2015-02-12T14:44:46-06:00 2014-06-30 KPMG LLP 1212 North 96th Street Suite 300 Omaha NE 68114 990 2013-07-01 470785575 UNMC PHYSICIANS % LINDA SCHOLTING UNMC 4025599789 988145 Nebraska Medical Center Suite Omaha NE 681988145 Carl V Smith MD CFO 4026618742 2015-02-12 true DONALD NEAL JR P00798244 4026618742 2013 2016-03-07 17:11:31Z X Mr Carl V Smith 988145 NEBRASKA MEDICAL CTR OMAHA NE 681988145 249961294 false X www.unmcphysicians.com X 1995 NE Support the mission of UNMC, improve the health of nebraska through education, research, the highest quality patient care, and outreach to underserved populations. 19 0 1351 0 144165 117248 0 0 223222106 238483952 426118 4423912 1854301 2556050 225502525 245463914 44761077 48170707 0 0 130264432 135250676 0 0 0 42736149 50359876 217761658 233781259 7740867 11682655 144062786 165028007 44161267 45526177 99901519 119501830 X SUPPORT THE MISSION OF THE UNIVERSITY OF NEBRASKA MEDICAL CENTER, AND ALSO TO IMPROVE THE HEALTH OF NEBRASKA THROUGH PREMIER EDUCATIONAL PROGRAMS, INNOVATIVE RESEARCH, THE HIGHEST QUALITY PATIENT CARE, AND OUTREACH TO UNDERSERVED POPULATIONS. false false 233062622 48170707 241040002 UNMC PHYSICIANS DIRECTS ITS RESOURCES TOWARD GIVING LEADING PHYSICIANS THE RESOURCES TO PROVIDE EXCELLENT HEALTHCARE TO PATIENTS ACROSS NEBRASKA AND BEYOND. UNMC PHYSICIANS CONTINUES TO LEAD THE REGION THROUGH A FOCUSED MISSION INCLUDING EXCEPTIONAL PATIENT CARE, EDUCATION THAT EMPOWERS, CUTTING-EDGE RESEARCH AND AN EMPHASIS ON GIVING BACK TO THE COMMUNITY. WITH MORE THAN 50 SPECIALTIES AND SUB-SPECIALTIES, UNMC PHYSICIANS PROVIDES SPECIALIZED SERVICES AND THE LATEST IN TREATMENT OPTIONS TO ITS PATIENTS. OUR PHYSICIANS NOT ONLY TREAT PATIENTS, BUT THEY EDUCATE FUTURE PHYSICIANS. MANY OF OUR DOCTORS TRAINED AND NOW TEACH AT THE UNIVERSITY OF NEBRASKA MEDICAL CENTER. THEY, ALONG WITH EXPERIENCED NURSES, ALLIED HEALTH PROFESSIONALS AND BUSINESS SUPPORT PERSONNEL ARE DEDICATED TO SERVING THE HEALTHCARE NEEDS OF OUR COMMUNITY. CHARITABLE CARE IS A HIGH PRIORITY, AND WE MAKE TREATMENT AVAILABLE TO ALL PERSONS WHO PRESENT THEMSELVES FOR CARE, REGARDLESS OF RACE, CREED, LIFESTYLE, OR ABILITY TO PAY. DURING FISCAL 2014, UNMC PHYSICIANS SERVED MORE THAN 365 THOUSAND PATIENTS IN ITS CLINICS AND OVER 238 THOUSAND PATIENTS THROUGH INPATIENT AND OTHER ANCILLARY SERVICE LINES. IN ADDITION, UNMC PHYSICIANS SUPPORTS MANY COMMUNITY BASED HEALTH PROGRAMS SERVING THE POOR THROUGH DONATED FUNDS, SUPPLIES, PHYSICIAN TIME AND NURSE TIME. UNMC PHYSICIANS PROVIDED MORE THAN 2.4 MILLION DOLLARS, AT COST, IN CHARITABLE CARE TO THE UNDERSERVED AND THOSE UNABLE TO PAY FOR MEDICALLY NECESSARY HEALTHCARE SERVICES. IN ADDITION, OVER 27 PERCENT OF UNMC PHYSICIANS NET PATIENT SERVICE REVENUE CAME FROM GOVERNMENT FUNDED HEALTH INSURANCE PROGRAMS, SUCH AS MEDICAID, MEDICARE AND TRICARE. WHILE THESE GOVERNMENT PROGRAMS DO NOT COVER THE FULL COST OF THE HEALTH SERVICES PROVIDED, UNMC PHYSICIANS TRANSFERRED OVER 37 MILLION DOLLARS TO THE COLLEGE OF MEDICINE AT THE UNIVERSITY OF NEBRASKA MEDICAL CENTER IN SUPPORT OF ITS CLINICAL, EDUCATION AND RESEARCH MISSION. PLEASE SEE THE COMMUNITY BENEFIT REPORT FOR ADDITIONAL DETAILS AT WWW.UNMCPHYSICIANS.COM. 233062622 true false false false false false false false false false true false false false true false true false false false true false false false false false true true true true true false false false false false false false false false false false false false true false false false true 88 0 true 1351 true true true false false false false false false false false false X 19 0 true false false false true true true true true true false true true true true true true true true true false X LINDA SCHOLTING 4025599789 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 X CARL V SMITH CHAIR/PRESIDENT 30.0 30.0 X X 313436 239535 26428 MICHAEL SITORIUS VICE CHAIR/DEPARTMENT CHAIR 30.0 30.0 X X 75232 247746 26469 ROBERT MUELLEMAN SECRETARY-TREASURER/DEPT CHAIR 30.0 30.0 X X 283958 181270 40541 CHARLES ENKE DIRECTOR 30.0 30.0 X 271365 230752 30580 CRAIG W WALKER DIRECTOR 30.0 30.0 X 219950 346162 38541 DANIEL MURMAN DIRECTOR 30.0 30.0 X 151620 107912 21083 DAVID W MERCER DIRECTOR 30.0 30.0 X 514705 223420 41844 DWIGHT JONES DIRECTOR 1.0 40.0 X 0 245028 23860 JOHN SPARKS DIRECTOR 1.0 40.0 X 0 220813 21829 JULIE VOSE DIRECTOR 30.0 30.0 X 219913 144683 17691 KEVIN GARVIN DIRECTOR 30.0 30.0 X 471626 219482 33038 LYNELL KLASSEN DIRECTOR 30.0 30.0 X 85140 274375 24982 MATTHEW MORMINO DIRECTOR 30.0 30.0 X 377584 117740 43853 QUAN NGUYEN DIRECTOR 30.0 30.0 X 266668 196297 41025 STEVE HINRICHS DIRECTOR 30.0 30.0 X 237918 219174 37011 STEVEN LISCO DIRECTOR 30.0 30.0 X 361475 243496 26023 STEVEN WENGEL DIRECTOR 30.0 30.0 X 70068 236971 24883 TROY PLUMB DIRECTOR 30.0 30.0 X 214819 92752 24813 Debra Romberger DIRECTOR 30.0 30.0 X 20903 44780 9268 CORY D SHAW EXEC VP/CEO/thru Dec 2013 30.0 10.0 X 220469 166604 22666 DENNIS BIERLE COO 30.0 10.0 X 241995 0 21988 TROY WILHELM CFO 30.0 10.0 X 260250 0 17881 William Dinsmoor CEO/effective Jan 2014 10.0 45.0 X 0 0 Brad Britigan MD President/effective Jan 2014 10.0 45.0 X 34694 369569 22701 BRYAN SCHWAHN ADMINISTRATOR 20.0 20.0 X 111673 83408 30470 CARIN BORG ADMINISTRATOR 20.0 20.0 X 108202 106979 26449 DAVID MELLIGER ADMINISTRATOR 20.0 20.0 X 78776 85210 22874 LISA RUNCO ADMINISTRATOR 20.0 20.0 X 97219 92392 27202 ALAN LANGNAS PHYSICIAN 50.0 10.0 X 799256 98601 41705 DANIEL SURDELL PHYSICIAN 50.0 10.0 X 468477 67985 46725 MICHAEL MOULTON PHYSICIAN 50.0 10.0 X 588948 122303 42217 WENDY JEAN WARD PHYSICIAN 50.0 10.0 X 609783 76442 44170 WILLIAM THORELL PHYSICIAN 50.0 10.0 X 556718 81676 43970 8332840 5183557 964780 307 false true false NEBRASKA MEDICAL CENTER 988145 Nebraska Medical Center OMAHA NE 681988145 Medical Call Center 397200 APEX PRINT TECHNOLOGIES LLC PO Box 9201 MINNEAPOLIS MN 554809201 Stmt Printing & Mail 247393 ADP PO Box 842875 BOSTON MA 022842875 Payroll Service 238206 NEUROLOGY LLP 8901 W Dodge RD Suite 210 OMAHA NE 681143442 Physician Service 200000 OPTUMINSIGHT 2771 Momentum Place CHICAGO IL 60689 Claims Manager 179824 5 0 PATIENT SVC REVENUE 621400 164008553 164008553 OTHER CONTRACTUAL REVENUE 900099 74475399 74475399 238483952 498248 144165 354083 0 0 0 0 0 8423044 4497380 3925664 3925664 3925664 0 0 0 DEPARTMENTAL MISC. DEPOSITS 561000 2556050 2556050 2556050 245463914 241040002 144165 4279747 41977405 41977405 6193302 6193302 0 0 5837679 5837679 0 107406189 107406189 11003404 11003404 6325839 6325839 4677565 4677565 0 392210 392210 79245 79245 0 0 0 389398 389398 287382 287382 0 0 0 3827905 3827905 153091 153091 0 79336 79336 0 0 2002394 2002394 2132810 1885628 247182 DEAN & DEPT DEVELOPMENT FUND 10190831 10190831 CONTRACTED PHYSICIAN SVC 1859163 1859163 PROVISION FOR BAD DEBT EXP 12517355 12517355 MEDICAL SUPPLIES/EQUIPMENT 5505718 5505718 10943038 10943038 233781259 233062622 718637 0 38686942 61043468 0 0 0 0 39868952 37776780 0 0 0 0 653798 903595 0 0 722864 474236 36342442 19527156 19011591 16815286 40868443 46742383 0 0 1049651 989382 0 0 3200545 282877 144062786 165028007 26500011 27898634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17661256 17627543 44161267 45526177 X 99901519 119501830 0 0 0 0 99901519 119501830 144062786 165028007 11682655 7917656 X false true X true false X 442860 345357 0 0 0 788217 204777880 218271919 218294260 225076407 241040002 1107460468 0 0 0 205220740 218617276 218294260 225076407 241040002 1108248685 0 25069283 31518323 35899279 53348364 54616699 200451948 25069283 31518323 35899279 53348364 54616699 200451948 907796737 403495 430515 384618 426118 498248 2142994 2181 117248 119429 403495 430515 384618 428299 615496 2262423 0 -1743803 -1743803 203880432 219047791 218678878 225504706 241655498 1108767305 0.81874 0.83687 0.00204 0.00204 X SCHEDULE A, PART III, LINE 12 LOSS IN JOINT VENTURE IN 2009: (1,743,803) 407536 407536 4427096 606692 3820404 12991308 4701502 8289806 18516502 14218962 4297540 16815286 0 FEES PAYABLE TO UNMC 13795121 RESERVE FOR SELF INSURANCE 3832422 17627543 196001186 7917656 -57380384 -49462728 245463914 245463914 176400875 176400875 57380384 57380384 233781259 Part XI, Line 2D 12,517,355 Bad Debt Expense Reclass 6,193,302 CHARITY CARE RECLASS 38,669,727 TRANSFER TO UNMC ---------- 57,380,384 PART X, LINE 2 FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES (FIN 48) IS NOT APPLICABLE TO UNMC PHYSICIANS AS THEY ARE CONSIDERED A GOVERNMENTAL ENTITY FOR ACCOUNTING PURPOSES. Part XII, Line 4B 12,517,355 Bad Debt Expense Reclass 6,193,302 CHARITY CARE RECLASS 38,669,727 TRANSFER TO UNMC ---------- 57,380,384 SUB-SAHARAN AFRICA PROGRAM SERVICES SEE PART IV 12000 12000 12000 false false false false false false PART I, LINE 3 GENERAL INFORMATION ON ACTIVITIES OUTSIDE THE U.S. UNMC PHYSICIANS FINANCIALLY SUPPORTS UNMC COLLEGE OF MEDICINE'S MEDICAL RESIDENT ROTATION PROGRAM. STUDENTS DO A MONTHLY ROTATION IN SOUTH AFRICA WORKING IN LOCAL HOSPITALS AND CLINICS. UNMC PHYSICIANS PAID $12,000 FOR THE MEDICAL RESIDENT HOUSING. true true X true X true X true true true false true true 2872275 2872275 0.01250 21781458 15304245 6477213 0.02830 3700 1758 1942 24657433 15306003 9351430 0.04080 16658 16658 0.00010 5348930 5348930 0.02340 253902 126112 127790 0.00060 41977405 41977405 0.18340 47596895 126112 47470783 0.20750 72254328 15432115 56822213 0.24830 true 13059011 1856822 25796821 65473693 -39676872 X true true NONE 1 1 BELLEVUE MEDICAL CENTER LLC 2500 MEDICAL CENTER DRIVE BELLEVUE NE 68123 http://bellevue.nebraskamed.com H000115 X X X BELLEVUE MEDICAL CENTER LLC 1 true X X X X X X X X X 13 true true true X SEE PART V, SECTION C X X X false false true true 200. true 400. true X X X X true true X X true false true X false false PART V, SECTION B, LINE 14G BMC PROVIDES INFORMATION ON WHERE TO FIND THE FINANCIAL ASSISTANCE POLICY (FAP) ON THE BILLING STATEMENT AND IN ACCESS AREAS OF THE HOSPITAL. IT IS CLEAR TO OUR PATIENTS THAT WE HAVE A FAP AND WHERE TO FIND IT. PART V, SECTION B, LINE 3 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. EIGHTY-SEVEN COMMUNITY STAKEHOLDERS, INCLUDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND BUSINESS AND COMMUNITY LEADERS PARTICIPATED IN FOCUS GROUP SESSIONS HELD IN AUGUST OF 2011. PART V, SECTION B, LINE 4 BELLEVUE MEDICAL CENTER, LLC CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: ALEGENT CREIGHTON HEALTH, NEBRASKA METHODIST HEALTH SYSTEM, AND THE NEBRASKA MEDICAL CENTER. PART V, SECTION B, LINE 7 BELLEVUE MEDICAL CENTER PARTICIPATED IN COLLABORATIVE DISCUSSIONS WITH ALL OF THE LOCAL HEALTH SYSTEMS AND COUNTY HEALTH DEPARTMENTS TO DETERMINE HOW EACH OF THE IDENTIFIED NEEDS WOULD BE ADDRESSED. EACH LOCAL HEALTH SYSTEM PRIORITIZED THE CHNA-IDENTIFIED NEEDS IN A WAY THAT MOST CLOSELY ALIGNED WITH THE CORE COMPETENCIES AND PROFILE OF PATIENTS SERVED BY THAT SYSTEM. FURTHER, THE HEALTH SYSTEM COLLABORATIVE GROUP RESEARCHED AND COMPILED A LIST OF LOCAL AGENCIES/RESOURCES FOUND ON ADDRESSING EACH OF THE CHNA-IDENTIFIED NEEDS. THROUGH THOSE COLLABORATIVE DISCUSSIONS, IT WAS DETERMINED THAT EACH OF THE IDENTIFIED NEEDS IN THE COMMUNITY WILL BE COVERED BY A LOCAL HEALTH SYSTEM OR OTHER COMMUNITY AGENCY. BELLEVUE MEDICAL CENTER'S FOCUS WILL BE ON ADDRESSING DIABETES, WHICH IS PREVALENT IN THE POPULATION SERVED BY THAT FACILITY. PART V, SECTION B, LINE 12I BMC TAKES INTO CONSIDERATION OTHER FACTORS TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, INCLUDING BUT NOT LIMITED TO IF PATIENTS ARE HOMELESS, HAD DEBTS DISCHARGED THROUGH CHAPTER 7 BANKRUPTCY PROCEEDINGS OR QUALIFIES FOR FOOD STAMPS. PART V, SECTION B, LINE 5 HOSPITAL FACILITY'S WEBSITE: http://bellevue.nebraskamed.com/community_health_needs_assessment.html PART I, LINE 3C BELLEVUE MEDICAL CENTER IS STRUCTURED AS AN LLC AND IS A HOSPITAL. UNMC PHYSICIANS IS NOT A HOSPITAL, BUT ITS INFORMATION IS BEING REPORTED AS REQUIRED due to its ownership held in the llc. Effective May 27, 2014, UNMC Physicians sold their minority interest in Bellevue Medical Center to the Nebraska Medical Center (TNMC). As of that date, TNMC became the 100% owner of Bellevue Medical Center. Per the instructions, unmc physicians has answered part I line 3 based on the joint venture charity care policy OF The Bellevue Medical Center, which is a hospital; and not on the charity care policy of UNMC Physicians, which is not a hospital. However, unmc physician's policy is determined by the fpg level of 150% for part I line 3a and 350% for part I line 3b. PART I, LINE 6A The UNMC Physicians community benefit report can be accessed at: http://clinics.nebraskamed.com/learn-about-us.aspx Bellevue Medical Center is not a 501(c)(3) tax-exempt hospital and is therefore not required to and does not file a community benefit report. PART I, LINE 7G The organization does not have information that indicates that services are provided despite a financial loss to the organization. All subsidized services reported on Line 7G were generated by Bellevue Medical Center. Bellevue Medical Center engaged in subsidized services during the fiscal year, such as its medical observation department. PART I, LINE 7, COLUMN F The amount used to calculate the table 7 percentages is $228,921,475. This amount is derived from part ix line 25 in the amount of $233,781,259, less bad debt of $12,517,355 for unmc physicians. Per the instructions, the proportionate share of total expenses of the Bellevue medical center joint venture of $8,274,702, less bad debt of $617,131 was added to the unmc physicians' amount. PART I, LINE 7 BOTH UNMC PHYSICIANS AND BELLEVUE MEDICAL CENTER USED THE COST TO CHARGE RATIO FOR FIGURES REPORTED IN THE TABLE. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 OF THE INSTRUCTIONS. PART III, LINE 4 Patient Service Revenue may qualify for financial assistance. The Patient is obligated to complete financial assistance forms and to submit supporting documentation to qualify. Services to patients who provide this information and qualify for assistance are not considered bad debt. Bad Debt is reported for services rendered to those unwilling to pay and /or work with the organization to provide financial assistance if available. This is only after the organization has exhausted all reasonable efforts to collect outstanding balances from the patient. If an account is determined to meet the criteria of a bad debt, the remaining balance will be written off to bad debt expense. As the organization does not have a cost accounting system, the COST OF THE BAD DEBT WAS ESTIMATED USING THE COST TO CHARGE RATIO. THERE IS NO SPECIFIC FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS FOR BAD DEBT, HOWEVER, A DISCUSSION ON NET PATIENT SERVICE REVENUE STATES, "UNMC Physicians has agreements with third party payers that provide payment to UNMC Physicians at amounts different from its established rates. Net patient service revenue is reported at the net realizable amounts from patients, third-party payers and others for services rendered." PATIENTS OF THE BELLEVUE MEDICAL CENTER 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. PART III, LINE 8 As a part of our mission, we will provide treatment to any patient who needs it. We have a disproportionate share of Medicare patients in the community where we provide care below our cost. This produces a loss and is considered a community benefit. Our costing methodology is the cost to charge ratio. We are not a hospital and do not have a hospital cost accounting system to produce detailed cost information at the service level. We do not have or prepare Medicare cost reports, therefore we use the cost to charge ratio. PART III, LINE 9B UNMC Physicians provides financial assistance to qualified uninsured or underinsured patients requiring non-elective medically necessary treatment. Patients known to qualify for financial assistance (after completing all paperwork and receiving approval) are identified accordingly in the financial systems to ensure financial assistance is used to cover services rendered by UNMC Physicians. Financial assistance can result in 100% assistance sliding to 20%. Consideration is given to medically necessary current charges and can extend for a period up to six months. Patients can renew every TWELVE months. A reevaluation of the patient's financial situation may be performed if the patient is unable to comply with the financial assistance arrangements. Patients receive a statement from the organization as long as they have a balance due. ALL ACCOUNTS ARE MONITORED IN THE SYSTEM TO ENSURE FINANCIAL ASSISTANCE IS "POSTED" TO THE PATIENT ACCOUNT. IF ADD'L CHARGES ARE RECEIVED AFTER THE 12 MONTHS THE PATIENT MUST SUBMIT UPDATED 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 LESS discount work with customer service or collection staff to outline payment arrangements according to set policy. PATIENTS OF THE BELLEVUE MEDICAL CENTER 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. PART V, SECTION A UNMC Physicians supports the mission of the University of Nebraska Medical Center, to improve the Health of Nebraska through premier educational programs, innovative research, the highest quality patient care, and outreach to underserved populations. UNMC Physicians is not a hospital, however, owns 13.646702% of Bellevue Medical Center, LLC. On May 31, 2014, UNMC Physicians sold their interest in Bellevue Medical Center, LLC. Therefore, per the instructions the Schedule H includes all clinical activities of UNMC Physicians, plus the 13.646702% of hospital activity of Bellevue Medical Center, LLC through May 31, 2014. NEEDS ASSESSMENT Schedule H, Part VI, Line 2 UNMC Physicians 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. Bellevue Medical Center is majority owned by The Nebraska Medical Center. UNMC Physicians HAS A MINORITY OWNERSHIP, which was sold to the nebraska medical center on may 27, 2014. Both OF THESE ORGANIZATIONS are 501(c)(3) organizations. It was determined from previous assessments that the community had a need for medical services that were not currently being fulfilled. A community needs assessment was underway in the Douglas/Sarpy County area during fiscal year 2011, and filed in 2013 as a collaborative effort between all Omaha area hospitals. this is the first needs assessment that has been performed specific to BMC. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE Schedule H, Part VI, Line 3 UNMC PHYSICIANS employs financial counselors and customer service staff, all of whom are trained in assisting our patients with resolution of the patients' liability. Depending on individual patient needs, payment arrangements or financial assistance may be offered to assist our patients with resolution of their balances. Patients are educated about the requirements and eligibility for patient assistance by financial counselors onsite at clinic locations, through brochures and pamphlets, and through the unmc physicians' website. Bellevue Medical Center employs 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 contracts with a company to work with our self pay population to pursue coverage through state, federal or local programs. THE CONTRACT ORGANIZATION PROVIDES THIS PATIENT POPULATION WITH FINANCIAL ASSISTANCE APPLICATIONS TO COMPLETE AS WELL, THEREFORE, IF THE PATIENT DOES NOT MEET REQUIREMENTS FOR STATE, FEDERAL OR LOCAL COVERAGE, A FINANCIAL ASSISTANCE APPLICATION CAN BE UTILIZED. COMMUNITY INFORMATION Schedule H, Part VI, Line 4 Our mission is to further the University of Nebraska Medical Center's mission by giving leading physicians the resources necessary to provide high quality health care to patients from across Nebraska and beyond. In addition, we support the missions of, and provide services to, The Nebraska Medical Center, Children's Hospital & Medical Center, and the Omaha VA Medical Center. We generally serve the local area of Omaha, but provide service to patients throughout the state of Nebraska. In addition, given our close proximity to Iowa, we serve many patients from that state as well. patients from the Omaha Metro area served by UNMC Physicians are predominately White-Non Hispanic with over 75.02% in this category. Black Non-Hispanic make up 15.25% of the population; .53% is Hispanic - White. The remaining 9.2% includes Asian, Native American, and Unknown classifications. UNMC Physicians continues to lead the region through a focused mission including exceptional patient care, education that empowers, cutting-edge research and an emphasis on giving back to the community. At UNMC Physicians, we recognize an individual's right to quality healthcare regardless of age, sex, race, religion, national origin, or ability to pay. In addition to providing free or reduced healthcare to low income patients, UNMC Physicians supports the community through employee volunteer hours, donations to many charities and extensive financial support of the University of Nebraska Medical Center. Because of the continued dedication of our talented physicians, we are able to significantly impact the community through leadership in many medical fields. UNMC Physicians grants credit without collateral to its patients, most of whom are local residents and are insured under third party payor arrangements. The mix of our receivables from patients as of June 30, 2014 was Medicare - 12%, Medicaid - 7%, Commercial Payors - 30%, Self-Pay - 40% and Other - 11%. Bellevue Medical Center opened on May 17, 2010 in Bellevue, NE as the first full service, public hospital serving a community of roughly 50,000 residents. The hospitals service area covers all of Sarpy County and extends throughout northern Cass County and southern Douglas County in Nebraska. The hospital also serves the men and women of Offutt Air Force base which is located within its primary market. PROMOTION OF COMMUNITY HEALTH Schedule H, Part VI, Line 5 The organization is a physician practice focused on its mission of providing exceptional patient care, education of future medical professionals for the region, and research, while supporting the community. Unmc physicians is not a hospital and therefore this question is not applicable. Bellevue Medical Center has an open medical staff policy and the leadership team is active on several community boards. Bellevue medical center is a hospital, however, it is not a tax exempt organization, and therefore this question is not applicable. STATE FILING OF COMMUNITY BENEFIT REPORT Schedule H, Part VI, Line 7 Unmc physicians is not required to file its community benefit report with any state, however Unmc physicians does make it available to the public via the web link provided above. Bellevue medical center is also not required to file a community benefit report with any state. AFFILIATED HEALTH CARE SYSTEM Schedule H, Part VI, Line 6 UNMC Physicians is a not for profit corporation committed to supporting the mission of the University of Nebraska Medical Center ("UNMC"). It was established by UNMC to provide a vehicle for the faculty of the College of Medicine to develop an integrated practice for management of clinical activities. The mission of the University of Nebraska Medical Center is to improve the health of Nebraska through premier education programs, innovative research, the highest quality patient care, and outreach to underserved populations. As previously discussed, Bellevue Medical Center is majority owned by The Nebraska Medical Center, an IRC 501(c)(3) organization. PART II UNMC Physicians and Bellevue Medical Center, LLC pay attention to needs of the community in addition to their focus on healthcare. For example, during the year a grant was made by UNMC Physicians to a 501(c)(3) organization to promote academic performance, raise graduation rates, and increase civic and community responsibility. true UNIVERSITY OF NEBRASKA MEDICAL CENTER 986800 NE MED CTR OMAHA NE 68198 470049123 GOVT 38674728 EDUC. SUPPORT UNIVERSITY OF NEBRASKA FOUNDATION 8712 W DODGE RD STE 100 OMAHA NE 68114 470379839 501(C)(3) 946735 FURTHER EXEMPT PURP. FURTHER EXEMPT PURP. BUILDING BRIGHT FUTURES 1004 FARNAM ST STE 102 OMAHA NE 68102 260436138 501(C)(3) 1958154 TO FURTHER EXEMPT PURPOSE FURTHER EXEMPT PURP. THE NEBR MEDICAL CENTER 988145 NEBRASKA MED CENTER OMAHA NE 68198 911858433 501(C)(3) 19417 TO FURTHER EXEMPT PURPOSE FURTHER EXEMPT PURP. MADONNA FOUNDATION 5401 SOUTH STREET LINCOLN NE 68506 237159940 501(C)(3) 350000 TO FURTHER EXEMPT PURPOSE FURTHER EXEMPT PURP. 5 CHARITY CARE 3488 6193302 BOOK PATIENT FIN'L ASSIST PART I, LINE 2 CHARITABLE GIVING IS PRIORITIZED AS FOLLOWS: 1) HEALTH AND WELLNESS 2) HUMAN SERVICES 3) MEDICAL EDUCATION AND RESEARCH. PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS IN THE U.S.: ALL DONATION REQUESTS MUST BE SUBMITTED TO THE CHARITABLE DONATIONS COMMITTEE AND THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. THE CFO MAY ALSO REQUEST ADDITIONAL INFORMATION, AND/OR MAKE THE APPROVAL CONTINGENT UPON THE ORGANIZATION PROVIDING ONE OR MORE REPORTS DURING OR AT THE CONCLUSION OF THE PROJECT SHOWING HOW THE GRANT FUNDS WERE SPENT. ANY SINGLE DONATION REQUEST, OR DONATIONS IN THE AGGREGATE TO ANY ONE CHARITY IN A FISCAL YEAR OF $10,000, SHALL REQUIRE THE APPROVAL OF THE UNMC PHYSICIANS BOARD OF DIRECTORS. PART III UNMC PHYSICIANS HAS A WRITTEN FINANCIAL ASSISTANCE/CHARITY CARE POLICY. X X X X X false false false false false false false false false CARL V SMITH CHAIR/PRESIDENT 308574 216535 4862 0 0 23000 7976 15678 0 2774 321412 257987 0 0 MICHAEL SITORIUS VICE CHAIR/DEPARTMENT CHAIR 41732 247746 33500 0 0 0 0 20268 0 6273 75232 274287 0 0 ROBERT MUELLEMAN SECRETARY-TREASURER/DEPT CHAIR 251958 181270 32000 0 0 0 19617 14895 0 6029 303575 202194 0 0 CHARLES ENKE DIRECTOR 269851 230752 0 0 1514 0 5561 18890 0 6129 276926 255771 0 0 CRAIG W WALKER DIRECTOR 164950 323162 55000 0 0 23000 4274 28138 0 6321 224224 380621 0 0 DANIEL MURMAN DIRECTOR 82341 84912 69279 0 0 23000 8577 8853 0 3677 160197 120442 0 0 DAVID W MERCER DIRECTOR 454705 223420 60000 0 0 0 22025 14788 0 5151 536730 243359 0 0 DWIGHT JONES DIRECTOR 0 245028 0 0 0 0 0 19894 0 4158 0 269080 0 0 JOHN SPARKS DIRECTOR 0 197813 0 0 0 23000 0 17831 0 4022 0 242666 0 0 JULIE VOSE DIRECTOR 212378 121683 7535 0 0 23000 3674 11685 0 2332 223587 158700 0 0 KEVIN GARVIN DIRECTOR 419407 219482 52219 0 0 0 15065 17566 0 407 486691 237455 0 0 LYNELL KLASSEN DIRECTOR 71879 274375 13261 0 0 0 0 22040 0 2942 85140 299357 0 0 MATTHEW MORMINO DIRECTOR 346787 100240 30797 0 0 17500 28186 9882 0 5785 405770 133407 0 0 QUAN NGUYEN DIRECTOR 266668 196297 0 0 0 0 21375 16333 0 3317 288043 215947 0 0 STEVE HINRICHS DIRECTOR 197918 207174 40000 0 0 12000 14465 17917 0 5907 252383 242998 0 0 STEVEN LISCO DIRECTOR 285125 220496 50000 0 26350 23000 0 19894 0 6129 361475 269519 0 0 STEVEN WENGEL DIRECTOR 66618 236971 3450 0 0 0 0 19350 0 5569 70068 261890 0 0 TROY PLUMB DIRECTOR 139209 92752 75610 0 0 0 10839 7845 0 6129 225658 106726 0 0 CORY D SHAW EXEC VP/CEO/thru Dec 2013 200469 166604 20000 0 0 0 3597 13192 0 5877 224066 185673 0 0 DENNIS BIERLE COO 221975 0 20000 0 20 0 13623 0 8365 0 263983 0 0 0 TROY WILHELM CFO 226215 0 20000 0 14035 0 13245 0 4636 0 278131 0 0 0 BRYAN SCHWAHN ADMINISTRATOR 111673 83408 0 0 0 0 18577 5764 0 6129 130250 95301 0 0 CARIN BORG ADMINISTRATOR 88202 106979 20000 0 0 0 12272 8903 0 5322 120474 121204 0 0 DAVID MELLIGER ADMINISTRATOR 43776 85210 35000 0 0 0 13239 6981 0 2654 92015 94845 0 0 LISA RUNCO ADMINISTRATOR 95219 92392 2000 0 0 0 14723 7705 0 4798 111942 104895 0 0 ALAN LANGNAS PHYSICIAN 709352 98601 89904 0 0 0 31522 7982 0 2200 830778 108783 0 0 DANIEL SURDELL PHYSICIAN 468477 50485 0 0 0 17500 35050 5890 0 6545 503527 80420 0 0 MICHAEL MOULTON PHYSICIAN 499450 104803 60000 0 29498 17500 28044 10044 0 4129 616992 136476 0 0 WENDY JEAN WARD PHYSICIAN 541052 58942 68731 0 0 17500 0 0 0 4938 609783 81380 0 0 WILLIAM THORELL PHYSICIAN 556718 81676 0 0 0 0 33580 6761 0 3629 590298 92066 0 0 Brad Britigan MD President/effective Jan 2014 34694 346569 0 0 0 23000 0 20585 0 2116 34694 392270 0 0 PART VI, SECTION B, QUESTION 12C GOVERNANCE, MANAGEMENT, AND DISCLOSURE - CONFLICTS OF INTEREST All Covered Persons are required to complete, on an annual basis (at a minimum), a Conflict of Interest Questionnaire and Attestation of Compliance. Any Covered Person considering activity that could create an actual or potential Conflict of Interest must immediately disclose the nature of the Conflict of Interest including all material facts within the Conflict of Interest Questionnaire and Attestation of Compliance. During the time period between annual attestations, Covered Persons are encouraged to seek counsel and advice from the Chairman of the Board of Directors (Chairman) or Chief Executive Officer (CEO) should any questions arise as to whether or not personal activity or proposed activity would be considered a Conflict of Interest. Whenever there is reason to believe that an actual or potential Conflict of Interest exists between UNMC Physicians and a Covered Person, the following procedures for reviewing a potential Conflict of Interest shall be undertaken: 1.Conflicts involving Board members or Members of Board Committees The Chairman shall serve as the Designated Reviewing Official and shall have responsibility (except when he/she is a Covered Person) to promptly bring the actual or potential Conflict of Interest to the attention of the Board for action at the next regular meeting of the Board, or during a special meeting called specifically to review the potential conflict of interest. When the Chairman has an actual or potential Conflict of Interest, the CEO shall serve as the Designated Reviewing Official. 2.Conflicts involving CEO, CFO or COO The Chairman shall serve as the Designated Reviewing Official and shall have responsibility to promptly bring the actual or potential Conflict of Interest to the attention of the Board for action at the next regular meeting of the Board, or during a special meeting called specifically to review the actual or potential Conflict of Interest. 3.Conflicts involving all other Covered Persons The CEO shall serve as the Designated Reviewing Official and shall be responsible for reviewing the actual or potential Conflict of Interest. UNMC Physicians shall refrain from acting upon any transaction involving an actual or potential Conflict of Interest until such time as the actual or potential Conflict of Interest has been reviewed and final resolution (i.e., approved, denied, and/or proposed an alternative arrangement) has been determined through the applicable process described below: Conflicts involving Board members or Members of Board Committees A) The Covered Person shall have an opportunity and must be available to provide factual information about the actual or potential Conflict of Interest. B) The Covered Person shall not participate in any way in, or be present during, the deliberations and decision-making vote with respect to such actual or potential Conflict of Interest. C) The disinterested members of the Board shall consider whether the terms of the actual or potential Conflict of Interest are fair and reasonable to UNMC Physicians and shall vote to determine final resolution. D)Final resolution of the arrangement by the disinterested members of the Board shall be by vote of a majority of directors in attendance at a meeting at which a quorum is present. A Covered Person shall not be counted for purposes of determining whether a quorum is present, nor for purposes of determining what constitutes a majority vote of Board members in attendance. 2.Conflicts involving CEO, CFO, COO A)The Covered Person shall have an opportunity and must be available to provide factual information about the actual or potential Conflict of Interest. B)The Covered Person shall not participate in any way in, or be present during, the deliberations and decision-making vote with respect to the actual or potential Conflict of Interest. C)The Chairman shall bring actual or potential Conflicts of Interest to the attention of the Board for action. Members of the Board shall consider whether the terms of the actual or potential Conflict of Interest are fair and reasonable to UNMC Physicians and shall vote to determine final resolution. D)Final resolution of the actual or potential Conflict of Interest by the disinterested members of the Board shall be by vote of a majority of directors in attendance at a meeting at which a quorum is present. 3.Conflicts involving all other Covered Persons A) The Covered Person shall have an opportunity and must be available to provide factual information about the actual or potential Conflict of Interest. B) The Covered Person shall not participate in any way in, or be present during, the deliberations and decision-making vote with respect to such actual or potential Conflict of Interest. C) The CEO shall be responsible for reviewing and determining final resolution of actual or potential Conflicts of Interest. All results shall be reported to the Chairman who may then determine whether any further board review or action is necessary. PART VI, SECTION B, QUESTION 15A & 15B POLICIES - COMPENSATION The Compensation Committee for accepting/revising/rejecting executive compensation is comprised of: 1. the Chair of the Board of Directors of UNMC Physicians ("Board"); 2. Vice Chancellor for Business and Finance of the University of Nebraska; 3. two members who are not employees of UNMC Physicians. These two members shall be appointed by the Committee Chair and are subject to approval of Board; and 4. three Board members, who are chairs of clinical departments. The Compensation Committee reviews all proposed compensation. 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. The Compensation Committee shall ensure, when reviewing and approving all compensation (subject to the Compensation Committee Policy and Procedure) 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 Compensation Committee shall: 1. ensure that no conflict of interest is present with Compensation Committee members present; 2. receive and rely upon appropriate data as to comparability from internal or external resources prior to making its determination; and 3. document the basis for its determination of reasonableness concurrently with making that determination. Such documentation shall include: a) the terms of the arrangement that was approved and the date it was approved; b) the members of the Compensation 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 Compensation Committee and how such material was obtained; and d) the action(s) taken by the Compensation Committee. AT THE END OF FISCAL 2013, UNMC PHYSICIANS RETAINED THE SERVICES OF AN INDEPENDENT CONSULTANT TO EVALUATE AND MAKE APPROPRIATE RECOMMENDATIONS ON EXECUTIVE COMPENSATION FOR FISCAL YEAR 2014. Form 990, Part VI, Line 19 GOVERNANCE, MANAGEMENT, AND DISCLOSURE Governing documents, Conflict of Interest policy, and audited financial statements are available to the public upon request in the administration offices. PART VI, LINE 11B GOVERNANCE, MANAGEMENT, AND DISCLOSURE The Form 990 is initially reviewed in detail by the Finance committee of the Board of Directors, with executive management and independent tax specialists present to assist with the review. The Committee's role is to thoroughly understand the Form 990 contents and to report to the full board of directors the results of its review. The review with the full Board of Directors is conducted prior to the filing of the Form 990 with the IRS. The Form 990 is sent to each Director of the Board one week prior to the Board Meeting at which the Form 990 will be reviewed and reported upon by the Committee. PART VII, SECTION A IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS UNIVERSITY OF NEBRASKA MEDICAL CENTER IS A PART OF THE UNIVERSITY OF NEBRASKA GOVERNED BY THE BOARD OF REGENTS. PART VI, SECTION A, LINE 6 GOVERNANCE, MANAGEMENT, AND DISCLOSURE The Corporation's Bylaws and Articles of Incorporation provide that all full time, part time and volunteer faculty members of the University of Nebraska College of Medicine who provide professional clinical healthcare services and have a separate employment arrangement with the Corporation are deemed members of the Corporation. Each full time member is entitled to one vote on any matter submitted to a vote of the members. PART VI, SECTION A, LINE 7A GOVERNANCE, MANAGEMENT, AND DISCLOSURE Four director seats on the board of directors shall be filled by and elected by the full time members of the corporation. PART VI, SECTION A, LINE 7B GOVERNANCE, MANAGEMENT, AND DISCLOSURE The Board of Regents of the University of Nebraska (Board of Regents), is a public corporate body organized and existing under the Constitution and laws of the State of Nebraska. The Corporation exists under the provisions of the medical service plan as adopted by the Board of Regents. Therefore, certain actions taken by the Corporation require approval by the Board of Regents. In addition, certain matters taken up by the Corporation's Board of Directors may require member approval. PART VI, SECTION A, LINE 2 GOVERNANCE, MANAGEMENT, AND DISCLOSURE CARL V SMITH AND MICHAEL SITORIUS HAVE A BOARD RELATIONSHIP PART IV, LINE 12B REQUIRED SCHEDULES UNMC PHYSICIANS IS A BLENDED COMPONENT UNIT OF THE UNIVERISTY OF NEBRASKA. PART VI, SECTION A, LINE 1A During the fiscal year ended June 30 2014, the Board of Directors of UNMC Physicians adopted a resolution which delegated certain authority over the governance of UNMCP to an Advisory Board comprised of Jeffrey Gold, MD, Bradley Britigan, MD., William Dinsmoor, Mogens Bay, Bruce Grewcock, Nancy Keegan, James McClurg PhD, Charles Burt, MD, Timothy Kingston, MD, Debra Romberger MD, and Carl Smith MD. The UNMCP's Board of Directors retained the authority to issue non-operating debt, matters concerning its members, and commitments of UNMCP's assets in excess of $500,000. The Board also retained the right and authority to rescind or amend the resolution at any time. This resolution and the resulting creation of an Advisory Board is an interim step towards the combination of The Nebraska Medical Center (TNMC), Bellevue Medical Center (BMC) and UNMCP to form an integrated clinical enterprise. Effective during January 2014, UNMC Physicians executive duties of President and CEO were assigned to Brad Britigan, MD and William Dinsmoor. PART VI, SECTION A, LINE 9 TROY WILHELM VICE PRESIDENT OF FINANCE UNIVERSITY OF MINNESOTA PHYSICIANS 720 WASHINGTON AVE SE MINNEAPOLIS, MN 55414 Part VII, Section A, Line 1A Brad Britigan, M.D. is an officer as of January 2014. He was not paid in 2013 as an officer, however, he did receive compensation and benefits as he served as the Dean & a Physician during 2013 for UNMC & UNMC Physicians respectively. UNIVERSITY OF NEBRASKA MEDICAL CENTER 986800 NEBRASKA MEDICAL CENTER OMAHA NE 68198 470049123 EDUCATION NE GOVT N/A NA false NONE NONE false true false false false false false false false false true false true true true true true true false