Tennessee hospitals must screen pregnant patients with emergency symptoms

A hospital emergency department must provide an appropriate medical screening exam. This applies when a woman says she is pregnant, or appears pregnant if she is unable to speak, and has active labor, symptoms associated with active labor, or a possible emergency medical condition. The exam must be within the emergency department's capabilities and include services routinely available there. The rule applies to conduct on or after July 1, 2026.

If the exam finds an emergency medical condition or active labor, the hospital must provide available stabilizing care or arrange a transfer. These duties apply when the emergency department finds that a woman covered by the screening rule has an emergency medical condition or is in active labor. A condition can qualify as an emergency when it seriously threatens health or bodily functions; during contractions, too little time for a safe transfer before delivery or a transfer that may threaten the woman or unborn child's health or safety also qualifies. An unstable patient may be transferred if she or her authorized representative makes a written request after hearing about the hospital's duties and transfer risks, or if a physician certifies that the expected medical benefits outweigh the risks. If no physician is in the emergency department, a qualified medical professional may sign after consulting a physician, who must later countersign. The transfer must meet federal requirements. A hospital with specialized services and room to treat the woman must accept an appropriate transfer that needs those services. If the woman or her authorized representative refuses offered care or transfer after hearing its risks and benefits, the hospital must take reasonable steps to obtain written informed refusal. The rules apply to conduct on or after July 1, 2026.

Health agencies may investigate violations and impose penalties; hospitals may not punish workers for reporting violations or refusing to authorize certain transfers. Enforcement covers hospitals, satellite emergency departments, and licensed health workers. The protection for reporting violations covers hospital employees; the protection for refusing transfers covers physicians and qualified medical professionals. Hospitals may face a civil penalty of up to $50,000 per violation, or up to $25,000 for a hospital with fewer than 100 beds; only one penalty may apply per patient encounter. A physician who knowingly and willfully violates the law may face a penalty and licensing action. An exception applies when an on-call physician fails to appear and the responsible physician orders a transfer because its benefits outweigh its risks. A physician, qualified medical professional, or hospital employee acting in good faith and using reasonable clinical judgment is not subject to penalties or other adverse action under this section. No penalty or licensing sanction applies to conduct covered by a federal enforcement action, settlement, corrective action plan, or final determination. The law does not authorize abortion unless separate state-law conditions are met. These rules apply to conduct on or after July 1, 2026.