2013-05-15T09:45:29-05:00 2012-06-30 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2011-07-01 311428613 OHIO MEDICAL TRANSPORTATION INC OHIO 6147348001 2827 WEST DUBLIN-GRANVILLE ROAD COLUMBUS OH 43235 DAN SKIDMORE 6147348001 2013-05-14 1 BERNIE OSTROWSKI P00366367 6148493000 2011 2016-02-24 21:20:13Z MEDFLIGHT MEDFLIGHT OF OHIO ROD CRANE 2827 WEST DUBLIN-GRANVILLE ROAD COLUMBUS OH 43235 38922742 0 X WWW.MEDFLIGHT.COM X 1995 OH TO CARE FOR AND TRANSPORT THE CRITICALLY ILL AND INJURED. MEDFLIGHT OPERATES 8 MEDICAL HELICOPTERS AND 3 MOBILE INTENSIVE CARE UNITS (MICU'S). 5 5 214 5 1455 -173 79351 24582 33294254 38265807 400029 272176 166070 130524 33939704 38693089 522726 3700 0 0 11825354 12071347 0 0 0 19547938 23635557 31896018 35710604 2043686 2982485 18531906 21535245 3288795 3102717 15243111 18432528 X TO CARE FOR AND TRANSPORT THE CRITICALLY ILL AND INJURED. 0 0 33931807 38355615 SEE SCHEDULE ODURING THE FISCAL YEAR ENDED 6/30/12, MEDFLIGHT TRANSPORTED 3,439 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 1,929 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. THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER MEDFLIGHT'S CHARITY CARE POLICY AGGREGATED APPROXIMATELY 4,690,547 IN 2012. 33931807 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 1 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 1 1 1 1 0 0 1 43 0 1 214 1 1 1 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 OH X DAN SKIDMORE 6147348001 2827 WEST DUBLIN-GRANVILLE ROAD COLUMBUS OH 43235 LARRY ANSTINE 1.00 X X 0 0 0 LARRY THORNHILL 1.00 X X 0 0 0 CHERIE GUSTER RN 1.00 X 0 0 0 VINSON YATES 1.00 X 0 0 0 GAIL MARSH 1.00 X X 0 0 0 ROD CRANE 40.00 X 261254 0 86572 CHARLES ANSLEY 40.00 X 160271 0 46764 TOM ALLENSTEIN 40.00 X 201456 0 39156 LINDA HINES 40.00 X 121963 0 17917 DALE MUETZEL 36.00 X 113617 0 7097 CHERYL SHOOP 40.00 X 103592 0 6732 LINDA BALDWIN 36.00 X 124545 0 12455 KATHLEEN MONTGOMERY 36.00 X 118591 0 21354 1205289 0 238047 5 0 1 0 OMNIFLIGHT HELICOPTERS INC 16415 ADDISON RD ADDISON TX 75001 HELICOPTER LEASE 6510327 METRO AVIATION INC PO BOX 7008 SHREVEPORT LA 71137 HELICOPTER LEASE 4046563 AIR METHODS CORPS PO BOX 172892 DENVER CO 80217 HELICOPTER LEASE 1238804 MIAMI VALLEY HOSPITAL 1 WYOMING ST DAYTON OH 45409 BACKUP HELICOPTER SERVICE 584340 CHASE EQUIPMENT FINANCE CORPORATE PROCESSING DEPT 0993 COLUMBUS OH 43271 HELICOPTER LEASE 567241 14 24582 24582 PATIENT SERVICES 621990 34409038 34409038 SERVICE FEE-GRMH 621990 1795500 1795500 SERVICE FEE-OSUH 621990 1138860 1138860 SERVICE FEE-AGMC 621990 795680 795680 SERVICE FEE-MT. CARMEL 621990 62500 62500 64229 64229 38265807 93435 93435 110687 20386 110646 0 41 20386 20427 20390 37 241750 55998 0 119007 241750 -63009 178741 178741 K-1 INCOME 900099 50925 50925 SALE OF JET FUEL 900099 39224 39224 MED GEAR SALES 453220 1455 1455 18493 18493 110097 38693089 38355615 1455 311437 3700 3700 819623 819623 8831560 8550099 281461 456386 450718 5668 1251124 1222007 29117 712654 641389 71265 73028 73028 58950 58950 40369 40369 315702 284132 31570 309793 309793 1324218 1191796 132422 167016 150314 16702 406034 365431 40603 123269 98615 24654 53814 53814 11 11 761436 685292 76144 327928 295135 32793 HELICOPTER 14376296 14376296 PROVISION FOR BAD DEBT 4690547 4690547 AMBULANCE & MICU EXPS 261805 261805 STAFF EXPENSES 197251 197251 148090 103662 44428 35710604 33931807 1778797 0 3625309 3334326 5352553 4814512 2725751 5084940 371036 342058 318242 384806 11048251 6931890 3673361 4116361 524360 450661 988945 1560492 952349 1447089 18531906 21535245 3068795 2733092 0 149625 220000 220000 3288795 3102717 X 15243111 18432528 15243111 18432528 18531906 21535245 X 2982485 206932 X X 0 1 1 X 0 X 30819 30231 85559 79351 21582 247542 35628871 35062237 32238523 33294254 38201578 174425463 150196 150196 35809886 35092468 32324082 33373605 38223160 174823201 0 2571290 2571290 2571290 2571290 172251911 374420 293986 259022 172874 224508 1324810 374420 293986 259022 172874 224508 1324810 1850 2377 1202 1630 1455 8514 157714 97175 101373 312038 175871 844171 36343870 35486006 32685679 33860147 38624994 177000696 0.97320 0.98840 0.00750 0.00760 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 112245 112245 1395683 601479 794204 1829017 904537 924480 4743043 3014664 1728379 2968263 2411210 557053 4116361 MEDCARE 1507664 F COOP HEALTH PARTNER 52828 F 1560492 OTHER RECEIVABLES 1447089 1447089 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FEDERAL INCOME TAX - THE INTERNAL REVENUE SERVICE HAS RULED THAT THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION, AND HAS CONCLUDED THAT AS OF JUNE 30, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2009. X X X 0 1 0 0 0 0 0 0 0 ROD CRANE 214686 0 41763 0 4805 0 75777 0 10795 0 347826 0 0 0 CHARLES ANSLEY 140782 0 19489 0 0 0 32151 0 14613 0 207035 0 0 0 TOM ALLENSTEIN 181967 0 19489 0 0 0 29332 0 9824 0 240612 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING THE YEAR: CHARLES ANSLEY - $20,174 TOM ALLENSTEIN - $6,118 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS TWO CLASS A MEMBERS WHO EACH APPOINT TWO BOARD MEMBERS AS WELL AS ONE CLASS B MEMBER WHO APPOINTS ONE BOARD MEMBER FOR A TOTAL OF FIVE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE CEOS OF THE TWO CLASS A MEMBERS APPROVE CERTAIN DECISIONS OF MEDFLIGHT. 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 11 THE DIRECTOR OF FINANCIAL SERVICES AND THE CFO REVIEW THE 990, AND 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 COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. AFTER THE CONFLICT OF INTEREST STATEMENTS ARE COMPLETED, THEY ARE REVIEWED BY LINDA HINES TO DETERMINE IF THERE ARE ANY CONFLICTS. DURING THE ACCOUNTS PAYABLE PROCESS THE DIRECTOR OF FINANCIAL SERVICES REVIEWS THE CHECK REGISTER FOR ANY DISTRIBUTIONS TO DISQUALIFIED PERSONS. THESE DISTRIBUTIONS ARE THEN REVIEWED AND DETERMINED BY THE CFO. 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 DETERMING 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 2011. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -349,979. EQUITY SHARE IN MEDCARE RECORDED ON THE FINANCIAL STATEMENTS 556,911. TOTAL TO FORM 990, PART XI, LINE 5: 206,932. PART XII, LINE 2C THE ENTIRE BOARD OVERSEES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE CENTER FOR MEDICAL TRANSPORT RESEARCH LLC 2865 W DUBLIN GRANVILLE RD SUITE 90 COLUMBUS OH 43235 264265085 MEDICAL TRANSPORTATION RESEARCH OH -54609 9831 OHIO MEDICAL TRANSPORTATION INC CEMS OF OHIO INC (MEDCARE) 3699 PARAGON DR COLUMBUS OH 43228 800249549 MEDICAL TRANSPORTATION OH 501(C)(3) LINE 9 OHIO MEDICAL TRANSPORTATION INC 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CEMS OF OHIO INC A 74386 RENTAL CONTRACT