For the last four months, Shannon Kellogg has been struggling to find a reliable EMS service. 

In March, medical transportation service MedCare stopped transporting residents from the Presidential Post-Acute nursing home in Marion to dialysis and doctors' appointments. Then last month, Life Line Medical Ambulance said they will be cutting its services, too, the administrator said. 

"There is nobody servicing my building right now," Kellogg said. "They state they don't have enough drivers to be able to do it. 

"At least they gave us that explanation, but it still doesn't help." 

Like many other industries right now, EMS agencies across Ohio and the country are experiencing staffing shortages. In May, eight Cleveland ambulances went out of service due to short staffing, reported WJW-TV. That is about a third below what the city plans on each day to handle emergency calls.

Other places facing shortages include Youngstown, Pennsylvania, Michigan, Kentucky, and Wyoming, where at least 10 ambulance companies are in danger of shuttering. 

The lack of staffing is part of the ongoing nationwide worker shortage, with the U.S. nearly 7 million jobs short of hitting pre-pandemic levels of employment, said USA Today. 

However, shortages for EMS agencies has been a problem even before the pandemic. 

Presidential, which is a skilled nursing and long-term living facility, mostly uses EMS transport for wheelchair and stretcher services, Kellogg said. On average, at least 20 residents per month need transportation, especially short-term rehab residents who often have follow-up appointments. While there is a doctor or nurse practitioner at the nursing home five days a week, some residents need a specialized doctor, such as a neurologist, orthopedist, or a cardiologist. 

"My facility and most facilities have their own van," Kellogg said. "So, wheelchair transport is sometimes manageable, depending on if you have the staff to do it. However, stretcher transport, none of us can do. If somebody requires a stretcher because they can't send a wheelchair, you literally cannot get people to appointments."

Kellogg said when MedCare was available, they often showed up late, making the resident late for their appointment. Then last month, staff picked up a resident from Marion General Hospital after MedCare was unable to. 

"It was just a mess," Kellogg said about the ambulance service. "So, sometimes, the patient wouldn't get seen at all, which then you've got all this expense tied up for no reason."

In the meantime, Presidential staff members have been arranging telehealth appointments for its residents or transporting them using company vans. However, the temporary solution is extra work for staff. The nursing home has also had to stop taking in dialysis patients because of the shortage. 

"We're being creative to find solutions so the patients are still getting taken care of," Kellogg said. "It's just taking away a lot of time that we should be doing patient care."

Harding Pointe is also facing similar issues when it comes to transporting residents, said Administrative Charge Nurse Robin Hicks. The skilled nursing and rehabilitation facility use Life Line and Pro Care Medical Transportation Service, which are constantly late for pick-ups, she said. 

With Harding Pointe working with residents who have mental illnesses, care is critical, Hicks said. 

"When you have patients that need help, they can't sit and wait for an hour or two for a transport," she said. 

Fortunately, the nursing home has its own in-house transportation to drive residents to appointments or to the hospital. Hicks said staff does at least 100 transport per month. 

"If there was a service out there that we could contract with, we'd welcome it," she said. 

Meanwhile, MedCare said they are not stopping service for nursing homes, but that they are struggling to find employees to help fill that need, said Todd Bailey, the vice president of business development. 

Based in Columbus, the agency operates seven bases throughout central and southern Ohio with an average of 50 vehicles on the road per day, states its website. One of those bases is in Marion. 

"Right now, we're trying to concentrate our efforts towards the more emergent service in which is serving the hospital, the 911," he said. "But we are planning and are in the process of doing the best we can to up the staffing so that we can serve the community in the best way possible and that would include the nursing homes."

Bailey said there are 235 current employees, with MedCare looking to hire 43 EMTs and paramedics. Starting pay for a basic EMT is $16 an hour, $16.75 for an advanced EMT and $18.50 for a paramedic. In addition, new hires can immediately build up PTO and sick time as well as health benefits. 

"We are actively involved in mitigation plans to do many things, to incentivize folks, to get good, quality individuals to become EMTs and responders so that we can train them and get them into service," Bailey said. 

"We'll even train individuals who are interested in first response or ALS (Advanced Life Support), BLS (Basic Life Support). We'll actually work with those individuals, if they're good candidates, and look at avenues for them to get training to join MedCare."

Life Line also cited shortages as the reason why the company has slowed nursing home visits. 

"Typically, what happens is a nursing home will give us a call and say, 'We have this appointment, could you help us out with it?'" office manager Michelle DeAngelo said. "I check our schedule and if we have availability for that day, then we'll go ahead and schedule that for them." 

Based in Fulton, the small, family-owned agency serves all of central Ohio. In Marion, Life Line usually serves residents at Presidential and Heartland of Marion. 

DeAngelo said there are about 15 paramedics and EMTs currently working at Life Line. She would like to hire at least 10 more people. 

"If any EMT basics or paramedics would like to come apply, we'll definitely give them an interview," DeAngelo said. 

One person passionate about finding a solution for nursing homes is Marion County Coroner Mark Davis. In April, he began meeting with Marion County Commissioner Kerr Murray, Marion Township Fire Chief Ben Meddles and First Consolidated and Pleasant Township Fire Chief Clint Canterbury on issues happening within the county and how they could try to fix them. 

In the three meetings the group has conducted, guests included a nurse from Presidential and representatives from MedCare. At the June meeting, Murray invited Rep. Jim Jordan. 

"This is not one of his committees, but he wants to make sure that CMS (Centers for Medicare & Medicaid Services) hears the complaints from patients and their families that this decreased reimbursement for transporting non-emergent patients is really hurting real people and real families in the fourth congressional district. I trust that congressman Jordan will relay that information to the appropriate committees." 

Davis said solutions for nursing homes should be multi-tiered, starting with finding another reliable EMS company other than MedCare for the moment. 

"MedCare's got to really look at their HR policies and how do we get workers that live right here in the city and county to come to work for the company," he said. 

"The other thing is the schools. Train more people to be EMTs, maybe offer them part-time shifts. Maybe I'm an EMT but I don't want to work a 24-hour shift. Allow me to work from 7 a.m. to 7 p.m., not a 24-hour shift. I think we're going to have to be flexible."

OhioHealth Marion General Hospital, which works with MedCare, relased a statement Friday. 

“Like many organizations, staffing shortages are impacting businesses across the country, in all sectors as we return to life after COVID," President Curt Gingrich said. "We are working closely with MedCare and local organizations to address hospital and nursing home transports in the community. We understand the need, and hope to partner to identify a solution as quickly as possible to honor our mission of improving the health of those we serve.”