Civic Intelligence

Tri-State Ambulance Inc.

990 • Fiscal year 2016 • EIN 39-1965415

Jan 01, 2016 to Dec 31, 2016 • Filed on Nov 07, 2017

Organization Profilewww.tristateambulance.org

View Organization Page

235 CAUSEWAY BoulevardLA Crosse, WI 54603

(608) 784-8827

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

62nd percentile

0.31x

Higher debt load relative to assets than 62% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Liabilities / Revenue

52nd percentile

0.20x

Higher debt load relative to revenue than 52% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Net Margin

75th percentile

13%

Higher net margin than 75% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Top Officer Pay

88th percentile

$297,657

Higher top officer pay than 88% of similar nonprofits.

Top officer pay equals 3.8% of source-year revenue.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Source year 2016

Asset Growth

86th percentile

24%

Faster asset growth than 86% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Annualized from 2015 to 2016

Revenue Growth

51st percentile

2.9%

Faster revenue growth than 51% of similar nonprofits.

2016 filings • 501(c)3 • $5M-$10M nonprofits • Annualized from 2015 to 2016

Balance Sheet
Liabilities / Assets62nd percentile

Assets

Up

$5,192,923

Up $1,012,644 (+24%) from 2015

Net Assets

Up

$3,608,147

Up $1,046,411 (+41%) from 2015

Liabilities

Down

$1,584,776

Down $33,767 (-2.1%) from 2015

Revenue And Expenses
Liabilities / Revenue52nd percentileNet Margin75th percentile

Revenue

Up

$7,775,370

Up $220,291 (+2.9%) from 2015

Expenses

Down

$6,728,959

Down $167,081 (-2.4%) from 2015

Net Income

Up

$1,046,411

Up $387,372 (+59%) from 2015

Historical Trend

Balance Sheet Trend

Asset Growth86th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$10M$5.0M$0Assets 2010: $2,663,516Liabilities 2010: $916,655Net Assets 2010: $1,746,8612010Assets 2011: $3,544,619Liabilities 2011: $1,760,845Net Assets 2011: $1,783,7742011Assets 2012: $4,360,673Liabilities 2012: $2,420,222Net Assets 2012: $1,940,4512012Assets 2013: $3,747,895Liabilities 2013: $2,048,046Net Assets 2013: $1,699,8492013Assets 2014: $3,950,938Liabilities 2014: $2,048,241Net Assets 2014: $1,902,6972014Assets 2015: $4,180,279Liabilities 2015: $1,618,543Net Assets 2015: $2,561,7362015Assets 2016: $5,192,923Liabilities 2016: $1,584,776Net Assets 2016: $3,608,1472016Assets 2017: $5,764,969Liabilities 2017: $1,415,449Net Assets 2017: $4,349,5202017Assets 2018: $6,050,301Liabilities 2018: $1,226,896Net Assets 2018: $4,823,4052018Assets 2019: $5,931,200Liabilities 2019: $613,158Net Assets 2019: $5,318,0422019Assets 2020: $6,376,849Liabilities 2020: $948,601Net Assets 2020: $5,428,2482020Assets 2021: $6,779,441Liabilities 2021: $859,551Net Assets 2021: $5,919,8902021Assets 2022: $7,298,962Liabilities 2022: $706,483Net Assets 2022: $6,592,4792022Assets 2024: $8,126,565Liabilities 2024: $587,575Net Assets 2024: $7,538,9902024

Highlighted filing

2016

Assets$5,192,923
Liabilities$1,584,776
Net Assets$3,608,147
Open 2016 Filing

Operations Trend

Revenue Growth51st percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$10M$5.0M$0-$5.0MExpenses 2010: $5,281,4972010Expenses 2011: $5,696,7992011Revenue 2012: $6,297,502Expenses 2012: $6,152,246Net Income 2012: $145,2562012Revenue 2013: $6,595,098Expenses 2013: $6,835,700Net Income 2013: -$240,6022013Revenue 2014: $7,206,948Expenses 2014: $7,004,100Net Income 2014: $202,8482014Revenue 2015: $7,555,079Expenses 2015: $6,896,040Net Income 2015: $659,0392015Revenue 2016: $7,775,370Expenses 2016: $6,728,959Net Income 2016: $1,046,4112016Revenue 2017: $7,976,295Expenses 2017: $7,234,922Net Income 2017: $741,3732017Revenue 2018: $7,903,662Expenses 2018: $7,429,777Net Income 2018: $473,8852018Revenue 2019: $8,359,805Expenses 2019: $7,865,168Net Income 2019: $494,6372019Revenue 2020: $7,661,673Expenses 2020: $7,551,467Net Income 2020: $110,2062020Revenue 2021: $7,643,517Expenses 2021: $7,151,875Net Income 2021: $491,6422021Revenue 2022: $8,543,010Expenses 2022: $7,870,421Net Income 2022: $672,5892022Revenue 2024: $9,720,021Expenses 2024: $9,321,224Net Income 2024: $398,7972024

Highlighted filing

2016

Revenue$7,775,370
Expenses$6,728,959
Net Income$1,046,411
Open 2016 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 7, 2017
Return Version
2016v3.0
Gross Receipts
$7,787,566
Mission and Program Overview

Mission

The mission of tri-state ambulance, inc. Is to be a primary provider of pre-hospital emergency care and transporation 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 over 45 experienced paramedics, 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.

The mission of Tri-State Ambulance, Inc. is to be a primary provider of pre-hospital emergency care and transporation 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 over 45 experienced paramedics, we continously 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.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$2,314,436$2,466,209▲ $151,773
Accounts Receivable$1,038,515$1,360,610▲ $322,095
Savings and Temporary Cash Investments$799,794$1,322,847▲ $523,053
Prepaid Expenses and Deferred Charges$27,261$42,984▲ $15,723
Cash and Non-Interest-Bearing Accounts$273$273→ $0
Total Assets$4,180,279$5,192,923▲ $1,012,644
Liabilities
Mortgage Notes Payable Secured by Investment Property$1,109,235$842,179▼ $267,056
Accounts Payable and Accrued Expenses$470,097$705,116▲ $235,019
Deferred Revenue$39,211$37,481▼ $1,730
Total Liabilities$1,618,543$1,584,776▼ $33,767
Net Assets / Fund Balance
Unrestricted Net Assets$2,561,736$3,608,147▲ $1,046,411
Total Net Assets Fund Balance$2,561,736$3,608,147▲ $1,046,411
Total Liabilities and Net Assets / Fund Balance$4,180,279$5,192,923▲ $1,012,644

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$1,223,653$2,520,343$3,743,996
Buildings$1,111,950$348,385$1,460,335
Land$130,543-$130,543
Leasehold Improvements$63$44,705$44,768
Compensation and Service Providers
Top Officer Pay88th percentile

Employees

NameTitleFull / Part TimeBaseOtherTotal
Thomas TornstromExecutive DirectorFT$114,353$18,123$132,476

Board Members and Trustees

NameTitle
James KlockPresident
Mike PoellingerVice President
Kyle BakkumBoard Member
Michael KittelsonBoard Member
Bryan ErdmannSecretary/Treasurer

Highest Paid Contractors

ContractorServicesLocationCompensation
Gundersen Health SystemPurchased Services1910 South Avenue, La Crosse, WI 54601$442,295
EMS Medical Billing AssociatesPurchased Services9401 West Brown Deer Road, Milwaukee, WI 53224$123,206
Revenue and Support

Revenue Composition

Contributions and Grants
$20,040
Program Service Revenue
$7,696,586
Investment Income
$58,744
Other Revenue
$0
Change in Net Assets
$1,046,411

Audited Revenue Reconciliation

Revenue per Audited Statements
$7,775,370
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$-930,546
Total Revenue per Audited Statements
$6,844,824
Total Revenue per Form 990
$7,775,370
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$3,923,181
Other Expenses$2,753,056
Grants and Similar Amounts Paid$52,722
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$2,571,038$378,469-$2,949,507
Other Employee Benefits$464,227$72,097-$536,324
Fees for Services Other$192,000$197,083-$389,083
Depreciation Depletion$353,004$34,593-$387,597
Payroll Taxes$195,010$36,237-$231,247
Occupancy$168,854--$168,854
Current Officers, Directors, Trustees, and Key Employees-$132,475-$132,475
Fees for Services Management-$107,880-$107,880
Pension Plan Contributions$65,426$8,202-$73,628
Office Expenses$13,692$50,099-$63,791
Grants to Domestic Orgs$52,722--$52,722
Interest-$43,686-$43,686
Conferences and Meetings$33,123--$33,123
Fees for Services Legal-$30,165-$30,165
Travel$26,221--$26,221
Insurance$25,844--$25,844
Information Technology-$12,896-$12,896
Fees for Services Accounting-$12,300-$12,300
Other Expenses$248,881$9,408-$9,408
Advertising-$4,872-$4,872
All Other Expenses$3,936$250-$4,186
Total Functional Expenses$5,598,247$1,130,712$0$6,728,959

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$6,728,959
Expenses per Audited Statements$5,749,863
Total Expenses per Audited Statements$5,749,863
Expenses Not Reported on Financial Statements$979,096
Other Expense Adjustments$979,096
Expenses Not Reported on Form 990$0
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Tri-State Regional Ambulance IncLa Crosse, WI501(c)(3)Faciliation of ambulance services-
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, line 6

“Gundersen Lutheran Health System, Inc. is the sole corporate member of this organization.”

Form 990, Part VI, Section A, line 7A

“The sole corporate member, Gundersen Luthern Health System, Inc. may elect the governing body.”

Form 990, Part VI, Section A, line 7B

“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, Section B, line 11B

“Prior to filing the form 990, it is reviewed for completeness and accuracy by management. For this purpose, management is the accounting manager, the chief financial officer for gundersen lutheran health system, inc., and the principal officer of the organization. A copy of the form 990 is made available to all board members.”

Form 990, Part VI, Section B, line 12C

“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, Section B, line 15

“The compensation of the Operations Manager is determined annually by the 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, Section C, line 19

“Requests for tri-state ambulance's governing documents, conflict of interest policy, and financial statements are available for public inspection and copying through gundersen lutheran health system, inc.'s legal department.”

Filing and Contact Details

Filer

Filer Name
Tri-state Ambulance Inc
EIN
39-1965415
Phone
6087848827
Address
235 CAUSEWAY Boulevard, LA CROSSE, WI 54603
Doing Business As
Gundersen Tri-State Ambulance

Signing Officer

Name
Bryan Erdmann
Title
Secretary/Treasurer
Phone
6087848827
Signed
2017-11-07
Discuss with paid preparer
Yes

Organization Details

Principal Officer
James Klock
Formed
2002
Legal Domicile
Wi
Voting Board Members
5
Independent Board Members
3
Employees
86
Volunteers
6

Preparer

Firm
Wipfli LLP
Address
3703 Oakwood Hills Pkwy, Eau Claire, WI 54701
Preparer
Paul M Traczek CPA
Phone
7158323407
Supplemental Narrative

Additional Explanations

Form 990, Part XII, Line 2C

“THE AUDITOR IS SELECTED BY Gundersen Lutheran Health System, Inc.”

Financial Statement Notes

Part XI, Line 2D - Other Adjustments:

“Provision for bad debts -930,546.”

Part XII, Line 4B - Other Adjustments:

“Provision for bad debts 930,546. Grant expense 48,550.”

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IRS990/ActivityOrMissionDesc0The mission of Tri-State Ambulance, Inc. is to be a primary provider of pre-hospital emergency care and transporation 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 over 45 experienced paramedics, we continously 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.
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IRS990/Desc0Tri-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 Amublance's 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 defibriliator could be used). Tri-State Ambulance has achieved an impressive six-year average of 42 percent of cardiac arrest victims who survived to be discharged from the hospital. This is near the top in the country according to the Study of Emergency Medical Services (EMS) system performance, which showed survival percentages across the country ranging from a best of 46 percent, to a low of 1 percent in certain areas. Our impressive cardiac arrest survival rate places our system among the best in the nation. 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 consoldiate 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 visability 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, Tri-State 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 defibrillators (AEDs). In 2016, Tri-State Ambulance began to install power stretcher lifts in the ambulances allowing for increased level of safety for parametics, EMT's, and patients. Tri-State Ambulance continues to meet and exceed contractual response time. In 2016, Tri-State Ambuance saw a record year in the service area for cardiac arrest survival and continues to work with hospitals throughout the service area to increase patient survival from medical emergencies.
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt50
IRS990/Form990PartVIISectionAGrp/TitleTxt0Secretary/Treasurer
IRS990/Form990PartVIISectionAGrp/TitleTxt1President
IRS990/Form990PartVIISectionAGrp/TitleTxt2Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt3Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt4Vice President
IRS990/Form990PartVIISectionAGrp/TitleTxt5Executive Director
IRS990/Form990ProvidedToGvrnBodyInd00
IRS990/FormationYr02002
IRS990/FormerOfcrEmployeesListedInd00
IRS990/FSAuditedBasisGrp/ConsolAndSepBasisFinclStmtInd0X
IRS990/FSAuditedInd01
IRS990/FundraisingActivitiesInd00
IRS990/GainOrLossGrp/OtherAmt056086
IRS990/GamingActivitiesInd00
IRS990/GoverningBodyVotingMembersCnt05
IRS990/GovernmentGrantsAmt020040
IRS990/GrantAmt052722
IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt052722
IRS990/GrantsToDomesticOrgsGrp/TotalAmt052722
IRS990/GrantsToIndividualsInd00
IRS990/GrantsToOrganizationsInd01
IRS990/GrantToRelatedPersonInd00
IRS990/GrossAmountSalesAssetsGrp/OtherAmt068282
IRS990/GrossReceiptsAmt07787566
IRS990/GroupReturnForAffiliatesInd00
IRS990/IncludeFIN48FootnoteInd00
IRS990/IndependentAuditFinclStmtInd01
IRS990/IndependentVotingMemberCnt03
IRS990/IndivRcvdGreaterThan100KCnt01
IRS990/IndoorTanningServicesInd00
IRS990/InfoInScheduleOPartIIIInd0X
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InfoInScheduleOPartXIIInd0X
IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt012896
IRS990/InformationTechnologyGrp/TotalAmt012896
IRS990/InsuranceGrp/ProgramServicesAmt025844
IRS990/InsuranceGrp/TotalAmt025844
IRS990/InterestGrp/ManagementAndGeneralAmt043686
IRS990/InterestGrp/TotalAmt043686
IRS990/InvestmentIncomeGrp/ExclusionAmt02658
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt02658
IRS990/InvestmentInJointVentureInd00
IRS990/IRPDocumentCnt030
IRS990/IRPDocumentW2GCnt00
IRS990/LandBldgEquipAccumDeprecAmt02913433
IRS990/LandBldgEquipBasisNetGrp/BOYAmt02314436
IRS990/LandBldgEquipBasisNetGrp/EOYAmt02466209
IRS990/LandBldgEquipCostOrOtherBssAmt05379642
IRS990/LegalDomicileStateCd0WI
IRS990/LessCostOthBasisSalesExpnssGrp/OtherAmt012196
IRS990/LoanOutstandingInd00
IRS990/LobbyingActivitiesInd00
IRS990/LocalChaptersInd00
IRS990/MaterialDiversionOrMisuseInd00
IRS990/MembersOrStockholdersInd01
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfCommitteesInd01
IRS990/MinutesOfGoverningBodyInd01
IRS990/MissionDesc0The mission of Tri-State Ambulance, Inc. is to be a primary provider of pre-hospital emergency care and transporation in the Tri-State region. We are committed to attaining the highest standard of emergency care for the people in our service area. We are dedicated to treating patients with dignity, respect, and compassion. We value teamwork, creativity, personal growth, honest and open communication, and high professional and ethical standards. We are committed to efficient use of resources. Proudly caring for our communities and families with compassion, innovation and excellence.
IRS990/MoreThan5000KToIndividualsInd00
IRS990/MoreThan5000KToOrgInd00
IRS990/MortgNotesPyblScrdInvstPropGrp/BOYAmt01109235
IRS990/MortgNotesPyblScrdInvstPropGrp/EOYAmt0842179
IRS990/NetAssetsOrFundBalancesBOYAmt02561736
IRS990/NetAssetsOrFundBalancesEOYAmt03608147
IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt056086
IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt056086
IRS990/NetUnrelatedBusTxblIncmAmt00
IRS990/NondeductibleContributionsInd00
IRS990/OccupancyGrp/ProgramServicesAmt0168854
IRS990/OccupancyGrp/TotalAmt0168854
IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt050099
IRS990/OfficeExpensesGrp/ProgramServicesAmt013692
IRS990/OfficeExpensesGrp/TotalAmt063791
IRS990/OfficerMailingAddressInd00
IRS990/OperateHospitalInd00
IRS990/Organization501c3Ind0X
IRS990/OrganizationFollowsSFAS117Ind0X
IRS990/OtherChangesInNetAssetsAmt00
IRS990/OtherEmployeeBenefitsGrp/ManagementAndGeneralAmt072097
IRS990/OtherEmployeeBenefitsGrp/ProgramServicesAmt0464227
IRS990/OtherEmployeeBenefitsGrp/TotalAmt0536324
IRS990/OtherExpensesGrp/Desc0Bad Debt Expense
IRS990/OtherExpensesGrp/Desc1Ground Transportation M
IRS990/OtherExpensesGrp/Desc2Medical Supplies
IRS990/OtherExpensesGrp/Desc3Dues/subscriptions/lice
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt09408
IRS990/OtherExpensesGrp/ProgramServicesAmt0930546
IRS990/OtherExpensesGrp/ProgramServicesAmt1253723
IRS990/OtherExpensesGrp/ProgramServicesAmt2248881
IRS990/OtherExpensesGrp/TotalAmt0930546
IRS990/OtherExpensesGrp/TotalAmt1253723
IRS990/OtherExpensesGrp/TotalAmt2248881
IRS990/OtherExpensesGrp/TotalAmt39408
IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt0378469
IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt02571038
IRS990/OtherSalariesAndWagesGrp/TotalAmt02949507
IRS990/PartialLiquidationInd00
IRS990/PayPremiumsPrsnlBnftCntrctInd00
IRS990/PayrollTaxesGrp/ManagementAndGeneralAmt036237
IRS990/PayrollTaxesGrp/ProgramServicesAmt0195010
IRS990/PayrollTaxesGrp/TotalAmt0231247
IRS990/PensionPlanContributionsGrp/ManagementAndGeneralAmt08202
IRS990/PensionPlanContributionsGrp/ProgramServicesAmt065426
IRS990/PensionPlanContributionsGrp/TotalAmt073628
IRS990/PoliticalCampaignActyInd00
IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt027261
IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt042984
IRS990/PrincipalOfficerNm0JAMES KLOCK
IRS990/ProfessionalFundraisingInd00
IRS990/ProgramServiceRevenueGrp/BusinessCd0621910
IRS990/ProgramServiceRevenueGrp/BusinessCd1900099
IRS990/ProgramServiceRevenueGrp/Desc0Pre-Hospital emergency
IRS990/ProgramServiceRevenueGrp/Desc1Community Education &
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt07536222
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt12345
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt07536222
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt12345
IRS990/ProhibitedTaxShelterTransInd00
IRS990/PYBenefitsPaidToMembersAmt00
IRS990/PYContributionsGrantsAmt043494
IRS990/PYExcessBenefitTransInd00
IRS990/PYGrantsAndSimilarPaidAmt05000
IRS990/PYInvestmentIncomeAmt029718
IRS990/PYOtherExpensesAmt02873699
IRS990/PYOtherRevenueAmt00
IRS990/PYProgramServiceRevenueAmt07481867
IRS990/PYRevenuesLessExpensesAmt0659039
IRS990/PYSalariesCompEmpBnftPaidAmt04017341
IRS990/PYTotalExpensesAmt06896040
IRS990/PYTotalProfFndrsngExpnsAmt00
IRS990/PYTotalRevenueAmt07555079
IRS990/QuidProQuoContributionsInd00
IRS990/RcvFndsToPayPrsnlBnftCntrctInd00
IRS990/ReconcilationRevenueExpnssAmt01046411
IRS990/RegularMonitoringEnfrcInd01
IRS990/RelatedEntityInd01
IRS990/RelatedOrganizationCtrlEntInd01
IRS990/ReportInvestmentsOtherSecInd00
IRS990/ReportLandBuildingEquipmentInd01
IRS990/ReportOtherAssetsInd00
IRS990/ReportOtherLiabilitiesInd00
IRS990/ReportProgramRelatedInvstInd00
IRS990/RevenueAmt07696586
IRS990/SavingsAndTempCashInvstGrp/BOYAmt0799794
IRS990/SavingsAndTempCashInvstGrp/EOYAmt01322847
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt0TRI-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.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc0Part I Section A Line 3
IRS990ScheduleA/HospitalInd0X
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd01
IRS990ScheduleD/BuildingsGrp/BookValueAmt01111950
IRS990ScheduleD/BuildingsGrp/DepreciationAmt0348385
IRS990ScheduleD/BuildingsGrp/OtherCostOrOtherBasisAmt01460335
IRS990ScheduleD/EquipmentGrp/BookValueAmt01223653
IRS990ScheduleD/EquipmentGrp/DepreciationAmt02520343
IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt03743996
IRS990ScheduleD/ExpensesNotReportedAmt00
IRS990ScheduleD/ExpensesNotRptFinclStmtAmt0979096
IRS990ScheduleD/ExpensesSubtotalAmt05749863
IRS990ScheduleD/LandGrp/BookValueAmt0130543
IRS990ScheduleD/LandGrp/OtherCostOrOtherBasisAmt0130543
IRS990ScheduleD/LeaseholdImprovementsGrp/BookValueAmt063
IRS990ScheduleD/LeaseholdImprovementsGrp/DepreciationAmt044705
IRS990ScheduleD/LeaseholdImprovementsGrp/OtherCostOrOtherBasisAmt044768
IRS990ScheduleD/OtherExpensesNotIncludedAmt0979096
IRS990ScheduleD/OtherRevenueAmt0-930546
IRS990ScheduleD/RevenueNotReportedAmt0-930546
IRS990ScheduleD/RevenueNotReportedFinclStmtAmt00
IRS990ScheduleD/RevenueSubtotalAmt07775370
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0Provision for bad debts -930,546.
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt1Provision for bad debts 930,546. Grant expense 48,550.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0Part XI, Line 2d - Other Adjustments:
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc1Part XII, Line 4b - Other Adjustments:
IRS990ScheduleD/TotalBookValueLandBuildingsAmt02466209
IRS990ScheduleD/TotalExpensesPerForm990Amt06728959
IRS990ScheduleD/TotalRevenuePerForm990Amt07775370
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt06844824
IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt05749863
IRS990ScheduleI/GrantRecordsMaintainedInd00
IRS990ScheduleI/RecipientTable/IRCSectionDesc0501(c)(3)
IRS990ScheduleI/RecipientTable/NonCashAssistanceAmt048550
IRS990ScheduleI/RecipientTable/NonCashAssistanceDesc0Ambulance
IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt0Faciliation of ambulance services
IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine1Txt0Tri-State Regional Ambulance Inc
IRS990ScheduleI/RecipientTable/RecipientEIN0391962965
IRS990ScheduleI/RecipientTable/USAddress/AddressLine1Txt0235 Causeway Boulveard
IRS990ScheduleI/RecipientTable/USAddress/CityNm0La Crosse
IRS990ScheduleI/RecipientTable/USAddress/StateAbbreviationCd0WI
IRS990ScheduleI/RecipientTable/USAddress/ZIPCd054603
IRS990ScheduleI/RecipientTable/ValuationMethodUsedDesc0Fair Market Value
IRS990ScheduleI/SupplementalInformationDetail/ExplanationTxt0The grant was made to a related party.
IRS990ScheduleI/SupplementalInformationDetail/FormAndLineReferenceDesc0Part I, Line 2:
IRS990ScheduleI/Total501c3OrgCnt01
IRS990ScheduleI/TotalOtherOrgCnt00
IRS990ScheduleJ/AnyNonFixedPaymentsInd00
IRS990ScheduleJ/BoardOrCommitteeApprovalInd0X
IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd00
IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd00
IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd00
IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd00
IRS990ScheduleJ/CompensationCommitteeInd0X
IRS990ScheduleJ/CompensationSurveyInd0X
IRS990ScheduleJ/EquityBasedCompArrngmInd00
IRS990ScheduleJ/InitialContractExceptionInd00
IRS990/ScheduleJRequiredInd01
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt0231686
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt1122419
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt035625
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt118889
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt028845
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt124465
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt01501
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt1360
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0Bryan Erdmann
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1James Klock
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0Secretary/Treasurer
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1President
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt0297657
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt1166133
IRS990ScheduleJ/SeverancePaymentInd00
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0Gundersen Lutheran Health System, Inc. is the sole corporate member of this organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1The sole corporate member, Gundersen Luthern Health System, Inc. may elect the governing body.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2Gundersen 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.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3PRIOR TO FILING THE FORM 990, IT IS REVIEWED FOR COMPLETENESS AND ACCURACY BY MANAGEMENT. FOR THIS PURPOSE, MANAGEMENT IS THE ACCOUNTING MANAGER, THE CHIEF FINANCIAL OFFICER FOR GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., AND THE PRINCIPAL OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4Each 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.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5The compensation of the Operations Manager is determined annually by the 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.

Document Assets

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Filings

Displayed year

2016 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$5,192,923
Liabilities
$1,584,776
Net assets
$3,608,147
Revenue
$7,775,370
Expenses
$6,728,959
Net income
$1,046,411
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$8.13$0.59$7.54$9.72$9.32$0.40
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$7.30$0.71$6.59$8.54$7.87$0.67
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$6.78$0.86$5.92$7.64$7.15$0.49
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$6.38$0.95$5.43$7.66$7.55$0.11
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$5.93$0.61$5.32$8.36$7.87$0.49
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$6.05$1.23$4.82$7.90$7.43$0.47
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$5.76$1.42$4.35$7.98$7.23$0.74
2016Detailed filing. Detailed filing data is available for this year.$5.19$1.58$3.61$7.78$6.73$1.05
2015XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$4.18$1.62$2.56$7.56$6.90$0.66
2014Summary only. Only limited summary data is available for this year.$3.95$2.05$1.90$7.21$7.00$0.20
2013Summary only. Only limited summary data is available for this year.$3.75$2.05$1.70$6.60$6.84$0.24
2012Summary only. Only limited summary data is available for this year.$4.36$2.42$1.94$6.30$6.15$0.15
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.54$1.76$1.78$5.70
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.66$0.92$1.75$5.28