2026-08-13T17:04:43+00:00 2025-09-30 135565207 KPMG LLP 200 EAST RANDOLPH DRIVE SUITE 5500 CHICAGO IL 606016436 990 2024-10-01 391962965 TRI-STATE REGIONAL AMBULANCE INC TRI- 6086378884 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 MICHAEL MICKEE PRESIDENT 2026-08-13 true RILEY KOBRICK P02401884 3126651000 2026-08-12 2024 2025-03-06 01:10:19Z MICHAEL MICKEE 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 5812838 false X NA X 1999 WI TRI-STATE REGIONAL AMBULANCE, INC. PROVIDES HIGH QUALITY, LOW COST MEDICAL TRANSPORTATION SERVICES TO AND FROM MEDICAL APPOINTMENTS AND HOME AFTER A HOSPITAL DISCHARGE. IN ADDITION, TRI-STATE REGIONAL AMBULANCE PROVIDES PRE-HOSPITAL EMERGENCY CARE AND INTERFACILITY ADVANCE LIFE SUPPORT TRANSPORTATION. 6 2 0 2 0 108483 355672 4846531 5438945 2024 16335 0 0 4957038 5810952 40479 24009 0 0 4367673 4516131 0 0 0 1884461 1716926 6292613 6257066 -1335575 -446114 4182968 5648597 6510475 8422218 -2327507 -2773621 TRI-STATE REGIONAL AMBULANCE, INC. PROVIDES HIGH QUALITY, LOW COST MEDICAL TRANSPORTATION SERVICES TO AND FROM MEDICAL APPOINTMENTS AND HOME AFTER A HOSPITAL DISCHARGE. IN ADDITION, TRI-STATE REGIONAL AMBULANCE PROVIDES PRE-HOSPITAL EMERGENCY CARE AND INTERFACILITY ADVANCE LIFE SUPPORT TRANSPORTATION. false false 5712418 24009 5059097 TRI-STATE REGIONAL AMBULANCE PROVIDES PRIMARY EMERGENCY 911 RESPONSE AS WELL AS EMERGENCY AND NON-EMERGENCY INTERFACILITY TRANSPORT AND INTERCEPT SERVICES. TRI-STATE REGIONAL AMBULANCE, INC IN 2024, 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 4 OF FOUR 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 REGIONAL AMBULANCE HAS COMPLETED THE CAAS REACCREDITATION, HIGH STAFF 12-MONTH RETENTION RATES IN THE LOW 90%S. IN 2025, HAD 3,490 TRANSPORTS, 17 STANDBYS, 510 NON-TRANSPORTS, AND 4,000 TOTAL CALLS. TSRA REMAINED ACCREDITED BY CAAS, AND HAD AN ACQUISITION OF SPARTA AMBULANCE. 100773 0 379848 PROVIDE NON-EMERGENCY MEDICAL TRANSPORTATION TO INDIVIDUALS NEEDING SPECIALIZED VEHICLES AND/OR ASSISTANCE. THE ORGANIZATION CONTINUED TO PROVIDE SERVICES TO LA CROSSE. MONROE, VERNON, RICHLAND, CRAWFORD, IOWA, AND GRANT COUNTIES. WE HAD 3,490 TRANSPORTS, 17 STANDBYS, 510 NON-TRANSPORTS, AND 4,000 TOTAL CALLS. ACQUIRED SPARTA AMBULANCE 5813191 true true false 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 false false true false false false false true 10 0 true 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 false true true true true true true false false false false WI X JOHN CEELEN 6087827300 1900 SOUTH AVENUE NCA1-01 LA CROSSE WI 54601 BRYAN ERDMANN BOD, TREASURER, SECRETARY, COO 2.0 48.0 X X 0 443670 76190 MICHAEL MCKEE BOARD OF DIRECTORS, PRESIDENT 2.0 48.0 X X 0 290401 71251 MIKEL POELLINGER BOARD OF DIRECTORS, VICE PRESIDENT 2.0 2.0 X X 0 0 0 CHRISTOPHER EBERLEIN MD BOARD OF DIRECTORS 2.0 48.0 X 0 422038 74967 KIM SMITH BOARD OF DIRECTORS 2.0 2.0 X 0 0 0 THERESE BINFET BOD, CLINICAL OPERATIONS DIRECTOR 2.0 48.0 X 0 184133 49695 JOHN CEELEN CHIEF FINANCIAL OFFICER 1.0 49.0 X 0 728316 54052 SCOTT RATHGABER MD CEO 1.0 49.0 X 0 1324275 73275 THOMAS TORNSTROM CLINICAL OPERATIONS DIRECTOR 24.0 26.0 X 0 181916 44625 STEVE LITTLE FORMER CHIEF FINANCIAL OFFICER 0.0 0.0 X 0 209856 0 0 3784605 444055 0 true true false 0 305500 49422 750 355672 PRE-HOSPITAL EMERGENCY 621990 4743770 4743770 PARAMEDIC AND EMT HOURS 621990 569090 569090 NON-EMERGENCY MEDICAL 621910 126085 126085 0 0 0 0 5438945 18221 18221 0 0 1886 0 -1886 -1886 0 -1886 0 0 0 0 0 5810952 5438945 0 16335 24009 24009 4508088 4508088 8043 7532 511 133465 133465 58441 0 58441 0 264 264 34922 1953 32969 7717 7717 147332 146823 509 15744 15132 612 6526 6068 458 316717 316717 28575 28575 BAD DEBT EXPENSE 440821 440821 RENT, REPAIRS & MAINTENANCE 229142 229142 MEMBERSHIPS & LICENSES 182278 1924 180354 SUPPLIES 114982 114982 0 0 0 0 6257066 5813191 443875 0 1209058 2737919 1232517 1126964 0 0 9313 23961 2603411 1409716 1140180 1193695 0 0 508550 508550 83350 57508 4182968 5648597 18069 17143 11195 0 0 6481211 8405075 6510475 8422218 X -2327507 -2773621 -2327507 -2773621 4182968 5648597 -446114 0 X false true true true true X 132786 88147 113392 108483 355672 798480 2059305 2607820 2914515 4846531 5438945 17867116 0 0 0 2192091 2695967 3027907 4955014 5794617 18665596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18665596 209 24 18221 18454 0 0 0 209 24 18221 18454 0 0 0 0 0 0 0 2192091 2695967 3028116 4955038 5812838 18684050 0.99901 0.99998 0 0 X SCHEDULE A, PART III SECTION A & B THE 5-YEAR COMPUTATION PERIOD INCLUDES THE CURRENT AND 4 PRIOR TAX PERIODS WHICH INCLUDES A SHORT YEAR PERIOD FROM JANUARY 1, 2023, THROUGH SEPTEMBER 30, 2023. THE PERIODS INCLUDED IN THE COMPUTATION ARE 2021, 2022, SHORT YEAR 2023, FISCAL YEAR 2024, AND FISCAL YEAR 2025. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18895 9546 9349 428772 190317 238455 2155744 1209853 945891 1193695 FEDERAL INCOME TAXES CURRENT OBLIGATION-OP LEASE 26967 LT OBLIGATION-OP LEASE 30541 UNCLAIMED PROPERTY 197 DUE TO GLAS 8347370 8405075 X 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, AND HAVE BEEN FULLY RESERVED. true CHARITY CARE 11 24009 COST 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 true false false false false false false false BRYAN ERDMANN BOD, TREASURER, SECRETARY, COO 0 443062 0 0 0 608 0 48300 0 27890 0 519860 0 0 MICHAEL MCKEE BOARD OF DIRECTORS, PRESIDENT 0 289289 0 0 0 1112 0 41410 0 29841 0 361652 0 0 CHRISTOPHER EBERLEIN MD BOARD OF DIRECTORS 0 417239 0 0 0 4799 0 48300 0 26667 0 497005 0 0 THERESE BINFET BOD, CLINICAL OPERATIONS DIRECTOR 0 181921 0 0 0 2212 0 26028 0 23667 0 233828 0 0 STEVE LITTLE FORMER CHIEF FINANCIAL OFFICER 0 209856 0 0 0 0 0 0 0 0 0 209856 0 0 JOHN CEELEN CHIEF FINANCIAL OFFICER 0 598104 0 129468 0 744 0 29147 0 24905 0 782368 0 0 SCOTT RATHGABER MD CEO 0 1278368 0 0 0 45907 0 48300 0 24975 0 1397550 0 0 THOMAS TORNSTROM CLINICAL OPERATIONS DIRECTOR 0 173251 0 0 0 8665 0 25578 0 19047 0 226541 0 0 SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION THE ADMINISTRATIVE DIRECTOR IS COMPENSATED BY TRI-STATE AMBULANCE, INC., A RELATED PARTY. THE RELATED PARTY DETERMINES COMPENSATION THROUGH THE USE OF A COMPENSATION COMMITTEE, A COMPENSATION STUDY, AND COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CERTAIN INDIVIDUALS LISTED IN SCHEDULE J, PART II, PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO WHICH THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS. THESE CONTRIBUTIONS ARE AT RISK AND DO NOT BECOME VESTED AND PAYABLE UNLESS AND UNTIL THE INDIVIDUAL SATISFIES A SUBSTANTIAL FUTUTE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN FOR CALENDAR YEAR 2024: JOHN CEELEN FORM 990, PART VI, LINE 15A COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANTS REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. FORM 990, PART VI, LINE 15B SENIOR LEADERS: COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL. 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 LUTHERAN 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., THE PARENT CORPORATION AND SOLE MEMBER OF THE CORPORATION, SHALL HAVE THE POWER TO RECOMMEND AND REVIEW, AS APPROPRIATE, AND APPROVE CERTAIN MATTER. ARTICLES OF INCORPORATION MAY BE AMENDED BY VOTE OF THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE FORM 990 IS REVIEWED BY THE ACCOUNTING MANAGER AND PRINCIPAL OFFICER. IT WILL BE MADE AVAILABLE FOR ALL BOARD MEMBERS BEFORE FILING. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. (GLAS), A RELATED ORGANIZATION ANNUALLY REQUIRES EXECUTIVE LEADERSHIP (VICE PRESIDENTS AND ABOVE), BOARD MEMBERS, MEDICAL GOVERNORS AND FOUNDATION BOARD MEMBERS TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED DISCLOSURE STATEMENTS ARE REVIEWED BY A CONFLICT OF INTEREST REVIEW PANEL WHICH INCLUDES REPRESENTATIVES FROM LEGAL, COMPLIANCE, MEDICAL LEADERSHIP, HUMAN RESOURCES AND SUPPLY CHAIN. INDIVIDUALS REPORTING A POTENTIAL CONFLICT OF INTEREST ARE SENT A RESOLUTION THANKING THEM FOR THEIR SERVICE TO THE ORGANIZATION, ADVISING THEM OF ANY RESTRICTIONS RELATED TO THEIR CONFLICT (I.E. INDIVIDUALS WITH A RELATIONSHIP TO ANOTHER ORGANIZATION ARE ADVISED THAT THEY MUST ABSTAIN FROM DECISION MAKING THAT WOULD DIRECTLY AND SOLELY IMPACT GLAS) AND REMINDING THEM OF THEIR CONFIDENTIALITY OBLIGATIONS WITH RESPECT TO GLAS' HEALTHCARE, EMPLOYMENT AND PROPRIETARY INFORMATION. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC REQUESTS FOR ALL DOCUMENTS ARE MADE THROUGH THE LEGAL DEPARTMENT AND THE APPROPRIATE DOCUMENTS ARE MADE AVAILABLE FOR INSPECTION IN THE LEGAL DEPARTMENT. 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