An effective emergency transfer depends on the existence of an established procedure, which is why it is highly recommended to create a written agreement between the CSA and its designated local hospital, even if it is not required by state accreditation rules or bodies. Finally, this emergency policy should include a compensation clause allowing any party to demand a refund from the other party in order to cover any liability, claim, action, loss, cost, damage or cost resulting from any of its acts or omissions in the execution of the agreement. No. 483.70 (d) (1) In accordance with section 1861(l) of the Act, the facility (with the exception of a state-based health care facility located on an Indian reserve) must in fact have a written transfer agreement with one or more hospitals authorized to participate in the Medicare and Medicaid programs, which reasonably guarantees that – (1) a participating hospital with which the SNF has in fact entered into an agreement under the agreement. 483.70 (d) of this chapter on patient transmission and the exchange of medical records; or residents are transferred from the hospital to the hospital and are admitted to the hospital in a timely manner if the transfer is medically appropriate, as defined by the attending physician or, in an emergency, by another physician, in accordance with the institution`s policy and in accordance with national law; and while 43 states require CET accreditation, only 30 require the possibility of obtaining emergency outpatient care. Fifteen of them are asking for a hospital transfer contract. The others require either an agreement or a hospital that grants privileges to CSA surgeons. (See the “State Situations” sidebar.) Transfer agreements must clearly define the respective responsibilities of the CSA and the hospital in a number of areas, including the transmission of patient information; Providing transportation; Sharing services, equipment and staff Providing care for agency setting and capacity; and the confidentiality of patient records. 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. Medical and other information that is necessary for the maintenance and treatment of residents and, if deemed appropriate, to determine whether these residents can receive appropriate services or services in a less restrictive environment than the facility or hospital, is exchanged between providers, including, but not limited to, the information required under paragraph 483.15 c) (2) iii.