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How could ambulance care change with Barton’s hospital move?

STATELINE, Nev. – The chainlink fence and Barton flag hint towards a coming change at the corner of Kahle Drive and Highway 50 in Stateline. That’s the proposed location for Barton Health’s replacement hospital.

Barton management plans on relocating the hospital to the Stateline site 6-8 miles away from the current site near the Y area in order to meet changing state requirements and expand services.

The change will impact ambulance transport times from certain locations, shortening some and lengthening others. However, Dr. Daniel Shocket, Barton Health EMS Director and Emergency Department Physician, expects the average times to remain below state averages and the care to continue to meet or exceed standards.



Although still in the planning stages and years away, the region’s ambulance providers are already preparing for the change and have started dialogue on the matter.

“We’ve thrown out probably more things than the average person is discussing, none of which are raising huge red flags,” Cal Tahoe’s Executive Director, Ryan Wagoner told the Tribune.



Cal Tahoe is short for California Tahoe Emergency Services Operations Authority, a joint powers authority that coordinates ambulance service in the south Tahoe area under a contract with El Dorado County. The JPA also services parts of northwestern Alpine County, which is where Kirkwood is located. The JPA is administered with members from the City of South Lake Tahoe, Lake Valley Fire, and Fallen Leaf Lake Fire.

Cal Tahoe JPA operates three full-time ambulances, one part-time ambulance and maintains two reserve ambulances.

Barton also receives patients by Tahoe Douglas Fire Protection District’s ambulances. The fire district and Barton have been in communication regularly since the new hospital site land purchase, planning emergency and ambulance response.

What will change?

The relocation moves a significant piece on the field that ambulance providers currently operate on. Here are the changes you can expect.

Transport times—patient to hospital—may increase primarily for calls originating in the area near Lake Valley Fire Protection District’s Station 7 on Keetak Street in Meyers.

That’s because of the four JPA ambulances consistently staffed, the ambulances at Lake Valley Fire Protection District Station 7, and the area it serves, will become the most impacted distance-wise by the hospital move. The station currently sits 5.4 miles away from Barton Memorial Hospital. The move will make it close to 11 miles away.

Cal Tahoe’s other ambulances are located centrally, between the Y and Stateline.

One consequence of the increased transport time for Lake Valley’s Keetak ambulance is it will take that ambulance out of service within the Meyers region for a longer period of time while it transports a patient, leaving a void in ambulance care.

Lake Valley’s Fire Chief, Chad Stephen, says there’s a solution for this. “As the ambulance delivery system, we just have to adjust how we cover each other and provide the same services to the residents.”

Thanks to the JPA, responding units work as one system and in that situation, an ambulance or engine shuffles to fill the void.

The increased distance may also result in the increased use of air ambulances in those areas, especially in critical situations, Chief Stephen says, whose district at times provides mutual aid services to Emerald Bay and North Tahoe, in addition to Kirkwood.

But Lake Valley’s loss in proximity is another’s gain.

“It will greatly improve our service to the Douglas County residents by lessening our transport times to the hospital, making us available for new emergencies quicker,” Tahoe Douglas Fire Protection District Fire Chief Scott Lindgren says. The new hospital will lie within Tahoe Douglas’s boundary.

“Basically, we’re just going to flip-flop roles in a sense,” the Lake Valley Chief Stephen says.

While the change increases transport times for some and reduces it for others, Wagoner of Cal Tahoe doesn’t foresee to hospital move significantly increasing their average transport time for the majority of their calls.

Instead, he sees the potential for critical call transport times in the city to shorten, rather than lengthen.

Currently, the average transport time for emergent calls within city limits, with the majority of calls taking place between Al Tahoe and Stateline, is 8 minutes via the JPA. These within-city-limit calls make up about 80% of Cal Tahoe’s 2,600 annual calls.

There is an average 15 minute transport time via Lake Valley Fire, which includes Echo Summit and Kirkwood and accounts for about 20% of Cal Tahoe’s yearly calls. That’s around 520 and 100 of those come from Kirkwood.

The transport times for Tahoe Douglas is estimated at 13-16 minutes on average up to 25 minutes in the outlying areas such as Spooner Summit and Boulder/Stagecoach.

One study shows California average transport time is approximately 14-15 minutes in urban areas and 26-35 minutes in rural areas. El Dorado County data shows the county average at 16-17 minutes for transport times.

Barton says, according a 2024 Community Health Needs Assessment, emergency services are utilized at a higher rate by residents in the area between the two current hospital campuses (spanning the Tahoe Keys, Al Tahoe, Bijou and Stateline neighborhoods) with the Meyers community utilizing emergency services the least.

If patients have an urgent need, Barton plans on providing a comprehensive Urgent Care on the South Lake Tahoe campus seven days a week. Urgent Care offices treat fractures, lacerations, sprains, infections and other illnesses needing same-day treatment. 

Casino corridor concerns

The change in location will place the new hospital on the other side of the Stateline casino corridor. Some South Tahoe residents have raised concerns this might pose delays with the congestion and traffic.

According to Wagner, congestion and traffic won’t impact code three transports, which is when an ambulance uses lights and sirens. “They just go down the center lane,” he says, “they get to bypass that traffic.”

It’s the code two transports that would be affected by challenges the corridor may pose since those transports stay with regular traffic and do not use lights and sirens to bypass traffic.

The codes are based on a patient’s medical needs; however, traffic and distance to definitive care can play a role. For example, a patient may be stable and traditionally require a code two transport, but if the traffic or distance creates a long transport wherein the patient could become unstable, there is the option to upgrade the code.

According to Shockett, EMS teams on an ambulance are in constant communication with hospital staff, often consulting directly with the emergency physician and making decisions regarding destination.

Although it’s not likely the corridor will typically impact code three transports, winter could pose challenges. Wagoner says the snow berm created down the center lane essentially leaves one lane on each side and could create delays through the casino corridor.

“That’s when it gets tough,” he says, “because traffic’s got nowhere to go.”

However, he says this issue isn’t exclusive to the casino corridor. “We have that going both directions regardless of where the hospital is.”

There is also an alternative to bypass the casino corridor using Lake Parkway if the need presents itself.

Other variables

Weather isn’t the only variable that currently impacts transport times. For the 80% of calls originating in the city limits, the specific location changes by season. For example, during ski season, many calls come from Heavenly, which isn’t too far away from the proposed future hospital location.

Traffic also changes seasonally. These variables aren’t going away with the hospital move.

While certain transport times will likely change, response times—the time it takes first responders to get to a patient—will not change since responding vehicles will continue to remain stationed at their current locations throughout the community.

“The treatment, obviously, isn’t going to change,” Stephen says and adds patients will continue to receive the highest level of care on their way to the hospital.

Barton’s cites numerous reasons for the hospital replacement, including California’s 2030 seismic requirements, limited space capacity at their current campus, aging infrastructure and the growing medical needs of the community.

Building at the Stateline location will save years and millions of dollars and allow for expanded services, according to the hospital. A new oncology center, broadened cardiovascular services, larger emergency department and expanded operating rooms are on the list of those expanded services. Shockett says this will improve overall emergency care and reduce the need to transport patients to other hospitals.

There will also be a benefit to residents in the Stateline/Bijou neighborhoods, who the hospital says are statistically more likely to have transportation challenges. These residents are closer to the new hospital location and within microtransit service boundaries.

“As somebody that’s in healthcare,” Wagoner, of Cal Tahoe says, “if there’s an expansion of services that increase the level of service to the community by going over there, that’s great.”

According to the executive director, Cal Tahoe will continue to have discussions to work through the changes the move may bring. The move to Nevada could potentially move inter-facility transfers out of the JPA’s hands, which would result in a loss of revenue. The JPA will have to review how that could impact their service.

As things evolve concerning EMS care and the hospital move, Wagoner says from the JPA side, the public won’t be kept in the dark on the JPA’s decisions. “They’ll be made in a public forum. They won’t just be made in a back office.”

For more information and to stay informed, visit Cal Tahoe’s website, ctesoa.org.

To stay informed with the hospital relocation project, visit Barton’s webpage, bartonhealth.org/about-us/dual-campus/.


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