[Editor’s note: This column addresses readers’ questions about the Emergency Medical Treatment and Labor Act (EMTALA). If you have a question you’d like answered, contact Steve Lewis, Editor, ED Management, 215 Tawneywood Way, Alpharetta, GA 30022. Phone: (770) 442-9805. Fax: (770) 664-8557. E-mail: steve@wordmaninc.com.]

Question: I know EMTALA signs are to be placed in registration areas, EDs, and public entrances. Right now we have signs in each of our four ED rooms, in the front hospital entrance, and the registration area. But I need to know if I should hang a sign in our back entrance leading to the ED. This entrance is not considered a public entrance, so do I need to put a sign there?

Answer: It wouldn’t hurt to place one there, but you probably don’t have to, says one EMTALA expert.

EMTALA, in essence, requires that you place the signs where patients are most likely to see them, says M. Steven Lipton, JD, an attorney with Davis Wright Tremaine in San Francisco who specializes in EMTALA.

The regulation wording requires that signs notifying patients of their rights under EMTALA be placed "conspicuously in any emergency department, or in places likely to be noticed by individuals entering the emergency department." So if the entrance in question is not likely to be used by patients entering the ED, a sign is not strictly necessary at that location, he says. Likewise, if patients are not likely to notice a sign placed in an entrance used by those entering the ED, the sign also is not necessary.

That’s why an EMTALA sign is not required in the entrance used to bring patients in from an ambulance, he notes. A patient strapped to a gurney and needing emergency care is not likely to notice, much less read and appreciate, an EMTALA sign as it whizzes by.

"I think it’s a lot more important that the signs be in the waiting area, and I know that some surveyors want to see them in the treatment rooms as well," Lipton explains.

"EMTALA does not actually say that you need to put a sign up in every [examination] room, but I’ve heard surveyors say that before. Some surveyors take a stricter interpretation of the regs than what they state," he notes.

Also, if your ED has a separate for registration that is away from the common waiting area, the registration area should have an EMTALA sign, he says.

"There’s no harm in putting the signs up anywhere you think they might be necessary," Lipton points outs.

"They’re definitely required where you think patients are coming in and can notice the signs, but you can put one at the back entrance, too, just for your own peace of mind. Show the surveyor that you put one there just for good measure," he adds.


For more information about EMTALA, contact:

  • M. Steven Lipton, JD, Davis Wright Tremaine, Suite 600, One Embarcadero Center, San Francisco, CA 94111-3611. Phone: (415) 276-6500.