[faithfulfrank]

Carla,
As I am still a few weeks away from being a full time Florida resident, I can only answer your question as it pertains to my experience here in NY.

As a patient, YOU have the right to go where you want or to not go at all, as long as you are making a INFORMED decision and are medically capable of making that decision. For instance, if you say had an injury in which it was clear you had an altered mental status, I could not allow you to "sign off" receiving care, as you were not showing that you could think rationally at that point. Before a person can refuse care they must be able to understand the consequences of that decision.

Sometimes it is partially determined by the "busy status" of a hospital.

Sometimes it is simply where your own doctor has staff rights to work.

Sometimes it is up to if you are stable or not. Some protocols say you must be taken to the nearest facility to be stabilized before going to a higher level of care.

Sometimes it is up to what the injury or sickness is. Say you had a severe hand injury......you should go to a hand center if one is close. More importantly, if you showed signs/symptoms of a stroke, you DEFINITELY should be taken to a stroke center. You should insist on that, as it makes all the difference in the world as to your outcome. Like a heart attack where "time is muscle", with a stroke "time is brain".

Most helicopters cannot transport a person who needs CPR, as there is not room to do it. The patient needs to be stabilized first.

Not sure if I answered your question, but I hope I shed a little light on the topic.

Frank