NEMT Vehicle Maintenance Log: A Free Printable Record for Each Van

Federal Medicaid law sets no vehicle standards of its own. CMS says in its Medicaid Transportation Coverage Guide (SMD 23-006, September 28, 2023) that vehicle standards generally come from state agencies. States and brokers fill the gap, and several of them ask for written proof that each vehicle is maintained. This log keeps that proof in one place per vehicle: routine service, repairs, lift and ramp work, recalls, defects, and outside inspections.

How to use this template

1. Start one log for each vehicle. Fill in Part 1 from the title, registration, and door label. Add the lift’s maker, model, and serial number from the lift itself.
2. Build the schedule in Part 2 from the manuals. Copy each item from the vehicle owner’s manual and from the lift maker’s insert to it. CareOregon requires a preventive maintenance schedule for each vehicle that covers, at minimum, everything the maker recommends. Minnesota allows the maker’s schedule or a better one based on how the vehicle is actually used.
3. Write every visit in Part 3 the same day. Record the date, the odometer reading, the work done, who did it, and the invoice number. Minnesota requires the date, the odometer reading, and the nature of the work each time a vehicle or lift is serviced. File the receipt behind the log.
4. Give the lift or ramp its own record in Part 4. Federal safety standards require platform lifts made since April 1, 2005 to have a cycle counter and a maintenance schedule that depends partly on its count, so write the count at every service.
5. Check recalls in Part 5. Look up the VIN when the vehicle joins your fleet and on the schedule you set: ______. Ask the lift maker about lift recalls too.
6. Copy every defect into Part 6. When the daily vehicle inspection checklist or a driver finds a safety problem, the vehicle stays off the road until it is fixed. Minnesota, Wisconsin, and Georgia all require the fix first.
7. Record outside inspections in Part 7. Include state inspections, broker inspections, and any yearly mechanic or ADA inspection your broker requires, with the next due date.
8. Review the log each month. Check what is due in the next 30 days and sign Part 9. Keep the log at your office, since Minnesota wants records you can show at your main place of business on request.

The template

Part 1: Vehicle details

Field	Write the entry here in pen
Vehicle or fleet number
Year, make, and model
VIN
Plate number and state
Vehicle type (sedan, minivan, wheelchair van, stretcher van)
Seats and wheelchair positions
Owner, or the person or company leasing it to us
Date it joined our fleet, and odometer reading that day
Lift or ramp maker, model, and serial number
Lift rated capacity and year made
Lift label (public use or private use)
Conversion company and conversion date, if converted
Roof or rollover certification on file (yes or no)
Radio, tablet, or camera installed
Registration expires
Insurance expires
Vehicle warranty ends (date or miles)
Lift warranty ends

Part 2: Maintenance schedule

Write the interval from the manual, then the next due mileage or date. Cross out items that do not apply.

Service	Every (miles)	Every (months)	From (manual page or rule)	Next due (miles)	Next due (date)
Engine oil and filter
Tire rotation, pressure, and tread check
Brake inspection
Transmission fluid
Coolant
Engine and cabin air filters
Battery test
Belts and hoses
Heating and air conditioning check
Wipers and washer fluid
Lift service (by cycles or months, per lift manual)
Ramp service
Securement tracks, tie-downs, and belts
Fire extinguisher check
State inspection
Broker inspection
Mechanic safety inspection (if a broker requires one)
ADA compliance check for wheelchair vans (if required)

Part 3: Service and repair record (one line per visit)

Date	Odometer	Work done (service, repair, or inspection)	Done by (shop or name)	Parts replaced	Invoice number and cost	Next due	Initials

Part 4: Wheelchair lift and ramp record (N/A if none)

Date	Odometer	Lift cycle count	Work done	Done by	Full cycle test passed (yes or no)	Initials

Part 5: Recall checks

Date checked	Where checked (NHTSA VIN search, vehicle maker, lift maker)	Recall number	What it fixes	Date repaired	Repaired by	Proof filed (yes or no)

Part 6: Defects and out-of-service record

Date found	Found by (daily check, driver, complaint, inspector)	Defect	Out of service (date and time)	Trips moved to (vehicle)	Repair made (what, by whom)	Back in service (date and time) and approved by

Part 7: Outside inspections

Date	Type (state, broker, mechanic, ADA, federal annual)	Inspector	Result (pass, fail, or in process)	Sticker or report number	Next due

Part 8: Accidents and damage

Date	Odometer	Damage	Checked by (mechanic and certification)	Repair made	Back in service (date)

Part 9: Monthly review

Month	Services due in the next 30 days	Open defects or recalls	Reviewed by	Signature

Which rule each record meets

No single rule asks for every line on this log. The table shows where each part is required, using states and brokers with clear written rules. Add anything your own state and broker contracts ask for.

Record	Where it is required
Year, make, model, VIN, fleet number, plate, vehicle type, special equipment, and devices installed	Texas Medicaid health plans and their providers (section 2630); federal rules for commercial vans ask for the company number, make, serial number, year, and owner if leased
A schedule with the nature and due date of each inspection and maintenance item	Federal rules for commercial vans (49 CFR 396.3)
Maintenance on the maker’s schedule, or a better one	Minnesota Rules 8840.5975; CareOregon (maker’s schedule at minimum); Georgia and MTM Health in Virginia (meet or exceed the maker’s maintenance standards); Texas (meet or exceed warranty and component standards)
Date, odometer, and nature of each service, for the vehicle and the lift	Minnesota Rules 8840.6100
Lift kept up by the lift maker’s manual, and the mechanic told to follow it	Minnesota Rules 8840.5975
Lift maker, model, age, and rated capacity	MTM Health in Virginia (wheelchair vans)
Lift and securement devices kept working and repaired promptly	Federal ADA rules (49 CFR 37.161)
Maintenance records for each vehicle for the contract term, plus inspection history	Texas (section 2630)
Deficiencies fixed before riders are carried, with the fix written down	Wisconsin DHS 105.39; Minnesota Rules 8840.5975 (fixed before the vehicle goes into service)
Corrective action after rider complaints, in the vehicle’s permanent record	Georgia (two or more complaints in 5 days); Texas (two substantiated complaints in 10 days)
Inspection before first use and on a schedule	MTM Health in Virginia (before first use and twice a year); Louisiana (before enrollment and yearly by the broker); Minnesota (MnDOT at least yearly); CareOregon (mechanic safety inspection within the last year)
Roof or rollover certification for vans	Minnesota Rules 8840.5940 and 8840.6100
Mechanic check after damage	CareOregon (an ASE-certified mechanic before the vehicle returns to service)
Fire extinguisher checks	CareOregon (recommended by eye monthly, and at least once a year)

State and broker rules for maintenance records

Minnesota. Vehicles must be maintained on the maker’s recommended schedule or an improved one based on actual operating conditions (Minnesota Rules 8840.5975, as of September 2026). Any deficiency that might interfere with safe operation must be fixed before the vehicle is placed in service. Lifts follow the lift maker’s manual, and when you have the vehicle serviced you must tell the mechanic to inspect and service the lift by the maker’s instructions. You keep service records for each vehicle and each lift, showing the date, the odometer reading, and the nature of the work (Minnesota Rules 8840.6100). Records may be electronic, but you must be able to show them at your main place of business. MnDOT inspects each vehicle at least once a year, may inspect without notice, and reviews each vehicle’s inspection, repair, and maintenance records at least once a year (Minnesota Rules 8840.5700).

Texas. Medicaid health plans and their transportation subcontractors must keep, or require providers to keep, records for each vehicle: maker, model, year, VIN, fleet number, type, plate, insurance, registration, special equipment such as a lift or ramp, communication and navigation devices, inspection activity and history, and maintenance records for the term of the contract (Uniform Managed Care Manual 16.4, version 2.0.1, section 2630). Vehicles must meet or exceed warranty and component standards for state and federal safety, mechanical, operating, and maintenance standards. A vehicle with two substantiated complaints about cleanliness, temperature, or other deficiencies within 10 days comes out of service until the corrective action is documented, and that record stays in the vehicle’s permanent file.

Georgia. Vehicles and all their parts must meet or exceed the maker’s, state, and federal safety and mechanical operating and maintenance standards (Part II NEMT manual, version dated July 1, 2026). A vehicle out of compliance comes off the road until the state certifies in writing that it may return. Two or more rider complaints about one vehicle within 5 days require an inspection, and the fix becomes part of the vehicle’s permanent record. A vehicle with broken climate control or a broken two-way communication system stays out of service until it is fixed.

Wisconsin. Each specialized medical vehicle is inspected, and the inspection written down, at least every 7 days by an assigned driver or mechanic (DHS 105.39, as of September 2026). Deficiencies are fixed before any rider is carried, the driver documents the fix, and the records are kept at least 12 months.

CareOregon. Its manual (version 1.3, February 2024) requires a preventive maintenance schedule for each vehicle covering at least the maker’s recommendations. After an accident or other damage, an ASE-certified mechanic must assess the vehicle before it returns to service, and a damaged vehicle may not keep doing NEMT trips. Each vehicle also needs a safety inspection by an ASE-certified mechanic within the last year, and wheelchair vans an ADA compliance certification within the last year.

MTM Health. In Virginia, vehicles and their parts must meet federal, state, local, and maker safety, mechanical, operating, and maintenance standards (handbook approved August 10, 2026). Each vehicle is inspected before it carries members and again twice a year. For wheelchair vans, you document the lift’s maker, model, age, and rated capacity. MTM also collects a vehicle roster with inspection and license expiration dates, insurance expiration, and the last broker inspection, and you must keep those credentials current. MTM’s standard agreement, in the January 1, 2023 version Pennsylvania posts, requires vehicles to meet any requirement set by the vehicle maker, allows unannounced inspections of your records, and asks you to keep full records of your operations for 10 years.

Louisiana. The broker inspects each vehicle before it joins the program and every year after that, with photos, and checks that it works as the maker intended (Medicaid Services Manual chapter 10, section 10.3, issued July 14, 2025). The state and the broker may also make unannounced compliance reviews.

For the equipment each vehicle must carry, see NEMT vehicle requirements. For a full service calendar, see NEMT vehicle maintenance.

Wheelchair lifts and ramps

Federal safety standard No. 403 requires every platform lift made since April 1, 2005 to have a counter that records each complete up and down cycle. The lift maker must supply an insert for the vehicle owner’s manual with a maintenance schedule that depends at least partly on that count, plus operating instructions, including the manual backup (49 CFR 571.403). For vehicles built since July 1, 2005, Standard No. 404 requires the owner’s manual, if the vehicle has one, to contain that insert (49 CFR 571.404). Keep the insert with this log, and copy its schedule into Part 2.

The cover of the insert says “DOT-Public Use Lift” or “DOT-Private Use Lift.” Write which one in Part 1. Standard No. 404 requires a public use lift on lift-equipped buses, school buses, and multipurpose passenger vehicles other than motor homes with a gross vehicle weight rating over 10,000 pounds.

Federal ADA rules require public and private transportation companies to keep lifts, securement devices, and other access features working, and to repair them promptly (49 CFR 37.161). While a feature is out of order, you must take reasonable steps to serve the riders who need it. The stricter rule in 49 CFR 37.163 applies to public entities: regular and frequent lift checks, and a vehicle with a broken lift off the road before its next service day, with short exceptions. For the daily and monthly lift checks, use the wheelchair lift inspection log.

How to find and fix recalls

Recall notices for a vehicle go to the owner shown on state registration records, or to the most recent buyer the maker knows. Notices for equipment sold separately go to the most recent buyer the maker knows (49 U.S.C. 30119). Keep the address on every registration current, and register each lift or conversion with its maker so notices reach you.

The maker must fix a recalled vehicle or piece of equipment without charge when you bring it in, by repairing it, replacing it, or refunding the price. That duty ends if the vehicle or equipment was first sold more than 15 years before the notice, or more than 5 years for tires (49 U.S.C. 30120). Search each VIN on NHTSA’s recall page, write the recall number and repair date in Part 5, and keep the dealer’s repair order.

Warranty and tax records

The same records protect your warranty. The FTC says you do not have to use the dealer for repairs or maintenance to keep a warranty in effect, and it is illegal for a dealer to deny coverage because someone else did routine maintenance or repairs. The warranty company can ask for your maintenance records, so keep receipts for oil changes, tire rotations, belts, brake pads, and inspections.

For taxes, the IRS says to keep records on business property until the period of limitations ends for the year you sell or otherwise dispose of it, because they support depreciation and your gain or loss (Publication 583, December 2024). Record miles for each trip in the mileage log, and keep odometer readings on the trip log consistent with this one.

If federal commercial vehicle rules cover your vans

Federal motor carrier rules cover some vans used in interstate commerce, depending on their weight rating and seating (49 CFR 390.5T). The same rules list exceptions, including “the transportation of human corpses or sick and injured persons” (49 CFR 390.3T), so ask FMCSA whether that exception covers your trips before you count on it. See FMCSA inspection rules for NEMT for the full test. When the rules apply, as of September 2026:

• Systematic maintenance. You must systematically inspect, repair, and maintain every vehicle you control, and keep parts in safe operating condition at all times (49 CFR 396.3).
• Required records. For each vehicle you control for 30 days in a row, keep its identity, a way to show the nature and due date of each inspection and maintenance task, and a record of inspections, repairs, and maintenance with their dates and nature. Keep them where the vehicle is housed or maintained for 1 year, and for 6 months after it leaves your control.
• Yearly inspection. Each vehicle passes a periodic inspection at least every 12 months, with proof carried on the vehicle (49 CFR 396.17). The inspector’s report is kept 14 months (49 CFR 396.21).

How long to keep maintenance records

Rule	Record	How long
Minnesota Rules 8840.6100	Vehicle and lift service records, and other records under chapter 8840	At least 3 years
Texas Uniform Managed Care Manual 16.4	Maintenance records for each vehicle	The term of the contract
Wisconsin DHS 105.39	Inspection and repair records	At least 12 months
49 CFR 396.3 (commercial vans)	Inspection, repair, and maintenance records	1 year, and 6 months after the vehicle leaves your control
49 CFR 396.21 (commercial vans)	Yearly inspection report	14 months
MTM Health standard agreement	Full records of your operations under the agreement	10 years
IRS Publication 583	Records on business property	Until the period of limitations ends for the year you dispose of it

The longest rule that applies to you wins. When a vehicle leaves your fleet, keep its log with your closed files rather than throwing it out. Auditors ask for these records, as the Medicaid audit guide explains.