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← TRI-STATE AMBULANCE INC

Form 990 for tax year 2023

Filed by TRI-STATE AMBULANCE INC.

What the amendment changed

Compared with the return it replaced , filed 14 August 2024. matched by us Only the return's totals, a 990-PF's accounting method and the names listed in Part VII (Part VIII on a 990-PF) are compared. We relate returns by organization, tax year and form, and order them by each return's own timestamp; the filer's own "amended return" checkbox is a separate fact.

Total revenue
$6,812,428 changed to $9,720,021
Total expenses
$6,264,714 changed to $9,321,224
Contributions and grants received
$201,257 changed to $35,507
Grants paid
$19,517 changed to $32,728
Program service revenue
$6,591,763 changed to $9,575,800
Investment income
$19,408 changed to $108,714
Total assets, end of year
$7,811,573 changed to $8,126,565
Total liabilities, end of year
$671,380 changed to $587,575
Net assets or fund balances, end of year
$7,140,193 changed to $7,538,990
Program services expenses
$5,265,829 changed to $8,037,920
Management and general expenses
$998,885 changed to $1,283,304
Program service expenses (Part III)
$5,265,829 changed to $8,037,920

Listed only on the earlier return

  • Kyle Bakkum
  • Michael Kittelson

Listed only on the later return

  • Cindy McDonald
  • Gregg Bulman
  • John Ceelen
  • Randy Young
  • Thomas E Tornstrom

Listed under a different title

  • Christopher Eberlein MD: BOARD OF DIRECTORS - MEMBER (BEGIN 2/23) then BOARD OF DIRECTORS - MEMBER
  • Gerald Oetzel: CHIEF FINANCIAL OFFICER AND TREASURER THRU 8/23 then FORMER CHIEF FINANCIAL OFFICER
  • Kim Smith: BOARD OF DIRECTORS - MEMBER (BEGIN 3/23) then BOARD OF DIRECTORS - MEMBER
  • Scott Rathgaber MD: CEO, CHAIRMAN then CHIEF EXECUTIVE OFFICER
  • Steve Little: INTERIM CHIEF FINANCIAL OFFICER AND TREASURER BEGIN 8/23 then INTERIM CHIEF FINANCIAL OFFICER, TREASURER (THRU 2/24)

Totals

Total revenue
$9,720,021
Total expenses
$9,321,224
Contributions and grants received
$35,507
Grants paid
$32,728
Program service revenue
$9,575,800
Investment income
$108,714
Other revenue
$0
Total assets, end of year
$8,126,565
Total liabilities, end of year
$587,575
Net assets or fund balances, end of year
$7,538,990
Program services expenses (Part IX)
$8,037,920
Management and general expenses
$1,283,304
Fundraising expenses
$0
Program service expenses (Part III)
$8,037,920

Program services were 86.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $14,000

  • 1e · Government grants (contributions)

    $21,507

  • 2a · Program service revenue: PRE-HOSPITAL EMERGENCY

    total $9,455,707 · related or exempt $9,455,707

  • 2b · Program service revenue: MEDICAL SUPPLIES SERVICES

    total $31,302 · related or exempt $31,302

  • 2c · Program service revenue: MISCELLANEOUS RENTAL INCOME

    total $88,791 · related or exempt $88,791

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $107,214 · excluded $107,214

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    other assets $1,500

  • 7b · Less cost or other basis and sales expenses

    other assets $0

  • 7c · Gain or loss

    securities $0 · other assets $1,500

  • 7d · Net gain or loss

    total $1,500 · excluded $1,500

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $1,000 · program services $1,000

  • 2 · Grants to domestic individuals

    total $31,728 · program services $31,728

  • 4 · Benefits paid to or for members

    total $0 · program services $0

  • 7 · Other salaries and wages

    total $4,491,056 · program services $3,726,565 · management and general $764,491

  • 8 · Pension plan contributions

    total $177,800 · program services $147,556 · management and general $30,244

  • 9 · Other employee benefits

    total $694,583 · program services $576,434 · management and general $118,149

  • 10 · Payroll taxes

    total $300,798 · program services $249,632 · management and general $51,166

  • 11a · Fees: management

    total $164,292 · management and general $164,292

  • 11c · Fees: accounting

    total $1,500 · program services $1,500

  • 11g · Fees: other

    total $442,447 · program services $413,807 · management and general $28,640 · fundraising $0

  • 12 · Advertising and promotion

    total $350 · management and general $350

  • 13 · Office expenses

    total $89,923 · program services $45,973 · management and general $43,950

  • 14 · Information technology

    total $46,034 · program services $13,907 · management and general $32,127

  • 16 · Occupancy

    total $262,023 · program services $217,522 · management and general $44,501

  • 17 · Travel

    total $34,367 · program services $34,367

  • 19 · Conferences, conventions and meetings

    total $42,120 · program services $42,120

  • 22 · Depreciation, depletion and amortization

    total $603,876 · program services $603,876

  • 23 · Insurance

    total $31,710 · program services $26,316 · management and general $5,394

  • 24a · Other expenses: BAD DEBT EXPENSE

    total $1,300,784 · program services $1,300,784

  • 24b · Other expenses: RENT, REPAIRS AND MAINTENANCE

    total $313,622 · program services $313,622

  • 24c · Other expenses: SUPPLIES

    total $264,954 · program services $264,954

  • 24d · Other expenses: Licenses/Permits/Fees

    total $16,726 · program services $16,726

  • 24e · All other expenses

    total $9,531 · program services $9,531 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $300 · end of year $300

  • 2 · Savings and temporary cash investments

    beginning of year $2,766,332 · end of year $2,969,676

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $2,044,220 · end of year $2,187,668

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $79,928 · end of year $8,227

  • 10a · Land, buildings and equipment: cost or other basis

    $7,574,387

  • 10b · Land, buildings and equipment: accumulated depreciation

    $4,632,527

  • 10c · Land, buildings and equipment, net

    beginning of year $2,920,793 · end of year $2,941,860

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $18,834

  • 17 · Accounts payable and accrued expenses

    beginning of year $512,094 · end of year $581,301

  • 19 · Deferred revenue

    beginning of year $24,085 · end of year $4,595

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0

  • 25 · Other liabilities

    beginning of year $135,201 · end of year $1,679

  • 27 · Net assets without donor restrictions

    beginning of year $7,140,193 · end of year $7,538,990

Mission and programs · 2023

Mission

See Schedule O

  • See Schedule O

    Expenses $8,037,920 · Grants $32,728 · Revenue $9,575,800

As filed on the 2023 return.

Listed in Part VII

  • Bryan Erdmann

    BOARD OF DIRECTORS - SECRETARY/TREASURER

    Total calculated
    $484,221
    From this org
    $0
    From related orgs
    $409,876
    Other
    $74,345
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $408,646 related
    Bonus
    $0
    Other
    $0 + $1,230 related
    Deferred
    $0 + $45,225 related
    Nontaxable benefits
    $0 + $29,120 related
    Filer's total
    $0 + $484,221 related

  • Michael McKee

    BOARD OF DIRECTORS - PRESIDENT

    Total calculated
    $351,145
    From this org
    $0
    From related orgs
    $281,060
    Other
    $70,085
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $279,802 related
    Bonus
    $0
    Other
    $0 + $1,258 related
    Deferred
    $0 + $41,528 related
    Nontaxable benefits
    $0 + $28,557 related
    Filer's total
    $0 + $351,145 related

  • Mikel Poellinger

    BOARD OF DIRECTORS - VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    2

  • Christopher Eberlein MD

    BOARD OF DIRECTORS - MEMBER

    Total calculated
    $468,781
    From this org
    $0
    From related orgs
    $398,553
    Other
    $70,228
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $391,338 related
    Bonus
    $0 + $2,000 related
    Other
    $0 + $5,215 related
    Deferred
    $0 + $45,225 related
    Nontaxable benefits
    $0 + $25,003 related
    Filer's total
    $0 + $468,781 related

  • Kim Smith

    BOARD OF DIRECTORS - MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Therese Binfet

    BOARD OF DIRECTORS - MEMBER

    Total calculated
    $224,810
    From this org
    $0
    From related orgs
    $176,918
    Other
    $47,892
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $174,552 related
    Bonus
    $0
    Other
    $0 + $2,366 related
    Deferred
    $0 + $25,889 related
    Nontaxable benefits
    $0 + $22,003 related
    Filer's total
    $0 + $224,810 related

  • John Ceelen

    CHIEF FINANCIAL OFFICER, TREASURER (BEGIN 2/24)

    Total calculated
    $0
    Hours/week
    2 + 48 related

  • Scott Rathgaber MD

    CHIEF EXECUTIVE OFFICER

    Total calculated
    $1,712,949
    From this org
    $0
    From related orgs
    $1,644,221
    Other
    $68,728
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,274,504 related
    Bonus
    $0 + $200,000 related
    Other
    $0 + $169,717 related
    Deferred
    $0 + $45,225 related
    Nontaxable benefits
    $0 + $23,503 related
    Filer's total
    $0 + $1,712,949 related

  • Steve Little

    INTERIM CHIEF FINANCIAL OFFICER, TREASURER (THRU 2/24)

    Total calculated
    $333,317
    From this org
    $0
    From related orgs
    $333,317
    Other
    $0
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $258,317 related
    Bonus
    $0 + $75,000 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $333,317 related

  • Thomas E Tornstrom

    ADMINISTRATIVE DIRECTOR

    Total calculated
    $206,567
    From this org
    $0
    From related orgs
    $163,870
    Other
    $42,697
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $160,902 related
    Bonus
    $0 + $900 related
    Other
    $0 + $2,068 related
    Deferred
    $0 + $24,013 related
    Nontaxable benefits
    $0 + $18,684 related
    Filer's total
    $0 + $206,567 related

  • Cindy McDonald

    CC PARAMEDIC

    Total calculated
    $134,920
    From this org
    $0
    From related orgs
    $93,589
    Other
    $41,331
    Hours/week
    0 + 40 related

  • Gregg Bulman

    PARAMEDIC

    Total calculated
    $131,505
    From this org
    $0
    From related orgs
    $103,057
    Other
    $28,448
    Hours/week
    0 + 40 related

  • Randy Young

    CC PARAMEDIC

    Total calculated
    $126,362
    From this org
    $0
    From related orgs
    $113,608
    Other
    $12,754
    Hours/week
    0 + 40 related

  • Gerald Oetzel

    FORMER CHIEF FINANCIAL OFFICER

    Total calculated
    $573,176
    From this org
    $0
    From related orgs
    $555,068
    Other
    $18,108
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $480,094 related
    Bonus
    $0 + $70,000 related
    Other
    $0 + $4,974 related
    Deferred
    $0 + $12,220 related
    Nontaxable benefits
    $0 + $5,888 related
    Filer's total
    $0 + $573,176 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

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.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • GUNDERSEN LUTHERAN ENVISION LLC

    C Corporation · RENEWABLE ENERGY · WI

    Directly controlled by NA

  • BEL-REGIONAL HOME MEDICAL INC

    C Corporation · DURABLE MEDICAL EQUIPMENT, RETAIL · WI

    Directly controlled by NA

  • GUNDERSEN EDGE LLC

    C Corporation · INNOVATION · WI

    Directly controlled by NA

  • BG ASSURANCE COMPANY

    C Corporation · SELF INSURANCE · CJ

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2023
Filed
14 August 2025
IRS schema version
2023v6.0
Source object
202512269349303161

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