many medevac services are "joint ventures"

many rotor wing medevac services in the usa are joint ventures -
several different companies or corporations or agencies can be
involved

sometimes a medevac is a "sole proprietorship" - my words - one
company owns and operates the entire operation - like AEL + Reach +
?NW LifeFlight? etc

but many medevac services are far more complicated

the underlying pieces are -

program ownership - who is in charge overall and who holds the "brand"
name / marketing name - who makes a "profit"

helicopter ownership - many are owned by large holding corporations -
maybe some are jointly owned by hospitals - maybe some are solely
owned by hospitals - (need to check faa records for thst info)

pilots - many / most are paid / hired / trained / directed / scheduled
by aviation firms

hangar / crew quarters - many are owned by holding corporations - many
are rented or leased - some are owned by medevac program or hospital I
imagine

mechanics - hired by aviation companies usually

dispatch / communications - some by large companies - some are inhouse

medical staff - mostly employed by hospitals - some are employed by
medevac firms - some are employed by governmental agencies (ie south
florida - couple of counties have medics on private helos)

billing - multi

npi number - many by large holding corps - some by medevac programs -
some by hospitals

admin - varies - meeting state and local regulations - making all the
various parts of the program play nice together - public relations /
web presence - etc

part 135 certificate - aka filling out the FAA paperwork for the
medevac program - usually done by pilot provider - sometimes done by
hospital - FAA tries to keep helos from crashing into things

payroll - probably by whoever hires the staff

supplies and fuel and insurance - ????

quality control - whoever does the hiring

research - ??? - no one ???

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note - some helos probably stay on an open helipad and only move to a
hangar for bad weather or maintenance or winter - mostly in the south
we presume

note - some dispatch operations are also joint ventures - AirCom from
Air Methods does joint dispatching with at least one hospital transfer
center - in recent years many large hospitals have set up 'transfer
centers' to coordinate the arrival of patients from outlying hospitals
- they might or might not be colocated with the medevac program
dispatch office