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Who should pay for parking lot 911 response?

Ambulance companies should get paid, even when responding to hospital parking lots – but who’s on the hook?

Point

In the case of Lori, who was writhing in pain in the hospital parking lot, the ambulance company is 100 percent right in sending a bill and expecting payment. After all, a service was requested and a service was performed.

Counterpoint

On the other hand, the real question is: who should pay?

Legally speaking: The hospital, of course!

According to the news story, the hospital owes a duty to care for anyone within 250 yards of the facility. Check.

I doubt the parking lot for the emergency department was longer than two-and-a-half football fields. Check.

Therefore, as a patient on the hospital premises and presenting with a medical complaint, Lori is the hospital’s responsibility. Check. Check. Check.

Furthermore, when the hospital staff called 911 – knowing that Lori was within 250 yards from the hospital – they knew or should have known that 911 emergency service comes with a price tag. There is nothing immoral or unethical about that; business is business.

The hospital called, the hospital should pay.

Nervous lawyer counter-counterpoint

I wish that the answer was as simple as that; it should be.

Unfortunately, lawyers have made us all way too skittish for simple answers.

Sources I contacted in preparing this piece have informed me that the practice of calling 911 for incidents that occur outside the hospital doors is not only common, it’s standard policy; not only in [those] hospitals, but just about everywhere.

For reasons of liability (thanks, lawyers), hospital staff are limited to a simple bystander level of care (CPR, AED, etc.) when individuals “go down” outside the facility doors – even though they may still be on hospital property. “We have teams that respond to incidents within the hospital itself, but they don’t respond outside the building. The doctors won’t even go outside at all,” I was told.

On the other hand, my sources tell me if someone simply requires mobility assistance – such as a wheelchair from the parking lot, for example – policy and practice dictate that they render transportation assistance as a matter of service and convenience.

Unintended consequences

This story, though, sheds light on a much more serious problem: the unintended consequences of calling 911 unnecessarily.

First, the hospital calls 911 for a situation they should be able to easily handle. An ambulance or fire apparatus or both respond from the station, through the streets with lights and sirens. If the emergency vehicles are involved in or cause an accident, even the worst lawyer in the world will know to go after the person/people/organization (read: those with deep pockets) who set in motion the events that led to the accident.

Second, and no less important, every call to 911 that results in a lights/sirens response risks the safety of those responding.

Third, when emergency resources are unnecessarily occupied, response times to other, real, emergencies are often extended, thus jeopardizing the health and safety of the community.

In this case

With full acknowledgement of the fact that I do not know any more about this story than you, it seems that Lori just needed some assistance ambulating into the ER; 911 was not necessary; the hospital should pay that bill.

However, I openly admit that I do not know all of the facts. My mind is open to being changed if the facts demand.

Afterthought

In case my two cents is worth anything at all, here it is: maybe it’s time to be less afraid of lawyers and more concerned about doing what needs to be done.

Maybe it’s time for hospitals to create swift response teams who can render more than basic aid in the hospital parking lot.

If I go down just outside the ER, I sure hope someone will come out and give me a little shock, some CPR, and a little Epinephrine pick-me-up before they wheel me on in and try to pull me back from the bright white lights at the end of the tunnel – or, in my case, they may be red.

On the other hand, if I need a little assistance getting in because my back is all seized up (again), just send me a wheelchair and let the folks at the rescue house relax. They need their sleep and I will need the $375 for the Toradol & Ibuprofen I will get in the ER.

EMS1.com columnist David Givot, a seasoned EMS employee with three years of law school under his belt, is looking to the future of EMS. He has created TheLegalGuardian.com as a first step toward improving the state of EMS through information and education designed to protect EMS professionals nationwide.
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