Skip to main content
U.S. flag

An official website of the United States government

Audit Reports


Delays in Meeting Statutory Requirements and Oversight Challenges Reduce FAA’s Opportunities To Enhance HEMS Safety

Requested By
Requested by the Ranking Member of the House Committee on Transportation and Infrastructure’s Aviation Subcommittee
Project ID
File Attachment

The Helicopter Emergency Medical Services (HEMS) industry safely transports over 400,000 patients in the United States each year, frequently in challenging conditions, including night flight, poor weather, low visibility, and landing at unfamiliar accident sites. The industry has grown significantly in the last few decades, with more than 1,500 specialized air medical helicopters used by 75 different companies in 2014. As the industry has grown, so has the number of accidents, and the Federal Aviation Administration (FAA) and Congress continue to seek ways to enhance safety in the HEMS industry. FAA issued a final HEMS rule in February 2014, and Congress passed the FAA Modernization and Reform Act of 2012 (FMRA). In light of these efforts, the Ranking Member of the House Aviation Subcommittee requested that we review FAA’s progress in improving air ambulance safety.

While FAA’s recently issued HEMS rule is a good first step toward realizing FMRA goals, continued delays in finalizing the remaining congressional mandates affect FAA’s ability to focus its accident reduction efforts and limit the effectiveness of safety initiatives. Additionally, until FAA updates key oversight policies and obtains meaningful safety data to analyze for trends, it will not be well positioned to effectively oversee a rapidly expanding HEMS industry. We made five recommendations to strengthen FAA's oversight of HEMS operators; FAA concurred with two recommendations and partially concurred with three.


Closed on
No. 1 to FAA
Develop helicopter-specific accident reduction goals and communicate them in FAA planning documents and business plans.
Closed on
No. 2 to FAA
Expand the criteria for dedicated certificate management teams and use of SEP for HEMS operators with 20 to 24 aircraft.
Closed on
No. 3 to FAA
Conduct a workforce assessment that includes a determination of whether: a. inspectors are at the right locations to provide adequate surveillance of the growing number of HEMS certificates, b. it has the correct number of inspectors with the required specialized knowledge, and c. district office inspector workload is adequately measured in complexity ratings and balanced between district offices.
Closed on
No. 4 to FAA
Review and revise inspector hiring and training policies so that they provide sufficient flight and aircraft systems experience and training needed for inspectors to successfully accomplish their surveillance duties.
Closed on
No. 5 to FAA
Develop and implement a plan to provide inspectors access to new technology training opportunities and leverage both airplane and helicopter training if needed in their surveillance requirements.