St. Vincent’s says nearby American Ambulance branch would ease discharge delays, but questions remain on rates and contracts

St. Vincent’s Medical Center urged a Department of Public Health hearing on March 16 that approval of an American Ambulance branch near the hospital would help clear patient backlogs and speed interfacility transfers.

Senior Vice President of Operations Andrew Turczak said the hospital’s Bridgeport and Westport campuses have seen growth in demand — ‘‘over the past three fiscal years, St. Vincent’s emergency room visits have grown to over 64,000 visits annually and inpatient transitions have grown by 9.9% to over 15,000 annually,’’ he testified — and that transport delays are a persistent nonclinical barrier that contributes to avoidable discharge delays.

Turczak told the hearing that American Ambulance proposed dedicating three ambulances to interfacility transfers from a base about two miles from St. Vincent’s Bridgeport campus, and that the proximity and the ambulances’ lack of 911 (PSA) obligations would produce ‘‘operational efficiency’’ for transfers and discharges. ‘‘Dedicated ambulances who have a sole focus … without the 911 responsibility to be focused strictly on helping the hospital transition patients out is second to none,’’ Turczak said.

He described the hospital’s efforts to reduce delays — multidisciplinary transition rounds, an EMR chat to coordinate pick‑ups, embedding a transport coordinator in care management, a utilization review team, expanded ambulatory services and a Ride Health program for non‑stretcher transport — and said those steps helped but did not eliminate transportation‑related delays, which he attributed primarily to heavy 911 volume and staffing shortages at provider services.

Turczak also said current interfacility transfers are handled mainly by AMR and Yaxis, with AMR performing an approximate 65% share of St. Vincent’s transfers. He testified that American Ambulance estimates it could perform roughly 5,400 St. Vincent‑initiated transfers in the next year and that approval ‘‘would provide a low‑cost provider for both our patients and our hospital to be able to transition patients.’’

During cross‑examination, attorneys pressed Turczak on bed‑staffing figures, the accuracy of the working group’s bed and boarding numbers, and whether St. Vincent’s could secure more favorable AMR contract rates than those American Ambulance has proposed. Turczak confirmed active negotiations with AMR and said cost would be ‘‘a component’’ of any contract but not the only factor. He declined to state specific ongoing contract terms, citing negotiation and confidentiality concerns.

Counsel asked Turczak for the hospital’s internal breakdown of causes for delayed departures and the percent attributable to transportation; he did not have a definitive, non‑speculative number in the record and the hearing officer requested the hospital file its analysis within a week if it could provide nonproprietary data.

Turczak acknowledged internal patient complaints about transport delays had been relayed to the hospital’s director of EMS but said he was not aware of Department of Public Health investigations that found patient harm from such delays.

The hearing record shows two competing concerns emerging: hospital leaders and American Ambulance proponents emphasize potential throughput and cost benefits from dedicated transfer ambulances operated without 911 obligations; opposing counsel emphasized the need for concrete data on rates, contract commitments and the possible operational impact on existing providers, including AMR. The record does not yet reflect any final contract terms or a Department decision on the proposed branch.