2015-08-07T11:44:59-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 301 SW ADAMS STE 1000 PEORIA IL 61602 990 2014-01-01 370999878 PEORIA HOSPITALS MOBILE MEDICAL SERVICES D/B/A ADV MEDICAL TRANS OF CENTRAL IL PEOR 3094946200 1718 NORTH STERLING AVE PEORIA IL 61604 ROBERT ANDERSON CURRENT BOARD CHAIRPERSON 3094946200 2015-07-08 1 SAMUEL A CIGELNIK P00324762 3096714500 2014 2016-02-25 16:41:14Z ROBERT ANDERSON 1718 NORTH STERLING AVE PEORIA IL 61604 20420292 0 X WWW.ADVANCEDMEDICALTRANSPORT.ORG X 1975 IL THE ORGANIZATION PROVIDES AMBULANCE AND PARAMEDIC SERVICES AS WELL AS TRANSPORTATION FOR WHEELCHAIR BOUND INDIVIDUALS. 7 6 403 0 0 0 0 0 19286054 19752615 91595 313222 3135 66324 19380784 20132161 169524 155709 0 0 11105901 11538120 0 0 0 6273555 6553892 17548980 18247721 1831804 1884440 17804522 18913081 4219661 3506012 13584861 15407069 X THE ORGANIZATION PROVIDES AMBULANCE AND PARAMEDIC SERVICES AS WELL AS TRANSPORTATION FOR WHEELCHAIR BOUND INDIVIDUALS. 0 0 14170704 155709 19484381 THE ORGANIZATION PROVIDES EMERGENCY AMBULANCE CARE, TREATMENT AND TRANSPORTATION TO MULTIPLE JURISDICTIONS IN ILLINOIS. IN ADDITION TO EMERGENCY AMBULANCE SERVICE, THE ENTITY PROVIDES SCHEDULED AMBULANCE, BEHAVIORAL HEALTH (IPT) AND WHEELCHAIR TRANSPORTATION BETWEEN HOSPITALS AND OTHER HEALTHCARE FACILITIES. THE ORGANIZATION PROVIDED 40,220 AMBULANCE TRANSPORTS, 2,827 IPT TRANSPORTS AND 4,180 WHEELCHAIR TRANSPORTS IN 2014. THE ORGANIZATION PROVIDED $560,614 IN CHARITABLE SERVICES TO QUALIFIED INDIVIDUALS AT NO CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE ORGANIZATION ALSO PROVIDED CARE TO MEDICAID PATIENTS AT RATES BELOW THE COST OF PROVIDING SERVICES. FOR 2014 PAYMENTS WERE LESS THAN ESTIMATED COSTS BY APPROXIMATELY $2,596,754. IN ADDITION, THE ORGANIZATION PROVIDED OTHER COMMUNITY BENEFIT ACTIVITIES THROUGHOUT THE YEAR THAT WOULD HAVE COST $338,906. 316667 316667 THE ORGANIZATION TOOK OVER THE TRINITY AMBULANCE SERVICE IN THE QUAD CITIES IN 2013. TRINITY HOSPITAL PROVIDED A CONTRIBUTION TO THE ORGANIZATION IN ORDER TO GET OPERATIONS UP AND RUNNING IN THE QUAD CITIES AREA. 188913 17891 THE ORGANIZATION PROVIDES MULTIPLE PARAMEDIC AND EMT BASIC TRAINING PROGRAMS EACH YEAR. THESE PROGRAMS ARE AVAILABLE TO EXTERNAL AGENCIES AND EMPLOYEES OF THE ORGANIZATION. 14676284 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 18 0 1 403 1 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X ANDREW RAND 3094946200 1718 N STERLING AVE PEORIA IL 61604 ANDREW RAND CEO/BOARD MEMBER 12.50 37.50 X X 315359 0 13802 SHERRY THOMPSON BOARD VICE-CHAIRPERSON 1.00 0.00 X X 0 0 0 ROBERT ANDERSON BOARD TREASURER/SECRETARY 1.00 0.00 X X 0 0 0 JAMES BROWN BOARD MEMBER 1.00 0.00 X 0 0 0 GREG SOWARDS BOARD CHAIRPERSON 1.00 0.00 X X 0 0 0 JAY WILLSHER BOARD MEMBER 1.00 1.00 X 0 0 0 JEANINE SPAIN BOARD MEMBER 1.00 0.00 X 0 0 0 TOM GERACI VP OF OPERATIONS 12.50 37.50 X X 108168 0 6956 TIM BECCUE CFO 12.50 37.50 X X 139689 0 21398 JOHN FAKLARIS CONTROLLER 12.50 37.50 X 100181 0 16124 663397 0 58280 4 0 1 0 0 TRANSPORT REVENUE 621990 18629608 18629608 SUBSIDY REVENUE 621990 788449 788449 TRINITY REVENUE 621990 316667 316667 TUITION REVENUE 611600 17891 17891 19752615 90260 90260 511093 288131 222962 222962 222962 MISCELLANEOUS 900099 66324 66324 66324 20132161 19818939 0 313222 X 155709 155709 563216 474876 88340 9223382 7776708 1446674 292317 246467 45850 662492 573661 88831 796713 668399 128314 79931 79931 57636 57636 152257 152257 10957 10957 199916 157916 42000 196255 124319 71936 197342 89094 108248 21826 21826 -443261 -443261 1638120 1288112 350008 953286 790157 163129 SUPPLIES 941141 692232 248909 FUEL 757914 757914 REPAIRS & MAINTENANCE 646122 568322 77800 RECRUITING, EDUCATION & 249251 249251 895199 506408 388791 18247721 14676284 3571437 0 1559562 1469010 2354192 3471629 3030040 2829360 1553017 1025488 808541 790674 19012286 9721366 8463170 9290920 36000 36000 17804522 18913081 543366 369641 714290 343056 1433333 733333 1528672 2059982 4219661 3506012 X 13584861 15407069 13584861 15407069 17804522 18913081 1884440 -62232 0 X X 0 1 X 1 0 X 14367597 15322500 14994888 19286054 19752615 83723654 14367597 15322500 14994888 19286054 19752615 83723654 0 0 0 83723654 18930 25086 51420 95546 90260 281242 18930 25086 51420 95546 90260 281242 36821 47590 74173 -816 289286 447054 14423348 15395176 15120481 19380784 20132161 84451950 0.99140 0.99470 0.00330 0.00260 X 1102200 1102200 4786460 1084585 3701875 13123626 8636781 4486845 9290920 ACCRUED WAGES, TAXES, AND WITHHOLDINGS 405947 OTHER LIABILITIES 304035 RELATED PARTY PAYABLE 350000 LINE OF CREDIT 1000000 2059982 20069929 -62232 -62232 20132161 0 20132161 18247760 39 39 18247721 0 18247721 PART XII, LINE 2D - OTHER ADJUSTMENTS: SUPPLIES PAID BY AMT INC. INCLUDED ON FINANCIAL STATEMENTS 39. 1 HEART OF ILLINOIS UNITED WAY 509 W HIGH ST PEORIA IL 61606 370661504 501(C)(3) 70985 SUPPORT LOCAL HEALTH AND HUMAN CARE PROGRAMS TRINITY HEALTH FOUNDATION 2121 1ST STREET A MOLINE IL 61265 363321751 501(C)(3) 25000 SUPPORT TRINITY EMERGENCY MEDICAL INITIATIVES QUALITY QUEST FOR HEALTH OF ILLINOIS 2116 N SHERIDAN ROAD PEORIA IL 61604 263896631 501(C)(3) 5000 SUPPORT IHI POPULATION HEALTH STUDY BRADLEY UNIVERSITY 1501 W BRADLEY AVE PEORIA IL 61625 370661494 501(C)(3) 8462 DONATION OF 8 AED'S ST JUDE CHILDREN'S RESEARCH HOSPITAL 4722 N SHERIDAN ROAD PEORIA IL 61614 351044585 501(C)(3) 5250 SUPPORT CHILDREN'S MEDICAL INITIATIVES OSF HEALTHCARE JUMP TRADING SIMULATION & EDUCATION CENTER 1306 N BERKELEY AVE PEORIA IL 61603 370813229 501(C)(3) 9311 SUPPORT EMS TRAINING AND EDUCATION INITIATIVES 6 X X X X 0 0 0 0 0 0 0 1 0 ANDREW RAND CEO/BOARD MEMBER 245359 0 70000 0 0 0 8567 0 5235 0 329161 0 0 0 TIM BECCUE CFO 121489 0 18200 0 0 0 7296 0 14102 0 161087 0 0 0 PART I, LINE 7 BASED ON EMPLOYEE PERFORMANCE FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PROVIDES A COPY OF FORM 990 TO THE BOARD FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE OF THE CONFLICT OF INTEREST POLICY. EACH BOARD MEMBER ANNUALLY COMPLETES A CONFLICT OF INTEREST STATEMENT. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD REVIEWS COMPARABLE DATA AND THE SPECIFIC PERFORMANCE OF THE EXECUTIVE DIRECTOR IN DETERMINING COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 24E COMMUNICATIONS: PROGRAM SERVICE EXPENSES 191,129. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 191,129. ADMINISTRATIVE EXPENSES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 149,396. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 149,396. BANK SERVICE CHARGES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 140,407. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 140,407. FRANCHISE FEES: PROGRAM SERVICE EXPENSES 96,160. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,160. SPONSORSHIPS: PROGRAM SERVICE EXPENSES 77,711. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 77,711. BIOHAZARD DISPOSAL: PROGRAM SERVICE EXPENSES 73,798. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,798. COMMUNITY PARTNERING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 69,688. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,688. UNIFORMS: PROGRAM SERVICE EXPENSES 67,610. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,610. DUES & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 21,741. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,741. CUSTOMER SURVEY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 7,559. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,559. FORM 990, PART XII, LINE 2C THE PROCESS FOR OVERSEEING THE AUDIT AND SELECTING AN INDEPENDENT AUDITOR HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART IV, LINE 12 AND PART XII, LINE 2C THE ORGANIZATION HAS AUDITED FINANCIAL STATEMENTS THAT ARE PREPARED ON A CONSOLIDATED BASIS. FORM 5471, SCHEDULE B NO U.S. PERSONS OWNED (AT ANY TIME DURING THE ANNUAL ACCOUNTING PERIOD), DIRECTLY OR INDIRECTLY, 10% OR MORE IN VALUE OR VOTE OF ANY CLASS OF THE CORPORATION'S OUTSTANDING STOCK. FORM 5471, SCHEDULE O, PART II, SECTION C & D THE TAXPAYER NEITHER ACQUIRED NOR DISPOSED OF STOCK IN THE FOREIGN CORPORATION, CATALYST INSURANCE, LTD., DURING THE YEAR ENDED MAY 31, 2014. THE TAXPAYER IS CLASSIFIED AS A CATEGORY 3 FILER FOR FORM 5471 PURPOSES BECAUSE THE TAXPAYER IS TREATED AS A U.S. SHAREHOLDER OF CATALYST INSURANCE, LTD. UNDER INTERNAL REVENUE CODE SEC. 953(C), AND IS THEREFORE REQUIRED TO COMPLETE SCHEDULE O. FORM 5471, SCHEDULE O, PART II, SECTION F CATALYST INSURANCE, LTD. FILED FORM 1120-F, U.S. INCOME TAX RETURN OF A FOREIGN CORPORATION, FOR ITS TAX YEARS ENDED MAY 31, 2011, 2012, AND 2013. CATALYST INSURANCE, LTD. HAD NO TAXABLE INCOME AND NO TAX DUE ON THE RETURN. ADDITIONAL FILING REQUIREMENTS FOR CATEGORY 3 FILERS: 1. THE AMOUNT AND TYPE OF ANY INDEBTEDNESS THE FOREIGN CORPORATION HAS WITH THE RELATED PERSONS DESCRIBED IN REGULATION SEC. 1.6046-1(B)(11). N/A - THERE IS NO INDEBTEDNESS BETWEEN CATALYST INSURANCE, LTD. AND RELATED PARTIES. 2. THE NAME, ADDRESS, INDENTIFYING NUMBER AND NUMBER OF SHARES SUBSCRIBED TO BY EACH SUBSCRIBER TO THE FOREIGN CORPORATION'S STOCK. N/A - THERE ARE CURRENTLY NO SUBSCRIPTIONS FOR ANY OF CATALYST INSURANCE, LTD.'S STOCK. ADVANCED MEDICAL TRANSPORT INC 1718 N STERLING AVE PEORIA IL 61604 260312211 CHARITABLE, SCIENTIFIC, AND EDUCATIONAL TO FUTHER PHMMS AND AMT OF IOWA IL 501(C)(3) 9 0 ADVANCED MEDICAL TRANSPORT OF IOWA 1718 N STERLING AVE PEORIA IL 61604 274133957 PROVIDES AMBULANCE AND PARAMEDIC SERVICES IA 501(C)(3) 9 ADVANCED MEDICAL TRANSPORT INC 0 MIDWEST EMERGENCY MEDICAL SERVICES 1718 N STERLING AVE PEORIA IL 61604 263021862 BILLING AND MANAGEMENT IL ADVANCED MEDICAL TRANSPORT INC C 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 1 1 0 1 0 MIDWEST EMERGENCY MEDICAL SERVICES R 875 INTEREST ON NOTE PAYABLE MIDWEST EMERGENCY MEDICAL SERVICES E 350000 NOTE PAYABLE FROM MEMSI MIDWEST EMERGENCY MEDICAL SERVICES P 343996 MEMSI EXPENSES PAID BY PHMMS MIDWEST EMERGENCY MEDICAL SERVICES O 231864 MEMSI PAYROLL PAID BY PHMMS ADVANCED MEDICAL TRANSPORT OF IOWA P 651175 AMT IOWA EXPENSES PAID BY PHMMS ADVANCED MEDICAL TRANSPORT OF IOWA O 415374 AMT IOWA PAYROLL PAID BY PHMMS ADVANCED MEDICAL TRANSPORT OF IOWA H 75690 PURCHASE OF ASSETS FROM AMT IOWA ADVANCED MEDICAL TRANSPORT OF IOWA G 95799 SALE OF ASSETS TO AMT IOWA