Journal
ambulance service
You take care of
our community.
Selfless Act by Southwest
Ambulance Paramedic Leads to
We take care
of you. Congressman Harry Mitchell and
Congresswoman Ann Kirkpatrick to
In this Issue Re-Present National “Star of
HIgHlIgHts: Life”Medal
1 selfless Act by southwest Josh Weiss, Southwest Ambulance & Rural/ Metro
Ambulance Paramedic
2 A ground Critical Care
transport Program In A Rural
Community.
H e didn’t know any-
one was watching.
In a touching trib-
ute to a friend, Southwest
Ambulance Paramedic
Francisco “Cisco” Preciado
4 AAA Director attends National placed his own “Star of Life”
EMs Memorial service medal inside the casket of his
friend and co-worker,
6 Maintain a strong lead Ahead Emergency Medical
Technician Mark Vernick, 32.
of the Ambulance Chasers Vernick was killed on January
7 Curing Emergency Medicine’s 8, 2010 in a motorcycle colli-
sion that occurred on his way
Financial Woes home from working a shift. Congressman Mitchell with 2009 Star of Life Francisco Preciado
But someone was watching.
9 sAVE tHE DAtE - 2010 Annual “It was possibly the most
Conference selfless act I’ve ever seen in EMS,” said Ken Daughtery, Market General Manager for
Southwest Ambulance in Pinal County, Arizona.
The “Star of Life” is a national award to recognize the country’s most outstanding
Paramedics and EMTs. Cisco was one of only three in Arizona to receive the award in
2009.
“In the world of EMS, it’s not a casual award, it’s THE award,” Daughtery added. “For
Cisco to so quietly and unassumingly leave his medal to lay with Mark forever was one of
the most powerful things I’ve ever witnessed.”
Unbeknownst to Cisco, Southwest Ambulance contacted the American Ambulance
8400 Westpark Drive, Second Floor
McLean, Virginia 22102
703-610-9018 • 1-800-523-4447 continues on page 2
703-610-0210 fax • www.the-aaa.org
continued from page 1
Association who agreed to send a replacement medal to be re- shows Cisco’s character and why he is so worthy of this national,
presented. lifetime achievement award.
In separate events, the medal was re-presented to Cisco in front of Southwest Ambulance Paramedics Andria Carter and Russ Yeskin
his family, peers and co-workers. Congresswoman Kirkpatrick met also received Star of Life medals in 2009.
with Cisco at Casa Grande Regional Medical Center on Memorial
Day, May 31 to re-present the medal. A few days later on Thursday
June 3, Congressman Harry Mitchell re-presented the Star of Life
medal during a special ceremony at Southwest Ambulance’s head-
quarters campus.
Southwest Ambulance is in Congressman Mitchell’s congressional
district. Also, when Cisco received the award in Washington DC,
Congressman Mitchell took the time to meet with him as part of OFFiCeRS
an EMS Day on the Hill program. Congresswoman Kirkpatrick’s
district includes Casa Grande, where Cisco lives and works, as did Jim Finger President
Mark Vernick.
Jim McPartlon Immediate Past President
Video of both presentations is posted on Southwest Ambulance’s
Steven Williamson President Elect
YouTube page at: www.youtube.com/swambulance Photos are also
Dale Berry Treasurer
available upon request.
J.D. Fuiten Secretary
Francisco “Cisco” Preciado lives and works in Casa Grande,
Arizona. He joined Southwest Ambulance as a Paramedic in 2005
after eight years with the U.S. Navy and U.S. Coastguard. He began StAFF
his EMS career in the State of Washington as a Firefighter/ EMT.
Cisco was initially nominated to receive this prestigious award Maria Bianchi Executive Vice President
because he truly epitomizes Southwest Ambulance’s “Tradition of 2009 Stars of Life Russ Yeskin, Francisco Preciado and Andria Carter of Southwest tristan North Sr. Vice President,
Caring” in his attitude and in every aspect of his daily performance. Ambulance with Congressman Mitchell Government Affairs
His selflessness displayed at Mark Vernick’s funeral only further Kim Almstedt Director of Meetings
erin Fano Director of Membership
A Ground Critical Care transport Program in A Rural Wendy Powell
Katie McNealy
Program Manager InvisibleBracelet
Program Coordinator
Community. Association
Management Group
Design and Production
By: Louis Mendiola NREMT-Intermediate Humboldt General Hospital Department of Emergency Medical Services
I n 2008 the community hospital in Winnemucca, Nevada, a
small town of 16,000 people located in northern Nevada,
changed one way patients receive care. This change makes
Winnemucca a model for other healthcare systems. Due to its size
and lack of specialty care Humboldt General Hospital has been
Physicians and nursing staff also faced an ethical dilemma when
transporting patients. Often times patients that were stable and only
had minor injuries or illnesses required transport to Reno.
Physicians and nurses had to face patients and their family and
explain why a $25,000 flight was necessary to fix a minor broken
suMMER 2010
Ambulance Service Journal is published quarterly by the American Ambulance
required to transfer many critically ill and seriously injured patients leg or receive dialysis.
Association, 8400 Westpark Drive Second Floor, McLean, VA 22102;
to Reno, the nearest large city with adequate medical facilities, 167 In 2008 the administration and hospital Board of Trustees called
800-523-4447
miles southwest of Winnemucca. In the past when patients fell too on the hospital’s Emergency Medical Services (EMS) department
ill to be cared for at Humboldt General Hospital, the patients to find a way to safely and cost effectively transport patients to
Advertising information:
required transport to one of four hospitals in the Reno area. These definitive medical centers. Under the direction of the hospital’s
Rates are available upon request.
transfers were carried out by an Air Medical Services (AMS) based CEO Jim Parrish and Director of EMS Pat Songer the EMS depart-
out of either Reno or Elko. ment underwent major changes to enable it to provide Critical
Copyright 2010, American Ambulance Association. No material can be repro-
This practice was carried out for decades, even though when Care Transport (CCT) by ground to the citizens of Humboldt
duced without the express written permission of the publisher.
utilizing air medical services the patients and clinicians often found County. Director Songer knew that a CCT program could work to
themselves faced with long wait times, air medical services refusing better patient outcomes. However, he also knew it would take
The opinions expressed herein are solely the author’s and do not necessarily
transports, and number of other logistical and patient care issues. much convincing of opponents and further education of his staff to
reflect that of the Association.
continues on page 4
2 A Mb u lA N CE s ER VI CE Jo u R N A l s u M M ER 2 0 10 3
continued from page 2
have a CCT program that was able to improve clinical outcomes.
In January of 2008 paramedics and emergency medical techni-
cians in the department received enhanced education on the care
Stringham to expand patient care protocols to include more inva-
sive procedures, and pharamalogical interventions aimed at improv-
ing patient outcome.
SucceSS is no accident
of critically ill and injured patients. The enhanced education In January 2010, two years after establishing the ground based
included the use of specialty medications, the use of specialty Critical Care Transport program, employees of the hospital, local With over 15,000 units in numerous countries world- of what needed improving. In his small garage, he
equipment, and how to recognize and treat patients with the most doctors, specialty doctors in Reno and most importantly patients wide, Demers engineers ambulances for both extreme thought, tinkered and tweaked his way to vastly improved
severe conditions. Although this process was rather time consuming, were amazed by how successful the program had become. After just
conditions outside and optimal safety inside. consis- ambulances, a practice that would become the hall-
it was made easier by having a number of paramedics and emer- two years the department had showed that a ground Critical Care
tently thinking outside the box, they examine every detail mark of his company for 50 years. This constant, quiet,
gency medical technicians that had had previous experience caring Transport program based in a rural setting was faster than air trans-
that may contribute to a safer, more efficient working breakthrough innovation has led to industry-lead-
for critically ill and injured patients in other air medical servic- port, safer, and exponentially more cost effective plus it provided
es. Nearly all of the paramedics in the department had substantial patients with the same or higher level care received from air medi-
environment in and around the ambulance. ing firsts that make Demers ambulances some of the
experience providing patient care either in a helicopter service or cal services providers. The ground Critical Care Transport program strongest and safest on the road.
That key approach began back in the late 50s when Paul
a fixed wing transport service and some paramedics were already illustrated how a small change can have lasting positive impacts on Demers first started the company. He saw for himself
accredited as Critical Care Paramedics (CCEMT-P) or Certified a community concerned with the effectiveness of healthcare. his vehicles’ end-user, developing a keen understanding
Flight Paramedics (CFP). The success of the program can be depicted qualitatively as well;
The Hospital Board also approved the purchase of better equip- the program has provided over 600 critical care transports since
ment and new ambulances so that the patients being transported by January of 2008. The 600 plus transports have saved the local com-
ground would receive the best care possible. The two new ambu- munity roughly 11 million dollars in just two years. The men and Demers DNA: sAfety is iN the DetAils
lances could withstand high mileage and had built in features to women of the EMS department of Humboldt General Hospital Cyber ConneCtion
make the ride more comfortable for the patient and family mem- have demonstrated an excellent way that even small or rural
bers. Both of the new ambulances included large patient care areas, departments can proactively help Americans save on healthcare For an emergency vehicle, the less downtime the bet-
televisions with DVD players, and additional seating for family expenditures. ter and Demers’ solution is unique and ingenious. every
members, so they could accompany the patient. Humboldt General Hospital EMS and Rescue is a CAAS accred- Demers ambulance is equipped with a standard Multi-
Improvements and enhancements continued throughout the ited ground ambulance provider in rural Northern Nevada. The 11 plex Demers electronic Management System (DeMS) that
MYSTeRe MX 170S tYPe iii
first two years of operation. This Included adding more specialty fulltime staff members and nearly 20 casual-call staff members field offers full operational flexibility to easily customize the
equipment such as new IV pumps and state of the art ventilators nearly 1,800 medical, CCT and rescue calls annually. For more vehicle’s electronic functions to specific needs.
for intubated/mechanically ventilated patients. Songer, Clinical information of the EMS department at Humboldt General Hospital
Coordinator Nico Simponis and other department staff collabo- please contact 775-623-5222.
if a dealership is too far away, or if a service technician the Demers DiffereNce
rated with local doctors and service Medical Director Dr. Charles
needs support, a Demers specialist can “plug in” the
system remotely and service the vehicle’s electric and Hundreds of innovative differences make a Demers
electronic systems from virtually everywhere in the world. ambulance stronger, more aerodynamic, more fuel-
AAA Director attends
efficient, longer lasting, smarter and safer. 50 years of
in fact, Demers is the only manufacturer that can remotely experience and customer feedback have led to contin-
access the customer’s Multiplex system in his ambulance ual improvements, driven by the philosophy that every
National eMS Memorial to diagnose, download and repair the system if necessary. single detail contributes to a superior vehicle. Demers
ambulances deliver significant and tangible added value,
Service low operating costs and excellent, 24/7 after-sale service.
Detail by detail, Demers ambulances have exceeded the
A AA Region 1 Alternate Director William Hathaway sum of their parts and are standouts in the industry.
attended the National EMS Memorial Service As more and more owners discover the Demers
weekend. He was there with other members of his
difference, the company today has vocal proponents the
service to serve as a Family escort to the Long family as
world over. Amidst the fanfare, Demers has quietly stayed
their family member Dale R. Long was memorial-
constant and true to their mission: to build innovative
ized. Dale Long was killed on June 15, 2009 in a tragic
ambulance accident while transporting a patient to the ambulances that deliver on customer expectations and
hospital. assist paramedics in saving lives.
The mission of the National EMS Memorial Service is to From left to right William Hathaway, Brenda Hathaway, Melissa elwell,
honor and remember men and women serving in EMS Jennifer Olansky
who have given their lives in the line of duty, and to recog-
nize the sacrifice they have made in service to their com- For more information about demers go to
munities and their fellow man. www.demers-ambulances.com
Demers field service coordinator providing assistance via remote
Multiplex CyberLink to a customer service technician.
4 A Mb u lA N CE s ER VI CE Jo u R N A l s u M M ER 2 0 10 5
Maintain a Strong Lead Ahead of the Ambulance Chasers Curing emergency Medicine’s Financial Woes
Janet Smith & Associates- On Assignment By Bruce Nelson, Vice President, SearchAmerica and Ted Williams, President, Noah Management Group
T he ambulance chaser label, undeservedly or justifiably so,
doesn’t belong to just the personal injury legal commu-
nity anymore. All you have to do is look up to see air
ambulance and medical helicopter businesses nipping away at
ground ambulance revenues or looking to acquire ground services
competitive shift in customer loyalties. The soon to be released
AAA Public Relations and Marketing Handbook will include a
special section regarding crisis communications. In the interim, I
have listed a few tips for organizing your own what if crisis com-
munication plan for addressing competitive threats.
E mergency physicians and Emergency Medical Services
(EMS) providers know that time is of the essence in caring
for their patients. Their staff and systems are equipped to
handle and assist with virtually any medical emergency. They are a
Luckily, the solution is straightforward.
they must obtain accurate address and
critical part of any community and have no shortage of patients.
outright. Factor in the renewed interest in public takeover of Unfortunately, the financial health of many providers is in need of
identity information on each patient at the
1. Consider potential market dynamics (takeover, aggres-
private ground ambulance services nationwide and it isn’t too urgent care.
much of a leap to realize that protecting local EMS market share
sive competitors, EMS system redesign, etc.) and deter-
With the increasing number of high deductible plans and self-pay
onset of their service relationship,
mine to what degree of importance each of those dynam-
is a crucial business strategy for AAA members. Our turbulent
economy has put significant pressure on municipalities to cut bud-
ics will have in regards to the company’s business com- patients, collections are more likely to come directly from the whenever possible.
munications, media relations, employee and customer patient than a third party. A recent survey by FIS, formerly
gets and to run public safety operations more like competitive relations. Metavante, concluded that 30 percent of all payments will come
businesses. Cash strapped medical facilities, physicians and care Find the payer source with ease
directly from patients in 2012. The result of this shift in a patient’s
centers are also looking for more cost effective transportation 2. Determine what internal leaders and/or outside con- The first question asked by most providers’ A/R department is who
financial responsibility is clogging the accounts receivable (A/R)
alternatives. Consequently, it is more important than ever to sultants you will engage in a crisis plan and/or a resulting is responsible to pay the patient’s bill. Is it their insurance company,
departments for most providers.
engage in issue-focused customer education, innovative strategy, campaign such as public relations counsel, legal counsel or the patient, a financial assistance provider such as Medicaid, or a
Luckily, the solution is straightforward. They must obtain accurate
value positioned marketing and influential public affairs. Making perhaps, a lobbyist. Then meet with them to learn about combination thereof? The answer is often unlocked with the
address and identity information on each patient at the onset of
that happen requires crisis communications strategy and imple- their ethics, their access to influencers and policy makers, patient’s Social Security Number (SSN). Using a third party service
their service relationship, whenever possible. Accurate information
mentation planning long before a crisis occurs. their track record of success and whom they have served to accurately match SSNs to every patient helps administrators to
into their A/R systems translates into reduced aging of accounts
Crisis communications strategy doesn’t just mean planning your in the past. determine eligibility and streamline the insurance claim reimburse-
and potentially millions of dollars in paid claims.
response to an internal crisis like an administrator’s or an employ- ment process.
3. Develop a specific plan and procedure for implement-
ee’s wrong doing. Crisis communications includes planning ahead ing campaign tactics including deciding when and who
for any kind of market dynamic that may have an acute impact on will address employees regarding crisis issues, how media
your private business including a public takeover or a significant inquiries will be addressed, who will educate and engage
current customers, and who will reach out to elected offi-
cials and/or advocacy groups.
Red ink happens. 4. Research case studies, news stories, industry reports
and/or examples of how similar issues played themselves
Black Ink can help. out for other communities and their emergency/medical
transportation health care stakeholders. Be ready to lever-
age the relative credibility of these studies based on their
U
results.
ninsured patients can account
5. As a regular business practice, exhaust all opportu-
for up to 36% of an emergency nities to get credit for what you do well. The bedrock of
transport service’s red ink. Black community goodwill and brand equity in any market is
Ink Systems finds and recovers the fodder for maintaining current business, engaging new
customers and realizing a successful crisis campaign.
funds from payer sources for many
A well thought crisis communications plan, especially one that is
of those accounts, putting other- focused on addressing any market threat is also the best and most
wise written-off dollars onto your inexpensive strategy for staying one step ahead of any provider
bottom line . . . reducing your red chasing after your ambulance business, let alone avoiding a crisis
altogether. I look forward to hearing how each and every one of
ink. you have avoided crisis and how you have maneuvered through
threatening market issues unsullied, true to your brand and formi-
dable as a competitor. Who knows, you might see your own
personal story as a featured case study in the aforementioned AAA
Public Relations and Marketing handbook.
www.blackinksystems.net 877.645.6240
A proud sponsor of the
American Ambulance Association’s
2010 Regional Finance Workshops
6 A Mb u lA N CE s ER VI CE Jo u R N A l s u M M ER 2 0 10 continues on page 8 7
continued from page 7
Without the SSN, it is virtually impossible to identify all patients
whose bills should be covered by Medicare, Medicaid, or other AmericAn AmBulAnce AssociAtion
payer sources. If a provider can correctly identify the patient’s
name, address, and SSN, they can often complete the necessary
Accurate patient address information is
2010 Annual
paperwork to qualify a patient for one of these payer sources. The
result is a greater return on patient billings that would have other-
wise become bad debt. For these patients, they are reassured that
simple and affordable to attain from third
party sources. By securing current and
Convention
their bills, or a portion thereof, will be covered by another payer
source thus enabling them to focus their full attention on recuper- accurate patient information, providers can
& Tradeshow
ating from their injury or condition. lAs VeGAs Hilton noVemBer 15 - 17
The savings to a provider by identifying the payer source quickly send bills to the appropriate address to
are significant. For example, one leading national emergency physi-
cian group is running their current A/R billings through a third minimize payment delays and decrease
party solution to find accurate SSN’s. More than 55 percent of
patient accounts have the SSN added to the patient record when account aging.
there had been only a name and address previously listed. Using the 2010 ANNUAL KEYNOTE
newly acquired SSNs, the provider is now able to find a payer
You won’t want to miss the
GET MOVED AND MOTIVATED BY RUDY!
source for a large number of accounts that were at one time uncol-
lectable.
Whether the cause is a more transient population, inaccurate
Powerful Presentation from
improve collections with accurate patient information information provided by the patient, inability to obtain complete Rudy Ruettiger!
If a patient’s current address and SSN are the key to faster collec- information at the time of service, or keying errors by staff, inac-
tions, most providers are in need of dramatic improvement. A 2008 curacy is prevalent in patient records and causing providers to suffer
INTERNATIONAL KNOWN CELEBRITY:
study on the accuracy of EMS-recorded patient demographic data from growing bad debt. Against all odds on a gridiron in South Bend,
by Informa Healthcare, found demographic error rates averaging as Indiana, Daniel “Rudy” Ruettiger in twenty seven
high as 73.9 percent in EMS patient records and a correct SSN in Advance financial processes to survive seconds, carved his name into history books as
33.3 percent of accounts. With a few simple steps, providers can Today’s patients and communities need the services of emergency perhaps the most famous graduate of the University
reduce this number significantly and use it to improve their bottom medicine -- their very lives depend on it. Unless these providers of Notre Dame. The son of an oil refinery worker
automate their administrative and billing processes to secure the and third of 14 children, Rudy rose from valleys of
line. Registe
Accurate patient address information is simple and affordable to accurate patient data that results in more rapid payment, their future
is cloudy at best.
discouragement and despair to the pinnacles of
success. As fans cheered RU-DY, RU-DY, he sacked
r Today!
attain from third party sources. By securing current and accurate
patient information, providers can send bills to the appropriate The time is now to prepare for the new patient population mix the quarterback in the last 27 seconds of the only
SAVE $1
address to minimize payment delays and decrease account aging.
Most patient billings are sent using traditional postal mailings.
of increased self-pay and high deductible health plans. This trend is
unlikely to reverse and is only expected to become more severe.
play in the only game of his college football
career. He is the only player in the school’s history 00
Providers need to equip their financial staff with access to new to be carried off the field on his teammates’ OFF EAR
Unfortunately, 15-20 percent of these mailings never reach the LY
solutions that ensure timely and complete payment for their ser- shoulders. REGISTER BIRD PRICING W
intended recipient.This is a significant number of accounts that will BEFORE H
vices. We are all depending on it. AUGUST EN YOU
never be collected. 31ST!
Let Rudy inspire and motivate
Visit ww
you and your staff to make w.th
annual_2 e-aaa.org/meeti
your service a success! 010 FOR ngs_edu
MORE D cation/
ETAILS
Success Begins in Vegas and Includes You!
SAVE THE DATE!
8 A Mb u lA N CE s ER VI CE Jo u R N A l s u M M ER 2 0 10 9