NEBRASKA PEDIATRIC PRACTICE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NEBRASKA PEDIATRIC PRACTICE INC (EIN 26-3064869)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-02-25
- IRS object ID
- 201430569349300403
- Schema version
- 2012v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-02-25T09:12:18-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1212 North 96th Street Suite 300 | AddressLine1 |
| City | Omaha | City |
| State | NE | State |
| ZIP Code | 68114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263064869 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nebraska Pediatric Practice Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MICHAEL BROWN | InCareOfName |
| Name Control | NEBR | NameControl |
| Phone | 4029554116 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8200 Dodge Street | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | Omaha | City |
| State | NE | State |
| ZIP Code | 68114 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael Brown | Name |
| Title | Secretary/Treasurer | Title |
| Phone | 4029554116 | Phone |
| Date Signed | 2014-02-20 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4023481450 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Children's Specialty Physicians | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL BROWN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8200 Dodge Street | AddressLine1 |
| City | Omaha | City |
| State | NE | State |
| ZIP Code | 68114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 46937204 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.childrensspecialtyphysicians.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2008 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | To develop, promote and make available to children from Omaha, Nebraska, and the region, clinical services and other related programs. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 142 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 450000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 245962 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 35458048 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 37875817 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6688356 | OtherRevenuePriorYear |
| Other Revenue Current Year | 8815425 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 42596404 | TotalRevenuePriorYear |
| Total Revenue Current Year | 46937204 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 33505017 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 36753252 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 25048958 | OtherExpensePriorYear |
| Other Expenses Current Year | 25298026 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 58553975 | TotalExpensesPriorYear |
| Total Expenses Current Year | 62051278 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -15957571 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -15114074 | RevenuesLessExpensesCY |
| Total Assets BOY | 8274851 | TotalAssetsBOY |
| Total Assets EOY | 9861438 | TotalAssetsEOY |
| Total Liabilities BOY | 8274851 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9861438 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 0 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 0 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PROVIDE 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, NEBRASKA AND THE SURROUNDING AREA, PEDIATRIC ACADEMIC AND CLINICAL SERVICES AND OTHER PROGRAMS AND ACTIVITIES RELATED THERETO IN ORDER TO ACHIEVE THE PHYSICIANS' COMMON GOALS OF IMPROVING THE MANNER, PROCESS, ENVIRONMENT, ACCESSIBILITY, TIMING, AND OTHER FACTORS INVOLVED IN THE DELIVERY OF PEDIATRIC ACADEMIC AND CLINICAL SERVICES IN ORDER TO ADVANCE THE HEALTH OF THE CHILDREN WITHIN THE REGION. PROMOTE AND SUPPORT EDUCATIONAL AND TEACHING PROGRAMS IN CHILDREN'S HEALTH. PROMOTE AND SUPPORT MEDICAL AND SCIENTIFIC RESEARCH IN CHILDREN'S HEALTH. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 57724353 | Expense |
| Revenue | 46691242 | Revenue |
| Description | To provide collective resources, expertise and knowledge of pediatric specialty physicians to develop promote and make available to children from Omaha, Nebraska 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. | Description |
| Total Program Service Expense | 57724353 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 6 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 142 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MICHAEL BROWN | NamePerson |
| Telephone Number | 4029554116 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8200 DODGE ST | AddressLine1 |
| City | Omaha | City |
| State | NE | State |
| ZIP Code | 68114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| GARY PERKINS | ||||||||
| MEMBER | 1.0 | 0.0 | X | 0 | 0 | 0 | ||
| MICHAEL BROWN | ||||||||
| SECRETARY/TREASURER | 1.0 | 0.0 | X | 0 | 0 | 0 | X | |
| CARL GUMBINER MD | ||||||||
| MEMBER | 1.0 | 0.0 | X | 0 | 0 | 0 | ||
| BRADLEY BRITIGAN MD | ||||||||
| MEMBER | 1.0 | 0.0 | X | 0 | 0 | 0 | ||
| MICHAEL MCGLADE | ||||||||
| SECRETARY/TREASURER | 1.0 | 0.0 | X | 0 | 0 | 0 | X | |
| JOHN SPARKS MD | ||||||||
| CHAIRMAN/Physician | 40.0 | 0.0 | X | 597706 | 0 | 30000 | X | |
| STEPHEN RAYNOR MD | ||||||||
| MEMBER/Physician | 40.0 | 0.0 | X | 727198 | 0 | 30000 | ||
| MOHAN MYSORE MD | ||||||||
| VICE-CHAIRMAN | 40.0 | 0.0 | X | 513917 | 30000 | X | ||
| PAUL ESPOSITO MD | ||||||||
| VICE-CHAIRMAN/Physician | 40.0 | 0.0 | X | 531879 | 0 | 30000 | X | |
| KARI SIMONSEN MD | ||||||||
| MEMBER/Physician | 40.0 | 0.0 | X | 167914 | 0 | 9456 | ||
| STEVEN C BURNHAM | ||||||||
| PRESIDENT | 40.0 | 0.0 | 327542 | 5000 | X | |||
| ROBERT A CUSICK MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 702682 | 0 | 30000 | X | ||
| SHAHAB F ABDESSALAM MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 716535 | 0 | 30000 | X | ||
| KENNETH S AZAROW MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 741986 | 0 | 30000 | X | ||
| JAMES M HAMMEL MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 918832 | 0 | 30000 | X | ||
| LYNNE WILLETT MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 538423 | 0 | 30000 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 6484614 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 284456 | TotalOtherCompensation |
| Number Individuals GT100 K | 133 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | true | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| UNMC PHYSICIANS | |||||
| 988105 NEBRASKA MEDICAL CENTER | OMAHA | NE | 681988105 | OPERATING AGREEMENT | 2177495 |
| SIOUX CENTER AVIATION | |||||
| 3028 360TH STREET | SIOUX CENTER | IA | 51250 | TRANSPORATION | 208480 |
| ABEO | |||||
| 4100 INTERNATIONAL PLAZA SUITE 600 | FORT WORTH | TX | 76109 | COLLECTIONS | 303211 |
| UNIVERSITY OF NE MED CENTER | |||||
| 988105 NEBRASKA MEDICAL CENTER | OMAHA | NE | 681988105 | HOUSE OFFICER | 270972 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| All Other Contributions | 245962 | AllOtherContributions |
| Total Contributions | 245962 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | 34141337 | 34141337 |
| OTHER PROGRAM SERVICES | 900099 | 3734480 | 3734480 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 37875817 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 541900 | BusinessCode |
| Total Revenue Column | 8815425 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8815425 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 8815425 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 46937204 | TotalRevenueColumn |
| Related Or Exempt Function Income | 46691242 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2832868 | Total |
| Program Services | 2832868 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29296821 | Total |
| Program Services | 28922756 | ProgramServices |
| Management And General | 374065 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2754668 | Total |
| Program Services | 2732861 | ProgramServices |
| Management And General | 21807 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 251037 | Total |
| Program Services | 251037 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1617858 | Total |
| Program Services | 1594612 | ProgramServices |
| Management And General | 23246 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2030078 | Total |
| Program Services | 438893 | ProgramServices |
| Management And General | 1591185 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3098 | Total |
| Program Services | 2315 | ProgramServices |
| Management And General | 783 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2375786 | Total |
| Program Services | 2334144 | ProgramServices |
| Management And General | 41642 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20769 | Total |
| Management And General | 20769 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10345114 | Total |
| Program Services | 8787678 | ProgramServices |
| Management And General | 1557436 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4489 | Total |
| Program Services | 4489 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 821143 | Total |
| Program Services | 793879 | ProgramServices |
| Management And General | 27264 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4154791 | Total |
| Program Services | 3857277 | ProgramServices |
| Management And General | 297514 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242817 | Total |
| Program Services | 242817 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 569305 | Total |
| Program Services | 486390 | ProgramServices |
| Management And General | 82915 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DEVELOPMENT SUPPORT EXPENSE | 2638674 | 2434460 | 204214 |
| PROVISION FOR BAD DEBT | 1142105 | 1142105 | |
| PROFESSIONAL BUSINESS EXPENSE | 338740 | 335600 | 3140 |
| MEMBERSHIP DUES & SUBSCRIPTION | 262851 | 260385 | 2466 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 348266 | Total |
| Program Services | 269787 | ProgramServices |
| Management And General | 78479 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62051278 | Total |
| Program Services | 57724353 | ProgramServices |
| Management And General | 4326925 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1211343 | BOY |
| EOY | 2369570 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7063508 | BOY |
| EOY | 7442217 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 51363 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1712 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 49651 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8274851 | BOY |
| EOY | 9861438 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8274851 | BOY |
| EOY | 9861438 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8274851 | BOY |
| EOY | 9861438 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8274851 | BOY |
| EOY | 9861438 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -15114074 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 15114074 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| General Explanation | NEBRASKA PEDIATRIC PRACTICE INC. (NPP) HAS CHECKED LINE 3 ON THE SCHEDULE A AS THE IRS HAS RECOGNIZED NPP AS A TAX EXEMPT HOSPITAL UNDER IRC SECTION 501(C)(3) AND AS A HOSPITAL UNDER IRC SECTION 170(B)(1)(A)(iii). ALTHOUGH NPP HAS BEEN RECOGNIZED AS A HOSPITAL, IT DOES NOT OWN OR OPERATE A LICENSED HOSPITAL. THEREFORE, A SCHEDULE H HAS APPROPRIATELY NOT BEEN COMPLETED. | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years | |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 51363 | OtherCostOrOtherBasis |
| Depreciation | 1712 | Depreciation |
| Book Value | 49651 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 49651 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 45795098 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 45795098 | RevenueSubtotal |
| Other Revenues Not Included | 1142106 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1142106 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 46937204 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 60909172 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 60909172 | ExpensesSubtotal |
| Other Expenses Not Included | 1142106 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1142106 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 62051278 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| SCHEDULE D, PART X, LINE 2 | CHILDREN'S SPECIALTY PHYSICIANS (CSP) RECOGNIZES THE EFFECT OF INCOME TAX POSITONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGERST 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. DURING fiscals year ending 2013 and 2012 CSP DID NOT RECORD ANY AMOUNTS RELATED TO UNCERTAIN TAX POSITIONS OR ANY ACCRUED INTEREST AND PENALTIES. |
| SCHEDULE D, PART XI, LINE 4B | PROVISION FOR BAD DEBT $1,142,106 |
| SCHEDULE D, PART XII, LINE 4B | PROVISION FOR BAD DEBT $1,142,106 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN SPARKS MD | ||||||||||||||
| CHAIRMAN/Physician | 375606 | 0 | 0 | 0 | 222100 | 0 | 30000 | 0 | 307 | 0 | 628013 | 0 | 0 | 0 |
| STEPHEN RAYNOR MD | ||||||||||||||
| MEMBER/Physician | 687648 | 0 | 0 | 0 | 39550 | 0 | 30000 | 0 | 307 | 0 | 757505 | 0 | 0 | 0 |
| MOHAN MYSORE MD | ||||||||||||||
| VICE-CHAIRMAN | 436642 | 41902 | 35373 | 30000 | 307 | 544224 | 0 | |||||||
| PAUL ESPOSITO MD | ||||||||||||||
| VICE-CHAIRMAN/Physician | 295503 | 0 | 116837 | 0 | 119539 | 0 | 30000 | 0 | 307 | 0 | 562186 | 0 | 0 | 0 |
| ROBERT A CUSICK MD | ||||||||||||||
| PHYSICIAN | 664148 | 0 | 0 | 0 | 38534 | 0 | 30000 | 0 | 307 | 0 | 732989 | 0 | 0 | 0 |
| SHAHAB F ABDESSALAM MD | ||||||||||||||
| PHYSICIAN | 675648 | 0 | 0 | 0 | 40887 | 0 | 30000 | 0 | 307 | 0 | 746842 | 0 | 0 | 0 |
| KENNETH S AZAROW MD | ||||||||||||||
| PHYSICIAN | 699648 | 0 | 0 | 0 | 42338 | 0 | 30000 | 0 | 307 | 0 | 772293 | 0 | 0 | 0 |
| JAMES M HAMMEL MD | ||||||||||||||
| PHYSICIAN | 841925 | 0 | 0 | 0 | 76907 | 0 | 30000 | 0 | 307 | 0 | 949139 | 0 | 0 | 0 |
| STEVEN C BURNHAM | ||||||||||||||
| PRESIDENT | 242000 | 82464 | 3078 | 5000 | 832 | 333374 | 0 | |||||||
| KARI SIMONSEN MD | ||||||||||||||
| MEMBER/Physician | 78669 | 0 | 0 | 0 | 89245 | 0 | 9456 | 0 | 134 | 0 | 177504 | 0 | 0 | 0 |
| LYNNE WILLETT MD | ||||||||||||||
| PHYSICIAN | 476577 | 0 | 25000 | 0 | 36846 | 0 | 30000 | 0 | 307 | 0 | 568730 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE J, PART I, LINE 3 | Identifier |
| Explanation | COMPENSATION FOR THE PRESIDENT IS PAID BY THE HOSPITAL MEMBER, CHILDREN'S HOSPITAL & MEDICAL CENTER, AN UNRELATED ORGANIZATION, FOR SERVICES PROVIDED TO THE NEBRASKA PEDIATRIC PRACTICE INC. SEE SCHEDULE O NARRATIVE FOR PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION ON THE PRESIDENT'S COMPENSATION ARRANGEMENT AND REVIEW PROCESS. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section B, Line 11B | The Form 990 will be distributed via e-mail to the Nebraska Pediatric Practice board members for review prior to filing to 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, SECTION, B, LINE 11A "NO." | |
| Form 990, Part VI, Section B, Line 12c | An Officer, Director, Commitee 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. A 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 disclosed 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 Review Committee shall: 1. Review all annual disclosure questionnaires and interim supplemental disclosures from persons subject to the policy. 2. Indentify 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 implementaion procedures to determine whether any changes are required. | |
| Form 990, Part VI, Section A, Lines 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 President. 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 the 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 Corporation's annual budget, capital expenditures budget, mission statement, operating plan, and long-range plan; (ii) incurrence or 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 distributions of capital or net earnings of the Corporation; and (viii) admission of new Members. The affirmative approval of both Members is necessary for any action of the Members. | |
| Form 990, Part VI, Section B, Line 15a | Each year, Towers Watson, an independent company, conducts a market analysis of executive compensation, to substantiate the compensation of the President of the Corporation. The President is employed by the Hospital Member and leased to the corporation. This information is presented to the Hospital Member's Compensation Committee for review. Executive base salaries are targeted for the 50th percentile of the market. Towers Watson issues a reasonableness opinion letter regarding the appropriateness of executive pay levels. The Hospital Member's Board of Directors receives a report from the compensation committee. | |
| Form 990, Part VI, Section B, Line 15b | DIRECTORS of the Corporation are not compensated for serving as DIRECTORS. The Corporation's management makes a determination annually of whether there are any employees who fall within the definition of "key employee" for purposes of filing the 990. | |
| Form 990, Part VI, Section C, Line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART XI, LINE 9 | SUPPORT FROM HOSPITAL MEMBER $15,114,074 | |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | DESCRIPTION:TEMP AND CONTRACT SERVICES TOTAL FEES:9241977 | FORM 990 PART IX LINE 11G |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | DESCRIPTION:RESIDENTS EXPENSE TOTAL FEES:175929 | FORM 990 PART IX LINE 11G |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | DESCRIPTION:CONTRACT PHYSICIANS TOTAL FEES:469849 | FORM 990 PART IX LINE 11G |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:210186 | FORM 990 PART IX LINE 11G |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | DESCRIPTION:RECRUITMENT TOTAL FEES:152848 | FORM 990 PART IX LINE 11G |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES | DESCRIPTION:COMMUNICATIONS TOTAL FEES:94325 | FORM 990 PART IX LINE 11G |
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