CITIZEN STAFF REPORT
Patriot Emergency Medical Services announced that it will consolidate operations, close multiple stations and reduce its workforce by approximately 50%, citing what the company described as mounting financial pressures tied to inadequate reimbursement rates and delayed insurance payments.
The announcement comes amid growing concern across the region about ambulance availability, including in Martin, Floyd and Magoffin counties, as well as neighboring Mingo County, West Virginia.
In a written statement dated Feb. 14, Patriot EMS, based in Ironton, Ohio, said ambulance providers across the United States are facing what it called “unprecedented” economic strain.
The company stated that private ambulance services must rely almost entirely on reimbursement revenue to sustain operations. Patriot EMS said reimbursement rates have not kept pace with the true cost of delivering emergency medical care, leaving many providers nationwide struggling to survive.
As part of its restructuring plan, Patriot EMS announced it will reduce its workforce by approximately 50% to maintain what it described as core community operations and preserve essential emergency response capabilities in its remaining service areas.
The company also announced it will close stations in Mingo County, West Virginia, and in Magoffin and Floyd counties in Kentucky. This leaves Magoffin County without a provider.
The Mingo County closure had already occurred before the formal announcement. On Feb. 6, Patriot EMS pulled its trucks and equipment from its station along Route 65 near Belo without advance notice, ending operations there.
Mingo County officials said at the time they did not receive formal notice before the service suspension. The sudden departure left local officials scrambling to secure coverage in a county where travel distances already complicate emergency response.
Patriot EMS said the closures and staffing reductions are necessary to stabilize the organization and prevent what it described as a total collapse of services.
“This decision is one of the most difficult in our company’s history,” said Krista Ellison, owner of Patriot EMS. “Our employees are dedicated professionals who serve their communities with compassion and skill. However, without meaningful reimbursement reform or local funding support, we are left with no alternative but to scale operations to remain viable.”
In Martin County, Patriot EMS has served as the sole ambulance provider since August 2022.
Judge/Executive Lon Lafferty confirmed he met with Patriot’s ownership and management amid concerns about layoffs, payroll disruptions and potential service changes.
“The thought of calling 911 and being told there’s no ambulance that can respond is very frightening,” Lafferty said previously.
He said the discussion ultimately centers on long-term funding for emergency medical services.
“This latest crisis with the ambulance service, in my opinion, is just the tip of the iceberg,” said Lafferty. “And my fears are that whether we manage to avoid the bullet today and find a short-term solution to avoid a lack of coverage, it’s only a matter of time until we find ourselves back here again.
“I know it’s not what anyone wants to hear, but at the end of the day our citizens are going to have to stand up and take this matter into their own hands and realize that the county needs additional funding to subsidize and offset the costs of EMS service. And that would probably come in the form of an additional tax. We were once a coal-producing county that could afford to operate our own police, fire, EMS, recreational projects and much more with ease. That is far from the case now. We are no longer an industrial economy.”
He added that while additional taxes would be difficult, emergency coverage carries life-and-death consequences.
“No one wants to pay a penny more than what they’re paying now,” said Lafferty. “But if we find ourselves in a situation where one of us or a member of our family has been in a vehicle accident or suffering a medical emergency, and an ambulance is the only answer, there is no doubt we would be willing to pay our share. And the reality of that is we none have a guarantee it won’t happen.”
In its statement, Patriot EMS reported approximately $5.1 million in outstanding accounts receivable, which it said has significantly impacted cash flow and operational sustainability. The company identified Kentucky Medicaid, Anthem and Wellcare as major payers that it said are not issuing reimbursement within appropriate time frames.
Patriot EMS further stated that the recent federal government shutdown disrupted Medicare and Medicaid reimbursements, “compounding an already critical financial situation.”
“Emergency medical services cannot operate like traditional businesses,” Ellison said. “We respond to every call, regardless of a patient’s ability to pay. But when reimbursement is delayed or insufficient, the financial burden becomes unsustainable.”
Patriot EMS said it approached multiple county governments seeking financial assistance or subsidy partnerships to help offset operational deficits. According to the company, it did not secure any funding agreements despite numerous discussions.
The company stated that without structural reimbursement reform or local government subsidy models, many communities risk losing essential emergency medical transport services.
Despite the reductions, Patriot EMS said it remains committed to maintaining reliable emergency response services within its remaining coverage areas. The consolidation effort, the company stated, is intended to preserve core operations, protect clinical quality and ensure long-term sustainability wherever possible.
“We remain dedicated to serving our communities,” Ellison said. “However, systemic changes are urgently needed to ensure that private EMS providers can continue delivering lifesaving care.”
Patriot Emergency Medical Services provides emergency and non-emergency medical transportation services in Kentucky, Ohio and West Virginia. The company employs certified EMTs and paramedics and states it is committed to delivering safe, timely and professional patient care.