NEBRASKA PEDIATRIC PRACTICE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
NEBRASKA PEDIATRIC PRACTICE INC (EIN 26-3064869)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-02-14
IRS object ID
201330459349302143
Schema version
2011v1.5
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

FieldValueIRS element (for citing)
Timestamp2013-02-14T15:23:42-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1Two Central Park Plaza Suite 1501AddressLine1
CityOmahaCity
StateNEState
ZIP Code681021626ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN263064869EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Nebraska Pediatric Practice IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MICHAEL MCGLADEInCareOfName
Name ControlNEBRNameControl
Phone4029554116Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line18200 Dodge StreetAddressLine1
CityOmahaCity
StateNEState
ZIP Code68114ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL R MCGLADEName
TitleTREASURERTitle
Date Signed2013-02-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLORRAINE A EGGERName
Phone4023481450Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Children's Specialty PhysiciansBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEVEN C BURNHAMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line18200 Dodge StreetAddressLine1
CityOmahaCity
StateNEState
ZIP Code68114ZIPCode
FieldValueIRS element (for citing)
Gross Receipts42596404GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.childrensspecialtyphysicians.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2008YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionTo develop, promote and make available to children from Omaha, Nebraska, and the region, clinical services and other related programs.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees134TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year405200ContributionsGrantsPriorYear
Contributions Grants Current Year450000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year37446196ProgramServiceRevenuePriorYear
Program Service Revenue CY35458048ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year3688414OtherRevenuePriorYear
Other Revenue Current Year6688356OtherRevenueCurrentYear
Total Revenue Prior Year41539810TotalRevenuePriorYear
Total Revenue Current Year42596404TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year32013694SalariesEtcPriorYear
Salaries Etc Current Year33505017SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year26296365OtherExpensePriorYear
Other Expenses Current Year25048958OtherExpensesCurrentYear
Total Expenses Prior Year58310059TotalExpensesPriorYear
Total Expenses Current Year58553975TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-16770249RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-15957571RevenuesLessExpensesCY
Total Assets BOY8026402TotalAssetsBOY
Total Assets EOY8274851TotalAssetsEOY
Total Liabilities BOY8026402TotalLiabilitiesBOY
Total Liabilities EOY8274851TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY0NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionProvide 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 ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense55075543Expense
Revenue42146404Revenue
DescriptionTo 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, enviornment, 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 Expense55075543TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees134NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL MCGLADENamePerson
Telephone Number4029554116TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18200 DODGE STAddressLine1
CityOmahaCity
StateNEState
ZIP Code68114ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
GARY PERKINS
MEMBER1.0X000
MICHAEL BROWN
SECRETARY/TREASURER1.0X000X
CARL GUMBINER MD
MEMBER1.0X000
BRADLEY BRITIGAN MD
MEMBER1.0X000
MICHAEL MCGLADE
SECRETARY/TREASURER1.0X000X
JOHN SPARKS MD
CHAIRMAN1.0X460881029400X
STEPHEN RAYNOR MD
MEMBER1.0X725893029400
JOHN KUGLER MD
MEMBER1.0X367058027172
MOHAN MYSORE MD
VICE-CHAIRMAN1.0X513048029400X
PAUL ESPOSITO MD
MEMBER1.0X444888029400
ROBERT GLOW
EXECUTIVE DIRECTOR/CAO40.0266802024200X
STEVEN C BURNHAM
PRESIDENT40.0000X
ROBERT A CUSICK MD
PHYSICIAN40.0689726029400X
SHAHAB F ABDESSALAM MD
PHYSICIAN40.0699152029400X
KENNETH S AZAROW MD
PHYSICIAN40.0721393029400X
JAMES M HAMMEL MD
PHYSICIAN40.0842152029400X
KIM DUNCAN MD
PHYSICIAN40.0595519029400X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6326512TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation315972TotalOtherCompensation
Number Individuals GT100 K123NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
UNMC PHYSICIANS
988105 NEBRASKA MEDICAL CENTEROMAHANE681988105OPERATING AGREEMENT1825258
SIOUX CENTER AVIATION
3028 360TH STREETSIOUX CENTERIA51250TRANSPORATION181271
ABEO
4100 INTERNATIONAL PLAZA SUITE 600FORT WORTHTX76109COLLECTIONS168851
MEDICAL DOCTOR ASSOCIATES
PO BOX 277185ATLANTAGA303847185LOCUM TENENS119500
UNIVERSITY OF NE MED CENTER
988105 NEBRASKA MEDICAL CENTEROMAHANE681988105HOUSE OFFICER103895
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions450000AllOtherContributions
Total Contributions450000TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6211103228830332288303
OTHER PROGRAM SERVICES90009931697453169745
FieldValueIRS element (for citing)
Total Program Service Revenue35458048TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS REVENUEDescription
Business Code541900BusinessCode
Total Revenue Column6688356TotalRevenueColumn
Related Or Exempt Function Income6688356RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue6688356TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column42596404TotalRevenueColumn
Related Or Exempt Function Income42146404RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3675710Total
Program Services3675710ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total25760442Total
Program Services25713209ProgramServices
Management And General47233ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2585315Total
Program Services2579165ProgramServices
Management And General6150ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total25635Total
Program Services25364ProgramServices
Management And General271ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1457915Total
Program Services1456427ProgramServices
Management And General1488ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2398634Total
Program Services1209330ProgramServices
Management And General1189304ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total948Total
Management And General948ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total1646353Total
Program Services1646353ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total15390Total
Management And General15390ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10032852Total
Program Services8522146ProgramServices
Management And General1510706ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total687898Total
Program Services650444ProgramServices
Management And General37454ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4990974Total
Program Services4739531ProgramServices
Management And General251443ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total213285Total
Program Services213285ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total662701Total
Program Services555763ProgramServices
Management And General106938ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DEVELOPMENT SUPPORT EXPENSE24700642311189158875
PROVISION FOR BAD DEBT1143316106522578091
PROFESSIONAL BUSINESS EXPENSE281124280982142
MEMBERSHIP DUES & SUBSCRIPTION252772252407365

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total252647Total
Program Services179013ProgramServices
Management And General73634ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total58553975Total
Program Services55075543ProgramServices
Management And General3478432ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2261504BOY
EOY1211343EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5764898BOY
EOY7063508EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8026402BOY
EOY8274851EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8026402BOY
EOY8274851EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8026402BOY
EOY8274851EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8026402BOY
EOY8274851EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-15957571ReconcilationRevenueExpenses
Reconcilation Other Changes15957571ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
General ExplanationNEBRASKA 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)(v). 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

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Total Revenue42596404TotalRevenue
Total Expenses58553975TotalExpenses
Excess Or Deficit For Year-15957571ExcessOrDeficitForYear
Excess Or Deficit Per FS-15957571ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt42596404TotRevenueEtcAuditedFinclStmt
Revenue Subtotal42596404RevenueSubtotal
Total Revenue Per Form99042596404TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt58553975TotExpensesEtcAuditedFinclStmt
Expenses Subtotal58553975ExpensesSubtotal
Total Expenses Per Form99058553975TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE D, PART X, LINE 2Identifier
ExplanationCHILDREN'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 POSITONS ARE MEASURED AT THE LARGERST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGINITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. DURING 2012 CSP DID NOT RECORD ANY AMOUNTS RELATED TO UNCERTAIN TAX POSITIONS OR ANY ACCRUED INTEREST AND PENALTIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN SPARKS MD
210926032786021716902940003130490594000
STEPHEN RAYNOR MD
6878480170903633602940003130755606000
JOHN KUGLER MD
211487012500014307102717202810394511000
MOHAN MYSORE MD
42026705664103614002940003130542761000
PAUL ESPOSITO MD
287957040000011693102940003110474599000
ROBERT GLOW
20558805913302081049000193000291002000
ROBERT A CUSICK MD
6518480003787802940003130719439000
SHAHAB F ABDESSALAM MD
6597860003936602940003130728865000
KENNETH S AZAROW MD
6799980004139502940003130751106000
JAMES M HAMMEL MD
7644630007768902940003130871865000
KIM DUNCAN MD
47385600012166302940003130625232000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE J, PART II, LINE 3Identifier
ExplanationCOMPENSATION FROM CHILDREN'S HOSPITAL & MEDICAL CENTER, AN UNRELATED ORGANIZATION, FOR SERVICES PROVIDED TO THE NEBRASKA PEDIATRIC PRACTICE INC.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, Line 11BThe 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 12cAn 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, 7bThere 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 15aEach 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 tha 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 15bDIRECTORS 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 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 5SUPPORT FROM HOSPITAL MEMBER $15,957,571

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