2022-05-10T10:47:48-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-07-01 311428613 OHIO MEDICAL TRANSPORTATION INC OHIO 6147348001 2827 WEST DUBLIN-GRANVILLE ROAD COLUMBUS OH 43235 THOMAS ALLENSTEIN CEO/PRESIDENT 6147348001 2022-04-19 1 THOMAS ALLENSTEIN 999009999 AMY CIMINELLO P00796388 6148493000 2022-04-19 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MEDFLIGHT MEDFLIGHT OF OHIO THOMAS ALLENSTEIN 2827 WEST DUBLIN-GRANVILLE ROAD COLUMBUS OH 43235 49619033 0 X WWW.MEDFLIGHT.COM X 1995 OH TO PROVIDE CUSTOMER FOCUSED MEDICAL TRANSPORTATION SOLUTIONS. (CONTINUED ON SCHEDULE O) 4 4 268 4 0 0 809402 10623 43369421 46111657 424572 1140870 1681531 841448 46284926 48104598 1175 100 0 0 14493391 17206722 0 0 0 31200600 27800459 45695166 45007281 589760 3097317 41424094 48420792 16663860 19500120 24760234 28920672 TO CARE FOR AND TRANSPORT THE CRITICALLY ILL AND INJURED. 0 0 44662875 100 46953395 DURING THE FISCAL YEAR ENDED 6/30/21, MEDFLIGHT TRANSPORTED 4,106 CRITICALLY ILL & INJURED PATIENTS BY HELICOPTER FROM ACCIDENT SCENES TO LEVEL 1 & 2 TRAUMA CENTERS OR FROM SMALLER COMMUNITY HOSPITALS TO LARGE TERTIARY CARE CENTERS TO RECEIVE SPECIALIZED CARE. AN ADDITIONAL 2,621 PATIENTS WERE TRANSPORTED BY MOBILE INTENSIVE CARE UNITS (MICU'S) FROM SMALLER COMMUNITY HOSPITALS TO LARGE TERTIARY CARE CENTERS TO RECEIVE SPECIALIZED CARE. INCLUDED IN THESE EXPENSES ARE COSTS ASSOCIATED WITH PROVIDING CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER MEDFLIGHT'S CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE MEDFLIGHT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. (CONTINUED ON SCHEDULE O) 44662875 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 46 0 1 268 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X JENNIFER COSTELLO 6147348001 2827 WEST DUBLIN-GRANVILLE ROAD COLUMBUS OH 43235 THOMAS ALLENSTEIN CEO 35.00 15.00 X 363671 0 79712 JENNIFER COSTELLO CFO 35.00 15.00 X 209825 0 22447 MIKE PERKINS COO 38.00 16.00 X 216853 0 14383 LINDA HINES VP LEGAL AFFAIRS (PART-YEAR) 40.00 0.00 X 178478 0 18625 JASON PIERCE ROTOR NURSE 65.00 0.00 X 146139 0 21854 TODD BAILEY VP OF BUSINESS DEVELOPMENT 40.00 0.00 X 154842 0 6638 TARA BEEBOUT VP OF CRITICAL CARE SERVICES 40.00 0.00 X 138869 0 22565 F DAVID EVANS ROTOR NURSE 48.00 0.00 X 131521 0 22545 JOSEPH ABEL BOARD CHAIR 1.00 0.00 X X 0 0 0 JOHN LINDAMAN BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 ELIZABETH SEELY BOARD SECRETARY 1.00 1.00 X X 0 0 0 MICHAEL LAWSON BOARD TREASURER 1.00 1.00 X X 0 0 0 DR ASHLEY LARRIMORE MEDICAL DIRECTOR 8.00 0.00 X 0 0 0 DR HOWARD WERMAN MEDICAL DIRECTOR (PART YEAR) 4.00 2.00 X 0 0 0 1540198 0 208769 24 0 1 0 METRO AVIATION PO BOX 7008 SHREVEPORT LA 71137 HELICOPTER SERVICES 13773821 MEDBILL RESOURCES 1866 W MAIN STREET NEWARK OH 43055 MEDICAL BILLING 232643 OSU EMERGENCY MEDICINE LLC 700 ACKERMAN RD STE 630 COLUMBUS OH 43202 MEDICAL DIRECTOR 226023 AIR METHODS CORPORATION PO BOX 713362 CINCINNATI OH 45271 HELICOPTER SERVICES 139753 ROBINAUGH EMS LLC 1180 W COLUMBUS AVE BELLFONTAINE OH 43311 GROUND TRANSPORTATION SERVICES 125954 5 10623 10623 PATIENT SERVICES 621990 41075637 41075637 DISPATCHING SERVICE 621990 2045104 2045104 SERVICE FEE-GRMH 621990 1535147 1535147 SERVICE FEE-OSUH 621990 973725 973725 SERVICE FEE- KH 621990 389225 389225 92819 92819 46111657 120013 120013 52120 51545 575 575 575 2479906 3841 1462007 883 1017899 2958 1020857 1020857 MEDICAL TRANSPORTS 480000 535991 535991 SALE OF JET FUEL 900099 294672 294672 AFFILIATE MEMBERSHIP REVENUE 900099 10500 10500 -290 -290 840873 48104598 46953395 0 1140580 100 100 969792 969792 13914160 13006891 907269 564526 485594 78932 679062 631579 47483 1079182 919788 159394 12204 12204 91296 91296 63350 63350 1195244 997447 197797 123600 93864 29736 931631 496197 435434 334386 286062 48324 597500 449980 147520 52090 47877 4213 2409 9631 -7222 414561 287525 127036 1722933 1608190 114743 290241 288072 2169 HELICOPTER 16736378 16736378 PROVISION FOR BAD DEBT 8048719 8048719 STAFF EXPENSES 136855 85996 50859 GROUND TRANSPORTATION 11127 182930 -171803 -2964065 55 -2964120 45007281 44662875 344406 0 3386667 1150748 6646584 8451309 456601 439115 527317 368472 25714210 12492491 12276247 13221719 7394709 8531944 9250000 9250000 1485969 7007485 41424094 48420792 4324007 3859661 2466876 2642297 9661100 12670325 211877 327837 16663860 19500120 X 24760234 28920672 24760234 28920672 41424094 48420792 3097317 1063121 0 X X 0 1 X 1 1 0 X 19508 11525 169 809402 2873 843477 44634702 43658756 40901505 43695218 46960280 219850461 44654210 43670281 40901674 44504620 46963153 220693938 0 1899677 3220083 2438924 2015810 1566166 11140660 1899677 3220083 2438924 2015810 1566166 11140660 209553278 267769 251826 261586 182696 172133 1136010 267769 251826 261586 182696 172133 1136010 27902 955 796 1349944 1379597 44949881 43923062 41164056 46037260 47135286 223209545 0.93880 0.93630 0.00510 0.00580 X 861559 418563 442996 2427809 1179479 1248330 6376048 3097615 3278433 16048794 7796834 8251960 13221719 MEDCARE 9250000 F 9250000 OTHER RECEIVABLES 1186510 SUPPLEMENTAL RETIREMENT PLAN 327837 INTERCOMPANY RECEIVABLES 5493138 7007485 ACCRUED SUPPLEMENTAL RETIREMENT PLAN- LT 327837 327837 X X X 0 1 0 0 0 0 0 0 0 THOMAS ALLENSTEIN CEO 361693 0 0 0 1978 0 68106 0 11606 0 443383 0 0 0 JENNIFER COSTELLO CFO 209825 0 0 0 0 0 8597 0 13850 0 232272 0 0 0 MIKE PERKINS COO 216853 0 0 0 0 0 8803 0 5580 0 231236 0 0 0 LINDA HINES VP LEGAL AFFAIRS (PART-YEAR) 178478 0 0 0 0 0 7361 0 11264 0 197103 0 0 0 JASON PIERCE ROTOR NURSE 146139 0 0 0 0 0 4994 0 16860 0 167993 0 0 0 TODD BAILEY VP OF BUSINESS DEVELOPMENT 154842 0 0 0 0 0 6067 0 571 0 161480 0 0 0 TARA BEEBOUT VP OF CRITICAL CARE SERVICES 138869 0 0 0 0 0 5941 0 16624 0 161434 0 0 0 F DAVID EVANS ROTOR NURSE 131521 0 0 0 0 0 5664 0 16881 0 154066 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING CALENDAR YEAR 2020: THOMAS ALLENSTEIN $55,652 THE DEFERRED COMPENSATION PLAN IS AVAILABLE ONLY TO EMPLOYEES WHO ARE MEMBERS OF A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES OF THE COMPANY. THE TOTAL GUARANTEED BENEFIT OF THE 457(F) PLAN IS EQUAL TO 60% OF EACH OFFICER'S SALARY EACH YEAR, REDUCED BY ANY SOCIAL SECURITY AND REGULAR PENSION PLAN PAYMENTS. THE DEFERRED COMPENSATION PLAN WILL VEST UPON THE EMPLOYEE'S TERMINATION OF THE EMPLOYEE'S EMPLOYMENT DUE TO DEATH, DISABILITY, TERMINATION WITHOUT JUST CAUSE OR RETIREMENT AT OR AFTER THE AGE OF 65. IF AN EMPLOYEE VOLUNTARILY TERMINATES EMPLOYMENT OR IS TERMINATED, A NONCOMPETE AGREEMENT IS IN PLACE FOR 2 YEARS. THE EMPLOYEE FORFEITS ANY DEFERRED COMPENSATION PAYMENTS IF HE/SHE DOES NOT CONFORM TO THE NONCOMPETE AGREEMENT. THE AMOUNTS LISTED ABOVE ARE INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II, COLUMN C. FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: MEDFLIGHT OPERATES 9 MEDICAL HELICOPTERS AND 4 MOBILE INTENSIVE CARE UNITS (MICU'S). FORM 990, PART III, LINE 4A: THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER MEDFLIGHT'S CHARITY CARE POLICY AGGREGATED APPROXIMATELY $5,371,000 FOR A COST OF APPROXIMATELY $1,749,000 IN FISCAL 2021. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES MANAGEMENT DUTIES TO THE MEDICAL DIRECTORS BELOW, WHO HAVE INPUT IN THE OPERATIONS, INCLUDING REVIEW OF MEDICAL OUTCOMES AND PLANNING/ SUPERVISING DUTIES. DR. HOWARD WERMAN (PART YEAR) - COMPENSATION PAID $115,004 DR. ASHLEY LARRIMORE - COMPENSATION PAID $50,228 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO CLASS A MEMBERS THAT CAN APPOINT TWO VOTING MEMBERS AND AN AFFILIATE MEMBER THAT DOES NOT HAVE RIGHTS TO APPOINT A VOTING OR NON-VOTING MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS TWO CLASS A MEMBERS WHO EACH APPOINT TWO BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE CEOS OF THE TWO CLASS A MEMBERS CAN ONLY APPROVE DECISIONS TO APPOINT BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE SENIOR ACCOUNTANT AND THE PAYROLL SPECIALIST PREPARE INFORMATION AND THE CONTROLLER AND THE CFO REVIEW THE RESULTING DRAFT 990. COPIES ARE EMAILED TO THE BOARD BEFORE THE CFO AUTHORIZES THE AUDITOR TO FILE ELECTRONICALLY. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL EMPLOYEES AND BOARD MEMBERS. BOARD MEMBERS, SENIOR EXECUTIVES, AND MEDICAL DIRECTORS COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. AFTER THE CONFLICT OF INTEREST STATEMENTS ARE COMPLETED, THEY ARE REVIEWED BY IN-HOUSE LEGAL COUNSEL TO DETERMINE IF THERE ARE ANY CONFLICTS. DURING THE ACCOUNTS PAYABLE PROCESS THE CONTROLLER REVIEWS THE CHECK REGISTER FOR ANY DISTRIBUTIONS TO DISQUALIFIED PERSONS. ANY POTENTIAL CONFLICTS WITH STANDARD EMPLOYEES ARE DETERMINED AND REVIEWED BY MANAGEMENT. ANY POTENTIAL CONFLICTS WITH SENIOR EXECUTIVES ARE DETERMINED AND REVIEWED AT THE BOARD LEVEL. THERE HAVE BEEN NO TRANSACTIONS WITH DISQUALIFIED PERSONS DURING THE FISCAL YEAR. SHOULD THERE BE ANY CONFLICTS OF INTEREST, THE BOARD MEMBER WITH THE CONFLICT WILL ABSTAIN FROM VOTING ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS VOTE ON AND DETERMINE COMPENSATION FOR THE PRESIDENT AND OFFICERS. OUTSIDE CONSULTING FIRMS PERFORM SALARY SURVEYS ONCE EVERY THREE YEARS FOR THE PRESIDENT AND EXECUTIVES TO PROVIDE SALARY RANGES. THIS SALARY SURVEY IS USED IN DETERMINING PRESIDENT AND EXECUTIVE COMPENSATION ADJUSTMENTS. IN ADDITION, THE ORGANIZATION DETERMINES COMPENSATION FOR THE PRESIDENT AND EXECUTIVES BY REVIEWING COMPENSATION AMOUNTS PAID TO OTHER HELICOPTER AND HOSPITALS' EXECUTIVES. DECISIONS REGARDING CHANGES IN THE PRESIDENT'S AND EXECUTIVES' COMPENSATION ARE DOCUMENTED IN THE MINUTES TO THE BOARD MEETING. THIS PROCESS WAS LAST COMPLETED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THESE ITEMS AVAILABLE TO THE PUBLIC. PART XI, LINE 2C THE ENTIRE BOARD OVERSEES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 3B: THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT YET BEEN COMPLETED. PLANS HAVE BEEN MADE TO HAVE THE REQUIRED SINGLE AUDIT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26. CEMS OF OHIO INC (MEDCARE) 3699 PARAGON DR COLUMBUS OH 43228 800249549 MEDICAL TRANSPORTATION OH 501(C)(3) 10 OHIO MEDICAL TRANSPORTATION INC 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 PART II, LINE (A) EXPLANATION AS OF MARCH 2020, THE ORGANIZATION ENTERED INTO AN AGREEMENT THAT RESULTED IN OHIO MEDICAL TRANSPORTATION, INC. OWNING 100% OF CEMS OF OHIO, INC. (MEDCARE).