# Cataldo Ambulance Service

Cataldo Ambulance Service and Atlantic Ambulance Service (a division of Cataldo Ambulance Service) are a private emergency medical services (EMS) provider in the Greater Boston and North Shore areas of the Commonwealth of Massachusetts, licensed at the advanced life support (ALS) level by the Massachusetts Department of Public Health. As of October 2022, Cataldo had 48 ambulances registered with the state, while the Atlantic division had an additional 45. Headquartered in Somerville, Massachusetts, and with base locations throughout the North Shore, Cataldo provides 911 and interfacility transportation (IFT) ambulance service to several communities, hospitals, and nursing facilities in Massachusetts. Cataldo also operates SmartCare, a mobile integrated health (MIH) provider.

## History

Cataldo was founded in 1977 as Somerville Ambulance Service in Somerville, Massachusetts, by Bob and Diane Cataldo. Beginning as Somerville's 911 ambulance provider with two ambulances and three employees, Cataldo would grow to become the largest 911 ambulance provider in Massachusetts measured by contracted communities.

### Cataldo Ambulance v. City of Chelsea

Starting in 1982, Cataldo became the sole provider of 911 ambulance service for Chelsea, Massachusetts, a contract they still held 41 years later.
This contract did not come without its struggles however. By the 1990s, the local government was faced with a major financial crisis, with a noted $9.5 million deficit. Unable to solve the crisis on their own, the city was placed under a receivership by the state legislature. In early 1995, prior to the expiration of the contract at the time, the city determined that other municipalities in the area were paying significantly less for their private EMS service. At the time, the city was paying Cataldo $90,000 per year for their services. After attempts to negotiate a lower rate for the contract renewal failed, the city put the ambulance contract out to bid.
The city's invitation for bids specified the need for one basic life support (BLS) ambulance, staffed with two EMT-Basics 24/7, at zero cost to the city (in these "zero cost" contracts, companies make money solely through billing patients for emergency transport). Notably, the city specified that the bidding process would follow the state's Uniform Procurement Act, even though ambulance contracts were specifically exempted from the act. Two companies placed bids: Cataldo, which offered the exact requests of the city (including zero cost, despite their previous resistance during negotiation), and CareLine Ambulance Service of Santa Ana, California, which went further to offer a fully staffed ALS ambulance in lieu of BLS. In the cover letter of its proposal, Cataldo wrote: "As you know, ambulance services are exempt from the Procurement Act, therefore, due to our standing and investment in the community, and in order to maintain continuity, we are requesting the opportunity of last refusal."
After reviewing the bids, the city's procurement officer awarded the contract to CareLine. Cataldo sued the city, arguing among other points that the process was bound to the Procurement Act based on the city's invitation for bids, and that therefore CareLine's bid should have been viewed as nonresponsive as the act states that "[t]he procurement officer shall award the contract to the lowest responsible and responsive bidder," which they argued would not apply since CareLine had offered ALS instead of BLS and because Cataldo was acting under the city's statement that the process must conform to the act. The Superior Court ruled in favor of the city, stating that, among other reasons, Cataldo's argument that they offered BLS to abide by the Procurement Act was without merit since Cataldo itself had expressed its knowledge that the act did not apply in its own cover letter, and that the procurement officer was right to select the highest quality of service for the lowest cost, where CareLine was offering ALS for the same zero cost as Cataldo's lower BLS offer. An appeals court reversed this decision in favor of Cataldo, however another appeals court ultimately upheld the Superior Court's initial ruling. CareLine was merged with Laidlaw's MedTrans in June 1995, just before the suit.

### Purchase of Atlantic Ambulance

In 2003, Cataldo purchased Atlantic Ambulance Service. Atlantic would retain its name and become an official division of Cataldo Ambulance representing its own service area.

### Purchase of Northshore Ambulance

In 2008, the city of Peabody, contracted with Northshore Ambulance of Salem, Massachusetts, put their 911 contract out to bid. Atlantic Ambulance submitted a bid and was awarded the contract. Later that year, Atlantic announced that they would be purchasing the assets and contracts of Northshore Ambulance, obtaining the latter's other 911 contracts with Salem and Marblehead. The deal also included Northshore's 13 ambulances, 6 chair cars, and two supervisor vehicles, including at least one Hummer. Days later, one of the supervisor vehicles as well as some office equipment were damaged in a bout of vandalism.

### Partners Healthcare

In 2009, Cataldo entered into a partnership with Fallon Ambulance Service of Quincy, Boston MedFlight of Bedford, and Spaulding Rehabilitation Network's ambulance service to bid for the contract to provide transport services to Partners Healthcare (Later renamed Mass General Brigham) in Massachusetts.This contract included 5 area hospitals, multiple facilities in the Spaulding Rehabilitation Network, and several outpatient care sites. This partnership led to the awarding of the primary contract to Fallon Ambulance, under which Cataldo would act as a subcontractor.

### New operations center

Later in 2009, Cataldo moved its main operations center to Malden, Massachusetts, into a brand new building with a communications center and training space. Cataldo retained its Somerville base as its administrative headquarters.

### Purchase of Lyons Ambulance

In 2017, Cataldo announced that it would be acquiring Danvers-based Lyons Ambulance Service, which having been founded in 1904 was the longest-running ambulance company in Massachusetts at the time. With the purchase came Lyons' 911 contracts with Danvers, East Boxford, and Wenham, as well as backup ALS service for Essex, Gloucester, Manchester-by-the-Sea, and Rockport.

### Smartcare

In 2019, Cataldo Ambulance received a special waiver from the state Office of Emergency Medical Services allowing them to start the state's first Mobile Integrated Health (MIH) service, named SmartCare. Already a concept practiced in other states, several other ambulance companies, both private and hospital-based, would follow suit and create their own MIH programs.

## Operations
### Ambulance transportation
#### Municipal service

Cataldo has been serving municipalities across Massachusetts since it was founded as Somerville's ambulance provider. Today, like many private EMS companies, Cataldo serves its contracted communities in multiple ways:
* Primary 911 ambulance coverage: Provision of dedicated ambulances for all medical emergencies
* Backup ALS service: Providing ALS response to acute emergencies upon request to communities that only run BLS service
* Emergency Medical Dispatch (EMD): Taking of medical-only 911 calls transferred from the community's primary PSAP
Measured by their 15 municipal contracts, Cataldo is the largest provider of 911 ambulance service in Massachusetts. The majority of these contracts are north of Boston, with some historical presence in MetroWest - however, their presence in MetroWest was greatly diminished with the loss of their Newton and Waltham contracts. The biggest departure from their normal service area came in 2022, when they became 911 provider for the city of Holyoke, Massachusetts, about 90 miles west of Boston.
911 & EMD Contracts :
| City/Town | Ambulance | EMD |
| City of Chelsea | Current, Since 1982 | Current, Since 2012 |
| Town of Danvers | Former, 2017-2023 | Not Serviced |
| East Boxford | Former | Not Serviced |
| City of Everett | Current | Current, Since 2012 |
| City of Holyoke | Current, Since 2022 | Current, Since 2022 |
| City of Lynn | Current, Since 2007 | Not Serviced |
| Town of Lynnfield | Not Serviced | Current, Since 2021 |
| City of Malden | Current | Current, Since 2012 |
| Town of Marblehead | Current | Not Serviced |
| City of Melrose | Former, 2008-2013 | Current, Since 2012 |
| Metro North RECC | N/A | Current, Since 2016 |
| City of Newbury | Not Serviced | Current, Since 2016 |
| City of Newburyport | Current | Current, Since 2012 |
| City of Newton | Former | Not Serviced |
| City of Peabody | Current | Current, Since 2012 |
| City of Revere | Current | Not Serviced |
| City of Salem | Current | Current, Since 2012 |
| Town of Salisbury | Current | Current, Since 2014 |
| Town of Saugus | Former | Not Serviced |
| City of Somerville | Current, Since 1977 | Current, Since 2012 |
| Town of Stoneham | Not Serviced | Current, Since 2021 |
| Town of Wakefield | Current | Current, Since 2019 |
| City of Waltham | Former, 2013-2021 | Not Serviced |
| Town of Wellesley | Former, 2016-2024 (1/20/24) | Not Serviced |
| Town of Wenham | Former | Not Serviced |

#### Interfacility transport

Cataldo also provides emergent and non-emergent IFT service for hospitals and nursing facilities. Starting in 2009, Cataldo signed on as a subcontractor under Fallon Ambulance Service, another Boston-area ambulance company, to provide this service for Partners Healthcare (later renamed Mass General Brigham), a contract which included hospitals in their service area such as Newton-Wellesley Hospital and Salem Hospital.

#### Special operations

Cataldo provides standby ambulance service for sporting events, music venues, and other gatherings. Cataldo is contracted with Fenway Park and TD Garden to provide standby service for any medical emergencies occurring within their venues during sporting and other events.

### Wheelchair transportation

Like many private ambulance companies in the region, Cataldo also maintains a fleet of wheelchair accessible vans, colloquially referred to as "chair cars", used primarily for transportation of individuals who are otherwise unable to secure transportation to medical appointments but do not require an ambulance. These vehicles are equipped with safety devices used to secure wheelchairs and many models of powerchairs in order to allow individuals to maintain a seated position throughout the duration of the transport.
Cataldo provides this service for routine medical appointments, for discharges from hospitals, and for transfers to rehabilitation.

### Mobile integrated health

Cataldo was the first ambulance service in the state to provide mobile integrated health (MIH) to patients, via its SmartCare division. Contracted with local hospitals, this service provides check-ups to patients who don't necessarily meet criteria for inpatient care, but also have difficulty traveling to doctor's appointments. Generally, a paramedic is sent by SmartCare to check on patients, perform vitals monitoring, and refer to a higher level of care if needed.

## Community service and accolades

Cataldo Ambulance has a long reputation of making charitable donations to the communities that it serves. Be it in the form of tangible gifts or life-saving education, the goal is to ensure the highest quality of medical care and knowledge to all of the residents of their communities. Furthermore, Cataldo Ambulance regularly hosts and participates in fundraising events that benefit non-profit research organizations like the American Cancer Society.
* 1993, annually. Cataldo Ambulance's Swing Fore Hope annual golf tournament to make contributions to the fight against cancer. All proceeds are donated to the American Cancer Society's Hope Lodge Boston.
* December 2001, annually. Cataldo Ambulance partners with the Somerville Housing Authority to collect toys for needy children for the winter holiday season. Cataldo participates annually by stationing an ambulance at the local K-Mart to collect the goods.
* March 2005. Twenty-four Everett school teachers received free CPR/AED training compliments of Cataldo Ambulance after Winter Hill Bank donated two AEDs to Everett Schools.
* November 2005. Cataldo Ambulance honored 12 EMTs and Paramedics who spent a total of four weeks, deployed in two teams each for two weeks, in disaster areas post-Hurricane Rita in Texas.
* February 2007, annually. Cataldo aids the American Cancer Society's Daffodil Days campaign. This too has become a routine event in which Cataldo Ambulance and its employees participate.
* May 2007. Cataldo sponsors mock "mash-up" in collaboration with many Malden officials and the Members of Students Against Destructive Decisions. This has become a routine annual event in several of Cataldo's communities in order to show high-school students the dangers of drunk driving - especially for seniors nearing the prom.
* September 2007. Cataldo Ambulance partners with Malden Fire and Police Departments in order to equip new command vehicles with OEMS-approved first-in EMS bags. They were recognized by the Malden Kiwanis Club.
* February 2008. Cataldo Ambulance Service donates four defibrillators to Saugus Fire Department.
* April 2008. Cataldo Ambulance Field Supervisor recognized by Everett Chamber as "Paramedic of the Year." Paramedic Supervisor O'Connell was recognized for his significant role as the first EMS responder on scene of a tanker rollover disaster that occurred in Everett in December 2007.
* September 2008. Atlantic Ambulance donates an AED to St. Mary's High School's (Lynn, MA) Athletic Department.
* November 2008. Cataldo Ambulance Service donates former field-supervisor vehicle SUV to City of Melrose Fire Department.
* December 2008. Cataldo Ambulance Only Private Service In State Equipping Vehicles With Priority Traffic Control System (3M Opticom e.g. see Traffic signal preemption).
* February 2009. Atlantic Ambulance Service donates four AEDs over four years to City of Peabody and to St. John's Baptist School.
* October 2009. Cataldo donates a used ambulance to the City of Somerville for conversion into a PD Incident Command Vehicle.
* December 2009. Cataldo Ambulance Service's Vice President, Dennis Cataldo, receives the "Region IV EMS Leader Award" from the Metropolitan Boston Emergency Medical Services Council (MBEMSC).
* January 2010. Atlantic Ambulance staffs a Peabody clinic providing H1N1 vaccines.
* May 2010. Cataldo Ambulance Golf Tournament Raises $28,000 for American Cancer Society.

## Controversies

Cataldo Ambulance Service was found liable for discrimination against an employee by the Massachusetts Commission Against Discrimination and ordered to pay lost wages and punitive damages to an employee who was fired while pregnant.
In August 2021, Cataldo settled with the Office of Inspector General (OIG) for $705,000. The settlement agreement resolves allegations that Cataldo presented claims to Medicare Part B for ambulance transportation to and from skilled nursing facilities (SNFs) where such transportation was already covered by the SNF consolidated billing payment under Medicare Part A.
A 2016 MassHealth Audit report showed Cataldo did not maintain properly completed Medical Necessity Forms (MNFs) for wheelchair car services. This affected services that totaled as much as $942,326.
Also in 2016, Massachusetts Attorney General Maura Healey has announced her office has sued Cataldo for $600,000 after allegations the company overbilled the state's Medicaid program (MassHealth). From 2005 to November 2015, the state alleges Cataldo billed MassHealth for emergency advanced life support (ALS) services in scenarios where patients only needed emergency basic life support (BLS) services.