CRETE AREA MEDICAL CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CRETE AREA MEDICAL CENTER (EIN 47-0841285)
Tax period
2009-06-01 to 2010-05-31
Filed
2011-04-15
IRS object ID
201101059349300805
Schema version
2009v1.7
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)
Timestamp2011-04-15T08:03:31-04:00Timestamp
Tax Period End Date2010-05-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1190 CARONDELET PLAZA SUITE 1300AddressLine1
CityCLAYTONCity
StateMOState
ZIP Code63105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-06-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470841285EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CRETE AREA MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCRETNameControl
Phone4024813190Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12910 BETTEN DRIVEAddressLine1
CityCRETECity
StateNEState
ZIP Code683330220ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRuss GronewoldName
TitleVP FINANCE & CFOTitle
Date Signed2011-04-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142901000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRussell GronewoldNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11600 SOUTH 48TH STREETAddressLine1
CityLINCOLNCity
StateNEState
ZIP Code68506ZIPCode
FieldValueIRS element (for citing)
Gross Receipts20773131GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.CRETEAREAMEDICALCENTER.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionCRETE AREA MEDICAL CENTER IS COMMITTED TO MAKING A DIFFERENCE IN OUR COMMUNITY AND THE LIVES OF THE INDIVIDUALS WE SERVE THROUGH COMPASSIONATE AND EXCEPTIONAL CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees196TotalNbrEmployees
Total Nbr Volunteers125TotalNbrVolunteers
Total Gross UBI971TotalGrossUBI
Contributions Grants Prior Year195328ContributionsGrantsPriorYear
Contributions Grants Current Year243317ContributionsGrantsCurrentYear
Program Service Revenue Prior Year18285663ProgramServiceRevenuePriorYear
Program Service Revenue CY20202752ProgramServiceRevenueCY
Investment Income Prior Year102848InvestmentIncomePriorYear
Investment Income Current Year108858InvestmentIncomeCurrentYear
Other Revenue Prior Year185903OtherRevenuePriorYear
Other Revenue Current Year203506OtherRevenueCurrentYear
Total Revenue Prior Year18769742TotalRevenuePriorYear
Total Revenue Current Year20758433TotalRevenueCurrentYear
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 Year8004822SalariesEtcPriorYear
Salaries Etc Current Year8874926SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7994735OtherExpensePriorYear
Other Expenses Current Year9155358OtherExpensesCurrentYear
Total Expenses Prior Year15999557TotalExpensesPriorYear
Total Expenses Current Year18030284TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2770185RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2728149RevenuesLessExpensesCY
Total Assets BOY24871987TotalAssetsBOY
Total Assets EOY26433282TotalAssetsEOY
Total Liabilities BOY18502186TotalLiabilitiesBOY
Total Liabilities EOY16813197TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6369801NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9620085NetAssetsOrFundBalancesEOY
Mission DescriptionThe formal mission statement adopted by the Crete Area Medical Center (CAMC) BOARD STATES "CAMC IS COMMITTED TO MAKING A DIFFERENCE IN OUR COMMUNITY AND THE LIVES OF THE INDIVIDUALS WE SERVE THROUGH COMPASSIONATE AND EXCEPTIONAL CARE." CAMC'S VISION IS TO BE A RESPECTED COMMUNITY LEADER AND HEALTH CARE PROVIDER, WHERE PATIENTS SEEK EXCEPTIONAL CARE, PHYSICIANS PREFER TO PRACTICE, AND TEAM MEMBERS DESIRE TO WORK. THE FOCUS OF CAMC IS ON THE PATIENT EXPERIENCE AND MEANINGFUL WORK. CAMC IS COMMITTED TO THE FOLLOWING FUNDAMENTAL BELIEFS: INTEGRITY - OUR FOUNDATION; RESPECT - OUR COMPASSION; SERVICE - OUR STANDARD; EXCELLENCE - OUR DISTINCTION; COLLABORATION - OUR INVESTMENT; AND LEADERSHIP - OUR FUTURE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense16511065Expense
Grants0Grants
Revenue20163789Revenue
DescriptionCAMC, located in Crete, Nebraska, is a Nebraska nonprofit corporation as described in Section 501(c)(3) of the Internal Revenue Code and has received determination that it is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code in order to provide health care services. CAMC was incorporated in April 2001 and operates a 25-licensed bed critical access hospital and two physician clinics serving patients and residents principally from Saline and Lancaster counties. During the fiscal year ending May 31, 2010, CAMC provided inpatient acute, swing bed and nursery services to 623 patients. CAMC performed 707 surgical procedures and provided primary care physician services with 21,106 visits. CAMC offers a specialized pediatric program and professionals to compliment our family practice medicine.Description
Total Program Service Expense16511065TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
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 MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109654NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees196NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
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
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
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 BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBRYCE BETKENamePerson
Telephone Number4028267945TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12910 BETTEN DRIVEAddressLine1
CityCRETECity
StateNEState
ZIP Code68333ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
COLLYN FLORENDO
BOARD CHAIRPERSON1.0X000
WILLIS LUEDKE
VICE CHAIRPERSON1.0X000
CAROL FRIESEN
PRESIDENT & CEO50.0X180543012863X
SHIRLEY SIEDHOFF
SECRETARY1.0X000X
GARY LOTHROP DVM
TREASURER1.0X000X
KENNETH FOSTER
DIRECTOR1.0X029148619392
ROBERT TUMA MD
DIRECTOR50.0X193370024631
JENNIFER LESOING-LUCS
DIRECTOR, RESIGNED 1/22/20101.0X0487107354342X
JACK HUCK
DIRECTOR1.0X000
KATHLEEN CAMPBELL
DIRECTOR1.0X021973813046
BRYCE BETKE
CHIEF FINANCIAL OFFICER50.0125817020141X
MARJORIE HEIER MD
PHYSICIAN50.0322536037664X
RUSSELL EBKE MD
PHYSICIAN50.0242382034010X
TAMMY SCHROEDER
PHYSICIAN ASSISTANT50.013170108170X
KURT SCHMECKPEPER
PHYSICIAN ASSISTANT50.012697806629X
RHONDA ERWAY
PHARMACIST50.011084409727X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1434171TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs998331TotalReportableCompFrmRltdOrgs
Total Other Compensation540615TotalOtherCompensation
Number Individuals GT100 K9NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sampson Construction Inc
6402 JudsonLINCOLNNE68502Construction Service1445599
Alley Todd
2525 South 79th StreetLINCOLNNE68506Anesthesia Services293665
Healthland
625 South Lakeshore DriveGLENWOODMN56334Maintenance Contract211022
Nebraska LabLinc
5440 South Street Suite 100LINCOLNNE68506Lab Services198743
Complete Children's Health
8201 Northwoods DriveLINCOLNNE68505Medical Services150831
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
Related Organizations230163RelatedOrganizations
Government Grants8854GovernmentGrants
All Other Contributions4300AllOtherContributions
Total Contributions243317TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Net Patient Care Revenue9000992013267220132672
Patient Wellness9000993111731117
Program Rental Revenue90009937992$37,992
Healthcare Mgmt & Education Services621300920920
Breast Biopsy Services6215005151
FieldValueIRS element (for citing)
Total Program Service Revenue20202752TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column93981TotalRevenueColumn
Exclusion$93,981ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other29575Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other14698Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other14877Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column14877TotalRevenueColumn

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 (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Cafeteria Sales90009995836$95,836
All other revenue900099107670$107,670
FieldValueIRS element (for citing)
Total Other Revenue203506TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column20758433TotalRevenueColumn
Related Or Exempt Function Income20163789RelatedOrExemptFunctionIncome
Unrelated Business Revenue971UnrelatedBusinessRevenue
Exclusion$335,479ExclusionAmount

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)
Total575674Total
Program Services339648ProgramServices
Management And General236026ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total15067Total
Program Services15067ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6782407Total
Program Services6295068ProgramServices
Management And General487339ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total256003Total
Program Services237649ProgramServices
Management And General18354ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total746106Total
Program Services692615ProgramServices
Management And General53491ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total499669Total
Program Services463846ProgramServices
Management And General35823ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total43208Total
Management And General43208ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total40212Total
Management And General40212ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total584Total
Management And General584ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1707032Total
Program Services1584648ProgramServices
Management And General122384ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total86959Total
Management And General86959ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3105415Total
Program Services3060887ProgramServices
Management And General44528ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total100480Total
Program Services93276ProgramServices
Management And General7204ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total255336Total
Program Services251675ProgramServices
Management And General3661ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total79158Total
Program Services72510ProgramServices
Management And General6648ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total34475Total
Program Services34475ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total294675Total
Management And General294675ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1440281Total
Program Services1419629ProgramServices
Management And General20652ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total242055Total
Program Services238584ProgramServices
Management And General3471ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debts863875863875
Dues & subscriptions60215577052510
All other expenses80139878990811490

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18030284Total
Program Services16511065ProgramServices
Management And General1519219ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3492532BOY
EOY1841494EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2257944BOY
EOY2466425EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY167620BOY
EOY226016EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY158929BOY
EOY176899EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis23034312LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9248753LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11916240BOY
EOY13785559EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6292375BOY
EOY7624934EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY63438BOY
EOY62381EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY522909BOY
EOY249574EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY24871987BOY
EOY26433282EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3738322BOY
EOY1983011EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY14763864BOY
EOY14830186EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18502186BOY
EOY16813197EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6369801BOY
EOY9620085EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6369801BOY
EOY9620085EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24871987BOY
EOY26433282EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteefalseAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$584GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB584TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationCRETE AREA MEDICAL CENTER IS A MEMBER OF THE NEBRASKA HOSPITAL ASSOCIATION (NHA). DURING THE CURRENT YEAR THE REPORTING ORGANIZATION MADE PAYMENTS FOR MEMBERSHIP DUES TO THE NHA IN THE AMOUNT OF $7,782. THE NHA REPORTED THAT 7.50% OF DUES PAID, OR $584, WAS USED FOR LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis61247OtherCostOrOtherBasis
Book Value61247BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis15679295OtherCostOrOtherBasis
Depreciation4802024Depreciation
Book Value10877271BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis105470OtherCostOrOtherBasis
Depreciation86428Depreciation
Book Value19042BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6029582OtherCostOrOtherBasis
Depreciation3885105Depreciation
Book Value2144477BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1158718OtherCostOrOtherBasis
Depreciation475196Depreciation
Book Value683522BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13785559TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
SWAP AGREEMENT$1,715,186
LONG TERM DEBT INTERCOMPANY LOAN$13,115,000
FieldValueIRS element (for citing)
Total Of Amounts14830186TotalOfAmounts
Total Revenue20758433TotalRevenue
Total Expenses18030284TotalExpenses
Excess Or Deficit For Year2728149ExcessOrDeficitForYear
Other$522,135OtherAmount
Total Adjustments522135TotalAdjustments
Excess Or Deficit Per FS3250284ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt21456890TotRevenueEtcAuditedFinclStmt
Other Revenues698457OtherRevenues
Revenue Not Rptd F990698457RevenueNotRptdF990
Revenue Subtotal20758433RevenueSubtotal
Total Revenue Per Form99020758433TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt18206606TotExpensesEtcAuditedFinclStmt
Other Expenses Included176322OtherExpensesIncluded
Expenses Not Rptd F990176322ExpensesNotRptdF990
Expenses Subtotal18030284ExpensesSubtotal
Total Expenses Per Form99018030284TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FIN 48 FOOTNOTES TO THE ORGANIZATION'S FINANCIAL STATEMENTSFORM 990, SCHEDULE D, PART X"CAMC ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. CAMC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT MAY 31, 2010, CAMC HAD NO UNCERTAIN TAX POSITIONS ACCRUED."
RECONCILIATION OF CHANGE IN NET ASSETS FORM 990SCHEDULE D, PART XI, LINE 8TRANSFER FROM RELATED PARTY $ 698,457 CHANGE IN VALUE OF SWAP AGREEMENT $(176,322) TOTAL $ 522,135
RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STMTSSCHEDULE D, PART XII, LINE 2D, OTHERTRANSFERS FROM RELATED PARTY $698,457
RECONCILIATION OF EXP PER AUDITED FINANCIAL STMTS WITH EXPENESE PER RETURNSCHEDULE D, PART XIII, LINE 2D, OTHERCHANGE IN VALUE OF SWAP AGREEMENT $176,322

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense291795TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense291795NetCommunityBenefitExpense
Percent Of Total Expense0.01700PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense291795TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense291795NetCommunityBenefitExpense
Percent Of Total Expense0.01700PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense202800TotalCommunityBenefitExpense
Direct Offsetting Revenue14648DirectOffsettingRevenue
Net Community Benefit Expense188152NetCommunityBenefitExpense
Percent Of Total Expense0.01100PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense202800TotalCommunityBenefitExpense
Direct Offsetting Revenue14648DirectOffsettingRevenue
Net Community Benefit Expense188152NetCommunityBenefitExpense
Percent Of Total Expense0.01100PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense494595TotalCommunityBenefitExpense
Direct Offsetting Revenue14648DirectOffsettingRevenue
Net Community Benefit Expense479947NetCommunityBenefitExpense
Percent Of Total Expense0.02800PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$608,600BadDebtExpenseAmount
Amount Attributable To121700AmountAttributableTo
Amount Reimbursed By Medicare5529979AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5470238CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall59741MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursOtherOther
CRETE AREA MEDICAL CENTER
2910 BETTEN DRIVECRETENE68333XXX
CRETE MEDICAL CLINIC
2910 BETTEN DRIVECRETENE68333RURAL HEALTH CLINIC
WILBER MEDICAL CLINIC
203 W 4TH STREETWILBERNE68465RURAL HEALTH CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaFEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE TO LOW INCOME INDIVIDUALS. CRETE AREA MEDICAL CENTER DOES NOT PROVIDE FOR DISCOUNTED CARE, OR USE A SLIDING FEE SCALE.IncomeBasedCriteria
Annual Community Benefit ExplnCRETE AREA MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED ANNUALLY BY BRYANLGH HEALTH SYSTEM, THE SOLE MEMBER OF THE ORGANIZATION. THIS BRYANLGH HEALTH SYSTEM COMMUNITY BENEFIT REPORT DESCRIBES THE PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITIES THAT ARE SERVED BY CRETE AREA MEDICAL CENTER AND ITS AFFILIATES. THE REPORT IS MAILED TO VARIOUS HOUSEHOLDS IN EASTERN NEBRASKA AND THE SURROUNDING AREA. THE REPORT IS ALSO AVAILABLE ONLINE AT WWW.BRYANLGH.COM/COMMUNITYBENEFIT.AnnualCommunityBenefitExpln
Costing Method UsedTHE COST OF CRETE AREA MEDICAL CENTER'S CHARITY CARE EXPENSE ON LINE 7A WAS DETERMINED BY APPLYING A RATIO OF PATIENT CARE COST TO CHARGES TO THE CHARITY CARE DEDUCTIONS REPORTED IN THE FINANCIAL STATEMENTS. THE TOTAL EXPENSES DIRECTLY ATTRIBUTABLE TO THE COMMUNITY BENEFIT ACTIVITIES WERE REPORTED ON LINE 7E.CostingMethodUsed
Subsidized Health Services ExplnN/ASubsidizedHealthServicesExpln
Percent Of Total Expense ExplnBAD DEBT EXPENSE INCLUDED IN TOTAL EXPENSES ON FORM 990 WAS $863,875. THIS BAD DEBT EXPENSE WAS SUBTRACTED FROM TOTAL EXPENSE FOR PURPOSE OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSES IN COLUMN (F) ($18,030,284 - $863,875 = $17,166,409).PercentOfTotalExpenseExpln
Bad Debt FootnoteThe cost of Crete Area Medical Center's bad debt expense was determined by applying a ratio of patient care cost to charges to the bad debt expense reported in the financial statements. Discounts and payments reduce bad debt expense. Only the remaining uncollectible balance is written-off as bad debt expense. About 1 of 5 financial assistance (charity care) applications is denied because the patient would not provide the supporting information required per the policy and procedure. The following is the footnote from Crete Area Medical Center's audited financial statements regarding bad debt expense: "The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payors, patients and others. An allowance for doubtful accounts has been established for the uncollectable portion of these receivables and is adjusted throughout the year based on a percentage of each funding source's receivable account balance. Individual accounts with balances over ninety days are reviewed periodically for funding source denial, rebills to different funding sources, submissions to a collection agency or write-off as bad debt."BadDebtFootnote
Shortfall As Community BenefitTHE MEDICARE ALLOWABLE COST ON LINE 6 IS FROM THE MEDICARE COST REPORT. THE MEDICARE SHORTFALL IS NOT REPORTED AS A COMMUNITY BENEFIT.ShortfallAsCommunityBenefit
Debt Collection PolicyN/ADebtCollectionPolicy
Number Of Facility Type ExplnN/ANumberOfFacilityTypeExpln
Needs AssessmentCrete Area Medical Center ("CAMC") conducted a study to examine community awareness and perceptions in June 2008. This information was used to build a three-year plan to effectively develop and execute CAMC's strategic plans. The study highlighted opportunities for improvement and needs within our primary service area. CAMC annually uses information provided by the Nebraska Hospital Association to determine what services patients in our service area are using and where they are getting access. If services are identified that CAMC can provide for patients closer to home we will evaluate the need and options. CAMC also reviews information on the appropriate number of physicians for our service area and will actively recruit physicians or other providers as needed to the community. CAMC partnered with Public Health Solutions to complete a community needs assessment in 2010. The results of this survey will be used to determine needs and opportunities to serve our patient population.NeedsAssessment
Patient Education AssistanceCharity care information is provided to patients during admission in their information packet. Patients may contact the hospital at anytime to request a charity care application. Hospital patient account collectors will also inform patients about our charity care program if they are unable to pay their bill and may qualify for charity care based on information provided. In addition, the financial assistance policy is mentioned on all billing statements.PatientEducationAssistance
Community InformationCrete Area Medical Center ("CAMC") is located in Crete, Nebraska. Crete has a population of 6,000 people and includes diverse ethnic backgrounds. Crete has a large Hispanic population (40%). Crete has three primary industrial employers: Farmland Industries, Nestle/Purina, and Bunge Mills. They employ almost 3,000 people. CAMC serves people in Crete and the surrounding communities in SalINE and Lancaster counties. Our primary service area is a 30-mile radius of Crete.CommunityInformation
Community Building ActivitiesN/ACommunityBuildingActivities
Other InformationCrete Area Medical Center ("CAMC") is a Nebraska nonprofit corporation as described in Section 501(c)(3) of the Internal Revenue Code. CAMC operates a 25-licensed bed critical access hospital and two physician clinics. CAMC has an open medical staff. The hospital Board of Directors includes members from the community. CAMC is committed to serving our patients and our community by investing funds in facilities, technology, physicians, and staff to deliver premium healthcare in our facilities. CAMC participates in local organizational events and provides uncompensated and charity care to our patients. CAMC supports educational opportunities for staff, high school students, local EMS volunteers, and community members. Public assistance with transportation, translation services, and healthy lifestyle programs are also offered at CAMC.OtherInformation
Affiliated Health Care SystemCrete Area Medical Center is a member of BryanLGH Health System, one of the largest nonprofit health care organizations in THE REGION. BryanLGH Health System includes two medical centers as well as numerous outpatient services and clinics THAT SERVE URBAN, SUBURBAN AND RURAL COMMUNITIES IN NEBRASKA, KANSAS, IOWA, MISSOURI AND SOUTH DAKOTA. PREMIER SERVICES INCLUDE CARDIOLOGY, NEUROSCIENCE, ORTHOPEDICS, VASCULAR, TRAUMA AND EMERGENCY CENTERS, INTENSIVE CARE, WOMEN'S AND CHILDREN'S HEALTH, IMAGING, AND MENTAL HEALTH.AffiliatedHealthCareSystem
Reports Filed With StatesNEReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
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 (7 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
CAROL FRIESEN
13231402500002322908524043390193406000
KENNETH FOSTER
017901303284307963001347505917031087800
ROBERT TUMA MD
175764040000136060109590136720218001000
JENNIFER LESOING-LUCS
027832604928001595010323503030839084144900
KATHLEEN CAMPBELL
0181161029079094990642906616023278300
MARJORIE HEIER MD
10456701849690330000175310201330360200000
RUSSELL EBKE MD
1700330558490165000123190216910276392000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USESCHEDULE J, PART I, LINE 1ATHE ORGANIZATION PROVIDED A HOUSING ALLOWANCE FOR TWO PHYSICIANS DURING THEIR RELOCATION TO CRETE, NEBRASKA, AS REQUIRED BY THEIR EMPLOYMENT AGREEMENTS. THE HOUSING ALLOWANCE WAS INCLUDED AS TAXABLE INCOME ON EACH PHYSICIAN'S W-2. COMPENSATION OF ORGANIZATION'S CEO/EXECUTIVE DIRECTOR SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON BRYANLGH HEALTH SYSTEM, ITS SOLE MEMBER, TO ESTABLISH COMPENSATION OF ITS SENIOR MANAGERS. BRYANLGH HEALTH SYSTEM USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY AND STUDIES APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE COMPENSATION AND BENEFIT AMOUNTS OF SENIOR MANAGERS ARE DETERMINED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF BRYANLGH HEALTH SYSTEM. THE COMPENSATION COMMITTEE MET IN APRIL, 2010 TO REVIEW AND CONSIDER MARKET DATA AND RESULTING COMPENSATION ADJUSTMENTS FOR SENIOR MANAGER POSITIONS FOR THE FOLLOWING FISCAL YEAR; AND MET AGAIN IN AUGUST, 2010 TO REVIEW COMPENSATION PHILOSOPHY AND THE RESULTS OF THE VARIABLE PORTION OF THE COMPENSATION PLAN FROM THE PRIOR YEAR. THIS COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT EXTERNAL TRUSTEES AND USES COMPARABLE BENCHMARKING DATA AND STUDIES PROVIDED BY AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTANT TO ESTABLISH COMPENSATION AMOUNTS AND GUIDELINES. ANNUALLY, THE COMPENSATION COMMITTEE REVIEWS ALL SENIOR MANAGEMENT POSITIONS TO CONFIRM THAT ALL COMPENSATION AND BENEFITS ARE REASONABLE WHEN COMPARED TO CURRENT BENCHMARKING DATA. DOCUMENTATION IS KEPT OF ALL MEETINGS OF THE COMPENSATION COMMITTEE LISTING THE DATE AND TERMS OF THE COMPENSATION REVIEWED AND APPROVED. ALL OTHER NON-SENIOR MANAGEMENT POSITIONS ARE REVIEWED BY HUMAN RESOURCES FOR APPROPRIATE COMPENSATION. EMPLOYED PHYSICIAN POSITIONS ARE REVIEWED AND COMPARED TO MGMA STANDARDS FOR THE SPECIFIC SPECIALTY UNDER REVIEW.
SEVERANCE PAYMENTSCHEDULE J, PART I, LINE 4AJENNIFER LESOING-LUCS, FORMER VP-FINANCE AND CFO OF BRYANLGH HEALTH SYSTEM, WILL RECEIVE SEVERANCE PAYMENTS TOTALING $310,028 DURING CALENDAR YEARS 2010 AND 2011. THE AMOUNT OF $310,028 HAS BEEN INCLUDED ON SCHEDULE J, PART II, COLUMN (C) RETIREMENT AND OTHER DEFERRED COMPENSATION. MARJORIE HEIER, MD, FORMER PHYSICIAN OF CRETE AREA MEDICAL CENTER, RECEIVED A SEVERANCE IN THE AMOUNT OF $10,768 IN APRIL 2010. THE AMOUNT OF $10,768 HAS BEEN INCLUDED ON SCHEDULE J, PART II, COLUMN (C) RETIREMENT AND OTHER DEFERRED COMPENSATION.
Supplemental Nonqualified Retirement PlanSchedule J, Part I, Line 4BTHE FOLLOWING PEOPLE LISTED IN FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN, OR RECEIVED A PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: KENNETH FOSTER: $30,590 CAROL FRIESEN: $7,408 JENNIFER LESOING-LUCS: $102,839 COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES SCHEDULE J, PART II COMPENSATION AMOUNTS REPORTED ON SCHEDULE J, PART II ARE BASED ON THE CALENDAR YEAR ENDED DECEMBER 31, 2009.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonDENISE LOTHROPNamePerson
FieldValueIRS element (for citing)
RelationshipSPOUSE IS BOARD MEMBERRelationship
Amount Of Transaction15067AmountOfTransaction
Description Of TransactionCOMPENSATIONDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierDescription of Family or Business RelationshipsIdentifier
Return ReferenceForm 990, Part VI, Question 2ReturnReference
ExplanationTHE FOLLOWING BUSINESS RELATIONSHIPS WERE REPORTED DURING THE FISCAL YEAR BETWEEN THE ORGANIZATION'S TRUSTEES, OFFICERS OR KEY EMPLOYEES: Collyn Florendo and Carol Friesen Collyn Florendo and Robert Tuma, MD Collyn Florendo and Bryce Betke Gary Lothrop and Collyn Florendo DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 AS STATED IN THE CORPORATION'S ORGANIZING DOCUMENTS, THE SOLE MEMBER OF CRETE AREA MEDICAL CENTER IS BRYANLGH HEALTH SYSTEM ("HEALTH SYSTEM"). HEALTH SYSTEM HAS THE RIGHTS UNDER THE ORGANIZING DOCUMENTS TO: 1) APPROVE SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY; 2) ELECT THE MEMBERS OF THE GOVERNING BODY; AND 3) RECEIVE ANY REMAINING ASSETS AFTER DISSOLUTION OF THE ORGANIZATION. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A BRYANLGH HEALTH SYSTEM ("HEALTH SYSTEM") AS SOLE MEMBER OF CRETE AREA MEDICAL CENTER ("CAMC"), HAS THE RIGHT UNDER THE ORGANIZING DOCUMENTS TO REMOVE ANY TRUSTEE FROM OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE BY A TWO-THIRDS (2/3) VOTE OF THE VOTING TRUSTEES OF HEALTH SYSTEM. DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B BRYANLGH HEALTH SYSTEM ("HEALTH SYSTEM") IS THE SOLE MEMBER OF CRETE AREA MEDICAL CENTER ("CAMC"). PURSUANT TO THE GOVERNING DOCUMENTS, THE BOARD OF CAMC MAY MANAGE THE AFFAIRS OF THE CORPORATION; HOWEVER, THE BOARD MAY NOT, WITHOUT THE PRIOR APPROVAL OF THE HEALTH SYSTEM (1) ADOPT ANY LONG-TERM CAPITAL OPERATIONAL BUDGET; (2) ADOPT ANY CHANGES IN ANY ANNUAL OR LONG-TERM CAPITAL BUDGET OR OPERATIONAL EXPENSE BUDGET EXCEEDING $250,000 IN ANY SINGLE TRANSACTION OR $1,000,000 IN ANY CORPORATION FISCAL YEAR; (3) ADOPT SUBSTANTIVE CHANGES TO EXISTING LONG-TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; (4) AMEND THE BYLAWS OR ARTICLES OF INCORPORATION (5) APPROVE THE TRANSFER, SALE OR OTHER DISPOSITION OF CAPITAL ASSETS IN ANY SINGLE TRANSACTION IN EXCESS OF $250,000, OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (6) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF ANY CORPORATION, SHARED SERVICE ARRANGEMENT, ASSOCIATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, TRUST, JOINT VENTURE OR OTHER ENTITY, DIRECTLY OR INDIRECTLY, WHERE THE CAPITAL EXPENDITURE OR OPERATING EXPENSES BY THE CORPORATION IN CONNECTION WITH SUCH ORGANIZATION OR ACQUISITION WHEN IT EXCEEDS $500,000 IN A SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (7) APPROVE ANY INDEBTEDNESS INVOLVING A MORTGAGE OR LIEN OF ANY KIND OR NATURE ON ASSETS OF THE CORPORATION WHERE THE BORROWING OR INDEBTEDNESS EXCEEDS $250,000 IN ANY SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (8) ELECT OR APPOINT TRUSTEES OF THE CORPORATION; (9) APPOINT OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; 10) PURCHASE INSURANCE COVERAGE FOR THE CORPORATION AND ITS OPERATIONS; 11) SELECT THE AUDITOR TO PERFORM THE ANNUAL AUDIT OF THE RECORDS OF THE CORPORATION; AND 12) TAKE ANY OTHER ACTIONS WHICH MAY BE INCONSISTENT WITH THE HEALTH SYSTEM'S GOALS AND OBJECTIVES. DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11A THIS FORM 990 WAS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 WAS DISTRIBUTED FOR REVIEW TO EACH MEMBER OF CRETE AREA MEDICAL CENTER'S BOARD OF DIRECTORS, AND TO BRYANLGH HEALTH SYSTEM'S FINANCE COMMITTEE PRIOR TO THE SUBMISSION OF THE FORM TO THE INTERNAL REVENUE SERVICE. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICT OF INTEREST FORM 990, PART VI, QUESTION 12C CRETE AREA MEDICAL CENTER ("CAMC") HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY THAT IS MONITORED AND ENFORCED BY THE CAMC BOARD OF DIRECTORS. BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE QUESTIONNAIRE TO IDENTIFY ANY POSSIBLE CONFLICTS OF INTEREST. THE BOARD REVIEWS ALL IDENTIFIED CONFLICTS RELATIVE TO THE MEMBER'S ABILITY TO VOTE ON CERTAIN TYPES OF TRANSACTIONS AND/OR WHETHER ANY IDENTIFIED CONTRACTS/TRANSACTIONS WILL REQUIRE FURTHER REVIEW/ALTERATION. OFFICES/POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, QUESTION 15A & 15B THE COMPENSATION AND BENEFIT AMOUNTS OF SENIOR MANAGERS ARE DETERMINED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF BRYANLGH HEALTH SYSTEM, THE SOLE MEMBER OF THE ORGANIZATION. THE COMPENSATION COMMITTEE MET IN APRIL, 2010 TO REVIEW AND CONSIDER MARKET DATA AND RESULTING COMPENSATION ADJUSTMENTS FOR SENIOR MANAGER POSITIONS FOR THE FOLLOWING FISCAL YEAR; AND MET AGAIN IN AUGUST, 2010 TO REVIEW COMPENSATION PHILOSOPHY AND THE RESULTS OF THE VARIABLE PORTION OF THE COMPENSATION PLAN FROM THE PRIOR YEAR. THIS COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT EXTERNAL TRUSTEES AND USES COMPARABLE BENCHMARKING DATA AND STUDIES PROVIDED BY AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTANT TO ESTABLISH COMPENSATION AMOUNTS AND GUIDELINES. ANNUALLY, THE COMPENSATION COMMITTEE REVIEWS ALL SENIOR MANAGEMENTS POSITIONS TO CONFIRM THAT ALL COMPENSATION AND BENEFITS ARE REASONABLE WHEN COMPARED TO CURRENT BENCHMARKING DATA. DOCUMENTATION IS KEPT OF ALL MEETINGS OF THE COMPENSATION COMMITTEE LISTING THE DATE AND TERMS OF THE COMPENSATION REVIEWED AND APPROVED. ALL OTHER NON-SENIOR MANAGEMENT POSITIONS ARE REVIEWED BY HUMAN RESOURCES FOR APPROPRIATE COMPENSATION. EMPLOYED PHYSICIAN POSITIONS ARE REVIEWED AND COMPARED TO BENCHMARKING DATA FOR THE SPECIFIC SPECIALTY UNDER REVIEW. JOINT VENTURE POLICY 990, PART VI, SECTION B, LINE 16B ON NOVEMBER 1, 2010, BRYANLGH HEALTH SYSTEM AND ITS AFFILIATES ADOPTED A WRITTEN JOINT VENTURE POLICY TO ASSURE APPROPRIATE PROVISIONS BE INCLUDED IN THE TERMS OF ANY JOINT VENTURE TO PROTECT THE TAX-EXEMPT STATUS OF THE HEALTH SYSTEM AND AFFILIATE. THE FOLLOWING PROVISIONS ARE REQUIRED TO BE INCLUDED: (1) THE ORGANIZATIONAL DOCUMENTS WILL INCLUDE A BINDING STATEMENT THAT ENSURES THE FURTHERANCE OF ITS CHARITABLE PURPOSES; (2) THE JOINT VENTURE WILL HAVE A WRITTEN CHARITY CARE POLICY; (3) THE HEALTH SYSTEM AND THE AFFILIATES WILL HAVE EFFECTIVE CONTROL AS EVIDENCED BY MAJORITY VOTING CONTROL, OR ADEQUATE RESERVE POWERS TO ASSURE THAT KEY DECISIONS AFFECTING ACCOMPLISHMENT OF CHARITABLE PURPOSES ARE PRESENT. AVAIL OF GOV DOCS, CONFLICT OF INT POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE FOR PUBLIC DISCLOSURE. COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES FORM 990, PART VII, SECTION A COMPENSATION AMOUNTS REPORTED ON FORM 990, PART VII, SECTION A, COLUMNS (D),(E) AND (F) ARE BASED ON THE CALENDAR YEAR ENDED DECEMBER 31, 2009. RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT FORM 990, PART XI, QUESTION 2C THE AUDIT COMMITTEE OF BRYANLGH HEALTH SYSTEM'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE ORGANIZATION'S AUDIT.Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
BRYANLGH HEALTH SYSTEM
1600 SOUTH 48TH STREETLINCOLNNE68506363414823HEALTHCARENE501(c)(3)11CNA
BRYANLGH MEDICAL CENTER
1600 SOUTH 48TH STREETLINCOLNNE68506470376552HEALTHCARENE501(C)(3)3NA
BRYANLGH FOUNDATION
1600 SOUTH 48TH STREETLINCOLNNE68506237005720CHARITABLENE501(c)(3)7NA
BRYANLGH PHYSICIAN NEWORK INC
1600 SOUTH 48TH STREETLINCOLNNE68506201357375HEALTHCARENE501(c)(3)9NA
BRYANLGH HEALTH SERVICES INC
1600 SOUTH 48TH STREETLINCOLNNE68506470712000HEALTHCARENE501(c)(3)9NA

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
BRYANLGH ENTERPRISES INC
1600 SOUTH 48TH STREETLINCOLNNE68506470701037MEDICAL SERVICESNENAC000.00000
INTEGRATED CARDIOLOGY GROUP LLC
1600 SOUTH 48TH STREETLINCOLNNE68506470844961CARDIOLOGYNENAC000.00000
LIFEPOINTE INC
1600 SOUTH 48TH STREETLINCOLNNE68506364588998HEALTH & WELLNESSNENAC000.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
BRYANLGH MEDICAL CENTER
E13225000
BRYANLGH HEALTH SERVICES INC
H259390
BRYANLGH MEDICAL CENTER
H389928
BRYANLGH MEDICAL CENTER
L302448
BRYANLGH MEDICAL CENTER
O298027
BRYANLGH MEDICAL CENTER
Q728236

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