The facility shall: Transfer the clinically appropriate acute stroke patient after initial treatment and stabilization to the appropriate MIEMSS designated primary stroke center, primary stroke center with endovascular capability, or comprehensive stroke center; and Maintain an agreement or agreements with a commercial ambulance service to: Transfer stroke patients as clinically necessary; Ensure the appropriate delivery of care during transport; and Limit utilization of local emergency medical services (EMS) resources unless by pre-existing agreement.