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Hospital testimony: 73 inpatient discharge delays recorded April–June prompt review of ambulance providers
Summary
At an administrative hearing, St. Vincent's witness said a newly used Epic field and prior staff feedback recorded 73 inpatient discharge delays from April–June 19, 2026; the hospital said those findings, which flagged ambulances for 66% of coded delays, helped prompt a review of ambulance providers including American Ambulance.
St. Vincent's witness told a hearing that a late filing submitted in support of an ambulance-services application documented 73 inpatient discharge delays reported from April through June 19, 2026, and that the hospital is using a new Epic field to track delay reasons going forward.
"The narrative was created as a summary in response to the late filing request," the witness said, describing how the document and an accompanying chart summarize staff-reported causes of delayed discharges. He confirmed the chart combines multiple reasons and is not limited to transportation delays.
The witness, Mr. Durk, said the hospital created a multidisciplinary throughput committee in late 2025 to develop a consistent way to collect discharge-delay data. The committee reviewed AMR on-time performance reports and manually collected feedback from nursing and case management before the Epic field was actively used. "We did not have detailed data at that time, which is why the throughput committee has been put together," he said.
Mr. Durk described how bedside nurses now select a reason in Epic when a patient departs after the expected discharge time: "Delay means patient was discharged past expected discharge time." He added the field records the reason chosen by the nurse but does not record the duration of the delay. "There is a level of subjectivity to that by the nurse," he said, explaining that if multiple factors apply the nurse typically codes the factor perceived to have caused the delay most.
Counsel reviewed the late-filing chart, which shows 48 instances flagged as "waiting on ambulance" (representing the 66% bar on the chart) and a separate "patient transport" bucket accounting for 21% of coded delays. The witness said the hospital does not have a contemporaneous, company-level breakdown of delays, nor a timestamped duration for each ambulance-related delay, and could not provide total delayed-discharge counts for 2024 or 2025 during testimony.
On how St. Vincent's counts an ambulance as "arrived," the witness said the hospital marks a transport "arrived" when the ambulance reaches the patient floor. He acknowledged that in-hospital factors—elevators, paperwork or cleaning—can make an ambulance be recorded as late even if it reached the campus on time.
The witness also confirmed that AMR performs roughly two-thirds of the hospital's interfacility transports and that AMR has not provided regular on-time performance reports to the hospital since December 2025. On redirect, counsel for St. Vincent's said the late filing's results "validated the on-time performance metrics that AMR has been providing us" and that the late filing was one component prompting the hospital to consider other providers, including American Ambulance.
The hearing officer allowed both parties to file post-hearing briefs and set a deadline of July 31 for those submissions. The hearing then adjourned.
The hospital said the Epic field will continue to be used to collect discharge-delay reasons; parties did not present contemporaneous logs or company-specific duration data during the hearing.
