Featured — EMTALA & CAH
Emergency screening, transfer, and Critical Access Hospital staffing. Each check is labelled with the law it quotes: federal, Texas, or both.
- Screening and stabilising — the order What has to happen when someone arrives at a Medicare hospital's emergency department, what may not happen first, and the one sentence in the section that protects an employee who reports it. Federal law · 42 CFR 489.24(a)-(g), 482.55, 409.10(a), 485.618(d)(2) · last verified 2026-09-17
- The transfer itself — three routes, a list of papers, and a name What has to be true before an unstabilized individual is moved: two conditions joined by "and", three routes each producing a different paper, four elements, and a list of records that runs on two clocks — ending with the name and address of a physician who did not come. Federal law · 42 CFR 489.24(e)(1); 42 CFR 489.24(e)(2); 42 CFR 489.24(d)(5); 42 CFR 489.24(j) · last verified 2026-09-17
- The receiving hospital — what it may not refuse, and what it has to report The other end of the transfer: four limits inside one sentence, the definition of capacity that puts qualified staff inside the switch, the two paragraphs that cut against each other, and a reporting duty aimed at the hospital up the road. Federal law · 42 CFR 489.24(f); 42 CFR 489.24(b); 42 CFR 489.24(d)(2)(i); 42 CFR 489.24(e)(2); 42 CFR 489.24(g); 42 CFR 489.20(l); 42 CFR 489.20(m); 42 CFR 412.96 · last verified 2026-09-17
- CAH on-duty coverage — 42 CFR 485.631 Who has to be available, and who has to be on duty, and when each clock runs. Federal law · 42 CFR § 485.631 · last verified 2026-09-17
- Overnight gap — disposition pathways A nurse has said no and someone still has to be there. Every option, and what each one rests on. Federal + Texas law · 42 CFR 485.608(b), 485.616(a), 485.618, 489.24, 485.631; Tex. Health & Safety Code 258.002, 258.004(b) · last verified 2026-09-17
- The paper trail — what the hospital has to keep, post and report The central log, the on-call list and its policies, five years of records for transferred individuals, two postings, and the duty to report a transfer received in an unstable emergency medical condition. Federal law · 42 CFR 489.20(l), (m), (q), (r); 42 CFR 489.24(j); 42 CFR 489.53(b)(2) · last verified 2026-09-17
More checks
- Observation status — what has to be said, by when, and who signs Twenty-four hours triggers it and thirty-six hours caps it. Two items the notice has to contain, an oral explanation with no person named, and two signature paths — one of which tells a staff member exactly what to write. Federal law · 42 CFR 489.20(y); 42 CFR 489.20(w)(1); 42 CFR 409.30(a)(1); 42 CFR 489.53(b)(2) · last verified 2026-09-17
- Inpatient status — who counts Two paragraphs turn on the word inpatient and neither defines it. The one that does defines it for payment. Federal law · 42 CFR §§ 412.3, 485.620, 485.631, 485.638, 485.645; 42 CFR § 409.30; 42 CFR § 489.24(d)(2) · last verified 2026-09-17
- On-call and standby — six texts Defined once in Texas law, banned once as a substitute, and prescribed three times in the federal CAH rules — with a different answer each time. Federal + Texas law · Tex. Health & Safety Code 258.001(3), 258.002, 258.003(c), 258.004(b); 42 CFR 485.608(b), 485.618(d), 485.618(f), 485.631(a)(4)-(a)(5) · last verified 2026-09-17
- Nurse staffing plan — ch. 257 The chapter before chapter 258: what a hospital must plan for, what the committee must look like, and the two numbers that must be given at the start of every shift. Federal + Texas law · Tex. Health & Safety Code 257.001-257.007; 42 CFR 485.635(a)(1), (a)(4), (d); Tex. Health & Safety Code 241.003(5), (7), (15) · last verified 2026-09-17
- Retaliation — ch. 257 and ch. 258 Two anti-retaliation sections that protect different acts, one enforcement bridge shared by both, and the single federal sentence that uses the word the other way. Federal + Texas law · Tex. Health & Safety Code 258.005, 258.006(a), 257.003(a), 257.003(a)(5), 257.004(a), 257.006, 257.007(a), 241.055(a)-(b), 241.056; 42 CFR 485.614(e) · last verified 2026-09-17
- After the report — inspection, confidentiality, publication Who may inspect a hospital and on what basis, whether anyone has to investigate, what stays confidential and from whom, and the two numbers the Texas section gives for publishing the outcome. Federal + Texas law · Tex. Health & Safety Code Sec. 241.051; 42 CFR 489.53 · last verified 2026-09-17
Texas only — Chapter 258 mandatory overtime
These checks quote Texas law and apply only in Texas. Where chapter 258 meets a federal rule, they link to the federal checks above.
- Texas nurse mandatory overtime Can a hospital require it? Ch. 258 definition, prohibition, four exceptions. Texas law · Tex. Health & Safety Code ch. 258 · last verified 2026-09-16
- Chapter 258 complaint — filing and what comes back What HHSC must put in the written decision notice, what stays confidential, and what the chapter never says. Texas law · Tex. Health & Safety Code ch. 258 · last verified 2026-09-17
Sources
Each check quotes from one of these, with the date the text was last verified. Verify against them before relying on anything here.
- 42 CFR 489.24(a)-(g), 482.55, 409.10(a), 485.618(d)(2) The order — screening, stabilising, and the things a hospital may not do before it does them Used by: Screening and stabilising — the order · last verified 2026-09-17
- 42 CFR 489.24(e)(1); 42 CFR 489.24(e)(2); 42 CFR 489.24(d)(5); 42 CFR 489.24(j) The transfer itself — three routes, a list of papers, and the name that travels with them Used by: The transfer itself — three routes, a list of papers, and a name · last verified 2026-09-17
- 42 CFR 489.24(f); 42 CFR 489.24(b); 42 CFR 489.24(d)(2)(i); 42 CFR 489.24(e)(2); 42 CFR 489.24(g); 42 CFR 489.20(l); 42 CFR 489.20(m); 42 CFR 412.96 The receiving hospital — what it may not refuse, and what it has to report Used by: The receiving hospital — what it may not refuse, and what it has to report · last verified 2026-09-17
- 42 CFR § 485.631 Condition of participation: Staffing and staff responsibilities Used by: CAH on-duty coverage — 42 CFR 485.631 · last verified 2026-09-17
- 42 CFR 485.608(b), 485.616(a), 485.618, 489.24, 485.631; Tex. Health & Safety Code 258.002, 258.004(b) Overnight staffing gap — disposition pathways Used by: Overnight gap — disposition pathways · last verified 2026-09-17
- 42 CFR 489.20(l), (m), (q), (r); 42 CFR 489.24(j); 42 CFR 489.53(b)(2) What the hospital has to keep, post, and report — the documentary layer Used by: The paper trail — what the hospital has to keep, post and report · last verified 2026-09-17
- 42 CFR 489.20(y); 42 CFR 489.20(w)(1); 42 CFR 409.30(a)(1); 42 CFR 489.53(b)(2) Observation status — what the hospital has to tell you, when, and who signs Used by: Observation status — what has to be said, by when, and who signs · last verified 2026-09-17
- 42 CFR §§ 412.3, 485.620, 485.631, 485.638, 485.645; 42 CFR § 409.30; 42 CFR § 489.24(d)(2) Who counts as an inpatient Used by: Inpatient status — who counts · last verified 2026-09-17
- Tex. Health & Safety Code 258.001(3), 258.002, 258.003(c), 258.004(b); 42 CFR 485.608(b), 485.618(d), 485.618(f), 485.631(a)(4)-(a)(5) On-call time and standby — six texts, six different things Used by: On-call and standby — six texts · last verified 2026-09-17
- Tex. Health & Safety Code 257.001-257.007; 42 CFR 485.635(a)(1), (a)(4), (d); Tex. Health & Safety Code 241.003(5), (7), (15) Nurse staffing plan — the chapter upstream of chapter 258 Used by: Nurse staffing plan — ch. 257 · last verified 2026-09-17
- Tex. Health & Safety Code 258.005, 258.006(a), 257.003(a), 257.003(a)(5), 257.004(a), 257.006, 257.007(a), 241.055(a)-(b), 241.056; 42 CFR 485.614(e) Retaliation — two chapters that protect different acts, and a federal text that uses the word the other way Used by: Retaliation — ch. 257 and ch. 258 · last verified 2026-09-17
- Tex. Health & Safety Code Sec. 241.051; 42 CFR 489.53 After the report — who may inspect, what stays confidential, and what becomes public Used by: After the report — inspection, confidentiality, publication · last verified 2026-09-17
- Tex. Health & Safety Code ch. 258 MANDATORY OVERTIME FOR NURSES PROHIBITED Used by: Texas nurse mandatory overtime · last verified 2026-09-16
- Tex. Health & Safety Code ch. 258 MANDATORY OVERTIME FOR NURSES PROHIBITED Used by: Chapter 258 complaint — filing and what comes back · last verified 2026-09-17
How these pages are built
- Every rule shown is quoted verbatim from the official source, with a link and the date the text was last verified.
- Where a regulator's reading differs from the statutory text, it is labelled as a regulator reading and kept separate.
- No page states a conclusion about your situation. They state what the law says and which facts you need to confirm.
- Where text has not been captured, the page says so instead of filling the gap.