BLS Ambulance Service Team Structure Responsibilitie

Benefits:

401(k) Bonus based on performance Company parties Free uniforms Opportunity for advancement TIER 1 —

EXECUTIVE LEADERSHIP

Chief Executive Officer / Owner Incumbent / Staffing Ernst Appolon FTE 1 (existing)

Requirement Required Certifications:

Business license, NPI registration Key Responsibilities Overall strategic direction and accountability for BLS license acquisition Sign affiliation agreements with affiliate hospital(s) (MGH, BMC) per 105 CMR 170.300 Authorize capital expenditures for ambulance vehicle, equipment, and personnel Execute contracts with MA Office of Emergency Medical Services (OEMS) Serve as primary liaison to OEMS during licensure review Operations / Compliance Manager Incumbent / Staffing To be assigned / Ernst Appolon (interim)

FTE 1 FTE

Requirements required before license issuance Certifications EMS operations background preferred; MA OEMS familiarity Key Responsibilities Compile and submit BLS license application to MA OEMS (Form OEMS-1) Maintain all required documentation (vehicle inspection, insurance, policies) Ensure 105 CMR 170.000 ongoing compliance post-licensure Coordinate QA/QI program required under affiliation agreement Manage scheduling to maintain 24/7 BLS coverage per 105 CMR 170.385 Track personnel certifications and renewals TIER 2 —

MEDICAL OVERSIGHT

Affiliate Hospital Medical Director Incumbent / Staffing To be contracted — MGH or BMC FTE Contracted / Part-time Requirement

MANDATORY

— License cannot be issued without this Certifications Licensed MA physician with EMS medical director authority Key Responsibilities Execute written affiliation agreement with Epoch Health Care LLC per 105 CMR 170.300 Approve and oversee all clinical protocols for BLS operations Assess and certify EMT-Basic skill competencies per 105 CMR 170.305(B)(1)(a) Provide medical oversight and sign off on QA/QI reviews Authorize EMT/First Responder staffing configurations if applicable Act as point of contact for OEMS for all medical issues TIER 3 —

CLINICAL FIELD STAFF

EMT-Basic — Lead (Patient Care Responsible) Incumbent / Staffing Minimum 1 per vehicle on every call FTE Minimum 2 FTEs for coverage rotation Regulatory Requirement

MANDATORY

per 105 CMR 170.305(B)(1) Required Certifications Current MA EMT-Basic cert; BLS CPR; valid MA driver's license; Hazmat & MCI training Key Responsibilities Responsible for all patient care at the BLS level on every call Assess patient condition and administer BLS interventions (CPR, O2, AED, splinting, bleeding control) Complete electronic Patient Care Reports (ePCR) for every transport Ensure ambulance is stocked, clean, and OEMS-inspection-ready at all times Participate in QA/QI program reviews under affiliation agreement Meet minimum experience and skill competency levels set by Medical Director Report any discipline, conviction, or license issue to agency within 5 days (105 CMR 170.305) EMT-Basic — Second Crew / Driver Incumbent / Staffing Minimum 1 per vehicle OR qualified First Responder driver FTE Minimum 2 FTEs for full coverage Regulatory Requirement

MANDATORY

— 2 EMTs required unless FR driver conditions met Required Certifications Current MA EMT-Basic OR First Responder per 105 CMR 171.000; valid MA driver's license in good standing Key Responsibilities Drive the ambulance safely and operate within MA traffic law Assist lead EMT-Basic with patient care and equipment Ensure driving record remains clean; disclose any violations per 105 CMR 170.305(B)(1)(b) Complete required annual continuing education Respond as second EMT-Basic when patient acuity requires per agency protocol Support QA/QI documentation requirements TIER 4 —

ADMINISTRATIVE & SUPPORT

Billing & Revenue Cycle Coordinator Incumbent / Staffing 1 (part-time / contracted initially)

FTE 0.5 - 1 FTE

Regulatory Requirement Strongly recommended Certifications Medical billing experience; MassHealth & Medicare billing familiarity Key Responsibilities Submit ambulance transport claims to MassHealth (ID #110177982A) and Medicare (ID #

S301319456

) Ensure compliance with ambulance billing regulations (CMS A-0001 form) Track authorization requirements and denied claims Maintain transport documentation supporting medical necessity Coordinate with EMTs for accurate ePCR data to support billing Vehicle & Equipment Coordinator Incumbent / Staffing 1 (can be dual-hatted with Operations Manager)

FTE 0.25 FTE

initially Requirement Required before license issuance Certifications Clean driver record; familiarity with OEMS vehicle standards Key Responsibilities Ensure ambulance vehicle meets MA OEMS Class I or II certification standards Coordinate scheduled vehicle inspections with OEMS Maintain inventory of required BLS equipment per 105 CMR 170.430 Manage vehicle maintenance logs, insurance certificates, and registration Track and replenish medical supplies (O2, AED pads, PPE, etc.)

BLS LICENSE ACQUISITION CHECKLIST

(105 CMR 170.000) Complete these steps to obtain the

MA OEMS BLS

Ambulance Service License. Items marked Critical Path must be resolved before any other step can advance. # Action Item Owner Priority 1 Obtain signed Affiliation Agreement with hospital Medical Director OEMS Form / Hospital Legal Critical Path 2 Submit BLS Ambulance Service License Application (OEMS-1) to

MA OEMS MA OEMS

Critical Path 3 Certify ambulance vehicle as Class I or II with

OEMS MA OEMS

Vehicle Inspection Critical Path