Investigation Uncovers Ambulance Problems At Illinois Ambulance Service!

Author: Bill Grimes, Effingham Daily News.

An investigation by the Illinois Department of Public Health revealed numerous problems with Effingham Advanced Ambulance before the service had its license suspended earlier this month, IDPH officials say.

The IDPH suspended Advanced's license on Sept. 10, effective at 12:01 a.m. Sept. 11. On Sept. 13, the Effingham County Board passed an ordinance prohibiting ambulance services not currently operating in the county from taking emergency calls, effectively putting Advanced out of business in Effingham County.

IDPH spokesman Tom Schafer said Effingham Advanced owner Clay Hobbs was issued a notice of violation on Aug. 4. In that notice, Hobbs was ordered to comply with issues of concern and submit a plan of correction.

"The plan was received, but did not address the issues," Schafer said. At that point, the suspension notice was issued.

Schafer said Effingham Advanced was under investigation for several issues, including the ability to pay bills and a threat to have telephone service terminated for failing to pay.

But there was more. Other issues for which Advanced was being investigated included:

  • No evidence of insurance.
  • Failing to respond to calls in defined response areas.
  • Using staff not in the EMS system.
  • Operating a dispatch center using pre-arrival instructions that had not been approved.
  • Taking calls for other ambulance services without EMS system approval.
  • Not having recording capabilities in the dispatch center.
  • Failing to use closest Advanced Life Support ambulance provider to ensure timely responses.
  • Failing to use mutual aid agreements.
  • Altering patient care records.

Mary Reis, the EMS regional coordinator with the IDPH Division of Emergency Medical Systems, said some of the issues involve other state agencies. For example, the Secretary of State's Police was on its way to Effingham to retrieve license plates from Advanced ambulances on April 1 when company officials finally provided proof of insurance.

"Our rules say they have to be in compliance with other entities," Reis said. "Mr. Hobbs would have you believe that it (the insurance issue) didn't occur, but it did."

Reis emphasized the violations don't necessarily mean that Advanced was providing sub-standard patient care. But she added that the lack of recording at the dispatch center, for example, could make it hard to determine the level of patient care received.

"Our rules require calls to be recorded for QA (quality assurance) and QI (quality inprovement)," she said. "I don't think we have patient care issues, but there's no way to know what had been said to tell whether the public was in jeopardy.

"We can't say there were patient care errors," she said. "We are just trying to protect the general public from patient care errors."

The lack of recorded calls, she added, makes it difficult to determine the level of patient care received.

Other findings appear to stem from Advanced's business priorities.

'What he does is get contracts from various entities to provide service," Reis said. The company ran into problems when it would get an emergency call and not route the call to other ambulance services if there was no available ambulance in the Advanced fleet.

"We found several incidents where they failed to use mutual aid agreements," Reis said.

Hobbs is also accused of shuffling staff from his Mercy Regional operation in Franklin County to Effingham, and vice versa, without having them certified by both regional EMS systems charged with oversight over services in their area.

Effingham-area staffers are supposed to be certified by the Springfield Area Mobile Intensive Care, based at St. John's Hospital in Springfield. But personnel working for Hobbs in Franklin County are certified by another regional entity based in Mount Vernon.

"He has been staffing gaps using an entire roster (of employees), instead of using those who belong to the SAMIC system," Reis said.

Reis added that she had never seen this many cases of non-compliance in her 15 years with IDPH. While most of the violations are on the operations end, she warned that operational errors can ultimately affect patient care.

"There was nothing to give us an indication that patient care was being jeopardized," Reis said. "Most of these issues are from an operational standpoint, but with potential to jeopardize the public."

Reis said Hobbs does have the right to appeal his license suspension.

'These are just findings at this point," she said. "This is what the investigation showed."

But Hobbs appears to be ready to put Effingham behind him, according to published reports. The Daily American newspaper in West Frankfort reported that three ambulances formerly used by Advanced are being moved to Franklin County to beef up service in that area.

The Daily American quoted Hobbs as saying he didn't want the Effingham problems to spill over into his Franklin County operation.

"We have several very positive things going on in Franklin County," Hobbs said. "We do not want to associate with this (Effingham situation) in any way."

The Daily American also reported Mercy Regional had been having problems with bounced payroll checks, much as had been the case in Effingham for a period of time earlier this year.

Hobbs declined to return telephone calls to the Effingham Daily News.

Bill Grimes can be reached at 217-347-7151 ext. 132 or