2024-08-14T12:10:41+00:00 2023-09-30 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2023-01-01 391965415 Tri-State Ambulance Inc TRI- 6087848827 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 MICHAEL MCKEE PRESIDENT 6087848827 2024-08-14 true Emily Upstrom P01765498 3128792000 2024-08-14 2023 2024-08-08 14:25:15Z MICHAEL MCKEE 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 6812428 false X WWW.TRISTATEAMBULANCE.ORG X 2002 WI SEE SCHEDULE O. 6 2 0 2 0 0 171305 201257 8363377 6591763 8328 19408 0 0 8543010 6812428 21515 19517 0 0 4668817 3695994 0 0 0 3180089 2549203 7870421 6264714 672589 547714 7298962 7811573 706483 671380 6592479 7140193 SEE SCHEDULE O. false false 5265829 19517 6591763 SEE SCHEDULE O. 5265829 true true false false false false false false false true false false false true true false true false false false false false false false false false false true false false false false false false false false false false false false false false true true false false false true 0 0 0 false false false false false false false false false false false false X 6 2 false false false false true true true true true false false true true true true true true true true false WI X JOHN CEELEN 6087827300 1900 SOUTH AVENUE NCA1-01 LA CROSSE WI 54601 BRYAN ERDMANN BOARD OF DIRECTORS - SECRETARY/TREASURER 1.0 49.0 X X 0 0 0 MICHAEL MCKEE BOARD OF DIRECTORS - PRESIDENT 1.0 41.3 X X 0 0 0 MIKEL POELLINGER BOARD OF DIRECTORS - VICE PRESIDENT 1.0 0.5 X X 0 0 0 CHRISTOPHER EBERLEIN MD BOARD OF DIRECTORS - MEMBER (BEGIN 2/23) 1.0 44.5 X 0 0 0 KIM SMITH BOARD OF DIRECTORS - MEMBER (BEGIN 3/23) 1.0 0.5 X 0 0 0 KYLE BAKKUM BOARD OF DIRECTORS - MEMBER (END 3/23) 1.0 0.5 X 0 0 0 MICHAEL KITTELSON BOARD OF DIRECTORS - MEMBER (END 1/23) 1.0 0.5 X 0 0 0 THERESE BINFET BOARD OF DIRECTORS - MEMBER 1.0 40.5 X 0 0 0 GERALD OETZEL CHIEF FINANCIAL OFFICER AND TREASURER THRU 8/23 0.0 42.0 X 0 0 0 SCOTT RATHGABER MD CEO, CHAIRMAN 0.0 46.0 X 0 0 0 STEVE LITTLE INTERIM CHIEF FINANCIAL OFFICER AND TREASURER BEGIN 8/23 0.0 42.0 X 0 0 0 0 0 0 0 false false false 0 110000 91257 201257 PRE-HOSPITAL EMERGENCY 621910 6468545 6468545 MEDICAL SUPPLIES SERVICES 621990 56643 56643 MISCELLANEOUS RENTAL INCOME 621990 66575 66575 0 0 0 0 6591763 19408 19408 0 0 0 0 0 0 0 0 0 6812428 6591763 0 19408 2000 2000 17517 17517 0 0 2981060 2404138 576922 50874 41038 9836 460280 371290 88990 203780 164381 39399 123219 123219 1125 1125 352711 301036 51675 0 10840 10840 70404 35859 34545 25826 7875 17951 212966 171853 41113 24361 24361 26860 26860 434070 434070 22733 18338 4395 BAD DEBT EXPENSE 661011 661011 RENT, REPAIRS AND MAINTENANCE 317974 317974 SUPPLIES 244354 244354 MISCELLANEOUS OTHER EXPENSES 20749 20749 0 0 0 0 6264714 5265829 998885 0 300 300 3161502 2766332 0 0 1621761 2044220 0 0 0 0 0 0 0 0 58411 79928 7414383 4493590 2456988 2920793 0 0 0 0 7298962 7811573 495106 512094 196066 24085 0 0 0 0 15311 135201 706483 671380 X 6592479 7140193 6592479 7140193 7298962 7811573 547714 0 X X false true X true false X Schedule A, Part I, Line 3 CRITERIA FOR PUBLIC SUPPORT PURPOSES TRI-STATE AMBULANCE, INC. MEETS THIS CRITERIA FOR PUBLIC SUPPORT PURPOSES, BUT NOT FOR SCHEDULE H PURPOSES. FILING ORGANIZATION IS NOT LICENSED AND IS NOT REQUIRED TO BE LICENSED AS A HOSPITAL. ACCORDINGLY, SCHEDULE H DOES NOT APPLY AND IS NOT REQUIRED TO BE COMPLETED. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 296281 296281 1925269 832116 1093153 2287159 1676227 610932 2905674 1985247 920427 2920793 UNCLAIMED PROPERTY 1679 DUE TO GLAS 133522 135201 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, WITH THE EXCEPTION OF GUNDERSEN LUTHERAN ENVISION, LLC AND GUNDERSEN EDGE, LLC, WHICH ARE FOR-PROFIT ENTITIES. AT SEPTEMBER 30, 2023, AND NOVEMBER 30, 2022, NET DEFERRED TAX ASSETS OF $7,057 AND $7,351, RESPECTIVELY, WHICH PRIMARILY ARE RELATED TO NET OPERATING LOSS CARRYFORWARDS, HAVE VALUATION ALLOWANCES OF $7,057 AND $7,351, RESPECTIVELY, RECORDED AGAINST THEM DUE TO THE UNCERTAINTY OF REALIZING THOSE BENEFITS IN THE FUTURE. AT SEPTEMBER 30, 2023, THE SYSTEM'S FEDERAL NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $26,700, AND THE STATE NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $24,600, WHICH WILL EXPIRE BETWEEN 2032 AND 2041. THE SYSTEM HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS. THE SYSTEM'S INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR 2018 AND PRIOR YEARS. true CHARITY CARE 15 17517 COST CHARITY CARE Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. WHEN A PATIENT HAS INDICATED OR DEMONSTRATED AN "INABILITY TO PAY", A TRI-STATE AMBULANCE REVENUE CYCLE REPRESENTATIVE WILL PROVIDE THE PATIENT WITH A FINANCIAL HARDSHIP APPLICATION (FHA) AND EXPLICIT INSTRUCTIONS FOR ITS COMPLETION ALONG WITH A REQUEST FOR ANY DOCUMENTS NECESSARY TO VERIFY POTENTIAL PATIENT ASSETS AND LIABILITIES. AFTER RECEIPT OF THE PACKET IT IS THEN REVIEWED AS COMPILED AND PUT ONTO A SLIDING POVERTY DETERMINATION SCALE. AN ANNUAL COMPLIANCE AUDIT IS COMPLETED TO ENSURE ALL POLICY STANDARDS ARE BEING FOLLOWED. Form 990, Part I, Line 1 ORGANIZATION'S MSSION THE MISSION OF TRI-STATE AMBULANCE, INC. IS TO BE A PRIMARY PROVIDER OF PRE-HOSPITAL EMERGENCY CARE AND TRANSPORTATION IN THE TRI-STATE REGION. THE COMPANY UTILIZES A TEAM ENVIRONMENT WHERE ALL MEMBERS WORK TOWARD THE SHARED GOAL OF PROVIDING THE HIGHEST LEVEL OF PATIENT CARE TO THE LARGEST NUMBER OF PEOPLE IN AN EFFICIENT MANNER. WITH 43 EXPERIENCED PARAMEDICS, 37 EMTS, AND 19 AMBULANCES WE CONTINUOUSLY SET THE STANDARD FOR EMERGENCY MEDICAL SERVICES. SINCE 1970, TRI-STATE AMBULANCE HAS SERVED AS THE SOLE 911 ADVANCE LIFE SUPPORT PROVIDER FOR THE REGION COVERING NEARLY 2,200 SQUARE MILES AND SERVING A POPULATION OF APPROXIMATELY 150,000. TRI-STATE AMBULANCE OFFERS ITS RESIDENTS AND VISITORS UNSURPASSED PRE-HOSPITAL CARE. Form 990, Part III, Line 1 ORGANIZATION'S MISSION THE MISSION OF TRI-STATE AMBULANCE, INC. IS TO BE A PRIMARY PROVIDER OF PRE-HOSPITAL EMERGENCY CARE AND TRANSPORTATION IN THE TRI-STATE REGION. THE COMPANY UTILIZES A TEAM ENVIRONMENT WHERE ALL MEMBERS WORK TOWARD THE SHARED GOAL OF PROVIDING THE HIGHEST LEVEL OF PATIENT CARE TO THE LARGEST NUMBER OF PEOPLE IN AN EFFICIENT MANNER. WITH 43 EXPERIENCED PARAMEDICS, 37 EMTS, AND 19 AMBULANCES WE CONTINUOUSLY SET THE STANDARD FOR EMERGENCY MEDICAL SERVICES. SINCE 1970, TRI-STATE AMBULANCE HAS SERVED AS THE SOLE 911 ADVANCE LIFE SUPPORT PROVIDER FOR THE REGION COVERING NEARLY 2,200 SQUARE MILES AND SERVING A POPULATION OF APPROXIMATELY 150,000. TRI-STATE AMBULANCE OFFERS ITS RESIDENTS AND VISITORS UNSURPASSED PRE-HOSPITAL CARE. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENT DESCRIPTION TRI-STATE AMBULANCE HAS PROUDLY SERVED SOUTHWEST WISCONSIN, SOUTHEAST MINNESOTA, AND NORTHEAST IOWA SINCE 1970, WITH THE MOST ADVANCED PRE-HOSPITAL PATIENT CARE AVAILABLE TO THOUSANDS OF PATIENTS EVERY YEAR. PRIMARY EMERGENCY 911 RESPONSE AS WELL AS EMERGENCY AND NON-EMERGENCY INTERFACILITY TRANSPORT AND INTERCEPT SERVICES ARE PROVIDED 24 HOURS A DAY. ANOTHER MEASURE OF TRI-STATE AMBULANCES' SUCCESS IS DESCRIBED IN A RECENT COMPREHENSIVE STUDY ANALYZING THE PERCENTAGE OF PATIENTS WHO WERE DISCHARGED FROM A HOSPITAL AFTER SUFFERING A CARDIAC ARREST IN WHICH THE EVENT WAS WITNESSED AND THE VICTIM WAS IN A SHOCKABLE HEART RHYTHM (WHERE A DEFIBRILLATOR COULD BE USED). IN SEPTEMBER 2011, TRI-STATE AMBULANCE PURCHASED A NEWLY RENOVATED 23,400 SQUARE FOOT FACILITY IN LA CROSSE, WI. THE SIZE OF THE NEW BUILDING HAS ALLOWED TRI-STATE AMBULANCE TO INCREASE TRAINING OPPORTUNITIES FOR BOTH EMERGENCY MEDICAL SERVICE PROVIDERS AND COMMUNITY MEMBERS, PROVIDE PROPER SERVICE AND MAINTENANCE TO THEIR FLEET VEHICLES, AND CONSOLIDATE CENTRAL SUPPLY OF MEDICAL SUPPLIES AND EQUIPMENT FOR DISBURSEMENT TO OUTLYING TRI-STATE AMBULANCE LOCATIONS. OPERATIONS BEGAN IN THE NEW FACILITY IN THE EARLY PART OF 2012. IN THE SPRING OF 2012, TRI-STATE AMBULANCE TOOK DELIVERY OF TWO NEW AMBULANCES AS PART OF A FOUR YEAR COMPREHENSIVE AMBULANCE FLEET REPLACEMENT PLAN. NOT ONLY ARE THE NEW AMBULANCES MARKED WITH HIGHLY VISIBLE LIGHTING AND REFLECTIVE STRIPING, BUT THEY ARE DESIGNED TO OFFER BOTH PATIENTS AND STAFF A SAFER, SMOOTHER, AND MORE SECURE AMBULANCE RIDE. THE SLIGHTLY SMALLER SIZE AND SWITCH FROM DIESEL MOTORS TO GASOLINE HAS MADE OUR FLEET 20 TO 30 PERCENT LESS EXPENSIVE TO PURCHASE AND 30 TO 40 PERCENT LESS COSTLY TO MAINTAIN AND SERVICE. IN ADDITION TO THE HIGHER VISIBILITY AMBULANCES, ALL PARAMEDICS AND EMT'S NOW HAVE HIGH-VISIBILITY OUTERWEAR THAT WILL HELP PROTECT THEM WHILE AT DANGEROUS SCENES. IN 2014, TRI-STATE AMBULANCE DEDICATED ONE OF THEIR AMBULANCES AS A CRITICAL CARE AMBULANCE. THIS ALLOWED FOR THE EXPANSION OF THEIR CRITICAL CARE AMBULANCE SERVICES TO BE ABLE TO RESPOND TO SMALL REGIONAL HOSPITALS. THIS PROGRAM ALLOWS TRI-STATE AMBULANCE TO PROVIDE LIFE SAVING ADVANCED CARE FOR THE SMALL REGIONAL HOSPITALS WHICH ARE UNDERSERVED BY ADVANCED PARAMEDICS. IN 2014, TRISTATE AMBULANCE ALSO INVESTED IN THE PURCHASE OF PULSEPOINT CITIZEN RESPONDER TECHNOLOGY. THE INVESTMENT IN THE PULSEPOINT CITIZEN RESPONDER TECHNOLOGY ASSISTS IN ALERTING USERS OF A SUDDEN CARDIAC ARREST IN A PUBLIC PLACE AND THE LOCATION OF THE NEARBY AUTOMATED EXTERNAL DEFIBRIALTORS (AEDS). IN 2016, TRI-STATE AMBULANCE BEGAN TO INSTALL POWER STRETCHER LIFTS IN THE AMBULANCES ALLOWING FOR INCREASED LEVEL OF SAFETY FOR PARAMEDICS, EMTS, AND PATIENTS. TRI-STATE AMBULANCE CONTINUES TO MEET AND EXCEED CONTRACTUAL RESPONSE TIME. IN 2016, TRI-STATE AMBULANCE SAW A RECORD YEAR IN THE SERVICE AREA OF CARDIAC ARREST SURVIVAL AND CONTINUES TO WORK WITH HOSPITALS THROUGHOUT THE SERVICE AREA TO INCREASE PATIENT SURVIVAL FROM MEDICAL EMERGENCIES. IN 2017, TRI-STATE AMBULANCE BEGAN A PARTNERSHIP WITH THE LA CROSSE FIRE DEPARTMENT IN WHICH FIREFIGHTER PARAMEDICS WILL BE ABLE TO WORK AS EMPLOYEES OF TRI-STATE AMBULANCE THIS ARRANGEMENT WILL ASSIST TRI-STATE AMBULANCE WITH MUCH NEEDED STAFF AND ALSO HELP THE FIRE DEPARTMENT LOWER THEIR TURNOVER. IN 2018, THE RELATIONSHIP WITH LA CROSSE FIRE DEPARTMENT CONTINUED TO GROW AND THE USE OF SHARED STAFFING HAS BEEN WORKING WELL. IN ADDITION, DURING THE LATTER PART OF 2018 TRI-STATE AMBULANCE DONATED BLEEDING CONTROL KITS TO NEARLY 50 BUSINESSES IN THE LA CROSSE AREA TO PLACE IN THE AED ENCLOSURES. TRI-STATE AMBULANCE ALSO PARTNERED WITH WESTERN TECHNICAL COLLEGE AS A GRANT RECIPIENT TO TRAIN ADDITIONAL PARAMEDICS. TRI-STATE AMBULANCE PROVIDES PRIMARY EMERGENCY 911 RESPONSE AS WELL AS EMERGENCY AND NON-EMERGENCY INTERFACILITY TRANSPORT AND INTERCEPT SERVICES. IN 2019, TRI-STATE AMBULANCE CONTINUED TO EXCEED RESPONSE TIMES AND IMPROVED CLINICAL QUALITY BY JOINING PROGRAMS OF COVERDALE STROKE, CARES REGISTRY. IN ADDITION, TRI-STATE AMBULANCE APPLIED FOR AND WERE CHOSEN TO PARTICIPATE IN A CMS INITIAIVE CALLED THE ET3 PROGRAM WHICH WILL DRASTICALLY CHANGE HOW PATIENT CARE IS PROVIDED. TRI-STATE AMBULANCE SPENT MUCH OF 2019 PREPARING FOR CAAS ACCREDITATION AND COMPLETED A RE-WRITE OF POLICIES AND PROCEDURES. TRI-STATE AMBULANCE ALSO BEGAN TESTING TELEMEDICINE IN THE AMBULANCES AND EXPANDED CLINICAL TREATMENT PROTOCOLS TO INCLUDE ADDITIONAL MEDICATIONS. TRI-STATE AMBULANCE ALSO WORKED CLOSELY WITH AREA HOSPITALS TO STREAMLINE PROCESSES FOR HEART ATTACK AND STROKE PATIENTS. IN 2019 TRI-STATE AMBULANCE HAD A GREATER THAN 90% FIRST PASS INTUBATION SUCCESS AND ALSO PAID OFF ALL LONG TERM DEBT WHICH HAS BEEN ON THE BOOKS FOR MANY YEARS. IN 2019, USING ADVANCED MEDICAL PROTOCOLS WE SEND ECGS OR ELECTROCARDIOGRAMS TO THE HOSPITALS VIA THE INTERNET TO SPEED UP THE TREATMENT OF HEART ATTACK VICTIMS. IN 2020, TRI-STATE AMBULANCE RESPONDED TO COVID PANDEMIC WHILE ENCOUNTERING LARGE PPE EXPENSES AND STAFFING EVEN THOUGH REVENUE DROPPED. TRI-STATE AMBULANCE, INC UTILIZED TELEHEALTH INTEGRATION TO ALLOW SPECIALISTS TO PARTICIPATE IN VIRTUAL CARE IN MOVING AMBULANCE. THEY WERE ONE OF LESS THAN 200 AMBULANCE SERVICES IN THE NATION CHOSEN TO PARTICIPATE IN ET3 - EMERGENCY TRIAGE, TREATMENT, AND TRANSPORT. THEY ARE PARTNERING WITH OTHER GUNDERSEN DEPARTMENTS TO INCREASE STAFF FLEXIBILITY AND ARE EXPANDING PULSEPOINT COMMUNITY APP. IN 2021, TRI-STATE AMBULANCE, INC WAS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF AMBULANCE SERVICES (CAAS). IN 2022, TRI-STATE AMBULANCE HAD 11,590 TRANSPORTS, 221 STANDBYS, 6,203 NON-TRANSPORTS, AND 18,014 TOTAL CALLS. TSA HAS LAUNCHED A PROGRAM WHICH ALLOWS ALTERNATE DESTINATION TRANSPORTS AS WELL AS TELEHEALTH USE FOR 911 PATIENTS. IN 2022, TSA BECAME ACCREDITED WITH THE COMMISSION ON ACCREDITATION FOR AMBULANCE SERVIES (CAAS). THIS IS A THREE YEAR ACCREDITATION AND WILL BE UP FOR RENEWAL IN 2024. IN ADDITION, IN PARTNERSHIP WITH GUNDERSEN HEALTH SYSTEM, TSA LAUNCHED A "PARAMEDIC TRAINEE" PROGRAM WHICH IS AN "EARN WHILE YOU LEARN" OPPORTUNITY. TSA HIRED 7 EMTS IN FULL-TIME CAPACITY WHO WILL RECEIVE PAY AND BENEFITS WHILE THEY ATTEND PARAMEDIC SCHOOL. IN 2023, TRI-STATE AMBULANCE HAD 8,517 TRANSPORTS, 54 STANDBYS, 3,149 NON-TRANSPORTS, AND 11,720 TOTAL CALLS. TSA HAS LAUNCHED A PROGRAM WHICH ALLOWS ALTERNATE DESTINATION TRANSPORTS AS WELL AS TELEHEALTH USE FOR 911 PATIENTS. WE WERE ABLE TO MAINTAIN A POSITIVE FISCAL MARGIN DESPITE HIGHER OVERTIMES COSTS WITH STAFFING SHORTAGES. WE CONTINUE TO BE ACCREDITED BY THE COMMISSION ON ACCREDITATION OF AMBULANCE SERVICES (CAAS). A SIGNIFICANT AREA OF EXPENSE THIS YEAR WAS THE CREATION OF A PARAMEDIC TRAINEE PROGRAM. WITH THIS PROGRAM, WE HAVE HIRED EMTS INTO FULL-TIME POSITIONS AND PAID FOR THEIR FULL-TIME PARAMEDIC SCHOOLING. WHILE THIS PROGRAM WAS COSTLY, THE INDUSTRY SHORTAGE OF PARAMEDICS MADE IT A NECESSITY. ADDITIONALLY, THE CMS FEDERAL PROGRAM ENDED THEIR ET3 TELEHEALTH AND ALTERNATE DESTINATION PROGRAM AT THE END OF THIS CALENDAR YEAR. WE WILL CONTINUE TO FIND WAY TO TREAT PATIENTS WITHOUT COSTLY EMERGENCY DEPARTMENT VISITS. Form 990, Part VI, Line 15 A AND B - PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE COMPENSATION OF THE OPERATIONS MANAGER IS DETERMINED ANNUALLY BY THE TRI-STATE AMBULANCE, INC. 39-1965415 PRESIDENT OF THE BOARD. THE DETERMINATION IS MADE AFTER A REVIEW OF THE MARKET DATA IS OBTAINED FROM SEVERAL ORGANIZATIONS. THE COMPENSATION AMOUNTS ARE NOT EFFECTIVE UNTIL THE BOARD APPROVES THEM. MEETING MINUTES ARE TAKEN AND KEPT AT THE MEETINGS WHERE THE BOARD REVIEWS AND APPROVES THE COMPENSATION OF THE KEY EMPLOYEES. Form 990, Part VI, Line 6 Classes of members or stockholders GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF THIS ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE SOLE CORPORATE MEMBER, GUNDERSEN LUTHERN HEALTH SYSTEM, INC. MAY ELECT THE GOVERNING BODY. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. HAS THE ABILITY TO PROVIDE, BY RESOLUTION, FOR MORE THAN THE DESIGNATED SIX DIRECTORS. UPON DISSOLUTION, THE DISTRIBUTION OF ASSETS SHALL BE DETERMINED BY THE BOARD OF GOVERNORS AND THE BOARD OF TRUSTEES OF GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. Form 990, Part VI, Line 11b Review of form 990 by governing body PRIOR TO FILING THE FORM 990, IT IS REVIEWED FOR COMPLETENESS AND ACCURACY BY MANAGEMENT. FOR THIS PURPOSE, MANAGEMENT IS THE ACCOUNTING MANAGER, THE DIRECTOR OF FINANCE FOR THE GUNDERSEN LUTHERAN HEALTH SYSTEM., AND THE PRINCIPAL OFFICE OF THE ORGANIZATION. A COPY OF THE FORM 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS. Form 990, Part VI, Line 12c Conflict of interest policy EACH MEMBER OF THE TRI-STATE AMBULANCE, INC. GOVERNING BOARD SIGNS A CONFLICT OF INTEREST STATEMENT EACH YEAR. MEMBERS ARE ASKED TO DISCLOSE CONFLICTS AS APPROPRIATE AND ABSTAIN FROM VOTING WHEN APPLICABLE. Form 990, Part VI, Line 19 Required documents available to the public REQUESTS FOR FORM 990 AND CERTAIN OTHER INFORMATION IS AVAILABLE FOR PUBLIC INSPECTION AND COPYING THROUGH THE GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.'S LEGAL DEPARTMENT. Form 990, Part VII, Section A, Line 1a COMPENSATION REPORTING DUE TO THE SHORT YEAR RETURN IN WHICH THERE WAS NO CALENDAR YEAR THAT ENDS WITH OR WITHIN THE SHORT YEAR, NO REPORTABLE COMPENSATION IS SHOWN FOR INDIVIDUALS LISTED ON PART VII OF THE 990 RETURN. AS SUCH, NO KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, OR INDEPENDENT CONTRACTORS ARE LISTED PER THE REPORTING INSTRUCTIONS. Form 990, Part XII, Line 2c Change of oversight process or selection process THE AUDITOR IS SELECTED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. 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