Life Line Ambulance, the local company owned by Colorado-based American Medical Response (AMR), has been struggling to respond to emergencies in a timely fashion for the past several weeks, and, according to fire department sources, has had emergency response times upwards of 30 minutes.
Life Line is the only ambulance company serving the Quad cities area.
Starting in about mid-April, the company’s response times have increased.
A Prescott Fire Department official, who spoke on condition on of anonymity, said, “I can tell you that I had not heard a conversation about long response times in the last few years, but I have heard it in the last few weeks.
“It’s being discussed.”
Central Arizona Fire and Medical Authority Chief Scott Freitag said his firefighters have responded to Med-3 calls — emergencies — and have had to wait a long time for an ambulance to take their patient to the hospital.
“I can tell you there was a time a couple of weeks back, we had one engine wait an hour- and-a-half for an ambulance,” he said, “another waited 45 minutes, and another waited 20, all in the same day.”
The condition is known as Code Red, and it refers to a situation in which there are no ambulances available to respond to emergency calls.
Glenn Kasprzyk, Chief Operating Officer for AMR’s northern Arizona region, denied that anything had changed in terms of ambulance response times or numbers of “cars,” as they’re called, assigned to the area.
He said the company was meeting its state-mandated windows of 10 minutes or less 70 percent of the time and 15 minutes or less 90 percent of the time.
“There are times when the system gets busy, and the system gets taxed, and we’re moving resources,” he said.
“There’s been absolutely no change in deployment for many years. The system in Prescott is pretty predictable, overall.”
The view from inside
The Daily Courier spoke with a current Life Line Ambulance employee who said a driver of an ambulance, who was returning from a hospital transfer fell asleep as the ambulance approached Prescott Valley and ran off the roadway.
“(Life Line management) is trying to keep it really quiet, even from us,” the anonymous employee said. “The ambulance was damaged, but I don’t think there were any serious injuries.”
Kasprzyk acknowledged the incident but said that neither reduced staffing nor extra work hours were the cause. “They (the ambulance crew) worked a 12-hour shift, and the reality is, if they work a 12-hour shift and they’re driving in town or they go out of town — it was an unfortunate circumstance that occurred … but accidents happen.”
He said no patients were on board at the time, and that the ambulance was re-locating from one station to another along Highway 69.
There is a lack of ambulances, the employee said, because, of the cars 10 in service on a typical day, and seven at night, a number of them are unavailable because they’re tied up on inter-hospital transports to Flagstaff, Phoenix or Tucson.
At times, there are as few as two ambulances to answer emergency calls in the entire Quad cities area, the employee said, and as a result, “I have responded all the way from Prescott Valley out to Chino. That happens quite frequently. It’s very frustrating.”
“There’s a lot of variability in the managing the system that we take into consideration to ensure the one side of the system isn’t depleted and that the other side of the system is still getting service to move those patients,” Kaspyrzk said, noting that the unpredictable nature of emergency medicine has always been a challenge.
The employee was not aware of any specific instances where a delayed response has caused a patient’s condition to become worse from lack of speedy care.
The Emergency Medical Services Landscape
A privately owned ambulance service, like Life Line Ambulance, responds to 911 emergency calls, but does not make much money from them.
“Inter-facility transports, those that are pre-scheduled transports from a medical facility to another medical facility or from a medical facility to home, those are pre-approved by the insurance company,” Freitag said. “So they’re guaranteed to get paid for those.
“The 911 calls, there’s no guarantee what, if anything, you’re going to get paid,” he continued. “So the 911 calls tend to be more of a drain. You can break even on them, but it’s very difficult to do.”
The problem, Freitag said, is the number of hospital transports, say, from Yavapai Regional Medical Center to a Phoenix-area hospital, isn’t growing.
Meanwhile, the number of 911 calls is steadily increasing.
“You start reaching that tipping-point where you’re no longer generating the revenue,” he said. “For a private company, that’s an issue.”
Life Line owner AMR is up for sale by its parent company, Envision Healthcare, which, based on industry reports, appears to want to divest itself of EMS operations in favor of its much larger physician staffing division and to reduce debt.
“Is AMR changing something in its corporate business structure to make themselves look more sellable by decreasing costs and staffing since Envision put them on the block?” asked the Prescott Fire official. “I don’t know.”
Kasprzyk said that is not the case.
“There have been no changes to any operational aspects for Life Line Ambulance since Envision announced the sale of AMR. That is an absolutely inaccurate assertion.”