2023-10-27T15:30:07+00:00 2022-12-31 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2022-01-01 391962965 Tri-State Regional Ambulance Inc TRI- 6086378884 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 MICHAEL MCKEE PRESIDENT 6087848827 2023-10-27 true MICHAEL MCKEE 999009999 Emily Upstrom P01765498 4142748740 2023-10-18 2022 2023-04-26 12:10:37Z MICHAEL MCKEE 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 2695967 false X N/A X 1999 WI SEE SCHEDULE O. 6 3 0 3 0 0 132786 88147 2059305 2607820 687 0 0 0 2192778 2695967 12696 4919 0 0 1515552 2733013 0 0 0 839133 1011188 2367381 3749120 -174603 -1053153 1164152 2235756 1201688 3326445 -37536 -1090689 SEE SCHEDULE O. false false 3544086 4919 2456963 SEE SCHEDULE O 49860 0 150857 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 UTILIZING 7 VANS AND REDUCED STAFFING TO 7 DRIVERS. 3593946 true true false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 15 0 true 0 false false false false false false false false false false false false X 6 3 false false true false true true true true true false false true true true true true true true true false WI X STEVE LITTLE 6087827300 1900 SOUTH AVENUE NCA1-01 LA CROSSE WI 54601 BRYAN ERDMANN SECRETARY/TREASURER 0.5 48.0 X X 0 316306 72463 MICHAEL MCKEE PRESIDENT 0.5 47.5 X X 0 270756 67960 MICHAEL POELLINGER VICE PRESIDENT 0.5 1.0 X X 0 0 0 KYLE BAKKUM BOARD MEMBER 0.5 1.0 X 0 0 0 MICHAEL KITTELSON BOARD MEMBER 0.5 1.0 X 0 0 0 THERESE BINFET BOARD MEMBER 0.5 41.0 X 0 163779 45783 TOM TORNSTROM ADMINISTRATIVE DIRECTOR 0.5 41.0 X 0 146760 39263 0 897601 225469 0 false true false GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES 1910 SOUTH AVE LA CROSSE WI 54601 PURCHASED SERVICES 890031 1 88129 18 88147 PRE-HOSPITAL EMERGENCY 621990 2448936 2448936 NON-EMERGENCY MEDICAL 621910 142145 142145 PARAMEDIC AND EMT HOUR 621990 16739 16739 0 0 0 0 2607820 0 0 0 0 0 0 0 0 0 2695967 2607820 0 0 4919 4919 0 0 2731460 2731453 7 912 861 51 641 605 36 79390 79390 512 512 1876 0 1876 0 985 985 24162 8188 15974 2868 2868 124583 121104 3479 11826 11481 345 6370 6370 25596 25596 87081 87081 20759 20759 BAD DEBT EXPENSE 343819 343819 RENT, REPAIRS & MAINTENANCE 181427 181427 SUPPLIES 96638 96638 MEMBERSHIPS & LICENSES 3296 3296 0 0 0 0 3749120 3593946 155174 0 0 0 187810 446052 0 0 341361 594336 0 0 0 0 0 0 0 0 38587 10711 1344448 848356 87844 496092 0 0 0 508550 508550 0 180015 1164152 2235756 187202 90870 0 0 77861 71657 0 0 0 0 0 0 0 0 0 0 936625 3163918 1201688 3326445 X -37536 -1090689 0 -37536 -1090689 1164152 2235756 -1053153 0 X false true X true false X 1876 37720 125546 132786 88147 386075 2161033 2195808 1825149 2059305 2607820 10849115 0 0 0 2162909 2233528 1950695 2192091 2695967 11235190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11235190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2162909 2233528 1950695 2192091 2695967 11235190 1 1.0 0 0.0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6000 6000 0 231161 101932 129229 1094392 740424 353968 12895 0 12895 496092 RIGHT OF USE ASSETS 180015 180015 DUE TO GLAS 2129944 LONG TERM NOTE PAYABLE 853192 LONG TERM OBLIGATION - OPERATING LEASE 125850 CURRENT OBLIGATION - OPERATING LEASE 54932 3163918 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, WHICH IS A FOR-PROFIT ENTITY. AT NOVEMBER 30, 2022 AND DECEMBER 31, 2021, NET DEFERRED TAX ASSETS OF $7,351 AND $7,545, RESPECTIVELY, WHICH PRIMARILY ARE RELATED TO NET OPERATING LOSS CARRYFORWARDS, HAVE VALUATION ALLOWANCES OF $7,351 AND $7,545, RESPECTIVELY, RECORDED AGAINST THEM DUE TO THE UNCERTAINTY OF REALIZING THOSE BENEFITS IN THE FUTURE. AT NOVEMBER 30, 2022, THE SYSTEM'S FEDERAL NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $27,800, AND THE STATE NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $25,700, WHICH WILL EXPIRE BETWEEN 2031 AND 2040. 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. false false false false false false false BRYAN ERDMANN SECRETARY/TREASURER 0 312047 0 0 0 4259 0 44225 0 28238 0 388769 0 0 MICHAEL MCKEE PRESIDENT 0 270131 0 0 0 625 0 40054 0 27906 0 338716 0 0 THERESE BINFET BOARD MEMBER 0 162354 0 0 0 1425 0 24049 0 21734 0 209562 0 0 TOM TORNSTROM ADMINISTRATIVE DIRECTOR 0 145795 0 0 0 965 0 21537 0 17726 0 186023 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. Form 990, Part I, Line 1 ORGANIZATION'S MISSION 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. Form 990, Part III, Line 1 ORGANIZATION'S MISSION 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. IN 2021, ALL TSRA EMPLOYEES TRANSFERRED TO GUNDERSEN 12/13/2021. EXPANSION PROJECT STARTED AT TSRA IN WHICH TWO ADDITIONAL LOCATIONS WILL BE ADDED. AN ASSUMED NAME (DBA) WAS CREATED UNDER TSRA AS GUNDERSEN HEALTH SYSTEM AMBULANCE (IN DECEMBER). IN 2022, TRI-STATE REGIONAL AMBULANCE HAD 2,327 TRANSPORTS, 21 STANDBYS, 904 NON-TRANSPORTS, AND 3,252 TOTAL CALLS WITH 9 AMBULANCES. IN 2022, TSRA EXPANDED ITS SERVICES INTO 2 MARKETS IN 2022. AN INTERFACILITY AMBULANCE BASE WAS ADDED IN RICHLAND CENTER, WISCONSIN AS WELL AS TOMAH, WISCONSIN. THIS EXPANSION REQUIRED ADDITIONAL STAFF OF PARAMEDICS AND EMTS. ALSO, IN PARTNERSHIP WITH GUNDERSEN HEALTH SYSTEM, TSRA LAUNCHED A "PARAMEDIC TRAINEE" PROGRAM WHICH IS AN "EARN WHILE YOU LEARN" OPPORTUNITY. TSRA HIRED 8 EMTS IN FULL-TIME CAPACITY WHO WILL RECEIVE PAY AND BENEFITS WHILE THEY ATTEND PARAMEDIC SCHOOL. Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION 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. UTILIZED 6 AMBULANCES, 8 PARAMEDICS, AND 15 EMT'S TO MAKE APPROXIMATELY 1,949 TRANSPORTS IN 2021 USING ADVANCED MEDICAL PROTOCOLS. WE SEND ECG'S OR ELECTROCARDIOGRAMS TO THE HOSPITALS VIA THE INTERNET TO SPEED UP THE TREATMENT OF HEART ATTACK VICTIMS. TELEHEALTH WAS INTEGRATED ALLOWING SPECIALISTS TO PARTICIPATE IN VIRTUAL CARE IN MOVING AMBULANCE. IN 2022, TRI-STATE REGIONAL HAD 2,327 TRANSPORTS, 21 STANDBYS, 904 NON-TRANSPORTS, AND 3,252 TOTAL CALLS WITH 9 AMBULANCES. IN 2022, TSRA EXPANDED ITS SERVICES INTO 2 MARKETS IN 2022. AN INTERFACILITY AMBULANCE BASE WAS ADDED IN RICHLAND CENTER, WISCONSIN AS WELL AS TOMAH, WISCONSIN. THIS EXPANSION REQUIRED ADDITIONAL STAFF OF PARAMEDICS AND EMTS. ALSO, IN PARTNERSHIP WITH GUNDERSEN HEALTH SYSTEM, TSRA LAUNCHED A "PARAMEDIC TRAINEE" PROGRAM WHICH IS AN "EARN WHILE YOU LEARN" OPPORTUNITY. TSRA HIRED 8 EMTS IN FULL-TIME CAPACITY WHO WILL RECEIVE PAY AND BENEFITS WHILE THEY ATTEND PARAMEDIC SCHOOL. Form 990, Part VI, Line 4 Significant changes to organizational documents GUNDERSEN AND BELLIN HEALTH SYSTEMS, INC. (BELLIN), EACH A WISCONSIN NONPROFIT, NON-STOCK CORPORATION, ENTERED INTO A COMBINATION AGREEMENT DATED JULY 29, 2022 (THE AGREEMENT), TO ALIGN THEIR RESPECTIVE OPERATIONS AND TO FORM A SINGLE NONPROFIT HEALTH SYSTEM THROUGH THE CREATION OF BELLIN GUNDERSEN HEALTH SYSTEM, INC., A WISCONSIN NONPROFIT, NON-STOCK CORPORATION (BELLIN GUNDERSEN). ON DECEMBER 1, 2022, UPON CONSUMMATION OF THE ALIGNMENT OF THE TWO SYSTEMS (THE AFFILIATION), BELLIN GUNDERSEN BECAME THE SOLE CORPORATE MEMBER OF BOTH BELLIN AND GUNDERSEN. BELLIN AND GUNDERSEN AND THEIR RESPECTIVE AFFILIATES ARE EXPECTED TO MAINTAIN THEIR RESPECTIVE CORPORATE EXISTENCE. IN DECEMBER 2022, THE BYLAWS OF GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. WERE AMENDED AND RESTATED TO UPDATE THE SOLE CORPORATE MEMBER TO BELLIN GUNDERSEN HEALTH SYSTEM, INC. THE BYLAWS WERE ALSO UPDATED TO SPECIFY THE POWERS RETAINED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. THE CHIEF EXECUTIVE OFFICER OF BELLIN GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. RETAINS AUTHORITY TO APPROVE ANY SIGNIFICANT CHANGES TO THE CORPORATION. SUBJECT TO THE RESERVED POWERS SPECIFIED IN THE BYLAWS, THE AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY ITS BOARD OF TRUSTEES. 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 UPON DISSOLUTION, THE DISTRIBUTION OF ASSETS SHALL BE DETERMINED BY THE BOARD OF GOVERNORS AND 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 FOR COMPLETENESS AND ACCURACY BY MANAGEMENT. FOR THIS PURPOSE, MANAGEMENT INCLUDES THE ACCOUNTING MANAGER, THE EXECUTIVE DIRECTOR FINANCE FOR GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., AND AN OFFICER OF THE TRI-STATE REGIONAL AMBULANCE, INC., BOARD OF DIRECTORS. 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 REGIONAL AMBULANCE, INC.'S GOVERNING BOARD SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY. MEMBERS ARE ASKED TO DISCLOSE CONFLICTS AS APPROPRIATE AND ABSTAIN FROM VOTING WHEN APPLICABLE. Form 990, Part VI, Line 15a Process to establish compensation of top management official 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, Line 19 Required documents available to the public GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST. GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391866425 SUPPORTING ORG WI 501(c)(3) Type II BGHS false GUNDERSEN LUTHERAN MEDICAL CENTER INC 1910 SOUTH AVENUE LA CROSSE WI 54601 390813416 HEALTHCARE WI 501(c)(3) 3 GLHS false GUNDERSEN CLINIC LTD 1836 SOUTH AVENUE LA CROSSE WI 54601 391028657 HEALTHCARE WI 501(c)(3) 3 GLHS false GUNDERSEN LUTHERAN ADM SERVICES INC 1910 SOUTH AVENUE LA CROSSE WI 54601 391606449 SUPPORTING ORG WI 501(c)(3) Type II GLHS false GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391249705 FOUNDATION WI 501(c)(3) 7 GLHS false GUNDERSEN LUTHERAN CREDENTIALING SVS INC 1910 SOUTH AVENUE LA CROSSE WI 54601 391856898 CREDENTIALING WI 501(c)(3) Type III-FI GLHS false TRI-COUNTY MEMORIAL HOSPITAL INC 18601 LINCOLN STREET WHITEHALL WI 54773 390704510 HEALTHCARE WI 501(c)(3) 3 GLHS false HARMONY COMMUNITY HEALTHCARE INC 815 MAIN AVENUE HARMONY MN 55939 410711606 HEALTHCARE MN 501(c)(3) 10 GLHS false TWEETEN LUTHERAN HEALTHCARE CENTER INC 125 FIFTH AVENUE SE SPRING GROVE MN 55974 411565003 HEALTHCARE MN 501(c)(3) 10 GLHS false TRI-STATE AMBULANCE INC 235 CAUSEWAY BLVD LA CROSSE WI 54603 391965415 MEDICAL TRANSPORT WI 501(c)(3) 3 GLHS false LUTHERAN REAL ESTATE HOLDING CORPORATION 1910 SOUTH AVENUE LA CROSSE WI 54601 391480826 HOUSING WI 501(c)(3) Type III-FI GLHS false COMMUNITY HOUSING OF LA CROSSE INC 1900 SOUTH AVENUE LA CROSSE WI 54601 391586700 INDEPENDENT LIVING WI 501(c)(3) 10 LREH CORP false LUTHERAN HOUSING OF LA CROSSE INC 1900 SOUTH AVENUE LA CROSSE WI 54601 391751934 INDEPENDENT LIVING WI 501(c)(3) 10 LREH CORP false ST JOSEPH'S HEALTH SERVICES INC 400 WATER AVENUE HILLSBORO WI 54634 390929538 HEALTHCARE WI 501(c)(3) 3 GLHS false ST JOSEPH'S MEMORIAL FOUNDATION INC 400 WATER AVENUE HILLSBORO WI 54634 391455787 FOUNDATION WI 501(c)(3) Type I ST JO HTH SV false TRI-COUNTY MEMORIAL FOUNDATION INC 18601 LINCOLN STREET WHITEHALL WI 54773 300093022 FOUNDATION WI 501(c)(3) Type I TRI CTY HSPT false MEMORIAL HOSPITAL OF BOSCOBEL 205 PARKER STREET BOSCOBEL WI 53805 390845590 HEALTHCARE WI 501(c)(3) 3 GLHS false PALMER LUTHERAN HEALTH CENTER INC 112 JEFFERSON STREET WEST UNION IA 52175 421320763 HEALTHCARE IA 501(c)(3) 3 GLHS false MOUNDVIEW MEMORIAL HOSPITALS & CLINICS 402 WEST LAKE STREET FRIENDSHIP WI 53934 390944012 HEALTHCARE WI 501(c)(3) 3 GLHS false MEMORIAL HC FDN OF ADAMS COUNTY INC 402 WEST LAKE STREET FRIENDSHIP WI 53934 391775074 FOUNDATION WI 501(c)(3) Type I MDVW MEM HOS false SAINT ELIZABETH'S HOSP OF WABASHA INC 1200 5TH GRANT BOULEVARD WEST WABASHA MN 55981 410693877 HEALTHCARE MN 501(c)(3) 3 GLHS false BELLIN GUNDERSEN HEALTH SYSTEM INC 1836 SOUTH AVENUE LA CROSSE WI 54601 920504278 SUPPORTING ORG WI 501(c)(3) Type II NA false BELLIN HEALTH SYSTEMS INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 391512904 SUPPORTING ORG WI 501(c)(3) Type II BGHS false LAKE MICHIGAN HEALTH SERVICES INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 391512903 SUPPORTING ORG WI 501(c)(3) Type II BHS false BELLIN COLLEGE INC 3201 EATON ROAD GREEN BAY WI 54311 391620530 EDUCATION WI 501(c)(3) 2 BHS false BELLIN PSYCHIATRIC CENTER INC PO BOX 23725 GREEN BAY WI 54301 391657627 HEALTHCARE WI 501(c)(3) 3 BHS false BELLIN MEMORIAL HOSPITAL INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 390884478 HEALTHCARE WI 501(c)(3) 3 BHS false THE BELLIN HEALTH FOUNDATION INC PO BOX 23400 GREEN BAY WI 54301 391809171 FOUNDATION WI 501(c)(3) 7 BHS false OCONTO HOSPITAL & MEDICAL CENTER INC 820 ARBUTUS AVENUE OCONTO WI 54153 061745397 HEALTHCARE WI 501(c)(3) 3 BMH false GUNDERSEN LUTHERAN ENVISION LLC 1836 SOUTH AVENUE LA CROSSE WI 54601 264706546 RENEWABLE ENERGY WI GLHS C Corporation false BEL-REGIONAL HOME MEDICAL INC 617 S ROOSEVELT GREEN BAY WI 54301 391504766 DURABLE MEDICAL EQUIPMENT, RETAIL WI NA C Corporation false BELLIN INVESTMENTS INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 391564939 OTHER WI NA C Corporation false false false false false true false false false false false false false false false false true true false false