ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM (EIN 47-0484764)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201121339349302517
Schema version
2009v1.4
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)
Timestamp2011-05-13T11:13:04-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

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 PLAZASUITE 1501AddressLine1
CityOMAHACity
StateNEState
ZIP Code68102ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470484764EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ALEGENT HEALTH- BERGAN MERCY HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlALEGNameControl
Phone4023434323Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17500 MERCY ROADAddressLine1
CityOMAHACity
StateNEState
ZIP Code68124ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSCOTT M WOOTENName
TitleSENIOR VP/CFOTitle
Phone4023434323Phone
Date Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameHeidi KrieteName
Phone4023481450Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSCOTT M WOOTENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line112809 WEST DODGE ROADAddressLine1
CityOMAHACity
StateNEState
ZIP Code68142ZIPCode
FieldValueIRS element (for citing)
Gross Receipts518051773GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.ALEGENT.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1961YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HIGH QUALITY CARE FOR THE BODY, MIND AND SPIRIT OF EVERY PERSON.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees3751TotalNbrEmployees
Total Nbr Volunteers699TotalNbrVolunteers
Total Gross UBI6725669TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year8798620ContributionsGrantsPriorYear
Contributions Grants Current Year7217626ContributionsGrantsCurrentYear
Program Service Revenue Prior Year484475893ProgramServiceRevenuePriorYear
Program Service Revenue CY489519489ProgramServiceRevenueCY
Investment Income Prior Year-6352313InvestmentIncomePriorYear
Investment Income Current Year8837616InvestmentIncomeCurrentYear
Other Revenue Prior Year6308823OtherRevenuePriorYear
Other Revenue Current Year8782526OtherRevenueCurrentYear
Total Revenue Prior Year493231023TotalRevenuePriorYear
Total Revenue Current Year514357257TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year31810962GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY45561805GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year223130050SalariesEtcPriorYear
Salaries Etc Current Year215854278SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year468970TotalFundrsngExpCurrentYear
Other Expense Prior Year229901332OtherExpensePriorYear
Other Expenses Current Year255705725OtherExpensesCurrentYear
Total Expenses Prior Year484842344TotalExpensesPriorYear
Total Expenses Current Year517121808TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8388679RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2764551RevenuesLessExpensesCY
Total Assets BOY530640380TotalAssetsBOY
Total Assets EOY621960900TotalAssetsEOY
Total Liabilities BOY96355027TotalLiabilitiesBOY
Total Liabilities EOY188123787TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY434285353NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY433837113NetAssetsOrFundBalancesEOY
Mission DescriptionFaithful to the healing ministry of Jesus Christ, our Mission is to provide high quality care for the body, mind and spirit of every person. Our commitment to healing calls us to:Create caring and compassionate environments Respect the dignity of every person Care for the resources entrusted to us as responsible stewards Collaborate with others to improve the health of our communities Attend especially to the needs of those who are poor and disadvantaged Act with integrity in all endeavors To achieve this Mission, we pledge to be creative, visionary leaders committed to holistic healthcare in the region.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense21653183Expense
Grants2254122Grants
Revenue153664814Revenue
DescriptionBergan Mercy Medical Center is equipped with the latest technologies in the Diagnostic Center. The Center is completely digital, so patients are never waiting on films. Female patients can count on expert imaging tests including ultrasound, bone density testing, stereotactic breast biopsy and digital mammography. There are a wide range of available tests at the Diagnostic Center that include the following: Digital Mammography, MRI and Open MRI, CT, PET CT and Cardiac CT, 64-Slice CT, Fluoroscopy, Pulmonary Function Testing, Ultrasound, Cardiovascular Imaging, Phlebotomy, Nuclear Medicine, Digital Imaging, EEG, EKG and EMG, Stress Testing and Arteriogram.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense22561445Expense
Grants2348673Grants
Revenue102486143Revenue
DescriptionBergan Mercy Medical Center and Mercy Hospital, Council Bluffs offer a wide range of the most comprehensive range of cardiovascular services in the region, using a team approach to address the total needs of the cardiovascular patient. Alegent Health-Bergan Mercy Health System provides a comprehensive range of cardiac services, including but not limited to: vascular and cardiac surgery, heart scans and heart checks, cardiac rehabilitation, vascular ultrasound, nuclear stress tests, dual source CT scanner and angioplasty. In 2006, Mercy Hospital opened a new state-of-the-art Cardiac Catheterization lab, allowing physicians to perform procedures such as heart catheterizations, coronary interventions including balloon angioplasty and stenting, as well as implantation of pacemakers and defibrillators.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense6230969Expense
Grants648651Grants
Revenue15849137Revenue
DescriptionBergan Mercy Medical Center and Mercy Hospital, Council Bluffs Cancer Support Team is comprised of a group of healthcare professionals who work together in a variety of ways to help the patient and family cope with cancer. Bergan Mercy Medical Center cancer center offers the full continuum of cancer care for both inpatients and outpatients. They are equipped to diagnose and treat patients with cancer and get them back to their life as soon as possible. The Cancer Center is also an area leader in stem cell research and transplantation. Individual team members include Cancer Support Service Specialists, Medical Social Workers, Cancer Rehabilitation Specialists, Pastoral Services, Dietitians, Oncology Nurse Navigators, Hospice & Home Care Services, Inpatient Nursing Services, Radiation Oncology, and Volunteer Services.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense387222890Expense
Grants40310359Grants
Revenue205601130Revenue
DescriptionBERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS PROVIDE ADDITIONAL SERVICES INCLUDING BUT NOT LIMITED TO: EMERGENCY DEPARTMENT, INPATIENT HOSPITAL FACILITIES, PROCEDURE CENTER, ORTHOPEDIC SERVICES, DIGESTIVE HEALTH CENTER, FAMILY LIFE CENTER, RADIOLOGY, UROLOGY AND PHYSICAL THERAPY. PATIENTS ARE AT THE CENTER OF EVERYTHING DONE AT BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp387222890TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt40310359TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev205601130TotalOfOtherProgramServiceRev
Total Program Service Expense437668487TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming1Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096206NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3751NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledIAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SCOTT M WOOTEN SENIOR VPCFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4023434323TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line112809 WEST DODGE ROADAddressLine1
CityOMAHACity
StateNEState
ZIP Code68154ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (44 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
LESLIE R ANDERSEN
CHAIR6.00XX000
SR LILLIAN MURPHY RSM
DIRECTOR4.00X000
ANTHONY HATCHER DO
SECRETARY/TREASURER6.00XX049826335568
JOHN HEWITT
VICE CHAIR6.00XX000
MARTIN MANCUSo MD
dIRECTOR4.00X0160000
SUSAN PEACH RN
DIRECTOR4.00X000
RICHARD VIERK
DIRECTOR4.00X0235000
MICHAEL DEFREECE
DIRECTOR4.00X000
PAUL EDGETT III
DIRECTOR4.00X000
ERIC GURLEY
DIRECTOR4.00X000
KEITH SCHMODE
DIRECTOR4.00X050000
GUILLERMO HUERTA MD
DIRECTOR4.00X000
WAYNE A SENSOR
CHIEF EXECUTIVE OFFICER29.00X83544592138923329
RICHARD HACHTEN II
PRESIDENT & CEO29.00X778407858483734490
FRED HOSLER MD
SVP/CMO29.00X444370490082369747
KENNETH LAWONN
SVP INFORMATION TECH29.00X30757733922038536
SCOTT WOOTEN
SVP/CFO29.00X36227939954820275
MARGARET BREEN
SVP-HUMAN RESOURCES29.00X22459124769517268
AMY PROTEXTER
SVP MARKETING & COMM29.00X19479121483028487
PATRICIA NADLE
SVP/CNO29.00X6287369339252625
MARK KESTNER MD
SVP-CMO29.00X249972275689158309
JOAN NEUHAUS
SVP-COO29.00X220810243524185398
MARTIN HICKEY MD
SVP/CEO CLINICS29.00X38810342802745701
MARIE KNEDLER
COO-MERCY HOSPITAL29.00318831351629156737X
SHEREE KEELY
VP-Behavioral Health Svc29.0010425811498521999X
Elizabeth LLEWELLYN
VP-Mission Integration29.0012725414034621048X
PATRICIA MASEK
VP-MEDICAL AFFAIRS29.0010389211457843278X
FRANK EMSICK
VP-CONSTRUCTION29.0012700814007424435X
JOSEPH HOAGBIN
MEDICAL DIRECTOR60.00270412034786X
PAUL EBMEIER
COO-AHC29.0015772917395522704X
SHIRLEY HUERTER MD
MEDICAL DIRECTOR60.00048561235837X
ENEH OKORUWA MD
PHYSICIAN60.00524876036405X
SRIRAMAMURTHY RAVIPATI
PHYSICIAN60.00482016041370X
Stephen Budd MD
PHYSICIAN60.00336896036801X
Craig Seamands MD
PHYSICIAN60.00275606035833X
NARENDRA REDDY MD
PHYSICIAN60.00347098040399X
THEODORE SCHWAB
FORMER SVP/CIO0.0017716419538919719X
DUANE DAVID
FORMER SVP CLINICS0.00995821098270X
DAVID TEW
FORMER COO-BMMC0.00298472329176141864X
Ann Jones
FORMER VP-ONCOLOGY SVC0.001243681371614177X
JARROD JOHNSON
FORMER VP-ORTHOPEDIC SVC0.001045561153135703X
JOHN MAY
FORMER VP-CARDIOVASCULAR0.001250851379543737X
PETE FESTERSEN
FORMER VP-PUBLIC AFFAIRS0.0087430964231087X
MICHAEL ANDERSON MD
FORMER VP-Behavioral HS0.0073158806844836X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8334909TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs7753695TotalReportableCompFrmRltdOrgs
Total Other Compensation2642488TotalOtherCompensation
Number Individuals GT100 K86NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CASSLING DIAGNOSTIC
13808 F STREETOMAHANE68137DIAGNOSTIC IMAGING SERVICES2224566
DELTA CONSTRUCTION SERVICES INC
1105 S 24TH STREETOMAHANE68108CONSTRUCTION1550187
ARUP LABORATORIES
500 CHIPETA WAYSALT LAKE CITYUT84108LABORATORY RESEARCH1284709
NORTHWEST ANESTHESIA PC
6901 N 72ND STREETOMAHANE68122ANESTHESIA SERVICES1268517
CAPITAL EXPRESS
3326 S 67TH STREETOMAHANE68106COURIER SERVICE728973
FieldValueIRS element (for citing)
Number Of Contractors GT100 K44NumberOfContractorsGT100K
Membership Dues143305MembershipDues
Fundraising Events52500FundraisingEvents
Related Organizations171679RelatedOrganizations
Government Grants6814082GovernmentGrants
All Other Contributions36060AllOtherContributions
Total Contributions7217626TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
NET PATIENT SERV REV6215004627037614598612642842497
REIMBURSABLE AFFILIATE9000991765330717653307
PHARMACY44611072986073195641$4,102,966
FOOD SERVICE7223201777161146429$1,630,732
HEALTH EDUCATION PRGMS6117108665386653
FieldValueIRS element (for citing)
Total Program Service Revenue489519489TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column254524TotalRevenueColumn
Exclusion$254,524ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2955705Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1986875Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real968830Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column968830TotalRevenueColumn
Exclusion$968,830ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities8755578Securities
Other1164789Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other1337275Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities8755578Securities
Other-172486Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column8583092TotalRevenueColumn
Exclusion$8,583,092ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events62192GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events52500CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses42135FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column20057TotalRevenueColumn
Exclusion$20,057ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming49600GrossIncomeGaming
Gaming Direct Expenses25822GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column23778TotalRevenueColumn
Exclusion$23,778ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory651153GrossSalesOfInventory
Cost Of Goods Sold302409CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column348744TotalRevenueColumn
Exclusion$348,744ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
REIMBURSED SERVICES9000994724694$4,724,694
CHILD CARE6244101392265$1,392,265
MISC OPERATING REVENUE9000031250183$763,056487127

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column53975TotalRevenueColumn
Unrelated Business Revenue53975UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue7421117TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column514357257TotalRevenueColumn
Related Or Exempt Function Income477601224RelatedOrExemptFunctionIncome
Unrelated Business Revenue6725669UnrelatedBusinessRevenue
Exclusion$22,812,738ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total28800Total
Program Services28800ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total45533005Total
Program Services45533005ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total5406236Total
Program Services4054677ProgramServices
Management And General1351559ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total164964088Total
Program Services132602623ProgramServices
Management And General32043310ManagementAndGeneral
Fundraising318155Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6655821Total
Program Services5556510ProgramServices
Management And General1099311ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total29498914Total
Program Services18790123ProgramServices
Management And General10601703ManagementAndGeneral
Fundraising107088Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9329219Total
Program Services7739249ProgramServices
Management And General1583811ManagementAndGeneral
Fundraising6159Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total35765Total
Management And General35765ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total21390Total
Program Services21390ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total21759657Total
Program Services14874956ProgramServices
Management And General6884701ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total36631Total
Program Services36631ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total97524290Total
Program Services95676664ProgramServices
Management And General1847339ManagementAndGeneral
Fundraising287Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total7951111Total
Program Services7951111ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total523709Total
Program Services225706ProgramServices
Management And General296712ManagementAndGeneral
Fundraising1291Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total105134Total
Program Services105134ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total2706902Total
Program Services2706902ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total32369325Total
Program Services23646821ProgramServices
Management And General8722504ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total954570Total
Program Services609084ProgramServices
Management And General345486ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBTS2577404025774040
PURCHASED SERVICES2119425969991551415911435990
MANAGEMENT ALLOCATIONS2089382820893828
Joint Venture1782559917825599
OTHER54850055485005

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total544510Total
Program Services531474ProgramServices
Management And General13036ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total517121808Total
Program Services437668487ProgramServices
Management And General78984351ManagementAndGeneral
Fundraising468970Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3498916BOY
EOY1044159EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY31873899BOY
EOY20019456EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY49633782BOY
EOY50919748EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1550000BOY
EOY2975000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY8731671BOY
EOY9130447EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY22249BOY
EOY111548EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis554244137LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec257443541LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY243896027BOY
EOY296800596EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY148921057BOY
EOY192439888EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY31327779BOY
EOY16108779EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11185000BOY
EOY32411279EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY530640380BOY
EOY621960900EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY19221301BOY
EOY13061612EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY355505BOY
EOY526305EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY75946369BOY
EOY171451063EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY831852BOY
EOY3084807EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY96355027BOY
EOY188123787EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY429831574BOY
EOY428915113EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2653779BOY
EOY3131000EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1800000BOY
EOY1791000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY434285353BOY
EOY433837113EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY530640380BOY
EOY621960900EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

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)
Political Expenditures0PoliticalExpenditures
Volunteer Hours0VolunteerHours
Amt Of4955 Tax0AmtOf4955Tax
Amt Of4955 Tax On Managers0AmtOf4955TaxOnManagers
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$21,390GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB21390TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3665977BeginningOfYearBalance
Contributions149013Contributions
Investment Earnings Or Losses298938InvestmentEarningsOrLosses
Grants Or Scholarships9996GrantsOrScholarships
Other Expenditures142744OtherExpenditures
End Of Year Balance3961188EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2688014BeginningOfYearBalance
Contributions1800115Contributions
Investment Earnings Or Losses-448721InvestmentEarningsOrLosses
Grants Or Scholarships3875GrantsOrScholarships
Other Expenditures369556OtherExpenditures
End Of Year Balance3665977EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.36000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.64000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3341409OtherCostOrOtherBasis
Book Value3341409BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis225134729OtherCostOrOtherBasis
Depreciation92503440Depreciation
Book Value132631289BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis13394211OtherCostOrOtherBasis
Depreciation8695536Depreciation
Book Value4698675BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis268447126OtherCostOrOtherBasis
Depreciation156244565Depreciation
Book Value112202561BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis43926662OtherCostOrOtherBasis
Book Value43926662BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings296800596TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionINTERCOMPANY RECEIVABLEDescription
Book Value32411279BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets32411279TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
PAYABLE UNDER DEFERRED COMP PLANS$885,451
3RD PARTY PAYER SETTLEMENT$2,199,356
FieldValueIRS element (for citing)
Total Of Amounts3084807TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM.
PART X, LINE 2 - THE ENTITIES REPORTED IN THE CONSOLIDATED AUDIT HAVE ADOPTED FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, INCLUDED IN FASB ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL, ENTITIES OF ALEGENT HEALTH RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. DURING 2010 AND 2009, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Candle Light BallNameOfEvent1
Gross Receipts Event1114692GrossReceiptsEvent1
Charitable Contributions Event152500CharitableContributionsEvent1
Gross Revenue Event162192GrossRevenueEvent1
Cash Prizes Event125000CashPrizesEvent1
Other Direct Expenses Event117135OtherDirectExpensesEvent1
Gross Receipts Total114692GrossReceiptsTotal
Charitable Contributions Total52500CharitableContributionsTotal
Gross Revenue Total Events62192GrossRevenueTotalEvents
Cash Prizes Total Events25000CashPrizesTotalEvents
Other Direct Expenses Total Events17135OtherDirectExpensesTotalEvents
Direct Expense Summary Events42135DirectExpenseSummaryEvents
Net Income Summary20057NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming49600GrossRevenueOtherGaming
Other Direct Expenses Other Gaming25822OtherDirectExpensesOtherGaming
Volunteer Labor Other Gaming1VolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming0.04000VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming49600GrossRevenueTotalGaming
Other Direct Expenses Total Gaming25822OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming25822DirectExpenseSummaryGaming
Net Gaming Income Summary23778NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedNEStatesWhereGamingConducted
States Where Gaming ConductedIAStatesWhereGamingConducted
Licensed1Licensed
License Suspended Etc0LicenseSuspendedEtc
Gaming With Nonmembers0GamingWithNonmembers
Member Of Other Entity0MemberOfOtherEntity
Percentage Of Gaming Own Facility0.00000PercentageOfGamingOwnFacility
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility

Name Of Gaming Rec Keeper Bus NameOfGamingRecKeeperBus

FieldValueIRS element (for citing)
Business Name Line1ALEGENT HEALTHBusinessNameLine1

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line112809 WEST DODGE ROADAddressLine1
CityOMAHACity
StateNEState
ZIP Code68154ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev

Gaming Manager Name Business GamingManagerNameBusiness

FieldValueIRS element (for citing)
Business Name Line1VolunteersBusinessNameLine1
FieldValueIRS element (for citing)
Gaming Manager Compensation0GamingManagerCompensation
Gaming Manager Services ProvidedGaming responsibilities are handled by Volunteers of the Bergan and Mercy Auxiliaries. Therefore, no compensation is reported.GamingManagerServicesProvided
Charitable Distrib Required0CharitableDistribRequired

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care0FPGReferenceFreeCare
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served8419PersonsServed
Total Community Benefit Expense17671748TotalCommunityBenefitExpense
Direct Offsetting Revenue273685DirectOffsettingRevenue
Net Community Benefit Expense17398063NetCommunityBenefitExpense
Percent Of Total Expense0.03540PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served5322PersonsServed
Total Community Benefit Expense58012286TotalCommunityBenefitExpense
Direct Offsetting Revenue54990545DirectOffsettingRevenue
Net Community Benefit Expense3021741NetCommunityBenefitExpense
Percent Of Total Expense0.00610PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served13741PersonsServed
Total Community Benefit Expense75684034TotalCommunityBenefitExpense
Direct Offsetting Revenue55264230DirectOffsettingRevenue
Net Community Benefit Expense20419804NetCommunityBenefitExpense
Percent Of Total Expense0.04150PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served2357PersonsServed
Total Community Benefit Expense354380TotalCommunityBenefitExpense
Direct Offsetting Revenue53976DirectOffsettingRevenue
Net Community Benefit Expense300404NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served213PersonsServed
Total Community Benefit Expense2420TotalCommunityBenefitExpense
Direct Offsetting Revenue45DirectOffsettingRevenue
Net Community Benefit Expense2375NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense9406050TotalCommunityBenefitExpense
Direct Offsetting Revenue7085925DirectOffsettingRevenue
Net Community Benefit Expense2320125NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1022473TotalCommunityBenefitExpense
Direct Offsetting Revenue216935DirectOffsettingRevenue
Net Community Benefit Expense805538NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served1642PersonsServed
Total Community Benefit Expense688810TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense688810NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served4212PersonsServed
Total Community Benefit Expense11474133TotalCommunityBenefitExpense
Direct Offsetting Revenue7356881DirectOffsettingRevenue
Net Community Benefit Expense4117252NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served17953PersonsServed
Total Community Benefit Expense87158167TotalCommunityBenefitExpense
Direct Offsetting Revenue62621111DirectOffsettingRevenue
Net Community Benefit Expense24537056NetCommunityBenefitExpense
Percent Of Total Expense0.04980PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Persons Served2PersonsServed
Total Community Building Expense184593TotalCommunityBuildingExpense
Direct Offsetting Revenue17568DirectOffsettingRevenue
Net Community Building Expense167025NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Persons Served29PersonsServed
Total Community Building Expense326334TotalCommunityBuildingExpense
Direct Offsetting Revenue3706DirectOffsettingRevenue
Net Community Building Expense322628NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Persons Served7PersonsServed
Total Community Building Expense660TotalCommunityBuildingExpense
Net Community Building Expense660NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Persons Served38PersonsServed
Total Community Building Expense511587TotalCommunityBuildingExpense
Direct Offsetting Revenue21274DirectOffsettingRevenue
Net Community Building Expense490313NetCommunityBuildingExpense
Percent Of Total Expense0.00100PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$10,468,906BadDebtExpenseAmount
Amount Attributable To2779824AmountAttributableTo
Amount Reimbursed By Medicare95766408AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare134836944CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-39070536MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursEr OtherErOtherOtherOther
ALEGENT HEALTH MERCY HOSPITAL
800 MERCY DRIVECOUNCIL BLUFFSIA51503XXX
Alegent Health LASTING HOPE RECOVERY CTR
415 S 25th AvenueOMAHANE68131XXX
ALEGENT HEALTH HOSPICE
7070 Spring StreetOMAHANE68106Licensed Hospice
ALEGENT HEALTH HOSPICE
703 Rosary DriveCORNINGIA50041LICENsed Hospice
ALEGENT HEALTH AT HOME
7070 Spring StreetOMAHANE68106HOME HEALTH AGENCY
AH BERGAN MERCY MEDICAL CENTER
7500 MERCY ROADOMAHANE68124XXX

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaPart I, Line 3c: Bergan Mercy Health System is part of the Alegent Health System. The amount of financial assistance write-off for entities of the Alegent Health system are based on a financial assistance sliding fee schedule utilizing a derivative of the current US Department of Housing and Urban Development (HUD) very low income guidelines, which are updated yearly.All efforts are made to establish whether patients are eligible for financial assistance prior to service if possible, otherwise as soon as possible following service. Representatives of the Alegent Health system help patients seek reimbursement from local, state and federal programs at no charge to the patient. After these efforts and resources have been exhausted, patients are assisted in the application process for financial assistance consistent with Alegent HEALTH'S Financial Assistance Policy. The application process requires that the patient complete a personal financial application and provide verification documents. Verification includes employment verification and obtaining documentation of the APPLICANT'S financial condition such as federal tax return, pay stub, net worth and/or liquid assets and reasonable household or business expenses. Financial assistance may still be granted in certain circumstances involving a catastrophic occurrence resulting in medical bills grossly exceeding the PATIENT'S ability to pay, and in these situations, the PATIENT'S responsibility will be limited to 20% of the FAMILY'S gross annual income.Part I, line 6a: The Alegent Health System produces a public community benefit report that is mailed to a core constituency and placed in key places throughout the organization. It is also available on the COMPANY'S intranet site, and on its public website at www.alegent.com.IncomeBasedCriteria
Costing Method UsedPart I, Line 7: The costing methodology used to calculate the amounts reported in the table were worksheets 1 - 8 provided with the Schedule H instructions. The cost to charge ratio derived from Worksheet 2 was used to calculate total community benefit expense for charity care, medicaid and other means tested.CostingMethodUsed
Subsidized Health Services ExplnPart I, Line 7g: Alegent Health Bergan Mercy Health System provides subsidized health to the broader community via a neonative intensive care unit, home health and hospice care, and behavioral health services.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnPart I, Line 7f: Bad debt of $25,774,040 included in the functional expense total part IX, line 25 is not included in the total operating expense used to calculate the table 7 percentages.PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: THE AUDITED FOOTNOTES FOR ENTITIES OF THE ALEGENT HEALTH SYSTEM DO NOT CONTAIN FOOTNOTES RELATED TO BAD DEBT EXPENSE. BAD DEBT EXPENSE IS IDENTIFIED ON THE CONSOLIDATED STATEMENT OF OPERATIONS WHICH IS CONSISTENT WITH THE REPORTING PRACTICE OF OTHER HEALTH CARE ORGANIZATIONS.BAD DEBT EXPENSE (AT COST) FOR ENTITIES OF ALEGENT HEALTH ARE DETERMINED BY USING THE COST TO CHARGE RATIO FROM MEDICARE COST REPORTS PER ENTITY AND MULTIPLYING THE RATIO BY THE ACTUAL BAD DEBT CHARGES PER ENTITY.TO DETERMINE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST)ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CAREPOLICY, REPRESENTATIVES OF THE ALEGENT HEALTH SYSTEM DETERMINE IF ANACCOUNT NEEDS TO BE MOVED FROM BAD DEBT TO CHARITY WHEN A PATIENT EITHERCOMES FORWARD AND COMPLETES A CHARITY APPLICATION, WHICH IS APPROVED OR IF IT IS DETERMINED THAT THE PATIENT HAS NO OTHER RESOURCES TO PAY THEACCOUNT BALANCE.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: The Alegent Health System does not consider Medicare shortfalls to be community benefit, per the recommendation of the Catholic Health Association. The Medicare charges reported on line 5 and 6 are from Medicare cost reports which use a cost to charge ratio.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: Alegent HEALTH'S SELF PAY BILLING AND BAD DEBT POLICY HAS A CLEARLY DELINEATED PROCESS FOR COLLECTION AGENCIES TO FOLLOW, INCLUDING EXPLICIT INSTRUCTIONS THAT ENSURE THE CHARITY CARE PATIENTS WHO HAVE BEEN IDENTIFIED DO NOT GO TO COLLECTIONS.Part V: 2 licensed hospices and 1 home health agency.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: The Alegent Health system approaches community needs assessment as a corporate activity that develops and integrates county based health profiles for each of the counties WHERE THE licensed hospitals ARE located. The process to develop the assessments is collaborative in nature and involves health departments, existing health coalitions, community members and hospital leadership, as is supported by the Alegent Health Planning and Community Benefit Department staff. The Alegent Health Planning department conducts market assessments that identify the OMAHA METROPOLITAN STATISTICAL AREA'S population and demographic characteristics. Additionally, in cooperation with local health departments and coalitions, the Alegent Health Community Benefit/Healthier Community department conducts an annual review of the documented community health needs and plans of each of the communities it serves. This assessment process involves summarizing existing data and research from local health department reports and local coalition reports into a comprehensive summary grid incorporating a multitude of factors including- demographics, health status metrics, BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY data, documented health issues, qualitative information from qualitative and community based processes and identification of Alegent HEALTH'S participation and specific strategic action plans. The profiles are integrated into the governance and planning for Alegent Health on two levels: I. Reporting to the committee of the Board of Directors charged with health planning oversightII. Into the annual strategic planning processes of Alegent Health. Particular to Douglas County, which Bergan Mercy Medical Center resides, needs assessment and reporting of those needs is led by Live Well Omaha, a membership based coalition. LIVE WELL OMAHA has been in existence for 14 years and Alegent Health was a founding member and is the largest financial contributor.NeedsAssessment
Patient Education AssistancePart VI, Line 3: There are several financial assistance access points throughout a PATIENT'S care cycle. Bills contain financial assistance verbiage; signs are posted in clinics and hospital, and there is information on financial assistance posted at registration points throughout clinics and hospitals. Additionally, information on The Alegent Health SYSTEM'S financial assistance policies are located AT www.alegent.com.PatientEducationAssistance
Community InformationPart VI, Line 4: Alegent Health (system) serves the Omaha Metropolitan Statistical Area (MSA), with an estimated population of 842,976, ranking 60th out of 366 MSAs in total population. On average, the population is older than the U.S. with a current median age of 34.9 years that is projected to increase to 35.5 by 2014. 50.6% of the population is female. The Omaha MSA racial and ethnic makeup is approximately 83.9% white, 7.7% black and 7.6% Hispanic or Latino. THE 2009 Estimates show that there are approximately 326,989 households, which is projected to increase over the next five years. The average household income is $68,637, with a per capita income of $26,840 (vs national of $26,410).CommunityInformation
Community Building ActivitiesPart VI, Line 5: As a result of community health needs assessment conducted in 2006 which pointed to childhood obesity as a serious health needs issue across all Omaha MSA counties served, the Alegent Health system partnered with the community AND Made a multi-year commitment to impact childhood obesity through community based best practice interventions. This initiative has had a primary focus of impact in Douglas County, but the funding to underwrite has come from the fiscal performance of all Alegent Health hospitals. The community coalition known as Live Well Omaha Kids (LWOK) is staffed and funded by Alegent Health. Executive Committee, which consists of community leaders and policy makers, have implemented an ecological approach that improves programs, policies and promotes physical activity and healthy eating habits at the individual and organizational levels. More than 200 volunteers have participated in the planning and implementation of LWOK initiatives. A portion of this investment in LWOK is allocated to the ALEGENT HEALTH-Bergan Mercy HEALTH System.CommunityBuildingActivities
Other InformationPart VI, Line 6: The primary care physician clinics that are part of the ALEGENT HEALTH SYSTEM participate in medical student preceptorships that advance the healthcare provider education process. THE Alegent Health SYSTEM has Open Medical staffs AND THE Alegent Health SYSTEM IS one of 3 health systems that fund the operations of a coalition that exists to provide access for the patients of 3 area Federally Qualified Community Health CenterS to specialty physician services and hospital based diagnostics and Treatment. THE Alegent Health SYSTEM is the sole comprehensive acute mental health provider in the Omaha MSA area. THE Alegent Health SYSTEM is a joint venture partner in a not-for-profit Hospice inpatient hospital and provides the management support contract. THE Alegent Health SYSTEM budgets for an emergency fund as a subset of other community donations to respond to crisis or unplanned funding needs of a vital community service, which Was first used in FY2010 with the economic downturn. THE Alegent Health SYSTEM Has a current commitment to set aside up to 6% of its EBIDA in a given fiscal year for collaborative initiatives to improve the health of the communities served, which is the Catalyst Fund. BOARD OF DIRECTORS - THE ALEGENT HEALTH SYSTEM IS governed by a Board of Directors primarily comprised of volunteer members of our local community who are leaders in the fields of business, healthcare, accounting and medicine and understand their role in providing strong corporate governance. The Board of Directors consists of twelve voting members and two non-voting members. EMERGENCY DEPARTMENT - ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM hospitals have full-time emergency departments that are open to the public and provide medical screening examinations and stabilizing treatment within the capabilities and capacitY of the hospitals regardless of but not limited to the PATIENT'S race, color, sex, age, and/or ability to pay. The hospitals are in compliance with the federal EMTALA regulations.In addition, ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM, together with unrelated hospitals in the area, workS closely with local fire and rescue departments to ensure that ambulances take patients to the appropriate hospital. This is generally the hospital that is closest geographically with exceptions based on patient preference, PATIENT'S physician preference, and capacity or the availability of specialized facilities or programs related to the PATIENT'S condition. Finally, ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM maintains detailed procedures regarding when and under what circumstances a patient can be transferred. Under this policy, no patient will be transferred based on race, creed, religion or ability to pay.MEDICAL STAFF - ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM maintain an open medical staff. All qualified MDs, DOs, other healthcare practitioners, and mid-level practitioners are eligible to apply for privileges at the hospitals. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM'S policy on physician credentialing is that no individual is to be denied medical staff appointment based on sex, race, creed, color or national origin. The standards a physician must meet for appointment relate to (1) educational qualifications and licensing; (2) professional competence, (3) character, (4) ethical standing, and (5) ability to relate to and work with others. Applications are reviewed at several levels within the organization. Physicians who have been granted staff privileges automatically become members of the medical staff at the hospital(s) for which privileges have been granted.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: The senior leadership of the individual hospitals ARE engaged in the community needs assessment process that is conducted from the corporate offices of the Alegent Health system (See Part VI-2/Community Needs Assessment). The hospitalS ARE involved in shared budget decision making to meet the prioritized community health needs in collaboration with community partners. The corporate function is funded from the operations of the individual hospitals to leverage expertise and time that is focused on promoting health versus addressing acute care needs. The individual hospitals become more involved in specific strategic responses through the services they provide and their participation in the coalitions across the Alegent Health service area.AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
HARBOR HOUSE
12809 WEST DODGE ROADOMAHANE68154364003095501(C)(3)15000GENERAL SUPPORT
MOHMS PLACE
1435 N 15th StCOUNCIL BLUFFSIA51503421407712501(C)(3)10000General Support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
SCHOLARSHIP2911900
Mercy Fund Distributions5832157
CHARITY CARE841945488948BOOKREDUCE OR WRITE OFF OF PATIENT SERVICES.

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Procedure for Monitoring Grants in the U.S.:Part I, Line 2:Schedule I, Part I, Line 2: MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES OR SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS. THE BERGAN MERCY AUXILIARY TEEN SCHOLARSHIP PROGRAM WAS SET UP IN 1986 BY BERGAN MERCY. THE PURPOSE OF THE SCHOLARSHIP PROGRAM IS TO PROVIDE COLLEGE SCHOLARSHIPS TO TEEN VOLUNTEERS WHO HAVE VOLUNTEERED THEIR SERVICES AT BERGAN MERCY MEDICAL CENTER. IN ORDER TO RECEIVE A SCHOLARSHIP IN THIS PROGRAM, THE APPLICANT MUST BE AN ACTIVE VOLUNTEER THROUGHOUT ALL THE YEARS THEY DO SERVICE, INCLUDING THEIR SENIOR YEAR. IF A STUDENT IS TO DROP OUT OF THE PROGRAM OR IS TO BE DISMISSED, THEY ARE NOT ELIGIBLE FOR THE SCHOLARSHIP. MERCY FUND DISTRIBUTIONS ARE ESTABLISHED FOR THE DISBURSEMENT OF ALEGENT HEALTH BERGAN MERCY AUXILIARY MONIES FOR PATIENT ASSISTANCE THAT ARE COMPLIANT WITH ALEGENT HEALTH POLICIES AND PROCEDURES, INTERNAL REVENUE SERVICE (IRS) REGULATIONS AND OTHER APPLICABLE FEDERAL, STATE, AND LOCAL LAWS AND REGULATIONS.
Other Information:Part IV:Alegent Health-BERGAN MERCY HEALTH SYSTEM recognizes the right to quality healthcare regardless of age, sex, race, religion, national origin, or ability to pay. Business office staff helps patients seek local, state, and federal reimbursement at no charge when no other source of payment is available. Financial assistance is provided to patients with demonstrated inability to pay for medically necessary services. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. SCHEDULE I, PART I, LINE 2: ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM OCCASIONALLY DISTRIBUTES FUNDS TO OTHER 501(C)(3) ORGANIZATIONS. THESE DISTRIBUTIONS ARE MONITORED TO ENSURE THEY ARE BEING USED AS SPECIFIED BY THE ORGANIZATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org1CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (33 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
ANTHONY HATCHER DO
0361253057454079556019380016188053383100
WAYNE A SENSOR
2557762820881565941727034230754665988051887930433356846539933624392491432867
RICHARD HACHTEN II
137062151162768584756336606988463481803839991099121211276861243694615333678634
FRED HOSLER MD
176733194914854139419918222420096917254619029732833621620199684000156902173043
KENNETH LAWONN
135872149850642687088010743711849015360169402966327032590335943098911109086
SCOTT WOOTEN
1786301970068102189356102628113186630369523338368237192041018291635101061
MARGARET BREEN
89540987516096867240740838170469917710122113462328032567516337369893
AMY PROTEXTER
679947498958331643326846675509971510714383242262083382297705343158927
PATRICIA NADLE
610686734900180519901182341303981899209418300620183100
MARK KESTNER MD
1068001177864872153733944511041707074478022453850053252543587166944976593
JOAN NEUHAUS
139440153784426544704238716426988637895264178619703089743407583700340810
MARTIN HICKEY MD
18444920342367753747231359011498811765319469408044994098364519955175357077
MARIE KNEDLER
1273461404463907943099152406168084722587969222762511393365433832150593166084
SHEREE KEELY
69912771052231324609120331327182509099221124391147191265231189313116
Elizabeth LLEWELLYN
6897176067261272881532156354649528105094815301372631513852362126051
PATRICIA MASEK
6566872422210532321817171189381873020656185120411244731372751058711676
FRANK EMSICK
79624878142578728440215972382080988932352138841386271528902106423231
JOSEPH HOAGBIN
25277000017642026730080560305198000
PAUL EBMEIER
129370142678240012647043584807805188792746302816852618586200
SHIRLEY HUERTER MD
042791100057701019380016457052144900
ENEH OKORUWA MD
37116901312650224420193800170250561281000
SRIRAMAMURTHY RAVIPATI MD
467225000147910218300195400523386000
Stephen Budd MD
321623000152730169300198710373697000
Craig Seamands MD
253051000225550193800164530311439000
NARENDRA REDDY MD
322277000248210193800210190387497000
THEODORE SCHWAB
00001771641953891750193076278412186541205731176935195136
DUANE DAVID
00009958210982700009958210982799358109579
DAVID TEW
557056143545025496571977422180846434770967311534353659344035787257780044
Ann Jones
3840423515888175221046401154040019862191126354139352102197112711
JARROD JOHNSON
434247891380615227864089529710771188163518031072681183048274591258
JOHN MAY
47135199156921730610468011544912621391515569126862139914100011110300
PETE FESTERSEN
49085412115961278870926782230051757087947969936978576964
MICHAEL ANDERSON MD
43754825148221634753961595121968217033236675458832205131256591

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aAs part of the executive compensation arrangement, executives are provided with a set sum, approximately 30 - 40% of their base salary, which can be used to elect various benefits. Some of the benefits available for election include health club dues, automobile allowance, financial planning fees and legal fees. Payment for these benefits are either made directly by Alegent Health or reimbursed to the executive after the appropriate substantiation for the expense is provided. The amount paid for these benefits is included in the EXECUTIVE'S wages as taxable income.
Part I, Line 4aThe following reportable individuals received severance payments from Alegent Health (a related organization) during the 2009 calendar year and these severance payments were included in the INDIVIDUAL'S W-2 income and reportable as compensation on Schedule J: DUANE DAVID - $208,937 THEODORE SCHWAB - $371,912 WAYNE SENSOR - $124,126 RICHARD HACHTEN II - $363,816 FRED HOSLER, MD - $87,750 MARGARET BREEN - $53,962 AMY PROTEXTER - $49,415 ANN JONES - $187,565 JARROD JOHNSON - $162,988 MARK KESTNER, MD - $63,691 JOHN MAY - $185,254 MICHAEL ANDERSON - $29,164 PETE FESTERSEN - $136,893. Part I, Line 4B: ALEGENT HEALTH HAS A MARKET BASED NONQUALIFIED RETIREMENT PLAN APPROVED BY THE BOARD OF DIRECTORS THAT EXECUTIVES PARTICIPATE IN OF WHICH ANNUAL CONTRIBUTIONS ARE MADE. DURING 2009, THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TERMINATED AND PARTICIPANTS RECEIVED A TOTAL PAYOUT OF THEIR BALANCE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS FROM ALEGENT HEALTH DURING THE 2009 CALENDAR YEAR AND THE PAYMENTS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE AS COMPENSATION ON SCHEDULE J: Richard Hachten II - $930,151 Fred Hosler, MD - $242,195 KENNETH LAWONN - $207,997 MARGARET BREEN - $79,304 DAVID TEW - $152,621 MARTIN HICKEY - 108,830 MARIE KNEDLER - $316,677 Jarrod Johnson - $11,015 Ann Jones - $27,343 SHEREE KEELY - $25,009 MARK KESTNER, MD - $82,351 ELIZABETH LLEWELLYN - $49,672 Patricia Masek - $22,264 FRANK EMSICK - $44,295 John May - $25,057 Joan Neuhaus - $77,813 Amy Protexter - $62,943 Scott Wooten - $192,696 MICHAEL ANDERSON - $78,739 PETE FESTERSEN - $9,856 THEODORE SCHWAB - $159 WAYNE SENSOR - $701,232.
Part I, Line 5PHYSICIANS EMPLOYED BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM ARE ELIGIBLE FOR QUARTERLY PRODUCTIVITY BONUSES BASED ON INDIVIDUAL QUALITY MANAGEMENT, WHICH INCLUDE CORE MEASURES, PHYSICIAN REFFERAL AND ATTENDANCE AT MEETINGS. THE CORE MEASURES USED TO DETERMINE THE PHYSICIAN BONUSES ARE NATIONALLY ACCEPTED MEASURES OF PHYSICIAN PRODUCTIVITY.
Part I, Line 6Compensation for members of management of Alegent Health and related entities is determined at a system level. MEMBERS OF ALEGENT HEALTH management ARE eligible for an annual incentive bonus. INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE. One of the FOUR SYSTEM PERFORMANCE GOALS Is dependent on the financial results of the entire Alegent Health system for the fiscal year.
Part IIISCHEDULE J, PART I, LINE 3: ALEGENT HEALTH GOVERNANCE OF EXECUTIVE COMPENSATION: ACTING AS PRUDENT STEWARDS OF ITS FINANCIAL RESOURCES, THE ALEGENT HEALTH BOARD COMPENSATION COMMITTEE RECOMMENDS AND THE BOARD EXECUTIVE COMMITTEE APPROVES EXECUTIVE COMPENSATION PHILOSOPHY, POLICY AND GUIDELINES. IT DOES SO WITH THE OBJECTIVE OF ATTRACTING AND RETAINING TOP EXECUTIVE TALENT TO ENSURE ALEGENT HEALTH IS ABLE TO FULFILL ITS FAITH-BASED MISSION AND ACHIEVE ITS VISION OF BECOMING WORLD-CLASS. THE ALEGENT HEALTH COMPENSATION COMMITTEE FOLLOWS A THOROUGH AND INTENTIONAL PROCESS THAT INCLUDES CONSULTATION WITH INDEPENDENT, EXPERT COUNSEL AND CAREFULLY COMPARES COMPENSATION LEVELS TO MARKET-BASED COMPENSATION OF SIMILAR SIZED, NON-PROFIT AND FOR-PROFIT HEALTH SYSTEMS AND ALSO UTILIZES A BLEND OF NOT-FOR PROFIT AND GENERAL INDUSTRY DATA FOR EXECUTIVE ROLES WHERE THE RECRUITING MARKET IS ARGUABLY BROADER THAN THE NOT-FOR-PROFIT SECTOR. TOTAL COMPENSATION INCLUDES BASE COMPENSATION, AND ALSO INCLUDES PERFORMANCE-BASED INCENTIVE COMPENSATION FOR ACHIEVING BOARD-SET GOALS FOR CLINICAL QUALITY, PATIENT SAFETY AND SATISFACTION, PHYSICIAN PERCEPTION, STRATEGIC AND FACILITY PLANNING AND FINANCIAL PERFORMANCE. IT MAY ALSO INCLUDE OTHER CASH PAYMENTS SUCH AS ONE-TIME RELOCATION COSTS. SCHEDULE J, PART II: THE ALEGENT HEALTH EXECUTIVES HAVE A PROVISION IN THEIR COMPENSATION AGREEMENT THAT PROVIDES FOR POTENTIAL SEVERANCE PAYMENTS IN THE EVENT OF TERMINATION WITHOUT CAUSE OR CHANGE OF CONTROL. THE AMOUNT OF SEVERANCE AN EXECUTIVE MAY OR MAY NOT RECEIVE IF TERMINATED ACCORDING TO THE COMPENSATION AGREEMENT IS INCLUDED AS DEFERRED COMPENSATION IN COLUMN C.Supplemental Information

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonMICHAEL DEFREECE-BOARD MEMBERNamePerson
FieldValueIRS element (for citing)
RelationshipH-CARD,LLC - OfficerRelationship
Amount Of Transaction133410AmountOfTransaction
Description Of TransactionSUPPLIER PAYMENT NETWORKDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6THE SOLE MEMBER OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM IS CATHOLIC HEALTH INITIATIVES. CATHOLIC HEALTH INITIATIVES DOES NOT HAVE ANY VOTINGS RIGHTS AS A MEMBER OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. INSTEAD CATHOLIC HEALTH INITIATIVES ELECTS 50% OF THE DIRECTORS OF ALEGENT HEALTH.
Form 990, Part VI, Section A, line 7aTHE BUSINESS AND AFFAIRS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM ARE MANAGED BY OR UNDER THE DIRECTION OF THE ALEGENT HEALTH BOARD OF DIRECTORS, AND ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM DELEGATES TO THE ALEGENT BOARD OF DIRECTORS, TO THE EXTENT PERMITTED BY LAW, COMPLETE GOVERNANCE AUTHORITY OVER IT, SUBJECT ONLY TO THE APPROVAL POWERS OF THE ALEGENT CORPORATE MEMBERS SET FORTH IN THE ARTICLES OF INCORPORATION AND BYLAWS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. DIRECTORS SHALL BE APPOINTED BY THE ALEGENT BOARD IMMEDIATELY FOLLOWING THE APPOINTMENT AND RATIFICATION BY ALEGENT CORPORATE MEMBERS OF THE ALEGENT DIRECTORS PURSUANT TO THE ARTICLES OF INCORPORATION AND BYLAWS OF ALEGENT. THE ALEGENT BOARD SHALL APPOINT DIRECTORS SUCH THAT, AT ALL TIMES , ALL OF THE PERSONS SERVING AS ALEGENT DIRECTORS ALSO SHALL BE SERVING AS DIRECTORS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM.
Form 990, Part VI, Section A, line 7bTHE FOLLOWING ACTIONS SHALL BE EFFECTIVE ONLY IF APPROVED BY THE ALEGENT BOARD AND BY BOTH IMMANUEL HEALTH SYSTEMS (IHS) AND CATHOLIC HEALTH INITIATIVES (CHI) IN THEIR CAPACITIES AS ALEGENT CORPORATE MEMBERS: A. ADOPTION OR AMENDMENT OF THE UNFIIED PHILOSOPHY AND MISSION OF THE CORPORATION; B. SALE, LEASE, TRANSFER, ENCUMBRANCE OR DISPOSITION OF THE TANGIBLE PROPERTY OR INVESTMENTS OF THE CORPORATION HAVING A FAIR MARKET VALUE IN ANY INDIVIDUAL TRANSACTION IN EXCESS OF $3 MILLION OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS, PROVIDED THAT TRANSFERS OF INVESTMENTS BETWEEN THE CORPORATION AND ANOTHER PARTICIPANT SHALL NOT REQUIRE THE APPROVAL OF CHI AND IHS; AND PROVIDED FURTHER THAT APPROVAL OF CHI AND IHS SHALL NOT BE REQUIRED FOR ANY TRANSFER OF ASSETS TO CHI BY THE CORPORATION PURSUANT TO THE TERMS OF THE ALEGENT FINANCING AGREEMENT (AFA); C. INCURRENCE, ASSUMPTION OR GUARANTY BY THE CORPORATION IN ANY INDIVIDUAL TRANSACTION OF LONG-TERM INDEBTEDNESS, INCLUDING CAPTIAL LEASES, OUTSTANDING FOR MORE THAN 365 DAYS, IN EXCESS OF THE GREATER OF $2 MILLION OR 2% OF THE TOTAL LONG-TERM INDEBTEDNESS OF ALL THE PARTICIPANTS, OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; D. MERGER, DISSOLUTION, CONSOLIDATION OR SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION EXCEPT FOR A MERGER IN WHICH (I) THE CORPORATION IS THE SURVIVING ENTITY, AND (II) THE TOTAL BOOK VALUE OF THE ASSETS OF THE MERGING ENTITY DOES NOT EXCEED 2% OF THE TOTAL BOOK VALUE OF THE ASSETS OF ALL THE PARTICIPANTS, OR SUCH GREATER VALUE AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; AND E. NOTWITHSTANDING ANY OTHER PROVISIONS IN THE BYLAWS TO THE CONTRARY. THE ACTIONS THAT CAN BE TAKEN WITHOUT THE APPROVAL OF IHS AND CHI INCLUDE, WITHOUT LIMITATION: (I) TERMINATION OF THE AFA IN ACCORDANCE WITH ITS TERMS. (II) FORMATION OF THE UNIFIED ALEGENT HEALTH SYSTEM (AS THAT TERM IS DEFINED IN THE AFA) (III) PREPAYMENT BY THE CORPORATION OF THE FULL AMOUNTS OUTSTANDING ON ITS NOTES TO CHI UNDER THE AFA, FOR PURPOSES OF EXERCISING THE RIGHTS OF TERMINATION OF THE AFA, OR FORMATION OF THE UNIFIED ALEGENT HEALTH SYSTEM CREDIT, AND THE TAKING OF ALL ACTIONS NECESSARY OR APPROPRIATE TO OBTAIN FUNDING OR OTHERWISE MAKE ARRANGEMENTS TO PREPAY SUCH NOTES INCLUDING WITHOUT LIMITATION INCURRENCE OF INDEBTEDNESS NECESSARY OR APPROPRIATE TO PREPAY THE NOTES OUTSTANDING.
Form 990, Part VI, Section B, line 11Tax returns for entities of the Alegent Health system are prepared by THE SYSTEM tax department. Following the preparation of ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM Form 990 by internal tax staff, the return is reviewed by the Tax Director, External Tax Advisor and the Chief Financial Officer. The final tax return is posted on the electronic DIRECTOR'S portal to be reviewed and presented at the Finance and Audit Committee of the Board. THE FINAL TAX RETURN IS PRESENTED AT THE SCHEDULED BOARD MEETING. THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR ARE PRESENT AT THE MEETING TO ANSWER ANY QUESTIONS THE BOARD MAY HAVE. Additionally, the Board of Directors are notified that the final Form 990, including all required schedules is available on the electronic portal for review and will be filed on May 16, 2011.
Form 990, Part VI, Section B, line 12cWritten Conflict of Interest Policy - ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM has adopted the conflict of interest policy and conflict investigation process of Alegent Health, the parent corporation of the Alegent Health System. Annual completion of the disclosure statement is required By the Board of DIRECTORS. Stated disclosures are investigated by the Alegent Health Compliance Officer and reported to the Conflicts of Interest Committee. The Conflicts of Interest Committee reviews the investigation and makes recommendations to the Governance Committee. The Governance Committee makes the final determination of whether or not there is a disqualifying event and communicates it to the Board OF DIRECTORS. At any time a Board Member or Key Employee may declare a conflict of interest and recuse his/herself from the discussion. The individual is also required to disclose any known or possible conflicts of interest that arise during the calendar year.
Form 990, Part VI, Section B, line 15The governing board engaged the services of an independent consulting firm that holds itself out to the public as a compensation consultant that is qualified to and regularly performs executive and officer compensation studies. The consulting firm conducted a review and analysis of the total compensation paid to the CEO and other officers and key employees of the organization, based on comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated organizations and determined that the compensation was reasonable. The consulting firm issued an opinion letter as to the reasonableness of the total compensation paid to employees identified as disqualified persons. The opinion letter setting forth the findings was reviewed and approved by the compensation committee of the governing board. Contemporaneous documentation and recordkeeping with respect to deliberations and decisions regarding the compensation arrangements were maintained. This process was used for the following positions: President and Chief Executive Officer Executive Vice President Senior Vice President and Chief Financial Officer Chief Executive Officer Alegent Health Clinic Senior Vice President Chief Operations Officer Senior Vice President Chief Medical Officer Medical Directors Vice President Operations (Bergan Mercy) Vice President Operations (Mercy) Senior Vice President Chief Information Officer (2010) Senior Vice President Human Resources Senior Vice President Marketing
Form 990, Part VI, Section C, line 19The conflict of interest policy is made available to the public on the website at www.alegent.com. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM does not make the financial statements or governing documents available to the public. However, the ARTICLES OF INCORPORATION are available at www.sos.state.ne.us.
FORM 990, PART I, LINE 5 AND PART V, LINE 2A:THE EMPLOYEES LISTED IN PART I, LINE 5 AND PART V, LINE 2A ARE EMPLOYED BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. HOWEVER, THROUGH A COMMON PAY AGENT AGREEMENT, THE EMPLOYEES ARE PAID BY ALEGENT HEALTH AND PAYROLL EXPENSES ARE ALLOCATED TO ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM.
FORM 990, PART V, LINE 1A:PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF THE ALEGENT HEALTH SYSTEM ARE MADE BY ALEGENT HEALTH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. ALEGENT HEALTH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. HOWEVER, PER THE INSTRUCTIONS, THOSE 1099S ISSUED BY ALEGENT HEALTH ON BEHALF OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM ARE REPORTED.
FORM 990, PART VI, SECTION B, LINE 16:ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, ALEGENT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNER'S RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S LENGTH, WITH PRICES SET AT FAIR MARKET VALUE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
ALEGENT HEALTH-IMMANUEL MEDICAL CENTER
6901 N 72ND STREETOMAHANE68122470376615LICENSED HOSPITALNE501(C)(3)L3ALEGENT hEALTH
ALEGENT hEALTH
12809 WEST DODGE ROADOMAHANE68154470757164LICENSED HOSPITAL/ADIMINSTRATIVE SUPPORTNE501(C)(3)L3N/A
ALEGENT HEALTH CLINIC
12809 WEST DODGE ROADOMAHANE68154470765154CLINICAL SERVICESNE501(C)(3)L3ALEGENT hEALTH
ALEGENT HEALTH FOUNDATION
12809 WEST DODGE ROADOMAHANE68154470648586SUPPORT OF ALEGENT HEALTH AND AFFILIATES EXEMPT ACTIVITIESNE501(C)(3)L7ALEGENT hEALTH
Alegent Health-Mercy Hospital Corning IA
603 Rosary DriveCORNINGIA50841420782518LICENSED HOSPITALIA501(C)(3)L3N/A
Mercy Health Care Foundation Corning IA
603 Rosary DriveCORNINGIA50841421461064SUPPORT OF ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA EXEMPT ACTIVITIESIA501(C)(3)L11 IAlegent Health-Mercy Hospital Corning IA
Alegent Health Memorial Hospital Schuyler NE
104 West 17th StreetSCHUYLERNE68661470399853LICENSED HOSPITALNE501(C)(3)L3ALEGENT HEALTH-IMMANUEL MEDICAL CENTER
Schuyler Memorial Hospital Foundation INC
104 West 17th StreetSCHUYLERNE68661363630014SUPPORT OF ALEGENT HEALTH-MEMORIAL HOSPITAL, SCHUYLER EXEMPT ACTIVITIESNE501(C)(3)L11 IAlegent Health Memorial Hospital Schuyler NE
Alegent Health Community Memorial Hospital of MO Valley IA
631 North 8th StreetMissouri ValleyIA51555420776568LICENSED HOSPITALIA501(C)(3)L3ALEGENT HEALTH-IMMANUEL MEDICAL CENTER
Community Memorial Hospital Medical Service Foundation Missouri Valley IA
631 North 8th StreetMissouri ValleyIA51555421294399SUPPORT OF ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY,IA501(C)(3)L11 IAlegent Health Community Memorial Hospital of MO Valley IA
MERCY HOSPITAL FOUNDATION
800 MERCY DRIVECOUNCIL BLUFFSIA51503421178204SUPPORT OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEMIA501(C)(3)L11 IN/A

Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartner
AVANTAS LLC
11128 JOHN GALT BLVD STE 400OMAHANE68137392045003STAFFING OF NURSESNEN/ARELATED-90040240512190$125,5351
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17030 LAKESIDE HILLS PLZ STE 206OMAHANE68130204267902AMBULATORY SURGICAL CENTERNEN/AN/A00
LAKESIDE ENDOSCOPY CENTER LLC
17001 Lakeside Hills Plaza STE 201OMAHANE68130205544496ENDOSCOPY SERVICESNEN/AN/A00
Omaha Ambulatory Investment Company LLC
12809 WEST DODGE ROADOMAHANE68154061786989PARENT HOLDING COMPANY ASCNEN/AN/A00
Alegent Health Northwest Imaging Center LLC
3606 N 156th Street Ste 104OMAHANE68154061786985DIAGNOSTIC TESTING FACILITYNEN/AN/A00
Prairie Health Ventures LLC
421 South 9th Street Ste 102LINCOLNNE68508204962103PROFESSIONAL TECH SERVICESNEN/AN/A00
Bergan Mercy Surgery Center LLC
7710 Mercy Road Ste 100OMAHANE68124208671994AMBULATORY SURIGICAL CENTERNEN/AN/A00

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Alegent HealthCreighton St Joseph Managed Care Services IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line112809 WEST DODGE ROADAddressLine1
CityOMAHACity
StateNEState
ZIP Code68164ZIPCode
FieldValueIRS element (for citing)
EIN470802396EIN
Primary ActivityMANAGED CARE SERVICESPrimaryActivity
Legal Domicile StateNELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1AVANTAS LLCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeDTransactionType
Amount Involved2975000AmountInvolved

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