Shady Companies In LA City

[jgmedic]

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.

 

[JPINFV]

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.

 

[jgmedic]

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."

 

[JPINFV]

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.

 

[somePerson]

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.

 

[mfelton]

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

 

[alf5118]

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

 

[MusicMedic]

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

 

[looker]

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.

 

[looker]

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

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.

 

[MusicMedic]

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

 

[looker]

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

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.

 

[looker]

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?

 

[MusicMedic]

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..

 

[looker]

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, etc etc..

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?

 

[medic417]

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.

 

[TransportJockey]

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?

 

[looker]

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).

 

[looker]

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.

 

[medic417]

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.