1. (1) Each REH shall have in effect an agreement with at least one Medicare-certified hospital that is a Level I or Level II trauma center for the referral and transfer of patients requiring emergency medical care beyond the capabilities of the REH. The certified hospital receiving the REH's patients must have a valid and current license from the Board, or from the comparable state agency or licensing body of a bordering state, and be designated by the applicable state as Level I or Level II trauma center or verified by the American College of Surgeons as a Level I or Level II trauma center. An REH may have additional transfer agreements in effect with hospitals which are not designated as a Level I or Level II trauma center, provided that such hospitals are licensed by the Board, or the comparable state agency or licensing body of a bordering state, and such hospitals do not serve as the referring or transfer hospital for patients requiring emergency medical care beyond the capabilities of the REH, for purposes of this rule. The REH shall endeavor to facilitate an agreement with the Medicare­-certified hospital that is a Level I or Level II trauma center that is in the closest proximity to the REH.
2. (2) The REH shall transfer or refer patients when necessary, along with all necessary medical information, to appropriate licensed facilities, agencies, or outpatient services for follow up or ancillary care. In no event shall an REH knowingly refer a patient to an unlicensed health care facility in violation of §22-21-33(b), Code of Ala. 1975.
3. (3) For transportation out of a facility, if a patient is unable to ride in an upright position or if such patient's condition is such that he or she needs observation or treatment by EMS personnel, or if the patient requires transportation on a stretcher, gurney or cot, the facility shall arrange or request transportation services only from providers who are EMS providers licensed by the Board. For the purposes of this rule, an upright position means no more than 20 degrees from vertical. If such patient is being transported to or from a health care facility in another state, transportation services may be arranged with a transport provider licensed as an EMS provider in that state.

Author: Dana H. Billinglsey

Statutory Authority: Code of Ala. 1975, §§22-21-20, et seq.

History: New Rule: Published August 31, 2023; effective October 15, 2023.