Some states require that the hospital with which the CSA arranges transfers be within a period of CSA travel. Illinois and Mississippi, for example, indicate 15 minutes, while Oklahoma indicates 20 minutes and Florida 30 minutes. Can a critical access hospital that has placed a patient at a higher level of care return a patient to hospitalization or should it return to swing-bed status? We have a transfer return agreement, but they always came to see us in a rocking bed, and recently the upper hospital wanted to send the patient back, because they wanted to solve the heart problem and send them back as inpatients so that we could deal with the first admission of cellulite. Is that permissible? Supporters of the hospital say they fear that a removal of the requirement could put patients at risk. In emergency situations, when a patient needs to be transferred from a CSA to a hospital, the host hospital must quickly know the details of the moving patient, such as the type of operation performed, the anesthesia used and the problems encountered, Marilyn Litka-Klein, vice president of the Michigan Health Hospital Association, said in a commentary. Hospital industry leaders are urging the CMS to abandon a proposal that would make the need for a written transfer agreement redundant when an outpatient operations centre attempts to transfer a patient to the hospital. “As a result, there may be problems with continuity of care,” Blackmond said in a comment. “Perhaps the revised regulations would reduce the burden on CSA, but it will increase the burden on comprehensive care hospitals and not improve the quality of patient care.” Operational centres continued to insist on the CMS to eliminate the need for a transfer contract. They argued that even if hospitals grant the agreements, they use them to control the centres inappropriately. Most of the concerns I have heard about these elements are that smaller hospitals often receive “transfer back” patients who are able to return to the lower environment just to let them arrive in a condition that exceeds minor hospital capacities and often requires, within hours or days, a new transmission to the higher care facility. Currently, operating centres must have a written transfer contract with a hospital to transfer a patient or ensure that all doctors who perform an operation have privileges at a nearby hospital. In the case of billing, collection and insurance obligations, the peculiarities are usually to protect oneself and each for oneself.
A strong hospital transfer contract should require each party to maintain professional liability insurance or equivalent liability insurance to cover its facilities and staff against claims made during and after the termination of the contract. In addition, each party should be responsible for collecting its own fees for the services provided and should not be held responsible for the collection of services provided by the other party.