# Shady Companies In LA City



## MusicMedic (Jul 20, 2010)

Ive been noticing, there are alot of Ambulance Companies Operating Illegally or close to Illegal in Los Angeles City... 

Mainly all of them are IFT companies, i was wondering if the city is going to crack down on them? why dont they do anything? 

im quickly noticing LA City is a really F'ed up place to work if your not in Fire! 

we need reform


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## medic417 (Jul 20, 2010)

Even fire has problems there.  

The local areas will never do anything.  The feds will get a few for medicare/medicaid fraud but that does not really put a stop to any of it.


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## MusicMedic (Jul 20, 2010)

medic417 said:


> Even fire has problems there.
> 
> The local areas will never do anything.  The feds will get a few for medicare/medicaid fraud but that does not really put a stop to any of it.




its sad, because im starting to find out all these IFT companies operate in the same shady way.. 

i wish i could go to a decently reputuable company but its soo impossible right now in CA


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## somePerson (Jul 20, 2010)

go to Care or McCormick


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## MusicMedic (Jul 20, 2010)

somePerson said:


> go to Care or McCormick



Mcormick isnt hiring, and Care takes a few months to get back to you


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## looker (Jul 20, 2010)

MusicMedic said:


> Ive been noticing, there are alot of Ambulance Companies Operating Illegally or close to Illegal in Los Angeles City...
> 
> Mainly all of them are IFT companies, i was wondering if the city is going to crack down on them? why dont they do anything?
> 
> ...



Define illegally as i haven't been noticing it. Also city of L.A. got pain in the *** process of being able to put vehicle in to service unlike any other city/town with exception of la county.


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## looker (Jul 20, 2010)

medic417 said:


> Even fire has problems there.
> 
> The local areas will never do anything.  The feds will get a few for medicare/medicaid fraud but that does not really put a stop to any of it.



I am guessing that is not what he/she is talking about...but will wait till he/she replys


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## somePerson (Jul 20, 2010)

MusicMedic said:


> Mcormick isnt hiring, and Care takes a few months to get back to you




I just went to McCormicks site just for :censored::censored::censored::censored:s and giggles and found out they hire paramedics. Do they use medics for IFTs or do they actually run 911?


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## MusicMedic (Jul 20, 2010)

looker said:


> Define illegally as i haven't been noticing it. Also city of L.A. got pain in the *** process of being able to put vehicle in to service unlike any other city/town with exception of la county.



Missing Stickers, Missing Equipment, Run Down Rigs... 

i dont know how half of the Rigs that are in service at least for our company are able to pass CHP/DOT Certifications...

as well as Medic417 mentioned the Amount of Medi/Medi Fraud... 

it seems like there are quite a few companies in LA City that are run by Foreigners who want a quick buck from Medi/Medi.... and dont really give a damn about how they run the Company (or lack of running)


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## terrible one (Jul 20, 2010)

There medics run both, primary IFT and back up 911. However, don't expect to use your ALS skills on emergency calls, that is LA co FD only. I know two medics who have been written up/let go for just that. 
McCormick only has two ALS cars a day, one in Hawthorne the other in North Hollywood.


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## terrible one (Jul 20, 2010)

MusicMedic welcome to SoCal EMS. If you want to get with any reputable company move out of CA (or atleast LA/OC/SD area)


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## looker (Jul 20, 2010)

MusicMedic said:


> Missing Stickers, Missing Equipment, Run Down Rigs...
> 
> i dont know how half of the Rigs that are in service at least for our company are able to pass CHP/DOT Certifications...
> 
> ...



It takes around 4 month to get approval for existing company to put vehicle in to service and once you get that approval you got 120 days to do it or it expires and you have to start process over. With that being said, driving patient in to LA is not illegal, it's only illegal to pick them up from city of LA. So if all they are doing is dropping them in LA, they are not violating any rules/laws. 

Regarding passing CHP/DOT. Have you looked at what is required for passing CHP? As long as vehicle is in running order that is all that is needed. Equipment beyond basic is not checked or required. 

Medi-cal do not pay much, it's mainly medicare/private insurance company's. We are all for profit so yes we want a quick buck otherwise we would not be in this business. It's the reality of the business.


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## MusicMedic (Jul 21, 2010)

terrible one said:


> MusicMedic welcome to SoCal EMS. If you want to get with any reputable company move out of CA (or atleast LA/OC/SD area)



yeah i wish i could, hopefully once i get my paramedic i can go somewhere reputable

Edit: there are a few reputable companies in Socal: Mccormick, Gerber, Doctors, Care, Hall, Schafer, etc.. 

but everyone and their mom wants to work for them...


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## MusicMedic (Jul 21, 2010)

looker said:


> It takes around 4 month to get approval for existing company to put vehicle in to service and once you get that approval you got 120 days to do it or it expires and you have to start process over. With that being said, driving patient in to LA is not illegal, it's only illegal to pick them up from city of LA. So if all they are doing is dropping them in LA, they are not violating any rules/laws.
> 
> Regarding passing CHP/DOT. Have you looked at what is required for passing CHP? As long as vehicle is in running order that is all that is needed. Equipment beyond basic is not checked or required.
> 
> Medi-cal do not pay much, it's mainly medicare/private insurance company's. We are all for profit so yes we want a quick buck otherwise we would not be in this business. It's the reality of the business.



I know its not illegal to drop off in LA City, but its Illegal to pick them up as you stated, and ive seen a few companies pick up... 

and about the quick buck, Sure All of us here to make a Profit, but when the owner does not care about Supplying the Rigs, Maintenance of the rigs and gurneys, Staffing Morale... Etc etc.. then the company isnt that great... ive heard of quite a few IFT companies skipping out on Equipment/Pay/Etc..... in LA City... Heck i even work for a company that refuses to change our gurneys or even repair them...


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## looker (Jul 21, 2010)

MusicMedic said:


> I know its not illegal to drop off in LA City, but its Illegal to pick them up as you stated, and ive seen a few companies pick up...
> 
> and about the quick buck, Sure All of us here to make a Profit, but when the owner does not care about Supplying the Rigs, Maintenance of the rigs and gurneys, Staffing Morale... Etc etc.. then the company isnt that great... ive heard of quite a few IFT companies skipping out on Equipment/Pay/Etc..... in LA City... Heck i even work for a company that refuses to change our gurneys or even repair them...



If vehicle is not in order report them to CHP, also call ladot and report them. If you need ladot numbers i got no problem giving them to you. The pick up in the city is likely due to 120 days it takes to put vehicle officially in to service. To me that is crazy but it's all about money. Regarding pay, welcome to la over supply of emt why would we have pay more compare to what market says we should?


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## somePerson (Jul 21, 2010)

MusicMedic said:


> yeah i wish i could, hopefully once i get my paramedic i can go somewhere reputable
> 
> Edit: there are a few reputable companies in Socal: Mccormick, Gerber, Doctors, Care, Hall, Schafer, etc..
> 
> but everyone and their mom wants to work for them...



I worked for Medix as an EMT, I thought it was a great company. Rural metro in SD is a fun company to work for as a medic or an emt.


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## MrBrown (Jul 21, 2010)

Keep an eye out for a black dude who drinks from a hip flash, has a bad *** afro and stores a 357 Magnum in the glove compartment .... 

Seriously my buddy used to work for a company in South LA where guys drank on the job.  

Whatever you do mate, stay north of the 10 freeway


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## JPINFV (Jul 21, 2010)

MrBrown said:


> Whatever you do mate, stay *southwest of the 605.*



Fixed that for ya.

/real Californians don't need to be told that a random jumble of numbers is a freeway
//Kinda of misses going N on the 73 to N 55 to N 5 to N 57 to get to work. 
///Yes, that's 3 interchanges of "north bound" to "north bound" traffic.


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## MrBrown (Jul 21, 2010)

JPINFV said:


> Fixed that for ya.
> 
> /real Californians don't need to be told that a random jumble of numbers is a freeway
> //Kinda of misses going N on the 73 to N 55 to N 5 to N 57 to get to work.
> ///Yes, that's 3 interchanges of "north bound" to "north bound" traffic.



See this is why its easier to take a big red and yellow helicopter to get places 

I was told to stay north of the Century Fwy (105) and apparently I hear it was good advice ....


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## terrible one (Jul 21, 2010)

MusicMedic said:


> Edit: there are a few reputable companies in Socal: Mccormick, Gerber, Doctors, Care, Hall, Schafer, etc..



Having worked for a few of them I can tell you there not as great as you think. Better than others sure, but I wouldn't get your hopes to high


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## JPINFV (Jul 21, 2010)

MrBrown said:


> See this is why its easier to take a big red and yellow helicopter to get places
> 
> I was told to stay north of the Century Fwy (105) and apparently I hear it was good advice ....




South of the 605 and you won't, for the most part, be in LA County until you get past the 5 (the one row of cities in that area that is LaCO isn't too bad).


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## Fbarba123 (Jul 21, 2010)

Is AMR in the LA Area? I can't remember, my buddy says he used to work over in the la county, but has since transfered to Ventura County.

I'm glad the BLS Company I work for has most of their ducks in a row. You can't beat fully stocked rigs, and the Stryker PowerPro Hydraulic Gurneys don't hurt either!

AMR in this county drools over them, ahahaha


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## terrible one (Jul 22, 2010)

Fbarba123 said:


> Is AMR in the LA Area? I can't remember, my buddy says he used to work over in the la county, but has since transfered to Ventura County.



They have two out of the 5 zones in LAcounty. Palmdale/Lancaster area and I believe the other is East off the 10 in the inland empire


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## looker (Jul 22, 2010)

Fbarba123 said:


> Is AMR in the LA Area? I can't remember, my buddy says he used to work over in the la county, but has since transfered to Ventura County.
> 
> I'm glad the BLS Company I work for has most of their ducks in a row. You can't beat fully stocked rigs, and the Stryker PowerPro Hydraulic Gurneys don't hurt either!
> 
> AMR in this county drools over them, ahahaha



Believe this or not but majority of EMS company are the all the same. Yes some company do cut corners but majority of them do not as it's not worth the lawsuit when something goes wrong.


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## MDA (Jul 22, 2010)

Man, and to think I almost took a couple job offers in the area. I'm so thankful (and lucky) to have found unemployment in the Central Valley. I honestly couldn't imagine doing IFT's an entire shift, especially under bad company circumstances (whatever they may be).

I'll keep the L.A. area to a day vacation type thing, I think I'm over wanting to live there, haha.


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## Fbarba123 (Jul 22, 2010)

MDA said:


> Man, and to think I almost took a couple job offers in the area. I'm so thankful (and lucky) to have found unemployment in the Central Valley. I honestly couldn't imagine doing IFT's an entire shift, especially under bad company circumstances (whatever they may be).
> 
> I'll keep the L.A. area to a day vacation type thing, I think I'm over wanting to live there, haha.



Right there with ya!


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## medic417 (Jul 22, 2010)

looker said:


> Believe this or not but majority of EMS company are the all the same. Yes some company do cut corners but majority of them do not as it's not worth the lawsuit when something goes wrong.



To be young and idealistic.


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## looker (Jul 22, 2010)

medic417 said:


> To be young and idealistic.



I own an EMS company.


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## medic417 (Jul 22, 2010)

looker said:


> I own an EMS company.



Then perhaps you have blinders on.  h34r:


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## reaper (Jul 22, 2010)

looker said:


> I own an IFT company.



Fixed that for you!


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## looker (Jul 22, 2010)

reaper said:


> Fixed that for you!



Is an IFT not an EMS company?   Yes I own IFT company which is what all others are  I am hopping to be able to get in to 911 in couple of years.


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## MDA (Jul 23, 2010)

I'm lucky, the only IFT/transfer I've had in the last month was critical and from one trauma center to the nearest higher leveled trauma center.

That's the extent of transfers we have to do.


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## MusicMedic (Jul 23, 2010)

MDA said:


> I'm lucky, the only IFT/transfer I've had in the last month was critical and from one trauma center to the nearest higher leveled trauma center.
> 
> That's the extent of transfers we have to do.



Jealousy Ensews,

and looker, im starting to think you own one of those shady IFT companies  

gosh i wish i can get out of LA CO/Orange CO to do EMS, Hall ambulance was hiring but they wanted me to relocate closer to bakersfield (i cant right now)


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## MDA (Jul 23, 2010)

I might go to Hall after Medic school, I grew up in Bakersfield. I live north of there now. 

I don't know though, if you're stationed metro at Hall on a 24 hour car you'll run pretty much near non stop according to my recent refresher instructor who was Management there. Busy is good, but you don't want to burn out fast.


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## terrible one (Jul 23, 2010)

Hall doesn't have 24hr cars in Bakersfield. All 12hr cars in the city, the 24 hr stations are in Arvin, shafter, tehachipi, pine mtn, Lamont, and mohave desert. (sorry for the mispelled cities)


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## jgmedic (Jul 24, 2010)

terrible one said:


> Hall doesn't have 24hr cars in Bakersfield. All 12hr cars in the city, the 24 hr stations are in Arvin, shafter, tehachipi, pine mtn, Lamont, and mohave desert. (sorry for the mispelled cities)



and the 12's are busy as hell, I've run 14 transports on a Sat night in metro. Don't work there anymore though.


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## WolfmanHarris (Jul 24, 2010)

MDA said:


> I'm lucky, the only IFT/transfer I've had in the last month was critical and from one trauma center to the nearest higher leveled trauma center.
> 
> That's the extent of transfers we have to do.



Ya we only do stable IFT's here during certain day time hours, when resources are above a minimum level and as long as coverage can be maintained. The conditions are so restrictive that most facilities just suck it up and call the private stretcher-taxi services. (Stable IFT is a separate industry; a poorly regulated one at that) A transfer could be sent to us and then be held for 24 hours when call volume spikes. The only reason they still ask us to do them, is that we don't bill for services like the privates do.

The only transfers we do regularly are one's that actually require a Paramedic to monitor, not just a bed. Usually these are post PCI Pt.'s getting repatriated to their home hospital.

Of course we still do emerg transfers and CCT with escort team (when the provincial CCT service isn't available), but not too much of the taxi driver duties.


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## looker (Jul 24, 2010)

WolfmanHarris said:


> Ya we only do stable IFT's here during certain day time hours, when resources are above a minimum level and as long as coverage can be maintained. The conditions are so restrictive that most facilities just suck it up and call the private stretcher-taxi services. (Stable IFT is a separate industry; a poorly regulated one at that) A transfer could be sent to us and then be held for 24 hours when call volume spikes. The only reason they still ask us to do them, is that we don't bill for services like the privates do.
> 
> The only transfers we do regularly are one's that actually require a Paramedic to monitor, not just a bed. Usually these are post PCI Pt.'s getting repatriated to their home hospital.
> 
> Of course we still do emerg transfers and CCT with escort team (when the provincial CCT service isn't available), but not too much of the taxi driver duties.



Taxi service? Hahahaha i love the name. In reality it makes no difference to us as we are making plenty of money from doing the taxi transport


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## MusicMedic (Jul 24, 2010)

looker said:


> Taxi service? Hahahaha i love the name. In reality it makes no difference to us as we are making plenty of money from doing the taxi transport





looker im.really starting to be convinced you run one of these shady companies...


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## terrible one (Jul 24, 2010)

looker said:


> Taxi service? Hahahaha i love the name. In reality it makes no difference to us as we are making plenty of money from doing the taxi transport



I bet your employees have a different take on that


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## MrBrown (Jul 24, 2010)

MusicMedic said:


> looker im.really starting to be convinced you run one of these shady companies...



So long as he has some people on staff who don't drink or smoke crack and have a valid DL51 to partner with, a forward thinking medical director who will let me practice at Intensive Care Paramedic level and not have to ring up to fart or stick in a drip I'm OK with it

What, Brown needs to diversify  a little ok


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## looker (Jul 24, 2010)

MusicMedic said:


> looker im.really starting to be convinced you run one of these shady companies...



As long as medicare continues to pay me, I personally do not care what anyone thinks.


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## looker (Jul 24, 2010)

terrible one said:


> I bet your employees have a different take on that



I never asked them and really do not make a difference to me. It can be called taxi, or anything else as long as i am making money that is all i really care about.  I am pretty sure that taxi driver would love to have those red lights on top of the vehicle, i am sure his job would be so much easier


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## somePerson (Jul 25, 2010)

looker said:


> I never asked them and really do not make a difference to me. It can be called taxi, or anything else as long as i am making money that is all i really care about.  I am pretty sure that taxi driver would love to have those red lights on top of the vehicle, i am sure his job would be so much easier



Too bad an IFT company should never use those red lights, either it's just another BS taxi transport or ALS should be called for a serious patient.


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## looker (Jul 25, 2010)

somePerson said:


> Too bad an IFT company should never use those red lights, either it's just another BS taxi transport or ALS should be called for a serious patient.



If you pick up a patient and his condition become unstable you need to rush that person to the hospital. What do you suggest BLS ambulance do, call 911?  Red lights use is directly up to EMT and him/her only. In some city IFT responds to emergency to nursing homes with whom they have a contract. No need to call 911 when IFT can respond code 3.


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## somePerson (Jul 25, 2010)

looker said:


> If you pick up a patient and his condition become unstable you need to rush that person to the hospital. What do you suggest BLS ambulance do, call 911?  Red lights use is directly up to EMT and him/her only. In some city IFT responds to emergency to nursing homes with whom they have a contract. No need to call 911 when IFT can respond code 3.



I forgot, my bad. BLS rigs that run IFT's all day can handle everything, there is no reason to call for ALS when the patient needs it, wouldn't want that CHFER to get some ALS treatment cause the :censored::censored::censored::censored:y SNIF decided to call a shady ift company to not get audited.

I


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## JPINFV (Jul 25, 2010)

somePerson said:


> I forgot, my bad. BLS rigs that run IFT's all day can handle everything, there is no reason to call for ALS when the patient needs it, wouldn't want that CHFER to get some ALS treatment cause the :censored::censored::censored::censored:y SNIF decided to call a shady ift company to not get audited.



Without knowing where Looker's company is at, depending on the location, the situation is a little more nuanced than that. There's a big difference between deciding which patients gets a paramedic first response in a system with IFT ALS resources and where the choice is IFT BLS and 911 ALS. Some things that end up going BLS should never have been dispatched BLS, but should 911 be called every time a patient have abnormal electrolyte levels, regardless of how out of range it is? How about that patient with a history of seizures who had a seizure in the morning and is now being transported for evaluation 5 hours after the seizure and the patient is back to his normal state of being?


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## WolfmanHarris (Jul 26, 2010)

looker said:


> If you pick up a patient and his condition become unstable you need to rush that person to the hospital. What do you suggest BLS ambulance do, call 911?  Red lights use is directly up to EMT and him/her only. In some city IFT responds to emergency to nursing homes with whom they have a contract. No need to call 911 when IFT can respond code 3.



Funny little quirks of various systems, but in Ontario, yes. IFT vehicles are not Ambulances under the law (even though retired Ambulances are the most popular vehicle choice for IFT companies) and are not able to display emerg lights, sound a siren or any of that Ambulance stuff EMS does. They must pull over and call 911. Nursing homes, MD offices, even hospital here cannot contact an IFT company for an emerg call. If the transfer is a stat, it must go through EMS or ORNGE (the provincial critical care/air ambulance service).


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## looker (Jul 26, 2010)

WolfmanHarris said:


> Funny little quirks of various systems, but in Ontario, yes. IFT vehicles are not Ambulances under the law (even though retired Ambulances are the most popular vehicle choice for IFT companies) and are not able to display emerg lights, sound a siren or any of that Ambulance stuff EMS does. They must pull over and call 911. Nursing homes, MD offices, even hospital here cannot contact an IFT company for an emerg call. If the transfer is a stat, it must go through EMS or ORNGE (the provincial critical care/air ambulance service).



What you talking about is called non-emergency medical transportation vehicles. They do not have emergency lights and generally are not staffed by an emt. Instead the requirement is that driver be first aid/cpr certified. During emergency the driver is required to dial 911. 

Being that IFT company bls units are staffed by 2 emt's there is no reason why they should not be able to handle emergency runs. Understand that many IFT's company have 911 contract with local city's.


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## somePerson (Jul 26, 2010)

looker said:


> Being that IFT company bls units are staffed by 2 emt's there is no reason why they should not be able to handle emergency runs. Understand that many IFT's company have 911 contract with local city's.



Good IFT companys have 911 contracts with local cities to provide transport supervised by an ALS authority (usually an FD). The als first responder determine if the patient can be transported BLS or ALS.

It's the crappy companies that are encouraged to never call for ALS by their employer, even if the patient can benefit from ALS care. They wouldn't want to have an ALS unit take money away from them for the transport, god forbid you give up money for the sake of patient care.


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## looker (Jul 26, 2010)

somePerson said:


> Good IFT companys have 911 contracts with local cities to provide transport supervised by an ALS authority (usually an FD). The als first responder determine if the patient can be transported BLS or ALS.
> 
> It's the crappy companies that are encouraged to never call for ALS by their employer, even if the patient can benefit from ALS care. They wouldn't want to have an ALS unit take money away from them for the transport, god forbid you give up money for the sake of patient care.



If BLS unit determine that it's quicker to transport patient to ER compare to waiting for ALS unit, i got no problem with unit transporting pt to the hospital. Unit on scene always the ones that make the call if ALS should be called or not. 

If you think I would like the unit to play with patient care you are out of your mind. I currently have 5 million auto insurance, 3 million liability insurance and also 3 million umbrella. I am paying out of my *** already for insurance, i have no desire to have claim to happen and have my insurance double.


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## MDA (Jul 26, 2010)

looker said:


> If BLS unit determine that it's quicker to transport patient to ER compare to waiting for ALS unit, i got no problem with unit transporting pt to the hospital. Unit on scene always the ones that make the call if ALS should be called or not.
> 
> If you think I would like the unit to play with patient care you are out of your mind. I currently have 5 million auto insurance, 3 million liability insurance and also 3 million umbrella. I am paying out of my *** already for insurance, i have no desire to have claim to happen and have my insurance double.



I'm guessing that's your coverage limits, not your premium.


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## JPINFV (Jul 26, 2010)

Sigh.

This is why every system should have a policy like Riverside County, CA has. Especially in systems where access to IFT ALS is limited. 

http://www.rivcoems.org/downloads/downloads_memos/2009/BLS_Ambulance_Usage_Guidelines.pdf


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## looker (Jul 26, 2010)

MDA said:


> I'm guessing that's your coverage limits, not your premium.



Yes  sorry if i didn't make that clear.


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## MusicMedic (Jul 26, 2010)

JPINFV said:


> Sigh.
> 
> This is why every system should have a policy like Riverside County, CA has. Especially in systems where access to IFT ALS is limited.
> 
> http://www.rivcoems.org/downloads/downloads_memos/2009/BLS_Ambulance_Usage_Guidelines.pdf



Wow, i wish LA County/City had that policy... then our Dispatchers wouldnt be sending us into Blind ER calls...


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## Sassafras (Jul 26, 2010)

somePerson said:


> I forgot, my bad. BLS rigs that run IFT's all day can handle everything, there is no reason to call for ALS when the patient needs it, wouldn't want that CHFER to get some ALS treatment cause the :censored::censored::censored::censored:y SNIF decided to call a shady ift company to not get audited.
> 
> I



If I need als during an ift I'm calling my boss. Our company has als providers and at least one is at the station most of the time. We also have per diem medics for scheduled transports of certain patient types. But since I'm new there and haven't done als calls there yet I do not know what makes them need a medic vs and emt for certain transports.


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## WolfmanHarris (Jul 26, 2010)

looker said:


> What you talking about is called non-emergency medical transportation vehicles. They do not have emergency lights and generally are not staffed by an emt. Instead the requirement is that driver be first aid/cpr certified. During emergency the driver is required to dial 911.
> 
> Being that IFT company bls units are staffed by 2 emt's there is no reason why they should not be able to handle emergency runs. Understand that many IFT's company have 911 contract with local city's.



I know what I'm talking about. Stable IFT's are primarily done that way here. They're staffed by FR or EMR trained staff, and looking at the EMT-B curriculum, is nearly equivalent staffing levels vs. PCP.

As for there being no reason for EMT-B's being equipped to handle emergency runs, I'll leave that be. It's been covered in many threads on education over the years.

I understand how the system works in the US. I was just providing contrast with our system where every area has a single EMS provider, and IFT is a separate industry.


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## looker (Jul 26, 2010)

WolfmanHarris said:


> I know what I'm talking about. Stable IFT's are primarily done that way here. They're staffed by FR or EMR trained staff, and looking at the EMT-B curriculum, is nearly equivalent staffing levels vs. PCP.
> 
> As for there being no reason for EMT-B's being equipped to handle emergency runs, I'll leave that be. It's been covered in many threads on education over the years.
> 
> I understand how the system works in the US. I was just providing contrast with our system where every area has a single EMS provider, and IFT is a separate industry.



The primary reason why EMS does IFT is because of insurance reasons. Medi-care(fed gov insurance) do not cover NEMT. They only cover EMS. Medi-cal(state health insurance) does cover NEMT but they pay crap and not everyone have it.


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## jgmedic (Jul 26, 2010)

JPINFV said:


> Sigh.
> 
> This is why every system should have a policy like Riverside County, CA has. Especially in systems where access to IFT ALS is limited.
> 
> http://www.rivcoems.org/downloads/downloads_memos/2009/BLS_Ambulance_Usage_Guidelines.pdf



Yes this a good policy, esp. after certain BLS companies whose employees only take visual vitals have brought in critical patients with no interventions. However, in the city where I work, there is a con home in the parking lot of the local ED. On the one hand it is not a STEMI center, but the time it takes for one of our ALS units to respond, assess and txp, the patient could already be in the ED. On a side note, if the BLS unit is unsure, med control anyone? There has been some argument in RivCo regarding BLS ambos contacting for destination.


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## JPINFV (Jul 26, 2010)

jgmedic said:


> Yes this a good policy, esp. after certain BLS companies whose employees only take visual vitals have brought in critical patients with no interventions. However, in the city where I work, there is a con home in the parking lot of the local ED. On the one hand it is not a STEMI center, but the time it takes for one of our ALS units to respond, assess and txp, the patient could already be in the ED.


The problem is that, if paramedic resources are readily available via the 911 system, there's absolutely zero reason for an IFT BLS unit to be dispatched to a chest pain call. A unit has to be dispatched before they can mess up an assessment. So, it isn't just about visual vitals. I would love to hear the reason why IFT BLS is more appropriate than 911 ALS when the dispatch complaint is, for example, "BP 80/50." Yes, I've been on that call and there's no justification I can think of for a BLS unit to be dispatched on that, or any of the other resp emergencies at SNFs that BLS IFT units are routinely sent to in So. California.  




> On a side note, if the BLS unit is unsure, med control anyone? There has been some argument in RivCo regarding BLS ambos contacting for destination.


What about, say, Orange County, where BLS units do not have access to online medical control?


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## jgmedic (Jul 26, 2010)

JPINFV said:


> The problem is that, if paramedic resources are readily available via the 911 system, there's absolutely zero reason for an IFT BLS unit to be dispatched to a chest pain call. A unit has to be dispatched before they can mess up an assessment. So, it isn't just about visual vitals. I would love to hear the reason why IFT BLS is more appropriate than 911 ALS when the dispatch complaint is, for example, "BP 80/50." Yes, I've been on that call and there's no justification I can think of for a BLS unit to be dispatched on that, or any of the other resp emergencies at SNFs that BLS IFT units are routinely sent to in So. California.
> 
> 
> 
> What about, say, Orange County, where BLS units do not have access to online medical control?



I agree 100% on the 1st part, but SNF's often contact ambo dispatch 1st right? If they call us (AMR), one, in my division it'll be ALS most likely because we only have 2 BLS units, and our dispatch will usually send ALS for anything remotely questionable, but then I know SNF's that will call BLS ambulances for anything, and then the BLS dispatchers who will just send a unit anyway. The OC is a terrible example of an EMS system, where if you upgrade, you are usually just ridiculed by the FD medics for thinking it was an ALS call, and the mgmt who tells their units, just take the patient.


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## JPINFV (Jul 26, 2010)

The 2 years I worked in OC I never really had a problem with either management or the fire department. It's amazing what being a little diplomatic can do, which was a skill missing from a lot of my coworkers. 

As far as dispatching units, the company I used to work for had a detachment running out of Hemet and the dispatchers were well aware of the Riverside protocol and constatly had to turn down calls in Riverside. Unfortunately for the patients, that policy wasn't applied to OC where the bulk of the company was located at. 

Also, OC is a perfect example of how not to organize an emergency medical system.


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## jgmedic (Jul 26, 2010)

JPINFV said:


> The 2 years I worked in OC I never really had a problem with either management or the fire department. It's amazing what being a little diplomatic can do, which was a skill missing from a lot of my coworkers.
> 
> As far as dispatching units, the company I used to work for had a detachment running out of Hemet and the dispatchers were well aware of the Riverside protocol and constatly had to turn down calls in Riverside. Unfortunately for the patients, that policy wasn't applied to OC where the bulk of the company was located at.
> 
> Also, OC is a perfect example of how not to organize an emergency medical system.



You worked for Lynch, right? diplomacy is all well and good, and I didn't get treated poorly all the time, but certain fire crews would always look annoyed when we would call them out as an upgrade, e.g. had a pt with a BP of 200/120 with rales and CHF hx with mild SOB, when the ANA engine came, they took a BP, said "ok so it's high, take her to the hospital" and left(just one example of a common situation). . When I worked at Care. never had problems with management, but as a medic have been at the hospital and seen these crews bring people in and say "well, I called the sup and he said just take them."


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## JPINFV (Jul 26, 2010)

jgmedic said:


> You worked for Lynch, right?


Yep.


> diplomacy is all well and good, and I didn't get treated poorly all the time, but certain fire crews would always look annoyed when we would call them out as an upgrade, e.g. had a pt with a BP of 200/120 with rales and CHF hx with mild SOB, when the ANA engine came, they took a BP, said "ok so it's high, take her to the hospital" and left(just one example of a common situation). . When I worked at Care. never had problems with management, but as a medic have been at the hospital and seen these crews bring people in and say "well, I called the sup and he said just take them."



I've, thankfully, never had a fire crew clear a patient for BLS after I've requested them. I'm not 100% sure how I'd handle it if they did since most of the time if I called the patient was already on deaths door. However that's why I've always found the patients who were in the middle of "stable" and "circling the drain" to be the most interesting. Resp. failure? Haul to the ER or call 911. Not much to it at the BLS level. Take the patient who's RR is, say, 30, cough, etc. Not necessarily as clear cut of a choice now. I also didn't call when the emergency room was just down the street, which ended with more complaints from the ED nurses than from the fire fighters (No, Miss RN. I'm not going to call 911 for the chest pain patient who's at the SNF in the cul-de-sac behind the hospital with the 30 second transport time from the SNF to the ED.). I also didn't consult the crew chief or dispatchers on whether to call 911 or not. They aren't there, how could they make any determination.

Of course on the list of things that I could care less of than disturbing a fire crew is pretty damn small as, unlike a lot of EMTs in So Cal, I was never looking to become a fire fighter.


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## somePerson (Jul 27, 2010)

JPINFV said:


> Also, OC is a perfect example of how not to organize an emergency medical system.



I worked for Medix in the OC, ems system sucks here. Also, the "nurses" that call from board and cares or SNFs always give the wrong information to get away with a BLS transport because every 911 call gets investigated.

Had a "back pain" BLS urgent that ended up being a lady completely unconcious, no bp, barely palpable carotid pulse.


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## mfelton (Aug 9, 2010)

Gerber Ambulance has the best of both worlds........ If there is such a thing:glare:


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## alf5118 (Oct 6, 2010)

Royalty Ambulance is being operated by Armenians and are doing Medicare?Medicaid fraud.
dont work for them,
Rig #3 has no air conditioning and missing the rear left hub cap, it over heats and they syill use it to run calls


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## MusicMedic (Oct 6, 2010)

alf5118 said:


> Royalty Ambulance is being operated by Armenians and are doing Medicare?Medicaid fraud.
> dont work for them,
> Rig #3 has no air conditioning and missing the rear left hub cap, it over heats and they syill use it to run calls



and they have purple patches

there are three rigs at my company which the A/C wasnt working, (had to switch it out on a hot *** day)

on friday i had to switch out two rigs in one day because there was something wrong with both of them... 

I hate IFT Companies in La City/County with a great passion


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## looker (Oct 6, 2010)

alf5118 said:


> Royalty Ambulance is being operated by Armenians and are doing Medicare?Medicaid fraud.
> dont work for them,
> Rig #3 has no air conditioning and missing the rear left hub cap, it over heats and they syill use it to run calls



No working air condition...ye that is a crime :lol: Also missing rear left hub cap, omg that totally going to kill the car:lol: 

How are they defrauding medicare/medicaid? Are they creating runs that never happened, write  reports on them and fake emt signature on the report? A bit more details would be nice.


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## looker (Oct 6, 2010)

MusicMedic said:


> and they have purple patches
> 
> there are three rigs at my company which the A/C wasnt working, (had to switch it out on a hot *** day)
> 
> ...



You're welcome to find another job. Seriously what is wrong with IFT compare to 911 company being that 911 company still does IFT. So do yo hate all ambulance companys? If the a/c do not work on regular bases and there are a lot of problem with vehicles than maybe it' s time to look for another company to work for.


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## MusicMedic (Oct 6, 2010)

looker said:


> You're welcome to find another job. Seriously what is wrong with IFT compare to 911 company being that 911 company still does IFT. So do yo hate all ambulance companys? If the a/c do not work on regular bases and there are a lot of problem with vehicles than maybe it' s time to look for another company to work for.



Well i already just got another job,
and i dont hate ALL ambulance companies, just the ones who dont give a damn about their employees and equipment 


but with flood or EMT's in the market, alot of us are stuck at these shady companies for Paychecks and Ambulance time for Medic school...
lemme tell you, if there was a shortage of EMT's NONE of these shady companies would be open, including yours!

and looker, try working in the back of a rig on a hot day with out A/c, it can easily get to temperatures to about 105+, its like working inside a sauna


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## looker (Oct 6, 2010)

MusicMedic said:


> Well i already just got another job,
> and i dont hate ALL ambulance companies, just the ones who dont give a damn about their employees and equipment
> 
> 
> ...



Its called supply and demand. If there was shortage of emts the pay would be much higher. However as you know that is unlikely to happen anytime soon. So Ift's got nothing worry about. As for my company, all vehicles are in working order. As long as i am told there is a problem it gets fixed. It's the time when no one say anything that is the problem.


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## looker (Oct 7, 2010)

btw MusicMedic i am still trying to figure out definition of shady ambulance company. Is is those company that have bad equipment or does it have to do with low pay while they are making a lot of money or both?


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## MusicMedic (Oct 7, 2010)

looker said:


> btw MusicMedic i am still trying to figure out definition of shady ambulance company. Is is those company that have bad equipment or does it have to do with low pay while they are making a lot of money or both?


Shady Ambulance Company=

a company that makes some sort of profit but does not show it in the quality of the company

a company that endulges in shady business practices Such as (but not limited to): Taking patients who can be transported in Wheelchair vans in an ambulance, marking patients as non ambulatory when they actually are. using rigs that shouldnt be on the road, not properly maintaining rigs. forging signatures of Nurses

Examples of those Companies: GCTI Inc., Elite Ambulance, ProCare, ProMed, Ambuline ambulance, Shoreline(they are in OC, but they operate in LA City), Ambuserve, Royalty Ambulance, Enova, Gentle Care Ambulance, Gentle Ride Ambulance, Medi-star Transport, AMT, Aegeis, Mauran,  etc etc..


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## looker (Oct 7, 2010)

MusicMedic said:


> Shady Ambulance Company=
> 
> a company that makes some sort of profit but does not show it in the quality of the company
> 
> ...



So basically all IFT company are shady in your view. Even those company's that are certified(ambuserve). A nurse orders an ambulance transport, it's not the decision of the ambulance company. If the patient is in bed when you come to pick them up and you're told they can't get up guess what they are non ambulatory. If the company using ambulances that should not be on the road because something mechanically wrong with them call ladot or chp or both. Forging signatures of nurses is fraud and should be reported to medicare. 

I am sure you would include impulse ambulance, dependable care ambulance also in your list.

btw , GTIC is Gentel care ambulance, inc.

edit:Are the only non shady company in your opinion are in that case AMR, McCormick, Gerber ambulance?


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## medic417 (Oct 7, 2010)

looker said:


> A nurse orders an ambulance transport, it's not the decision of the ambulance company. If the patient is in bed when you come to pick them up and you're told they can't get up guess what they are non ambulatory.



Wrong.  That is fraud.  You still need to assess the patient and if you find different than what the doctor put on the necessity form you need to document the difference.  You might put per DR X patient bed confined per observation patient got up walked to closet got dressed then set down own cot and wheeled to ambulance.  If you find differences often from same doctor you have responsibility to report the doctor for possible fraud.  

If you require your employees to use the Dr form as their findings you are making your employees commit fraud.  If you have a list of things to not say and things that must be said you may be causing employees to commit fraud.  

I am sure you know the above but you did not communicate it that way in your post.


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## TransportJockey (Oct 7, 2010)

I have to ask cause I'm a little confused. The way you say private company is as if there are no private 911 companies. It seems every time you say 'private company' it's implied that it has to be IFT. Is that about right for your area?


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## looker (Oct 7, 2010)

jtpaintball70 said:


> I have to ask cause I'm a little confused. The way you say private company is as if there are no private 911 companies. It seems every time you say 'private company' it's implied that it has to be IFT. Is that about right for your area?



When OP and other says private company they talking about those company that do not do 911 calls or are only have 911 back up provider contract. We do have private companys such as AMR and others that do both 911 and IFT.

We have a lot of IFT only companys and mainly why most complain about them is because they do not pay much(we have excess of emt).


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## looker (Oct 7, 2010)

medic417 said:


> Wrong.  That is fraud.  You still need to assess the patient and if you find different than what the doctor put on the necessity form you need to document the difference.  You might put per DR X patient bed confined per observation patient got up walked to closet got dressed then set down own cot and wheeled to ambulance.  If you find differences often from same doctor you have responsibility to report the doctor for possible fraud.
> 
> If you require your employees to use the Dr form as their findings you are making your employees commit fraud.  If you have a list of things to not say and things that must be said you may be causing employees to commit fraud.
> 
> I am sure you know the above but you did not communicate it that way in your post.



True you do still need to assess a patient no way around that. With that being said, there many reason why someone that can get up and dress them self still can and will be transported by ambulance.


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## medic417 (Oct 7, 2010)

looker said:


> True you do still need to assess a patient no way around that. With that being said, there many reason why someone that can get up and dress them self still can and will be transported by ambulance.



Yes but it does not meet the bed confined standard being discussed at that point, so if you say bed confined because that is what the doctor put on the paperwork you have committed fraud if you do not state your findings that were different.


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## looker (Oct 7, 2010)

medic417 said:


> Yes but it does not meet the bed confined standard being discussed at that point, so if you say bed confined because that is what the doctor put on the paperwork you have committed fraud if you do not state your findings that were different.



True, no argument about that....everything *must be documented.*


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## eypeon (Jul 3, 2011)

MusicMedic said:


> Shady Ambulance Company=
> 
> a company that makes some sort of profit but does not show it in the quality of the company
> 
> ...



You forgot about West Coast Ambulance, the shadiest of them all!


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## fafinaf (Jul 30, 2011)

terrible one said:


> MusicMedic welcome to SoCal EMS. If you want to get with any reputable company move out of CA (or atleast LA/OC/SD area)



or work with CARE Ambulance. They are legit and well respected.


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## justforfun1795 (Aug 15, 2011)

Just cause someone tells you to do something, does not mean you should do it.  If the call is shady, just say no!


I worked for Care years ago, and while with them, I was never once sent to a call as a BLS IFT that had any remote possibility of needing ALS.  I assume part of that was because Care had 911 contracts, so they had a lot to lose if they got auditing and that they got many 911 in their jurisdiction anyway.  

I've also worked, for a very short time, for an IFT only, BLS company in LA (County first then later they got LA City DOT permit). That company pulled many "shady" acts.  It wasn't that the owners didn't care, it was that they cared more about money and the consequences to them were nill.  County did not care and they could always just blame the EMTs. 

I was repeatedly sent to calls that were illegal for me to have taken, so quess what I DID NOT TRANSPORT!  When I arrived on scene and the chief complain was chest pain. I told the nurse at the snf she HAD to call 911 PER LA COUNTY POLICY (that's the policy I was taught anyway).  When I was told to PICK-up a patient but that location was Los Robles hospital, I knew that was Ventura County and that Ventura EMS REQUIRED ambulance to be licensed in Ventura and EMT's running in Ventura to have County cards, so I REFUSED THE CALL!  The onus is on me in these case to know better.  If I had taken these calls, I would be just as guilty as the company.   I refused a couple more cardiac patients, demanding 911 ALS.  Every time, I was backed up by Fire when they arrived on scene who told the snf nurse we (BLF IFT) are not allowed to take a chest pain patient.  

If your boss tells you to mark every patient as non-ambulatory, but you do not agree, then DO NOT mark it! 

I was never mean to the nurse or my boss, I politely and quickly explain the situation and what needed to be done.  The nurse and my company always argued with me, but I stood my ground.  

Any EMT that participates in these shady calls are at fault too!  Don't think these companies would not hang you out to dry if they ever did get in hot water.  It is your job to assess the patient.  Your supervisor will claim they were not on scene, so how could they really know what was going on. The nurse is likely to also claim that you should know what patients you can take, not her.  Don't expect that "my boss told me to do it" is going to stand up in court!  Your certification is proof that you know better.  

If you are sent to a call you know you shouldn't be taking, then DON'T TAKE THE PATIENT.  Use your personal cell phone to call 911 if the nurse will not! And do not leave until 911 gets there to take over!

Do not allow these companies to do this.  Do not allow yourself to be just as shady as these companies you condemn.   If every EMT grew a backbone and learned to just say no, this would not be a problem.  

Remember, the EMT takes ALL THE RISK (you are responsible for assessment and determination of additional resources, ie ALS and rapid transport=911) and the company gets ALL THE MONEY.


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## JPINFV (Aug 15, 2011)

justforfun1795 said:


> I was repeatedly sent to calls that were illegal for me to have taken, so quess what I DID NOT TRANSPORT!  When I arrived on scene and the chief complain was chest pain. I told the nurse at the snf she HAD to call 911 PER LA COUNTY POLICY (that's the policy I was taught anyway).



Yes. It is against protocol for an IFT unit to be dispatched to a 911 call (Principal 1). That's where the righteous indignation over protocol ends, though (and trust me, I know a thing or two about righteous indignation). However, when a patient is suffering from a medical emergency, and in your good judgement, the patient is better off being transported BLS rather than waiting for paramedics (based off of ETA of paramedics and estimated transport time), then protocol dictates transport (Principal 7). 

As an EMT and not a dispatcher, I can not imagine any way you can violate the protocol dictating IFT units not being dispatched to 911 calls. It's simply not your responsibility. In contrast, I can't see how, "Well, they should have called 911 in the first place, so we're going to sit on scene for 7 minutes waiting for paramedics instead of transporting to the hospital 5 minutes away" is showing "good clinical judgement" required under the transport protocol. 

When I was told to PICK-up a patient but that location was Los Robles hospital, I knew that was Ventura County and that Ventura EMS REQUIRED ambulance to be licensed in Ventura and EMT's running in Ventura to have County cards, so I REFUSED THE CALL!  The onus is on me in these case to know better.  If I had taken these calls, I would be just as guilty as the company.   I refused a couple more cardiac patients, demanding 911 ALS.  Every time, I was backed up by Fire when they arrived on scene who told the snf nurse we (BLF IFT) are not allowed to take a chest pain patient.

Finally, if you want to play the righteous indignation game (nothing wrong with being a gad fly), have your ducks in a row. All of LACo's protocols are online. Go off of them and not what some random person says (and don't go off what I say, go off of what I -linked.-) 




> If you are sent to a call you know you shouldn't be taking, then DON'T TAKE THE PATIENT.  Use your personal cell phone to call 911 if the nurse will not! And do not leave until 911 gets there to take over!


It's not that simple, and to claim it's that simple completely moves you off of any high ground you have. You treat the patient in front of you, regardless of how much of a mistake the dispatch office made in accepting and dispatching that call.


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## thegreypilgrim (Aug 15, 2011)

Every last one of them (and yes, I work for one) should have their licenses revoked, be subjected to a scornful investigation from LADHS, USHHS, and possibly even the LA County District Attorney's Office. Beyond that legislation should be passed prohibiting such organizations from incorporating unless they are operated on a not-for-profit basis or as some other highly regulated public utility.

They're a bottom-feeding, blood-sucking scourge upon the earth barely above the status of a racketeering syndicate. And as evinced by our resident poster, looker, they are bereft of even a modicum of professional ethics or scrupulous business practices. It's a deplorable situation that should not be permitted to continue to exist.


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## justforfun1795 (Aug 15, 2011)

JPINFV said:


> It's not that simple, and to claim it's that simple completely moves you off of any high ground you have. You treat the patient in front of you, regardless of how much of a mistake the dispatch office made in accepting and dispatching that call.



Yes it that simple!  Two wrongs do not make a right.  Just cause dispatch sent you to a call does not make it right or legal.  If ALS is needed, don't just go, "well dispatch sent me, I just take them anyway"  That's wrong and it really is that simple!  

 It's rare that an EMT ETA to hospital is less that fire's arrival time. And this certain was not the case in my experience. People are citing it like it is the get out of jail free card that applies every time!  It is very rare that is the case, especially in LA city!  Maybe in a rural area where Fire is an hour away, but we are talking about LA here.  The LA 911 system is designed that response is 10 minutes or less from when DISPATCH gets the call.

You are clearly just trying to justify your own shady behavior and no one is buying it, hence why that vast majority of people here think of companies as shady!  

I'm sure many have stood up to them, but too many others are all talk and no action.


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## JPINFV (Aug 15, 2011)

justforfun1795 said:


> Yes it that simple!  Two wrongs do not make a right.  Just cause dispatch sent you to a call does not make it right or legal.  If ALS is needed, don't just go, "well dispatch sent me, I just take them anyway"  That's wrong and it really is that simple!
> 
> It's rare that an EMT ETA to hospital is less that fire's arrival time. And this certain was not the case in my experience. People are citing it like it is the get out of jail free card that applies every time!  It is very rare that is the case, especially in LA city!  Maybe in a rural area where Fire is an hour away, but we are talking about LA here.  The LA 911 system is designed that response is 10 minutes or less from when DISPATCH gets the call.


Does it apply every time? No. Does it apply often? Yes. Yea, the response time is short, but how long is your average transport time to the closest facility? While I'm more familiar with Orange County than LA County, both have a rather high number of emergency departments for geographical area. For a lot of LA County, you aren't going to be too terribly far from a hospital.  




> *You are *clearly just trying to justify your own shady behavior and no one is buying it, hence why that vast majority of people here think of companies as shady!


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## justforfun1795 (Aug 15, 2011)

LA county scope of practice for EMT does clearly list scenarios that require ALS and rapid transport, which is NOT BLS IFT!  See if for yourself.  LA does have very clear protocols, but very few bother to read them thoroughly.  

Go to the county website and read everything carefully that is part of the prehospital care policy manual.  It explains how if BLS arrives before ALS, then ALS must NOT be canceled and if ALS has not been request it must be.   Contacting them is the only sure way to know what their arrival time is at that very moment in question!  If you don't, when you stand up in court and try to say, "our ETA was faster than arrival time" the lawyer suing you will ask "How did you know what paramedic's arrival time was?  Did you contact 911 dispatch to find out?"  

LA county clearly spells out what meats "base contact" (direct hospital contact) criteria.  BLS companies do NOT even have base hospitals. In order to contact base, you must be a paramedic, thus it requires ALS.  This includes (taken from LA county prehosiptal care manual, which is available online and I highly suggest everyone look it up for themselves! It is readily available on the LA County DHS EMS website)

BASE HOSPITAL CONTACT	(*EMT-I*/PARAMEDIC/MICN) AND TRANSPORT CRITERIA	REFERENCE NO. 808
Signs or symptoms of shock
B.	Cardiopulmonary arrest (excluding patients defined in Ref. Nos. 814 and 815)
C.	*Chest pain* or discomfort
D.	*Shortness of breath* and/or tachypnea
E.	Pediatric Medical Care (PMC) guidelines as defined in Ref. No. 510
F.	Situations involving five or more patients who require transport (Contacting the Medical Alert Center constitutes base hospital contact)
G.	*Altered level of consciousness* as defined in the Medical Control Guidelines H.	Suspected ingestion of potentially poisonous substances I.	Exposure to hazardous materials with a medical complaint J.	Abdominal pain in a pregnant or in a suspected pregnant patient
K.	Childbirth or signs of labor L.	Suspected fractures of the pelvis or femur M.	Facial, neck, electrical, or extensive burns:
1. 2. 3.
20% or greater BSA in adults 15% or greater BSA in children 10% or greater BSA in infants
N.	Trauma Triage Criteria and Guidelines as defined in Ref. No. 506.
O.	Traumatic Crush Syndrome
P.	*Syncope or loss of consciousness*, or acute neurological symptoms (i.e., blurred vision, weak and dizzy, numbness, etc) prior to or upon EMS personnel arrival.
Q.	A patient meeting any criteria in Section I who refuses transport against medical advice (AMA). Base contact is required prior to the patient leaving the scene.


You DO NOT get out of this base contact requirement by using the ETA less that arrival time!  That policy also dictates that EMTs must contact the MAR when they do transport before ALS arrival under that policy.  How many EMTs actually try to do that?  How many even knew they had to?


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## justforfun1795 (Aug 15, 2011)

you know you spend waaayyy too much time online when you can't even bother to use real words.  Clearly you don't like real life.  Feel free to continue arguing your "points" or posting pictures when you don't have one.  

 The rest of us all clearly agree and can see the situation for what it really is and can rise above it.


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## JPINFV (Aug 15, 2011)

justforfun1795 said:


> LA county scope of practice for EMT does clearly list scenarios that require ALS and rapid transport, which is NOT BLS IFT!  See if for yourself.  LA does have very clear protocols, but very few bother to read them thoroughly.
> 
> Go to the county website and read everything carefully that is part of the prehospital care policy manual.  It explains how if BLS arrives before ALS, then ALS must NOT be canceled and if ALS has not been request it must be.   Contacting them is the only sure way to know what their arrival time is at that very moment in question!  If you don't, when you stand up in court and try to say, "our ETA was faster than arrival time" the lawyer suing you will ask "How did you know what paramedic's arrival time was?  Did you contact 911 dispatch to find out?"



1. How many people do you personally know have been successfully sued for a 5 minute transport time for not calling paramedics? Not "I've heard through the grapevine." Not "but but but it could happen." First hand knowledge?

2. "7. In life-threatening situations in which the estiamted time of arrival (ETA) of the paramedics exceeds the ETA of the most accessible receiving facility (MAR), EMT-Is [EMT-1s aka EMTs. EMT-I is now antiquated nomenclature] should exercise their clinical judgement as to whether it is in the patient's best interest to be transported prior to the arrival of paramedics. EMT-Is shall make every effort to notify the MAR via the Hospital emergency Administrative Radio Radio (HEAR), telephone, dispatch, or other appropriate means of communication when exercising this principle."
-http://ems.dhs.lacounty.gov/policies/Ref800/808.pdf

Gee, a few things pop out. First, this protocol puts no requirement for EMT-Is to contact a base hospital. Second, it includes telephone or dispatch as appropriate methods of communication. Third, it requires "every effort" for the EMT. If the company is so shady as to not provide a way, including through dispatch, to contact the receiving facility, then the issue is with the company, not with the EMT. The EMT has made every effort available, but the company choose not to provide proper methods. Fourth, the protocol calls for use of clinical judgement. Estimated ETA is just that. Based on the closest fire station, what is the ETA? Similarly, call 911 and request an ETA. It can be done. If you want to make an argument that EMTs are incapable of making judgement calls, then I'm all ears. Also, please stay off of any and every ambulance until you can do so. 



> You DO NOT get out of this base contact requirement by using the ETA less that arrival time!  That policy also dictates that EMTs must contact the MAR when they do transport before ALS arrival under that policy.  How many EMTs actually try to do that?  How many even knew they had to?


Actually, based on a strict reading of protocol 808, you do get out of base hospital if you are unable to do so. Additionally see the above. For the company I worked for in Orange County, unless you were looking at an insanely short (less than 1 minute) ETA, the ED was contacted for every patient going to the ED, every time, through dispatch. If your company is that screwed up that there is no method to contact the hospital at all, then quit.


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## JPINFV (Aug 15, 2011)

justforfun1795 said:


> *Y*ou know you spend *way* too much time online when you can't even bother to use real words.  Clearly you don't like real life.  Feel free to continue arguing your "points" or posting pictures when you don't have one.
> 
> The rest of us all clearly agree and can see the situation for what it really is and can rise above it.



Next time you want to complain about the grammar is my posts, or more laughably the grammar in meme pictures, you might want to proof read your own post. I've taken the time to make some modification, which I've placed in bold. 

1. Appeal to majority (which doesn't exist).
2. Ad hominem. 
3. Pot meet kettle. Also, I love your (since you brought this up) confusion between "meat" and "meet" in your prior post.


----------



## looker (Aug 17, 2011)

thegreypilgrim said:


> Every last one of them (and yes, I work for one) should have their licenses revoked, be subjected to a scornful investigation from LADHS, USHHS, and possibly even the LA County District Attorney's Office. Beyond that legislation should be passed prohibiting such organizations from incorporating unless they are operated on a not-for-profit basis or as some other highly regulated public utility.
> 
> They're a bottom-feeding, blood-sucking scourge upon the earth barely above the status of a racketeering syndicate. And as evinced by our resident poster, looker, they are bereft of even a modicum of professional ethics or scrupulous business practices. It's a deplorable situation that should not be permitted to continue to exist.



You do realize that every single provider does some form of IFT. The last time I checked doing ambulance transportation for those that needing is providing proper care. What do you suggest those that need ambulance use? A taxi? 

I would love to know what is you definition of bottom-feeding? Not everyone can do 911 yet there are plenty of people that need ambulance service. I guess you feel those people should be out of luck?


----------



## thegreypilgrim (Aug 17, 2011)

looker said:


> You do realize that every single provider does some form of IFT. The last time I checked doing ambulance transportation for those that needing is providing proper care. What do you suggest those that need ambulance use? A taxi?
> 
> I would love to know what is you definition of bottom-feeding? Not everyone can do 911 yet there are plenty of people that need ambulance service. I guess you feel those people should be out of luck?


 If you read closely, you'll notice I'm not disparaging the utility of IFT as a patient care service. In fact, I recognize it as an important and necessary.

No, what I would like is a way of providing such services to these patients which does not insult their dignity as persons, which is essentially what the _sort_ of organizations providing IFT services for-profit in the Greater Los Angeles County do. It's not IFTs in and of themselves, looker, it's the grossly unethical, inefficient, and counterproductive way it is handled that I take issue with.


----------



## looker (Aug 17, 2011)

thegreypilgrim said:


> If you read closely, you'll notice I'm not disparaging the utility of IFT as a patient care service. In fact, I recognize it as an important and necessary.
> 
> No, what I would like is a way of providing such services to these patients which does not insult their dignity as persons, which is essentially what the _sort_ of organizations providing IFT services for-profit in the Greater Los Angeles County do. It's not IFTs in and of themselves, looker, it's the grossly unethical, inefficient, and counterproductive way it is handled that I take issue with.



I am bit confused being you're not going in to much detail. A crew let say comes to NFS and picks up a patient and transport(s) them to dialysis service, hospital etc. Once they are done an ambulance take them back. What is grossly unethical, inefficient, underproduction about this? During transport patient is monitored by emt/medic depending on lvl of ambulance.


----------



## thegreypilgrim (Aug 17, 2011)

looker said:


> I am bit confused being you're not going in to much detail. A crew let say comes to NFS and picks up a patient and transport(s) them to dialysis service, hospital etc. Once they are done an ambulance take them back. What is grossly unethical, inefficient, underproduction about this? During transport patient is monitored by emt/medic depending on lvl of ambulance.


 Explain to me what is ethical or in accordance with proper business practice as any of the following:

(1) Accepting calls from SNFs or urgent care facilities which should have been 911 activations from the start without any caller interrogation - leaving the patient to suffer with whatever progressively worsening problem they've got and creating needless delays in care.

(2) Restricting access to supplies and forcing crews to go into service with defective/missing equipment.

(3) Ignoring service dates and/or mileage markers for vehicle maintenance.

(4) Creative billing practices.

(5) Holding crews accountable for the lackluster appearance of ambulances that should have been retired 200K miles ago and look as though were once used in some sort of crash derby event.

(6) Consistently and predictably making accounting errors on crew's paychecks which mysteriously always seem to work in the company's favor.

(7) Refusing to reimburse employees for expenses they incurred as means of employment (renewing certifications, etc.)

Should I go on? What sort of organizations in the world of EMS do the above remind one of without even having to think about it to any great extent?


----------



## looker (Aug 17, 2011)

thegreypilgrim said:


> Explain to me what is ethical or in accordance with proper business practice as any of the following:
> 
> (1) Accepting calls from SNFs or urgent care facilities which should have been 911 activations from the start without any caller interrogation - leaving the patient to suffer with whatever progressively worsening problem they've got and creating needless delays in care.
> 
> ...



1-3 and 5-6 no justification.

4) Depends if it legal or not. You can say same thing but using "creative way of saying" to get paid. 

7) I do not see a problem with that. You need to have certificates to perform your work. Now if it's internal requirement that is totally different.


----------



## ArtEry (Aug 19, 2011)

*oh man*

i am so jaded...baby fresh EMT @ my first EMT job! AAAAND...im a real adult who has had real jobs before, including infantry!!! thought i was getting into an industry that cared, across the board. :sad:


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## looker (Aug 19, 2011)

ArtEry said:


> i am so jaded...baby fresh EMT @ my first EMT job! AAAAND...im a real adult who has had real jobs before, including infantry!!! thought i was getting into an industry that cared, across the board. :sad:



Care about what? Did you not do your homework before you decided to become emt?


----------



## ArtEry (Aug 19, 2011)

looker said:


> Care about what? Did you not do your homework before you decided to become emt?



obviously not well enough. i expected the low pay, education and respect. knew i wanted to medic and keep going further. but didnt find out about how easy it is to lose cert's, job through lawsuits and such until almost done with EMT school. however i didnt expect to hear about shady practices like fakeing calls or what not. i am not accusing anyone of anything here! like i said, im babyfresh in EMS. there's alot i gotta learn, see for myself, so on. just bummed. not gonna quit, i know better than to let others make up my mind for me. and real change happens from within, happens slowly.


----------



## usalsfyre (Aug 19, 2011)

For the number of "girlfriend's brother's cousin's dog's kennel owner's neighbor's" who have been sued or lost their cert...in 10 years I've met no one who's unfairly lost their cert, and less than 10 who have been sued, successfully or not.


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## LonghornMedic (Aug 20, 2011)

usalsfyre said:


> For the number of "girlfriend's brother's cousin's dog's kennel owner's neighbor's" who have been sued or lost their cert...in 10 years I've met no one who's unfairly lost their cert, and less than 10 who have been sued, successfully or not.



Exactly! I know a couple guys who lost their certs. One gave the wrong med and didn't own up to it. Had he admitted he did it and reported it, there would have been no problem. But he lied to cover it up and lied to the health board who revoked his license. The second person had a drug problem and was given a second AND third chance and still continued to have dirty UA's after rehab and the licensing authority revoked at the employer's request.

As far as lawsuits, I have been at this for almost 10 years, in busy systems with lots of employees, and have yet to see anyone sued. No one. Zip. Zero. You have to really screw up and I mean BADLY screw up to get sued. It is really hard for an attorney to go after pre-hospital providers because of their limited scope and training. As long as you follow your protocols, you will be fine. Not to mention there isn't a whole lot of money in suing an EMT or Paramedic or even their employers. The money for lawyers is in going after doctors and hospitals.


----------



## MrBrown (Aug 20, 2011)

JPINFV said:


>



<not a hijack>

Why does that pear have teeth? That creeps Brown the frunk out! Srsly :unsure:

</not a hijack>


----------



## iftmedic (Apr 10, 2014)

MusicMedic said:


> Missing Stickers, Missing Equipment, Run Down Rigs...
> 
> i dont know how half of the Rigs that are in service at least for our company are able to pass CHP/DOT Certifications...
> 
> ...



Foreigners or not... That's not even relevant. Even the ones that ran by EMS lifers... Or EMS experienced owners they're just as bad or even worse...


----------



## ITBITB13 (Apr 11, 2014)

looker said:


> No working air condition...ye that is a crime :lol: Also missing rear left hub cap, omg that totally going to kill the car:lol:
> 
> How are they defrauding medicare/medicaid? Are they creating runs that never happened, write  reports on them and fake emt signature on the report? A bit more details would be nice.



Your grammar is no better than a 5th grader's.


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## TransportJockey (Apr 11, 2014)

Ivan_13 said:


> Your grammar is no better than a 5th grader's.



Since when did we grade people on grammar here?


----------



## iftmedic (Apr 11, 2014)

Ivan_13 said:


> Your grammar is no better than a 5th grader's.



5th grader's actually have the ability to convey their thoughts clearly and concisely...


----------



## iftmedic (Apr 11, 2014)

LonghornMedic said:


> Exactly! I know a couple guys who lost their certs. One gave the wrong med and didn't own up to it. Had he admitted he did it and reported it, there would have been no problem. But he lied to cover it up and lied to the health board who revoked his license. The second person had a drug problem and was given a second AND third chance and still continued to have dirty UA's after rehab and the licensing authority revoked at the employer's request.
> 
> As far as lawsuits, I have been at this for almost 10 years, in busy systems with lots of employees, and have yet to see anyone sued. No one. Zip. Zero. You have to really screw up and I mean BADLY screw up to get sued. It is really hard for an attorney to go after pre-hospital providers because of their limited scope and training. As long as you follow your protocols, you will be fine. Not to mention there isn't a whole lot of money in suing an EMT or Paramedic or even their employers. The money for lawyers is in going after doctors and hospitals.



Shady


----------



## Tired of the fools (May 20, 2014)

*Gcti*

Hello all,

Just wondering if anyone has heard anything about GCTI. I have heard they have cut back to almost nothing as far as units on the street. Anyone hear anything about this company?


----------



## Kupay0910 (May 20, 2014)

iftmedic said:


> 5th grader's actually have the ability to convey their thoughts clearly and concisely...



Lol....


----------



## iftmedic (May 20, 2014)

MusicMedic said:


> Shady Ambulance Company=
> 
> a company that makes some sort of profit but does not show it in the quality of the company
> 
> ...



Don't hate the player hate the game...Hey everyone has to get a piece of that pie... And to be quite honest everything is about money bro. And everyone is shady to an extent and its all politics bro. Its all about who's getting a bigger piece of the pie. Don't be naive money makes the world go  round. I don't blame the ambulance crooks its easy money. Look at the fire depts they want to offer EMS services for their own self preservation more funds funneled their way... Money Money Money.


----------



## looker (May 20, 2014)

iftmedic said:


> Don't hate the player hate the game...Hey everyone has to get a piece of that pie... And to be quite honest everything is about money bro. And everyone is shady to an extent and its all politics bro. Its all about who's getting a bigger piece of the pie. Don't be naive money makes the world go  round. I don't blame the ambulance crooks its easy money. Look at the fire depts they want to offer EMS services for their own self preservation more funds funneled their way... Money Money Money.



Outright fraud is hard and those that do it , get caught. Questionable fraud is a bit easier but it's also dangerous. Yes it's all about money but it's also about staying in business. All of the cost such as gas, insurance, wages etc are going up and yet reimbursement rate is going down. At the end of the day people didn't start a company or buy one to make money. They got in to this business to make money and anyone that says otherwise is lying.


----------



## gonefishing (May 22, 2014)

Tired of the fools said:


> Hello all,
> 
> Just wondering if anyone has heard anything about GCTI. I have heard they have cut back to almost nothing as far as units on the street. Anyone hear anything about this company?



Same thing as all the others.  Shady.
Russian/Armenian boss: "Bro I need to talk to you"

EMT: "Yea?"

Russian/Armenian boss: "Bro you put down the patient was walking (or that they were standing, sitting upright in a wheel chair) we need to change that Bro or we wont get paid by medicare and medical bro.  Put down that they were weak and you had to lift them out of chair to gurney bro.  You found them in bed bro.  We wont get paid bro."

EMT: "Ok"

This conversation takes place daily at many Ambulance companys in L.A.  when caught they place the company under somebody else and play puppet master or change names etc.  Or hide get paid under the table or are labeld a "consultant"


----------



## looker (May 27, 2014)

gonefishing said:


> Same thing as all the others.  Shady.
> Russian/Armenian boss: "Bro I need to talk to you"
> 
> EMT: "Yea?"
> ...



hahahahaha if you think that any competent EMT or any company management would risk getting shutdown and be prosecuted , you're kidding yourself.


----------



## terrible one (May 27, 2014)

looker said:


> hahahahaha if you think that any competent EMT or any company management would risk getting shutdown and be prosecuted , you're kidding yourself.



I've had that conversation take place on more than one occasion when I listed the patient was standing/walking. We had a regular pt meet us down stairs of his apartment holding a suitcase after walking 3 flights of stairs. When I brought it up to sup/management I was told that he was too weak for a taxi. I guarantee it happens on a daily basis in LA with the smaller ambulance companies.


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## iftmedic (May 27, 2014)

terrible one said:


> I've had that conversation take place on more than one occasion when I listed the patient was standing/walking. We had a regular pt meet us down stairs of his apartment holding a suitcase after walking 3 flights of stairs. When I brought it up to sup/management I was told that he was too weak for a taxi. I guarantee it happens on a daily basis in LA with the smaller ambulance companies.



It happens daily for sure ...the Scenario you just mentioned is exactly what its like I know from experience. That's just how LA is...its a fertile ground for this behavior


----------



## gonefishing (May 31, 2014)

looker said:


> hahahahaha if you think that any competent EMT or any company management would risk getting shutdown and be prosecuted , you're kidding yourself.



If any emt knew where to report such instances such companys would not exsist.  But than again this is how they work around it.

1) place management in question on "leave/termination" when smoke clears hire them back as an "advisor" or under the table.
2) start new company.  Place family in charge such as a cousin or mother and be the puppet master.
3) Flee the country get new identity from ex: Azerbaijan and return.  Start new company find outside source from another company offer more pay to reel them in.  Remember money talks bull:censored::censored::censored::censored: walks.
4) Run within county areas DOT wont spot you.
5) Start in OC easy to get a license hire in new gullible emts cloak and dagger your way into LA city.


----------



## looker (May 31, 2014)

gonefishing said:


> If any emt knew where to report such instances such companys would not exsist.  But than again this is how they work around it.
> 
> 1) place management in question on "leave/termination" when smoke clears hire them back as an "advisor" or under the table.
> 2) start new company.  Place family in charge such as a cousin or mother and be the puppet master.
> ...



Until county required everyone to file for county license, I totally would have agree with you on most points but that is not the case anymore. 

1) Medicare is not going to fall for that. They will hold owner responsible for fraud unless it's 1 or 2 case at most. Once you get in to hundred/thousand of case all bets are off. Unless owner can demonstrate that they were living in another state/country and had no contact management in the company ,they will for sure take the heat

2) Starting new company used to be the way to go when first one didn't have good reputation. Unfortunately getting back in to LA County is hard, you can't just stay out of LA and do work, you now must have county license before you can do any pick up here. 

3) Ye you can fleet the country, get new identity but getting back in to legally is much harder. Not saying it's impossible but it's nearly impossible

4) See #2, unless you're operating like in Marina Del Rey or some other remote, small area the county will spot you. 

5) See #2, not going to work unless you want to wait currently few years to get your hearing and get approved. Being the company wasn't in business prior to ordinance becoming the law, the company can't operate in the county until they are approved.


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## gonefishing (Jun 1, 2014)

http://www.justice.gov/opa/pr/2014/May/14-crm-474.html

Just to prove a point.........


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## iftmedic (Jun 1, 2014)

looker said:


> Until county required everyone to file for county license, I totally would have agree with you on most points but that is not the case anymore.
> 
> 1) Medicare is not going to fall for that. They will hold owner responsible for fraud unless it's 1 or 2 case at most. Once you get in to hundred/thousand of case all bets are off. Unless owner can demonstrate that they were living in another state/country and had no contact management in the company ,they will for sure take the heat
> 
> ...



Locker is right


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## gonefishing (Jun 1, 2014)

iftmedic said:


> Locker is right



Than how are the companys at present time operatIng with the same people or use of puppet masters?


----------



## looker (Jun 1, 2014)

gonefishing said:


> Than how are the companys at present time operatIng with the same people or use of puppet masters?



LA County ordinance didn't go in to effect until July 28,2011. As long as you had approved ambulance by CHP, were already operating in la county and filed the paperwork by end of 2012 you are okay to operated in the area that you're are licensed until hearing in which time you would either be approved or denied. If denied you could file appeal with appeal officer and likely get a stay pending appeal. An appeal officer have few options, deny appeal, grant appeal or send it back to la county ems board. If they again deny your application you can appeal again. Elite for example just won appeal outright. Med-Life was sent back to the hearing board, got their application denied and went back to appeal officer which granted them appeal and they got licensed. If you look at pending application, you feel see few companies are there that can't operated in la county until their application is approved because they were not operating in la county on July 28,2011


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## iftmedic (Jul 8, 2014)

looker said:


> It takes around 4 month to get approval for existing company to put vehicle in to service and once you get that approval you got 120 days to do it or it expires and you have to start process over. With that being said, driving patient in to LA is not illegal, it's only illegal to pick them up from city of LA. So if all they are doing is dropping them in LA, they are not violating any rules/laws.
> 
> Regarding passing CHP/DOT. Have you looked at what is required for passing CHP? As long as vehicle is in running order that is all that is needed. Equipment beyond basic is not checked or required.
> 
> Medi-cal do not pay much, it's mainly medicare/private insurance company's. We are all for profit so yes we want a quick buck otherwise we would not be in this business. It's the reality of the business.



Bottom line "Shady" I have more respect for criminals that don't put up a front...and keep it real...


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## usalsfyre (Jul 8, 2014)

iftmedic said:


> Bottom line "Shady" I have more respect for criminals that don't put up a front...and keep it real...


So you have more respect for outright criminal operations than companies who operate legally but don't meet your arbitrary standards of "keeping it real". Good luck with that....


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## iftmedic (Jul 8, 2014)

usalsfyre said:


> So you have more respect for outright criminal operations than companies who operate legally but don't meet your arbitrary standards of "keeping it real". Good luck with that....



Legally?? That's what I'm referring too...hiding behind the smoke screen ,  Yeah "legally" because they get away with it maybe...but not legally... I've seen it for myself working for alot of these dirt bag companies. You keep drinking that kool aid buddy and good luck to you with that...


----------



## gonefishing (Jul 9, 2014)

iftmedic said:


> Legally?? That's what I'm referring too...hiding behind the smoke screen ,  Yeah "legally" because they get away with it maybe...but not legally... I've seen it for myself working for alot of these dirt bag companies. You keep drinking that kool aid buddy and good luck to you with that...


How come nobody sucks it up and reports them anonymously online? It's fast and easy.  By doing so we can rid these shady people and run them out of the county and or country.


----------



## looker (Jul 10, 2014)

gonefishing said:


> How come nobody sucks it up and reports them anonymously online? It's fast and easy.  By doing so we can rid these shady people and run them out of the county and or country.



It's simple because nothing illegal is done.


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## ffemt8978 (Jul 10, 2014)

Off topic posts removed...

but let this serve as a reminder...


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## SkiMaskWay (Jul 11, 2014)

looker said:


> it's simple because nothing illegal is done.


----------



## SkiMaskWay (Jul 11, 2014)

iftmedic said:


> Legally?? That's what I'm referring too...hiding behind the smoke screen ,  Yeah "legally" because they get away with it maybe...but not legally... I've seen it for myself working for alot of these dirt bag companies. You keep drinking that kool aid buddy and good luck to you with that...



Actually these are outright criminals....


----------



## looker (Jul 11, 2014)

SkiMaskWay said:


> Actually these are outright criminals....



I am not sure I ever seen description of what exactly this so called criminals ambulance are doing. Honestly in all of this pages I haven't seen clear description of it. So this supposedly criminal companies, what are they guilty of?

Ex: Defrauding medicare/medicaid, making their emt falsify reports etc?


----------



## BASICallyEMT (Jul 11, 2014)

looker said:


> I am not sure I ever seen description of what exactly this so called criminals ambulance are doing. Honestly in all of this pages I haven't seen clear description of it. So this supposedly criminal companies, what are they guilty of?
> 
> Ex: Defrauding medicare/medicaid, making their emt falsify reports etc?





Sounds pretty accurate to me :0


----------



## SkiMaskWay (Jul 11, 2014)

looker said:


> I am not sure I ever seen description of what exactly this so called criminals ambulance are doing. Honestly in all of this pages I haven't seen clear description of it. So this supposedly criminal companies, what are they guilty of?
> 
> Ex: Defrauding medicare/medicaid, making their emt falsify reports etc?



Yeah that's why your not one of the FBI and LAPD that raided GCTI Ambulance yesterday... But obviously they had a search warrant. Mmmmm! Still you think no criminal activity?


----------



## Tigger (Jul 11, 2014)

SkiMaskWay said:


> Yeah that's why your not one of the FBI and LAPD that raided GCTI Ambulance yesterday... But obviously they had a search warrant. Mmmmm! Still you think no criminal activity?



I don't think you quite grasp how the legal system works...


----------



## ffemt8978 (Jul 11, 2014)

SkiMaskWay said:


> Actually these are outright criminals....



You keep saying that, but I have yet to see any proof that a crime was committed....and I am willing to bet you don't have it either.

Law enforcement executing a search warrant does NOT mean a crime was committed...nor does it mean those on the receiving end of the search are criminals.


----------



## gonefishing (Jul 11, 2014)

Time will tell.  Innocent until proven guilty right? 
If it happens to go for the worse I hope some of the guys and gals there are able to find jobs and carry on for the best of their familys and themselves.


----------



## looker (Jul 12, 2014)

gonefishing said:


> Time will tell.  Innocent until proven guilty right?
> If it happens to go for the worse I hope some of the guys and gals there are able to find jobs and carry on for the best of their familys and themselves.



I always tell people not to judge the book by its covers, it's same for people that are get transported by ambulance. That person might look perfectly healthy but if you look at their medical hx, you will find that they are much sicker compare to what you thought by just looking at them. Yes a person might seem like they can be wheelchair bound and transported by medivan before dialysis but come after and you might find that they are too sick to be in wheelchair and need monitored during transportation.


----------



## SkiMaskWay (Jul 12, 2014)

ffemt8978 said:


> You keep saying that, but I have yet to see any proof that a crime was committed....and I am willing to bet you don't have it either.
> 
> Law enforcement executing a search warrant does NOT mean a crime was committed...nor does it mean those on the receiving end of the search are criminals.



Yeah and you keep being naive about the whole ambulance biz.....its not very common to see Feds and LAPD executing search warrants.... Obviously they had enough evidence to feel they could frag these guys.... By the way yes I do know... Just like when Alpha came crashing down ...and Mr Russ and the poor rancho medic that was altering the pcrs and everyone else that got hooked .... In LA that's just the way it is.


----------



## ffemt8978 (Jul 12, 2014)

SkiMaskWay said:


> Yeah and you keep being naive about the whole ambulance biz.....its not very common to see Feds and LAPD executing search warrants.... Obviously they had enough evidence to feel they could frag these guys.... By the way yes I do know... Just like when Alpha came crashing down ...and Mr Russ and the poor rancho medic that was altering the pcrs and everyone else that got hooked .... In LA that's just the way it is.



No, I am not naive about  the whole ambulance biz....

By the same token, I do not equate a search warrant being executed to mean that the company employees or even the company are criminals.    The criteria for a search warrant is substantively less than the criteria for a conviction.  Sometimes search warrants are fishing expeditions by law enforcement, and sometimes they do not turn up any evidence of wrong doing.

But if you "do know" as you state, then provide your proof.  Since you weren't a member here when "Alpha came crashing down...", we have no way of knowing how accurate your information is...especially considering hindsight is twenty-twenty.


----------



## gonefishing (Jul 12, 2014)

ffemt8978 said:


> No, I am not naive about  the whole ambulance biz....
> 
> By the same token, I do not equate a search warrant being executed to mean that the company employees or even the company are criminals.    The criteria for a search warrant is substantively less than the criteria for a conviction.  Sometimes search warrants are fishing expeditions by law enforcement, and sometimes they do not turn up any evidence of wrong doing.
> 
> But if you "do know" as you state, then provide your proof.  Since you weren't a member here when "Alpha came crashing down...", we have no way of knowing how accurate your information is...especially considering hindsight is twenty-twenty.


The joke floating around is they did an Alpha.lol. I hear that their will be more raids coming up real soon.  Will see what happens.  The only way anyone really could of covered up anything is the run reports.  You have a receiving signature on the back vs. The front and have your emt "redo" the run to your billing personnels wants and your needs.  You then trash the original and place the new one in place.  But a group testimonial would challenge that.


----------



## ffemt8978 (Jul 12, 2014)

Until law enforcement comes forward and says what the warrant was about, then everything is speculation.


----------



## looker (Jul 12, 2014)

SkiMaskWay said:


> Yeah and you keep beng naive about the whole ambulance biz.....its not very common to see Feds and LAPD executing search warrants.... Obviously they had enough evidence to feel they could frag these guys.... By the way yes I do know... Just like when Alpha came crashing down ...and Mr Russ and the poor rancho medic that was altering the pcrs and everyone else that got hooked .... In LA that's just the way it is.



LAPD was really there for show. FBI always like to have local pd present. Also ambulance was interesting case, it was really the doing of one owner and manager and the other one just got swept up because he was ignorant once he because the owner. Alpha had amazing contracts and to this day i don't understand why they did fraud except greed got the best of them. Regarding GCTI, the warrant is currently sealed so any rumors that go around is that rumor. Also that is really needed to get a warrant is to have a current/former employee come forward and show some "evidence", as long their is even a chance of fraud FBI will go for it. According to news they were going through garage which tells me they were looking at previous period records. If evidence of wrong doing is there, they likely will get indited in the few weeks to months, depending how strong the evidence is.


----------



## ffemt8978 (Jul 12, 2014)

looker said:


> LAPD was really there for show. FBI always like to have local pd present. Also ambulance was interesting case, it was really the doing of one owner and manager and the other one just got swept up because he was ignorant once he because the owner. Alpha had amazing contracts and to this day i don't understand why they did fraud except greed got the best of them. Regarding GCTI, the warrant is currently sealed so any rumors that go around is that rumor. Also that is really needed to get a warrant is to have a current/former employee come forward and show some "evidence", as long their is even a chance of fraud FBI will go for it. According to news they were going through garage which tells me they were looking at previous period records. If evidence of wrong doing is there, they likely will get indited in the few weeks to months, depending how strong the evidence is.



Good point.  This may turn out to be an ex-employee with an ax to grind, so they go to the FBI and make something up in order to get GCTI investigated.


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## Akulahawk (Jul 12, 2014)

looker said:


> *LAPD was really there for show. FBI always like to have local pd present.* Also ambulance was interesting case, it was really the doing of one owner and manager and the other one just got swept up because he was ignorant once he because the owner. Alpha had amazing contracts and to this day i don't understand why they did fraud except greed got the best of them. Regarding GCTI, the warrant is currently sealed so any rumors that go around is that rumor. Also that is really needed to get a warrant is to have a current/former employee come forward and show some "evidence", as long their is even a chance of fraud FBI will go for it. According to news they were going through garage which tells me they were looking at previous period records. If evidence of wrong doing is there, they likely will get indited in the few weeks to months, depending how strong the evidence is.


There's a couple reasons for involving local LE in their operations like this. One is simply to preserve the working relationship the FBI has with the "locals" as well as a manpower issue. Sometimes the FBI needs additional bodies to secure scenes. There's another issue with involving local LE in things. If they sufficiently anger a Sheriff, the Sheriff can wreak all kinds of havoc on the FBI's operations. The El Dorado County Sheriff caused some problems with the US Forestry Service when he basically stripped them of quite a bit of their enforcement powers...


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## BASICallyEMT (Jul 13, 2014)

ffemt8978 said:


> Good point.  This may turn out to be an ex-employee with an ax to grind, so they go to the FBI and make something up in order to get GCTI investigated.





I have been told by ex-employees of GCTI that the FBI contacted them trying to get statements. And I heard this over a year ago


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## looker (Jul 13, 2014)

BASICallyEMT said:


> I have been told by ex-employees of GCTI that the FBI contacted them trying to get statements. And I heard this over a year ago



Assuming that is what happened, it fits the basic fishing expedition. Every single company have employees that were no good fit etc and were either fired or left and now they get contacted by FBI who ask them to make a statement. I am sure if enough people are contacted, someone will say something that FBI waned to hear.


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## BASICallyEMT (Jul 13, 2014)

looker said:


> Assuming that is what happened, it fits the basic fishing expedition. Every single company have employees that were no good fit etc and were either fired or left and now they get contacted by FBI who ask them to make a statement. I am sure if enough people are contacted, someone will say something that FBI waned to hear.



That is a good point


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## mike1390 (Jul 14, 2014)

Well seeing that last year an FBI agent stood up at an LACO EMS meeting and basically gave everyone a heads up that they are coming after all the shady companies this comes to no surprise, he said that there are more private ambulances in LaCo than taxies. So welcome to the start of the medicare/medical fraud cases in LA!:rofl:


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## gonefishing (Jul 15, 2014)

“The only thing necessary for the triumph of evil is for good men to do nothing.” Edmund Burke

Ill pop the popcorn for this show.lol


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## Notsilent man (Oct 21, 2014)

procare was raided today by FBI


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## Notsilent man (Oct 21, 2014)

Finally they are bringing down these thief's who bribe everyone


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## Notsilent man (Oct 21, 2014)

Down goes Procare ambulance they are being raided as we speak..FBI all over the place


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## NorthCountyEmt (Nov 4, 2014)

Gcti is reopening as Phoenix Ambulance. Aaaand hopefully Medlife/Ambulife is next


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## looker (Nov 8, 2014)

NorthCountyEmt said:


> Gcti is reopening as Phoenix Ambulance. Aaaand hopefully Medlife/Ambulife is next


Where are you getting this information from? GCTI is still in business, i saw their unit doing pick up at Cedar Sinai.


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## looker (Nov 8, 2014)

Notsilent man said:


> Down goes Procare ambulance they are being raided as we speak..FBI all over the place


From my understanding the raid was result of the lawsuit against them. No one yet got arrested.


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## NorthCountyEmt (Nov 9, 2014)

looker said:


> Where are you getting this information from? GCTI is still in business, i saw their unit doing pick up at Cedar Sinai.


I answered a craigslist ad for a Phoenix Ambulance job and they emailed me back for the interview from a GCTI email address. Lol then the lady emailed me back and said ignore GCTI, it was her old email. And the interview address was GCTI's location


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## NorthCountyEmt (Nov 9, 2014)

They may just be switching names, but they are also auctioning off a large chunk of rigs


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## medicsontheball (Nov 11, 2014)

NorthCountyEmt said:


> They may just be switching names, but they are also auctioning off a large chunk of rigs



Do you know who is hosting the auction? Any details would be helpful. Thank you.


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## gonefishing (Nov 11, 2014)

medicsontheball said:


> Do you know who is hosting the auction? Any details would be helpful. Thank you.


Kenporter auctions.  But I would be weary on the rigs up for sale I've heard horror storys how it looks good on the outside horrible inside.  Medicsontheball has a great reputation and I would hate to see you guys spoiled by crappy equipment which would leave you with a loss.


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## Mufasa556 (Nov 11, 2014)

http://www.kenporterauctions.com/vehicle_listing_temp.asp?auctionid=345

Takes place on the 21st. It's a bunch of GCTI rigs and a handful of blown out AMR units.

There's also a couple of old Lifeline rigs on Craigslist right now.


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## medicsontheball (Nov 13, 2014)

Mufasa556 said:


> http://www.kenporterauctions.com/vehicle_listing_temp.asp?auctionid=345
> 
> Takes place on the 21st. It's a bunch of GCTI rigs and a handful of blown out AMR units.
> 
> There's also a couple of old Lifeline rigs on Craigslist right now.



Yeah, bunch of ProCare rigs on CL too.


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## looker (Nov 14, 2014)

NorthCountyEmt said:


> They may just be switching names, but they are also auctioning off a large chunk of rigs


I can't find any company registered as phoenix ambulance. In California when you register new business name you must publish it in news paper for 30 days. I haven't found any mention of such name yet. Also auction likely happening because of new Ford vans being made which is much better on mpg compare to the old one's. Lastly Medicare been denying dialysis transportation with higher frequency compare to before which have reduced ambulance demand.


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## Mufasa556 (Nov 14, 2014)

I've never heard that rule, but at least Phoenix is a better name than GCTI.  

Does LA have a mileage limit? Some of those rigs have less miles than some of our assigned rigs. I have a hard time believing they'd auction off a bunch of rigs to purchase the new Ford van.


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## looker (Nov 16, 2014)

Mufasa556 said:


> I've never heard that rule, but at least Phoenix is a better name than GCTI.
> 
> Does LA have a mileage limit? Some of those rigs have less miles than some of our assigned rigs. I have a hard time believing they'd auction off a bunch of rigs to purchase the new Ford van.


No mileage limit, but there is age limit Also GCTI is not the name of the company, it is Gentle Care Transportation, Inc(GCTI).


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