Which people at the facility should get the report?

The administrator or clinic manager, the person who runs the facility's quality program, and whoever books most rides, such as the discharge planner or the transportation coordinator. Send Part 6 to accounts payable as well. Ask at the start which names the facility wants, and keep the list in the account file.

Can the report name the patients?

Usually it does not need to. Under HIPAA's minimum necessary rule, a covered entity or business associate shares only as much patient information as the task calls for, within reason. Counts, dates, units, and your trip numbers let the facility match each line to its own records. Where a line needs follow-up, such as a missed appointment, use the trip number and let the facility look up the person.

Why does a nursing home care about missed appointments?

Because inspectors ask about them. When a resident needs help getting to lab work, x-rays, or other diagnostic services, the nursing home must help arrange the ride. CMS tells surveyors that if appointments were cancelled because of transportation problems, including cost, they should find out whether the home's own procedures caused it. Part 4 gives the home that list before a surveyor does.

Should I send a report in a month with no problems?

Yes. A month of zero missed rides and zero complaints is part of the record that shows your service held up, and the facility's quality staff can only use numbers they receive. A steady monthly report also makes the month with a problem easier to explain.

What if the facility's numbers do not match ours?

Compare trip numbers line by line against the facility's booking log before discussing totals. Most gaps come from rides booked by phone that never reached the facility's own list, round trips counted once instead of as two legs, or a will-call return the facility recorded as a new booking. Settle the count before the invoice goes out.

Transportation Report for Facilities: Monthly Template

How to fill in the report

Send each facility one page a month about its own rides, built from your trip records, using the same definitions as your service agreement. Our guide to keeping facility accounts explains what targets to set, how to run the review meeting, and why the report stays the same from month to month. This page is the form itself.

Pull the facility’s legs for the month from your trip log, every leg booked by or for that facility, including discharges and will-call returns.
Use the agreement’s terms. In our facility transportation agreement, the pickup window is in clause 4.1, the will-call response time in 4.4, what counts as a pickup you missed in 5.3, and the monthly report itself in 8.4. Print the definitions on the report so nobody argues about them later.
Use counts and trip numbers. HIPAA’s minimum necessary rule keeps each disclosure to the patient information the task actually needs (45 CFR 164.502(b)). The facility can match a trip number to its own records.
Send it in the first week of the month, as a PDF, to the names in the account file.

The report

Item	Entry
Facility
Units or clinics covered
Month
Agreement date
Prepared by
Questions to (name, phone, email)

Part 1: Rides completed

Count one-way legs. A round trip is two.

Ride type	This month	Last month
Ambulatory
Wheelchair
Stretcher
Scheduled appointment rides
Will-call returns
Discharges
Total legs

Unit or clinic	Legs this month

Part 2: On time

Measure	Result	How it is measured
Pickups on time	___ %	Vehicle arrived within the window in clause 4.1 (___ minutes before to ___ minutes after)
Riders delivered by appointment time	___ %	Drop-off at or before the appointment time on the booking
Will-call returns, middle wait	___ min	From the facility’s ready call to the vehicle’s arrival
Will-call returns, longest wait	___ min	Same, with the trip number
Discharges, middle wait	___ min	From the ready call to the vehicle’s arrival
Discharges, longest wait	___ min	Same, with the trip number

Part 3: Rides that did not run

Reason	Count	Charged under the agreement?
Facility cancelled before the cutoff
Facility cancelled after the cutoff
Rider not ready or declined at pickup
Missed by us (clause 5.3)

Part 4: Appointments missed because of a ride

Date	Unit	Trip number	What happened	Rebooked for

Part 5: Complaints and incidents

Date received	Type	Trip number	Status	Days to close	What changed

Part 6: Invoices

Invoice number	Period	Amount	Paid	Balance

Part 7: Notes

Item	Entry
What we changed this month
What would help from your side
Next review meeting

Example Part 2 and Part 3 (made-up figures for a two-unit nursing home account):

Measure	Result	How it is measured
Pickups on time	96 %	Within 15 minutes before to 15 minutes after the scheduled time
Riders delivered by appointment time	98 %	Drop-off at or before the appointment time
Will-call returns, middle wait	38 min	Ready call to arrival
Will-call returns, longest wait	82 min	Trip 4471, Friday afternoon dialysis return

Reason	Count	Charged under the agreement?
Facility cancelled before the cutoff	9	No
Facility cancelled after the cutoff	3	Yes
Rider not ready or declined at pickup	2	Yes
Missed by us (clause 5.3)	1	No, credited on invoice 1093

Why the facility wants these numbers

Facilities answer for the services they get from outside companies, and their quality programs run on data. A report that arrives in numbers every month saves the facility from building those numbers itself, and gives its quality staff something they can file and act on.

Nursing homes. Under 42 CFR 483.75, every nursing home in Medicare or Medicaid runs a data-driven quality assurance and performance improvement (QAPI) program that must address all systems of care and management practices. It must keep systems to collect and use data from all departments and to track adverse events. Inspectors also look at transportation directly: for lab and imaging appointments, when any were cancelled because of transportation problems, CMS tells them to find out whether the home’s own procedures caused it. Part 4 gives the home a dated list of every appointment a ride put at risk, so it can answer that before a surveyor asks. The page on whether nursing homes provide transportation covers which appointments the rules name.
Hospitals. 42 CFR 482.21 requires a hospital-wide QAPI program that involves every department and service, including services furnished under contract or arrangement. When the hospital contracts a transportation company for discharges, that service can fall within the program’s reach, and the discharge waits in Part 2 give the hospital data for that work.
PACE organizations. Under 42 CFR 460.136, a PACE organization must involve its contract providers in its quality improvement work and make sure they know the results. The monthly report is your half of that conversation. The PACE transportation guide covers the rest of a PACE contract.

So send the report to the person who runs the quality program, not only to the person who approves the invoice.

Keeping the numbers honest

A report the facility can check against its own log earns trust; one that rounds in your favor loses the account. Our on-time performance guide has the measurement rules. For this report, five habits matter most:

Count legs, not round trips. The facility’s booking log almost always lists each leg.
Use the agreement’s window, even when a broker you also work for allows a wider one.
Start the will-call clock at the ready call, not when dispatch assigns a driver.
Keep your misses separate. A missed trip is a ride you did not run; a no-show or a rider who was not ready is something else. Never move a missed trip into the rider column.
Report the late rides nobody complained about. The facility’s staff saw them too.

Building the report from HealthRide

Start from HealthRide’s trip log and on-time performance report: each leg carries its scheduled and actual times, the driver and van, and GPS-recorded miles, and the invoices show what each facility has paid and still owes. On the facility’s side, its staff request rides, track vehicles live, and view and pay invoices in their own portal, so Part 6 matches what they already see. See reports.

Monthly transportation report for a facility account: trips, on-time, and issues