New PA EMS Inspection Forms
The Pennsylvania Department of Health (DOH) announced, via EMS Information Bulletin 2025-05, that effective July 1st, 2025, that it had updated its forms for EMS Agency Licensure Inspections. The new forms can be found under the “Agency Licensure Documents” section of the EMS Regulations and Protocol page on the DOH Website. Importantly for agencies preparing for licensure inspections, the revised documents are the only forms that will be used.
In addition to updated forms, DOH introduced two new forms:
Agency Attestation Statement. While during its first inspection, DOH will still manually verify that the agency has all of the policies and procedures required under 28 Pa. Code § 1027.3, in subsequent inspections, the agency undergoing inspection can instead provide a signed attestation that the required policies have been established and communicated to all appropriate staff, and that all appropriate staff have reviewed and operate under the required policies.
Agency Medical Director Verification Form. This form must be completed by each agency medical director and returned to the applicable regional EMS council prior to agency being inspected. The form must be dated no more than six (6) months prior to the agency’s expiration date, and must be completed for each inspection cycle.
What does this mean for EMS agencies? First, they can potentially streamline inspections (other than the first inspection for the agency) with the Agency Attestation Statement. But agency leaders should be absolutely certain that they can stand behind each part of the attestation and that all of their policies and procedures are available, disseminated, in force, and being adhered to, prior to making the attestation. Providing the attestation falsely could result in severe penalties for the agency, and possible criminal penalties for the chief officer making the false attestation. Second, agencies need to get their agency medical director verification forms done before the inspection! Hopefully medical directors are involved and easy to find, but ensuring this is complete in advance will help steam line agency inspections and avoid delays or loss of licensure.
Need help preparing for an EMS agency licensure inspection? Missing some policies or procedures or need help with updates? I’m happy to help.
