PEORIA HOSPITALS MOBILE MEDICAL SERVICES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PEORIA HOSPITALS MOBILE MEDICAL SERVICES (EIN 37-0999878)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-07-25
- IRS object ID
- 201432069349300538
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-07-25T15:14:04-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 SW ADAMS STE 900 BOX 1835 | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 616561835 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370999878 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEORIA HOSPITALS MOBILE MEDICAL SERVICES | BusinessNameLine1 |
| Business Name Line2 | D/B/A ADV MEDICAL TRANS OF CENTRAL IL | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEOR | BusinessNameControlTxt |
| Phone | 3094946200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 NORTH STERLING AVE | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61604 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GREG SOWARDS | PersonNm |
| Person Title | BOARD CHAIRPERSON | PersonTitleTxt |
| Phone | 3094946200 | PhoneNum |
| Signature | 2014-07-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAMUEL A CIGELNIK | PreparerPersonNm |
| PTIN | P00324762 | PTIN |
| Phone | 3096714500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GREG SOWARDS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 NORTH STERLING AVE | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61604 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,663,089 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ADVANCEDMEDICALTRANSPORT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES AMBULANCE AND PARAMEDIC SERVICES AS WELL AS TRANSPORTATION FOR WHEELCHAIR BOUND INDIVIDUALS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 398 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,994,888 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,286,054 | CYProgramServiceRevenueAmt |
| PY Investment Income | $49,618 | PYInvestmentIncomeAmt |
| CY Investment Income | $91,595 | CYInvestmentIncomeAmt |
| PY Other Revenue | $75,975 | PYOtherRevenueAmt |
| CY Other Revenue | $3,135 | CYOtherRevenueAmt |
| PY Total Revenue | $15,120,481 | PYTotalRevenueAmt |
| CY Total Revenue | $19,380,784 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $80,035 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $169,524 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,091,081 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,105,901 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,455,204 | PYOtherExpensesAmt |
| CY Other Expenses | $6,273,555 | CYOtherExpensesAmt |
| PY Total Expenses | $13,626,320 | PYTotalExpensesAmt |
| CY Total Expenses | $17,548,980 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,494,161 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,831,804 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,751,270 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,804,522 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,998,213 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,219,661 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,753,057 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,584,861 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION PROVIDES AMBULANCE AND PARAMEDIC SERVICES AS WELL AS TRANSPORTATION FOR WHEELCHAIR BOUND INDIVIDUALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,839,560 | ExpenseAmt |
| Grant | $169,524 | GrantAmt |
| Revenue | $18,819,301 | RevenueAmt |
| Desc | 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 AND WHEELCHAIR TRANSPORTATION BETWEEN HOSPITALS AND OTHER HEALTHCARE FACILITIES. THE ORGANIZATION PROVIDED 39,563 AMBULANCE TRANSPORTS AND 5,203 WHEELCHAIR TRANSPORTS IN 2013. THE ORGANIZATION PROVIDED $669,564 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 2013 PAYMENTS WERE LESS THAN ESTIMATED COSTS BY APPROXIMATELY $2,115,920. IN ADDITION, THE ORGANIZATION PROVIDED OTHER COMMUNITY BENEFIT ACTIVITIES THROUGHOUT THE YEAR THAT WOULD HAVE COST $287,064. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $404,278 | ExpenseAmt |
| Revenue | $404,278 | RevenueAmt |
| Desc | 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. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $156,216 | ExpenseAmt |
| Revenue | $65,610 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES MULTIPLE PARAMEDIC AND EMT BASIC TRAINING PROGRAMS EACH YEAR. THESE PROGRAMS ARE AVAILABLE TO EXTERNAL AGENCIES AND EMPLOYEES OF THE ORGANIZATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $14,400,054 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 398 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREW RAND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3094946200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 N STERLING AVE | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61604 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| ANDREW RAND | |||||||
| CEO/BOARD MEMBER | 12.50 | 37.50 | Yes (X) | Yes (X) | $293,153 | $0 | $14,194 |
| SHERRY THOMPSON | |||||||
| BOARD VICE-CHAIRPERSON | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROBERT ANDERSON | |||||||
| BOARD TREASURER/SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JAMES BROWN | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GREG SOWARDS | |||||||
| BOARD CHAIRPERSON | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JAY WILLSHER | |||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JEANINE SPAIN | |||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TOM GERACI | |||||||
| VP OF OPERATIONS | 12.50 | 37.50 | Yes (X) | Yes (X) | $81,102 | $0 | $4,557 |
| JERRY KOLB | |||||||
| FORMER CFO | 12.50 | 37.50 | Yes (X) | Yes (X) | $76,583 | $0 | $0 |
| TIM BECCUE | |||||||
| CFO | 12.50 | 37.50 | Yes (X) | Yes (X) | $32,433 | $0 | $1,622 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $483,271 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $20,373 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| TRANSPORT REVENUE | 621990 | $17,818,956 | $17,818,956 |
| SUBSIDY REVENUE | 621990 | $997,210 | $997,210 |
| TRINITY REVENUE | 621990 | $404,278 | $404,278 |
| TUITION REVENUE | 611600 | $65,610 | $65,610 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,286,054 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,546 | TotalRevenueColumnAmt |
| Exclusion | $95,546 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $278,354 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $282,305 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$3,951 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,951 | TotalRevenueColumnAmt |
| Exclusion | -$3,951 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $3,135 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,135 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,135 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,380,784 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,289,189 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $91,595 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,524 | TotalAmt |
| Program Services | $169,524 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,271 | TotalAmt |
| Program Services | $416,007 | ProgramServicesAmt |
| Management And General | $67,264 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,895,130 | TotalAmt |
| Program Services | $7,657,038 | ProgramServicesAmt |
| Management And General | $1,238,092 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,579 | TotalAmt |
| Program Services | $230,335 | ProgramServicesAmt |
| Management And General | $37,244 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,278 | TotalAmt |
| Program Services | $578,706 | ProgramServicesAmt |
| Management And General | $87,572 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $793,643 | TotalAmt |
| Program Services | $680,282 | ProgramServicesAmt |
| Management And General | $113,361 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,510 | TotalAmt |
| Management And General | $143,510 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,450 | TotalAmt |
| Management And General | $61,450 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,514 | TotalAmt |
| Management And General | $97,514 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,604 | TotalAmt |
| Management And General | $39,604 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,489 | TotalAmt |
| Program Services | $144,762 | ProgramServicesAmt |
| Management And General | $37,727 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,168 | TotalAmt |
| Program Services | $122,576 | ProgramServicesAmt |
| Management And General | $72,592 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,344 | TotalAmt |
| Program Services | $71,965 | ProgramServicesAmt |
| Management And General | $86,379 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,128 | TotalAmt |
| Management And General | $32,128 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$346,547 | TotalAmt |
| Program Services | -$346,547 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,401,580 | TotalAmt |
| Program Services | $1,053,583 | ProgramServicesAmt |
| Management And General | $347,997 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $848,736 | TotalAmt |
| Program Services | $692,923 | ProgramServicesAmt |
| Management And General | $155,813 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $1,034,609 | $845,838 | $188,771 |
| FUEL | $780,553 | $780,553 | |
| REPAIRS & MAINTENANCE | $650,458 | $585,942 | $64,516 |
| RECRUITING, EDUCATION & | $259,087 | $259,087 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $734,872 | TotalAmt |
| Program Services | $457,480 | ProgramServicesAmt |
| Management And General | $277,392 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,548,980 | TotalAmt |
| Program Services | $14,400,054 | ProgramServicesAmt |
| Management And General | $3,148,926 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,316,382 | BOYAmt |
| EOY | $1,559,562 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,115,431 | BOYAmt |
| EOY | $2,354,192 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,461,643 | BOYAmt |
| EOY | $3,030,040 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,357,258 | BOYAmt |
| EOY | $1,553,017 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $623,334 | BOYAmt |
| EOY | $808,541 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,757,652 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,294,482 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,841,222 | BOYAmt |
| EOY | $8,463,170 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,000 | BOYAmt |
| EOY | $36,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,751,270 | BOYAmt |
| EOY | $17,804,522 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $281,721 | BOYAmt |
| EOY | $543,366 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $714,290 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,533,333 | BOYAmt |
| EOY | $1,433,333 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,183,159 | BOYAmt |
| EOY | $1,528,672 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,998,213 | BOYAmt |
| EOY | $4,219,661 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,753,057 | BOYAmt |
| EOY | $13,584,861 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,753,057 | BOYAmt |
| EOY | $13,584,861 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,751,270 | BOYAmt |
| EOY | $17,804,522 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,831,804 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,643,491 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,367,597 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,322,500 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,994,888 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,286,054 | CurrentTaxYearAmt |
| Total | $75,614,530 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,643,491 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,367,597 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,322,500 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,994,888 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,286,054 | CurrentTaxYearAmt |
| Total | $75,614,530 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $75,614,530 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,778 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,930 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,086 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $51,420 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $95,546 | CurrentTaxYearAmt |
| Total | $198,760 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,778 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,930 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,086 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $51,420 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $95,546 | CurrentTaxYearAmt |
| Total | $198,760 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,526 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,821 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,590 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $74,173 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$816 | CurrentTaxYearAmt |
| Total | $203,294 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,696,795 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,423,348 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,395,176 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,120,481 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,380,784 | CurrentTaxYearAmt |
| Total | $76,016,584 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99470 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98920 | PublicSupportPY509Pct |
| Investment Income CY | 0.00260 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00220 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $233,789 | OtherCostOrOtherBasisAmt |
| Book Value | $233,789 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,993,910 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,043,128 | DepreciationAmt |
| Book Value | $3,950,782 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,529,953 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,251,354 | DepreciationAmt |
| Book Value | $4,278,599 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,463,170 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED WAGES, TAXES, AND WITHHOLDINGS | $786,847 |
| OTHER LIABILITIES | $391,825 |
| RELATED PARTY PAYABLE | $350,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,528,672 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $19,380,784 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,380,784 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,380,784 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,548,980 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $17,548,980 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $17,548,980 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| HEART OF ILLINOIS UNITED WAY | |||||||
| 509 W HIGH ST | PEORIA | IL | 61606 | 370661504 | 501(C)(3) | $48,437 | SUPPORT LOCAL HEALTH AND HUMAN CARE PROGRAMS |
| PEORIA PROMISE FOUNDATION | |||||||
| 620 W GLEN AVE | PEORIA | IL | 61614 | 134353454 | 501(C)(3) | $22,500 | TUITION ASSISTANCE TO QUALIFIED PEORIA AREA STUDENTS |
| OSF ST FRANCIS MEDICAL CENTER | |||||||
| 530 NE GLEN OAK AVE | PEORIA | IL | 61637 | 370662569 | 501(C)(3) | $50,000 | MEMORIAL TO OSF CANCER CENTER |
| PEORIA RIVERFRONT MUSEUM | |||||||
| 222 SW WASHINGTON ST | PEORIA | IL | 61602 | 272920016 | 501(C)(3) | $10,625 | SUPPORT MUSEUM AND MUSEUM ACTIVITIES |
| ISAA | |||||||
| PO BOX 464 | CANTON | IL | 61520 | 232881612 | 501(C)(3) | $8,250 | SUPPORT EDUCATION AND ADVOCACY OF ILLINOIS EMS |
| BOYS & GIRLS CLUB | |||||||
| 806 E KANSAS | PEORIA | IL | 61603 | 370800010 | 501(C)(3) | $7,500 | SUPPORT UNDERPRIVILEGED BOYS AND GIRLS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 7 | Total501c3OrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW RAND | PersonNm |
| Title | CEO/BOARD MEMBER | TitleTxt |
| Base Compensation Filing Org | $229,153 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $64,000 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $11,500 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $2,694 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $307,347 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | BASED ON EMPLOYEE PERFORMANCE | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | ONE MEMBER IS ELECTED BY THE COMMUNITY ADVISORY BOARD OF THE SAINT FRANCIS MEDICAL CENTER, ONE MEMBER IS ELECTED BY THE BOARD OF TRUSTEES OF THE UNITYPOINT HEALTH METHODIST HOSPITAL, AND ONE MEMBER IS ELECTED BY THE BOARD OF TRUSTEES OF UNITYPOINT HEALTH PROCTOR HOSPITAL. |
| 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 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, 2013. 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, 2010, 2011, AND 2012. THE COMPANY 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 0 | ADVANCED MEDICAL TRANSPORT INC |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST EMERGENCY MEDICAL SERVICES | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1718 N STERLING AVE | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61604 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263021862 | EIN |
| Primary Activities | BILLING AND MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANCED MEDICAL TRANSPORT INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (1) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| A | $1,408 | INTEREST ON NOTE PAYABLE |
| MIDWEST EMERGENCY MEDICAL SERVICES | ||
| R | $783 | INTEREST ON NOTE PAYABLE |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| D | $0 | NOTE PAYABLE TO AMT IOWA |
| MIDWEST EMERGENCY MEDICAL SERVICES | ||
| E | $350,000 | NOTE PAYABLE FROM MEMSI |
| MIDWEST EMERGENCY MEDICAL SERVICES | ||
| P | $289,354 | MEMSI EXPENSES PAID BY PHMMS |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| P | $606,939 | AMT IOWA EXPENSES PAID BY PHMMS |
| MIDWEST EMERGENCY MEDICAL SERVICES | ||
| O | $221,684 | MEMSI PAYROLL PAID BY PHMMS |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| O | $426,739 | AMT IOWA PAYROLL PAID BY PHMMS |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| H | $161,323 | PURCHASE OF ASSETS FROM AMT IOWA |
| ADVANCED MEDICAL TRANSPORT OF IOWA | ||
| G | $111,220 | SALE OF ASSETS TO AMT IOWA |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V, LINE 2 | FormAndLineReferenceDesc |
| Explanation | A NOTE PAYABLE TO ADVANCED MEDICAL TRANSPORT OF IOWA IS SHOWN ON SCHEDULE R WITH A ZERO BALANCE. THE LOAN BALANCE AT THE BEGINNING OF THE YEAR WAS $440,076. THE LOAN BALANCE AT THE END OF THE YEAR WAS $0, AS THE BALANCE WAS PAID IN FULL DURING THE YEAR. | ExplanationTxt |
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