NEBRASKA PEDIATRIC PRACTICE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NEBRASKA PEDIATRIC PRACTICE INC (EIN 26-3064869)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-03
- IRS object ID
- 202223079349301752
- Schema version
- 2021v4.2
- 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 | 2022-11-03T09:57:36-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1212 NORTH 96TH STREET SUITE 300 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68114 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263064869 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEBRASKA PEDIATRIC PRACTICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEBR | BusinessNameControlTxt |
| Phone | 4029556795 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8200 DODGE STREET | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68114 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALAN TINGLY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4029556795 | PhoneNum |
| Signature | 2022-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALAN | PersonFirstNm |
| Person Last | TINGLY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PHIL BARTLETT | PreparerPersonNm |
| PTIN | P01299075 | PTIN |
| Phone | 4023481450 | PhoneNum |
| Preparation | 2022-11-01 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S SPECIALTY PHYSICIANS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALAN TINGLY MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8200 DODGE STREET | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68114 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $95,753,000 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHILDRENSOMAHA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE OTO DEVELOP, PROMOTE AND MAKE AVAILABLE TO CHILDREN FROM OMAHA, NEBRASKA, AND THE REGION, CLINICAL SERVICES AND OTHER RELATED PROGRAMS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 278 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $994,475 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,214,827 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $56,932,040 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $93,061,206 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,057 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,134,931 | PYOtherRevenueAmt |
| CY Other Revenue | $467,910 | CYOtherRevenueAmt |
| PY Total Revenue | $82,061,446 | PYTotalRevenueAmt |
| CY Total Revenue | $95,753,000 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,365,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $79,979,391 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $92,623,635 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $49,278,815 | PYOtherExpensesAmt |
| CY Other Expenses | $55,016,963 | CYOtherExpensesAmt |
| PY Total Expenses | $129,258,206 | PYTotalExpensesAmt |
| CY Total Expenses | $149,005,598 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$47,196,760 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$53,252,598 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,723,929 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,693,690 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,723,929 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,693,690 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEUDULE OPROVIDES A MEANS WHEREBY THE RESOURCES, EXPERTISE, AND KNOWLEDGE OF THE PEDIATRIC SPECIALTY PHYSICIANS CAN BE MARSHALED TO DEVELOP, PROMOTE, AND MAKE AVAILABLE TO PATIENTS FROM OMAHA, NE AND THE SURROUNDING AREA, PEDIATRIC, ACADEMIC, AND CLINICAL SERVICES AND OTHER PROGRAMS AND ACTIVITIES RELATED THERETO IN ORDER TO ACHIEVE THE PHYSICIANS' COMMON GOALS OF IMPROVING THE MANNER, PROCESS, ENVIRONMENT, ACCESSIBILITY, TIMING AND OTHER FACTORS INVOLVED IN THE DELIVERY OF PEDIATRIC, ACADEMIC, AND CLINICAL SERVICES IN ORDER TO ADVANCE THE HEALTH OF THE CHILDREN WITHIN THE REGION. PROMOTE AND SUPPORT EDUCATIONAL AND TEACHING PROGRAMS IN CHILDREN'S HEALTH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $142,288,626 | ExpenseAmt |
| Grant | $1,365,000 | GrantAmt |
| Revenue | $93,529,116 | RevenueAmt |
| Desc | TO PROVIDE COLLECTIVE RESOURCES, EXPERTISE AND KNOWLEDGE OF PEDIATRIC SPECIALTY PHYSICIANS TO DEVELOP, PROMOTE AND MAKE AVAILABLE TO CHILDREN FROM OMAHA, NE AND THE SURROUNDING REGION, CLINICAL SERVICES AND OTHER RELATED PROGRAMS AND ACTIVITIES TO ACHIEVE THE GOALS OF IMPROVING THE MANNER, PROCESS, ENVIRONMENT, ACCESSIBILITY, TIMING AND OTHER FACTORS INVOLVED IN THE DELIVERY OF PEDIATRIC CLINICAL SERVICES TO ADVANCE THE HEALTH OF THE CHILDREN OF THE REGION. | Desc |
| Total Program Service Expenses | $142,288,626 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| 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 | 0 | 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 | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 278 | 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMY HATCHER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4029556795 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8200 DODGE STREET | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68114 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CHANDA CHACON | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| AMY HATCHER | ||||||||
| SECRETARY/TREASURER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHRISTOPHER MALONEY MD | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRADLEY BRITIGAN MD | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL MCGLADE | ||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| NICOLE BIRGE MD | ||||||||
| MEMBER/MEDICAL DIRECTOR | 40.00 | 0.00 | Yes (X) | $604,549 | $0 | $34,800 | ||
| KARI SIMONSEN MD | ||||||||
| MEMBER/ PEDIATRICIAN IN CHIEF | 40.00 | 0.00 | Yes (X) | $578,845 | $0 | $34,800 | ||
| JESSICA GOELLER MD | ||||||||
| VICE CHAIRMAN/MEDICAL DIRECTOR | 40.00 | 0.00 | Yes (X) | $544,071 | $0 | $34,800 | Yes (X) | |
| SUZANNE HANEY MD | ||||||||
| MEMBER/DIVISION CHIEF | 40.00 | 0.00 | Yes (X) | $262,608 | $0 | $26,626 | ||
| LISA SIECZKOWSKI MD | ||||||||
| CHAIRMAN/PHYSICIAN | 40.00 | 0.00 | Yes (X) | $269,112 | $0 | $27,873 | Yes (X) | |
| SIDHARTH MAHAPATRA MD | ||||||||
| MEMBER/PHYSICIAN | 40.00 | 0.00 | Yes (X) | $422,693 | $0 | $23,403 | ||
| ALAN TINGLEY MD | ||||||||
| PRESIDENT | 40.00 | 0.00 | $583,564 | $0 | $34,800 | Yes (X) | ||
| JAMES HAMMEL MD | ||||||||
| DIVISION CHIEF | 40.00 | 0.00 | $1,855,613 | $0 | $34,800 | Yes (X) | ||
| ALI IBRAHIMIYE MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,263,229 | $0 | $34,800 | Yes (X) | ||
| JOHN MAKARI MD | ||||||||
| DIVISION CHIEF | 40.00 | 0.00 | $962,216 | $0 | $34,800 | Yes (X) | ||
| ABDALLA ZARROUG MD | ||||||||
| DIVISION CHIEF | 40.00 | 0.00 | $839,107 | $0 | $34,800 | Yes (X) | ||
| CAMILLE HANCOCK FRIESEN MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $833,036 | $0 | $34,800 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $9,018,643 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $391,102 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 229 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHILDREN'S HOSPITAL & MEDICAL CENTER | |||||
| 8200 DODGE STREET | OMAHA | NE | 68114 | OPERATING AGREEMENT | $53,252,598 |
| UNIV OF NE MEDICAL CENTER | |||||
| 988145 NEBRASKA MEDICAL CENTER | OMAHA | NE | 68198 | OPERATING AGREEMENT | $5,249,483 |
| COMPHEALTH MEDICAL STAFFING | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | TEMPORARY STAFFING | $2,014,612 |
| LOCUMTENENSCOM | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | TEMPORARY STAFFING | $1,441,511 |
| ADVANCED RADIOLOGY OF GRAND ISLAND | |||||
| 527 N DIERS AVE STE 3 | GRAND ISLAND | NE | 68803 | RADIOLOGY SERVICES | $541,667 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,138,000 | GovernmentGrantsAmt |
| All Other Contributions | $1,076,827 | AllOtherContributionsAmt |
| Total Contributions | $2,214,827 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE RE | 621110 | $65,914,992 | $65,914,992 |
| CONTRACT REVENUE | 621110 | $22,178,351 | $22,178,351 |
| FACILITY FEE AND UPL R | 621110 | $3,666,906 | $3,666,906 |
| FICA INCOME | 621110 | $655,654 | $655,654 |
| OTHER DEPARTMENTAL REV | 621110 | $645,303 | $645,303 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $93,061,206 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,057 | TotalRevenueColumnAmt |
| Exclusion | $9,057 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | $457,888 | $457,888 |
| EDUCATIONAL DEPARTMENT | 541900 | $10,022 | $10,022 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $467,910 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,753,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $93,529,116 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,057 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,365,000 | TotalAmt |
| Program Services | $1,365,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,265,441 | TotalAmt |
| Program Services | $3,265,441 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,774,612 | TotalAmt |
| Program Services | $76,287,385 | ProgramServicesAmt |
| Management And General | $487,227 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,304,113 | TotalAmt |
| Program Services | $6,268,318 | ProgramServicesAmt |
| Management And General | $35,795 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,874,721 | TotalAmt |
| Program Services | $2,851,086 | ProgramServicesAmt |
| Management And General | $23,635 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,404,748 | TotalAmt |
| Program Services | $3,386,884 | ProgramServicesAmt |
| Management And General | $17,864 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,867,082 | TotalAmt |
| Program Services | $856,300 | ProgramServicesAmt |
| Management And General | $3,010,782 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,378 | TotalAmt |
| Program Services | $14,623 | ProgramServicesAmt |
| Management And General | $755 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,414 | TotalAmt |
| Management And General | $80,414 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,444,262 | TotalAmt |
| Program Services | $33,413,814 | ProgramServicesAmt |
| Management And General | $2,030,448 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250 | TotalAmt |
| Program Services | $250 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,437,261 | TotalAmt |
| Program Services | $3,368,905 | ProgramServicesAmt |
| Management And General | $68,356 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,029,861 | TotalAmt |
| Program Services | $4,009,305 | ProgramServicesAmt |
| Management And General | $20,556 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,798 | TotalAmt |
| Program Services | $378,878 | ProgramServicesAmt |
| Management And General | $920 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,045,694 | TotalAmt |
| Program Services | $917,032 | ProgramServicesAmt |
| Management And General | $128,662 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DEVELOPMENT SUPPORT EXP | $4,209,483 | $3,971,757 | $237,726 |
| OTHER EXPENSES | $1,462,359 | $906,910 | $555,449 |
| DUES & SUBSCRIPTIONS | $614,674 | $596,551 | $18,123 |
| PROF. BUSINESS EXPENSE | $397,490 | $397,230 | $260 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,957 | TotalAmt |
| Program Services | $32,957 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,005,598 | TotalAmt |
| Program Services | $142,288,626 | ProgramServicesAmt |
| Management And General | $6,716,972 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,556,556 | BOYAmt |
| EOY | $2,859,555 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,770,101 | BOYAmt |
| EOY | $15,165,817 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,549 | BOYAmt |
| EOY | $105,242 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,607 | BOYAmt |
| EOY | $413,779 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $51,362 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,389 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,973 | BOYAmt |
| EOY | $20,973 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,143 | BOYAmt |
| EOY | $1,128,324 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,723,929 | BOYAmt |
| EOY | $19,693,690 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,101,684 | BOYAmt |
| EOY | $18,199,940 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,245 | BOYAmt |
| EOY | $1,493,750 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,723,929 | BOYAmt |
| EOY | $19,693,690 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,723,929 | BOYAmt |
| EOY | $19,693,690 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$53,252,598 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $53,252,598 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART-I LINE-12A | FormAndLineReferenceDesc |
| Explanation | NEBRASKA PEDIATRIC PRACTICE, INC. (NPP) HAS CHECKED LINE 3 ON THE SCHEDULE A AS THE IRS HAS RECOGNIZED NPP AS A TAX-EXEMPT HOSPITAL UNDER IRC SECTION 501(C)(3) AND AS A HOSPITAL UNDER IRC SECTION 170(B)(1)(A)(III). ALTHOUGH NPP HAS BEEN RECOGNIZED AS A HOSPITAL, IT DOES NOT OWN OR OPERATE A LICENSED HOSPITAL. THEREFORE, A SCHEDULE H HAS APPROPRIATELY NOT BEEN COMPLETED. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,362 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,389 | DepreciationAmt |
| Book Value | $20,973 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,973 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET RIGHT-OF-USE ASSETS | Desc |
| Book Value | $1,128,324 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,128,324 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $333,336 |
| CURRENT PORTION OF LEASE PAYMENT | $198,052 |
| LEASE/LOAN OBLIGATION | $962,362 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,493,750 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $94,388,000 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $94,388,000 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,365,000 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,365,000 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $95,753,000 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $147,640,598 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $147,640,598 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,365,000 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,365,000 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $149,005,598 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | CHILDREN'S SPECIALTY PHYSICIANS (CSP) RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. AS OF DECEMBER 31, 2021 AND 2020, CSP HAS NOT RECORDED ANY AMOUNTS RELATED TO UNCERTAIN TAX POSITIONS OR ANY ACCRUED INTEREST AND PENALTIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CHARITY CARE |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CHARITY CARE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | CHARITY CARE | GrantTypeTxt |
| Recipient | 4777 | RecipientCnt |
| Non Cash Assistance | $1,365,000 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | CHARITY CARE | NonCashAssistanceDesc |
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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES HAMMEL MD | ||||||||||||||
| DIVISION CHIEF | $1,469,965 | $0 | $384,636 | $0 | $1,012 | $0 | $34,800 | $0 | $0 | $0 | $1,890,413 | $0 | $0 | $0 |
| ALI IBRAHIMIYE MD | ||||||||||||||
| PHYSICIAN | $1,184,023 | $0 | $78,546 | $0 | $660 | $0 | $34,800 | $0 | $0 | $0 | $1,298,029 | $0 | $0 | $0 |
| JOHN MAKARI MD | ||||||||||||||
| DIVISION CHIEF | $621,403 | $0 | $339,295 | $0 | $1,518 | $0 | $34,800 | $0 | $0 | $0 | $997,016 | $0 | $0 | $0 |
| ABDALLA ZARROUG MD | ||||||||||||||
| DIVISION CHIEF | $803,369 | $0 | $34,830 | $0 | $908 | $0 | $34,800 | $0 | $0 | $0 | $873,907 | $0 | $0 | $0 |
| CAMILLE HANCOCK FRIESEN MD | ||||||||||||||
| PHYSICIAN | $804,225 | $0 | $4,156 | $0 | $24,655 | $0 | $34,800 | $0 | $0 | $0 | $867,836 | $0 | $0 | $0 |
| NICOLE BIRGE MD | ||||||||||||||
| MEMBER/MEDICAL DIRECTOR | $463,374 | $0 | $140,704 | $0 | $471 | $0 | $34,800 | $0 | $0 | $0 | $639,349 | $0 | $0 | $0 |
| ALAN TINGLEY MD | ||||||||||||||
| PRESIDENT | $519,923 | $0 | $60,116 | $0 | $3,525 | $0 | $34,800 | $0 | $0 | $0 | $618,364 | $0 | $0 | $0 |
| KARI SIMONSEN MD | ||||||||||||||
| MEMBER/ PEDIATRICIAN IN CHIEF | $573,194 | $0 | $4,795 | $0 | $856 | $0 | $34,800 | $0 | $0 | $0 | $613,645 | $0 | $0 | $0 |
| JESSICA GOELLER MD | ||||||||||||||
| VICE CHAIRMAN/MEDICAL DIRECTOR | $482,802 | $0 | $60,592 | $0 | $677 | $0 | $34,800 | $0 | $0 | $0 | $578,871 | $0 | $0 | $0 |
| SIDHARTH MAHAPATRA MD | ||||||||||||||
| MEMBER/PHYSICIAN | $378,455 | $0 | $44,075 | $0 | $163 | $0 | $23,403 | $0 | $0 | $0 | $446,096 | $0 | $0 | $0 |
| LISA SIECZKOWSKI MD | ||||||||||||||
| CHAIRMAN/PHYSICIAN | $237,449 | $0 | $31,365 | $0 | $298 | $0 | $27,873 | $0 | $0 | $0 | $296,985 | $0 | $0 | $0 |
| SUZANNE HANEY MD | ||||||||||||||
| MEMBER/DIVISION CHIEF | $235,483 | $0 | $26,645 | $0 | $480 | $0 | $26,626 | $0 | $0 | $0 | $289,234 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION FOR THE PRESIDENT IS PAID BY THE HOSPITAL MEMBER, CHILDREN'S HOSPITAL & MEDICAL CENTER, AN UNRELATED ORGANIZATION, FOR SERVICES PROVIDED TO THE NEBRASKA PEDIATRIC PRACTICE INC. SEE SCHEDULE O NARRATIVE PART VI, LINE 15A FOR ADDITIONAL INFORMATION ON THE PRESIDENT'S COMPENSATION ARRANGEMENT AND REVIEW PROCESS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THERE ARE TWO MEMBERS OF THE CORPORATION: (A) THE BOARD OF REGENTS OF THE UNIVERSITY OF NEBRASKA, A PUBLIC BODY CORPORATE, ACTING ON BEHALF OF THE UNIVERSITY OF NEBRASKA MEDICAL CENTER, COLLEGE OF MEDICINE (THE ACADEMIC MEMBER), AND (B) CHILDREN'S HOSPITAL AND MEDICAL CENTER, A NEBRASKA NONPROFIT CORPORATION (THE HOSPITAL MEMBER). THE MEMBERS RETAIN THE FOLLOWING POWERS, NOTWITHSTANDING ANYTHING IN THESE BYLAWS TO THE CONTRARY: A. IN ACCORDANCE WITH THE BYLAWS, EACH MEMBER SHALL HAVE THE POWER TO APPOINT THREE DIRECTORS OF THE CORPORATION UNDER ARTICLE III, SECTION 2, AND REMOVE DIRECTORS OF THE CORPORATION UNDER ARTICLE II, SECTION 13. B. IN ACCORDANCE WITH THE BYLAWS, THE MEMBERS SHALL HAVE THE POWER TO APPROVE THE APPOINTMENT AND REMOVAL OF THE PERSON DESIGNATED BY THE BOARD OF DIRECTORS AS THE CORPORATION'S EXECUTIVE DIRECTOR. C. THE MEMBERS SHALL HAVE THE POWER TO APPROVE OR REFUSE TO APPROVE ANY AMENDMENT TO THE CORPORATION'S ARTICLE OF INCORPORATION OR THE BYLAWS, OR ANY ACTION REQUIRED TO BE SUBMITTED TO AND APPROVED BY VOTING MEMBERS OF A NONPROFIT CORPORATION UNDER THE NEBRASKA NONPROFIT CORPORATION ACT. D. THE FOLLOWING ACTIONS OF THE CORPORATION ARE SUBJECT TO APPROVAL BY THE MEMBERS: (I) ADOPTION AND ADJUSTMENT OF THE CORPORATIONS ANNUAL BUDGET, CAPITAL EXPENDITURES BUDGET, MISSION STATEMENT, OPERATING PLAN, AND LONG-RANGE PLAN; (II) INCURRENCE OF ASSUMPTION OF DEBT (OTHER THAN TRADE PAYABLES); (III) ADOPTION OF COMPENSATION PLANS; (IV) ASSESSMENTS AGAINST MEMBERS; (V) REORGANIZATION AND TRANSFER OF ASSETS OUTSIDE OF THE ORDINARY COURSE OF BUSINESS; (VI) ESTABLISHMENT OF A SUBSIDIARY OR PARTICIPATION AS A SHAREHOLDER, PARTNER, OR MEMBER OF ANY OTHER ENTITY; (VII) ANY DISTRIBUTION OF CAPITAL OR NET EARNINGS OF THE CORPORATION; AND (VIII) ADMISSION OF NEW MEMBERS. THE AFFIRMATIVE APPROVAL OF BOTH MEMBERS IS NECESSARY FOR ANY ACTION OF THE MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | SEE NARRATIVE ABOVE FOR FORM 990, PART VI, SECTION A, LINE 6. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE NARRATIVE ABOVE FOR FORM 990, PART VI, SECTION A, LINE 6. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WILL BE DISTRIBUTED VIA DIRECTOR'S DESK TO THE NEBRASKA PEDIATRIC BOARD MEMBERS FOR REVIEW PRIOR TO FILING WITH THE IRS. HOWEVER, SINCE ALL COMPENSATION INFORMATION WILL BE REDACTED FROM THE COPY SENT TO THE BOARD, THE TAXPAYER IS ANSWERING THE QUESTION ON PART VI, LINE 11A "NO". |
| FORM 990, PART VI, SECTION B, LINE 12C | AN OFFICER, DIRECTOR, COMMITTEE MEMBER (INCLUDING A MEMBER OF A BOARD-APPOINTED SUBCOMMITTEE), OR KEY EMPLOYEE SHALL BE DEEMED TO HAVE A POTENTIAL CONFLICT OF INTEREST IN A CONTRACT OR TRANSACTION IF HE OR SHE, OR A FAMILY MEMBER, IS A PARTY (OR ONE OF THE PARTIES) CONTRACTING OR DEALING WITH THE CORPORATION. ANY DUALITY OF INTEREST OR POTENTIAL CONFLICT OF INTEREST ON THE PART OF ANY OFFICER, DIRECTOR, COMMITTEE MEMBER, OR KEY EMPLOYEE SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD WHENEVER IT ARISES, OR WHENEVER IT INVOLVES A MATTER OF BOARD ACTION. ANY OFFICER, DIRECTOR, OR KEY EMPLOYEE HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. THE MAJORITY OF THE BOARD WHO HAVE NO CONFLICT OF INTEREST IN THE TRANSACTION COMPRISE A QUORUM FOR THE PURPOSE OF TAKING ACTION ON A CONFLICT TRANSACTION. IN CASES IN WHICH AN OFFICER, DIRECTOR, COMMITTEE MEMBER, OR KEY EMPLOYEE HAS A FINANCIAL INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN, AT THE DISCRETION OF THE BOARD: A. THE INTERESTED PERSON MAY BE REQUIRED TO LEAVE THE MEETING FOR THE GENERAL DISCUSSION OF THE MATTER AND THE BOARD VOTE; AND/OR B. A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED AGREEMENT OR TRANSACTION. ALL OFFICERS, DIRECTORS, COMMITTEE MEMBERS, AND KEY EMPLOYEES SHALL REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE UPON INITIALLY AFFILIATING WITH THE CORPORATION. EACH YEAR AT AN ESTABLISHED TIME, A DESIGNATED PERSON WITHIN THE CORPORATION SHALL SEND DISCLOSURE QUESTIONNAIRES AND A COPY OF THE CONFLICT OF INTEREST POLICY TO ALL OFFICERS, DIRECTORS, COMMITTEE MEMBERS, AND KEY EMPLOYEES OF THE CORPORATION. PERSONS RECEIVING QUESTIONNAIRES SHALL RESPOND WITH RESPECT TO POTENTIAL CONFLICTS OF INTEREST. PERSONS REQUIRED TO REPORT WHO HAVE NOT RETURNED QUESTIONNAIRES WILL BE CONTACTED AND FOLLOW-UP WILL CONTINUE ON A REGULAR BASIS UNTIL ALL QUESTIONNAIRES HAVE BEEN RETURNED. THE INFORMATION WILL BE USED TO IDENTIFY AND RESOLVE POTENTIAL CONFLICTS OF INTEREST. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE CONFLICT REVIEW COMMITTEE, UNLESS, IN ITS DISCRETION, IT CHOOSES TO APPOINT A COMMITTEE COMPOSED OF DIRECTORS OF THE BOARD TO ASSUME THE RESPONSIBILITY. WHEN QUESTIONNAIRES OR INTERIM DISCLOSURES OF ANY OF THE MEMBERS OF THE CONFLICT REVIEW COMMITTEE ARE BEING REVIEWED, THE MEMBER BEING REVIEWED SHALL BE EXCUSED FROM THE COMMITTEE'S DELIBERATIONS AND ACTION. THE CONFLICT COMMITTEE SHALL: 1. REVIEW ALL ANNUAL DISCLOSURE QUESTIONNAIRES AND INTERIM SUPPLEMENTAL DISCLOSURES FROM PERSONS SUBJECT TO THE POLICY. 2. IDENTIFY POTENTIAL CONFLICTS OF INTEREST DISCLOSED IN SUCH ANNUAL DISCLOSURE QUESTIONNAIRES OR INTERIM DISCLOSURES. 3. INVESTIGATE AND EVALUATE, AS NECESSARY, POTENTIAL CONFLICTS OF INTEREST, CONTAINED IN ANNUAL DISCLOSURE QUESTIONNAIRES OR INTERIM DISCLOSURES. 4. REPORT FINDINGS, CONCLUSION, AND RECOMMENDATION OF THE BOARD FOR DECISION AND ACTION. 5. IDENTIFY, BY POSITION OR CAPACITY, THE EMPLOYEES OR OTHER INDIVIDUALS TO BE DESIGNATED AS KEY EMPLOYEES SUBJECT TO DISCLOSURE REQUIREMENTS UNDER THE POLICY. 6. KEEP COMPLETE RECORDS OF ITS ACTIVITIES. 7. PERIODICALLY REVIEW THE POLICY AND ITS IMPLEMENTATION PROCEDURES TO DETERMINE WHETHER ANY CHANGES ARE REQUIRED. |
| FORM 990, PART VI, SECTION B, LINE 15 | EACH YEAR, SULLIVAN COTTER, AN INDEPENDENT COMPANY, CONDUCTS A MARKET ANALYSIS OF EXECUTIVE COMPENSATION, TO SUBSTANTIATE THE COMPENSATION OF THE EXECUTIVE DIRECTOR OF THE CORPORATION. THE EXECUTIVE DIRECTOR IS EMPLOYED BY THE HOSPITAL MEMBER AND LEASED TO THE CORPORATION. THIS INFORMATION IS PRESENTED TO THE HOSPITAL MEMBER'S COMPENSATION COMMITTEE FOR REVIEW. EXECUTIVE BASE SALARIES ARE TARGETED FOR THE 50TH PERCENTILE OF THE MARKET. SULLIVAN COTTER ISSUES A REASONABLENESS OPINION LETTER REGARDING THE APPROPRIATENESS OF EXECUTIVE PAY LEVELS. THE HOSPITAL MEMBER'S BOARD OF DIRECTORS RECEIVES A REPORT FROM THE COMMITTEE. OFFICERS OF THE CORPORATION ARE NOT COMPENSATED FOR SERVING AS OFFICERS. THE CORPORATION'S MANAGEMENT MAKES A DETERMINATION ANNUALLY OF WHETHER THERE ARE ANY EMPLOYEES WHO FALL WITHIN THE DEFINITION OF KEY EMPLOYEE FOR PURPOSES OF FILING THE 990. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | STAFF SUPPORT: PROGRAM SERVICE EXPENSES 19,375,415. MANAGEMENT AND GENERAL EXPENSES 1,782,065. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,157,480. CONTRACT PROVIDERS: PROGRAM SERVICE EXPENSES 8,446,474. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,446,474. BILLING FEES: PROGRAM SERVICE EXPENSES 4,880,180. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,880,180. RECRUITMENT: PROGRAM SERVICE EXPENSES 179,426. MANAGEMENT AND GENERAL EXPENSES 51,319. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 230,745. CONSULTING: PROGRAM SERVICE EXPENSES 17,944. MANAGEMENT AND GENERAL EXPENSES 47,858. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,802. OTHER: PROGRAM SERVICE EXPENSES 514,375. MANAGEMENT AND GENERAL EXPENSES 149,206. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 663,581. |
| FORM 990, PART XI, LINE 9: | SUPPORT FROM HOSPITAL MEMBER FOR CASH FLOW - REASON FOR NO FUND BALANCE AT AT END OF YEAR 53,252,598. |
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