2026-08-13T17:03:55+00:00 2025-09-30 135565207 KPMG LLP 200 EAST RANDOLPH DRIVE SUITE 5500 CHICAGO IL 606016436 990 2024-10-01 391965415 TRI-STATE AMBULANCE INC TRI- 6087848827 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 MICHAEL MCKEE PRESIDENT 2026-08-13 true RILEY KOBRICK P02401884 3126651000 2026-08-12 2024 2025-03-06 01:10:19Z MICHAEL MCKEE 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 13742163 false X WWW.TRISTATEAMBULANCE.ORG X 2002 WI SEE SCHEDULE O 6 2 102 2 0 35507 509176 9575800 13100943 108714 132044 0 0 9720021 13742163 32728 38513 0 0 5664237 6203747 0 0 0 3624259 4910492 9321224 11152752 398797 2589411 8126565 10957362 587575 828961 7538990 10128401 SEE SCHEDULE O false false 9600245 38513 13100943 SEE SCHEDULE O 9600245 true false 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 18 0 true 102 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 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, MD 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 GREGG BULMAN PARAMEDIC - TRI-STATE AMBULANCE 40.0 0 X 114548 0 35366 JAMES BARLOON PARAMEDIC 40.0 0 X 101101 0 30107 STEVE LITTLE FORMER CHIEF FINANCIAL OFFICER 0.0 0.0 X 0 209856 0 215649 3784605 509528 2 true true false ECP SERVICES LLC 117 N MAIN ST 6 LAKE MILLS WI 535511609 PURCHASED SERVICES 138747 1 0 0 0 0 509176 0 0 509176 PRE-HOSPITAL EMERGENCY 621910 11414547 11414547 0 0 MEDICAL SUPPLIES SERVICES 621990 1597970 1597970 0 0 MISCELLANEOUS RENTAL INCOME 621990 88426 88426 0 0 0 0 0 0 13100943 132044 0 0 132044 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 13742163 13100943 0 132044 224 224 38289 38289 4849994 4023909 826085 471897 391627 80270 540731 448752 91979 341125 283099 58026 209030 209030 1500 1500 844008 760966 83042 0 11755 11755 112493 27731 84762 99578 48961 50617 291154 241946 49208 30867 30867 69114 69114 559578 559578 34505 28636 5869 BAD DEBT EXPENSE 1214097 1214097 MISC OTHER EXPENSES 735624 735260 364 RENT, REPAIRS & MAINTENANCE 353128 353128 SUPPLIES 317396 317396 26665 26665 0 0 11152752 9600245 1552507 0 300 300 2969676 5866956 2187668 2208584 0 0 8227 25665 7756048 4900191 2941860 2855857 0 0 18834 0 8126565 10957362 581301 646657 4595 34769 0 1679 147535 587575 828961 X 7538990 10128401 7538990 10128401 8126565 10957362 2589411 0 X false true true true true X SCHEDULE A, PART I, LINE 3 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. 2217694 919015 1298679 2730878 2015159 715719 2807476 1966017 841459 2855857 FEDERAL INCOME TAXES DUE TO GLAS 144724 UNCLAIMED PROPERTY 2811 147535 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 30 38289 CASH 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, MD 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 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 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 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 38 EXPERIENCED PARAMEDICS, 54 EMTS, AND 14 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 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 38 EXPERIENCED PARAMEDICS, 54 EMTS, AND 14 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 2025, TRI-STATE AMBULANCE HAD 13,067 TRANSPORTS, 110 STANDBYS, 4,068 NON-TRANSPORTS, AND 17,135 TOTAL CALLS. TRI-STATE AMBULANCE REMAINED ACCREDITED BY CAAS, AND A SUCCESSFUL PARTNERSHIP WITH LOCAL FIRE DEPARTMENT. 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 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 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 FORM 990 AND CERTAIN OTHER INFORMATION IS AVAILABLE FOR PUBLIC INSPECTION AND COPYING THROUGH THE GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.'S LEGAL DEPARTMENT. 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