SAN JOAQUIN COUNTY
EMERGENCY MEDICAL SERVICES AGENCY
TITLE: MEDICAL PATIENT DESTINATION EMS Policy No. 5201 Effective: May 1, 2026 Page 1 of 4
Supersedes: November 10, 2025
Approved: ____________ _____________
Medical Director EMS Director
PURPOSE:
The purpose of this policy is to provide direction to EMS personnel on determining the appropriate destination for medical patients.
AUTHORITY:
Health and Safety Code, Division 2.5, Section 1797.220, 1798, and 1798.170 DEFINITIONS: See SJCEMSA Definitions policy
POLICY:
I. Prehospital personnel shall assess all patients and offer ambulance transportation to any patient needing medical care and provide ambulance transportation to any patient requesting transport to a receiving hospital with implicit or implied consent.
II. Medical patients shall be transported to a receiving hospital based on the following priorities:
A. Multi-casualty incident
destination as coordinated with DCF.
B. Cardiac arrest closest receiving hospital.
C. Acute STEMI or ROSC closest STEMI receiving center.
D. Sustained ventricular tachycardia with a pulse closest STEMI receiving center.
E. Acute stroke:
1. Patients with last known well time of less than 4 hours transport to closest PSC.
2. All other patients transport to PSC of their choice or if no choice transport to closest PSC.
F. Non-traumatic life-threatening condition closest receiving hospital or base hospital direction.
G. Active labor with complications closest hospital with labor and delivery (L&D) service.
H. Active labor without complications patient choice of receiving hospital with labor and delivery services.
I. Non-emergent condition patient choice.
J. No preference specified closest receiving hospital.
K. Ventricular assist devices stable patients patients implant center L. Ventricular assist devices unstable patients nearest STEMI center.
ATTACHMENT C
SAN JOAQUIN COUNTY
EMERGENCY MEDICAL SERVICES AGENCY
TITLE: MEDICAL PATIENT DESTINATION EMS Policy No. 5201 Effective: May 1, 2026 Page 2 of 4
Supersedes: November 10, 2025
Approved: ____________ _____________
Medical Director EMS Director
III. Parameters affecting transport destinations for medical patients:
A. Acute ST Elevated Myocardial Infarction (STEMI) Patient Considerations:
1. Patients with an acute STEMI shall be transported to a designated STEMI Receiving Center (SRC) by-passing all other receiving hospitals.
2. The following receiving hospitals are designated or recognized a s S
RCs for the San Joaquin County EMS System:
a. Dameron Hospital.
b.
c. Doctors Medical Center
d. Memorial Medical Center.
3. If a STEMI patient does not express a preference the patient should be transported to the closet SRC.
B. The following receiving hospitals are designated or recognized as a Primary Stroke Center (PSC) by the SJCEMSA:
1. Adventist Lodi Memorial Hospital.
2. Dameron Hospital.
3. Doctors Hospital of Manteca.
4. Kaiser Hospital Manteca.
5. San Joaquin General Hospital.
6. 7. Sutter-Tracy Community Hospital.
8. Doctors Medical Center, Modesto.
9. Kaiser Medical Center, Modesto.
10. Memorial Medical Center, Modesto.
C. Active Labor Considerations:
1. Active labor without complications is deemed to be a non-emergent condition. These patients may be taken to the receiving hospital with labor and delivery services (L&D) of their choice, as listed in subparagraph C. 3.
2. Active labor with complications (prolapsed cord, breech presentation) shall be transported to the closest receiving hospital with L&D services.
ATTACHMENT C
SAN JOAQUIN COUNTY
EMERGENCY MEDICAL SERVICES AGENCY
TITLE: MEDICAL PATIENT DESTINATION EMS Policy No. 5201 Effective: May 1, 2026 Page 3 of 4
Supersedes: November 10, 2025
Approved: ____________ _____________
Medical Director EMS Director
3. The following is a list of receiving hospitals with L&D services in San Joaquin County and in areas immediately adjacent to San Joaquin County:
a. Adventist Lodi Memorial Hospital.
b. San Joaquin General Hospital.
c.
d. Sutter-Tracy Community Hospital.
e. Kaiser Medical Center, Modesto.
f. Doctors Medical Center, Modesto.
g. Memorial Medical Center, Modesto.
h. Kaiser Medical Center, South Sacramento.
D. Non-Emergent Medical Patient Destination Considerations:
1. In a non-emergent situation, as determined by prehospital care personnel on scene or following base hospital consultation, the patient may be transported to the receiving hospital of their choice in San Joaquin County, Stanislaus County, or Sacramento County.
2. If the patient is unable or unwilling to express a choice, defer to the wishes of
In the
absence of such direction, patients should be transported to the closest receiving hospital.
3. Whenever possible ambulance personnel should determine where the patient normally receives medical care and encourage the patient to return to that hospital.
4. Prehospital care personnel should only provide the patient and/or family with the available destination options and should not endorse a receiving facility or otherwise provide their opinion on the qualit y
o
r merits of any receiving hospital.
5. If the patient is a member of a health plan with a preferred hospital, an attempt should be made to transport the patient to a participating or preferred receiving hospital.
6. If the countywide system status management ambulance availability is less than seven (7) ambulances, non-emergent medical destinations may be limited to receiving hospitals in San Joaquin County.
7. Ambulance personnel are not required to contact and should not contact the base hospital for permission to transport a non- emergent patient to a receiving hospital in San Joaquin County, Stanislaus County, or Sacramento County.
ATTACHMENT C
SAN JOAQUIN COUNTY
EMERGENCY MEDICAL SERVICES AGENCY
TITLE: MEDICAL PATIENT DESTINATION EMS Policy No. 5201 Effective: May 1, 2026 Page 4 of 4
Supersedes: November 10, 2025
Approved: ____________ _____________
Medical Director EMS Director
E. Ventricular Assist Device (VAD) patients:
1. Unstable patients shall be transported to the nearest STEMI Center.
2. Stable patients with complaints related to their VAD shall be VAD Coordinator is suggested but shall not delay transport.
3. The following receiving hospitals located in Sacramento County, CA., are recognized as VAD Implant Centers by SJCEMSA for purposes of transport from the scene:
a. U.C. Davis Medical Center.
b. Mercy General Hospital Sacramento.
c. Sutter Medical Center Sacramento.
4. VAD patients with non-emergent complaints unrelated to VAD shall and pursuant to
Section III of this policy.
IV. Medical Multi-Casualty Incidents:
A. During an MCI the DCF may expand patient destinations to any receiving hospital within OES Region IV with initial preference being hospitals located in San Joaquin County, Stanislaus County, and Sacramento County.
V. Receiving Hospital Facility Status:
A. Patients shall not be transported to a receiving hospital with a facilit y
status of internal disaster/closed.
B.
is unavailable or limited, patients requiring such specialty care services should be advised and given the option of transport to similar receiving hospital with specialty care services.
C. Specialty Care Services:
1. Trauma Center.
2. Primary Stroke Center.
3. STEMI Receiving Center.
4. Labor and delivery services.
ATTACHMENT C