2020-07-10T13:34:16-05:00 2019-06-30 KPMG LLP 1212 North 96th Street Suite 300 Omaha NE 68114 990 2018-07-01 911858433 The Nebraska Medical Center % KAREN KERSTETTER NEBR 4025594000 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 STEPHANIE DAUBERT CFO 4025594000 2020-07-10 true DONALD NEAL JR P00798244 4023481450 2020-07-09 199.206.0.5 47006120201925000002 2020-07-10 P B3D39BAE449679459B48A0C30762FBC339990D2C 65CF9D49F64C2267637B54237ED8CC7527705457 2018 2021-01-29 14:40:06Z STEPHANIE DAUBERT 987400 NEBRASKA MEDICAL CENTER OMAHA NE 681987400 1500200068 false X www.nebraskamed.com X 1997 NE Lead the world in transforming lives to create a healthy future for individuals & communities through premier educational programs, innovative research & extraordinary patient care 11 6 10153 577 3878292 0 7800358 17498328 1253062354 1368766590 12892665 21742912 67816814 90875419 1341572191 1498883249 240665456 294860140 0 0 465959505 512000793 26199 17508 791083 576475561 648437522 1283126721 1455315963 58445470 43567286 1438973391 1518041391 564917572 563684281 874055819 954357110 X OUR MISSION IS TO LEAD THE WORLD IN TRANSFORMING LIVES TO CREATE A HEALTHY FUTURE FOR INDIVIDUALS & COMMUNITIES THROUGH PREMIER EDUCATIONAL PROGRAMS, INNOVATIVE RESEARCH, & EXTRAORDINARY PATIENT CARE. false false 239820548 30364737 291658815 ONCOLOGY SERVICE LINE CANCER TREATMENT SERVICES OFFERED BY THE CORPORATION INCLUDE TREATMENT OF LYMPHOMA, LEUKEMIA, MULTIPLE MYELOMA, HEAD AND NECK, BREAST, GASTROINTESTINAL, PANCREATIC, LUNG, GENITOURINARY PROSTATE, GYNECOLOGIC, MELANOMA, BRAIN AND SPINE CANCERS. THE PATIENTS ARE SUPPORTED BY RESEARCH THAT IS CONDUCTED ON THE UNMC CAMPUS. TNMC IS THE ONLY CLINICAL CANCER CENTER IN ITS SERVICE AREA DESIGNATED BY THE NATIONAL CANCER INSTITUTE. IN ADDITION TO TREATMENT AND CLINICAL TRIALS TNMC OFFERS SUPPORT GROUPS, SOCIAL WORK, PAIN MANAGEMENT, FINANCIAL COUNSELORS, SUVIVORSHIP GROUPS, GENETIC COUNSELING, AND A VARIETY OF ADDITIONAL PATIENT SUPPORTIVE SERVICES. IN JUNE 2017, TNMC OPENED THE FRED & PAMELA BUFFETT CANCER CENTER. THE CENTER IS JOINTLY OWNED WITH UNMC AND IS ONE OF THE FOREMOST CANCER RESEARCH AND TREATMENT FACILITIES IN THE COUNTRY. IT IS THE SITE OF INPATIENT HOSPITAL CARE, AS WELL AS OUTPATIENT AND DIAGNOSTIC CARE. UNMC'S FACILITIES, WITHIN THE CENTER, HOUSE RESEARCH LABS. TNMC ALSO OPERATES CANCER TREATMENT LOCATIONS IN BELLEVUE, IN WEST OMAHA AT ITS VILLAGE POINTE LOCATION, AND IN SHENANDOAH, IOWA. IN ADDITION, AS ONE OF THE BUSIEST PROGRAMS IN THE WORLD, THE BONE MARROW TRANSPLANTATION PROGRAM SERVED 189 PATIENTS IN THE YEAR ENDED JUNE 30, 2019. A 24/7 EMERGENCY AND EVALUATION TREATMENT CENTER IS DEDICATED TO CANCER AND TRANSPLANT PATIENTS. THE PROGRAM BENEFITS FROM THE RESEARCH CONDUCTED ON TNMC/UNMC CAMPUS. TNMC WAS ONE OF THE FIRST CANCER CENTERS IN THE NATION TO PARTICIPATE IN CLINICAL TRIALS FOR CAR-T CELL THERAPY. IT WAS FDA-APPROVED IN OCTOBER OF 2017. IN AUGUST OF 2018, THE THERAPY WAS EXTENDED TO LEUKEMIA PATIENTS. IN 2019, MULTIPLE MEYELOMA PATIENTS BEGAN RECEIVING THE THERAPY. DURING FISCAL YEAR 2019, THE ONCOLOGY SERVICE LINE TREATED 122,090 CASES AND 30,464 PATIENT DAYS. APPROXIMATELY 40% OF THE NET REVENUE WAS DERIVED FROM INPATIENT CASES. 160212669 19477740 192589286 HEART AND VASCULAR SERVICE LINE TNMC PROVIDES A WIDE RANGE OF CARDIOVASCULAR SERVICES FROM DIET COUNSELING TO SURGICAL PROCEDURES AND REHABILITATION. TNMC HAS GROWN INTO ONE OF THE BUSIEST CENTERS IN THE COUNTRY FOR VENTRICULAR ASSIST DEVICE OPERATIONS. TNMC HAS BEEN SUCCESSFUL IN RECRUITING PHYSICIANS AND HAS THE ONLY HEART FAILURE SPECIALIST IN THE REGION AND THE ONLY HEART FAILURE PROGRAM CERTIFIED BY THE JOINT COMMISSION IN THE STATE OF NEBRASKA. IN 2016, TNMC BEGAN A LUNG TRANSPLANT PROGRAM AND IN DECEMBER OF 2017 PERFORMED THE STATE'S FIRST EVER HEART AND LUNG TRANSPLANT. IN THE YEAR ENDED JUNE 30, 2019, TNMC PERFORMED 6 LUNG TRANSPLANTS. THE CONGESTIVE HEART FAILURE PROGRAM AND ACUTE MYOCARDIAL INFARCTION PROGRAM EACH RECEIVED THE GOLD SEAL OF APPROVAL CERTIFICATION FROM AMERICAN HEART ASSOCIATION AND ARE CERTIFIED BY THE JOINT COMMISSION. THESE SERVICES ARE THE FIRST AND ONLY NATIONALLY CERTIFIED PROGRAMS OF THEIR KIND IN THE STATE OF NEBRASKA. THE CHEST PAIN CENTER HAS RECEIVED FULL CHEST PAIN CENTER ACCREDITATION FROM THE SOCIETY OF CHEST PAIN CENTERS. THE NEBRASKA MEDICAL CENTER HAS BEEN RECOGNIZED FOR SERVICE EXCELLENCE UNDER THE J.D. POWER AND ASSOCIATES DISTINGUISHED HOSPITAL PROGRAM. TNMC HAS THE ONLY JOINT COMMISSION CERTIFIED DESTINATION THERAPY PROGRAM IN THE STATE AND IS THE ONLY HOSPITAL IN THE REGION PERFORMING ADULT HEART TRANSPLANTS AND IMPLANTING TOTAL ARTIFICIALS HEARTS. TNMC TREATS PATIENTS FROM THE SURROUNDING REGION AND IN THE YEAR ENDED JUNE 30, 2019, 819 OPEN HEART SURGERIES WERE PERFORMED INCLUDING: 35 HEART TRANSPLANTS, AND 44 MECHANICAL CIRCULATORY SYSTEMDEVICE IMPLANTATIONS. 136671158 20950283 176418652 DIGESTIVE DISEASE & KIDNEY SERVICE LINE THE NEBRASKA MEDICAL CENTER (TNMC) OPERATES ONE OF THE BUSIEST SOLID ORGAN TRANSPLANT PROGRAMS IN THE WORLD. IN 2016, TNMC JOINED A SMALL NUMBER OF TRANSPLANT CENTERS WHICH HAVE PROGRAMS FOR TRANSPLANTS OF ALL SOLID ORGANS. TNMC'S LUNG TRANSPLANT PROGRAM DID ITS FIRST TRANSPLANT IN FEBRUARY OF 2016 AND PERFORMED 9 LUNG TRANSPLANTS DURING 2019. IN THE YEAR ENDED JUNE 30, 2019, TNMC PERFORMED 279 SOLID ORGAN TRANSPLANTS INCLUDING LIVER, KIDNEY, HEART, LUNG, PANCREAS AND SMALL BOWEL. THE SUCCESS OF TNMC'S SOLID ORGAN TRANSPLANT PROGRAM IS HEIGHTENED BY RESEARCH DONE ON THE TNMC/UNIVERSITY OF NEBRASKA MEDICAL CENTER (UNMC) CAMPUS. SINCE ITS INCEPTION, PATIENTS HAVE COME TO TNMC FOR SINGLE OR MULTIPLE ORGAN TRANSPLANTS FROM ALL 50 STATES AND FIVE CONTINENTS. DURING FISCAL YEAR 2019, THE SOLID ORGAN TRANSPLANTATION SERVICE LINE INCURRED 110,680 CASES AND 29,458 PATIENT DAYS. APPROXIMATELY 67% OF THE REVENUE WAS DERIVED FROM INPATIENT CASES. ALL OTHER HOSPITAL SERVICES WITH A HISTORY DATING BACK TO 1869, TNMC WAS FORMED WITH THE MERGING OF BISHOP CLARKSON MEMORIAL HOSPITAL AND UNIVERSITY HOSPITAL, AND IN JULY, 2016, UNMC PHYSICIANS OUTPATIENT CLINICS BECAME PART OF THE ORGANIZATION. TNMC CONTINUES TO ATTRACT PATIENTS FROM THE REGION AND AROUND THE WORLD. TNMC IS A TERTIARY/QUATERNARY ACADEMIC MEDICAL CENTER. IT IS THE LARGEST HEALTH CARE FACILITY IN THE STATE WITH MORE THAN 10,000 EMPLOYEES AND OVER 900 PHYSICIANS PRACTICING IN ALL MAJOR SPECIALTIES AND SUB-SPECIALTIES. BESIDES SEVERAL KEY SERVICES IN CARDIOLOGY, ONCOLOGY, TRANSPLANT AND NEUROLOGY, TNMC OFFERS COMPREHENSIVE CARE IN WOMEN'S SERVICES FOR OBSTETRICS AND GYNECOLOGY, AS WELL AS PEDIATRIC SERVICES, ORTHOPEDICS, RHEUMATOLOGY, AND PULMONARY CARE. IN ADDITION, TNMC HAS ONE OF THE REGION'S LARGEST HYPERBARIC MEDICINE PROGRAMS. TNMC IS THE MOST ESTEEMED ACADEMIC HEALTH SYSTEMS IN THE REGION, WITH 809 LICENSED BEDS AT ITS TWO HOSPITALS, NEBRASKA MEDICINE - NEBRASKA MEDICAL CENTER, AND NEBRASKA MEDICINE - BELLEVUE. TNMC ALSO OPERATES 40 SPECIALTY AND PRIMARY CARE CLINICS IN OMAHA AND SURROUNDING AREAS. TNMC ALSO HAS ONE OF THE FEW BIOCONTAINMENT UNITS IN THE UNITED STATES EQUIPPED TO SAFELY CARE FOR THOSE EXPOSED TO HIGHLY CONTAGIOUS, DANGEROUS DISEASES. IN SEPTEMBER, OCTOBER, AND NOVEMBER OF 2014, THE NEBRASKA BIOCONTAINMENT UNIT WAS ACTIVATED TO PROVIDE CARE FOR THREE AMERICANS WHO CONTRACTED THE EBOLA VIRUS DURING THE WEST AFRICA OUTBREAK. THIS RESPONSE RESULTED IN TNMC AND UNMC BECOMING ONE OF THREE DESIGNATED EBOLA TREATMENT AND EDUCATION CENTERS IN THE UNITED STATES. BIOCONTAINMENT UNIT STAFF HAVE CONTINUED TO EDUCATE PUBLIC HEALTH AND INFECTIOUS DISEASE TEAMS FROM AROUND THE WORLD ABOUT SAFE PROTOCOLS AND RESPONSES TO INFECTIOUS DISEASES. IN 2020, TNMC AND UNMC WILL OPEN THE NATIONAL CENTER FOR HEALTH SECURITY AND BIOPREPAREDNESS, AS A PART OF THE DAVIS GLOBAL CENTER FOR ADVANCED INTERPROFESSIONAL LEARNING. THIS CENTER WILL BE THE NEXT STEP IN PROVIDING TRAINING ON HOW TO HANDLE HIGHLY INFECTIOUS DISEASES, ALONG WITH A QUARANTINE FACILITY FOR THOSE POSSIBLY INFECTED BY SUCH DISEASES. TNMC ALSO FURTHER SOLIDIFIED ITS ROLE AS A REGIONAL LEADER IN TRAUMA CARE WITH THE ESTABLISHMENT OF ITS 24/7 TRAUMA PROGRAM IN AUGUST OF 2014. IN FYE 2017, TNMC BECAME CERTIFIED AS A LEVEL I TRAUMA CENTER BY THE AMERICAN COLLEGE OF SURGEONS, EARNING THE GOLD STANDARD FOR TRAUMACARE NATIONWIDE. IN 2016, TNMC OPENED THE LAURITZEN OUTPATIENT CENTER ON ITS CAMPUS. THE CENTER PROVIDES ADDITIONAL SPACE FOR CLINCIAL, RESEARCH AND EDUCATIONAL AREAS. THE FRITCH SURGERY CENTER, AS PART OF THIS NEW BUILDING, PROVIDES OUTPATIENT SURGERY PROCEDURES. THE ORGANIZATION CONTINUES ITS COMMITMENT TO PROVIDING CONVENIENT, COMPREHENSIVE CARE IN OMAHA AND THE SURROUNDING COMMUNITIES. IN JULY 2018, A NEW HEALTH CENTER OPENED AT THE UNIVERSITY OF NEBRASKA - LINCOLN, WITH PRIMARY CARE, COUNSELING, PHARMACY, DENTAL, NUTRITION, LAB AND RADIOLOGY, AMONG OTHER SERVICES, FOR STUDENTS OF THE UNIVERSITY. A NEW DERMATOLOGY CLINIC LOCATED ON THE NEBRASKA MEDICAL CENTER CAMPUS OPENED IN SUMMER 2018. IT ADDRESSES A SHORTAGE OF SERVICES IN THE STATE, WITH NEBRASKA HAVING ONE OF THE LOWEST RATIOS OF DERMATOLOGISTS PER RESIDENTS IN THE COUNTRY. IN DECEMBER 2018, THE FONTENELLE HEALTH CENTER, NOW LOCATED AT 5005 AMES AVENUE, WAS RELOCATED TO BETTER SERVE THE NORTH OMAHA COMMUNITY. THE NEBRASKA MEDICAL CENTER OUTPATIENT PHARMACY, LOCATED IN THE DURHAM OUTPATIENT CENTER WAS RENOVATED AND TRIPLED ITS PREVIOUS SIZE. THE NEW SPACE OPENED IN JANUARY 2019. IN MARCH 2019, CLARKSON FAMILY MEDICINE MOVED ITS PRACTICE TO THE NEWLY OPENED Nebraska Medicine OLD MARKET HEALTH CENTER IN DOWNTOWN OMAHA AT 13TH & LEAVENWORTH STREETS. IN FY19, NEBRASKA MEDICAL CENTER EARNED THE FOLLOWING CERTIFICATIONS: - Magnet designation from the American Nurses Credentialing Center - 14 Nebraska Medicine primary care clinics RECOGNIZED as Level III patient-centered medical homes, the highest quality level of achievement FROM The National Committee for Quality Assurance (NCQA) recognized - full accreditation as a Chest Pain Center with Primary PCI (percutaneous coronary intervention) from the American College of Cardiology - LUNG TRANSPLANT PROGRAM CERTIFICATION FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES - SAFE SLEEP DESIGNATION FROM THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES - Stage 7 designation, the highest certification for electronic medical record adoption, FOR INPATIENT AND OUTPATIENT PRIMARY CARE FROM THE Health Information and Management System Society 175184869 21983534 199936390 NEUROSCIENCES 736282464 202083846 508163447 OTHER PROGRAM SERVICES 911467333 224067380 708099837 1448171708 true true false true false false false true false true true false false false true true false true false false false false false true false false true true true true true true false false false false false false false false true true false false false false true true true true false false true 326 0 true 10153 true true true false false false false false false false false false true false X 11 6 true false false false true true true true true false false true true true true true true true true true false X KAREN KERSTETTER 4025523278 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 X Jeffrey Gold DIRECTOR (CHAIRMAN) 1.0 2.0 X X 0 0 0 Mogens Bay DIRECTOR (VICE CHAIRMAN) 1.0 2.0 X X 0 0 0 Bruce Grewcock DIRECTOR (TREASURER) 1.0 2.0 X X 0 0 0 James Linder SEC THRU 8/18; CEO BEG 8/18 45.0 10.0 X X 348011 0 4170 Nancy Keegan Secretary (Start 10/2/2018) 1.0 2.0 X X 0 0 0 Louis W Burgher Director 40.0 1.0 X 207328 0 9846 James T Canedy Director 1.0 2.0 X 0 0 0 Lance M Fritz Director 1.0 2.0 X 0 0 0 Eric K Keen Director 1.0 2.0 X 0 0 0 James E McClurg Director 1.0 2.0 X 0 0 0 DEBRA ROMBERGER Director 30.0 30.0 X 0 484540 28750 DAVID W MERCER Director 30.0 30.0 X 0 576594 30622 Carl V Smith Director (thru 10/2/2018) 30.0 30.0 X 0 575473 24012 Stephanie R Daubert Officer-NM CFO 45.0 10.0 X 703778 0 36422 Daniel DeBehnke Officer-NM CEO (Thru 8/8/2018) 45.0 10.0 X 1607237 0 20634 Suzanne Nuss Chief Nursing Officer 45.0 10.0 X 453186 0 44836 Cory D Shaw Chief Operations Officer 45.0 10.0 X 757107 0 45298 Harris A Frankel Chief Medical Officer 10.0 45.0 X 0 693408 25944 Theresa Franco Cancer Ctr/Rad/Imag Svcs VP 55.0 0.0 X 410175 0 40457 Julie Lazure Acute Care/Path Svcs VP 55.0 0.0 X 360578 0 41274 Thomas C Macy Amb Clinics/Clinical Prog VP 55.0 0.0 X 383159 0 42055 Matthew E Pospisil Periop Svs/Bellevue VP 55.0 0.0 X 312069 0 42231 Frank V Venuto Chief Human Capital Officer 45.0 10.0 X 500834 0 38773 Michael A Ash EVP/Chief Transformation Ofc 30.0 30.0 X 0 711678 27463 Brian J Lancaster Information Technology VP 30.0 30.0 X 376042 0 19425 Anna Cramer Chief Legal Officer 45.0 10.0 X 299507 0 1005 Chadwick Brough Chief Experience Officer 55.0 0.0 X 475569 0 28653 Frank S Lococo Corp Marketing & Comm VP 55.0 0.0 X 323479 0 476 Isaac J Berg Staff Physician-Primary 55.0 0.0 X 331709 0 24092 Jennifer L Brown Staff Physician-Primary 55.0 0.0 X 354075 0 24405 Jian Zhao Faculty Physician 55.0 0.0 X 332102 0 868 Dennis D Bierle System Clinical Operations COO 0.0 0.0 X 449501 0 15175 8985446 3041693 616886 731 true true false CARDINAL HEALTH INC 5840 F STREET OMAHA NE 68117 MANAGEMENT FEE 7793858 SODEXO CTM INC 7100 COMMERCE WAY STE 280 BRENTWOOD TN 37027 SERVICE CONTRACT 7501256 UNMC 986900 NEBRASKA MEDICAL CENTER OMAHA NE 68198 MEDICAL SERVICES 5366732 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 ONE CHART 5071127 HURON CONSULTING SERVICES LLC 3005 Momentum Place CHICAGO IL 60689 Mgmt Consulting 4037125 57 3622923 13875405 17498328 Oncology & BMT 900099 291658815 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5158889 Pharmacy & Medical Supplies 383677437 383677437 Contracted Services 41560617 41560617 REPAIRS AND MAINTENANCE 8437055 8437055 Affiliated Agreements 1644510 1644510 9556874 9556738 136 1455315963 1448171708 6353172 791083 25118022 17702481 410035753 450611202 4230082 5968920 243856854 264750117 0 0 0 0 3146593 2688492 9169814 9704032 35660767 49816976 1459722363 823389471 624416111 636332892 43962393 47182812 21073262 23978485 0 0 0 0 18303740 9304982 1438973391 1518041391 200273030 212217100 0 0 13835444 16590928 294175509 288199513 0 0 0 0 6009990 10396957 0 0 50623599 36279783 564917572 563684281 X 857744668 934559700 13651902 17138061 2659249 2659349 874055819 954357110 1438973391 1518041391 X 43567286 5722766 31011239 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 85221 85221 false Schedule C, Part II-B, Line 1i LOBBYING EXPENSES THIS AMOUNT CONSISTS OF HOSPITAL LOBBYING DUES PAID THROUGH ANNUAL DUES OF THE NATIONAL AND STATE HOSPITAL ASSOCIATIONS. 819284 X false 17850984 1863357 1457066 1373999 19797408 16989461 1044460 482671 665608 17850984 34360380 451767 792128 18614814 16989461 11773235 22709595 342375 464825 34360380 12403086 529283 386414 1545548 11773235 0.13000 0.87000 false false 14201136 14201136 355077200 132747615 222329585 32066969 12091986 19974983 1042339449 672820956 369518493 16037609 5728914 10308695 636332892 0 THIRD PARTY PAYOR SETTLEMENT 16073035 OTHER CLAIMS PAYABLE 12333285 DUE TO AFFILIATES 6418145 OTHER LONG-TERM LIABILITIES 1455318 36279783 X Schedule D, Part III, Line 4 DESCRIPTION OF ART COLLECTION THE HOSPITAL DISPLAYS ITS COLLECTION OF ART THROUGHOUT THE WALLS OF THE ORGANIZATION. IT IS A COLLECTION OF IMAGES & PORTRAITS TAKEN OF VARIOUS CULTURES AROUND THE WORLD & PORTRAYS THE HOSPITAL'S CULTURE OF PROVIDING MEDICAL CARE TO PEOPLE OF ALL CULTURES. Schedule D, Part V, Line 4 ENDOWMENT FUNDS THE MAJORITY OF THE ENDOWMENT FUNDS HELD BY THE HOSPITAL ARE HELD IN ORDER TO EARN INTEREST IN ORDER TO PROVIDE SCHOLARSHIPS OR EDUCATION FOR EMPLOYEES OF THE HOSPITAL OR FOR PATIENT NEEDS/EXPERIENCE. THE TERM ENDOWMENT FUNDS INCLUDE CHARITABLE GIFT ANNUITIES. THE CONTRIBUTIONS WERE MADE TO THE HOSPITAL AND INTEREST IS PAID BACK TO THE CONTRIBUTOR AS AN ANNUITY UNTIL THE TIME OF THEIR PASSING. WHEN THIS OCCURS, THE BALANCE OF THE ANNUITY IS NO LONGER ENDOWED. Schedule D, Part X, Line 2 FIN 48 FOOTNOTE NMC HAS ADOPTED FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO. 109 (FIN 48). FIN 48 PROVIDES SPECIFIC GUIDANCE ON HOW TO ADDRESS UNCERTAINTY IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES, PRESCRIBING RECOGNITION THRESHOLDS AND MEASUREMENT ATTRIBUTES. THERE WERE NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2019 OR 2018. X X X X X X X true All amounts under 5000 Grant Writing false University of Nebraska Foundation Fundraising false 1498962 407059 1498962 407059 true true X true X true X true true true false true true 7364 18534547 0 18534547 0.01270 121911 129317537 95352214 33965323 0.02330 611 711114 379755 331359 0.00020 129886 148563198 95731969 52831229 0.03620 19 22428 5421722 2723140 2698582 0.00180 7 5326 51422171 9994951 41427220 0.02840 8 21 28600208 24059320 4540888 0.00310 1 0 3731170 1113258 2617912 0.00180 12 1337 162554700 0 162554700 0.11130 47 29112 251729971 37890669 213839302 0.14640 47 158998 400293169 133622638 266670531 0.18260 2 1508969 1508969 0.00100 1 40000 40000 2 100 174890 174890 0.00010 1 100 543 543 5 3051 517305 517305 0.00040 11 3251 2241707 2241707 0.00150 true 41028857 236195550 267531106 -31335556 X true true NEB ORTHO HOSPITAL ORTHOPEDIC HOSPITAL 0.5872 2 1 THE NEBRASKA MEDICAL CENTER 987400 Nebraska Medical Center Omaha NE 68198 HTTP://NEBRASKAMED.COM 260011 X X X X A 2 BELLEVUE MEDICAL CENTER 2500 Bellevue Medical Center Drive Bellevue NE 68123 HTTP://BELLEVUE.NEBRASKAMED.COM H000115 X X X A GROUP A 2 false false true X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 200. 400. X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X true X false false Schedule H, Part V, Line 5 (CHNA) FOR NEBRASKA MEDICINE (WHICH INCLUDES TNMC and BELLEVUE MEDICAL CENTER (BMC)) FOR THE COMPREHENSIVE CHNA PROCESS, A STEERING COMMITTEE COMPRISED OF KEY STAKEHOLDERS FROM AREA HEALTH SYSTEMS, LOCAL COUNTY HEALTH DEPARTMENT REPRESENTATIVES, AND KEY INFORMANTS FROM SEVERAL COMMUNITY AGENCIES WORKED COLLABORATIVELY TO OVERSEE THE PROCESS. THE CHNA STEERING COMMITTEE RETAINED PROFESSIONAL RESEARCH CONSULTANTS (PRC), INC. TO CONDUCT THE SURVEY. PRC IS A NATIONALLY RECOGNIZED HEALTH CARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING CHNAS SUCH AS THIS IN HUNDREDS OF COMMUNITIES ACROSS THE UNITED STATES SINCE 1994. INPUT FROM COMMUNITY STAKEHOLDERS KEY INFORMANT FOCUS GROUP DISCUSSIONS INCLUDED REPRESENTATION FROM ALL OF THE ASSESSED COUNTIES. FOCUS GROUP PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO PROVIDE INPUT REGARDING VULNERABLE OR MEDICALLY UNDERSERVED POPULATIONS, MINORITIES, AND/OR POPULATIONS WITH CHRONIC DISEASE. ONE HUNDRED SIXTY-THREE COMMUNITY STAKEHOLDERS, INCLUDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND BUSINESS AND COMMUNITY LEADERS PARTICIPATED IN FOCUS GROUP SESSIONS. A FULL LIST OF PARTICIPATING KEY INFORMANT FOCUS GROUPS AND THEIR AREAS OF EXPERTISE CAN BE FOUND HERE: HTTPs://WWW.NEBRASKAMED.COM/ABOUT-US/COMMUNITY-HEALTH-IMPROVEMENT STEERING COMMITTEE PARTICIPANT NAMES BELOW IS A LISTING OF THE PARTICIPANTS AND THE SPONSORING ORGANIZATIONS REPRESENTING THE CHNA STEERING COMMITTEE. CHI HEALTH: KELLY NIELSEN - DIRECTOR, COMMUNITY BENEFIT AND HEALTHIER COMMUNITIES DOUGLAS COUNTY HEALTH DEPARTMENT: DR. ADI POUR - HEALTH DIRECTOR LIVE WELL OMAHA: SARAH SJOLIE - EXECUTIVE DIRECTOR METHODIST HEALTH SYSTEM: JEFF PROCHASKA - DIRECTOR, STRATEGIC PLANNING SARPY/CASS COUNTY HEALTH DEPARTMENT: SARAH SCHRAM - HEALTH DIRECTOR NEBRASKA MEDICINE (TNMC and BMC): BECKY JACKSON, DIRECTOR, PATIENT & COMMUNITY ENGAGEMENT VISITING NURSES ASSOCIATION/POTTAWATTAMIE COUNTY: KRIS STAPP - VICE PRESIDENT, COMMUNITY HEALTH SERVICE CHARLES DREW HEALTH CENTER: KENNY MCMORRIS, CHIEF EXECUTIVE OFFICER OMAHA COMMUNITY FOUNDATION: KALI BAKER, VICE PRESIDENT OF COMMUNITY RELATIONS ONEWORLD COMMUNITY HEALTH CENTERS: ANDREA SKOLKIN, CHIEF EXECUTIVE OFFICER UNITED WAY OF THE MIDLANDS: MARIEL HARDING, DIRECTOR, COMMUNITY IMPACT Schedule H, Part V, Line 6a & 6b THE CHNA WAS CONDUCTED WITH OTHER HOSPITAL AND COMMUNITY BASED FACILITIES AS LISTED BELOW: THE NEBRASKA MEDICAL CENTER AND BELLEVUE MEDICAL CENTER CHI HEALTH METHODIST HEALTH SYSTEM DOUGLAS, SARPY, CASS AND POTTAWATTAMIE COUNTY HEALTH DEPARTMENTS LIVE WELL OMAHA Schedule H, Part V, Line 7b HTTP://WWW.DOUGLASCOUNTYHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, LINE 7A & 10A HTTP://WWW.NEBRASKAMED.COM/ABOUT-US/COMMUNITY-HEALTH-IMPROVEMENT Schedule H, Part V, Line 11 NEBRASKA MEDICINE HAS CURRENT PROGRAMS AND SERVICES IN PLACE TO ADDRESS EACH OF THE ELEVEN CHNA-IDENTIFIED COMMUNITY NEEDS. HOWEVER, IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENTLY, NEBRASKA MEDICINE WILL PLACE A PRIMARY FOCUS ON INJURY & VIOLENCE PREVENTION, MENTAL HEALTH AND ACCESS TO HEALTHCARE SERVICES. HOWEVER, IT HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING THE REMAINING CHNA-IDENTIFIED NEEDS, AND MAY TOUCH UPON EACH OF THESE CATEGORIES WITHIN ITS EFFORTS TO ADDRESS ISSUES SURROUNDING ACCESS TO CARE IN UNDERSERVED POPULATIONS. FURTHER, IN ORDER TO ENSURE ALL IDENTIFIED NEEDS WILL BE ADDRESSED IN THE COMMUNITY, NEBRASKA MEDICINE MET WITH THE OTHER LOCAL HEALTH SYSTEMS AND COUNTY HEALTH DEPARTMENTS TO DISCUSS THE CHNA-IDENTIFIED COMMUNITY NEEDS AND LOOK FOR OPPORTUNITIES TO COLLABORATE. THE IDENTIFIED NEEDS NOT BEING ADDRESSED BY NEBRASKA MEDICINE ARE IDENTIFIED AS CANCER, NUTRITION, PHYSICAL ACTIVITY & WEIGHT, SUBSTANCE ABUSE, DIABETES, HEART DISEASE & STROKE, DEMENTIA INCLUDING ALZHEIMER'S DISEASE, RESPIRATORY DISEASES AND SEXUALLY TRANSMITTED DISEASES. EACH OF THESE REMAINING CHNA-IDENTIFIED NEEDS ARE BEING ADDRESSED BY ONE OF THE OTHER COMMUNITY HEALTH SYSTEMS, LOCAL UNIVERSITY MEDICAL SCHOOLS, COUNTY HEALTH DEPARTMENTS, OR COMMUNITY-BASED ORGANIZATIONS. A FULL LISTING OF THESE ARE PROVIDED IN TNMC'S CHNA REPORT AND CAN BE FOUND HERE: HTTP://WWW.NEBRASKAMED.COM/ABOUT-US/COMMUNITY-HEALTH-IMPROVEMENT IMPLEMENTATION STRATEGY PLAN UPDATE NEBRASKA MEDICINE'S FISCAL 2016-2019 CHNA AND IMPLEMENTATION PLANNING CYCLE IDENTIFIED ELEVEN SIGNIFICANT HEALTH NEEDS, FOUR OF WHICH WERE PRIORITIZED FOR THE PLANNING PERIOD: (1)CANCER, (2)INJURY AND VIOLENCE PREVENTION, (3)MENTAL HEALTH AND (4)ACCESS TO HEALTHCARE SERVICES. BELOW ARE SOME HIGHLIGHTS ON THE PROGRESS OF THE 2016-2019 PLAN: - ESTABLISHED 4 IMMEDIATE CARE CLINIC LOCATIONS THROUGHOUT THE METRO AREA. - HELPED SECURE HEALTH INSURANCE AND NAVIGATION OF THE HEALTHCARE MARKETPLACE TO OVER 6,180 INDIVIDUALS OVER THE THREE YEAR PERIOD. - INVESTED OVER $200,000 IN SERVERAL NON-PROFIT PARTNERS TO CONNECT UNDERSERVED CANCER PATIENTS TO COMMUNITY RESOURCES. - INCREASED THE NUMBER OF MENTAL HEALTH PROVIDERS FOR OUTPATIENT CARE WITHIN THE THREE YEAR PERIOD. - TRAINED OVER 1,549 INDIVIDUALS IN THE STOP THE BLEED CAMPAIGN TO BUILD A TRAUMA-INFORMED COMMUNITY OVER THE THREE YEAR PERIOD. DURING FISCAL YEAR 2019, THE NEXT CHNA WAS CONDUCTED TO MEET THE 2019-2022 TIMELINE. NEBRASKA MEDICINE'S 2019-2022 CHNA AND IMPLEMENTATION PLANNING CYCLE IDENTIFIED ELEVEN SIGNIFICANT HEALTH NEEDS, THREE OF WHICH WERE PRIORITIZED FOR THE PLANNING PERIOD: (1) INJURY & VIOLENCE PREVENTION, (2) MENTAL HEALTH AND (3) ACCESS TO HEALTHCARE SERVICES. BELOW ARE SOME HIGHLIGHTS ON THE PROGRESS OF THE 2019-2022 PLAN. - INCREASE AVAILABILITY/ACCESSIBILITY OF DOCTOR APPOINTMENTS AND POINTS OF CARE FOR RESIDENTS OF THE OMAHA METRO AREA, WITH AN ADDITIONAL FOCUS ON EXPANDING CARE FOR POPULATIONS IN NORTHEAST OMAHA - HELP PATIENTS SECURE HEALTH INSURANCE THROUGH ASSISTANCE WITH THE ENROLLMENT PROCESS AND NAVIGATION OF THE HEALTHCARE MARKETPLACE - REDUCE THE NUMBER OF PREVENTABLE DEATHS RELATED TO POISONING, FALLS AND MOTOR VEHICLE ACCIDENTS - PARTICIPATE IN COMMUNITY INITIATIVES TO REDUCE VIOLENT CRIME AND BUILD A TRAUMA INFORMED COMMUNITY - INCREASE THE CAPACITY TO TREAT PATIENTS WITH CO-OCCURING MENTAL HEALTH AND SUBSTANCE USE PROBLEMS Schedule H, Part V, Section b, Line 13h POLICY FN16: DISCOUNT/FINANCIAL ADJUSTMENTS TALKS ABOUT DISCOUNTS FOR PATIENTS WITH NON THIRD-PARTY PAYMENT SOURCE, DISCOUNTS, SIMILAR TO DISCOUNTS OFFERED TO MANAGED CARE PLANS, ARE OFFERED FOR MOST PATIENTS THAT DO NOT HAVE THIRD-PARTY INSURANCE AND DO NOT MEET THE GUIDELINES FOR GOVERNMENTAL ASSISTANCE PROGRAMS. THIS DISCOUNT IS SUBJECT TO CHANGE BASED ON THE RATES AGREED UPON THROUGH MANAGED CARE CONTRACTS. THESE DISCOUNTS ARE INDEPENDENT OF THE CHARITY ADJUSTMENTS, AND THAT CHARITY ADJUSTMENTS ARE APPLIED AFTER THE SELF-PAY ADJUSTMENT IS APPLIED TO THE BILLED CHARGES. Schedule H, Part V, Line 16a-16c HTTPS://WWW.NEBRASKAMED.COM/PATIENTS/BILLING/FINANCIAL-COUNSELING Schedule H, Part V, Section B, Line 16J INFORMATION ON HOW TO GET FINANCIAL ASSISTANCE IS POSTED ON THE WEBSITE UNDER PATIENT FRIENDLY BILLING WHICH IS LOCATED UNDER THE PATIENT & VISITORS SECTION. THERE ARE DEPARTMENTS LISTED WITH PHONE NUMBERS TO CALL FOR MORE INFORMATION OR TO SET UP AN APPOINTMENT. Schedule H, Part V, Section D WE DO NOT HAVE REHABILITATION, FREE STANDING DIAGNOSTIC FACILITIES, OR SKILLED NURSING. OUR OFF SITE DIAGNOSTIC SERVICES ARE INCLUDED ON OUR HOSPITAL LICENSE AND OUR HOSPITAL ANCILLARY SERVICES ARE HOSPITAL BASED AND INCLUDED ON OUR LICENSE. 2 NE MEDICINE - INTERNAL MEDICINE 729 North Custer Avenue Grand Island NE 68805 INTERNAL MEDICINE CLINIC GIRLS INC OF OMAHA 2811 North 45th Street Omaha NE 68104 FAMILY MEDICINE CLINIC Schedule H, Part I, Line 3c NOT APPLICABLE AS THE ORGANIZATION DOES FOLLOW FPG TO DETERMINE ELIGIBILITY FOR PROVIDING FEE CARE TO LOW INCOME INDIVIDUALS. Schedule H, Part I, Line 6a THE ORGANIZATION'S COMMUNITY BENEFIT REPORT CAN BE ACCESSED AT: HTTP://WWW.NEBRASKAMED.COM/ABOUT-US/COMMUNITY-BENEFIT-REPORT Schedule H, Part I, Line 7 THESE NUMBERS ARE COMPUTED IN A COST ACCOUNTING SYSTEM THAT PRODUCES A COST FOR EVERY SERVICE THE HOSPITAL PROVIDES. RELATIVE VALUE UNITS, FOR SEVEN CATEGORIES OF EXPENSE, ARE UPDATED ANNUALLY FOR EACH PATIENT SERVICE WHICH KEEPS THE COST ACCOUNTING CURRENT. THESE COSTS PER UNIT VALUES ARE APPLIED TO THE PATIENT UTILIZATION TO COMPUTE THE TOTAL COST. THE COST ACCOUNTED TOTAL IS TIED BACK TO THE HOSPITAL'S FINANCIAL STATEMENTS TO ENSURE SYSTEM INTEGRITY. SCHEDULE H, PART I, LINE 7, COLUMN F THE DENOMINATOR USED TO CALCULATE THE PERCENTAGE IN COLUMN(F) IS FORM 990, PART IX, LINE 25(A). Schedule H, Part II COMMUNITY BUILDING ACTIVITIES COMMUNITY-BUILDING ACTIVITIES ARE DESIGNED TO ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS. POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS ALL CONTRIBUTE TO POOR HEALTH. THE TYPES OF PROGRAMS INCLUDED IN THIS CATEGORY SUPPORT WORKFORCE DEVELOPMENT AND TRAINING PROGRAMS TO PROVIDE EMPLOYMENT AND LEADERSHIP SKILLS TRAINING, JOB SHADOWING FOR STUDENTS INTERESTED IN HEALTH CAREERS AND ECONOMIC DEVELOPMENT SUPPORT GRANTS TO HELP REVITALIZE LOW-INCOME AREAS AND BUSINESSES. Schedule H, Part III, Line 2 & 4 TNMC'S FOOTNOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE SPECIFICALLY COVERING BAD DEBT EXPENSE. THOUGH PATIENT INCOME MAY QUALIFY THEM FOR FINANCIAL ASSISTANCE, THE PATIENT HAS OBLIGATIONS AS WELL TO COMPLETE FINANCIAL ASSISTANCE FORMS AND TO SUBMIT SUPPORTING DOCUMENTATION TO QUALIFY. PATIENTS WHO PROVIDE THIS INFORMATION AND QUALIFY FOR ASSISTANCE WOULD NEVER GO TO BAD DEBT. THEREFORE, IT IS REASONABLE TO STATE THAT OUR BAD DEBT EXPENSE IS FOR THOSE UNWILLING TO PAY OR UNWILLING TO WORK WITH US TO PROVIDE FINANCIAL ASSISTANCE IF AVAILABLE. IF AN ACCOUNT IS COMPLETELY WRITTEN OFF TO BAD DEBT, THE TOTAL COST VIA THE COST ACCOUNTING SYSTEM IS APPLIED. IF ONLY A PORTION OF THE ACCOUNT WAS WRITTEN OFF TO BAD DEBT, THEN BAD DEBT AS A PERCENTAGE OF CHARGE IS THEN APPLIED TO THE TOTAL COST FOR THE ENCOUNTER TO ESTIMATE THE COST ASSOCIATED WITH THE BAD DEBT. THE AMOUNT THAT GOES TO COLLECTIONS IS PATIENT LIABILITY. NOT COLLECTING THESE DOLLARS IS A DIRECT EXPENSE TO THE ORGANIZATION. AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, IT IS OUR RESPONSIBILITY TO HELP ANYONE WHO PRESENTS THEMSELVES WITH A HEALTH ISSUE; AS SUCH WE HAVE LESS CONTROL OVER WHAT GETS RECOGNIZED AS BAD DEBT. TO COMPUTE BAD DEBT AT COST, MANAGEMENT USED ALL DISCHARGED CASES IN PRIOR FISCAL YEAR WITH BAD DEBT WRITE-OFF. THE WRITE-OFF WAS COMPUTED AS A PERCENTAGE OF CHARGE AND THEN MULTIPLIED BY THE TOTAL COST (DETERMINED BY A DETAILED COST ACCOUNTING METHODOLOGY) TO ESTIMATE THE COST OF BAD DEBT. Schedule H, Part III, Line 8 OVERALL MEDICARE PATIENTS PRODUCE A NEGATIVE 13.27% MARGIN ON GROSS CHARGES. THIS IS SPREAD ACROSS MOST OF OUR PRODUCT LINES. OUR HEAVIEST LOSSES ARE FROM THE INPATIENT NEUROLOGY, ONCOLOGY AND CARDIAC PRODUCT LINES AND FROM ONCOLOGY AND SURGERY ON THE OUTPATIENT SIDE. IN GENERAL MEDICARE INPATIENTS DO COVER THE DIRECT COSTS OF PROVIDING THEIR CARE. HOWEVER, THE INDIRECT COSTS TO SUPPORT THE HOSPITAL MUST BE ACCOUNTED FOR AND TURNS THE MARGIN NEGATIVE. THESE NUMBERS ARE COMPUTED IN A COST ACCOUNTING SYSTEM THAT PRODUCES A COST FOR EVERY SERVICE THE HOSPITAL PROVIDES. THE SYSTEM IS UPDATED ANNUALLY AND TIED TO OUR FINANCIAL STATEMENTS TO ENSURE INTEGRITY OF THE PRODUCT LINE PROFITABILITY STATEMENTS. Schedule H, Part III, Line 9b A PATIENT KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE (ONCE ALL PAPERWORK IS RECEIVED AND APPROVED) ARE FLAGGED IN THE SYSTEM AND MONITORED ACCORDINGLY TO ENSURE FINANCIAL ASSISTANCE IS POSTED TO THE PATIENT ACCOUNT. WHEN THE 12 MONTH APPROVAL EXPIRES, PATIENTS ARE CONTACTED IF SERVICES HAVE BEEN RENDERED WITHIN THE LAST SIX MONTHS TO DISCUSS SUBMITTAL OF NEW INFORMATION FOR CONTINUATION OF ASSISTANCE. IF PATIENTS NO LONGER QUALIFY, OTHER PAYMENT OPTIONS ARE DISCUSSED PER ORGANIZATIONAL POLICY. REPORTS ARE UTILIZED FOR FOLLOW UP PURPOSES. PATIENTS WHO QUALIFY FOR 100% ASSISTANCE DO NOT RECEIVE GUARANTOR STATEMENTS (BILLS) FROM THE ORGANIZATION. PATIENTS WHO QUALIFY FOR AN 80% OR 60% DISCOUNT WORK WITH CUSTOMER SERVICE OR COLLECTION STAFF TO OUTLINE PAYMENT ARRANGEMENTS ACCORDING TO SET POLICY. Schedule H, Part VI, Line 2 NEEDS ASSESSMENT NEBRASKA MEDICINE USES DISEASE INCIDENCE AND PREVALENCE DATA, LEADING CAUSES OF DEATH, COMMUNITY HEALTH STATUS RESEARCH AND SUPPLY AND DEMAND ANALYSIS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. ADDITIONALLY, NEBRASKA MEDICINE ENGAGED PROFESSIONAL RESEARCH CONSULTANTS (PRC) TO PERFORMA COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN COLLABORATION WITH THE LOCAL HEALTH SYSTEMS AND COUNTY HEALTH DEPARTMENTS. Schedule H, Part VI, Line 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE TNMC AND BMC EMPLOY FINANCIAL COUNSELORS, CUSTOMER SERVICE STAFF AND COLLECTION STAFF, ALL OF WHOM ARE TRAINED IN ASSISTING OUR PATIENTS WITH RESOLUTION OF PATIENT LIABILITY. DEPENDING UPON INDIVIDUAL PATIENT NEEDS, PAYMENT ARRANGEMENTS OR FINANCIAL ASSISTANCE MAY BE OFFERED TO ASSIST OUR CUSTOMERS WITH RESOLUTION OF PATIENT BALANCES. ADDITIONALLY, THE ORGANIZATION WORKS WITH OUR SELF PAY POPULATION TO PURSUE COVERAGE THROUGH STATE, FEDERAL OR LOCAL PROGRAMS. CHARITY CARE POLICY: THIS POLICY OUTLINES THE GUIDELINES PATIENT FINANCIAL SERVICES (PFS) WILL USE TO ENSURE ADEQUATE AND APPROPRIATE FOLLOW UP IS COMPLETED IN ORDER FOR QUALIFYING PATIENTS TO RECEIVE CHARITY CARE. PFS WILL WORK WITH PATIENTS TO FIND PAYMENT SOLUTIONS WHEN AVAILABLE. THIS POLICY IS WRITTEN TO ENSURE A FAIR AND COMPREHENSIVE SYSTEM OF DISTRIBUTING CHARITY CARE TO FINANCIALLY BURDENED PATIENTS WITHIN THE AVAILABLE RESOURCES OF NMC IN A MANNER THAT DOES NOT DISCRIMINATE BASED ON RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, RELIGION OR AGE. POLICY: A. CHARITY CARE IS AVAILABLE WHEN ALL OTHER RECOVERY SOURCES HAVE BEEN EXHAUSTED. B. CHARITY CARE IS PROVIDED TO PATIENTS WHO HAVE DEMONSTRATED INABILITY TO MEET THEIR FINANCIAL OBLIGATION TO NMC. C. CHARITY CARE WILL NOT BE APPROVED FOR ELECTIVE AND/OR COSMETIC CARE. D. CHARITY CARE MAY BE APPROVED IN THE INSTANCE OF CATASTROPHIC CARE AS DEFINED. 1. THIS COULD BE OCCASIONED BY A PERSONAL CATASTROPHE OR UNAVOIDABLE CRISIS AFFECTING AN INDIVIDUAL WHO WOULD OTHERWISE BE ABLE TO PAY FOR SERVICE, OR A PERSON WHO HAS INCOME ABOVE POVERTY LEVEL BUT IS STILL NOT ABLE TO PAY THE ENTIRE COST OF SERVICE. 2. A PATIENT GENERALLY MAY QUALIFY FOR CATASTROPHIC CHARITY CARE IN INSTANCES WHERE THE PATIENT LIABILITY IS IN EXCESS OF 25% OF ANNUAL HOUSEHOLD INCOME. E. ALL TRANSPLANT AND IRP PATIENTS MUST MEET WITH A TRANSPLANT FINANCIAL COUNSELOR TO SECURE FINANCIAL CLEARANCE. TRANSPLANT AND IRP PATIENTS MUST PASS FINANCIAL SCREENING (ACCESS-FIC-082) OR MUST BE APPROVED VIA THE TRANSPLANT VARIANCE POLICY (FN 21) CHARITY APPROVAL FOR OTHER SERVICES PRIOR TO CONSIDERATION FOR TRANSPLANT DOES NOT MEET THIS REQUIREMENT. F. PRIOR APPROVAL FOR CHARITY CARE DOES NOT APPLY FOR FUTURE ELECTIVE OR COSMETIC PROCEDURES. GUIDELINES: A. IDENTIFICATION PROCESS 1) THE HOSPITAL MAINTAINS A SEPARATE POLICY IN ORDER TO ASSURE COMPLIANCE WITH THE EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA) AND A SEPARATE PATIENT RIGHTS AND ORGANIZATIONAL ETHICS POLICY. THIS CHARITY CARE POLICY IS SUBJECT TO THE TERMS OF THOSE POLICIES. 2) FINANCIAL COUNSELORS AUTHORIZED BY NMC WILL IDENTIFY PATIENTS REQUIRING FINANCIAL SCREENING. B. VERIFICATION OF INSURANCE ELIGIBILITY AND BENEFITS 1) THE PATIENT WILL EXECUTE AN ASSIGNMENT OF INSURANCE BENEFITS ON BEHALF OF THE HOSPITAL. 2) VERIFICATION OF ELIGIBILITY, BENEFITS, AND PAYER SOURCE WILL BE PERFORMED IN A TIMELY MANNER ACCORDING TO PATIENT FINANCE AND ACCESS SERVICES DEPARTMENTAL PROCEDURES. C. FINANCIAL COUNSELING 1) FINANCIAL COUNSELORS AND CONTRACTED VENDORS WILL ASSIST PATIENTS REQUIRING FINANCIAL ASSISTANCE. 2) FINANCIAL COUNSELORS AND VENDORS WILL ASSIST PATIENTS IN SEEKING REIMBURSEMENT FROM LOCAL, STATE, AND FEDERAL PROGRAMS WHEN THERE IS NO OTHER SOURCE OF PAYMENT AS WELL AS ASSISTING PATIENTS WITH APPLICATIONS OR MAKING APPOINTMENTS TO QUALIFY FOR GOVERNMENT PROGRAMS. 3) PATIENTS ARE RESPONSIBLE FOR FOLLOW UP MEETINGS WITH AN AGENCY THAT MAY PROVIDE FINANCIAL RESOURCES FOR HEALTH CARE SERVICES. CHARITY ASSISTANCE MAY BE TERMINATED AT ANY TIME DUE TO NON COMPLIANCE WITH THIS EXPECTATION. Schedule H, Part VI, Line 4 WE SERVE MANY COMMUNITIES, INTERNATIONAL, REGIONAL, STATE AND LOCAL OMAHA. THE STATISTICS BELOW DESCRIBE OUR LOCAL OMAHA COMMUNITY DEFINED AS DOUGLAS AND SARPY COUNTIES IN NEBRASKA. THIS LOCAL AREA REPRESENTS APPROXIMATELY 70% OF OUR INPATIENT AND OUTPATIENT DISCHARGES AND VISITS. THE 2018 COLLEGE OF PUBLIC HEALTH PROFESSIONS TRACKING ESTIMATED POPULATION FOR THIS LOCAL AREA IS 834,374. THE ESTIMATED RACE BREAKDOWN OF THE POPULATION IS BELOW. WHITE NON-HISPANIC 83.1% BLACK NON-HISPANIC 8.3% SOME OTHER RACE 5.8% MULTIPLE RACES 2.7% THERE ARE ELEVEN HOSPITALS IN NEBRASKA TO SERVE THE LOCAL COMMUNITY. METHODIST HOSPITAL, METHODIST WOMEN'S HOSPITAL, LAKESIDE HOSPITAL, BERGAN MERCY MEDICAL CENTER, MIDLANDS HOSPITAL, CREIGHTON MEDICAL CENTER, CHILDREN'S HOSPITAL, IMMANUEL HOSPITAL, NEBRASKA ORTHOPAEDIC HOSPITAL, THE NEBRASKA MEDICAL CENTER AND BELLEVUE MEDICAL CENTER. THERE ARE FOUR DESIGNATED MEDICALLY UNDERSERVED AREAS IN DOUGLAS COUNTY (THREE AREAS) AND SARPY COUNTY (ONE AREA.) Schedule H, Part VI, Line 5 COMMUNITY BUILDING ACTIVITIES AND PROMOTION OF HEALTH TNMC RECOGNIZES THE COMMUNITY BENEFIT OF ADDRESSING ROOT CAUSES OF POOR HEALTH IN ORDER TO IMPROVE COMMUNITY HEALTH. THE HOSPITAL PARTICIPATED IN SEVERAL COMMUNITY BUILDING ACTIVITIES THROUGHOUT THE PAST YEAR DESIGNED TO ADDRESS THESE ROOT CAUSES. INCLUDED IN THIS TOTAL ARE THE HOSPITAL'S EFFORTS TO SUPPORT THE MID-AMERICA HOSPITAL ALLIANCE (MAHA); AN ALLIANCE OF RURAL AND CRITICAL ACCESS HOSPITALS IN THE REGION OF WHICH THE HOSPITAL IS A FOUNDING MEMBER. THE HOSPITAL SPENDS TIME COORDINATING RESOURCES TO ENSURE SMALLER, RURAL HOSPITALS CAN HAVE ACCESS TO THE EXPERTISE AND SERVICES OF A LARGE ACADEMIC MEDICAL CENTER. TNMC'S COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE PROGRAMS INTENDED TO DRIVE ENTRY INTO HEALTH CAREERS AND NURSING PRACTICE. MANY HOSPITAL STAFF MEMBERS GIVE EDUCATIONAL PRESENTATIONS ON THE HEALTH PROFESSIONS AND PROVIDE MOCK INTERVIEW TRAINING TO AREA STUDENTS. NMC ALSO PROVIDES JOB SHADOWING OPPORTUNITIES TO UNDERGRADUATE STUDENTS WHO WISH TO EXPLORE THE HEALTH CAREERS. ADDITIONALLY, TNMC HAS THE ONLY BIO-CONTAINMENT UNIT IN THE STATE AND ONE OF FEW ACROSS THE NATION, CONTRIBUTING TO DISASTER PREPAREDNESS ABOVE AND BEYOND LICENSURE REQUIREMENTS. MEMBERS OF THE HOSPITAL'S CRITICAL CARE AND TRAUMA STAFF SHARE THE EXPERTISE BY PARTICIPATING IN COMMUNITY COALITIONS TO IMPROVE SAFETY AND REDUCE ACCIDENTS AMONG CHILDREN, TEENS, AND SENIORS. THE HOSPITAL WORKS TO ENCOURAGE ECONOMIC GROWTH AND DEVELOPMENT BY SUPPORTING AN ECONOMIC DEVELOPMENT PARTNERSHIP AIMED AT THE DEVELOPMENT OF NEW BUSINESS IN THE CITY'S URBAN AREAS. BELLEVUE MEDICAL CENTER HAS PARTICIPATED IN, AND HOSTED A NUMBER OF EVENTS DESIGNED TO PROMOTE A HEALTHIER COMMUNITY. IN ADDITION TO FINANCIAL SUPPORT OF SEVERAL COMMUNITY-BASED CHARITABLE ORGANIZATIONS AND THE LOCAL CHAMBER OF COMMERCE, THE HOSPITAL'S LEADERSHIP TEAM IS ACTIVE ON COMMUNITY BOARDS. OTHER INFORMATION TNMC IS A NONPROFIT HOSPITAL MEETING THE REQUIREMENTS OF REVENUE RULING 69-545. IN SUMMARY, TNMC OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS WITHOUT REGARD TO ABILITY TO PAY, THE HOSPITAL ALSO HAS A BOARD COMPRISED OF MEMBERS FROM THE COMMUNITY, THEY HAVE AN OPEN MEDICAL STAFF POLICY, THEY ACCEPT PATIENTS PAYING THEIR BILLS WITH MEDICAID AND MEDICARE, AND THEY USE THE SURPLUS OF THEIR FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH. Schedule H, Part VI, Line 6 NEITHER TNMC NOR BMC ARE IN AN AFFILIATED HEALTHCARE SYSTEM. Schedule H, Part VI, Line 7 TNMC AND BMC FILE A COMMUNITY BENEFIT REPORT WITH THE NEBRASKA HOSPITAL ASSOCIATION ANNUALLY. true American Cancer Society 9850 Nicholas St Omaha NE 68114 131788491 501(C)(3) 26250 General Support American Heart Association 10100 J St Ste A Omaha NE 68127 135613797 501(C)(3) 25090 General Support General Support Father Flanagan's Boy Home 13603 Flanagan Blvd Omaha NE 68010 470376606 501(C)(3) 10000 General Support General Support Great Plains Colon Cancer PO Box 3434 Omaha NE 68103 272123378 501(C)(3) 6500 General Support General Support Greater Omaha Chamber Foundation 1301 Harney St Omaha NE 68102 470258610 501(C)(3) 42250 General support for clinic operations serving unde General support Heartland Family Services 2101 S 42nd St Omaha NE 68105 470390618 501(C)(3) 11000 General Support General support Hope Medical Outreach Coalition 4920 S 30th St Omaha NE 68107 470548990 501(C)(3) 30000 General Support General support JDRF 9202 W Dodge St Ste 304 Omaha NE 68114 231907729 501(C)(3) 7500 support General support Leukemia and Lymphoma Society 12100 W Center Rd Ste 202 Omaha NE 68154 135644916 501(C)(3) 15000 General Support General support Live Well Omaha PO Box 31518 Omaha NE 68131 470834161 501(C)(3) 10000 General Support General support Make a Wish 11926 Arbor St Ste 102 Omaha NE 68144 470671096 501(C)(3) 10000 General Support General support March of Dimes 11840 Nicholas St Omaha NE 68154 131846366 501(C)(3) 22000 General support for lymphoma research and educatio General support National Safety Council 11620 M Cir Omaha NE 68137 470259720 501(C)(3) 10000 General Support General support Nebraska Aids Project 250 S 77th St Ste A Omaha NE 68114 470786622 501(C)(3) 10000 General Support General support Nebraska HOSA PO Box 94711 Lincoln NE 68509 454782061 501(C)(3) 15000 General support of auxiliary's community efforts General support Omaha Equestrian Foundation 1004 Farnam St Ste 400 Omaha NE 68102 273520778 501(C)(3) 7500 General support of society's operations General support Omaha Symphony 1605 Howard St Omaha NE 68102 476039304 501(C)(3) 6500 General support of museum operations General support Professional Research 11326 P St Omaha NE 68137 470628654 501(C)(3) 17880 General operations and support CHNA Project Pink'd Inc 4089 S 84th St Ste 108 Omaha NE 68127 455212995 501(C)(3) 7000 Faculty Support for the University General support Ronald McDonald House 620 S 38th St Omaha NE 68105 470755104 501(C)(3) 265700 General support (AAA agreement) General support Susan G Komen Nebraska 8707 W Center Rd Omaha NE 68124 751835298 501(C)(3) 10000 General support General support Team Mates Mentoring 6801 O St Lincoln NE 68510 470840990 501(C)(3) 6000 General support General support United Way of the Midlands 1805 Harney St Omaha NE 68102 470376605 501(C)(3) 50600 General support General Support Visiting Nurse Foundation 12565 W Center Rd Ste 100 Omaha NE 68144 911467848 501(C)(3) 10000 Matching Grants General Support Building Healthy Futures 3555 Farnam St Ste 222 Omaha NE 68131 460598062 501(C)(3) 2471451 General support General Support University of Nebraska - Lincoln PO Box 830861 Lincoln NE 68583 470049123 501(C)(3) 82041 General support General Support National Stratigic Research Institute 984238 Nebraska Medical Center 405 E Main St Omaha NE 68198 455426026 501(C)(3) 140913 General support General Support Board of Regents - University of Nebraska 3835 Holdrege Lincoln NE 68583 470049123 501(C)(3) 8000000 Support the College of Public Health for reducing General support Clarkson College 101 S 42nd St Omaha NE 68131 363649217 501(C)(3) 5670363 Support Operations General support Clarkson Regional Health Sevices Inc 9300 Underwood Ave Ste 110 Omaha NE 68114 470376531 501(C)(3) 8000000 General Support University of Nebraska Medical Center 986800 NE MED CTR Omaha NE 68198 470049123 501(C)(3) 70753736 General support UNMC Physicians 988145 NE MED CTR Omaha NE 68198 470785575 501(C)(3) 120865135 General support 32 0 Financial Assistance (Charity Care) 7364 73508529 Book Charity Care Financial Assistance (Renal-Indigent Patients) 24 975703 Book Indigent Dialysis Financial Assistance (Pharmaceuticals) 5198 1712027 Book Pharmaceuticals Schedule I, Part I, Line 1 REVIEW AND APPROVAL OF CHARITABLE CONTRIBUTIONS THE NEBRASKA MEDICAL CENTER (NMC) HAS A COMMITTEE WHOSE RESPONSIBILITY IS TO REVIEW AND APPROVE OR DISPROVE REQUESTS FOR SPONSORSHIP. THIS COMMITTEE IS COMPRISED OF KEY EXECUTIVES AND OTHER MEMBERS OF THE LEADERSHIP TEAM, AS WELL AS REPRESENTATIVES FROM THE UNIVERSITY OF NEBRASKA MEDICAL CENTER. DECISIONS ARE MADE ON EACH REQUEST INDIVIDUALLY BASED ON A SET OF GUIDELINES ESTABLISHED BY THE ORGANIZATION. IN ORDER TO EFFECTIVELY EVALUATE AND REVIEW THE MANY REQUESTS WE RECEIVE, EACH REQUEST IS BROUGHT BEFORE OUR SPONSORSHIPS AND CHARITABLE CONTRIBUTIONS COMMITTEE FOR CONSIDERATION. THIS COMMITTEE IS COMPRISED OF KEY EXECUTIVES AND OTHER MEMBERS OF THE HOSPITAL LEADERSHIP TEAM. THE COMMITTEE CONSIDERS EACH REQUEST INDIVIDUALLY, AND CONTRIBUTIONS ARE MADE BASED ON THREE PRIMARY OBJECTIVES: 1) TO SUPPORT THE COMMUNITY NEED FOR RESOURCES ADDRESSING NEBRASKA'S LEADING CAUSES OF DEATH; INCLUDING CANCER, STROKE AND HEART DISEASE. 2) TO ALIGN WITH ORGANIZATIONS FURTHERING NMC'S CHARITABLE MISSION TO SUPPORT CAUSES WHICH SIGNIFICANTLY IMPACT THE OVERALL HEALTH STATUS OF THE COMMUNITY. 3) TO SUPPORT ORGANIZATIONS WHICH IMPACT FAVORABLY THE PUBLIC IMAGE OF THE HOSPITAL AND ENHANCE EXISTING PARTNERSHIPS OR INITIATIVES. IF A SPONSORSHIP OR CHARITABLE CONTRIBUTION REQUEST FALLS WITHIN OUR THREE PRIMARY OBJECTIVES, THE FOLLOWING CRITERIA ARE THEN APPLIED TO FURTHER ASSIST THE COMMITTEE IN MAKING FUNDING DECISIONS: 1) ORGANIZATION MUST PROVIDE PROOF OF 501(C)(3) STATUS FROM THE IRS, OR NONPROFIT DESIGNATION AS A GOVERNMENTAL OR TRIBAL ENTITY. 2) ALL REQUESTS MUST BE RECEIVED IN WRITING- NO PHONE REQUESTS WILL BE CONSIDERED. 3) REQUESTOR MUST BE ABLE TO PROVIDE THE ORGANIZATION'S NON-DISCRIMINATION POLICY. 4) MUST BE ABLE TO PROVIDE AN ORGANIZATIONAL OPERATING BUDGET AND PROJECT BUDGET UPON REQUEST. 5) PROPOSAL MUST INCLUDE A LIST OF BOARD MEMBERS, DIRECTORS, AND KEY PROJECT STAFF MEMBERS AND THE ROLE THEY SERVE IN THE ORGANIZATION. 6) REQUEST MUST INCLUDE A BRIEF NARRATIVE OF THE PROJECT, INCLUDING AN ESTIMATE OF NUMBERS OF PEOPLE SERVED BY THE REQUEST AND LOCATION OF COMMUNITIES IMPACTED BY THE ORGANIZATION'S MISSION. 7) REQUESTS FOR SPONSORSHIP NEED TO BE SUBMITTED AT LEAST 90 DAYS PRIOR TO THE EVENT, WITH REQUESTS OVER $10,000 BEING SUBMITTED BY MARCH 1 FOR CONSIDERATION IN THE NEXT FISCAL YEAR. GROUPS, PROGRAMS, AND ACTIVITIES NOT SUPPORTED BY NMC: 1) ORGANIZATIONS WITHOUT IRS 501(C)(3) OR EQUIVALENT TAX EXEMPT STATUS. 2) ORGANIZATIONS THAT DISCRIMINATE ON THE BASIS OF AGE, DISABILITY, RELIGION, ETHNIC ORIGIN, GENDER, OR SEXUAL ORIENTATION. 3) ORGANIZATIONS WITH DIVISIVE OR LITIGIOUS PUBLIC AGENDAS. 4) MEMBER BASED ORGANIZATIONS, INCLUDING CHAMBERS OF COMMERCE, ROTARY CLUBS OR IRS 501(C)(4) LEGIONS AND ASSOCIATIONS. 5) MUNICIPALITIES, INCLUDING FIRE AND POLICE DEPARTMENTS OR RELATED SOCIAL SERVICE GROUPS AND POLITICAL ORGANIZATIONS. 6) RELIGIOUS ORGANIZATIONS OR SECTARIAN PROGRAMS FOR RELIGIOUS PURPOSES. 7) FRATERNAL ORGANIZATIONS, SOCIAL CLUBS, SPORTS TEAMS OR CLUBS, ATHLETIC COMPETITIONS. 8) ENDOWMENTS. 9) MULTIYEAR REQUESTS AND PLEDGES. 10) INDIVIDUALS REQUESTING LOANS, DEBT RETIREMENTS, SCHOLARSHIP OR FELLOWSHIP ASSISTANCE. 11) TRAVEL- INCLUDING STUDENT TRIPS OR TOURS. 12) MARKETING ACTIVITIES OR PROMOTIONAL MERCHANDISE. 13) PURCHASE OR MAINTENANCE OF VEHICLES. 14) FILM OR VIDEO PROJECTS, INCLUDING DOCUMENTARIES. 15) BEAUTY PAGEANTS Schedule I, Part I, Line 2 Grant Monitoring Procedures Based on the detailed gift policy in part I, line 1, the funds are only provided for charitable purposes, and those organizations that receive monies from nmc are required to follow their 501(c)(3) requirements surrounding the use of funds received. Schedule I, Part III AMOUNTS PROVIDED TO PATIENTS ARE DETERMINED BY THE NEBRASKA MEDICAL CENTER'S WRITTEN AND PUBLISHED FINANCIAL ASSISTANCE POLICY. X X X X X X true true false false false true false false false James Linder SEC THRU 8/18; CEO BEG 8/18 343327 0 0 0 4684 0 0 0 5624 0 353635 0 0 0 Louis W Burgher Director 206686 0 0 0 642 0 9846 0 0 0 217174 0 0 0 DEBRA ROMBERGER Director 0 318187 0 166353 0 0 0 28750 0 2991 0 516281 0 0 DAVID W MERCER Director 0 424275 0 152319 0 0 0 30622 0 2991 0 610207 0 0 Carl V Smith Director (thru 10/2/2018) 0 468763 0 106710 0 0 0 24012 0 2991 0 602476 0 0 Dennis D Bierle System Clinical Operations COO 99678 0 68373 0 281450 0 9037 0 7135 0 465673 0 0 0 Stephanie R Daubert Officer-NM CFO 498705 0 175208 0 29865 0 22125 0 15377 0 741280 0 0 0 Daniel DeBehnke Officer-NM CEO (Thru 8/8/2018) 512849 0 751005 0 343383 0 14438 0 7520 0 1629195 0 0 0 Suzanne Nuss Chief Nursing Officer 331376 0 111575 0 10235 0 22131 0 24427 0 499744 0 0 0 Cory D Shaw Chief Operations Officer 551290 0 195704 0 10113 0 22125 0 24177 0 803409 0 0 0 Harris A Frankel Chief Medical Officer 0 511052 0 173956 0 8400 0 23971 0 2964 0 720343 0 0 Theresa Franco Cancer Ctr/Rad/Imag Svcs VP 340407 0 68811 0 957 0 22540 0 17917 0 450632 0 0 0 Julie Lazure Acute Care/Path Svcs VP 305816 0 53495 0 1267 0 22126 0 21848 0 404552 0 0 0 Thomas C Macy Amb Clinics/Clinical Prog VP 313312 0 68006 0 1841 0 22131 0 19924 0 425214 0 0 0 Matthew E Pospisil Periop Svs/Bellevue VP 261662 0 49350 0 1057 0 22126 0 21904 0 356099 0 0 0 Frank V Venuto Chief Human Capital Officer 366043 0 125112 0 9679 0 14438 0 24335 0 539607 0 0 0 Michael A Ash EVP/Chief Transformation Ofc 0 504278 0 199000 0 8400 0 27145 0 3309 0 742132 0 0 Brian J Lancaster Information Technology VP 304107 0 70176 0 1759 0 0 0 19425 0 395467 0 0 0 Anna Cramer Chief Legal Officer 258603 0 36141 0 4763 0 1005 0 1401 0 301913 0 0 0 Chadwick Brough Chief Experience Officer 286174 0 135392 0 54003 0 7049 0 22601 0 505219 0 0 0 Frank S Lococo Corp Marketing & Comm VP 260214 0 62500 0 765 0 0 0 2264 0 325743 0 0 0 Isaac J Berg Staff Physician-Primary 309200 0 21761 0 748 0 0 0 29268 0 360977 0 0 0 Jennifer L Brown Staff Physician-Primary 252145 0 101198 0 732 0 0 0 24405 0 378480 0 0 0 Jian Zhao Faculty Physician 185711 0 146003 0 388 0 0 0 1948 0 334050 0 0 0 Schedule J, Part I, Line 4a SEVERANCE PAYMENTS THE FOLLOWING EMPLOYEES WERE TERMED PRIOR TO FISCAL YEAR 2019 AND RECEIVED SEVERANCE PAYMENTS DURING CALENDAR YEAR 2018: DENNIS BIERLE: $278,919 CHADWICH BROUGH: $47,332 DANIEL DEBEHNKE: $325,410 Schedule J, Part I, Line 4b NONQUALIFIED RETIREMENT PLANS CERTAIN EXECUTIVES DO PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. NO PAYOUT OCCURRED DURING THE YEAR FROM A SUPPLEMENTAL NONQUALIFIED PLAN TO CURRENT OR FORMER* INDIVIDUALS. IN ADDITION, TNMC HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (AMENDED AND RESTATED JANUARY 1, 2008) WHICH CONSTITUTES AN UNFUNDED, UNSECURED PLAN TO PROVIDE SUPPLEMENTAL RETIREMENT BENEFITS TO A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES UPON SEPARATION OF SERVICE, SUBJECT TO THE TERMS AND CONDITIONS OF THE PLAN. THE BENEFIT IS PAID IN FULL ONE YEAR AFTER EMPLOYMENT SEPARATION, AND THE AMOUNT IS BASED ON THE PARTICIPANT'S ANNUAL COMPENSATION, VALUE OF THE PARTICIPANT'S TNMC QUALIFIED RETIREMENT PLAN BENEFIT, SOCIAL SECURITY BENEFIT, AND NUMBER OF YEARS OF SERVICE. NO PAYOUT OCCURRED DURING THE YEAR FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO ANY CURRENT AND FORMER* INDIVIDUALS. Schedule J, Part I, Line 6a CONTINGENT COMPENSATION THE ORGANIZATION'S FINANCIAL RESULTS ARE TAKEN INTO CONSIDERATION WHEN CALCULATING COMPENSATION IN ADDITION TO OTHER NON-FINANCIAL FACTORS. EXECUTIVE INCENTIVE COMPENSATION IS DETERMINED BY SEVERAL KEY METRICS THAT ARE ESTABLISHED BY THE NEBRASKA MEDICAL CENTER GOVERNING BODY. THESE METRICS ARE INCLUSIVE OF STRATEGIC, FINANCIAL, OPERATIONAL AND QUALITY OUTCOMES. ON AN ANNUAL BASIS, THE NEBRASKA MEDICAL CENTER GOVERNING BODY REVIEWS ACHIEVEMENT OF PRESET TARGETS AND APPROVES INCENTIVES WHEN WARRANTED. THESE PERFORMANCE PAYMENTS ARE SET IN CONSIDERATION OF TOTAL COMPENSATION VS. COMPARED TO MARKET FOR SIMILIAR POSITIONS. AS IT WAS DETERMINED THAT IT IS IN THE BEST INTEREST OF THE ORGANIZATION TO HAVE A PORTION OF THEIR BASE PAY SUBJECT TO FORFEITURE UNLESS THE PRE-DETERMINED FINANCIAL AND NON-FINANCIAL FACTORS DISCUSSED ABOVE ARE ACHIEVED. INCENTIVE COMPENSATION RELATED TO FY19 PERFORMANCE WERE PAID TO THE FOLLOWING INDIVIDUALS: Deborah Romberger: $166,353 Carl V. Smith: $106,710 David W. Mercer: $152,319 Daniel DeBehnke: $751,005 Stephanie Daubert: $175,208 Cory Shaw: $195,704 William Pospisil: $49,350 Theresa Franco: $68,811 Anna L. Cramer: $36,141 Michael A. Ash: $199,000 Thomas Macy: $68,006 Frank Venuto: $125,112 Julie Lazure: $53,495 Isaac J. Berg: $21,761 Jennifer L. Brown: $101,198 Frank S. Lococo: $62,500 Brian J. Lancaster: $70,176 Harris Frankel: $173,956 Chad Brough: $135,392 Suzanne Nuss: $111,575 Dennis Bierle: $68,373 Jian Zhao: $146,003 A HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE 521440769 259230MV9 2016-08-23 157496093 CAPITAL PROJECT & REFUND PRIOR LEA false false false B HOSPITAL AUTH NO 1 OF SARPY COUNTY NE 470834151 80372PAR7 2016-08-23 147968496 Capital Project & refund prior lea false false false A 12070000 0 157516214 0 0 0 0 0 0 115024453 42491761 0 2016 true false true true B 0 0 147968496 0 0 0 0 0 0 130156459 17812037 0 2016 true false true true A false true true true true true 0.02260 0.02260 false false true true B false true true true true true 0.02260 0.02260 false false true true A false true true false false false 0 false 0 false true B false true true false false false 0 false 0 false true A true B true SCHEDULE K, PART II, LINE 3, COLUMN A THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, LINE A, COLUMN (E) DUE TO INVESTMENT EARNINGS. Bruce Grewcock Kiewit Construction, President 983584 Construction Services false Stephanie Daubert NOH, LLC Board Member 146246 Services and Supplies false James T Canedy Simply Well Board Member 938099 Services and Supplies false James T Canedy Wife is employee 66178 Employment false Schedule L, Part IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS 1.) THE SERVICES THAT ARE PROVIDED BY KIEWIT CONSTRUCTION CONSIST OF FEES EARNED ON CONSTRUCTION CONTRACTS FOR PROJECTS THROUGHOUT THE CAMPUS. 2.) THE TRANSACTIONS WITH SIMPLYWELL CONSISTS OF RENTAL INCOME TO NMC FOR THE LEASE OF SPACE AND OTHER INCOME FOR SALE OF SERVICES AND SUPPLIES, SUCH AS PARKING, SUPPLY CHAIN AND PHONE SERVICES. APPROXIMATELY 80% OF THE TOTAL TRANSACTION RELATES TO PAYMENTS TO SIMPLYWELL FOR THE WELLNESS PROGRAM FOR NMC EMPLOYEES. 3.) THE SERVICES PROVIDED TO/FROM NOH LLC ARE COMPRISED OF RENT, SUPPLIES AND SERVICES. Form 990, Part III, Line 4D NEUROLOGICAL SCIENCES SERVICE LINE THE CORE SERVICES INCLUDE PRECISE DIAGNOSIS AND TREATMENT OF STROKE AND VASCULAR DISEASE, MOVEMENT AND MEMORY DISORDERS, MULTIPLE SCLEROSIS BRAIN AND SPINAL TUMORS, SPINE AS WELL AS EPILEPSY. THE EPILEPSY CENTER IS THE ONLY LEVEL 4 CENTER IN THE REGION AND TREATS PATIENTS FROM THE STATE OF NEBRASKA AND THE REGION. TNMC HAS ONE OF THE FEW MAGNETOENCEPHALOGRAPH (MEG) SCANNERS AND TRAINED MEG SCIENTISTS IN THE REGION. THE MEG CAN DETECT BRAIN ACTIVITY IN MUCH GREATER DETAIL AND WITH MORE ACCURACY THAN PREVIOUS METHODS AND ADVANCES PATIENT CARE AND RESEARCH OPPORTUNITIES GREATLY. IN JULY OF 2018, TNMC OPENED THE TWIN CREEK HEALTH CENTER, A DEDICATED NEUROLOGICAL SCIENCES AMBULATORY CLINIC IN BELLEVUE. TNMC HAS EARNED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD. GET WITH THE GUIDELINES IS A HOSPITAL-BASED, QUALITY-IMPROVEMENT PROGRAM DESIGNED TO ENSURE HOSPITALS CONSISTENTLY CARE FOR CARDIAC AND STROKE PATIENTS FOLLOWING THE MOST UP-TO-DATE GUIDELINES AND RECOMMENDATIONS. TNMC ALSO HOSTS THE ONLY YOUNG ADULT STROKE SUPPORT GROUP TO ADDRESS THE EMOTION AND PHYSICAL CHALLENGES OF RECOVERING FROM STROKE. DURING FISCAL YEAR 2019, NEUROSCIENCES INCURRED 6,098 INPATIENTS WITH 30,608 PATIENT DAYS AND OVER 151,703 OUTPATIENT BILLING UNITS. APPROXIMATELY 53% OF THE REVENUE WAS DERIVED FROM INPATIENT CASES. Form 990, Part VI, Line 2 BUSINESS AND FAMILY RELATIONSHIPS MR. BRUCE GREWCOCK AND MR. MOGENS BAY HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP). DR. JAMES T. CANEDY, MS. STEPHANIE DAUBERT AND MR. LOUIS BURGHER HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP, CLARKSON REGIONAL HEALTH SERVICES). DR. JAMES T. CANEDY, MR. THOMAS MACY, AND MS. STEPHANIE DAUBERT HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP, NEBRASKA HEALTH PARTNERS). DR. LOUIS BURGHER AND DR. JAMES T. CANEDY HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP, CLARKSON COLLEGE). DR. JAMES T. CANEDY, MR. DANIEL DEBEHNKE, DR. CARL SMITH AND MS. STEPHANIE DAUBERT HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP, NEBRASKA HEALTH NETWORK). DR. JAMES T. CANEDY AND MS. STEPHANIE DAUBERT HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP, NEBRASKA ORTHOPAEDIC HOSPITAL). Form 990, Part VI, Line 6 MEMBERS Nebraska Medicine is the sole member of TNMC. Form 990, Part VI, Line 7a EFFECTIVE 2017, TNMC HAS ONE MEMBER, NEBRASKA MEDICINE, A NONPROFIT ORGANIZATION THAT HAS BEEN RECOGNIZED AS EXEMPT FROM TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TNMC'S BYLAWS PROVIDE THAT THE MEMBERS OF TNMC'S BOARD OF DIRECTORS SHALL BE THE SAME PERSONS WHO SERVE AS MEMBERS OF THE BOARD OF NEBRASKA MEDICINE. THE TNMC BOARD IS COMPRISED OF 15 DIRECTORS, SPECIFICALLY 11 VOTING DIRECTORS AND 4 EX-OFFICIO NON-VOTING DIRECTORS. Form 990, Part VI, Line 7b THE FOLLOWING POWERS ARE RESERVED TO TNMC'S SOLE MEMBER, NEBRASKA MEDICINE: - AMENDMENT TO TNMC'S ARTICLES OF INCORPORATION; - A MERGER OR CONSOLIDATION OF TNMC WITH OR INTO ANY OTHER ENTITY; - SALE, TRANSFER, LEASE, DISPOSITION, OR CHANGE IN USE OF (A) MORE THAN 50% OF THE ASSETS OF THE CLINICAL OPERATIONS OF TNMC; OR (B) SUCH OTHER ASSETS AS THE TNMC BOARD DESIGNATES; - ENTRY INTO A JOINT OPERATING AGREEMENT, INTEGRATION AGREEMENT, OR SIMILAR AGREEMENT, OR AMENDMENT TO ANY EXISTING SIMILAR AGREEMENT; - ISSUANCE OR INCURRENCE OF INDEBTEDNESS RESULTING IN A DEBT/EQUITY RATIO IN EXCESS OF 40% OR A DEBT COVERAGE RATIO LESS THAN 1.25; - LIQUIDATION OR DISSOLUTION OF TNMC; - ADMISSION OF ONE OR MORE ADDITIONAL MEMBERS OF TNMC; - ENTRY INTO ANY AFFILIATIONS THAT WOULD CHANGE THE SIZE OF THE BOARD, A CHANGE TO THE QUORUM REQUIREMENTS, OR CHANGE IN THE SUPERMAJORITY VOTING REQUIREMENTS; - APPROVAL OF ANY AMENDMENT TO THE BYLAWS; OR - A GIFT, PLEDGE, DONATION, OR GRANT IN EXCESS OF ONE MILLION DOLLARS. Form 990, Part VI, Line 11b REVIEW OF 990 PRIOR TO FILING A COPY OF THE FORM 990 WAS PRESENTED TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. IN ADDITION, THE BOARD OF DIRECTORS WERE PROVIDED A COPY OF THE FORM 990 TO REVIEW ON THE SECURED BOARD PORTAL CALLED BOARD EFFECT BEFORE IT WAS FILED. Form 990, Part VI, Line 12c MONITORING AND ENFORCEMENT OF BOARD INDEPENDENCE EACH MEMBER OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES DISCLOSES ANNUALLY THAT HE/SHE IS EITHER AN OFFICER, DIRECTOR, MEMBER, OWNER, AGENT OR ASSOCIATED IN SOME MANNER WITH DELINEATED BUSINESS ENTITIES THAT EITHER HAVE OR MIGHT REASONABLY BE EXPECTED TO HAVE A BUSINESS RELATIONSHIP WITH TNMC. EACH BOARD MEMBER AGREES TO MAKE CONFLICTS KNOWN AND WITHDRAW FROM PARTICIPATION IN DELIBERATIONS IF A SUBSEQUENT CONFLICT ARISES. DISCLOSURE STATEMENTS ARE DISTRIBUTED ANNUALLY AND MONITORED BY THE CORPORATE COMPLIANCE OFFICER FOR COMPLETION. ANY DISCLOSED CONFLICTS ARE BROUGHT TO THE ATTENTION OF THE CHAIRMAN OF THE BOARD FOR BOARD MEMBERS AND OFFICERS OR TO THE OFFICERS FOR KEY EMPLOYEES. Form 990, Part VI, Line 15a & 15b POLICIES - COMPENSATION THE EXECUTIVE AND PHYSICIAN COMPENSATION COMMITTEE OF THE TNMC BOARD OF DIRECTORS IS COMPRISED OF A CHAIR, APPOINTED BY THE BOARD OF DIRECTORS, A VICE CHAIR, AND NOT LESS THAN TWO (2) ADDITIONAL DIRECTORS FROM THE BOARD, ALL OF WHOM ARE DETERMINED BY THE BOARD TO BE INDEPENDENT FROM THE UNIVERSITY OF NEBRASKA MEDICAL CENTER AND NEBRASKA MEDICINE, WHICH INCLUDES UNMC PHYSICIANS AND TNMC. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR OVERSEEING THE PERFORMANCE AND COMPENSATION OF THE CEO, ASSESSING THE APPROPRIATENESS AND REASONABLENESS OF THE EXECUTIVE COMPENSATION AND BENEFIT PROGRAMS, AND MONITORING COMPENSATION PROGRAMS WITH SENIOR EXECUTIVES AND PHYSICIANS TO CONFIRM COMPLIANCE WITH REGULATIONS AND BUSINESS NEED. THE COMMITTEE REVIEWS ALL PROPOSED COMPENSATION FOR PHYSICIANS AND SENIOR EXECUTIVES INCLUDING THE CEO. ALL COMPENSATION SUBMITTED FOR REVIEW MUST BE SUPPORTED BY APPROPRIATE DOCUMENTATION, INCLUDING, BUT NOT LIMITED TO, COMPARABILITY DATA (I.E., ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC)) RELEVANT FOR THE OCCUPATION AND CORPORATION POSITION. SUCH DATA IS COMPARED TO SIMILARLY SITUATED AAMC ORGANIZATIONS OF COMPARABLE REVENUE. THE EXECUTIVE COMPENSATION DATA IS PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM HIRED BY THE COMMITTEE AND ARE REPORTED DIRECTLY TO THE COMMITTEE. THE COMMITTEE ENSURES THAT ITS REVIEW AND APPROVAL QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS REGULATIONS (26 C.F.R. 53.4958-6, AS AMENDED). TO ENSURE SUCH COMPLIANCE, THE COMMITTEE: 1. ENSURES COMMITTEE MEMBERS ARE FREE FROM ANY RELATIONSHIPS OR CONFLICTS OF INTEREST THAT MAY IMPAIR, OR APPEAR TO IMPAIR, A COMMITTEE MEMBER'S ABILITY TO MAKE INDEPENDENT JUDGMENTS; 2. RECEIVES AND RELIES UPON APPROPRIATE DATA AS TO COMPARABILITY FROM INTERNAL OR EXTERNAL RESOURCES PRIOR TO MAKING ITS DETERMINATION; AND 3. DOCUMENTS THE BASIS FOR ITS DETERMINATION OF REASONABLENESS CONCURRENTLY WITH MAKING THAT DETERMINATION. SUCH DOCUMENTATION INCLUDES: A) THE TERMS OF THE ARRANGEMENT THAT WAS APPROVED AND THE DATE IT WAS APPROVED; B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT AND THOSE WHO VOTED ON IT (QUORUM IS REQUIRED FOR ANY APPROVAL); C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW SUCH MATERIAL WAS OBTAINED; AND D) THE ACTION(S) TAKEN BY THE COMMITTEE. Form 990, Part VI, Line 19 PUBLIC DISCLOSURE OF DOCUMENTS THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE TYPICALLY NOT MADE AVAILABLE TO THE PUBLIC. HOWEVER, IF SOMEONE COMES INTO THE ACCOUNTING DEPARTMENT AND REQUESTS TO VIEW THE DOCUMENTS, THEY WOULD BE MADE AVAILABLE TO VIEW IN THE OFFICE. Form 990, Part XI, Line 9 RECONCILIATION OF NET ASSETS INVESTMENT IN CLARKSON COLLEGE $ 5,454,847 CHANGE IN PENSION ACCOUNTS $ 26,967,191 NET ASSETS RELEASED $ (1,412,503) OTHER $ 1,704 _________________ TOTAL $ 31,011,239 Bellevue Medical Ctr 2500 BMC DR Bellevue NE 68123 204305186 Acute Care NE 85994894 142564364 NMC UNMC Physicians 988145 NEBRASKA MEDICAL CENTER OMAHA NE 68198 470785575 Healthcare NE 501(C)(3) Line 3 NM false CLARKSON COLLEGE 101 SOUTH 42ND STREET OMAHA NE 68131 363649217 COLLEGE NE 501(C)(3) LINE 2 TNMC true Nebraska Medicine 987400 Nebraska Medical Center Omaha NE 681987400 813158267 SUPPORT NE 501(C)(3) 12, Type 1 NA false NE HEALTH NETWORK 8511 DODGE RD OMAHA NE 68114 271784907 HEALTHCARE NE NH PARTNERS Related 0 0 false false NC LAB LLC 8303 DODGE ST OMAHA NE 68114 461173104 DIAGNOSTIC SVC NE NMC Related 0 0 false true 0.25000 NHS ORTHOPAEDIC SERVICES INC 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 470845238 INVESTMENT SVC NE NMC C Corp 4040822 12177998 1.00000 true NEBRASKA HEALTH PARTNERS INC 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 470816463 MANAGEMENT NE NMC C Corp 1703495 2687813 1.00000 true false true false true false false false false false true false true true true true true true false false CLARKSON COLLEGE b 5610770 BOOK CLARKSON COLLEGE j 15936111 BOOK CLARKSON COLLEGE l 5290773 BOOK NEBRASKA HEALTH PARTNERS o 868896 BOOK