2020-11-11T16:12:23-06:00 2019-12-31 KPMG LLP 1212 North 96th Street Suite 300 Omaha NE 68114 990 2019-01-01 263064869 Nebraska Pediatric Practice Inc % AMY HATCHER NEBR 4029556795 8200 Dodge Street Omaha NE 68114 DR ALAN TINGLEY PRESIDENT 4029554116 2020-11-11 true DONALD NEAL JR P00798244 4023481450 2020-11-10 199.206.0.5 47006120203165000000 2020-11-11 P 9C230E3C43A1AC01475832C9617E9CAF99CA9519 65CF9D49F64C2267637B54237ED8CC7527705457 2019 2021-01-29 14:40:06Z Children's Specialty Physicians Alan Tingley MD 8200 Dodge Street Omaha NE 68114 83093909 false X www.childrensomaha.org X 2008 NE To develop, promote and make available to children from Omaha, Nebraska, and the region, clinical services and other related programs. 9 5 241 5 0 0 3963527 619374 56242893 59886350 0 0 19785776 22588185 79992196 83093909 0 0 0 0 68996769 75544855 0 0 0 39202894 49253894 108199663 124798749 -28207467 -41704840 11807715 15650196 11807715 15650196 0 0 X Provides 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 clnical services and other programs and activities related thereto in order to achieve the physicians' common goals of improving the manner, process, environment, accessability, 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. false false 118150578 0 82474535 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. 118150578 true true false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 21 0 true 241 true false false false false false false false false false false false false X 9 5 false false false false true true true true true false false false true true true true false true true false X AMY HATCHER 4029556795 8200 Dodge Street Omaha NE 68114 X James Hammel MD Clinical Service Chief 40.0 0.0 X 1942459 0 0 Adam Conley MD Physician 40.0 0.0 X 959394 0 0 Brian Hasley MD Physician 40.0 0.0 X 700211 0 0 Ali Ibrahimiye MD Physician 40.0 0.0 X 691748 0 0 Donny Suh MD Physician 40.0 0.0 X 681444 0 0 Steve Burnham Presdient 40.0 0.0 X 512262 0 80576 Jessica Goeller MD Vice Chairman/Physician 40.0 0.0 X X 518948 0 0 Robert Spicer MD Member/Physician 40.0 0.0 X 373926 0 0 Suzanne Haney MD Chairman/Physician 40.0 0.0 X X 227247 0 0 Anna Spagnoli MD Member 1.0 0.0 X 0 0 0 Michael Brown Secretary/Treasurer 1.0 0.0 X X 0 0 0 Richard Azizkhan MD Member thru 8/16/19 1.0 0.0 X 0 0 0 Michael McGlade Member 1.0 0.0 X 0 0 0 Bradley Britigan MD Member 1.0 0.0 X 0 0 0 Christopher Maloney M Member 1.0 0.0 X 0 0 0 Rodrigo Lopez Member beg 8/16/19 1.0 0.0 X 0 0 0 6607639 0 80576 178 false true true Children's Hospital Medical Cente 8200 Dodge Street Omaha NE 68114 Operating agreemnet 36404836 Univ of NE Medical Center 988145 Nebraska Medical Center Omaha NE 68198 Operating agreement 4407329 Comphealth Medical Staffing PO Box 972651 Dallas TX 75397 Temporary staffing 4286726 Locumtenenscom PO Box 405547 Atlanta GA 30384 Temporary staffing 1821948 Huron Consulting Service LLC 3005 Momentum Place Chicago IL 60689 Consulting 1507538 22 619374 619374 Net Patient Service Revenue 621110 56408109 56408109 Other Program Services 900099 3478241 3478241 59886350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Miscellaneous Revenue 541900 22588185 22588185 22588185 83093909 82474535 X 0 0 0 0 1632384 1632384 0 65145999 64865356 280643 4932578 4899474 33104 1013983 1013616 367 2819911 2804703 15208 3722932 781317 2941615 21069 17257 3812 76390 76390 0 0 0 33344218 31117897 2226321 4922 4922 2162634 2139069 23565 198 198 0 2454824 2454257 567 459573 453578 5995 0 0 0 0 0 882342 727354 154988 Development support expense 3718612 3470815 247797 PROFESSIONAL BUSINESS EXP 700801 682718 18083 MEMBERSHIP DUES & SUB 611300 551046 60254 PROVISION FOR BAD DEBT 83074 83074 1011005 451543 559462 124798749 118150578 6648171 0 777480 3326958 0 0 0 0 10870825 11850402 0 0 0 0 0 176552 0 0 138437 152076 51362 30389 20973 20973 0 0 0 0 0 0 0 0 0 123235 11807715 15650196 11711046 15195696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96669 454500 11807715 15650196 X 0 0 0 0 0 0 11807715 15650196 X -41704840 41704840 X false true X true false X Schedule A, Part I, Line 3 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 51362 30389 20973 20973 0 DEFERRED COMPENSATION 316669 CURRENT PORTION OF LEASE PAYME 114230 LEASE/LOAN OBLIGATION 23601 454500 X 83093909 83093909 83093909 124798749 124798749 124798749 Schedule D, 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, 2019 and 2018, CSP has not recorded any amounts related to uncertain tax positions or any accrued interest and penalties. X X X X true false false false false false false false false Robert Spicer MD Member/Physician 347651 0 21695 0 4580 0 0 0 0 0 373926 0 0 0 Jessica Goeller MD Vice Chairman/Physician 484539 0 33981 0 428 0 0 0 0 0 518948 0 0 0 Suzanne Haney MD Chairman/Physician 210836 0 16121 0 290 0 0 0 0 0 227247 0 0 0 Steve Burnham Presdient 360840 0 143362 0 8060 0 66100 0 14476 0 592838 0 0 0 James Hammel MD Clinical Service Chief 1766459 0 175010 0 990 0 0 0 0 0 1942459 0 0 0 Adam Conley MD Physician 675389 0 35000 0 249005 0 0 0 0 0 959394 0 0 0 Ali Ibrahimiye MD Physician 654068 0 37020 0 660 0 0 0 0 0 691748 0 0 0 Donny Suh MD Physician 609576 0 70412 0 1456 0 0 0 0 0 681444 0 0 0 Brian Hasley MD Physician 525326 0 174029 0 856 0 0 0 0 0 700211 0 0 0 Schedule J, Part I, Line 3 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. IN ADDITION, THE SAME UNRELATED ORGANIZATION HAS A 457(F) PLAN WHICH THE PRESIDENT OF NPP PARTICIPATED IN DURING 2019. THE AMOUNTS OF DEFERRED COMPENSATION DISTRIBUTED AND ACCRUED FOR EACH OF THE INDIVIDUALS DURING 2019 ARE AS FOLLOWS: STEVEN C. BURNHAM $46,166 ACCRUAL, $0 PLAN DISTRIBUTION Schedule J, Part I, Line 4a Severance Payments The following employee received severance payments during the calendar year 2019: Adam Conley, MD $175,220 Form 990, Part VI, Line 6, 7a & 7b 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) Incurrance 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, 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, 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, Line 15a 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. 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. Form 990, Part VI, Line 15b 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, Line 19 Governing documents, conflict of interest policy, and financial statements are not available to the public. Form 990, Part XI, Line 9 Support from Hospital member for cash flow - reason for no fund balance at end of year: $41,704,840 FORM 990 PART IX LINE 11G DESCRIPTION:Contract Labor TOTAL FEES:17643111 FORM 990 PART IX LINE 11G DESCRIPTION:Contract Providers TOTAL FEES:9544016 FORM 990 PART IX LINE 11G DESCRIPTION:Billing Fees TOTAL FEES:4149610 FORM 990 PART IX LINE 11G DESCRIPTION:Residents TOTAL FEES:89749 FORM 990 PART IX LINE 11G DESCRIPTION:Recruitment TOTAL FEES:642079 FORM 990 PART IX LINE 11G DESCRIPTION:Consulting TOTAL FEES:1100572 FORM 990 PART IX LINE 11G DESCRIPTION:Other TOTAL FEES:175081