I worked for a large city so this was not the way it worked. I can't say for sure what it is like other places. Our paramedics called into the hospital when people were dead, talked to the “physician” on duty, wrote down their name, they were declared dead and we were given a time to put in our reports.
You are correct. This changed with the standardization of Paramedic licensing. My daughter is a medic and she pronounces people dead all the time. The medical controller (the doc on the phone) actually signs the document, but paramedics have seen enough dead people to know when someone is dead.
They DO often transport dead people, doing “courtesy” CPR. This is to benefit the family who don’t want grandpa dying in the bathroom and having to wait until the hearse gets there.
I was just talking rule of thumb and traditional practice. There are lots of variations at the state and municipal level.
I remember an old medical anecdote of a young doctor with an inflated ego who halted two ambulance jockeys pushing a gurney with a sheet covered cadaver, and demanded to know where they were going. “We’re taking this dead guy to the basement morgue,” one replied.
“I’ll be the judge of that (death),” he replied, pulling down the sheet to reveal the cadaver with its head tucked under its armpit.