive a physician examination falls through the cracks.

As with all policies and procedures, this sample should be reviewed by legal counsel and appropriate medical and hospital personnel before adoption

This system is used in conjuction with a full policy on medical screening in general and OB medical screening in particular. OB nurses must be properly authorized as Qualified Medical Personnel for non-physician screening to implement this system and quality assurance monitoring, education, and medical staff bylaws must support the practice.

This system is typically implemented to avoid having to have an OB or other physician come in to see each presenting patient with contractions or other OB issues.

The system, however, requires that a physician respond promptly to complete the medical assessment of the patient per the criteria regardless of whether the delivery is imminent. The hospital policy must mandate response. Physicians who attempt to avoid response compromise the system and expose the hospital and the physician to EMTALA citations and possible malpractice litigation.

As with all policies and procedures, this sample should be reviewed by legal counsel and appropriate medical and hospital personnel before adoption

SAMPLE SCORING SYSTEM FORM

SAMPLE SCORING SYSTEM POLICY