Chapter 4766-5 Medical Transportation

4766-5-01 Definitions.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of this rule.]

(A) "Air Operator" means holder of a " 14 C.F.R. Part 135 Certificate."

(B) "Aircraft" means either or both of the following:

(1) Fixed wing air ambulance;

(2) Rotorcraft air ambulance.

(C) "AMSO" means air medical service organization as defined in division (B) of section 4766.01 of the Revised Code.

(D) "Board" means the state board of emergency medical, fire, and transportation services as described in section 4765.02 of the Revised Code.

(E) "CFR" means the "Code of Federal Regulations," which is a codification of the general and permanent rules and regulations published in the Federal Register by the executive departments and agencies of the federal government of the United States.

(F) "DEA" means the United States drug enforcement administration.

(G) "FAA" means the federal aviation administration.

(H) "FAR" means the federal air regulation.

(I) "FCC" means the federal communication commission.

(J) "Headquarters" means the location which a licensee operates, designated by the licensee as the location where the records described in this chapter are required to be maintained or readily available.

(K) "Health Care Profession" means the occupation of:

(1) Physician assistant;

(2) Physician;

(3) Registered nurse;

(4) Respiratory care professional;

(5) Paramedic.

(L) "HIPAA" means Health Insurance Portability and Accountability Act (HIPAA) "Privacy Rule" which protects the fundamental rights of nondiscrimination and health information privacy.

(M) "IFR" means flight under instrument flight rules.

(N) "Inspection Fee" means a fee required to be paid for the inspection of an aircraft.

(O) "License Fee" means a fee required to be paid to obtain a license to operate an AMSO in the state of Ohio.

(P) "Operate" means to engage in conduct or activity in furtherance of the licensed activity at or from a physical location, owned, leased or maintained by the licensee where employees report to work and vehicles or aircraft are stored. Operate also includes the act of receiving a person within Ohio for transportation to a location within Ohio.

(Q) "Part 135 Certificate" means a certificate issued to the air operator by the FAA setting forth the air operating requirements for commuter and on-demand air operations and rules governing persons on board such aircraft.

(R) "Permit Fee" means a fee required to be paid to obtain a permit for each aircraft owned by AMSO.

(S) "Pilot in Command (PIC)" means the pilot with the final authority and responsibility for operation and safety of the flight.

(T) "Primary Aircraft" means an aircraft permitted in accordance with section 4766.07 of the Revised Code.

(U) "Reinspection Fee" means a fee required to conduct an inspection as a result of the issuance of a violation notification.

(V) "Satellite Base" means a physical location other than headquarters from which a licensee operates.

(W) "Second in Command (SIC)" means a pilot who is designated to be second in command of an aircraft during flight time.

(X) "Service Number" means the number assigned to the licensee by the state board of emergency medical, fire, and transportation services for the purpose of identifying and validating the service or licensee.

(Y) "Service Code" has the same meaning as service number.

(Z) "Temporary Aircraft" means an aircraft used to temporarily replace a primary aircraft that is out-of-service until the primary aircraft is returned to service.

(AA) "VFR" means flight under visual flight rules.

(BB) Incorporated by reference. This chapter of the Administrative Code includes material that has been incorporated by reference. If the material is subject to change, only the current version listed in this rule is incorporated.

(1) " 14 C.F.R. Part 21 , (July, 2014), Part 43 (February, 2010), and Part 91 (April, 2014)," establish the FAA airworthiness standards requiring aircraft to be in a condition for safe operation and maintenance and can be found at http://www.ecfr.gov.

(2) " 14 C.F.R. Part 135 Certificate," (April, 2014), is the certificate that an air medical service must obtain, via the federal aviation administration, to operate and can be found at http://www.ecfr.gov and http://www.faa.gov/licenses_certificates/.

(3) " 29 C.F.R. Part 1910.1030 ," (July, 1992), covers exposure to blood or other potentially infectious materials and can be found at https://www.ecfr.gov.

(4) " 42 C.F.R. Part 493," Clinical Laboratory Improvement Amendments (CLIA), (July, 2014), is a waiver for laboratory services and can be found at http://www.cms.gov [File Link Not Available].

(5) " 45 C.F.R. Part 164.512 ," (March, 2013), specifies what information can be shared under the HIPAA laws and can be found at http://www.ecfr.gov.

(6) " 47 C.F.R. Parts 20 - 39, Section 22.925 ," (July, 2014), is the federal standard covering cellular phones in aircraft and can be found at http://www.ecfr.gov.

(7) " 47 C.F.R Part 90, Section 90.203 ," (April, 2014), covers regulations for radio equipment and can be found at http://www.ecfr.gov.

(8) "Application for Air Medical License" or form "EMS 4003," (June, 2014), is the application used for initial and renewal licensure to operate an air medical service in Ohio and can be accessed via the division's website at http://www.ems.ohio.gov/ems_medical_transportation.stm.

(9) "Application for New Satellite" or form "EMS 4005," (June, 2014), is submitted by an AMSO to request a location be added to the service's license and be inspected and can be accessed via the division's website at http://www.ems.ohio.gov/ems_medical_transportation.stm.

(10) "Deletion of Permitted Aircraft" or form "EMS 4013," (June, 2014), is submitted by an AMSO to permanently delete an aircraft from service and can be accessed via the division's website at http://www.ems.ohio.gov/ems_medical_transportation.stm.

(11) "Temporary Aircraft Permit" or form "EMS 4032," (June, 2014), is a permit issued by the board to enable an AMSO to use a temporary aircraft to replace a specific primary aircraft that is out-of-service which expires on the same date as the permit issued to the specific primary aircraft and can be accessed via the division's website athttp://www.ems.ohio.gov/ems_medical_transportation.stm.

(12) "Temporary Aircraft Permit Affidavit" or form "EMS 4037," (June, 2014), is an affidavit that the AMSO must complete to allow the use of the temporary aircraft permit and can be accessed via the division's website at http://www.ems.ohio.gov/ems_medical_transportation.stm.

(13) "Violation Notification" or form "EMS 4029," (June, 2014), is issued by the board to an AMSO that is in violation of Chapter 4766. of the Revised Code and Chapter 4766-5 of the Administrative Code and can be viewed at http://www.ems.ohio.gov/ems_medical_transportation.stm.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014 and 09/16/2019
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.01
Prior Effective Dates: 1/06/2008

4766-5-02 Application for initial or renewal licensure.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) An AMSO applying for licensure shall file with the board an "Application for Air Medical License," as appropriate, in the English language and shall submit the completed application to the board accompanied by the appropriate fee as defined in rule 4766-5-03 of the Administrative Code.

(B) In addition to the requirements set forth in section 4766.04 of the Revised Code, for each application the AMSO applicant shall provide:

(1) The name, organization structure and address of AMSO applicant to include as follows:

(a) Name;

(b) Identification of organizational structure as a corporation (whether for profit or non-for-profit); limited liability company; partnership; limited liability partnership; government unit; or sole proprietor (individual human);

(c) All other names under which applicant plans to operate;

(d) Copies of all trade name registrations and fictitious name registrations for all other names under which applicant plans to operate on file with the Ohio secretary of state;

(e) Address of physical location of applicant's headquarters (no post office box);

(2) All medicare provider numbers, all medicaid provider numbers;

(3) Service areas including county and state;

(4) A list of the names of all officers, directors, and/or owners of the AMSO;

(5) For each satellite base, the AMSO shall provide the street address, city, county, state, and zip code;

(6) The name of the primary contact person, business or administrative office telephone number, and if applicable, office fax number and e-mail address;

(7) Year of manufacture, make, model, tail number, and aircraft hours on airframe;

(8) A color photograph of the side of the applicant's aircraft displaying color scheme insignia, monogram, or other distinguishing characteristic. If multiple color schemes, insignias, monograms, or other distinguishing characteristics are used, a color photograph of each must accompany application. (Digital photographs are preferred.);

(9) A current certificate of liability insurance in the name of the applicant, listing state board of emergency medical, fire, and transportation services as a certificate holder with a thirty day cancellation notice as specified in section 4766.06 of the Revised Code. The actual name on the licensure application shall appear on the certificate of liability insurance.

(C) Each AMSO shall pay the appropriate fees as specified in rule 4766-5-03 of the Administrative Code.

(D) If an application for licensure is incomplete, the board shall notify the AMSO applicant that the application will not be processed until it is complete. Such notification will occur via certified mail one time for each submission.

(E) No applicant or licensee shall submit false statements in order to obtain a license or permit.

(F) A license is not transferable.

Replaces: 4766-5-02

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.03 , 4766.04 , 4766.06 , 4766.07
Prior Effective Dates: 7/02/09

4766-5-03 Fees.

(A) Each AMSO shall pay an annual license fee of one hundred dollars for initial or renewal licensing, whichever is applicable.

(B) Each AMSO shall pay a permit fee for each aircraft of one hundred dollars annually .

(C) Each AMSO shall pay an inspection fee of one hundred dollars per aircraft annually.

(D) If an AMSO adds an aircraft to the service within six months of the service's expiration date, the AMSO shall pay fifty dollar permit fee and fifty dollar inspection fee.

(E) If an AMSO adds an aircraft to the service within thirty days of the service's expiration date, the permit and inspection fees will be waived at the time of renewal.

(F) Each AMSO shall pay a one hundred dollar reinspection fee for every aircraft that requires reinspection as a result of a violation notification issued by the board.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014 and 09/16/2019
Promulgated Under: 119.03
Statutory Authority: 4766.03 , 4766.05
Rule Amplifies: 4766.05
Prior Effective Dates: 1/06/08

4766-5-04 Physical facilities.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) The board shall conduct initial and renewal inspections of all AMSOs pursuant to Chapter 4766. of the Revised Code and rules 4766-5-04 , 4766-5-05 , and 4766-5-06 of the Administrative Code to include the following:

(1) AMSO service headquarters;

(2) AMSO service satellite location(s).

(B) An AMSO shall not commence operations from its headquarters or satellite(s) until the location is licensed as required by section 4766.04 of the Revised Code.

(C) An AMSO shall ensure compliance with the inspection requirements for physical facilities. The inspection requirements for physical facilities of an AMSO are as follows:

(1) The physical facilities shall be clean and free of debris;

(2) Board issued license(s) shall be prominently displayed in conspicuous location(s) at every licensed facility;

(3) Crew quarters shall be clean;

(4) The physical facilities shall be compliant with state and local building codes;

(5) The physical facilities shall be compliant with state and local fire codes;

(6) The physical facilities shall maintain all single use supplies and equipment as set forth in rule 4766-5- 10 of the Administrative Code.

(D) The board may conduct announced and unannounced inspections at any location a licensed AMSO operates at any time, including nights or weekends, to determine compliance with Chapter 4766. of the Revised Code and rules promulgated thereunder, including but not limited to:

(1) AMSO service headquarters;

(2) AMSO service satellite location(s);

(3) Aircraft.

(E) An AMSO shall maintain at each location, as applicable, the following:

(1) Ohio state board of pharmacy license(s);

(2) DEA registration(s);

(3) " 14 C.F.R. Part 135 Certificate";

(4) Evidence of appropriate insurance as defined in section 4766.06 of the Revised Code;

(5) Verification of employee certification and licenses;

(6) Statutorily required permits and licenses such as fuel, oil, or hazardous waste;

(7) Emergency contact list with telephone numbers;

(8) Copy of written sanitation plan as described in rule 4766-5-07 of the Administrative Code.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014 and 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03 , 4766.07
Rule Amplifies: R.C. 4766.03 , 4766.06 , 4766.07
Prior Effective Dates: 1/06/08

4766-5-05 Transportation records.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) Each licensed AMSO shall maintain or have readily available the following at its headquarters:

(1) Current copy of the organization's operating protocol(s) as filed with the Ohio state board of pharmacy;

(2) Verification of certification or license of all personnel;

(3) A current certificate of liability insurance issued by an insurer licensed to do business in Ohio that includes a thirty day notice of cancellation to the board in compliance with the terms set forth in section 4766.06 of the Revised Code listing the state board of emergency medical, fire, and transportation services as a certificate holder;

(4) Current copy of the AMSO's written policy covering the use of warning devices;

(5) Records or other documents related to patient care or to emergency medical service personnel maintained by the licensed AMSO which shall be made available for review by the board in accordance with 45 C.F.R. 164.512 ;

(6) Documentation as required under rule 4766-5-07 of the Administrative Code;

(7) Current maintenance records for aircraft as specified in rule 4766-5-09 of the Administrative Code;

(8) Current maintenance records for all equipment used for patient care as specified in rule 4766-5-09 of the Administrative Code;

(9) Dispatch log;

(10) Written plan for restocking of supplies in compliance with rule 4766-5-10 of the Administrative Code;

(11) Ohio state board of pharmacy license and addendum;

(12) DEA registration certificate (as applicable);

(13) Clinical laboratory improvement amendments (CLIA) waiver (as applicable);

(14) Current written plan for the handling and disposal of bio-medical infectious materials in accordance with 29 C.F.R. Part 1910.1030 .

(B) A licensee shall maintain or have readily available the following at each satellite base:

(1) Current copy of the organization's operating protocol(s) as filed with the Ohio state board of pharmacy;

(2) Documentation as required under rule 4766-5-07 of the Administrative Code;

(3) Current copy of the AMSO's written policy covering the use of warning devices;

(4) Written plan for restocking of supplies or compliance with paragraph (C)(6) of rule 4766-5-04 of the Administrative Code;

(5) Ohio state board of pharmacy license(s) and addendum(s);

(6) Current written plan for the handling and disposal of bio-medical infectious materials in accordance with 29 C.F.R. Part 1910.1030 .

(C) Upon licensure, each licensed AMSO shall prominently display the original certification of licensure at its headquarters and each satellite base.

(D) Patient records

(1) A licensed AMSO shall maintain accurate records that contain the information set forth in paragraph (D)(2) of this rule concerning the transportation of each patient for a period of five years from the date of the transport;

(2) The following information shall include, if available:

(a) Patient name;

(b) Gender;

(c) Age;

(d) Date of birth;

(e) Address;

(f) Location of incident;

(g) Patient's chief complaint;

(h) Patient's history;

(i) List of patient's current medications, route, dosage, administration schedule;

(j) Patient's allergies and reaction;

(k) Vital signs as appropriate;

(l) Responsible guardian;

(m) Advanced directives;

(n) Beginning location and final destination;

(o) Treatment rendered;

(p) Time interventions and treatments performed;

(q) Time call received;

(r) Time dispatched;

(s) Time enroute;

(t) Time of arrival on-scene;

(u) Time departed;

(v) Time of arrival at destination;

(w) Names and level of certification or licensure of medical personnel;

(3) An AMSO shall be responsible for ensuring that a copy of the record for each patient is provided to the receiving facility.

Replaces: 4766-5-09

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 , 4766.06
Prior Effective Dates: 01/06/2008

4766-5-06 Communication requirements.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) All licensed AMSO communication centers shall comply with the following:

(1) Shall be equipped with a base station capable of two-way communications with associated radios on an assigned frequency:

(a) The base station must be hard-wired;

(b) Use of a hand held battery operated base station used as primary source of communication is prohibited;

(c) The base station shall be staffed during all phases of aircraft operations;

(d) Assigned frequency shall be used exclusively for dispatch and tactical communications and shall be independent of any involvement in the Ohio emergency radio network.

(2) The communication center shall demonstrate and maintain a voice communications linkage with the radios used in the permitted aircraft within the declared service area;

(3) All in-coming and out-going telephone and radio transmissions regarding medical transports shall be recorded on a system with time recording and playback capabilities.

(a) Recordings must be kept for at least thirty days from the day of recording;

(b) Recordings shall be made available to the board upon request.

(4) An emergency plan for communications during power outages and in disaster situations shall be established;

(5) Service area maps and/or navigational charts or mapping software shall be readily available.

(B) All permitted aircraft shall be equipped with two-way communications capable of communication with the licensed AMSO's communication center, air traffic control, and medical control.

(1) The pilot shall be able to control and override radio transmissions from the cockpit in the event of an emergency situation;

(2) Medical team members shall be able to communicate with each other during flight. Rotorcraft air ambulance medical personnel shall wear headsets and/or helmets with communication capabilities during medical transports;

(3) If cellular telephones or other such communications are used on board the aircraft, they are to be used in accordance with FCC regulations 47 C.F.R. parts 20 - 39, section 22.925 .

(C) All licensed AMSOs shall maintain a detailed radio log that documents the following:

(1) Time call received;

(2) Location of call, requesting agency;

(3) Nature of call;

(4) Initial dispatch time;

(5) Time enroute, as applicable;

(6) Estimated time of arrival (ETA), as applicable;

(7) Time of arrival on-scene, as applicable;

(8) Departure from scene time;

(9) Arrival at destination time;

(10) Souls on-board;

(11) Pilot(s) name(s);

(12) Date of service;

(13) Fuel on-board;

(14) Estimated flight time, as applicable;

(15) Time in-service, as applicable.

(D) Radio equipment used in permitted aircraft shall meet the FCC requirements specified in 47 C.F.R. part 90, section 90.203 and all FAA rules and regulations.

Replaces: 4766-5-10

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 , 4766.07
Prior Effective Dates: 01/06/2008

4766-5-07 Sanitation requirements.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) An AMSO shall comply with all occupational safety and health administration, bloodborne pathogens regulations pertaining to the sanitation and maintenance of licensed bases and aircraft in accordance with 29 C.F.R. part 1910.1030 .

(B) An AMSO shall create and utilize a written sanitation plan describing its sanitation procedures in compliance with 29 C.F.R. part 1910.1030 , regarding bloodborne pathogens and other communicable diseases for each of its bases and aircraft.

(C) An AMSO shall provide a copy of its sanitation plan to all of its personnel in a written document that conforms to current standards as set forth in in compliance with 29 C.F.R. part 1910.1030 , bloodborne pathogens protocol.

Replaces: 4766-5-11

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 , 4766.07
Prior Effective Dates: 01/06/2008

4766-5-08 Inspection of aircraft.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) All aircraft to be permitted shall be made available for inspection.

(B) Except as otherwise provided in this chapter, no AMSO shall operate an aircraft without obtaining a permit from the board. In addition to submitting the appropriate fee and application to obtain a permit, an aircraft shall meet or comply with the following inspection requirements:

(1) A standardized insignia, monogram or other distinguishing characteristics of the AMSO shall be displayed on each rotorcraft air ambulance. If an AMSO is under contract which requires other signage, the AMSO's name and service code shall be permanently affixed with each letter being at a minimum of three inches in height on both sides of the air ambulance.

(2) A current and valid FAA certificate which demonstrates airworthiness, in compliance with 14 C.F.R. parts 21 , 43 and 91, shall be readily available at the time of the inspection or upon request of the board.

(3) Contain/possess all applicable equipment set forth in rule 4766-5-10 of the Administrative Code.

(C) An AMSO shall ensure that all aircraft permits are displayed in a manner that complies with all applicable federal aviation regulations and on each aircraft in accordance with division (B)(3) of section 4766.07 of the Revised Code.

Replaces: 4766-5-05

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 , 4766.07
Prior Effective Dates: 01/06/2008

4766-5-09 Maintenance requirements and documentation.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) An AMSO shall ensure that all permitted aircraft are in compliance at all times with FAA regulations pertaining to safety and maintenance operating specifications set forth in 14 C.F.R. part 135 Certificate under which the AMSO operates.

(B) An AMSO shall maintain documentation of all periodical maintenance and repairs of bio-medical equipment as required by the manufacturer and the food and drug administration for a period of two years from date of repair or maintenance. Information shall include but not be limited to the following:

(1) Date of last bio-medical inspection;

(2) Date of service or repair;

(3) Description of service or repair performed;

(4) Documentation of who performed inspection, service, or repair.

Replaces: 4766-5-12

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 and 4766.07
Prior Effective Dates: 01/06/2008

4766-5-10 Equipment for aircraft.

Air ambulances shall carry all equipment and supplies listed herein. Disposable equipment is acceptable where applicable. All equipment and supplies shall have current expiration dates where applicable.

(A) Isolation equipment:

(1) Four packaged kits or

(a) Isolation goggles & masks or mask/shield combination (four);

(b) Isolation gowns (four);

(c) Isolation gloves (four);

(2) High particulate filter washes [HEPA filter or N95 mask (four)]-assorted sizes;

(3) Containers (bags) for infectious medical waste (four);

(4) Sharps container;

(5) Disinfectant/germicidal;

(6) Waterless hand cleaner.

(B) Airway equipment:

(1) Complete set of oropharyngeal airway devices: adult, pediatric, and infant;

(2) Complete set of nasopharyngeal airway devices: adult, pediatric, and infant;

(3) Complete set of intubation equipment-adult, pediatric, and infant:

(a) Extra batteries and bulbs;

(b) Syringes, assorted sizes;

(c) Adult stylet;

(d) Pediatric stylet;

(e) Infant stylet;

(f) Adult magill forceps;

(g) Pediatric magill forceps;

(h) Booted hemostat or device appropriate clamp;

(i) Adult endotracheal tube set, one each: cuffed 6.0, 7.0, 8.0;

(j) Pediatric/infant endotracheal tube set, one each: cuffed or uncuffed 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5;

(k) Water soluble lubricant;

(l) Laryngoscope handle;

(m) Laryngoscope blades, curved and straight, sizes 0-1-2 -3;

(n) End-tidal CO2 detector or capnometer;

(o) Supraglottic airways, age and size appropriate.

(4) Advanced airway procedure kit, as applicable.

(C) Definitive equipment:

(1) Approved medications;

(2) ECG monitor/defibrillator and appropriate pads:

(a) Adult (two);

(b) Pediatric (two);

(3) External pacemaker and pads;

(4) Pulse oximeter:

(a) Adult;

(b) Pediatric;

(5) Doppler & gel;

(6) Inverter for a one hundred ten volt power source;

(7) Spare batteries as appropriate for powered medical devices;

(8) Ventilator appropriate to age and scope of care;

(9) Medical infusion device(s) capable of infusing three medications.

(D) Bleeding/burns equipment:

(1) Gauze pads;

(2) Sterile sponge pads;

(3) Universal trauma dressings;

(4) Tourniquet (two).

(E) Suction equipment:

(1) Wall mounted suction unit;

(2) Portable suction unit powered or hand operated;

(3) Hard tip suction;

(4) Soft tip suction catheters set:

(a) Adult;

(b) Pediatric;

(5) Suction tubing;

(6) Suction bags (package) or equivalent;

(7) 5, 6, 7 French suction catheter;

(8) Sterile gloves.

(F) Oxygen equipment:

(1) Main oxygen (M tank equivalent or greater);

(2) Wall mounted oxygen gauge 0-15 L/min. minimum;

(3) Compressed air as appropriate;

(4) Portable oxygen unit-minimum "D" tanks;

(5) Portable variable flow regulator 0-15 L/min. minimum;

(6) Bag-valve-mask with reservoir one hundred per cent oxygen flow:

(a) Adult;

(b) Pediatric;

(7) Transparent oxygen masks, simple and non rebreather:

(a) Adult;

(b) Pediatric;

(8) Nasal cannulas:

(a) Adult;

(b) Pediatric;

(9) Oxygen connective tubing and appropriate adapters;

(10) Oxygen humidifier/nebulizer and appropriate connecting tubing;

(11) Infant bag valve mask;

(12) Infant oxygen mask.

(G) Adjunct equipment:

(1) Trauma shears;

(2) Stethoscope;

(3) B/P cuffs:

(a) Neonatal;

(b) Pediatric;

(c) Adult;

(d) Large adult;

(4) Penlight;

(5) Flashlight;

(6) Patient litter with three straps with shoulder restraints;

(7) Patient hearing protection, rotor air ambulance only;

(8) Assorted tape;

(9) Exam gloves;

(10) Obstetrical kit;

(11) Nasogastric tubes:

(a) Adult sizes;

(b) Pediatric sizes;

(12) Patient restraints;

(13) Hats for neonates;

(14) Chemical warming mattress if no isolette;

(15) Pediatric restraining system, age and size appropriate.

(H) Intravenous equipment:

(1) Alcohol or betadine preps;

(2) IV administration sets:

(a) IV infusion pump tubing;

(3) IV catheters and butterfly needles, assorted sizes 24-14;

(4) Intraosseous needles, age and size appropriate;

(5) Needles, assorted sizes;

(6) IV solutions, per protocol;

(7) Associated adjunct equipment:

(a) Invasive line set-up;

(b) Pressure bags;

(c) Survival kit.

Replaces: 4766-5-22

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 and 4766.07
Prior Effective Dates: 01/06/2008, 04/16/2012

4766-5-11 [Rescinded] Sanitation requirements.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 and 4766.07
Prior Effective Dates: 01/06/2008

4766-5-12 Temporary use of aircraft and disaster operations.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) No AMSO shall operate an aircraft without a permit issued in accordance with section 4766.07 of the Revised Code except as provided in paragraph (F) of this rule.

(B) An AMSO may obtain a "Temporary Aircraft Permit" by submitting an executed "Temporary Aircraft Permit Affidavit," which shall include assertions that the AMSO shall:

(1) Use the "Temporary Aircraft Permit" for the sole purpose of temporarily replacing the specific primary aircraft that is out-of-service;

(2) Clearly and conspicuously display the "Temporary Aircraft Permit" on any temporary aircraft used by the AMSO;

(3) Immediately remove the "Temporary Aircraft Permit" from the temporary aircraft upon the return to service of the primary aircraft;

(4) Ensure that any temporary aircraft used by the AMSO will be equipped in accordance with the requirements of rule 4766-5-10 of the Administrative Code;

(5) Not use the "Temporary Aircraft Permit" for any purpose when the primary aircraft is in service.

(C) The board shall create a "Temporary Aircraft Permit" which shall contain a log form to be completed by the AMSO at any time the "Temporary Aircraft Permit" is used by or removed from a temporary aircraft. The log shall contain the following information:

(1) Primary aircraft out of service date and time;

(2) "Temporary Aircraft Permit" in use date and time;

(3) Primary aircraft return to service date and time;

(4) "Temporary Aircraft Permit" removed from temporary aircraft date and time.

(D) The AMSO shall complete and maintain a log for the "Temporary Aircraft Permit" at any time the "Temporary Aircraft Permit" is used by or removed from a temporary aircraft.

(E) Any "Temporary Aircraft Permit" not in use shall be stored and made readily available to the board upon request.

(F) In the event of a disaster situation when permitted aircraft based in the locality of the disaster situation are incapacitated or insufficient in number to render services needed, a licensed AMSO may utilize whatever means necessary to transport and treat patients.

Replaces: 4766-5-16

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.07
Prior Effective Dates: 01/06/2008

4766-5-13 Staffing compliance.

All AMSOs must comply with the staffing requirements under section 4766.17 of the Revised Code.

(A) An AMSO, licensed under this chapter, that operates a permitted rotorcraft or fixed wing air ambulance shall staff the aircraft with, at a minimum, a physician who holds a current and valid license issued under Chapter 4731. of the Revised Code or a registered nurse who holds a current and valid license issued under Chapter 4723. of the Revised Code, and a paramedic or one other person, designated by the medical director of the AMSO, who holds a current and valid certificate or license to practice a health care profession in this state.

(B) An AMSO, licensed under this chapter, that operates a permitted rotorcraft or fixed wing air ambulance shall employ as a medical director an individual who holds a current and valid license issued under Chapter 4731. of the Revised Code authorizing the practice of medicine and surgery or osteopathic medicine and surgery.

Replaces: 4766-5-13

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.17
Prior Effective Dates: 1/06/08

4766-5-15 Changes to be reported to the board.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) A licensed AMSO shall give written notification to the board within ten business days of any additions, deletions or changes in:

(1) Primary contact name;

(2) Executive officers, board members, or owners;

(3) FCC license modifications;

(4) Medical director;

(5) Purchase or acquisition of a licensed organization.

(B) Within ten days of the date a permitted aircraft is permanently withdrawn from service, the licensed AMSO shall return to the board a completed "Deletion of Permitted Aircraft" and the decal that was required to be displayed on the aircraft.

(C) If an AMSO operates or plans to operate in more than one location under the same or different identities, the AMSO shall apply for licensure on the "Application for New Satellite" and meet all requirements for licensure or renewal of a license, except payment of a license fee or renewal fee for operating at each separate location.

(D) Within ten days of the date a licensed AMSO ceases to operate a satellite location, it shall return to the board the certificate of licensure.

(E) Within ten days of the date a licensed AMSO ceases to operate, it shall return to the board all aircraft permits and certificates of licensure.

Replaces: 4766-5-18

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 and 4766.07
Prior Effective Dates: 01/06/2008

4766-5-16 Investigation of alleged violations.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see paragraph (BB) of rule 4766-5-01 of the Administrative Code.]

(A) The board may investigate alleged violations of Chapter 4766. of the Revised Code and the rules promulgated thereunder.

(B) Board investigations may include but not be limited to the following:

(1) Interviews:

(a) Employer;

(b) Employees;

(c) Client;

(d) Health care professionals;

(e) Public safety personnel;

(f) General public;

(2) Record review:

(a) Transportation documentation;

(b) Incident report;

(c) Crash and/or injury report;

(d) First report of injury;

(e) Employee records;

(3) Physical inspection;

(4) Photographs;

(5) Audio recordings;

(6) Physician and/or coroner findings;

(7) Written and/or verbal complaints;

(8) Factual evidence;

(9) Any other item(s) deemed appropriate for specific investigations.

(C) The board may issue a "Violation Notification" during any inspection or investigation.

Replaces: 4766-5-19

Effective: 09/26/2014
Five Year Review (FYR) Dates: 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03 , 4766.11
Rule Amplifies: R.C. 4766.11
Prior Effective Dates: 01/06/2008

4766-5-18 [Rescinded] Changes to be reported to the board.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 and 4766.07
Prior Effective Dates: 1/6/08

4766-5-19 [Rescinded] Investigation of alleged violations.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03 , 4766.11
Rule Amplifies: R.C. 4766.11
Prior Effective Dates: 1/6/08

4766-5-20 Grounds for suspension, revocation, or denial of license or permit.

The board may, in compliance with Chapter 119 . of the Revised Code, suspend, revoke, or refuse to issue a license or service permit for any of the following reasons:

(A) Any violation of Chapter 4766. of the Revised Code or the rules promulgated thereunder.

(B) Failure of the organization to correct violation(s) cited by the inspectors of the board or provide sufficient documentation that the organization is correcting said violation(s) within seventy-two hours of the date of the notification.

(C) Making a false statement on the application for a license or permit.

(D) Fraud or deceit in obtaining or attempting to obtain a license or permit.

(E) Incompetence, negligence, or misconduct in operating the licensed organization or in providing emergency medical care to patients.

(F) Failure to have all equipment required in rule 4766-5- 10 of the Administrative Code, appropriate to the level of licensure on each in-service aircraft at all times.

(G) Failure to staff each aircraft with a sufficient number of certified or licensed personnel as defined in rule 4766-5-13 of the Administrative Code.

(H) Failure of the licensed organization to notify the board of a change of ownership within ten business days of purchase or acquisition.

(I) Abuse or abandonment of a patient.

(J) Unauthorized disclosure of medical or other confidential information.

(K) Willful preparation or filing of false reports or records, or the inducement of another to do so.

(L) Alteration or inappropriate destruction of medical records.

(M) Discrimination in the rendering of medical services because of patient's race, sex, creed, national origin, sexual preference, age, handicap, medical problem or financial inability to pay.

(N) Misuse or misappropriation of drugs or medication.

(O) Action by the licensed organization that is reckless or negligent so as to endanger the health or safety of patients or members of the general public while in the course of business as a licensed organization.

(P) Continued pattern of violations.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014 and 09/16/2019
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 , 4766.07 , 4766.08 , and 4766.11
Prior Effective Dates: 01/06/2008

4766-5-21 [Rescinded] Summary suspension.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.11
Prior Effective Dates: 01/06/2008

4766-5-22 [Rescinded] Equipment for aircraft.

Effective: 09/26/2014
Five Year Review (FYR) Dates: 07/11/2014
Promulgated Under: 119.03
Statutory Authority: R.C. 4766.03
Rule Amplifies: R.C. 4766.04 , 4766.07
Prior Effective Dates: 1/6/08, 4/16/12