Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | 31,465 | 31,465 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 980,741 | 1,735,702 | 2,716,443 | |||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 0 | 0 | 0 | 980,741 | 1,767,167 | 2,747,908 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 2,747,908 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 0 | 0 | 0 | 980,741 | 1,767,167 | 2,747,908 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | 0 | ||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 0 | 0 | ||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | 0 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 0 | 0 | 0 | 980,741 | 1,767,167 | 2,747,908 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, LINE 1A | GOVERNING BODY AND MANAGEMENT EACH CURRENT DIRECTOR OF REID HEALTH AMBULANCE, INC. IS APPOINTED AS A DIRECTOR BY THE BOARD OF DIRECTORS OF REID HOSPITAL AND HEALTH CARE SERVICES, INC., WHICH IS COMPRISED PRIMARILY OF INDEPENDENT DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIP REID HEALTH AMBULANCE, INC. OFFICER, CRAIG KINYON, AND REID HEALTH AMBULANCE, INC. BOARD MEMBER, JOHN MCBRIDE, HAVE A BUSINESS RELATIONSHIP THROUGH WEST END BANK. MORE SPECIFICALLY, MR. KINYON SERVES ON THE BOARD OF DIRECTORS OF WEST END BANK, AND MR. MCBRIDE IS THE BOARD CHAIRMAN OF WEST END BANK. THERE WERE NO TRANSACTIONS BETWEEN REID HEALTH AMBULANCE, INC. AND WEST END BANK DURING 2020. |
| FORM 990, PART VI, SECTION A, LINE 6 | GOVERNING BODY AND MANAGEMENT THE CORPORATION'S ONLY MEMBER IS REID HOSPITAL AND HEALTH CARE SERVICES, INC., WHICH IS A 501(C)(3) ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | GOVERNING BODY AND MANAGEMENT REID HOSPITAL AND HEALTH CARE SERVICES, INC., AS THE CORPORATE MEMBER OF REID HEALTH AMBULANCE,INC. MAY APPOINT AND REMOVE ANY DIRECTOR OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | GOVERNING BODY AND MANAGEMENT PURSUANT TO THE BYLAWS OF REID HEALTH AMBULANCE, INC., REID HOSPITAL AND HEALTH CARE SERVICES, INC. (AS THE CORPORATE MEMBER OF REID HEALTH AMBULANCE, INC.) HOLDS CERTAIN RESERVED POWERS, WHICH MEANS THAT THE BOARD OF DIRECTORS OF REID HEALTH AMBULANCE, INC. CANNOT EXERCISE THESE POWERS WITHOUT THE APPROVAL OF REID HOSPITAL AND HEALTH CARE SERVICES, INC. |
| FORM 990, PART VI, SECTION B, LINE 11B | POLICIES THIS FORM 990 WAS PREPARED AND REVIEWED BY AN OUTSIDE ACCOUNTING FIRM AND LEGAL COUNSEL BEFORE BEING PRESENTED TO MANAGEMENT FOR REVIEW. FOLLOWING MANAGEMENT'S REVIEW, THE FORM 990 WAS PRESENTED TO THE BOARD FOR FINAL REVIEW AND APPROVAL BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | POLICIES EVERY YEAR ALL KEY EMPLOYEES, OFFICERS, AND DIRECTORS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST RELATING TO REID HEALTH AMBULANCE, INC. AND ITS AFFILIATES. THIS INFORMATION IS REVIEWED BY THE ORGANIZATION'S ADMINISTRATIVE STAFF AND INTERNAL AUDITOR. DURING THE YEAR EACH EMPLOYEE AND OFFICER IS REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST WHEN IT OCCURS. THE BOARD OF DIRECTORS IS ASKED IF THERE ARE ANY CONFLICTS OF INTEREST ISSUES BEFORE EACH AND EVERY BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | POLICIES THE BOARD OF DIRECTORS OF REID HOSPITAL AND HEALTH CARE SERVICES, INC. HAS ULTIMATE AUTHORITY AND RESPONSIBILITY FOR THE COMPENSATION OF REID HEALTH AMBULANCE, INC. DIRECTORS, OFFICERS, AND KEY EMPLOYEES. THIS RESPONSIBILITY EXTENDS TO QUALITY OF SERVICES RENDERED, QUALITY OF ITS STAFF, QUALITY OF ITS LEADERSHIP AND OTHER FINANCIAL, LEGAL, ETHICAL, AND OPERATIONAL CONSIDERATIONS. AS A SERVICE TEAM PROVIDING HUMAN SERVICES, REID HEALTH AMBULANCE, INC.'S PEOPLE (LEADERSHIP, STAFF, EMPLOYEES, AND VOLUNTEERS) REPRESENT THE SINGLE MOST IMPORTANT ASSET POSSESSED BY THE ORGANIZATION. MORE THAN ANY OTHER FACTOR (BUILDINGS, EQUIPMENT, TECHNOLOGY, ETC.), THE QUALITY OF HUMAN RESOURCES DETERMINES THE QUALITY OF SERVICES ULTIMATELY PROVIDED TO ITS PATIENTS AND FAMILIES. THIS COMMITMENT TO QUALITY AND THE STEWARDSHIP OF HUMAN RESOURCES SERVES AS THE FOUNDATION FOR REID HEALTH AMBULANCE, INC.'S EMPLOYEE RELATIONS POSTURE. THIS APPLIES TO ALL ASPECTS OF EMPLOYEE RELATIONS AT ALL LEVELS. A COMPENSATION PHILOSOPHY THAT ATTRACTS AND RETAINS QUALIFIED, HIGH QUALITY AND COMMITTED EMPLOYEES AT ALL LEVELS IS IN THE BEST INTEREST OF REID HEALTH AMBULANCE, INC. AND THOSE WE SERVE. THE PRESIDENT AND CEO OF REID HOSPITAL AND HEALTH CARE SERVICES, INC., APPOINTED BY REID HOSPITAL AND HEALTH CARE SERVICES, INC.'S GOVERNING BOARD, IS CHARGED WITH THE RESPONSIBILITY FOR DEVELOPING AND ADMINISTERING A COMPENSATION PLAN THAT REFLECTS THE PREVIOUSLY STATED PHILOSOPHY AND MISSION OF REID HEALTH AMBULANCE, INC. THE COMPENSATION PROGRAM ADDRESSES THE FOLLOWING GOALS: 1.) THE ABILITY TO ATTRACT AN INDIVIDUAL WHO IS HIGHLY QUALIFIED BY REASON OF PROFESSIONAL EDUCATION, PAST EXPERIENCE, AND PERSONAL CHARACTERISTICS; 2.) APPROPRIATE RECOGNITION OF PERFORMANCE (POSITIVE OR NEGATIVE); 3.) MAINTENANCE OF MOTIVATION FOR FURTHER PERFORMANCE AT A LEVEL OF EXCELLENCE; 4.) RETENTION (WHEN DESIRED) OF LEADERSHIP EXPERTISE; AND 5.) FAIRNESS. IT IS IMPORTANT TO NOTE THAT THE ISSUE OF FAIRNESS RELATES TO THE COMMUNITY, REID HEALTH AMBULANCE, INC., AND THE INDIVIDUAL. THE GOAL IS NOT TO MINIMIZE COST PER SE, NOR TO MAXIMIZE INCOME AS A SINGLE OBJECTIVE. THE GOAL IS TO ACHIEVE A COMPENSATION PACKAGE THAT IS FAIR TO THE COMMUNITY, FAIR TO REID HEALTH AMBULANCE, INC. AND FAIR TO THE INDIVIDUAL. IN MEETING THIS FAIRNESS OBJECTIVE, EMPLOYEE COMPENSATION IS EVALUATED AND DETERMINED BY THE FOLLOWING FACTORS: MARKET CONDITIONS, GEOGRAPHIC CONSIDERATIONS, THIRD PARTY CONSULTATIONS, LEGAL REVIEW, AND COMPENSATION SURVEYS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DISCLOSURE THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| Software ID: | |
| Software Version: |