Stretcher training for NEMT crews: what states require, the skills to practice, and who can teach it

Only some state rules name stretcher training, so the requirement usually comes from three places: a state rule where one exists, the broker’s class, and the cot maker’s own manual. In practice they ask for the same things: train each crew member, have them practice on the real cot and van, and keep a dated record of it.

This page is about the training itself. Two-person crews, pay and rider screening are in starting a stretcher van business, the kit is in stretcher van equipment, and bed-to-cot hand techniques are in safe rider transfers. The stairs part has its own page, stair chair training.

What do states require for a stretcher crew?

Five state sources show the range. Only one gives hours, and none prescribes a single curriculum.

Minnesota is the most detailed. A stretcher crew member needs the eight-hour passenger assistance requirement, which covers wheelchair riders and transfers, and the stretcher course is added to it. Both can be completed within 45 days after the person starts providing service. Every required course has to include proficiency testing and be a classroom course, unless the state signed off on another format ahead of time. A provider who thinks a driver’s earlier training is equivalent can send the evidence to the state, which sends a written reply within 30 days, and the provider keeps that reply in the driver’s file. Every three years the person also takes two hours of securement training, among other refreshers, and three hours of continuing education.

Virginia works in steps for a stretcher driver. MTM Health requires the online PASS Basic and then the in-person Driver Training (six hours, with securement instruction and hands-on practice), and only then lets the driver enroll in Stretcher Training. Attendees bring a van they work in plus its gear, such as stretchers and sideboards, and anyone who misses 30 minutes or more repeats the training in full. The state’s own requirements add that the broker must approve an in-house program in writing first.

Illinois attaches the training to the person: every stretcher van attendant needs CPR certification and training in operating stretchers, and the rule gives neither hours nor a course list. The two-attendant minimum behind it is covered in starting a stretcher van business. Wisconsin names no stretcher course either, but its rule for specialized medical vehicles requires instruction in all ramps, lift equipment and restraint devices a provider uses, and its vehicle rule counts cot and stretcher restraints among them.

What do cot makers require before a first rider?

The manuals for the cots themselves add a second layer, and it follows the cot wherever it is used. They are written for ambulance cots, but the Virginia stretcher van standard asks for cots that meet the GSA ambulance specification KKK-A-1822E, so a van crew works from the same manuals.

• Stryker, Performance-PRO XT (September 2025). The manual tells owners to set methods and procedures to educate and train staff. An occupied cot always takes two operators, and untrained assistants must not help. It says to practice changing heights and loading until the operation is fully understood.
• Ferno, Model 35X (2013) and iN∫X (2022). Operators must read and understand the manual, be trained on the cot, practice with it before using it with a patient, and keep training records. The 35X says to permit only trained personnel to operate the cot, the iN∫X says trained operators run the controls and direct any helpers, and both include a sample training record.
• Stryker, Power-PRO XT (2008). Loading, unloading or changing the position of a loaded cot takes at least two trained operators who can lift the total weight of the patient, the cot and everything on it.

The 35X was sold with a users’ manual and a training CD-ROM. A cot maker’s materials teach the cot, not your van, your fastener or your state’s rules, so they cover part of the training and never all of it.

Which skills should a crew practice before the first trip?

Practice the tasks in the maker’s own manual, on your cot, in your van, with a volunteer or a weighted load before a real rider. This order follows the chapters of the Stryker and Ferno manuals:

1. Check the cot before service. Read the labels, clear the area, and confirm the cot and the fastener in the van are a matched pair. Ferno’s 35X manual warns that mixing makers’ cots and fasteners raises the user’s risk.
2. Roll the cot. Keep it low to reduce the risk of a tip. Lift each set of wheels over a door sill separately, and avoid curbs, steps and rough ground, or get extra hands or take another route.
3. Raise and lower with two operators. Both people must be able to lift the combined weight of the rider, the cot and any gear. As an example, a 250-pound rider on a 90-pound cot is already 340 pounds before a mattress, straps, a blanket or an oxygen bottle is added.
4. Load and lock. Lock the head section and the undercarriage as the manual orders, support the load once the wheels leave the ground, and never let the undercarriage drop on its own. Confirm the cot is latched into the fastener before the door closes.
5. Strap the rider. Use every restraint strap on every trip. Virginia loads riders headfirst and keeps the assistant in the patient compartment during the drive.
6. Unload and move on. Reverse the sequence with the same two people. Also practice the one-person load of an empty cot, which the Stryker manual allows only when no rider is on it.
7. Know the limits. Never leave a rider alone on the cot, and know your next call for stairs, elevators and tight halls. Stretcher won’t fit in the elevator covers the building side.

Bloodborne pathogen training is one of the three subjects Virginia names for stretcher crews. OSHA for NEMT explains when OSHA’s bloodborne pathogens standard applies.

Who can teach stretcher training?

Where a rule names the teacher, follow it. Elsewhere, choose someone who works the cot every day and can show how they learned it.

Minnesota’s rules require the state to approve courses and instructors, for three years at a time. For passenger assistance training the instructor list starts with doctors, nurses and physical and occupational therapists. It also allows a public health nurse or anyone with work experience with people who have disabilities or are aging, alone or as part of a team. The state’s training rule groups the stretcher course with its passenger assistance courses. Training required before the first trip, and continuing education, must be taught by someone knowledgeable in the topic whose qualifications are documented.

In Virginia, the broker’s program comes first, and an internal program needs the broker’s sign-off in writing. Neither Illinois nor New York names a trainer. A crew lead, or an EMT or paramedic on your staff, can teach if the session follows the cot manual and is recorded, though a broker may still ask for its own class.

How do you record that a crew member is competent?

Record the course, the date, the trainer and what the person did, because the maker’s own manual asks for it and states and brokers ask for dates. Minnesota requires the instructor or sponsor to complete a certificate of completion for every driver and attendant who passes a course. MTM Health collects training dates for each driver. Ferno’s sample sheet has three columns: date, name and training method. Stryker’s older sheet adds basic training and refresher dates.

Build the record from those pieces:

• Who and what. Name, role (driver or attendant), cot model and fastener type.
• When and how. Date, hours, trainer, and the method: manual, in-service session or class.
• What was observed. Each skill above, checked off while watching the person do it.
• Result and next date. Pass or repeat, and a refresher date tied to your longest rule, such as Minnesota’s three-year cycle.

The driver training log has the columns, and the driver file checklist places the record among licenses and background checks.

Keeping stretcher crews on the right trips in HealthRide

HealthRide matches stretcher needs to vehicles set up with a stretcher space. Each crew member’s certifications can carry an expiration date, so a lapsed first aid card or a refresher due next month shows up in the portal and as a warning when you assign a trip. Put the stretcher refresher date there too. Stretcher transportation software shows how stretcher trips run on the board.