Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 25 - DEPARTMENT OF HEALTH SERVICES - EMERGENCY MEDICAL SERVICES › Article 7 - AIR AMBULANCE SERVICE LICENSING › Section R9-25-705 - Minimum Standards for Operations as an Air Ambulance Service (Authorized by A.R.S. Sections 36-2202(A)(3) and (4), 36-2209 (A)(2), and 36-2213)

Current through Register Vol. 30, No. 28, July 12, 2024
A. A licensee shall
				ensure that the air ambulance service:
1.
				Maintains eligibility for licensure as required under R9-25-703(C);
2. Makes a good faith effort to communicate
				information about its hours of operation to the general public through print
				media, broadcast media, the Internet, or other means;
3. Makes the air ambulance service's schedule
				of rates available to any individual upon request and, if requested, in
				writing;
4. Provides an accurate
				estimated time of arrival to the person requesting transport at the time that
				transport is requested and provides an amended estimated time of arrival to the
				person requesting transport if the estimated time of arrival changes;
5. Except as provided in subsection (B), only
				transports patients for whom the air ambulance service has the resources to
				provide appropriate medical care;
6. Does not perform interfacility transport
				of a patient unless:
a. The transport is
				initiated by the sending health care institution, and
b. The destination health care institution
				confirms that a bed is available for the patient;
7. Ensures that the protocol for the transfer
				of information to be communicated to emergency receiving facility staff
				concurrent with the transfer of care, required in R9-25-201(E)(2)(d)(i),
				includes:
a. The date and time the call
				requesting service was received by the air ambulance service;
b. The unique number used by the air
				ambulance service to identify the mission;
c. The name of the air ambulance
				service;
d. The number or other
				identifier of the air ambulance used for the mission;
e. The following information about the
				patient:
i. The patient's name;
ii. The patient's date of birth or age, as
				available;
iii. The principal reason
				for requesting services for the patient;
iv. The patient's medical history, including
				any chronic medical illnesses, known allergies to medications, and medications
				currently being taken by the patient;
v. The patient's level of consciousness at
				initial contact and when reassessed;
vi. The patient's pulse rate, respiratory
				rate, oxygen saturation, and systolic blood pressure at initial contact and
				when reassessed;
vii. The results
				of an electrocardiograph, if available;
viii. The patient's glucose level at initial
				contact and when reassessed, if applicable;
ix. The patient's level of responsiveness
				score, as applicable, at initial contact and when reassessed;
x. The results of the patient's neurological
				assessment, if applicable; and
xi.
				The patient's pain level at initial contact and when reassessed; and
f. Any procedures or
				other treatment provided to the patient at the scene or during transport,
				including any agents administered to the patient;
8. Creates a prehospital incident history
				report, in a Department-provided format, for each patient that includes the
				following information:
a. The name and
				identification number of the air ambulance service;
b. Information about the software for the
				storage and submission of the prehospital incident history report;
c. The unique number assigned to the
				mission;
d. The unique number
				assigned to the patient;
e.
				Information about the response to the call requesting service, including:
i. The mission level requested;
ii. Information obtained by the person
				providing direction for response to the request;
iii. Information about the air ambulance
				assigned to the mission;
iv.
				Information about the medical team responding to the call requesting
				service;
v. The priority assigned
				to the response; and
vi. Response
				delays, as applicable;
f.
				Whether patient care was transferred from another EMS provider or ambulance
				service and, if so, identification of the EMS provider or ambulance
				service;
g. The date and time that:
i. The call requesting service was
				received;
ii. The request was
				received by the person coordinating transport;
iii. The air ambulance service received the
				transport request;
iv. The air
				ambulance left for the patient's location;
v. The air ambulance arrived at the patient's
				location;
vi. The medical team in
				the air ambulance arrived at the patient's side;
vii. Transfer of the patient's care occurred
				at a location other than the destination, if applicable;
viii. The air ambulance departed the
				patient's location;
ix. The air
				ambulance arrived at the destination;
x. Transfer of the patient's care occurred at
				the destination;
xi. The air
				ambulance was available to take another mission;
h. Information about the patient, including:
i. The patient's first and last
				name;
ii. The address of the
				patient's residence;
iii. The
				county of the patient's residence;
iv. The country of the patient's
				residence;
v. The patient's gender,
				race, ethnicity, and age;
vi. The
				patient's estimated weight;
vii.
				The patient's date of birth; and
viii. If the patient has an alternate
				residence, the address of the alternate residence;
i. The primary method of payment for services
				and anticipated level of payment;
j.
				Information about the scene, including:
i.
				Specific information about the location of the scene;
ii. Whether the air ambulance was first on
				the scene;
iii. The number of
				patients at the scene;
iv. Whether
				the scene was the location of a mass casualty incident; and
v. If the scene was the location of a mass
				casualty incident, triage information;
k. Information about the reason for
				requesting service for the patient, including:
i. The date and time of onset of symptoms and
				when the patient was last well;
ii.
				Information about the complaint;
iii. The patient's symptoms;
iv. The results of the medical team's initial
				assessment of the patient;
v. If
				the patient was injured, information about the injury and the cause of the
				injury;
vi. If the patient
				experienced a cardiac arrest, information about the etiology of the cardiac
				arrest and subsequent treatment provided; and
vii. For an interfacility transport, the
				reason for the transport;
l. Information about any specific barriers to
				providing care to the patient;
m.
				Information about the patient's medical history, including;
i. Known allergies to medications,
ii. Surgical history,
iii. Current medications, and
iv. Alcohol or drug use;
n. Information about the patient's current
				medical condition, including the information in subsections (A)(7)(e)(v)
				through (xi) and the time and method of assessment;
o. Information about agents administered to
				the patient, including the dose and route of administration, time of
				administration, and the patient's response to the agent;
p. If not specifically included under
				subsection (A)(8)(k), (m)(iv), (n), or (o), the information required in A.A.C.
				R9-4-602(A);
q. Information about
				any procedures performed on the patient and the patient's response to the
				procedure;
r. Whether the patient
				was transported and, if so, information about the transport;
s. Information about the destination of the
				transport, including the reason for choosing the destination;
t. Whether patient care was transferred to
				another EMS provider or ambulance service and, if so, identification of the EMS
				provider or ambulance service;
u.
				Unless patient care was transferred to another EMS provider or ambulance
				service, information about:
i. Whether the
				destination facility was notified that the patient being transported has a
				time-sensitive condition and the time of notification;
ii. The disposition of the patient at the
				destination; and
iii. The
				disposition of the mission;
v. Any other narrative information about the
				patient, care receive by the patient, or transport; and
w. The name and certification level of the
				medical team member providing the information;
9. Creates a record for each mission that
				includes:
a. Mission date;
b. Mission level;
c. Mission type;
d. Staffing of the mission;
e. Aircraft type'fixed-wing aircraft or
				rotor-wing aircraft;
f. Name of the
				person requesting the transport;
g.
				Time of receipt of the transport request;
h. The estimated time of arrival, as provided
				according to subsection (A)(4);
i.
				Departure time to the patient's location;
j. Address of the patient's
				location;
k. Arrival time at the
				patient's location;
l. Departure
				time to the destination health care institution;
m. Name and address of the destination health
				care institution;
n. Arrival time at
				the destination health care institution;
o. Either the:
i. Unique reference number used by the air
				ambulance service to identify the patient, or
ii. Unique call number used by the air
				ambulance service to identify the specific mission; and
p. Aircraft tail number for the air ambulance
				used on the mission;
10.
				Establishes, documents, and, if necessary, implements a plan to address and
				minimize potential issues of patient health and safety due to the air ambulance
				service terminating operations at a physical address used for the air ambulance
				service that:
a. Is developed in conjunction
				with hospitals near the physical address used for the air ambulance service and
				other persons who may be adversely affected by the air ambulance service
				terminating operations;
b. Includes
				notification by the air ambulance service of the persons in subsection
				(A)(10)(a) of the intent to terminate operations, at least 30 calendar days
				before the termination of operations; and
c. Includes temporary measures that will be
				used until alternate methods may be arranged for patient transport that address
				patient health and safety;
11. Establishes, documents, and implements a
				quality improvement program, as specified in policies and procedures, through
				which:
a. Data related to initial patient
				assessment, patient care, transport services provided, and patient status upon
				arrival at the destination are:
i. Collected
				continuously;
ii. For the
				information required in subsection (A)(8), submitted to the Department, in a
				Department-provided format and within 48 hours after the date of a mission, for
				quality improvement purposes; and
iii. If the air ambulance service is notified
				that the submission of information to the Department according to subsection
				(A)(11)(a)(ii) was unsuccessful, corrected and resubmitted within seven days
				after notification;
b.
				Continuous quality improvement processes are developed to identify, document,
				and evaluate issues related to the provision of services, including:
i. Care provided to patients with
				time-sensitive conditions;
ii.
				Transport or documentation, and
iii. Patient status upon arrival at the
				destination;
c. A
				committee consisting of the administrative medical director, the individual
				managing the air ambulance service or desig-nee, and other employees as
				appropriate:
i. Review the data in subsection
				(A)(11)(a) and any issues identified in subsection (A)(11)(b) on at least a
				quarterly basis; and
ii. Implement
				activities to improve performance when deviations in patient care, transport,
				or documentation are identified; and
d. The activities in subsection (A)(11)(c)
				are documented, consistent with A.R.S. §§ 36-2401, 36-2402, and
				36-2403; and 12. Beginning within 12 months after the effective date of this
				Section, establish and maintain a method to electronically document patient
				information and treatment that is capable of being transferred.