Buying a medical transport company in Canada

A medical transport company looks like a fleet with a phone number, but what a buyer acquires includes permission: permission to carry a certain kind of patient, and permission to keep carrying them for a particular health authority. If either does not move with the business, what remains is a set of vehicles. This guide is for someone evaluating a purchase and asks what to look for, what a seller may not mention, and what you must qualify for personally.

What a good one looks like

Look for a business that can describe its service in one sentence and prove it: this tier, these vehicles, these certified crews, these contracts, with paperwork that lines up with the description. Also check whether contract revenue is spread across more than one counterparty, whether the fleet is all due for replacement together, and whether anyone besides the seller knows the routes and the hospital contacts.

What you must qualify for yourself

Check first whether the regulator will deal with you. In Ontario, the Ambulance Act says no person shall operate an ambulance service unless the person holds a certificate from the certifying authority, and a certificate is issued only to a person who has successfully completed the certification process set by regulation. For land services the person must also have been selected under the Act or be otherwise entitled to provide them. A buyer who is not already certified should ask the regulator what a change of ownership requires before signing anything binding. Other provinces have their own rules, so the first task outside Ontario is to find the provincial rule.

The same question applies to the lower tiers. Whether a wheelchair-accessible service is caught by ambulance legislation, or is regulated some other way, depends on the province’s definitions. In Ontario, the Act’s definition of an ambulance turns on the condition of the people the conveyance is used or intended to be used to transport. Do not assume either answer. Ask the regulator or your lawyer in writing.

What the seller may not volunteer

Ask directly about contract consent rather than waiting for the seller to raise it: has a health authority declined to assign its contract, or is a re-tender coming? Ask also whether any contracted trips went unfilled, why attendants have left, and whether the service the company advertises is the one its licence and vehicles support. Ask who owns the dispatch software and whether the booking links hospitals use are in the company’s name or the owner’s.

Look at the fleet as a regulated asset

The Ambulance Act lets the regulations prescribe standards for ambulances, vehicles and equipment, including their maintenance and repair, so a vehicle is not just a van with a stretcher in it. Ask for each vehicle’s age, service history and any inspection findings, and ask which standard the seller says it meets. Compare that with the tier the business advertises. A fleet that was fit for the previous owner’s service may need work before it suits yours, and that cost belongs in your price discussion, not after closing.

People and records come with the business

You are inheriting attendants, and with them the training they hold. Ask which certifications each person has, when they expire, and what the contract requires. You may also inherit patient records. Ontario’s Personal Health Information Protection Act lets a custodian transfer records to its successor if it makes reasonable efforts to give notice to the individual before transferring the records or, if that is not reasonably possible, as soon as possible after transferring them. Ask the seller how it will do that.

• Ask the regulator in writing what a change of ownership requires for the licence or certificate
• Ask each contract counterparty, through the seller and your lawyer, whether it will consent to assignment
• Match the fleet and crew certifications against the service tier described in the listing
• Request the attendant roster with certification expiry dates and tenure
• Confirm who owns the dispatch system, phone numbers and booking links

Think about funding early

The Canada Small Business Financing Program’s guidelines list motor vehicles among its examples of equipment and name goodwill, if part of a going concern purchase, among its intangible assets, while vehicles for personal use are ineligible. The guidelines also list the acquisition of shares, and the part of the price a vendor finances, as ineligible. Check the current guidelines and talk to a participating lender about how your deal would fit. BDC likewise says a buyer should have a clear transaction structure and an agreed price before applying. The financing guide goes further, and the diligence guide covers the checks once you have a letter of intent.