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Nonprofiteer
← ST CROIX VALLEY EMERGENCY MEDICAL SERVICES INC

Form 990 for tax year 2022

Filed by ST CROIX VALLEY EMERGENCY MEDICAL SERVICES INC.

Totals

Total revenue
$3,623,488
Total expenses
$3,531,067
Contributions and grants received
$360,190
Grants paid
$0
Program service revenue
$3,252,434
Investment income
$3,893
Other revenue
$6,971
Total assets, end of year
$2,853,723
Total liabilities, end of year
$270,188
Net assets or fund balances, end of year
$2,583,535
Program services expenses (Part IX)
$2,807,779
Management and general expenses
$723,288
Fundraising expenses
$0
Program service expenses (Part III)
$2,807,779

Program services were 79.5% 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.

  • 1e · Government grants (contributions)

    $139,049

  • 1f · All other contributions, gifts and grants

    $221,141

  • 2a · Program service revenue: FEE INCOME

    total $3,252,434 · related or exempt $3,252,434

  • 3 · Investment income

    total $3,893 · excluded $3,893

  • 11a · Other revenue: MISCELLANEOUS

    total $6,971 · excluded $6,971

  • 11e · Other revenue, total

    $6,971

Functional expenses

Part IX, the statement of functional expenses.

  • 11a · Fees: management

    total $2,732,130 · program services $2,026,119 · management and general $706,011

  • 11c · Fees: accounting

    total $3,418 · management and general $3,418

  • 11g · Fees: other

    total $13,859 · management and general $13,859

  • 12 · Advertising and promotion

    total $5,291 · program services $5,291

  • 13 · Office expenses

    total $7,431 · program services $7,431

  • 14 · Information technology

    total $348 · program services $348

  • 16 · Occupancy

    total $31,919 · program services $31,919

  • 17 · Travel

    total $109,733 · program services $109,733

  • 22 · Depreciation, depletion and amortization

    total $162,000 · program services $162,000

  • 23 · Insurance

    total $16,788 · program services $16,788

  • 24a · Other expenses: BAD DEBT WRITEOFFS

    total $271,611 · program services $271,611

  • 24b · Other expenses: MEDICAL SUPPLIES

    total $94,862 · program services $94,862

  • 24c · Other expenses: REPAIRS AND MAINTENANCE

    total $8,848 · program services $8,848

  • 24e · All other expenses

    total $72,829 · program services $72,829

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $478,589 · end of year $873,841

  • 2 · Savings and temporary cash investments

    beginning of year $1,013,256 · end of year $983,310

  • 4 · Accounts receivable

    beginning of year $748,583 · end of year $460,838

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

    $1,299,530

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

    $763,796

  • 10c · Land, buildings and equipment, net

    beginning of year $528,935 · end of year $535,734

  • 17 · Accounts payable and accrued expenses

    beginning of year $144,631 · end of year $195,953

  • 19 · Deferred revenue

    beginning of year $60,370

  • 25 · Other liabilities

    beginning of year $73,248 · end of year $74,235

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $776,822 · end of year $776,822

  • 31 · Retained earnings, endowment or other funds

    beginning of year $1,714,292 · end of year $1,806,713

Mission and programs · 2022

Mission

TO LEASE, MAINTAIN AND OPERATE AN EMERGENCY AMBULANCE SERVICE WHICH WILL SERVE THE POLK CO WI AREA TO RENDER AID TO THE SICK, INJURED, OR DISABLED WITHOUT THE REGARDS TO RACE, CREED, OR TO STATION IN LIFE. TO SERVE THE SOCIAL WELFARE OF THE PEOPLE.

Activities or mission (Part I)

TO LEASE, MAINTAIN AND OPERATE AN EMERGENCY AMBULANCE SERVICE WHICH SERVES POLK COUNTY, WI AREA.

  • ST. CROIX VALLEY EMS, INC. OPERATES AS AN "OUT-OF-HOSPITAL" CARE ORGANIZATION THAT PROVIDES MEDICAL CARE AND COMPREHENSIVE MEDICAL TRANSPORTATION IN THE COMMUNITIES WE SERVE. THE CORE PURPOSE OF ST. CROIX VALLEY EMS, INC. IS PROVIDING CARE TO PEOPLE DURING THEIR TIME OF NEED RESULTING FROM ACCIDENTS AND MEDICAL EMERGENCIES. ST. CROIX VALLEY EMS, INC. RESPONDS TO "911" CALLS IN EACH COMMUNITY SERVED WITHOUT ANY REGARD TO REIMBURSEMENT FOR SERVICES, INCLUDING THE ABILITY OF THE CALLING PARTY TO PAY FOR COSTS ASSOCIATED WITH THE SERVICE.ST. CROIX VALLEY EMS, INC. PROVIDES SERVICES TO THE COMMUNITIES OF: CITY OF ST. CROIX, TOWN OF ST. CROIX, TOWN OF GARFIELD, TOWN OF EUREKA, TOWN OF OSCEOLA, TOWN OF BALSAM LAKE, TOWN OF MILLTOWN, TOWN OF STERLING, CITY OF DRESSER, VILLAGE OF BALSAM LAKE, VILLAGE OF CENTURIA, VILLAGE OF MILLTOWN, IN POLK COUNTY WISCONSIN AND THE COMMUNITIES OF THE CITY OF TAYLORS FALLS, AMADOR TOWNSHIP AND SHAFER TOWNSHIP IN CHISAGO COUNTY, MN.ST. CROIX VALLEY EMS, INC. SERVES APPROXIMATELY 7,400 RESIDENTS IN THE ABOVE CITIES/VILLAGES/TOWNS.

    Expenses $2,807,779 · Revenue $3,252,434

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Dave Dobosenski

    PRESIDENT

    Total calculated
    $550,193
    From this org
    $0
    From related orgs
    $508,650
    Other
    $41,543
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $425,977 related
    Bonus
    $0 + $82,000 related
    Other
    $0 + $673 related
    Deferred
    $0 + $21,500 related
    Nontaxable benefits
    $0 + $20,043 related
    Filer's total
    $0 + $550,193 related

  • Sally Bajak

    CFO (THROUGH JULY 2022)

    Total calculated
    $175,073
    From this org
    $0
    From related orgs
    $145,564
    Other
    $29,509
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $141,375 related
    Bonus
    $0 + $4,000 related
    Other
    $0 + $189 related
    Deferred
    $0 + $8,058 related
    Nontaxable benefits
    $0 + $21,451 related
    Filer's total
    $0 + $175,073 related

  • Aarron Reinert

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    1

  • Pat McCaully

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Ralph J Frascone

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Michael Youso

    CFO

    Total calculated
    $122,414
    From this org
    $0
    From related orgs
    $111,322
    Other
    $11,092
    Hours/week
    1 + 40 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)

PART II
THE FILING ORGANIZATION RELIES ON A RELATED ORGANIZATION TO DETERMINE THE COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WHICH IS PAID BY THE RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING PRACTICES TO DETERMINE COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL: 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) WRITTEN EMPLOYMENT CONTRACT 4) COMPENSATION SURVEY OR STUDY 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

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.

Provenance

Return type
form_990
Tax year
2022
Filed
10 November 2023
IRS schema version
2022v5.0
Source object
202343189349317594

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