Las Vegas - somewhat employment related...

SandpitMedic said:
Ok
Welcome to the team. (Gotta say, you're lucky to have gotten MedicWest, the best in LV to work for). Not hating on the others- just sayin'
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Vegas has AMR, MedicWest, and now Community running 911. Since MW is owned by AMR and AMR also has operations in Vegas, why do you say MW is better over the three?

Vegas is on my short list of places I'd love to work. If I ever pulled the trigger on it, why one over the other?
 
Mufasa556 said:
Since MW is owned by AMR...Vegas is on my short list of places I'd love to work. If I ever pulled the trigger on it, why one over the other?
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Now does AMR own MedicWest, or does their parent company? I often hear people say AMR bought out such and such company and can't help but wonder that there would be a vast difference in them buying out/ taking over a company, versus their parent company doing so. Things such as culture, day--to-day operations, etc. I would imagine vary greatly not only by division, but by their oversight, or lack thereof.

When I was a newer paramedic, I also contemplated moving to Vegas for the experience and call volume, now?...not so much, lol.
 
Here's the rub. AMR and MedicWest Ambulance (MWA) are technically two different companies with two different tax IDs. They are owned by the same parent company- Envision (who I might add is about to merge with AmSurg to become the Skynet of the healthcare industry).

However, there is one general manager that oversees both operations, although both AMR & MWA have an operations manager. They are also sharing managerial staff offices, management meetings, and they are both dispatched from the AMR communications center in the AMR building. There is an MWA HQ in North Las Vegas and an AMR HQ in Las Vegas. Recently, the shift has been on moving things slowly over to AMR (dispatch last summer, special events management, etc). (After, IMO, a bad stretch in the events world under AMR management, MWA lost a lot of business including some big ticket events- as of about a month ago they selected someone from MWA to re-take over the events division to save that ship).

National AMR human resources training and policies have been in place for about 6 or 7 years or so since Envision Healthcare purchased MWA (before my time). Many AMR local policies have slowly been being implemented into MWA operations.

Now, the reason why they are two separate companies still, and why they have not merged completely is a two pronged answer. The company line is that MWA is an established name in the community. The real truth behind the matter is that Clark County and the Southern Nevada Health District have a law in place that says there can only be a maximum of three private ambulance providers that can obtain franchise agreements for the 911 system. So- by having two slots with AMR and MWA, that only leaves one slot (which was, as someone stated, recently filled by Community Ambulance out of Henderson, who recently got a small piece of southern Las Vegas, and a back up 911 contract for Henderson Fire. I can comment via PM on Community, but I will not comment on them in this public forum... I'll only say, choose wisely if you opt to apply in Vegas). If AMR were to completely absorb MWA it would leave a vacancy for another competitor which is the real reason they won't ever completely combine them.

As to why MWA is better is just my personal opinion, and as I stated about Community Ambulance I'm not going to publicly comment on AMR by bashing them... I will say that in my opinion MWA is better. AMR frequently holds over crews, drops late calls, forced mandatory shifts on your days off, micromanages, and there are a lot of employee complaints about their management and the way they are treated. It's a very... "corporate" feel... Where as MWA is a smaller operation feel and has less of that "corporate" feel. Again, my opinion only based on 5 years in this system and knowing many folks. That said, historically AMR was a larger operation overall, but the companies have roughly the same number of employees as of now.

To give you some perspective on the view of employees, when Community Ambulance won a slice of the 911 system (previously a small IFT outfit) they had a mass hiring. There was a mass exodus of AMR employees who fled AMR. I'd venture to say about 30-35 bounced out for Community Ambulance; it was intense at the time... Suddenly folks you knew for years in a white shirt were showing up in grey shirts at the ERs. Meanwhile, at MWA, I think we had 5 that went over to Community, of whom 3 returned after there first week at Community.
Most MWA employees are happy here, and when they leave, it is for advancement (FD/PD/RN/school/etc) not for a same-same swap of private ambulance companies.

That's pretty much it.
 
Has Las Vegas Fire's transport services affected any dynamic yet, or is it still pretty much business as usual?
 
The pendulum swings man. At first it was an issue. LVFR came into the transport game in the City. NLVFD transports a few in their city (3 per day I think is the policy). Overall, not much has changed in day to day operations. Sure, some trucks were cut, but I never heard of any lay offs or anything. We're all still busy as hell.
As far as revenue and reimbursement goes I have no idea how it changed. AMR/MWA lost the downtown area as well as city areas of well insured demographics to LVFR (they left the low payer/low reimbursement areas to AMR...lol- officially the department denies, but it was in all the news and stuff, and it happened because the dudes on the ground were still running in the **** areas). Also, everything south of Tropicana Blvd went to Community Ambulance (except "The Strip" Las Vegas Blvd which is still AMR & MWA). So they lost some
calls surely, but like I said we all stayed busy.

Today, it's as if it never changed, except there are some ****ty motels and hotels that I'm happy I don't have to respond to anymore! :)
 
We have never stopped hiring either. If that says anything. A lot of people, myself included, go part time... Leaving a lot of full time slots available. MWA has never been at risk of lay offs that I can recall.
 
SandpitMedic said:
The pendulum swings man. At first it was an issue. LVFR came into the transport game in the City. NLVFD transports a few in their city (3 per day I think is the policy). Overall, not much has changed in day to day operations. Sure, some trucks were cut, but I never heard of any lay offs or anything. We're all still busy as hell.
As far as revenue and reimbursement goes I have no idea how it changed. AMR/MWA lost the downtown area as well as city areas of well insured demographics to LVFR (they left the low payer/low reimbursement areas to AMR...lol- officially the department denies, but it was in all the news and stuff, and it happened because the dudes on the ground were still running in the **** areas). Also, everything south of Tropicana Blvd went to Community Ambulance (except "The Strip" Las Vegas Blvd which is still AMR & MWA). So they lost some
calls surely, but like I said we all stayed busy.

Today, it's as if it never changed, except there are some ****ty motels and hotels that I'm happy I don't have to respond to anymore! :)
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Can you expand on that a little? I am in backgrounds at NLVFD (Ok well so far all I've done is turn in a background packet and haven't heard anything back but I gather that's not entirely unusual either ha)....so does an NLV Engine+Rescue+AMR/MWA all show up to a call? (Not an entirely alien concept to me since I'm currently working for a private company here in CA that responds alongside FD engine+ALS rescue squad unit lol) or only the Engine plus whichever ambulance they decide to use?
 
SandpitMedic said:
What's up?

Welcome.

What agency will you be working for. There are 3 possibilities for 911 operations with 3 different headquarters. That will help me guide you on where to get a place.

The protocol test is a pain in the butt, but passable first round if you know them. They can be found under the SNHD EMS & Trauma website. Just google that and protocols.

It is a multiple choice test. Know the drugs and dosages, in particular with pediatrics and when you need orders, know hospital capabilities, destination criteria, and specifics on trauma catchment areas. Those are the biggies. It's been several years since I took it, but those are the main issues people have. Just read through them a lot and you should be good.
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I have a question, so i want to do 911 only no ift funny stuff so would my best bet be MedicWest??
 
JustinNV said:
I have a question, so i want to do 911 only no ift funny stuff so would my best bet be MedicWest??
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I'm pretty sure all private/ for-profit companies will do transfers to supplement their income.

911 isn't all it's cracked up to be, but I hear ya.
Both these companies are of the aforementioned, and need to "keep the lights on" so to speak which is often supplemented via guaranteed payouts via IFT's through the patients that have billable insurance:).
 
VentMonkey said:
I'm pretty sure all private/ for-profit companies will do transfers to supplement their income.

911 isn't all it's cracked up to be, but I hear ya.
Both these companies are of the aforementioned, and need to "keep the lights on" so to speak which is often supplemented via guaranteed payouts via IFT's through the patients that have billable insurance:).
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So i could end up doing both 911 and ift basically? and thanks for the reply
 
JustinNV said:
So i could end up doing both 911 and ift basically? and thanks for the reply
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Yes. Even some 3rd service, and fire departments supplement their call volume/ income with IFT's. Some IFT patients are sicker than most "911" patients.
 
JustinNV said:
So i could end up doing both 911 and ift basically? and thanks for the reply
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You're a future EMT, therefore your options are limited. Most 911 systems in the nation either moved on, or are in the process of moving onto 911 ALS intercepts. If you end up working for a system with 1+1 crews, you'll see more emergency calls than transfers. If not, you'll run BLS transfers. Either way, as @VentMonkey pointed out, 911 is overrated; IFT calls, as a rule, give you a much better learning experience if you expect to advance your knowledge/education.
 
Qulevrius said:
You're a future EMT, therefore your options are limited. Most 911 systems in the nation either moved on, or are in the process of moving onto 911 ALS intercepts. If you end up working for a system with 1+1 crews, you'll see more emergency calls than transfers. If not, you'll run BLS transfers. Either way, as @VentMonkey pointed out, 911 is overrated; IFT calls, as a rule, give you a much better learning experience if you expect to advance your knowledge/education.
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Ok thanks that helps so hypothetically as a new emt or paramedic starting out i would be doing ift? then getting experience and time in and getting a 911 job??
 
JustinNV said:
Ok thanks that helps so hypothetically as a new emt or paramedic starting out i would be doing ift? then getting experience and time in and getting a 911 job??
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You should probably focus on getting through your EMT class first, then passing the NREMT and eventually landing a steady gig. Once you're in the pipeline, most of the things you're asking about will become obvious.
 
Oh, to be new again...
 
Cypress creek is all 911.
 
TBCH, as the years pass "all 911" has less and less appeal to me on the whole.
 
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