Care Without Boundaries: Long-Distance NEMT

By: Michael Payton, NRP, Regional Operations Manager, IMPACT Mobility

As travel increases for vacations, holidays, and family gatherings, so does the possibility of illness or injury away from home. But what happens when a patient is too stable for an ambulance, too far away for traditional transport, and unable to afford a medical flight?

That is where long-distance NEMT can make a difference - helping patients safely return home and reunite with their families.

The questions are simple: Who, Where, When, and Cost?

Who: Patients, Staff, and Family

The first priority is determining whether the patient is medically stable and appropriate for NEMT. Never rely solely on someone else’s assessment. See the patient and perform your own assessment.

Consider:

• Is the patient stable and safe to transport?

• Do you have qualified, willing staff available?

• Is someone available to receive the patient?

• Do you have the necessary equipment and enough oxygen?

• Can you provide food, hydration, and basic care?

• Is the appropriate crew available for personal or incontinence care?

• Is the patient receiving hospice care?

• Is there a valid DNR, if applicable?

  
  

Once the patient’s needs can be safely met, move to Where.

Where: Distance, Time, and Crew

Where is the patient going, and how long will the trip take?

Consider the total travel time, patient needs, driving conditions, and the number of crew members required. Longer trips may require additional personnel to allow for driving and rest rotations. For example, a trip lasting 24 hours may require a larger crew than a routine local transport.

The goal is simple: build a crew that can complete the trip safely without compromising patient care or employee rest.

When: Timing Is Everything

When will the patient be ready? When will your crew be ready? When will the family be available?

Confirm the facility’s discharge time and make sure your crew is adequately rested before departure. Coordinate with the receiving family so someone is available when you arrive.

Consider traffic, weather, road conditions, oxygen requirements, and the most practical route. A departure time that avoids major-city traffic may reduce travel time and improve the overall experience.

Good planning can prevent unnecessary delays and reduce avoidable risks.

Cost: Know Your Numbers

Long-distance transportation involves more than mileage. Consider:

• Employee wages and potential overtime

• Fuel

• Meals

• Lodging

• Vehicle wear and tear

• Time the vehicle will be out of service

• Additional operational expenses

  
  

A trip that takes multiple days can significantly increase costs. Your pricing should account for these expenses while remaining reasonable and competitive.

If a vehicle normally generates a daily revenue goal, consider the revenue lost while it is committed to a long-distance trip. Add actual travel expenses, meals, lodging, fuel, and a reasonable amount for vehicle use and unexpected costs.

Most importantly, take care of your employees. Provide meals and appropriate lodging when necessary, and never compromise their safety to save money.

The Goal: Safe, Reliable, and Compassionate Transport

Long-distance NEMT is more than putting a patient in a vehicle and driving across the country. It requires careful planning, appropriate staffing, proper equipment, communication, and realistic pricing.

The goal is to get the patient home safely, efficiently, and with dignity while providing a sustainable service for the company and its employees.

When done correctly, long-distance NEMT can help bridge the gap between patients who are no longer in need of an ambulance and the families waiting to bring them home.

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