County officials concerned with growing delays in transferring ambulance patients — which prevent paramedics from answering next call.



Waiting for an ambulance can be excruciating. But the wait afterward for a hospital bed is often much longer.

It’s not uncommon in Riverside County for an hour or more to pass before paramedics can hand over care of a patient to a hospital.

Until then, they wait with gurney-bound patients in hallways and can’t respond to other calls. County officials have investigated cases of waits that lasted up to eight hours.

County officials are concerned with what they say is a growing trend in delays offloading ambulance patients. The county emergency medical services agency recently published a survey that showed some hospitals are better than others in getting ambulances back on the road.

A delay starts when an patient delivered by ambulance has not been transferred to a hospital’s care within 30 minutes. Any transfer taking place in under half an hour is considered timely.

Delays are partially blamed on a a surge in emergency room visits since the Affordable Care Act went into full effect in 2014. Other factors include an increased demand for mental health care at hospitals and inefficient bed management.

Bruce Barton, the county’s EMS director, said the delays are a byproduct of the county’s massive growth over the years. Hospital capacity has struggled to keep up and the county has lagged behind other parts of California in the ratio of hospital beds to people.

Ambulance offload delays are a problem nationwide. A county staff report quoted a national study conducted between 2006 and 2012 that found the average time it took to hand off an ambulance patient to a hospital went from 20 minutes to 45 minutes, a loss of almost 5 million hours of EMS productivity.

American Medical Response, a private company, is the county’s main provider of emergency ambulance rides.

In 2014, one in four patients transported by AMR waited on an ambulance gurney for more than 30 minutes before a hospital took over care, costing AMR more than 14,000 hours, county officials said. AMR is bound by its county contract to meet response time goals or it can be fined.

AMR spokesman Jason Sorrick said his company thinks offload delays are a significant issue.


Of the hospitals surveyed by the county, those in the desert — Desert Regional Medical Center in Palm Springs; Eisenhower Medical Center in Rancho Mirage and John F. Kennedy Memorial Hospital in Indio — had the fewest delays between January and April of this year.

Riverside County Regional Medical Center in Moreno Valley had one of the better compliance rates, meeting the 30-minute standard 73 percent of the time. Keven Porter, nurse manager for the county-run hospital’s ER, said the department is focused on saving space for patients arriving by ambulance.

“To create treatment space we focus on promptly providing a medical screening examination by a medical provider, implement diagnostic testing (lab and radiology) as soon (as) possible,” he wrote in an email.

“Additionally, we continue to timely discharge, admit or transfer patients depending on their needs in order to maintain the capacity to meet the demands of both ambulatory and EMS arriving individuals.”

The hospital’s 40-bed ER averages 210 patients a day.


1 in 4: Patients transported by American Medical Response who waited on an ambulance gurney for more than 30 minutes before a hospital took over care in 2014.

Source: AMR


Some hospitals are faster than others in offloading ambulance patients, according to a Riverside County survey.

There’s no delay if a hospital takes over a patient’s care from paramedics within 30 minutes of an ambulance’s arrival. The average delay time includes the first 30 minutes.

Ambulance Offload Patient Delays, January to April 2015

San Gorgonio Memorial Hospital (Banning)

  • Total transports: 2,189
  • Average delay time: 51 minutes
  • Compliance rate: 80.5%

Inland Valley Medical Center (Wildomar)

  • Total transports: 3,335
  • Average delay time: 57 minutes
  • Compliance rate: 80.3%

Temecula Valley Hospital

  • Total transports: 1,546
  • Average delay time: 53 minutes
  • Compliance rate: 74.6%

Riverside County Regional Medical Center (Moreno Valley)

  • Total transports: 4,637
  • Average delay time: 54 minutes
  • Compliance rate: 72.6%

Loma Linda University Medical Center – Murrieta

  • Total transports: 1,933
  • Average delay time: One hour, 4 minutes
  • Compliance rate: 62.9%

Hemet Valley Medical Center

  • Total transports: 5,024
  • Average delay time: One hour, 4 minutes
  • Compliance rate: 60%

Riverside Community Hospital

  • Total transports: 6,020
  • Average delay time: One hour
  • Compliance rate: 47.9%

Corona Regional Medical Center

  • Total transports: 2,358
  • Average delay time: One hour, 26 minutes
  • Compliance rate: 41.7%

Parkview Community Hospital (Riverside)

  • Total transports: 2,070
  • Average delay time: One hour, 16 minutes
  • Compliance rate: 38.7%