2024-08-14T12:12:54+00:00 2023-09-30 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2023-01-01 391962965 Tri-State Regional Ambulance Inc TRI- 6086378884 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 MICHAEL MCKEE PRESIDENT 6087848827 2024-08-14 true Emily Upstrom P01765498 3128792000 2024-08-14 2023 2024-08-08 14:25:15Z MICHAEL MCKEE 235 CAUSEWAY BOULEVARD LA CROSSE WI 546033119 3028116 false X N/A X 1999 WI SEE SCHEDULE O. 6 2 0 2 0 0 88147 113392 2607820 2914515 0 209 0 0 2695967 3028116 4919 15545 0 0 2733013 2716496 0 0 0 1011188 1050510 3749120 3782551 -1053153 -754435 2235756 3227714 3326445 4219646 -1090689 -991932 SEE SCHEDULE O. false false 3657850 15545 2792811 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 12 AMBULANCES, 18 PARAMEDICS, AND 21 EMT'S TO MAKE APPROXIMATELY 2,257 TRANSPORTS IN 2023 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 2023, TRI-STATE REGIONAL HAD 17 STANDBYS, 481 NON-TRANSPORTS, AND 2,755 TOTAL CALLS. 39941 0 121704 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. 3697791 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 false false false false false false false false false false false false false false true true true false false true 0 0 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 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 0.5 49.5 X X 0 0 0 MICHAEL MCKEE BOARD OF DIRECTORS - PRESIDENT 0.5 41.8 X X 0 0 0 MIKEL POELLINGER BOARD OF DIRECTORS - VICE PRESIDENT 0.5 1.0 X X 0 0 0 CHRISTOPHER EBERLEIN MD BOARD OF DIRECTORS - MEMBER (BEGIN 2/23) 0.5 45.0 X 0 0 0 KIM SMITH BOARD OF DIRECTORS - MEMBER (BEGIN 3/23) 0.5 1.0 X 0 0 0 KYLE BAKKUM BOARD OF DIRECTORS - MEMBER (END 3/23) 0.5 1.0 X 0 0 0 MICHAEL KITTELSON BOARD OF DIRECTORS - MEMBER (END 1/23) 0.5 1.0 X 0 0 0 THERESE BINFET BOARD OF DIRECTORS - MEMBER 0.5 41.0 X 0 0 0 GERALD OETZEL CHIEF FINANCIAL OFFICER AND TREASURER THRU 8/23 0.0 42.0 X 0 0 0 SCOTT RATHGABER MD CEO, CHAIRMAN 0.0 46.0 X 0 0 0 STEVE LITTLE INTERIM CHIEF FINANCIAL OFFICER AND TREASURER BEGIN 8/23 0.0 42.0 X 0 0 0 0 0 0 0 false false false 0 113272 120 113392 PRE-HOSPITAL EMERGENCY 621990 2794620 2794620 NON-EMERGENCY MEDICAL 621910 103863 103863 PARAMEDIC AND EMT HOUR 621990 16032 16032 0 0 0 0 2914515 209 209 0 0 0 0 0 0 0 0 0 3028116 2914515 0 209 15545 15545 2716567 2716567 5 5 0 -76 -72 -4 67757 67757 51435 0 51435 0 14800 2679 12121 2651 2651 109553 108876 677 2539 2421 118 14519 10061 4458 -75665 -75665 136190 136190 15916 15916 BAD DEBT EXPENSE 421731 421731 RENT, REPAIRS & MAINTENANCE 196656 196656 SUPPLIES 86903 86903 MEMBERSHIPS & LICENSES 4818 229 4589 707 0 707 0 3782551 3697791 84760 0 0 0 446052 607441 0 0 594336 960254 0 0 0 0 0 0 10711 8429 1988564 984546 496092 1004018 0 0 508550 508550 180015 139022 2235756 3227714 90870 9024 0 0 71657 33328 0 0 0 0 0 0 0 0 3163918 4177294 3326445 4219646 X -1090689 -991932 -1090689 -991932 2235756 3227714 X -754435 853192 X false true X true false X 37720 125546 132786 88147 113392 497591 2195808 1825149 2059305 2607820 2914515 11602597 0 0 0 2233528 1950695 2192091 2695967 3027907 12100188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12100188 209 209 0 0 0 0 0 209 209 0 0 0 0 0 0 0 2233528 1950695 2192091 2695967 3028116 12100397 1.0000 1.0 0 0.0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18895 6968 11927 1896043 977578 918465 73626 0 73626 1004018 DUE TO GLAS 4037437 LONG TERM OBLIGATION - OPERATING LEASE 83350 CURRENT OBLIGATION - OPERATING LEASE 56507 LONG TERM NOTE PAYABLE 4177294 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, 2023 AND NOVEMBER 30, 2022, NET DEFERRED TAX ASSETS OF $7,057 AND $7,351, RESPECTIVELY, WHICH PRIMARILY ARE RELATED TO NET OPERATING LOSS CARRYFORWARDS, HAVE VALUATION ALLOWANCES OF $7,057 AND $7,351, RESPECTIVELY, RECORDED AGAINST THEM DUE TO THE UNCERTAINTY OF REALIZING THOSE BENEFITS IN THE FUTURE. AT SEPTEMBER 30, 2023, THE SYSTEM'S FEDERAL NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $26,700, AND THE STATE NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $24,600, 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 6 15545 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. 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. AN ASSUMED NAME (DBA) WAS CREATED UNDER TSRA AS GUNDERSEN HEALTH SYSTEM AMBULANCE (IN DECEMBER). IN 2023, TRI-STATE REGIONAL AMBULANCE HAD 2,257 TRANSPORTS, 17 STANDBYS, 481 NON-TRANSPORTS, AND 2,755 TOTAL CALLS WITH 12 AMBULANCES. IN 2023, EXPANDED OUR NUMBER OF LOCATIONS IN ORDER TO BETTER PROVIDE AMBULANCE SERVICES TO RURAL AND UNDERSERVED HOSPITALS. THIS EXPANSION HAS DRAMATICALLY REDUCED PATIENT WAIT TIMES AND HELPED ENSURE PATIENTS WERE CARED FOR PROPERLY DURING TRANSPORT. SUCCESSFULLY CREATED A PARAMEDIC TRAINEE PROGRAM WITH NEAR 100% GRADUATION RATES. 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 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 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 matters. 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 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 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 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. Form 990, Part VII, Section A, Line 1a COMPENSATION REPORTING DUE TO THE SHORT YEAR RETURN IN WHICH THERE WAS NO CALENDAR YEAR THAT ENDS WITH OR WITHIN THE SHORT YEAR, NO REPORTABLE COMPENSATION IS SHOWN FOR INDIVIDUALS LISTED ON PART VII OF THE 990 RETURN. AS SUCH, NO KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, OR INDEPENDENT CONTRACTORS ARE LISTED PER THE REPORTING INSTRUCTIONS. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Equity transfer. - 853192; Form 990, Part XII, Line 2c AUDIT, REVIEW OR COMPILATION OF FINANCIAL STATEMENTS THE AUDITOR IS SELECTED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. 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 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 HEALTHCARE FOUNDATION 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 III-FI 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 Gundersen Edge LLC 1836 SOUTH AVENUE LA CROSSE WI 54601 921783811 INNOVATION WI GLHS C Corporation false false false false false true false false false false false false false false false false true true false true