When a serious illness or accident happens far from a medical facility, getting the patient to a hospital can mean the difference between life and death. Fort Lauderdale-based Trinity Air Ambulance International has been helping save lives by transporting patients quickly and safely for 15 years.
The company began with a young nurse’s dream and plenty of determination. In 1999, Inger-Lisa Skroder, then 32, had a newly minted master’s degree in nursing from the University of Washington and was living in Seattle. A broken romance motivated her to move to a different part of the country, and because she had lived previously in South Florida, earning her original three-year nursing degree here, she decided to return. But she knew she didn’t care for hospital duty, and she liked the idea of working for herself.
“I was trying to decide what to do,” she said. “I’d worked at one time for about six months for an air ambulance company, and I loved the excitement and adrenaline rush. I saw a need for a service here, because the companies I saw were all about business. I wanted empathy and compassion in addition to medical expertise. So I decided to start my own company.”
She ran the plan by Dr. Jeffrey Levy, who had worked with her in the past. He was surprisingly optimistic. “I told her it was a great idea,” said Levy, now a community physician at Jackson North Medical Center and Trinity’s medical director. After working with Skroder for 10 years, he believes he was right: “She does a great job medically, and the company has a spectacular record for safety, appropriate medical therapy and effective and rapid evacuations.”
Skroder’s younger brother Lars, already living in the area, agreed to help launch the company. She then called her other brother Tor, who was working as a firefighter in Vancouver. Would he come to Florida and join them? Tor promptly quit his job, moved to Fort Lauderdale and went back to school to get a degree in nursing while Lars handled management and marketing.
The three siblings incorporated Trinity in February 1999. Why the name? “There were three of us, so we were a trinity,” Skroder said.
The siblings were joining a fairly exclusive club. The FAA’s 2012 General Aviation/Air Taxi survey reported there were 173 fixed-wing medical aircraft in service. There are about 14 air ambulance operators with fixed-wing assets, according to FAA spokesperson Les Dorr.
Skroder estimates her initial investment to get the company up and running was about $50,000. “I maxed out three credit cards,” she says. “I worked three jobs — ER, home health and private duty. I worked all the time. And I even got a job as the first nurse practitioner ever hired by American Airlines.”
There were no loans or financial help from parents. “I purchased supplies and equipment as I made money,” she said.
Her thriftiness comes from her upbringing, she said. “My father came from Norway to Canada with a suitcase and a little money — very little. He worked all the time, and my mother also worked in the family business. When we can afford something, we buy it. We don’t over-extend ourselves.”
In the beginning, Trinity chartered aircraft on a trip-by-trip basis and worked under the charter companies’ FAA carrier certificates. But Skroder wanted Trinity to have its own planes, which would allow faster response times and better operational control.
By October 2007, the siblings were ready to purchase their first aircraft, a Learjet 35. Two years later, they bought a second Learjet 35 and obtained the company’s own FAA air carrier certificate under the name Skylink Jets.
Today, Trinity owns three Learjets and a Piper Navajo Chieftain, a smaller plane that can land on shorter runways, effective for flights to remote Caribbean islands. The aircraft represent an investment of about $3.5 million. The company’s annual revenues are in seven figures, and it has a 10 percent annual growth rate.
Trinity employs 11 medical and flight coordinators in its call center, and has about 35 per diem medical flight crew personnel. There are seven full-time pilots who go for recurrency training and upgrades at CAE Simuflite in Texas.
The early years were difficult. “We were on call 24 hours a day. And for the first eight years, none of us took a salary,” Skroder said.
Unsure how to market the fledgling firm, she printed brochures and began making the rounds of hospitals. “There was no ‘Starting an Air Ambulance Company for Dummies’ book,” she said with a laugh.
This year Trinity received the primary contract for fixed-wing air ambulance services for Jackson Health System. The contract was awarded in March and executed in April, according to JHS spokesperson Jennifer Piedra. It calls for an estimated 100 hours of flight time annually.
Trinity also works with other contractors throughout the United States, the Caribbean and South America. About 90 percent of its flights are international, and the company charges $2,400 per flight hour. Skroder estimates the cost of a flight to Nassau at about $9,500 and $23,000 to Colombia.
But Trinity also arranges flights all over the world. Tor Skroder recalls one case where a patient was in Australia and needed to be flown to New York. Another time, a patient in Bangkok had to get to Los Angeles. Trinity arranged both flights.
Then there was a patient who lived in Fort Lauderdale and was traveling with a friend in Romania. The two women were in a car accident, one was severely injured, and there were no adequate care facilities in Romania. “We coordinated a flight from Romania to Greece — we made arrangements halfway across the world — so she could be properly treated,” Tor said. “Later we flew them both back to Fort Lauderdale. Our reach is worldwide.”
Earlier this month, Trinity picked up a patient in Miami who had both left and right ventrical assist devices, mechanical pumps used to support heart function, and flew him to Chicago. “Usually a patient has just one of those devices,” Tor said. “It was the first time a patient had been transported in the U.S. with two of them.”
Once Trinity owned its aircraft, the Skroders also wanted to be able to service the planes themselves. Tor, who already had a degree in nursing, returned to school to become a licensed aircraft mechanic. “I can take care of patients or planes,” he said.
Skroder is proud of Trinity’s safety record, and the FAA’s database is clear of reports. “We’ve made thousands of flights, and we’ve had no accidents, no incidents, and no lawsuits,” she said.
Richard Earl of Burns & Roe Services at the Guantánamo Bay Naval Station in Cuba is a Trinity client. “Gitmo has a medical center that provides basic and emergency services, but when one of our employees is severely ill or seriously injured, we contact Trinity to medevac our employee to an appropriate medical care facility in South Florida,” he said. “We have been utilizing Trinity’s services for over eight years now because they provide a whole package of services, not just medical evacuations.”
Some of those services include arranging for needs like clothing, meals, accommodations, transportation and medications required by the patient or family members, as well as transportation back to Guantánamo or the patient’s home. “Overall, this is an efficient, professional and talented group that takes care of our unique needs in multiple ways,” Earl said.
Daniel Nord, director of medical services for Durham, North Carolina-based Divers Alert Network, also contracts with Trinity. “There are many great air ambulance operations that DAN interacts with each year, and they all provide safe and reliable patient care,” Nord said. “However, Trinity is a shining star, as their quick response times and ability to consistently stay on schedule have put them at the top of our list.”
In addition to four aircraft, Trinity owns the 10,000-square-foot hangar that houses them at Fort Lauderdale Executive Airport, and two buildings on Galt Ocean Drive. Call center employees work three 12-hour shifts a week.
“We also try to be flexible if people need time off for school,” Skroder said. “We don’t want employees to feel like numbers, and if they have needs, we try to accommodate them.”
Augustin Fuentes, Trinity’s chief pilot, said the company is a good place to work, and the job is exciting. “I like that it’s a small, family-owned company where everybody knows each other,” he said. “You know you can rely on the people you’re flying with.”
Fuentes’ schedule is, understandably, unpredictable: “You never know when the phone is going to ring. You know you’re going to pick up someone in dire need of medical attention, so it’s important to do it not just safely, but also effectively. And you know you’re helping people. It’s a pleasure to work at something that gives me an opportunity to help others while fulfilling my dream of being able to fly.”