Ambulance Patient Offload Time (APOT)
The EMS Authority was mandated (Health and Safety Code 1797.120) to develop a statewide methodology for calculating and reporting ambulance patient offload times by a LEMSA. This statewide, standard methodology was based on input received from stakeholders, including but not limited to: hospitals, LEMSAs, public and private EMS providers.
Documents and Guidance
- NEMSIS 3.5 APOT-1 Specifications (Updated December 2023) (pdf)
- NEMSIS 3.5 APOT-2 Specifications (Updated December 2023) (pdf)
- 2024 APOT Reporting Template (Updated December 2023) (xlsx)
- Toolkit to Reduce Ambulance Patient Offload Delays in the Emergency Department (pdf)
- Standardized Methods for Data Collection and Reporting (pdf)
- NEMSIS 3.4 APOT-1 Specifications (Updated Fall 2022) (pdf)
- NEMSIS 3.4 APOT-2 Specifications (Updated Fall 2022) (pdf)
- Memo – Fall 2022 APOT Specifications Update (10/20/2022) (pdf)
- Memo – APOT Reporting (7/20/2022) (pdf)
- Memo – APOT Reporting (7/19/2019) (pdf)
AB 40 Implementation and Guidance
- Memo to LEMSAs – “Clarification of APOT-1 Technical Specifications and Electronic Patient Care Record (ePCR) Documentation Requirements in Approved APOT Regulations.” (pdf) – June 26, 2025
- Hospital APOT Audit Webinar Presentation (pdf) – June 30, 2025
- Hospital APOT Webinar – Questions and Responses (pdf) – June 30, 2025
- LEMSA APOT Audit and AB 40 Implementation Webinar Presentation (pdf) – July 8, 2025
- EMS Provider APOT Audit and AB 40 Implementation Webinar (7/10/2025) Registration Flyer (pdf)
Data Collection and Reporting
- Ambulance Patient Offload Delays Report to the Commission on EMS – December 2024 (pdf)
- Ambulance Patient Offload Delays Report to the Commission on EMS – June 2024 (pdf)
- Ambulance Patient Offload Delays Report to the Commission on EMS – December 2023 (pdf)
- Ambulance Patient Offload Delays Report to the Commission on EMS – June 2023 (pdf)
- Ambulance Patient Offload Delays Report to the Commission on EMS – December 2022 (pdf)
- Ambulance Patient Offload Delays Report to the Commission on EMS – June 2022 (pdf)
- Ambulance Patient Offload Delays Report to the Commission on EMS – December 2021 (pdf)
- Ambulance Patient Offload Delays Report to the Commission on EMS – September 2021 (pdf)
- Ambulance Patient Offload Delays Report to Legislature – December 2020 (pdf)
For questions or inquiries related to ambulance patient offload time, please email APOT@emsa.ca.gov.