Nevada at top of a bad list: Ambulance deserts
Even in Nevada's urban areas, staffing shortages mean ambulance services struggle to meet response time targets. (Getty Images)
Every county in Nevada is considered an ambulance desert, and the state has the fewest ambulance stations per 1,000 square miles in the country, according to a nationwide study published in May.
Access to ambulance services helps treat, stabilize, and transport people who are injured and take them to hospitals if needed, but a delay in services can contribute to higher mortality rates for emergencies like car accidents. The impact of these deserts differs between urban and rural parts of the state.
The report by the University of Southern Maine defines an ambulance desert as a populated census area that’s geographic center is 25 minutes away from an ambulance service area. It notes that having ambulance services located within a reasonable driving distance doesn’t ensure that it’s adequately staffed or resourced — a problem unfolding in Clark County.
“It’s staffing, it’s the amount of people who have the qualifications, who are willing to work and want to work,” Clark County Fire Department (CCFD) Deputy Fire Chief Jennifer Wyatt said.
Wait times in urban areas for EMS to arrive range from 4 to 10 minutes, and 8-19 minutes in rural areas, according to the report. But in Clark County, the state’s largest urban area, the ambulance crews have just under 12 minutes to arrive for an emergency call before being considered late and out of compliance with their contractual agreements with local government entities.
Three private ambulance companies, Community Ambulance, American Medical Response (AMR), and MedicWest serve the larger Clark County region, each with different contracts for CCFD and the region’s three cities. But AMR and MedicWest have been struggling to meet the standard contractual response times due to staff shortages, Wyatt said.
The Southern Nevada Health District currently licenses 985 paramedics in Clark County that serve with the three private companies.
The Clark County Commission voted to put MedicWest and AMR under a corrective plan for their slow response times in June and awarded Community Ambulance with additional territories in July. It marks the third time the map has been redrawn, the Las Vegas Review-Journal reported last month.
“They don’t have enough ambulances or crews on the streets at the time when the calls are coming in to make that time response,” Wyatt said.
Community Ambulance, AMR and MedicWest contracts expire in 2026.
The Nevada Department of Health and Human Services, which oversees the rest of Nevada, did not respond by the deadline to the Current regarding how many ambulances there were, how many paramedics there were, and the impact this has on the rest of the counties.
The study by the University of Maine researchers notes that the number of ambulance stations per capita in Nevada is two per 100,000 residents and that Western states with large rural areas – Nevada, Wyoming, Montana, Utah, New Mexico, and Idaho – had fewer than three ambulances to cover every 1,000 square miles of land on average.
About10% of the state’s population resides in rural and frontier areas, which accounts for 87% of Nevada’s land mass, according to the 2021 Nevada Rural and Frontier Health Data Book by the University of Nevada Reno’s School of Medicine.
The Maine researchers’ report noted that the long transport distance and difficult terrain contribute to delayed access to care and longer waiting times with one in 10 rural patients waiting over 30 minutes for EMS personnel. It also highlighted that a greater distance to care was associated with poorer outcomes for the patient.
Wyatt said that the shortage of ambulances and paramedics isn’t unique to Nevada, “We’re experiencing this in every jurisdiction across the country and everyone is dealing with it a little differently depending on the agreements that they have.”
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