PEORIA HOSPITALS MOBILE MEDICAL SERVICES: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
PEORIA HOSPITALS MOBILE MEDICAL SERVICES (EIN 37-0999878)
Tax period
2010-01-01 to 2010-12-31
Filed
2012-03-29
IRS object ID
201230899349300418
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2012-03-29T09:13:03-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1301 SW ADAMS STREET BOX 1835AddressLine1
CityPEORIACity
StateILState
ZIP Code616561835ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370999878EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PEORIA HOSPITALS MOBILE MEDICAL SERVICESBusinessNameLine1
Business Name Line2D/B/A ADV MEDICAL TRANS OF CENTRAL ILBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlPEORNameControl
Phone3094946200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11718 NORTH STERLING AVEAddressLine1
CityPEORIACity
StateILState
ZIP Code61604ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDON WHITEName
TitleBOARD CHAIRMANTitle
Phone3094946200Phone
Date Signed2012-03-29DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLINDA MARTINName
Phone3096714500Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDON WHITENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11718 NORTH STERLING AVEAddressLine1
CityPEORIACity
StateILState
ZIP Code61604ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14423348GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.ADVANCEDMEDICALTRANSPORT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION PROVIDES AMBULANCE AND PARAMEDIC SERVICES AS WELL AS TRANSPORTATION FOR WHEELCHAIR BOUND INDIVIDUALS.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees343TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11643491ProgramServiceRevenuePriorYear
Program Service Revenue CY14367597ProgramServiceRevenueCY
Investment Income Prior Year9719InvestmentIncomePriorYear
Investment Income Current Year21575InvestmentIncomeCurrentYear
Other Revenue Prior Year43585OtherRevenuePriorYear
Other Revenue Current Year34176OtherRevenueCurrentYear
Total Revenue Prior Year11696795TotalRevenuePriorYear
Total Revenue Current Year14423348TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year52635GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY194945GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6913692SalariesEtcPriorYear
Salaries Etc Current Year8629950SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3809896OtherExpensePriorYear
Other Expenses Current Year4547220OtherExpensesCurrentYear
Total Expenses Prior Year10776223TotalExpensesPriorYear
Total Expenses Current Year13372115TotalExpensesCurrentYear
Revenues Less Expenses Prior Year920572RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1051233RevenuesLessExpensesCY
Total Assets BOY9443435TotalAssetsBOY
Total Assets EOY11617252TotalAssetsEOY
Total Liabilities BOY1231589TotalLiabilitiesBOY
Total Liabilities EOY2341753TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8211846NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9275499NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION PROVIDES AMBULANCE AND PARAMEDIC SERVICES AS WELL AS TRANSPORTATION FOR WHEELCHAIR BOUND INDIVIDUALS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11198188Expense
Grants94945Grants
Revenue14367597Revenue
DescriptionTHE ORGANIZATION PROVIDES AMBULANCE AND PARAMEDIC SERVICES AS WELL AS TRANSPORTATION FOR WHEELCHAIR BOUND INDIVIDUALS (32,867 AMBULANCE TRANSPORTS IN 2010 AND 1,417 WHEELCHAIR TRANSPORTS IN 2010).Description
Total Program Service Expense11198188TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees343NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ANDREW RANDBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3094946200TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11718 N STERLINGAddressLine1
CityPEORIACity
StateILState
ZIP Code61604ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
SUE WOZNIAK
BOARD MEMBER1.00X000
ROBERT KLAUS
BOARD MEMBER1.00X000
JEFF FICK
BOARD SECRETARY/TREASURER1.00X000X
LARRY CLORE
BOARD VICE CHAIRMAN1.00X000X
DEBBIE SIMON
BOARD MEMBER1.00X000
DON WHITE
BOARD CHAIRMAN1.00X000X
CAROL SHIELDS
BOARD MEMBER1.00X000
CAROL LINETT
BOARD MEMBER1.00X000
ANDREW RAND
EXECUTIVE DIRECTOR40.00260913011476XX
SHEROLYN TOLLIVER
ASST. EXECUTIVE DIRECTOR40.00113177010362XX
JERRY KOLB
CONTROLLER40.001223600780XX
FieldValueIRS element (for citing)
Total Reportable Comp From Org496450TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation22618TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
AMBULANCE6219101396793013967930
SERVICE CONTRACTS621990337691337691
WHEELCHAIR6219906197661976
FieldValueIRS element (for citing)
Total Program Service Revenue14367597TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column18930TotalRevenueColumn
Exclusion$18,930ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other2645Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other2645Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2645TotalRevenueColumn
Exclusion$2,645ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUSDescription
Business Code900099BusinessCode
Total Revenue Column34176TotalRevenueColumn
Exclusion$34,176ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue34176TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14423348TotalRevenueColumn
Related Or Exempt Function Income14367597RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$55,751ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total194945Total
Program Services194945ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total496450Total
Management And General496450ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6836852Total
Program Services6364382ProgramServices
Management And General472470ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total175097Total
Management And General175097ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total549485Total
Program Services480056ProgramServices
Management And General69429ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total572066Total
Program Services501596ProgramServices
Management And General70470ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total34825Total
Management And General34825ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total37875Total
Management And General37875ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total18933Total
Management And General18933ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total109407Total
Program Services109407ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total55553Total
Program Services51549ProgramServices
Management And General4004ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total9088Total
Management And General9088ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total953291Total
Program Services781123ProgramServices
Management And General172168ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total584943Total
Program Services478121ProgramServices
Management And General106822ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES61461852122793391
FUEL515415515415
REPAIR & MAINTENANCE39409834368650412
RECRUITING2569052512055700
COMMUNICATIONS17480614411030696

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total787463Total
Program Services461366ProgramServices
Management And General326097ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13372115Total
Program Services11198188ProgramServices
Management And General2173927ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY450BOY
EOY450EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3013924BOY
EOY837049EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2454704BOY
EOY2773384EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY144976BOY
EOY681539EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY178959BOY
EOY187605EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14668591LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7567366LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3614422BOY
EOY7101225EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY36000BOY
EOY36000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9443435BOY
EOY11617252EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY190338BOY
EOY691035EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY177827BOY
EOY623471EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY863424BOY
EOY1027247EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1231589BOY
EOY2341753EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8211846BOY
EOY9275499EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8211846BOY
EOY9275499EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9443435BOY
EOY11617252EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1051233ReconcilationRevenueExpenses
Reconcilation Other Changes12420ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9441290CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9492020CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10534120CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11643491CurrentTaxYearMinus1Year
Current Tax Year14367597CurrentTaxYear
Total55478518Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9441290CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9492020CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10534120CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11643491CurrentTaxYearMinus1Year
Current Tax Year14367597CurrentTaxYear
Total55478518Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50955478518PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years47438CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years68867CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years46980CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7778CurrentTaxYearMinus1Year
Current Tax Year18930CurrentTaxYear
Total189993Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years47438CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years68867CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years46980CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7778CurrentTaxYearMinus1Year
Current Tax Year18930CurrentTaxYear
Total189993Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years216196CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years497023CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years299532CurrentTaxYearMinus2Years
Total1012751Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years135441CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years85872CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years76553CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year45526CurrentTaxYearMinus1Year
Current Tax Year36821CurrentTaxYear
Total380213Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9840365CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10143782CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10957185CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11696795CurrentTaxYearMinus1Year
Current Tax Year14423348CurrentTaxYear
Total57061475Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97230PublicSupportPercentage509
Prior Year Support Percentage0.96980PriorYearSupportPercentage
Investment Income Percentage0.00330InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00330PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis150000InvestmentCostOrOtherBasis
Book Value150000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis3681641InvestmentCostOrOtherBasis
Depreciation643971Depreciation
Book Value3037670BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis81389InvestmentCostOrOtherBasis
Depreciation78906Depreciation
Book Value2483BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis10755561InvestmentCostOrOtherBasis
Depreciation6844489Depreciation
Book Value3911072BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7101225TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED WAGES, TAXES AND WITHHOLDINGS$554,422
OTHER LIABILITIES$322,825
RELATED PARTY PAYABLE$150,000
FieldValueIRS element (for citing)
Total Of Amounts1027247TotalOfAmounts

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
ADVANCED MEDICAL TRANSPORT OF IOWA
1718 N STERLING AVEPEORIAIL61604274133957100000ADVANCED MEDICAL TRANSPORT OF IOWA IS A NEW ORGANIZATION THAT WAS FORMED IN DECEMBER OF 2010. THE CONTRIBUTION WILL BE USED TO ASSIST IN BEGINNING THEIR OPERATIONS.
HEARTLAND COMMUNITY HEALTH CLINIC
1701 W GARDEN STPEORIAIL6160537127079425000CHARITABLE CONTRIBUTION
BRADLEY UNIVERSITY
1501 W BRADLEY AVEPEORIAIL6162537066149425000CHARITABLE CONTRIBUTION
QUEST CHARTER ACADEMY PEORIA PUBLIC SCHOOL DISTRICT 150
2503 N UNIVERSITYPEORIAIL616043760017595000CHARITABLE CONTRIBUTION
COMMUNITY FOUNDATION OF GREATER DUBUQUE
700 LOCUST STREET SUITE 195DUBUQUEIA520014215266145000CHARITABLE CONTRIBUTION
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations5TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonANDREW RANDNamePerson
Base Compensation Filing Org206913BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org54000BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org8256DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org3220NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org272389TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 7ReturnReference
ExplanationBASED ON EMPLOYEE PERFORMANCEExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 7ATWO MEMBERS ARE ELECTED BY THE COMMUNITY ADVISORY BOARD OF THE SAINT FRANCIS MEDICAL CENTER, TWO MEMBERS ARE ELECTED BY THE BOARD OF DIRECTORS OF THE METHODIST MEDICAL CENTER OF ILLINOIS, AND TWO MEMBERS ARE ELECTED BY THE BOARD OF TRUSTEES OF PROCTOR COMMUNITY HOSPITAL.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION PROVIDES A COPY OF FORM 990 TO THE BOARD FOR REVIEW PRIOR TO FILING.
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 12C
THE BOARD REVIEWS COMPARABLE DATA AND THE SPECIFIC PERFORMANCE OF THE EXECUTIVE DIRECTOR IN DETERMINING COMPENSATION.FORM 990, PART VI, SECTION B, LINE 15A
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 12,420.FORM 990, PART XI, LINE 5:
THE PROCESS FOR OVERSEEING THE AUDIT AND SELECTING AN INDEPENDENT AUDITOR HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XI, LINE 2(C)
THE ORGANIZATION HAS AUDITED FINANCIAL STATEMENTS THAT ARE PREPARED ON A CONSOLIDATED BASIS.FORM 990 PART IV LINE 12 AND PART XI LINE 2C

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrg
ADVANCED MEDICAL TRANSPORT INC
1718 N STERLING AVEPEORIAIL61604260312211CHARITABLE, SCIENTIFIC, AND EDUCATIONAL TO FUTHER PHMMSIL501(C)(3)90
ADVANCED MEDICAL TRANSPORT OF IOWA
1718 N STERLING AVEPEORIAIL61604274133957PROVIDES AMBULANCE AND PARAMEDIC SERVICESIA501(C)(3)90

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MIDWEST EMERGENCY MEDICAL SERVICESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11718 N STERLING AVEAddressLine1
CityPEORIACity
StateILState
ZIP Code61604ZIPCode
FieldValueIRS element (for citing)
EIN263021862EIN
Primary ActivityBILLING AND MANAGEMENTPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ADVANCED MEDICAL TRANSPORTBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org1SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MEMSI
M86720SHARED EXPENSES REPORTED ON 1120
MEMSI
N353722SHARED EXPENSES REPORTED ON 1120
ADVANCED MEDICAL TRANSPORT OF IOWA
B100000CONTRIBUTION REPORTED ON 990
ADVANCED MEDICAL TRANSPORT OF IOWA
D440076FMV OF ASSETS SOLD
ADVANCED MEDICAL TRANSPORT OF IOWA
F468315FMV OF ASSETS SOLD
ADVANCED MEDICAL TRANSPORT OF IOWA
M34286ACCOUNTS PAYABLE ADJUSTMENT
ADVANCED MEDICAL TRANSPORT OF IOWA
N18183ACCOUNTS PAYABLE ADJUSTMENT

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