Mayo Clinic

AMBULANCE SERVICE

PATIENT CARE - SEE SCHEDULE OPATIENT CARE:GOLD CROSS AMBULANCE SERVICE IS A MEDICAL TRANSPORTATION SERVICE THAT OPERATES AS AN "OUT-OF-HOSPITAL" CARE ORGANIZATION PROVIDING MEDICAL CARE, COMPREHENSIVE MEDICAL TRANSPORTATION AND MEDICAL EDUCATION AND TRAINING TO GROUPS AND INDIVIDUALS IN THE COMMUNITIES SERVED. THE CORE PURPOSE OF THE GOLD CROSS SERVICE IS PROVIDING CARE TO PEOPLE DURING THEIR TIME OF NEED RESULTING FROM ACCIDENTS AND MEDICAL EMERGENCIES. GOLD CROSS RESPONDS TO "911" CALLS IN EACH COMMUNITY SERVED WITHOUT ANY REGARD TO REIMBURSEMENT FOR SERVICES, INCLUDING THE ABILITY OF THE CALLING PARTY TO PAY FOR THE COSTS ASSOCIATED WITH THE SERVICE. GOLD CROSS PROVIDES BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE SERVICES. ALL GOLD CROSS AMBULANCES ARE STAFFED BY NATIONALLY REGISTERED PARAMEDICS AND EMT'S (EMERGENCY MEDICAL TECHNICIANS). THIS CERTIFICATION REPRESENTS THE HIGHEST LEVEL OF CERTIFICATION FOR OUT-OF-HOSPITAL EMERGENCY CARE PROVIDERS AVAILABLE AND EXCEEDS THE AMBULANCE SERVICE STANDARDS REQUIRED BY MINNESOTA AND WISCONSIN LAW. GOLD CROSS IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF MEDICAL TRANSPORT SERVICES (CAMTS). THIS ACCREDITATION REQUIRES MEETING AND MAINTAINING THE HIGHEST LEVEL, RIGOROUS STANDARDS FOR SERVICES TO MEET IN THE NATION FOR AMBULANCE SERVICES. BOTH THE NATIONAL REGISTRY STATUS OF GOLD CROSS PARAMEDICS AND EMTS, AS WELL AS THE ACCREDITATION OF GOLD CROSS BY CAMTS DEMONSTRATE THE FINANCIAL AND PRACTICAL COMMITMENT GOLD CROSS HAS MADE TO PROVIDING THE BEST POSSIBLE CARE TO PATIENTS SERVED.GOLD CROSS UTILIZES DISPATCHING SERVICES PROVIDED BY A SOPHISTICATED COMPUTER AIDED DISPATCH SYSTEM HOUSED IN OUR CENTRALIZED EMERGENCY COMMUNICATIONS CENTER (ECC) IN ROCHESTER, MN, WHICH IS LOCATED IN AND OPERATED BY MAYO CLINIC HOSPITAL -- ROCHESTER, A RELATED EXEMPT MAYO ENTITY. THE ECC ENABLES AREA-WIDE DIGITAL PAGING, PROVIDES PRE-ARRIVAL MEDICAL INSTRUCTIONS TO CALLERS, AND ENSURES TIMELY AND EFFICIENT DISPATCH FOR ALL GOLD CROSS UNITS. WHEN PATIENT CARE REQUIRES IT, GOLD CROSS TEAMS UP WITH SPECIALLY TRAINED STAFF, INCLUDING REGISTERED NURSES FROM REGIONAL MEDICAL HELICOPTER PROGRAMS TO PROVIDE A HIGHER LEVEL OF CARE FOR THE PATIENT - CRITICAL CARE. THE STANDARDIZATION OF PATIENT CARE, SERVICES AND SUPPLIES ACROSS THE SYSTEM AND THE INTEGRATION OF GROUND AND AIR RESPONSE THROUGH A CENTRALIZED EMERGENCY COMMUNICATIONS CENTER HAS ENABLED GOLD CROSS TO PREPARE AN EFFICIENT PLAN OF ACTION FOR MULTIPLE INJURY INCIDENTS. IN ADDITION, GOLD CROSS FILLS A VARIETY OF PUBLIC SAFETY SERVICES IN EACH COMMUNITY SERVED.IN 2014, GOLD CROSS AMBULANCE PROVIDED MEDICAL TRANSPORTATION TO ALMOST 59,600 PATIENTS, OFTEN INVOLVING COMPREHENSIVE MEDICAL CARE DURING TRANSPORTATION. IN ADDITION, GOLD CROSS RESPONDED TO OVER 21,000 EMERGENT REQUESTS FOR SERVICE THAT DID NOT RESULT IN THE TRANSPORTATION OF A PATIENT. THESE NO TRANSPORT REQUESTS CONSUME A SIGNIFICANT AMOUNT OF FINANCIAL RESOURCES, WITHOUT A MEANS OF BILLING FOR AND COLLECTING REVENUE, AS GOLD CROSS FULFILLS ONE OF ITS ROLES AS A PUBLIC SAFETY PROVIDER IN THE COMMUNITIES SERVED. APPROXIMATELY 500 OF THESE NO TRANSPORTS ARE SPECIFIC REQUESTS FOR US TO PROVIDE EMERGENCY MEDICAL STANDBY AS OTHER PUBLIC SAFETY PROVIDERS CONDUCT THEIR NORMAL BUSINESS SUCH AS FIGHTING FIRES, DOING HIGH-RISK POLICE ENTRIES AND ACTIVITIES, ETC., WHICH CAN OFTEN CONSUME SEVERAL HOURS OF UNPAID SERVICE BY OUR CREWS FOR EACH STANDBY. IN ADDITION, GOLD CROSS SERVES THE NEEDS OF VETERANS THROUGH CONTRACTS FOR AMBULANCE SERVICE WITH THE VETERANS ADMINISTRATION IN ST. CLOUD AND DULUTH, IN MINNESOTA AND SUPERIOR, IN WISCONSIN.GOLD CROSS PROVIDES CHARITY CARE FOR PATIENTS FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. SERVICES ARE ALSO PROVIDED TO PATIENTS COVERED BY MEDICARE, MEDICAID, AND OTHER GOVERNMENTAL PROGRAMS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. CHARITY CARE IS AN ADDITIONAL FINANCIAL STRAIN ON AMBULANCE SERVICES. A RECENT GAO STUDY ON MEDICARE REIMBURSEMENT INDICATED REIMBURSEMENT FOR AMBULANCE SERVICES FALLS SHORT OF ACTUAL COSTS BY 6% IN URBAN AND RURAL AREAS AND 17% IN SUPER-RURAL AREAS. THE COST OF CHARITY CARE PROVIDED IN 2014 WAS APPROXIMATELY $46,000 AND THE COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID IN 2014 WAS APPROXIMATELY $915,000. THE UNREIMBURSED COST OF MEDICARE WAS APPROXIMATELY $1,294,000. GCMN PAID $387,500 TO MNCARE, A PROGRAM THAT PROVIDES HEALTH CARE TO BENEFIT ELIGIBLE MINNESOTA RESIDENTS.

EDUCATION AND TRAINING - SEE SCHEDULE O: EDUCATION AND TRAINING:GOLD CROSS HAS BEEN DESIGNATED BY THE AMERICAN HEART ASSOCIATION (AHA) AS A COMMUNITY TRAINING CENTER (CTC) FOR THE AHA WHICH HAS ESTABLISHED GOLD CROSS AS A PROVIDER OF EMERGENCY CARDIAC CARE TRAINING AT VARIOUS PROFESSIONAL LEVELS FOR THE AHA. GOLD CROSS PROVIDES CUSTOMIZED EDUCATIONAL AND TRAINING PROGRAMS TO THE PUBLIC, MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, OTHER ALLIED HEALTH CARE AGENCIES, AND PUBLIC SAFETY AGENCIES COVERING TOPICS SUCH AS BASIC EMERGENCY CARE, MEDICAL-LEGAL ISSUES, OSHA REQUIREMENTS, ENVIRONMENTAL EMERGENCIES AND OTHER COURSES SPECIFIC TO CUSTOMER NEEDS. THROUGHOUT 2014 OVER 10,000 PEOPLE WERE TRAINED THROUGH THE CTC OPERATED BY GOLD CROSS.GOLD CROSS DONATES TRAINING TIME TO A VARIETY OF CITIES, COUNTIES, FIRE DEPARTMENTS, EMERGENCY MEDICAL SERVICE AGENCIES, AS WELL AS THE GENERAL PUBLIC. GOLD CROSS HAS DEMONSTRATED THIS COMMITMENT BY SUPPORTING VARIOUS ASSOCIATIONS INCLUDING THE SOUTHEAST REGIONAL EMS PROGRAM BOARD, THE ARROWHEAD EMS ASSOCIATION, THE CENTRAL MINNESOTA EMS JOINT POWERS BOARD, THE SOUTH CENTRAL EMS BOARD, THE MN EMS REGULATORY BOARD, THE MN EMS REGULATORY BOARD DATA COLLECTION SUBCOMMITTEE, THE MN EMS REGULATORY BOARD PREHOSPITAL EDUCATION ADVISORY COMMITTEE, THE MN EMS REGULATORY BOARD MENTAL HEALTH TRANSFER TASK FORCE, THE ROCHESTER/OLMSTED COUNTY INTEGRATED EMERGENCY MANAGEMENT SYSTEM DISASTER EXERCISE SUBCOMMITTEE, THE LAKEHEAD (MINNESOTA) AND VACATIONLAND (WISCONSIN) MUTUAL AID ASSOCIATIONS, THE AMERICAN HEART ASSOCIATION, THE MINNESOTA AMBULANCE ASSOCIATION, AND THE SOUTHEAST REGIONAL EMS PREHOSPITAL ADVISORY COMMITTEE. APPROXIMATELY 8,300 HOURS OF EMPLOYEE TIME WAS PROVIDED FOR A VARIETY OF SAFETY-RELATED PROGRAMS TO VARIOUS COMMUNITIES, BUSINESSES, AND SCHOOLS. IN ADDITION, GOLD CROSS AMBULANCE SERVICE EMPLOYEES PARTICIPATED IN A LARGE NUMBER OF COMMUNITY EVENTS, SCHOOL CAREER FAIRS, STUDENT TOURS, BROWNIE TROOPS, CUB SCOUTS, BOY SCOUTS, STUDENT MENTORSHIP PROGRAMS, VARIOUS PARADES, HEAD START EVENTS AND HEALTH FAIRS, AMONG OTHERS. THE ESTIMATED DOLLAR VALUE OF THESE EFFORTS AND OTHER DONATED SERVICES EXCEEDED $414,000. IN ADDITION GOLD CROSS HAS ESTABLISHED A 2-YEAR PARAMEDIC TRAINING PROGRAM IN CONJUNCTION WITH A LOCAL COMMUNITY COLLEGE AND THE MAYO SCHOOL OF HEALTH SCIENCES. THE INVESTMENT MADE IN THE PROGRAM HELPS SECURE A WELL-TRAINED WORKFORCE FOR GOLD CROSS AND OTHER AMBULANCE PROVIDERS THAT DEPEND ON A CONTINUOUS FLOW OF NEW, WELL-QUALIFIED AND CAPABLE PARAMEDICS INTO THE WORKFORCE. MANY LOCAL COMMUNITIES CANNOT UPGRADE THEIR AMBULANCE SERVICE FROM BASIC (BLS) TO ADVANCED (ALS) BECAUSE VOLUNTEERS DO NOT HAVE ACCESSIBLE TRAINING. INSPIRED BY THIS FACT, GOLD CROSS HAS WORKED WITH A MULTITUDE OF COMMUNITY PARTNERS TO DEVELOP INNOVATIVE TRAINING SOLUTIONS. SIMILARLY, VOLUNTEER COMMUNITY GROUPS SPECIALIZING IN FIRST RESPONSE OR DISASTER RESPONSE OFTEN LACK FINANCES TO MAKE INITIAL PURCHASES OF EQUIPMENT OR TO UPGRADE EQUIPMENT. GOLD CROSS DONATES USED EQUIPMENT TO SUCH ORGANIZATIONS REGULARLY. THE TOTAL VALUE OF DONATED EQUIPMENT, INCLUDING VEHICLES IN 2014 WAS APPROXIMATELY $71,500. GOLD CROSS FURTHER SUPPORTS VARIOUS COMMUNITIES BY CONTRACTING WITH THEM TO PROVIDE MANAGEMENT SUPPORT SERVICES FOR THEIR SERVICES.OVER THE YEARS, GOLD CROSS HAS DEVELOPED COOPERATIVE APPROACHES IN MEETING MEDICAL CENTER STAFFING NEEDS AS WELL AS INCREASING TRAINING FOR GOLD CROSS PARAMEDICS. BY COLLABORATING WITH HOSPITALS IN VARIOUS CITIES IN WHICH WE PROVIDE SERVICE, GOLD CROSS PARAMEDICS PROVIDE ADVANCED LEVEL PATIENT CARE IN THE EMERGENCY ROOM ENVIRONMENT IN COMMUNITIES THAT BENEFIT FROM THAT STAFFING. THROUGH THIS COLLABORATIVE EFFORT, GOLD CROSS PARAMEDICS RECEIVE TRAINING AND EXPERIENCE TO FURTHER ENHANCE THEIR SKILLS AND THE HOSPITAL AND MEDICAL CENTER BENEFIT FROM THE AVAILABILITY OF PARAMEDICS TO ASSIST DURING PERIODS OF TIME WHEN THEY EXPERIENCE SHORTAGES IN STAFFING.GOLD CROSS IS A FOUNDING MEMBER OF THE NORTH CENTRAL EMS COOPERATIVE (NCEMSC). THE NCEMSC IS MADE UP OF MEMBERS FROM THROUGHOUT THE UNITED STATES AND PROVIDES GROUP PURCHASING OF AMBULANCES, MEDICAL SUPPLIES AND DEVICES AND OTHER SERVICES ESSENTIAL TO AMBULANCE OPERATIONS IN AN EFFORT TO REDUCE COSTS OF VARIOUS INFRASTRUCTURES FOR AMBULANCE SERVICES FACING FINANCIAL HARDSHIP. IN ADDITION, GOLD CROSS PARTICIPATES IN THE WORK OF THE NORTH CENTRAL EMS INSTITUTE (NCEMSI) FOR THE PURPOSES OF ADVANCING BENCHMARKING AND PUBLIC POLICY RESEARCH RELATED TO THE EMS INDUSTRY. SIMILAR INVESTMENTS OF STAFF TIME AND ADMINISTRATIVE RESOURCES ARE EXPENDED IN EFFORTS WITH THE AMERICAN AMBULANCE ASSOCIATION ON NATIONAL BENCHMARKING EFFORTS FOR THE PURPOSE OF IMPROVING THE SERVICES PROVIDED TO THE PATIENTS SERVED BY EMS NATION WIDE, AS WELL AS THE AMERICAN HEART ASSOCIATION ON RESEARCH FUNDING AND EXECUTION OF COMMUNITY AWARENESS.

SHARED SERVICES - SEE SCHEDULE O:SHARED SERVICES:PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE.