NRS439B.410. Hospital required to provide emergency services and care; unlawful acts of hospital or physician working in hospital emergency room; treating hospital may recover penalty from transferring hospital; exceptions; administrative investigations and sanctions.

      1.  Except as otherwise provided in subsection 4, each hospital in this State has an obligation to provide emergency services and care, including care provided by physicians and nurses, and to admit a patient where appropriate, regardless of the financial status of the patient.

      2.  Except as otherwise provided in subsection 4, it is unlawful for a hospital or a physician working in a hospital emergency room to:

      (a) Refuse to accept or treat a patient in need of emergency services and care; or

      (b) Except when medically necessary in the judgment of the attending physician:

             (1) Transfer a patient to another hospital or health facility unless, as documented in the patient’s records:

                   (I) A determination has been made that the patient is medically fit for transfer;

                   (II) Consent to the transfer has been given by the receiving physician, hospital or health facility;

                   (III) The patient has been provided with an explanation of the need for the transfer; and

                   (IV) Consent to the transfer has been given by the patient or the patient’s legal representative; or

             (2) Provide a patient with orders for testing at another hospital or health facility when the hospital from which the orders are issued is capable of providing that testing.

      3.  A physician, hospital or other health facility which treats a patient as a result of a violation of subsection 2 by a hospital or a physician working in the hospital is entitled to recover from that hospital an amount equal to three times the charges for the treatment provided that was billed by the physician, hospital or other health facility which provided the treatment, plus reasonable attorney’s fees and costs.

      4.  This section does not prohibit the transfer of a patient from one hospital to another:

      (a) When the patient is covered by an insurance policy or other contractual arrangement which provides for payment at the receiving hospital;

      (b) After the county responsible for payment for the care of an indigent patient has exhausted the money which may be appropriated for that purpose pursuant to NRS 428.050, 428.285 and 450.425; or

      (c) When the hospital cannot provide the services needed by the patient.

Ê No transfer may be made pursuant to this subsection until the patient’s condition has been stabilized to a degree that allows the transfer without an additional risk to the patient.

      5.  As used in this section:

      (a) “Emergency services and care” means medical screening, examination and evaluation by a physician or, to the extent permitted by a specific statute, by a person under the supervision of a physician, to determine if an emergency medical condition or active labor exists and, if it does, the care, treatment and surgery by a physician necessary to relieve or eliminate the emergency medical condition or active labor, within the capability of the hospital. As used in this paragraph:

             (1) “Active labor” means, in relation to childbirth, labor that occurs when:

                   (I) There is inadequate time before delivery to transfer the patient safely to another hospital; or

                   (II) A transfer may pose a threat to the health and safety of the patient or the unborn child.

             (2) “Emergency medical condition” means the presence of acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:

                   (I) Placing the health of the patient in serious jeopardy;

                   (II) Serious impairment of bodily functions; or

                   (III) Serious dysfunction of any bodily organ or part.

      (b) “Medically fit” means that the condition of the patient has been sufficiently stabilized so that the patient may be safely transported to another hospital, or is such that, in the determination of the attending physician, the transfer of the patient constitutes an acceptable risk. Such a determination must be based upon the condition of the patient, the expected benefits, if any, to the patient resulting from the transfer and whether the risks to the patient’s health are outweighed by the expected benefits, and must be documented in the patient’s records before the transfer.

      6.  If an allegation of a violation of the provisions of subsection 2 is made against a hospital licensed pursuant to the provisions of chapter 449 of NRS, the Division of Public and Behavioral Health of the Department shall conduct an investigation of the alleged violation. Such a violation, in addition to any criminal penalties that may be imposed, constitutes grounds for the denial, suspension or revocation of such a license, or for the imposition of any sanction prescribed by NRS 449.163.

      7.  If an allegation of a violation of the provisions of subsection 2 is made against:

      (a) A physician licensed to practice medicine pursuant to the provisions of chapter 630 of NRS, the Board of Medical Examiners shall conduct an investigation of the alleged violation. Such a violation, in addition to any criminal penalties that may be imposed, constitutes grounds for initiating disciplinary action or denying licensure pursuant to the provisions of subsection 3 of NRS 630.3065.

      (b) An osteopathic physician licensed to practice osteopathic medicine pursuant to the provisions of chapter 633 of NRS, the State Board of Osteopathic Medicine shall conduct an investigation of the alleged violation. Such a violation, in addition to any criminal penalties that may be imposed, constitutes grounds for initiating disciplinary action pursuant to the provisions of subsection 1 of NRS 633.131.

      (Added to NRS by 1987, 867; A 1989, 1660; 2003, 1178; 2013, 3045)