2025-08-14T15:39:42+00:00 2024-09-30 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2023-10-01 391965415 Tri-State Ambulance Inc TRI- 6087848827 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 MICHAEL MCKEE PRESIDENT 2025-08-14 true true Emily Beckerman P01765498 3128792000 2025-08-06 2023 2025-03-06 01:10:19Z MICHAEL MCKEE 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 9720021 false X WWW.TRISTATEAMBULANCE.ORG X 2002 WI See Schedule O 6 2 80 2 0 0 201257 35507 6591763 9575800 19408 108714 0 0 6812428 9720021 19517 32728 0 0 3695994 5664237 0 0 0 2549203 3624259 6264714 9321224 547714 398797 7811573 8126565 671380 587575 7140193 7538990 See Schedule O false false 8037920 32728 9575800 See Schedule O 8037920 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 true false false false false false false false false false false false false false true true false false false true 18 0 true 80 true 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 2.0 48.0 X X 0 409876 74345 MICHAEL MCKEE BOARD OF DIRECTORS - PRESIDENT 2.0 48.0 X X 0 281060 70085 MIKEL POELLINGER BOARD OF DIRECTORS - VICE PRESIDENT 2.0 0.0 X X 0 0 0 CHRISTOPHER EBERLEIN MD BOARD OF DIRECTORS - MEMBER 2.0 48.0 X 0 398553 70228 KIM SMITH BOARD OF DIRECTORS - MEMBER 2.0 0.0 X 0 0 0 THERESE BINFET BOARD OF DIRECTORS - MEMBER 2.0 48.0 X 0 176918 47892 JOHN CEELEN CHIEF FINANCIAL OFFICER, TREASURER (BEGIN 2/24) 2.0 48.0 X 0 0 0 SCOTT RATHGABER MD CHIEF EXECUTIVE OFFICER 2.0 48.0 X 0 1644221 68728 STEVE LITTLE INTERIM CHIEF FINANCIAL OFFICER, TREASURER (THRU 2/24) 2.0 48.0 X 0 333317 0 THOMAS E TORNSTROM ADMINISTRATIVE DIRECTOR 0.0 50.0 X 0 163870 42697 CINDY MCDONALD CC PARAMEDIC 0.0 40.0 X 0 93589 41331 GREGG BULMAN PARAMEDIC 0.0 40.0 X 0 103057 28448 RANDY YOUNG CC PARAMEDIC 0.0 40.0 X 0 113608 12754 GERALD OETZEL FORMER CHIEF FINANCIAL OFFICER 0.0 0.0 X 0 555068 18108 0 4273137 474616 0 true true false ECP SERVICES LLC 117 N MAIN ST 6 LAKE MILLS WI 535511609 Purchased Services 129641 1 14000 21507 35507 PRE-HOSPITAL EMERGENCY 621910 9455707 9455707 MEDICAL SUPPLIES SERVICES 621990 31302 31302 MISCELLANEOUS RENTAL INCOME 621990 88791 88791 0 0 0 0 9575800 107214 107214 0 0 1500 0 0 1500 1500 1500 0 0 0 0 0 9720021 9575800 0 108714 1000 1000 31728 31728 0 0 4491056 3726565 764491 177800 147556 30244 694583 576434 118149 300798 249632 51166 164292 164292 1500 1500 442447 413807 28640 0 350 350 89923 45973 43950 46034 13907 32127 262023 217522 44501 34367 34367 42120 42120 603876 603876 31710 26316 5394 BAD DEBT EXPENSE 1300784 1300784 RENT, REPAIRS AND MAINTENANCE 313622 313622 SUPPLIES 264954 264954 Licenses/Permits/Fees 16726 16726 9531 9531 0 0 9321224 8037920 1283304 0 300 300 2766332 2969676 0 0 2044220 2187668 0 0 0 0 0 0 0 0 79928 8227 7574387 4632527 2920793 2941860 0 0 0 18834 7811573 8126565 512094 581301 24085 4595 0 0 0 135201 1679 671380 587575 X 7140193 7538990 7140193 7538990 7811573 8126565 398797 0 X X false true X true true true X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 218543 218543 2003007 879133 1123874 2407170 1924708 482462 2945667 1828686 1116981 2941860 UNCLAIMED PROPERTY 1679 1679 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, 2024 and 2023, net deferred tax assets of $11,395 and $10,512, respectively, which primarily are related to net operating loss carryforwards, have valuation allowances of $11,395 and $10,512, respectively, recorded against them due to the uncertainty of realizing those benefits in the future. At September 30, 2024, the System's federal net operating loss carryforwards were approximately $43,489, and the state net operating loss carryforwards were approximately $41,989, 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 82 31728 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. false false false false false false false false false BRYAN ERDMANN BOARD OF DIRECTORS - SECRETARY/TREASURER 0 408646 0 0 0 1230 0 45225 0 29120 0 484221 0 0 MICHAEL MCKEE BOARD OF DIRECTORS - PRESIDENT 0 279802 0 0 0 1258 0 41528 0 28557 0 351145 0 0 CHRISTOPHER EBERLEIN MD BOARD OF DIRECTORS - MEMBER 0 391338 0 2000 0 5215 0 45225 0 25003 0 468781 0 0 THERESE BINFET BOARD OF DIRECTORS - MEMBER 0 174552 0 0 0 2366 0 25889 0 22003 0 224810 0 0 GERALD OETZEL FORMER CHIEF FINANCIAL OFFICER 0 480094 0 70000 0 4974 0 12220 0 5888 0 573176 0 0 STEVE LITTLE INTERIM CHIEF FINANCIAL OFFICER, TREASURER (THRU 2/24) 0 258317 0 75000 0 0 0 0 0 0 0 333317 0 0 SCOTT RATHGABER MD CHIEF EXECUTIVE OFFICER 0 1274504 0 200000 0 169717 0 45225 0 23503 0 1712949 0 0 THOMAS E TORNSTROM ADMINISTRATIVE DIRECTOR 0 160902 0 900 0 2068 0 24013 0 18684 0 206567 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION FOR EXECUTIVES IS ESTABLISHED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., A RELATED PARTY. GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. USED A COMPENSATION COMMITTEE TO ESTABLISH COMPENSATION FOR EXECUTIVES. 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 37 EXPERIENCED PARAMEDICS, 40 EMTS, AND 17 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. TRISTATE AMBULANCE OFFERS ITS RESIDENTS AND VISITORS UNSURPASSED PRE-HOSPITAL CARE. 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 TRISTATE 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 XII, Line 2c Change of oversight process or selection process THE AUDITOR IS SELECTED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. 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 37 EXPERIENCED PARAMEDICS, 40 EMTS, AND 17 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. TRISTATE 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 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 FULLTIME 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. IN 2024, TRI-STATE AMBULANCE HAD 12,030 TRANSPORTS, 104 STANDBYS, 264 NON-TRANSPORTS, AND 16,322 TOTAL CALLS. TRI-STATE AMBULANCE, INC completed our second year of offering the paramedic trainee program, this program contracted with the local technical college to provide full-time paramedic education to 8-10 of our EMTs. These EMTs were hired into these roles with their main function to be full-time students and complete their education. The program was very successful, but costly. TRI-STATE AMBULANCE has completed the CAAS Reaccreditation, high staff 12-month retention rates in the low 90%s and a successful partnership with local fire department. 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