Pilot DAR is correct. You need to understand all the limitations of the medical interior as installed. First and foremost the RFM’s supplement section includes the published limitations of the litter installation. There may also be a placard located near the litter on the floor. Typically, there is only one certificated location for the litter installation. This is a certified position. All structural testing is based on this position. Other positions may appear to work but would not guarantee the same level of safety should the aircraft be involved in a mishap. As a side note, all EMS A Stars that I have had experience with have required additional ballast in the tail to improve the operational capability for heavier patients