Does the Emergency Medical Treatment and Active Labor Act (EMTALA) apply to an urgent care center owned by a hospital but located off the hospital's main campus?

EMTALA Application to Hospital-Owned Off-Campus Urgent Care Centers

EMTALA applies to hospital-owned urgent care centers located off the main hospital campus if patients present requesting examination or treatment for what could be an emergency medical condition. 1

Key Determining Factor: Location and Campus Definition

The critical issue is whether the urgent care facility is considered "on the hospital campus" under EMTALA regulations. The statute's application depends on this geographic determination:

• If the urgent care is on hospital property (within 250 yards of the main hospital building), EMTALA obligations fully apply when patients present requesting care for potential emergency medical conditions 1
• If the urgent care is truly off-campus (beyond 250 yards), EMTALA obligations generally do not apply to that facility itself, even though it is hospital-owned 2, 3

Hospital-Owned Ambulances: Special Consideration

A critical caveat exists for hospital-owned ambulances operating from these facilities:

• Hospital-owned ambulances are subject to EMTALA unless they operate under community-wide EMS protocols that direct transport to hospitals other than the owning hospital 4
• When operating under such community-wide protocols, the Centers for Medicare and Medicaid Services considers the individual to have "come to the emergency department of the hospital to which the individual is transported" rather than the hospital that owns the ambulance 4
• This exemption requires formal community-wide EMS protocols, not just internal hospital policies 4

Practical Implications for Off-Campus Urgent Care

If the urgent care is genuinely off-campus:

• The facility itself does not trigger EMTALA obligations when patients walk in 2, 3
• However, if the facility has hospital-owned ambulances, those ambulances remain subject to EMTALA unless operating under qualifying community-wide protocols 4
• Staff should still provide appropriate medical screening and stabilization as standard of care, even without EMTALA mandate 1

If the urgent care is technically on hospital property:

• Full EMTALA obligations apply: medical screening examination and stabilizing treatment must be provided without regard to ability to pay 1
• On-call physician services must be available within reasonable time 1
• Transfer requirements apply if the patient needs higher level of care 5

Common Pitfall to Avoid

The most significant error is assuming hospital ownership automatically triggers EMTALA regardless of location. The geographic relationship to the main hospital campus is the determining factor, not the ownership structure. 2, 3 Hospitals have attempted to avoid EMTALA obligations by establishing off-campus facilities, and CMS regulations specifically address this by focusing on the campus definition rather than ownership alone 2, 3.