Established in 1973, Rutherford County EMS began as a Basic Life Support Ambulance provider to serve the citizens of Rutherford County. Prior to the establishment of EMS, local rescue crews and funeral homes provided transport of patients to hospitals as needed. In 1986, with the growing need of a more advanced level of service, the department progressed to provide care at the paramedic level. For many years all responses were handled from the main base station in Spindale. With the growing need to decrease response times, the county established a plan to build more stations in the outlying areas. In 2005, EMS Station 2 was established by staffing a full time paramedic EMS ambulance that is located at the Hickory Nut Gorge Rescue base in Lake Lure. In 2007, EMS Station 3 was built, located on Willis Circle in Bostic, NC. This station serves dual roles by housing EMS crews on the upper level and is used for apparatus storage by the Bostic Fire Department on the lower level. In 2015, EMS Station 4 was built, located on Hwy. 221A in Caroleen, NC. EMS has been surviving the southeastern area of the county since 2012, when an ambulance and crew were placed at the current Cliffside Fire Department.