Do away with ambulance service

[AGill01]

I work for a small rural hospital based ambulance service. Over a year ago the hospital was having money problems and a bigger hospital came and took over the operations. Now the bigger hospital in charge wants to do away with the ambulance service, the only ambulance service that is based in our county. Don't they realize the impact that will have on the community and on the hospital. I live in a rural area and if they do away with the ambulance the citizens of our county are going to have a 45 - hour wait on another ambulance service from another county and then chances are they are not going to transport to our county hospital they will go back to their county. The bigger hospital says the ambulance service is costing the hospital 100's and thousands of dollars. How can this be when our operating costs are only $30,000/month and we go on a 100 calls or more a month. That doesn't count our AMA's. Ugh it's frustrating. We have board members who are a part of the community who are behind the big hospital getting rid of the ambulance service in our county. There is a board meeting soon and it will not be a pretty one. It's open to the public and I along with others are trying to make the public aware of what is going on. Sorry just had to vent

 

[akflightmedic]

Are you sure your operating costs are only 30K a month or are you neglecting all the hidden costs?

Most employees outside of management or the finance side are clueless about these things as they should be since they are not business people, only medical.

 

[Veneficus]

I work for a small rural hospital based ambulance service. Over a year ago the hospital was having money problems and a bigger hospital came and took over the operations. Now the bigger hospital in charge wants to do away with the ambulance service, the only ambulance service that is based in our county. Don't they realize the impact that will have on the community and on the hospital. I live in a rural area and if they do away with the ambulance the citizens of our county are going to have a 45 - hour wait on another ambulance service from another county and then chances are they are not going to transport to our county hospital they will go back to their county. The bigger hospital says the ambulance service is costing the hospital 100's and thousands of dollars. How can this be when our operating costs are only $30,000/month and we go on a 100 calls or more a month. That doesn't count our AMA's. Ugh it's frustrating. We have board members who are a part of the community who are behind the big hospital getting rid of the ambulance service in our county. There is a board meeting soon and it will not be a pretty one. It's open to the public and I along with others are trying to make the public aware of what is going on. Sorry just had to vent

You thought that a major for profit US hospital chain was going to accept an economic loss of providing ambulance service out of altruism?

This is what the pay to play medical system brings.

If they were really smart about making money, they would close down OB facilities if you have them there too.

It is unfortunate, but the little guy always loses. Not worth going to the board meeting. It is for show. You and others will vent and maybe feel better or that you will convince them, but you won't.

They are in it for the money. People who cannot pay out of pocket or have insurtance that can are worthless sociological parasites to them.

Edit: I cannot imagine operating costs are only 30K a month. That sounds very much on the low side.

 

[RocketMedic]

Well...no offense, but you have very little idea what you are talking about. Your insurance and payroll are almost certainly in excess of 30k/month, and you do not necessarily know what your hospital's reimbursement rate, insurance costs or even company policies are. Given the...overabundance of volunteers, your hospital might be relying on a volunteer agency to step up (bleh, but that's what we get as a profession for letting hobbyists in) or they may be banking on turning a profit by cutting the EMS service and putting the burden on your county or towns to make do. 'Rural' counties still afford police- why should the hospital bleed money to serve its (nonpaying) customers?

Best advice is to figure out who they're talking to to replace the local EMS service and start looking for work.

EDIT: Rural/Metro and AMR salivate over options like this. They can staff and provide services with a truck or two and a skeleton crew of guaranteed personnel at near-minimum wage with gear bought at cut-rate prices from the local (dead) hospital branch. They then turn a profit from a bill that covers all of those plus a profit margin from the county (contracted county EMS) and pad their revenues with collections that they get.

 

[AlphaButch]

With only 100 calls a month, the hospital is definately losing money (and not at a trickle). Like others said, volunteers, private service or a taxpayer subsidized service will step in.

The public input at a board meeting of a private hospital will mean next to nothing, numbers speak more than words sometimes. The public needs to address it through a public solution if it truly wants to ensure the service is provided.

 

[Wheel]

I work for a small rural hospital based ambulance service. Over a year ago the hospital was having money problems and a bigger hospital came and took over the operations. Now the bigger hospital in charge wants to do away with the ambulance service, the only ambulance service that is based in our county. Don't they realize the impact that will have on the community and on the hospital. I live in a rural area and if they do away with the ambulance the citizens of our county are going to have a 45 - hour wait on another ambulance service from another county and then chances are they are not going to transport to our county hospital they will go back to their county. The bigger hospital says the ambulance service is costing the hospital 100's and thousands of dollars. How can this be when our operating costs are only $30,000/month and we go on a 100 calls or more a month. That doesn't count our AMA's. Ugh it's frustrating. We have board members who are a part of the community who are behind the big hospital getting rid of the ambulance service in our county. There is a board meeting soon and it will not be a pretty one. It's open to the public and I along with others are trying to make the public aware of what is going on. Sorry just had to vent

There is a good chance a private company that handles an area close to you will want to take up the operation. The county may have to bid a contract for it.

 

[Christopher]

I work for a small rural hospital based ambulance service. Over a year ago the hospital was having money problems and a bigger hospital came and took over the operations. Now the bigger hospital in charge wants to do away with the ambulance service, the only ambulance service that is based in our county. Don't they realize the impact that will have on the community and on the hospital. I live in a rural area and if they do away with the ambulance the citizens of our county are going to have a 45 - hour wait on another ambulance service from another county and then chances are they are not going to transport to our county hospital they will go back to their county. The bigger hospital says the ambulance service is costing the hospital 100's and thousands of dollars. How can this be when our operating costs are only $30,000/month and we go on a 100 calls or more a month. That doesn't count our AMA's. Ugh it's frustrating. We have board members who are a part of the community who are behind the big hospital getting rid of the ambulance service in our county. There is a board meeting soon and it will not be a pretty one. It's open to the public and I along with others are trying to make the public aware of what is going on. Sorry just had to vent

24x7 ALS transport, 1 unit, call volume of ~2300 EMS calls per year, ~1200 transports.

EMS billing receipts ~$350k/yr

Using our current budget projections for FY11-12, I'll lay out the costs for our ALS service:

Facilities: $68k/yr (half of our current cost, assuming we're not paying for fire)
Salary+benefits of ~$450k/yr (assuming we only are paying to staff the EMS unit and half of command staff, includes training etc, 4 shifts)
Fuel for EMS units: ~$30k/yr
Disposable supplies: ~$12k/yr
Medications: ~$7k/yr
Maintenance: ~$6k/yr

Giving us a rough total of $573k/yr without factoring in the other items generally in a budget.

This puts us $223k/yr in the hole.

 

[WuLabsWuTecH]

You thought that a major for profit US hospital chain was going to accept an economic loss of providing ambulance service out of altruism?

This is what the pay to play medical system brings.

If they were really smart about making money, they would close down OB facilities if you have them there too.

It is unfortunate, but the little guy always loses. Not worth going to the board meeting. It is for show. You and others will vent and maybe feel better or that you will convince them, but you won't.

They are in it for the money. People who cannot pay out of pocket or have insurtance that can are worthless sociological parasites to them.

Edit: I cannot imagine operating costs are only 30K a month. That sounds very much on the low side.

There are some jurisdictions where a zero-bid contract for a private EMS service provider is feasible. Yours does not seem like one of them. Same thing happened to a department we used to run mutual aid with. Because we were closer to some of their district's addresses, we went in as automatic aid with them. Then a few years ago, the county wanted out of the EMS business and got the private hospital to zero-bid the contract. Now, what used to be a 6 station county has gone down to 1 with 2 vehicles. Their response times are crap. Also, they HAVE to transport to the hospital that owns the ambulance service no exceptions. If they need higher level of care, then there is a 3rd vehicle that does the transfer to the big city. We no longer have a mutual aid contract with them, because they wanted it written in the contract that if we were to go into their district to help them, then we either had to wait for one of their units on scene, intercept one of their units, or transport to THEIR hospital. We said "no way!" The result is that what used to be a 5-8 minute response time for us has now turned into a 35 minute response time because of how far away their stations are.

One of the townships down there got it right though--since they are much closer to our station than the hospital's station, they wanted to pass a levy to pay for us to go in as first due on their run card. Unfortunately for them, our board of directors told them that at 200 square miles, our district is full and is not planning on expanding at this time. But that's the right logic to have. Right now, the county is getting its EMS for free and you get what you pay for. If you want better service, then pay up and you can have pretty much whatever level of service you want.

And on the subject of $30k a month to run a department. If it's for a volunteer department, that is more than enough. One of my volunteer departments runs on just over 50k a year...

 

[AGill01]

I want to apologize for my erroneous quote at how much our operating costs are. We are at about 350 - 400 K where in the heck I go 30 k I dk. Again I apologize. But the good news is we are staying in the county. The hospital board voted Monday and a vote 5-1 was the result. Yay. The bad news is some medics have till May 1st to get their paper work in order for Medicare and Medicaid billing.