Shortage of EMTs, paramedics challenges private ambulance companies


By Mackenzi Klemann - [email protected]



Chris Cantrell, left, and Ron Cruse transport patients from Ohio hospitals to nursing homes, dialysis appointments and other hospitals for Spirit Medical Transport, one of the few remaining private ambulance companies in Northwest Ohio.

Chris Cantrell, left, and Ron Cruse transport patients from Ohio hospitals to nursing homes, dialysis appointments and other hospitals for Spirit Medical Transport, one of the few remaining private ambulance companies in Northwest Ohio.


Mackenzi Klemann | The Lima News

VAN WERT — Brian Hathaway often finds himself behind the wheel of an ambulance, working 24-hour shifts as his company, Spirit Medical Transport, contends with a dwindling pool of prospective EMTs and paramedics willing to work grueling hours transporting patients across Ohio.

He and Spirit Vice President Aaron Guthrie, both certified paramedics, are now accustomed to working several shifts each week, transporting patients to nursing homes, dialysis appointments and between hospitals, sometimes pulling office workers cross-trained as EMTs or paramedics to assist with the runs.

As one of the few remaining private ambulance companies operating in the Lima region, Spirit Medical Transport helps fill the gap for non-emergency medical transport not covered by public EMS crews, which focus on 911 calls.

But the shortage of EMTs and paramedics means Spirit Medical Transport also maintains a lengthy waiting list of nursing homes and medical facilities—now totaling 96—in need of services that the company cannot provide.

“We’re saying no to those 96 facilities on the waiting list because we’d only be in a situation where we overpromised and under delivered,” said Hathaway, president and CEO of Spirit.

For-profits claim low reimbursement rates hurt

Hathaway has watched as other private ambulance companies in the region have shuttered in recent years, a trend he blames on low Medicaid reimbursement rates in Ohio, particularly as inflation pushes the cost of fuel and wages higher.

“We can’t even start the engine for what they’re reimbursing,” he said.

While some hospitals and long-term care facilities like Mercy Health-St. Rita’s Medical Center have their own medical transport teams, Hathaway said his company is called upon by Lima hospitals almost daily to assist with patient discharges to other facilities when those crews are unavailable.

But Spirit is struggling to retain EMTs and paramedics as wages in other industries outpace what the company can offer, especially as those jobs come without the stress associated with emergency medical services.

In some cases, Hathaway said, hospitals are recruiting paramedics to staff emergency departments as the health care industry faces its own worker shortage.

Shortage a persistent problem for rural communities

Recruiting EMTs and paramedics has been a challenge ever since LuAnn Young Peter joined Spencerville EMS 14 years ago.

Ideally, Young Peter would like at least one paramedic to assist on every run, she said. But the volunteer department is currently operating without any paramedics, who undergo additional training compared to EMTs and first responders so they can administer medications and perform more advanced medical care.

Young Peter said many of her volunteers are unavailable to assist with daytime 911 calls too, despite the increase in call volume she attributes to the town’s aging population and the pandemic.

“You used to have businesses in your community, people were working for those businesses and they’d be able to leave and make the run,” Young Peter said. “But as your small towns lose those businesses, you don’t have those people available.”

Relying on nearby EMS crews for mutual aid has its downsides too: “You hate to rely on that too, because then that takes them out of running in their own area,” Young Peter said.

‘Real-life consequences’

The shortage of EMTs and paramedics has in turn led Hathaway to prioritize which patients to attend to first: trauma patients are given priority over nursing home discharges and mental health calls, the latter of which often use Medicaid and may take an ambulance out of service for four to eight hours, Hathaway said.

“Policymakers have to realize that there are real-life consequences to their decisions,” Darin Robinaugh, president of the Ohio Ambulance and Medical Transportation Association, said in a statement. “Compared to its neighbors—Illinois, West Virginia, Wisconsin, Michigan and Indiana—Ohio is reimbursed at the lowest rates for Medicaid.

“Private ambulance providers are on the front lines and these decisions are forcing patients to suffer. It’s time for change and to properly reimburse private ambulances at the cost of lifesaving care.”

Chris Cantrell, left, and Ron Cruse transport patients from Ohio hospitals to nursing homes, dialysis appointments and other hospitals for Spirit Medical Transport, one of the few remaining private ambulance companies in Northwest Ohio.
https://www.limaohio.com/wp-content/uploads/sites/54/2022/04/web1_CJO_5771-2-.jpgChris Cantrell, left, and Ron Cruse transport patients from Ohio hospitals to nursing homes, dialysis appointments and other hospitals for Spirit Medical Transport, one of the few remaining private ambulance companies in Northwest Ohio. Mackenzi Klemann | The Lima News

By Mackenzi Klemann

[email protected]

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