The accident happened in Clay County shortly after 11 p.m. EDT Thursday, Air Evac Lifeteam said in a statement.
"We are devastated at the loss of these crew members who we consider family," company officials said. "We have no details regarding the cause of the accident but will be working with the NTSB in coming days as they conduct their investigation."
There was no patient on board. WHAS radio reported that the helicopter, a Bell 206 LongRanger, came down in the parking lot of Paces Creek Elementary School outside Manchester, which is about 90 miles southeast of Lexington, in what witnesses described as a dense fog.
Company spokeswoman Julie Heavrin said the helicopter had been "completely refurbished with wiring, components" in May 2012 making it "more powerful and capable of carrying higher gross weight."
Air Evac Lifeteam operates 114 bases in 15 states. The last crash of one of helicopters occurred in Arkansas in 2010. All three crew members were killed when the helicopter, a Bell 206 built in 1978, went down in Van Buren County.
Ed Ray, a meteorologist at the National Weather Service's Jackson, Ky., office said he didn't have any information about fog in the area but said there was no violent weather overnight in the area of the crash.
The company identified the crewmembers as pilot Eddie Sizemore, flight paramedic Herman "Lee" Dobbs and flight nurse Jesse Jones. They were on their back to base in Manchester after transporting a patient to a hospital in London, Ky.
Laurel County Sheriff's spokesman Gilbert Acciardo told the Lexington Herald-Leader that Sizemore had retired as a deputy from the sheriff's office, but returned in 2011 before leaving the position to become a pilot for Air Evac Lifeteam.
"He enjoyed flying," Acciardo said. "That was his passion."
Air Evac Lifeteam President and CEO Seth Myers said the company is devastated by the loss of the crew.
Federal air safety officials planned to investigate the accident.
Heavrin said Air Evac Lifeteam has had two other fatal crashes in the past six years. One in Indiana in 2008 killed all three crew members, as did the other in Alabama in 2007.
The Missouri-based company has been providing medical transportation for 26 years. Its flight crews typically consist of a pilot, registered nurse and paramedic. Besides its fleet of helicopters, Air Evac Lifeteam also uses planes, including one based at the nearby Williamsburg-Whitley County Airport in southeastern Kentucky.
Judy Owens, former head of the University of Kentucky Center for Rural Heath in Hazard, said the mountainous terrain of central Appalachia makes helicopter transport a must if patients are to arrive at major hospitals within the so-called "golden hour" that can determine whether they live or die. Owens said the flight crews are considered heroes in central Appalachia.
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