2021-05-17T17:06:33-05:00 2020-06-30 KPMG LLP 1212 North 96th Street Suite 300 Omaha NE 68114 990 2019-07-01 911858433 The Nebraska Medical Center % KAREN KERSTETTER NEBR 4025594000 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 STEPHANIE DAUBERT CFO 4025594000 2021-05-17 true DONALD NEAL JR P00798244 4023481450 2021-05-17 2019 2022-09-23 18:48:47Z STEPHANIE DAUBERT 987400 NEBRASKA MEDICAL CENTER OMAHA NE 681987400 1632347113 false X www.nebraskamed.com X 1997 NE Lead the world in transforming lives to create a healthy future for individuals & communities through premier educational programs, innovative research & extraordinary patient care 11 6 10153 655 4166533 63749 17498328 70267424 1368766590 1426317370 21742912 9397744 90875419 124150539 1498883249 1630133077 294860140 335764475 0 0 512000793 524434053 17508 430475 678745 648437522 719297997 1455315963 1579927000 43567286 50206077 1518041391 2200629584 563684281 1182108173 954357110 1018521411 X OUR MISSION IS TO LEAD THE WORLD IN TRANSFORMING LIVES TO CREATE A HEALTHY FUTURE FOR INDIVIDUALS & COMMUNITIES THROUGH PREMIER EDUCATIONAL PROGRAMS, INNOVATIVE RESEARCH, & EXTRAORDINARY PATIENT CARE. false false 254986069 16965209 300913769 Oncology service line cancer treatment services offered by the corporation include treatment of lymphoma, leukemia, multiple myeloma, head and neck, breast, gastrointestinal, pancreatic, lung, genitourinary prostate, gynecologic, melanoma, brain and spine cancers. The patients are supported by research that is conducted on the UNMC campus. TNMC is the only clinical cancer center in its service area designated by the national cancer institute. In addition to treatment and clinical trials TNMC offers support groups, social work, pain management, financial counselors, survivorship groups, genetic counseling, and a variety of additional patient supportive services. In June 2017, TNMC opened the Fred & Pamela Buffett cancer center. The center is jointly owned with UNMC and is one of the foremost cancer research and treatment facilities in the country. It is the site of inpatient hospital care, as well as outpatient and diagnostic care. UNMC's facilities, within the center, house research labs. TNMC also operates cancer treatment locations in Bellevue, in west Omaha at its village pointe location, and in Shenandoah, Iowa. In addition, as one of the busiest programs in the world, the bone marrow transplantation program served 171 patients in the year ended June 30, 2020. A 24/7 emergency and evaluation treatment center is dedicated to cancer and transplant patients. The program benefits from the research conducted on TNMC/UNMC campus. TNMC was one of the first cancer centers in the nation to participate in clinical trials for car-t cell therapy. It was FDA-approved in October of 2017. In August of 2018, the therapy was extended to leukemia patients. In 2019, multiple myeloma patients began receiving the therapy. During fiscal year 2020, the oncology service line treated 122,002 cases and 25,086 patient days. Approximately 40% of the net revenue was derived from inpatient cases. 163240606 17838609 193517008 Heart and vascular service line TNMC provides a wide range of cardiovascular services from diet counseling to surgical procedures and rehabilitation. TNMC has grown into one of the busiest centers in the country for ventricular assist device operations. TNMC has been successful in recruiting physicians and has the only heart failure specialist in the region and the only heart failure program certified by the joint commission in the state of Nebraska. In 2016, TNMC began a lung transplant program and in December of 2017 performed the state's first ever heart and lung transplant. In the year ended June 30, 2020, TNMC performed 8 lung transplants. The congestive heart failure program and acute myocardial infarction program each received the gold seal of approval certification from American heart association and are certified by the joint commission. These services are the first and only nationally certified programs of their kind in the state of Nebraska. The chest pain center has received full chest pain center accreditation from the society of chest pain centers. The Nebraska medical center has been recognized for service excellence under the J.D. power and associates distinguished hospital program. TNMC has the only joint commission certified destination therapy program in the state and is the only hospital in the region performing adult heart transplants and implanting total artificial hearts. TNMC treats patients from the surrounding region and in the year ended June 30, 2020, 762 open heart surgeries were performed including: 46 heart transplants, and 36 mechanical circulatory system-device implantations. 141750566 10265079 175958083 Digestive disease & kidney service line the Nebraska medical center (TNMC) operates one of the busiest solid organ transplant programs in the world. In 2016, TNMC joined a small number of transplant centers which have programs for transplants of all solid organs. TNMC's lung transplant program did its first transplant in February of 2016 and performed 8 lung transplants during 2020. In the year ended June 30, 2020, TNMC performed 313 solid organ transplants including liver, kidney, heart, lung, pancreas and small bowel. The success of TNMC's solid organ transplant program is heightened by research done on the TNMC/university of Nebraska medical center (UNMC) campus. Since its inception, patients have come to TNMC for single or multiple organ transplants from all 50 states and five continents. During fiscal year 2020, the solid organ transplantation service line incurred 112,386 cases and 26,346 patient days. Approximately 67% of the revenue was derived from inpatient cases. All other hospital services With a history dating back to 1869, TNMC was formed with the merging of bishop Clarkson Memorial Hospital and University Hospital, and in July 2016, UNMC Physicians outpatient clinics became part of the organization. TNMC continues to attract patients from the region and around the world. TNMC is a tertiary/quaternary academic medical center. It is the largest health care facility in the state with more than 10,000 employees and over 900 physicians practicing in all major specialties and sub-specialties. Besides several key services in cardiology, oncology, transplant and neurology, TNMC offers comprehensive care in women's services for obstetrics and gynecology, as well as pediatric services, orthopedics, rheumatology, and pulmonary care. In addition, TNMC has one of the region's largest hyperbaric medicine programs. TNMC is the most esteemed academic health systems in the region, with 809 licensed beds at its two hospitals, Nebraska medicine - Nebraska medical center, and Nebraska medicine - Bellevue. TNMC also operates 40 specialty and primary care clinics in Omaha and surrounding areas. TNMC also has one of the few biocontainment units in the united states equipped to safely care for those exposed to highly contagious, dangerous diseases. In September, October, and November of 2014, the Nebraska biocontainment unit was activated to provide care for three Americans who contracted the Ebola virus during the west Africa outbreak. This response resulted in TNMC and UNMC becoming one of three designated Ebola treatment and education centers in the united states. Biocontainment unit staff have continued to educate public health and infectious disease teams from around the world about safe protocols and responses to infectious diseases. In January 2020, the Davis Global Center opened. It houses advanced education in simulation, artificial and virtual reality to learners and staff. Located in the center, the global center for health security includes biopreparedness, infectious diseases and high-consequence infections research, education and clinical care. The organization continues to strive toward its mission to lead the world in transforming lives to create a healthy future for all individuals and communities through premier educational programs, innovative research and extraordinary patient care. This was demonstrated through a variety of activities throughout FY20 as well as the health system emerging as a local, regional and national leader in the response to the covid-19 pandemic. FY20 expansion included the addition of a new linear accelerator at the Village Pointe Health Center in West Omaha, allowing for radiation treatments to be performed faster and more conveniently for cancer patients. A new cath/electrophysiology lab opened at the Nebraska Medical Center, consolidating heart and vascular services and increasing capacity. This is an important service offering, as cardiovascular disease is one of the top diseases affecting Nebraskans. Bellevue medical center marked its 10th anniversary in May 2020 and is home to nearly 500 employees and serves more than 31,000 emergency department visits, 4,600 discharges and 2,300 surgery cases each year. As of August 2019, patients have access to health information during their inpatient stay through a hospital-provided tablet. This is available on all medical-surgical, progressive care, and critical care units. A new benefit was added for staff beginning in July 2019, allowing for paid time off to volunteer within the community. In partnership with UNMC, Nebraska Medicine launched the Be Extraordinary Together culture shaping initiative in January 2020. The following initiatives were launched as a result of the COVID-19 pandemic: . Telehealth expansion allowing video visits to be scheduled through the online portal and includes primary, specialty and immediate care appointments . Provided inpatient and outpatient clinical care for patients affected by COVID-19 . Conducted educational Outreach calls to patients at greater risk of Covid-19 . Universal masking and personal protective equipment policies for staff and patients . Invention of Ultraviolet N95 decontamination process for personal protective equipment in short supply; this method was endorsed by the Centers for Disease Control and Prevention and used across the country . Partnership with Douglas County Health Department and One World Health Center to provide drive-through specimen collection in underserved South Omaha . Creation of training materials through The Global Center for Health Security . Provided training and education for health care workers through NETEC . Conducted and participated in clinical trials, including the use of Remdesivir in treating patients . Served as a community and national expert through media and social media IN FY20, Nebraska Medical Center earned the following: . U.S. news and world report recognition as one of the best hospitals, rated #1 in the Omaha metro and the state of Nebraska; cancer program received national ranking and gastroenterology/GI surgery and neurology/neurosurgery were ranked as high performing. Also received highest ranking possible for five procedures: Chronic Obstructive Pulmonary Disease, Colon Cancer Surgery, Heart Bypass Surgery, Heart Failure, Hip Replacement . Diabetes services named a top performer by the Society of Hospital Medicine (SHM) for Glycemic Control . College of Cardiology's National Cardiovascular Data Registry Chest Pain - Myocardial Infarction Registry Platinum Performance Achievement Award. Nebraska Medical Center was one of only 225 hospitals nationwide to receive the honor . Training Magazine's Top 125 Companies for Training Programs award . Becker's 100 Great Hospitals in America recognition . Newsweek's World's Best Hospitals 2020 ranking: #54 on the list of best hospitals in the United States 190252259 15041727 204660972 NEUROSCIENCES 822834630 275653851 551267538 OTHER PROGRAM SERVICES 1013086889 290695578 755928510 1573064130 true true false true false false false true false true true false false true true true false true false false false false false true false false true true true true true true false false false false false false false false true true true false false false true true true true false false true 280 0 true 10153 true true true false false false false false false false false false true false X 11 6 true false false false true true true true true false false true true true true true true true true true false X KAREN KERSTETTER 4025523278 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 X James Linder CEO 45.0 10.0 X 1423430 0 29084 Cory D Shaw Chief Operations Officer 45.0 10.0 X 788073 0 66666 Stephanie Daubert CFO 45.0 10.0 X 743860 0 48454 Daniel DeBehnke Former CEO 0.0 0.0 X 752470 0 0 Harris A Frankel Chief Medical Officer 10.0 45.0 X 0 702331 41489 Michael A Ash EVP/Chief Transformation Ofc 30.0 30.0 X 0 669576 20032 Kenneth Follett Emeritus, Neurosurgery 55.0 0.0 X 0 595661 15650 Frank V Venuto Chief Human Capital Officer 45.0 10.0 X 532590 0 49950 Suzanne Nuss Chief Nursing Officer 45.0 10.0 X 513174 0 61461 Anna Cramer Chief Legal Officer 45.0 10.0 X 512215 0 22822 David W Mercer Director 30.0 30.0 X 0 482789 12965 Theresa Franco Cancer Ctr/Rad/Imag Svcs VP 55.0 0.0 X 395539 0 66184 Debra Romberger Director 30.0 30.0 X 0 428868 26952 Thomas C Macy Amb Clinics/Clinical Prog VP 55.0 0.0 X 384004 0 55385 Brian J Lancaster Information Technology VP 30.0 30.0 X 395398 0 42603 Julie Lazure Acute Care/Path Svcs VP 55.0 0.0 X 365781 0 56770 Matthew E Pospisil Periop Svs/Bellevue VP 55.0 0.0 X 331059 0 52665 Jennifer L Brown Staff Physician-Primary 55.0 0.0 X 333885 0 47317 Michael A Donner Staff Physician-Primary 55.0 0.0 X 312740 0 49340 Frank S Lococo Corp Marketing & Comm VP 55.0 0.0 X 322976 0 20807 Jay C Anderson Staff Physician-Primary 55.0 0.0 X 306162 0 21671 Dennis D Bierle System Clinical Operations COO 0.0 0.0 X 279996 0 0 Aubray D Orduna Interim Pres Clarkson College 55.0 0.0 X 253888 0 20226 Louis W Burgher Director (thru 12/31/2019) 40.0 1.0 X 23185 0 0 Jeffrey P Gold Director (Chairman) 1.0 2.0 X X 0 0 0 Mogens Bay Director (Vice Chairman) 1.0 2.0 X X 0 0 0 Bruce Grewcock Director (Treasurer) 1.0 2.0 X X 0 0 0 Nancy Keegan Director (Secretary) 1.0 2.0 X X 0 0 0 Lance M Fritz Director 1.0 2.0 X 0 0 0 Eric K Keen Director 1.0 2.0 X 0 0 0 James E McClurg Director 1.0 2.0 X 0 0 0 Jim Pillen Director (beg 1/5/2020) 1.0 2.0 X 0 0 0 James T Canedy Director 1.0 2.0 X 0 0 0 8970425 2879225 828493 794 true true false UNMC 986900 NEBRASKA MEDICAL CENTER OMAHA NE 68198 MEDICAL SERVICES 8369024 CARDINAL HEALTH INC 5840 F STREET OMAHA NE 68117 MANAGEMENT FEE 8035906 NEBRASKA PEDIATRIC PRACTICE 8200 Dodge St OMAHA NE 68114 MEDICAL SERVICES 7714182 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 IT service contract 4866856 SODEXO CTM INC PO Box 415000 NASHVILLE TN 37241 Medical Equip Serv 4856150 118 60290253 9977171 2009619 70267424 ONCOLOGY & BMT 900099 300913769 300913769 NEUROSCIENCES 900099 204660972 204660972 CARDIOVASCULAR 446110 193517008 193517008 DIGESTIVE DISEASE & KIDNEY 900099 175958083 175958083 ALL OTHER 900099 551267538 551267538 1426317370 9577421 9577421 0 0 2826198 77214 2826198 77214 2903412 1456912 1446500 1933235 101124 2194031 20005 -260796 81119 -179677 -179677 0 0 0 0 0 0 0 0 0 Pharmacy Services 900099 75748322 75588998 159324 Lab Administration 900099 23977181 23977181 One Chart Practice 900099 11303895 11303895 10217729 7667432 2550297 121247127 1630133077 1544854876 4166533 10844244 237262753 237262753 98501722 98501722 0 0 6948455 764330 6184125 0 424814729 424644778 169951 22796636 22783359 13277 39385262 39370301 14961 30488971 30477819 11152 0 1383889 1383889 468923 468923 117621 117621 430475 430475 372233 372233 32645328 32645328 4854620 4854620 9272062 9269704 2358 32008421 31975720 32701 0 31570231 31570231 1007557 1007557 0 506612 506612 10468590 10468590 0 81646298 81643134 3164 4343604 4343604 Medical Supplies & Equipment 431537747 431537747 Contracted Services 54301025 54301025 REPAIR & MAINTENANCE 7934926 7934926 AFFILIATED AGREEMENTS 6849513 6849513 8008797 8008091 706 1579927000 1573064130 6184125 678745 17702481 10839704 450611202 921307808 5968920 7522469 264750117 257873378 0 0 0 0 2688492 2587407 9704032 11122055 49816976 21535224 1496431581 815821979 636332892 680609602 47182812 49029100 23978485 28657986 0 0 0 0 9304982 209544851 1518041391 2200629584 212217100 212172199 0 0 16590928 174037694 288199513 282617705 0 0 0 0 10396957 307129173 0 0 36279783 206151402 563684281 1182108173 X 934559700 995626887 19797410 22894524 954357110 1018521411 1518041391 2200629584 X 50206077 5939205 8019019 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 117621 117621 false Schedule C, Part II-B, Line 1i Lobbying Expenses This amount consists of hospital lobbying dues paid through annual dues of the national and state hospital associations. 819284 X false 19797408 3334961 1163014 1955715 22339668 17850984 1863357 1457066 1373999 19797408 16989461 1044460 482671 665608 17850984 34360380 451767 792128 18614814 16989461 11773235 22709595 342375 464825 34360380 0.11900 0.88100 false false 14201136 14201136 378415601 141968126 236447475 32110079 14230780 17879299 1054310613 653194701 401115912 17394152 6428372 10965780 680609602 BOND ACQUISITION COSTS 2735422 CASH SURRENDER VALUE - SERP 2290335 SOFTWARE AS SERVICE IMPLEMENT 288229 ROU ASSET OPERATING 200897365 OTHER LONG TERM ASSETS 3333500 209544851 0 THIRD PARTY PAYOR SETTLEMENT 12399293 OTHER CLAIMS PAYABLE 12288470 DUE TO AFFILIATES 14598729 OTHER LONG-TERM LIABILITIES 1783311 RIGHT OF USE OPERATING LEASES 165081599 206151402 X Schedule D, Part III, Line 4 Description of Art Collection The hospital displays its collection of art throughout the walls of the organization. It is a collection of images & portraits taken of various cultures around the world & portrays the hospital's culture of providing medical care to people of all cultures. Schedule D, Part V, Line 4 Endowment Funds The majority of the endowment funds held by the hospital are held in order to earn interest in order to provide scholarships or education for employees of the hospital or for patient needs/experience. The term endowment funds include charitable gift annuities. Schedule D, Part X, Line 2 FIN 48 Footnote TNMC has adopted FASB interpretation no. 48, accounting for uncertainty in income taxes - an interpretation of FASB statement no. 109 (fin 48). Fin 48 provides specific guidance on how to address uncertainty in accounting for income tax assets and liabilities, prescribing recognition thresholds and measurement attributes. There were no uncertain tax positions at June 30, 2020 or 2019. X X X X X X X true All amounts under 5000 Grant Writing false University of Nebraska Foundation PO Box 82555 Lincoln NE 68501 Fundraising false 1518815 430475 1518815 430475 true true X true X true X true true true false true true 9531 22386063 22386063 0.01420 90151 124355950 87323348 37032602 0.02340 1436 2715501 2810000 0 0.00000 101118 149457514 90133348 59418665 0.03760 16 18666 4179964 2655106 1524858 0.00100 371 54587559 10765553 43822006 0.02770 28567489 20684679 7882810 0.00500 4167843 990490 3177353 0.00200 13 804 185513457 185513457 0.11740 29 19841 277016312 35095828 241920484 0.15310 29 120959 426473826 125229176 301339149 0.19070 1 0 11448 0 11448 0.00000 1 0 30000 0 30000 0.00000 2 40 10616 0 10616 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 1 0 217 0 217 0.00000 0 0 0 0 6 3565 361794 0 361794 0.00020 0 0 0 0 11 3605 414075 0 414075 0.00020 true 39737643 196100573 225914859 -29814286 X true true NEB ORTHO HOSPITAL ORTHOPEDIC HOSPITAL 0.5972 2 1 THE NEBRASKA MEDICAL CENTER 987400 Nebraska Medical Center Omaha NE 68198 HTTP://NEBRASKAMED.COM 260011 X X X X A 2 BELLEVUE MEDICAL CENTER 2500 Bellevue Medical Center Drive Bellevue NE 68123 HTTP://BELLEVUE.NEBRASKAMED.COM H000115 X X X A GROUP A 2 false false true X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 200. 400. X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X true X false false Schedule H, Part V, Line 5 (CHNA) FOR NEBRASKA MEDICINE (WHICH INCLUDES TNMC and BELLEVUE MEDICAL CENTER (BMC)) FOR THE COMPREHENSIVE CHNA PROCESS, A STEERING COMMITTEE COMPRISED OF KEY STAKEHOLDERS FROM AREA HEALTH SYSTEMS, LOCAL COUNTY HEALTH DEPARTMENT REPRESENTATIVES, AND KEY INFORMANTS FROM SEVERAL COMMUNITY AGENCIES WORKED COLLABORATIVELY TO OVERSEE THE PROCESS. THE CHNA STEERING COMMITTEE RETAINED PROFESSIONAL RESEARCH CONSULTANTS (PRC), INC. TO CONDUCT THE SURVEY. PRC IS A NATIONALLY RECOGNIZED HEALTH CARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING CHNAS SUCH AS THIS IN HUNDREDS OF COMMUNITIES ACROSS THE UNITED STATES SINCE 1994. INPUT FROM COMMUNITY STAKEHOLDERS KEY INFORMANT FOCUS GROUP DISCUSSIONS INCLUDED REPRESENTATION FROM ALL OF THE ASSESSED COUNTIES. FOCUS GROUP PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO PROVIDE INPUT REGARDING VULNERABLE OR MEDICALLY UNDERSERVED POPULATIONS, MINORITIES, AND/OR POPULATIONS WITH CHRONIC DISEASE. ONE HUNDRED SIXTY-THREE COMMUNITY STAKEHOLDERS, INCLUDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND BUSINESS AND COMMUNITY LEADERS PARTICIPATED IN FOCUS GROUP SESSIONS. A FULL LIST OF PARTICIPATING KEY INFORMANT FOCUS GROUPS AND THEIR AREAS OF EXPERTISE CAN BE FOUND HERE: HTTPs://WWW.NEBRASKAMED.COM/ABOUT-US/COMMUNITY-HEALTH-IMPROVEMENT STEERING COMMITTEE PARTICIPANT NAMES BELOW IS A LISTING OF THE PARTICIPANTS AND THE SPONSORING ORGANIZATIONS REPRESENTING THE CHNA STEERING COMMITTEE. CHI HEALTH: KELLY NIELSEN - DIRECTOR, COMMUNITY BENEFIT AND HEALTHIER COMMUNITIES DOUGLAS COUNTY HEALTH DEPARTMENT: DR. ADI POUR - HEALTH DIRECTOR LIVE WELL OMAHA: SARAH SJOLIE - EXECUTIVE DIRECTOR METHODIST HEALTH SYSTEM: JEFF PROCHASKA - DIRECTOR, STRATEGIC PLANNING SARPY/CASS COUNTY HEALTH DEPARTMENT: SARAH SCHRAM - HEALTH DIRECTOR NEBRASKA MEDICINE (TNMC and BMC): BECKY JACKSON - DIRECTOR, PATIENT & COMMUNITY ENGAGEMENT VISITING NURSES ASSOCIATION/POTTAWATTAMIE COUNTY: KRIS STAPP - VICE PRESIDENT, COMMUNITY HEALTH SERVICE CHARLES DREW HEALTH CENTER: KENNY MCMORRIS - CHIEF EXECUTIVE OFFICER OMAHA COMMUNITY FOUNDATION: KALI BAKER - VICE PRESIDENT OF COMMUNITY RELATIONS ONEWORLD COMMUNITY HEALTH CENTERS: ANDREA SKOLKIN - CHIEF EXECUTIVE OFFICER UNITED WAY OF THE MIDLANDS: MARIEL HARDING - DIRECTOR, COMMUNITY IMPACT Schedule H, Part V, Line 6a & 6b THE CHNA WAS CONDUCTED WITH OTHER HOSPITAL AND COMMUNITY BASED FACILITIES AS LISTED BELOW: *THE NEBRASKA MEDICAL CENTER AND BELLEVUE MEDICAL CENTER *CHI HEALTH *METHODIST HEALTH SYSTEM *DOUGLAS, SARPY, CASS AND POTTAWATTAMIE COUNTY HEALTH DEPARTMENTS *LIVE WELL OMAHA Schedule H, Part V, Line 7b HTTP://WWW.DOUGLASCOUNTYHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, LINE 7A & 10A HTTP://WWW.NEBRASKAMED.COM/ABOUT-US/COMMUNITY-HEALTH-IMPROVEMENT Schedule H, Part V, Line 11 NEBRASKA MEDICINE HAS CURRENT PROGRAMS AND SERVICES IN PLACE TO ADDRESS EACH OF THE ELEVEN CHNA-IDENTIFIED COMMUNITY NEEDS. HOWEVER, IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENTLY, NEBRASKA MEDICINE WILL PLACE A PRIMARY FOCUS ON INJURY & VIOLENCE PREVENTION, MENTAL HEALTH AND ACCESS TO HEALTHCARE SERVICES. HOWEVER, IT HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING THE REMAINING CHNA-IDENTIFIED NEEDS, AND MAY TOUCH UPON EACH OF THESE CATEGORIES WITHIN ITS EFFORTS TO ADDRESS ISSUES SURROUNDING ACCESS TO CARE IN UNDERSERVED POPULATIONS. FURTHER, IN ORDER TO ENSURE ALL IDENTIFIED NEEDS WILL BE ADDRESSED IN THE COMMUNITY, NEBRASKA MEDICINE MET WITH THE OTHER LOCAL HEALTH SYSTEMS AND COUNTY HEALTH DEPARTMENTS TO DISCUSS THE CHNA-IDENTIFIED COMMUNITY NEEDS AND LOOK FOR OPPORTUNITIES TO COLLABORATE. THE IDENTIFIED NEEDS NOT BEING ADDRESSED BY NEBRASKA MEDICINE ARE IDENTIFIED AS CANCER, NUTRITION, PHYSICAL ACTIVITY & WEIGHT, SUBSTANCE ABUSE, DIABETES, HEART DISEASE & STROKE, DEMENTIA INCLUDING ALZHEIMER'S DISEASE, RESPIRATORY DISEASES AND SEXUALLY TRANSMITTED DISEASES. EACH OF THESE REMAINING CHNA-IDENTIFIED NEEDS ARE BEING ADDRESSED BY ONE OF THE OTHER COMMUNITY HEALTH SYSTEMS, LOCAL UNIVERSITY MEDICAL SCHOOLS, COUNTY HEALTH DEPARTMENTS, OR COMMUNITY-BASED ORGANIZATIONS. A FULL LISTING OF THESE ARE PROVIDED IN TNMC'S CHNA REPORT AND CAN BE FOUND HERE: HTTP://WWW.NEBRASKAMED.COM/ABOUT-US/COMMUNITY-HEALTH-IMPROVEMENT IMPLEMENTATION STRATEGY PLAN UPDATE NEBRASKA MEDICINE'S FISCAL 2019-2022 CHNA AND IMPLEMENTATION PLANNING CYCLE IDENTIFIED ELEVEN SIGNIFICANT HEALTH NEEDS, THREE OF WHICH WERE PRIORITIZED FOR THE PLANNING PERIOD: (1) INJURY & VIOLENCE PREVENTION, (2) MENTAL HEALTH AND (3) ACCESS TO HEALTHCARE SERVICES. BELOW ARE SOME HIGHLIGHTS ON THE PROGRESS OF THE 2019-2022 PLAN. - Opened a new 24/7 psychiatric emergency services unit in late calendar year 2019 to best meet the mental health needs of our community. - Increased the number of health providers by 3 MD's and 4 APRN's in the Intensive Outpatient program. - Assist 5,900 patients in securing prescription medications at the lowest possible cost. - Actively partnering with Medicare on the Primary Care First program which will expand further focus on population health management. - Funded over $150,000 to community nonprofit partners towards initiatives and programs related to accessing care. - Invested in the poison center which has had over 30,000 follow-up calls related to COVID-19. Schedule H, Part V, Section b, Line 13h POLICY FN16: DISCOUNT/FINANCIAL ADJUSTMENTS TALKS ABOUT DISCOUNTS FOR PATIENTS WITH NON THIRD-PARTY PAYMENT SOURCE, DISCOUNTS, SIMILAR TO DISCOUNTS OFFERED TO MANAGED CARE PLANS, ARE OFFERED FOR MOST PATIENTS THAT DO NOT HAVE THIRD PARTY INSURANCE AND DO NOT MEET THE GUIDELINES FOR GOVERNMENTAL ASSISTANCE PROGRAMS. THIS DISCOUNT IS SUBJECT TO CHANGE BASED ON THE RATES AGREED UPON THROUGH MANAGED CARE CONTRACTS. THESE DISCOUNTS ARE INDEPENDENT OF THE CHARITY ADJUSTMENTS, AND THAT CHARITY ADJUSTMENTS ARE APPLIED AFTER THE SELF-PAY ADJUSTMENT IS APPLIED TO THE BILLED CHARGES. Schedule H, Part V, Line 16a-16c HTTPS://WWW.NEBRASKAMED.COM/PATIENTS/BILLING/FINANCIAL-COUNSELING Schedule H, Part V, Section B, Line 16J INFORMATION ON HOW TO GET FINANCIAL ASSISTANCE IS POSTED ON THE WEBSITE UNDER PATIENT FRIENDLY BILLING WHICH IS LOCATED UNDER THE PATIENT & VISITORS SECTION. THERE ARE DEPARTMENTS LISTED WITH PHONE NUMBERS TO CALL FOR MORE INFORMATION OR TO SET UP AN APPOINTMENT. Schedule H, Part V, Section D WE DO NOT HAVE REHABILITATION, FREE STANDING DIAGNOSTIC FACILITIES, OR SKILLED NURSING. OUR OFF SITE DIAGNOSTIC SERVICES ARE INCLUDED ON OUR HOSPITAL LICENSE AND OUR HOSPITAL ANCILLARY SERVICES ARE HOSPITAL BASED AND INCLUDED ON OUR LICENSE. 4 NE MEDICINE - INTERNAL MEDICINE 729 North Custer Avenue Grand Island NE 68805 INTERNAL MEDICINE CLINIC GIRLS INC OF OMAHA 2811 North 45th Street Omaha NE 68104 FAMILY MEDICINE CLINIC Nebraska Medicine University Health Ctr 550 N 19th Street Lincoln NE 68588 Medical Clinic Nebraska Medicine UNO Health Ctr 6001 Dodge Street Omaha NE 68182 Medical Clinic Schedule H, Part I, Line 3c Not applicable as the organization does follow FPG to determine eligibility for providing fee care to low income individuals. Schedule H, Part I, Line 6a The organization's community benefit report can be accessed at: http://www.nebraskamed.com/about-us/community-benefit-report Schedule H, Part I, Line 7 These numbers are computed in a cost accounting system that produces a cost for every service the hospital provides. Relative value units, for seven categories of expense, are updated annually for each patient service which keeps the cost accounting current. These costs per unit values are applied to the patient utilization to compute the total cost. The cost accounted total is tied back to the hospital's financial statements to ensure system integrity. Schedule H, Part I, Line 7, column F The denominator used to calculate the percentage in column(f) is form 990, part ix, line 25(a). Schedule H, Part II Community Building Activities Community-building activities are designed to address the root causes of Health problems. Poverty, homelessness and environmental problems all Contribute to poor health. The types of programs included in this Category support workforce development and training programs to provide Employment and leadership skills training, job shadowing for students Interested in health careers and economic development support grants to Help revitalize low-income areas and businesses. Schedule H, Part III, Line 2 & 4 TNMC'S footnotes to the consolidated financial statements do not contain a footnote specifically covering bad debt expense. Though patient income may qualify them for financial assistance, the patient has obligations as well to complete financial assistance forms and to submit supporting documentation to qualify. Patients who provide this information and qualify for assistance would never go to bad debt. Therefore, it is reasonable to state that our bad debt expense is for those unwilling to pay or unwilling to work with us to provide financial assistance if available. If an account is completely written off to bad debt, the total cost via the cost accounting system is applied. If only a portion of the account was written off to bad debt, then bad debt as a percentage of charge is then applied to the total cost for the encounter to estimate the cost associated with the bad debt. The amount that goes to collections is patient liability. Not collecting these dollars is a direct expense to the organization. As a not-for-profit healthcare organization, it is our responsibility to help anyone who presents themselves with a health issue; as such we have less control over what gets recognized as bad debt. To compute bad debt at cost, management used all discharged cases in prior fiscal year with bad debt write-off. The write-off was computed as a percentage of charge and then multiplied by the total cost (determined by a detailed cost accounting methodology) to estimate the cost of bad debt. Schedule H, Part III, Line 8 Overall Medicare patients produce a negative 15.20% margin on gross charges. This is spread across most of our product lines. Our heaviest losses are from the inpatient neurology, oncology and cardiac product lines and from oncology and surgery on the outpatient side. In general Medicare inpatients do cover the direct costs of providing their care. However, the indirect costs to support the hospital must be accounted for and turns the margin negative. These numbers are computed in a cost accounting system that produces a cost for every service the hospital provides. The system is updated annually and tied to our financial statements to ensure integrity of the product line profitability statements. Schedule H, Part III, Line 9b A patient known to qualify for financial assistance (once all paperwork is received and approved) are flagged in the system and monitored accordingly to ensure financial assistance is posted to the patient account. When the 12 month approval expires, patients are contacted if services have been rendered within the last six months to discuss submittal of new information for continuation of assistance. If patients no longer qualify, other payment options are discussed per organizational policy. Reports are utilized for follow up purposes. Patients who qualify for 100% assistance do not receive guarantor statements (bills) from the organization. Patients who qualify for an 80% or 60% discount work with customer service or collection staff to outline payment arrangements according to set policy. Schedule H, Part VI, Line 2 Needs Assessment Nebraska Medicine uses disease incidence and prevalence data, leading Causes of death, community health status research and supply and demand analysis to assess the health care needs of the communities it serves. Additionally, Nebraska Medicine engaged professional research consultants (PRC) to perform a comprehensive Community Health Needs Assessment (CHNA) In collaboration with the local health systems and county health Departments. Schedule H, Part VI, Line 3 Patient Education of Eligibility for Assistance TNMC and BMC employ financial counselors, customer service staff and collection staff, all of whom are trained in assisting our patients with resolution of patient liability. Depending upon individual patient needs, payment arrangements or financial assistance may be offered to assist our customers with resolution of patient balances. Additionally, the organization works with our self-pay population to pursue coverage through state, federal or local programs. Charity Care Policy: This policy outlines the guidelines patient financial services (PFS) will use to ensure adequate and appropriate follow up is completed in order for qualifying patients to receive charity care. PFS will work with patients to find payment solutions when available. This policy is written to ensure a fair and comprehensive system of distributing charity care to financially burdened patients within the available resources of TNMC in a manner that does not discriminate based on race, creed, color, sex, national origin, religion or age. Policy: A. Charity care is available when all other recovery sources have been exhausted. B. Charity care is provided to patients who have demonstrated inability to meet their financial obligation to TNMC. C. Charity care will not be approved for elective and/or cosmetic care. D. Charity care may be approved in the instance of catastrophic care as defined. 1. This could be occasioned by a personal catastrophe or unavoidable crisis affecting an individual who would otherwise be able to pay for service, or a person who has income above poverty level but is still not able to pay the entire cost of service. 2. A patient generally may qualify for catastrophic charity care in instances where the patient liability is in excess of 25% of annual household income. E. All transplant and IRP patients must meet with a transplant financial counselor to secure financial clearance. Transplant and IRP patients must pass financial screening (access-fic-082) or must be approved via the transplant variance policy (FN 21) charity approval for other services prior to consideration for transplant does not meet this requirement. F. Prior approval for charity care does not apply for future elective or cosmetic procedures. Guidelines: A. Identification process 1) the hospital maintains a separate policy in order to assure compliance with the emergency medical treatment and active labor act (EMTALA) and a separate patient rights and organizational ethics policy. This charity care policy is subject to the terms of those policies. 2) financial counselors authorized by TNMC will identify patients requiring financial screening. B. Verification of insurance eligibility and benefits 1) the patient will execute an assignment of insurance benefits on behalf of the hospital. 2) verification of eligibility, benefits, and payer source will be performed in a timely manner according to patient finance and access services departmental procedures. C. Financial counseling 1) financial counselors and contracted vendors will assist patients requiring financial assistance. 2) financial counselors and vendors will assist patients in seeking reimbursement from local, state, and federal programs when there is no other source of payment as well as assisting patients with applications or making appointments to qualify for government programs. 3) patients are responsible for follow up meetings with an agency that may provide financial resources for health care services. Charity assistance may be terminated at any time due to noncompliance with this expectation. Schedule H, Part VI, Line 4 We serve many communities, international, regional, state and local Omaha. The statistics below describe our local Omaha community defined as Douglas and Sarpy counties in Nebraska. This local area represents approximately 67% of our inpatient and outpatient discharges and visits. The 2020 estimated census population (derived from 2010 census) for this local area is 769,749. The estimated race breakdown of the population is below. *White Alone 76.0% *Black Alone 9.3% *American Indian Alone 0.7% *Asian Alone 4.1% *Pacific Islander Alone 0.1% *Some Other Race Alone 6.1% *Two or More Races 3.6% *Hispanic Origin (Any Race) 12.7% There are sixteen acute care and children's hospitals in Douglas and Sarpy to serve the local community. Bellevue medical center, boys town national research hospital, chi health Creighton University Medical Center - Bergan Mercy, chi Health Immanuel, chi health lakeside, chi health midlands, children's hospital & medical center, Douglas county health center, Madonna rehabilitation hospitals-Omaha campus, Methodist hospital, Methodist women's hospital, Midwest surgical hospital, Nebraska spine hospital, Orthonebraska, select specialty hospital - Omaha, the Nebraska Medical Center. There are five designated medically underserved areas in Douglas County (three areas) and Sarpy county (two areas). Schedule H, Part VI, Line 5 Community Building Activities and Promotion of Health TNMC recognizes the community benefit of addressing root causes of poor Health in order to improve community health. The hospital participated in several community building activities throughout the past year designed to address these root causes. Included in this total are the hospital's Efforts to support the mid-America hospital alliance (MAHA); an alliance of rural and critical access hospitals in the region of which the Hospital is a founding member. The hospital spends time coordinating Resources to ensure smaller, rural hospitals can have access to the Expertise and services of a large academic medical center. TNMC'S Community building activities also include programs intended to drive Entry into health careers and nursing practice. Many hospital staff Members give educational presentations on the health professions and Provide mock interview training to area students. TNMC also provides job Shadowing opportunities to undergraduate students who wish to explore the Health careers. Additionally, TNMC has the only bio-containment unit in the state and one of few across the nation, contributing to disaster Preparedness above and beyond licensure requirements. Members of the Hospital's critical care and trauma staff share the expertise by Participating in community coalitions to improve safety and reduce Accidents among children, teens, and seniors. The hospital works to encourage economic growth and development by supporting an economic Development partnership aimed at the development of new business in the City's urban areas. Bellevue medical center has participated in, and hosted a number of Events designed to promote a healthier community. In addition to Financial support of several community-based charitable organizations and the local chamber of commerce, the hospital's leadership team is active on community boards. Schedule H, Part VI, Line 6 Neither TNMC nor BMC are in an affiliated healthcare system. Schedule H, Part VI, Line 7 TNMC and BMC file a community benefit report with the Nebraska Hospital Association annually. true American Cancer Society 9850 Nicholas St Omaha NE 68114 131788491 501(C)(3) 12500 General Support American Heart Association 10100 J St Ste A Omaha NE 68127 135613799 501(C)(3) 28700 General Support Father Flanagan's Boy Home 13603 Flanagan Blvd Omaha NE 68010 470376606 501(C)(3) 10000 General Support Greater Omaha Chamber Foundation 1301 Harney St Omaha NE 68102 470258610 501(C)(3) 23050 General support Heartland Family Services 2101 S 42nd St Omaha NE 68105 470390618 501(C)(3) 20750 General Support Hope Medical Outreach Coalition 4920 S 30th St Omaha NE 68107 470548990 501(C)(3) 25000 General Support JDRF 9202 W Dodge Rd Ste 304 Omaha NE 68114 231907729 501(C)(3) 6480 General support Leukemia and Lymphoma Society 12100 W Center Rd Ste 202 Omaha NE 68154 135644916 501(C)(3) 12500 General Support Make a Wish 11926 Arbor St Ste 102 Omaha NE 68144 470671096 501(C)(3) 9500 General Support March of Dimes 11840 Nicholas St Omaha NE 68154 131846366 501(C)(3) 30600 General support National Safety Council 11620 M Cir Omaha NE 68137 470259720 501(C)(3) 5300 General Support Nebraska Aids Project 250 S 77th St Ste A Omaha NE 68114 470786622 501(C)(3) 8500 General Support Nebraska HOSA PO Box 94711 Lincoln NE 68509 461094994 501(C)(3) 15000 General support Project Pink'd Inc 4089 S 84th St Ste 108 Omaha NE 68127 455212995 501(C)(3) 8450 General support Ronald McDonald House 620 S 38th St Omaha NE 68105 470755104 501(C)(3) 14250 General support Susan G Komen Nebraska 8707 W Center Rd Omaha NE 68124 260056671 501(C)(3) 7500 General support Team Mates Mentoring 6801 O St Lincoln NE 68510 470840990 501(C)(3) 5300 General support United Way of the Midlands 1805 Harney St Omaha NE 68102 470376605 501(C)(3) 37552 General Support Visiting Nurse Foundation 12565 W Center Rd Ste 100 Omaha NE 68144 470690846 501(C)(3) 9800 General Support Building Healthy Futures 3555 Farnam St Ste 222 Omaha NE 68131 460598062 501(C)(3) 1237851 General Support University of Nebraska - Lincoln PO Box 830861 Lincoln NE 68583 470049123 501(C)(3) 29537 General support General Support National Strategic Research Institute 984238 NE MED CTR 405 E Main St Omaha NE 68198 455426026 501(C)(3) 144537 General Support Board of Regents - University of Nebraska 3835 Holdrege Lincoln NE 68583 470049123 501(C)(3) 8000000 General support Clarkson College 101 S 42nd St Omaha NE 68131 363649217 501(C)(3) 8876781 General support Clarkson Regional Health Sevices Inc 9300 Underwood Ave Ste 110 Omaha NE 68114 470376531 501(C)(3) 8000000 General Support University of Nebraska Medical Center 986800 NE MED CTR Omaha NE 68198 470049123 501(C)(3) 73638961 General support UNMC Physicians 988145 NE MED CTR Omaha NE 68198 470785575 501(C)(3) 136621573 General support Wellcom 6001 Dodge St Community Engagement Center Room 2 Omaha NE 68182 470642708 501(C)(3) 7880 General Support Benson High (Metro Comm ColNM Hlthcre Academy) 5120 Maple St Omaha NE 68104 470596504 501(C)(3) 40000 Scholarship Lauritzen Garden 100 Bancroft St Omaha NE 68108 470659701 501(C)(3) 25000 Scholarship I-AM-HOME 987810 NE MED CTR ARS 2020 Omaha NE 68198 470049123 GOVT 10000 General Support City of Omaha Blackstone BID 1819 Farnam St Omaha NE 68183 476006304 GOVT 10000 General Support 30 2 Financial Assistance (Charity Care) 7453 87115630 Book Charity Care Financial Assistance (Renal-Indigent Patients) 28 896499 Book Indigent Dialysis Financial Assistance (Pharmaceuticals) 4308 10175530 Book Pharmaceuticals Financial Assistance (Utilization Mgmt - Patients) 650 287384 BOOK UTILIZATION MGMT Financial Assistance (Behavioral Health-Patients) 19 26679 Book Behavioral Health Schedule I, Part I, Line 1 Review and Approval of Charitable Contributions The Nebraska Medical Center (TNMC) has a committee whose responsibility is to review and approve or disprove requests for sponsorship. This Committee is comprised of the chief medical officer and members of the community engagement team. Decisions are made on each request individually Based on a set of guidelines established by the organization. In order to Effectively evaluate and review the many requests we receive, each Request is brought before the committee considers each request individually, and contributions are made based on three primary objectives: 1) to support the community need for Resources addressing Nebraska's leading causes of death; including access to healthcare services, mental health and injury & violence prevention. 2) to align with organizations Furthering TNMC'S charitable mission to support causes which significantly Impact the overall health status of the community. 3) to support Organizations which impact favorably the public image of the hospital and Enhance existing partnerships or initiatives. If a sponsorship or Charitable contribution request falls within our three primary Objectives, the following criteria are then applied to further assist the Committee in making funding decisions: 1) organization must provide proof Of 501(c)(3) status from the IRS, or nonprofit designation as a Governmental or tribal entity. 2) all requests must be received in Writing - no phone requests will be considered. 3) requestor must be able to provide, if requested, the organization's non-discrimination policy. 4) must be able to provide an organizational operating budget and project budget upon Request. 5) proposal must include a list of board members, directors, and Key project staff members and the role they serve in the organization. 6) request must include a brief narrative of the project, including an Estimate of numbers of people served by the request and location of Communities impacted by the organization's mission. 7) requests for Sponsorship need to be submitted at least 90 days prior to the event. Groups, programs, and activities not supported by TNMC: 1) organizations without IRS 501(c)(3) or equivalent tax exempt Status. 2) organizations that discriminate on the basis of age, Disability, religion, ethnic origin, gender, or sexual orientation. 3) Organizations with divisive or litigious public agendas. 4) member based organizations, including rotary clubs or IRS 501(c)(4) legions and associations. 5) municipalities, including fire and Police departments or related social service groups and political Organizations. 6) religious organizations or sectarian programs for Religious purposes. 7) fraternal organizations, social clubs, sports Teams or clubs, athletic competitions. 8) endowments. 9) multiyear Requests and pledges. 10) individuals requesting loans, debt retirements, Scholarship or fellowship assistance. 11) travel- including student trips or tours. 12) marketing activities or promotional merchandise. 13) Purchase or maintenance of vehicles. 14) film or video projects, Including documentaries. 15) beauty pageants. Schedule I, Part I, Line 2 Grant Monitoring Procedures Based on the detailed gift policy in part I, line 1, the funds are only provided for charitable purposes, and those organizations that receive monies from TNMC are required to follow their 501(c)(3) requirements surrounding the use of funds received. Schedule I, Part III AMOUNTS PROVIDED TO PATIENTS ARE DETERMINED BY THE NEBRASKA MEDICAL CENTER'S WRITTEN AND PUBLISHED FINANCIAL ASSISTANCE POLICY. X X X X X X true true false false false true false false false David W Mercer Director 0 414380 0 68409 0 0 0 12965 0 2991 0 498745 0 0 Debra Romberger Director 0 319207 0 109661 0 0 0 21540 0 8403 0 458811 0 0 James Linder CEO 946220 0 464400 0 12810 0 16131 0 15114 0 1454675 0 0 0 Stephanie Daubert CFO 520667 0 193580 0 29613 0 35068 0 14669 0 793597 0 0 0 Daniel DeBehnke Former CEO 0 0 0 0 752470 0 0 0 0 0 752470 0 196700 0 Michael A Ash EVP/Chief Transformation Ofc 0 451292 0 209884 0 8400 0 20032 0 3309 0 692917 0 0 Anna Cramer Chief Legal Officer 354358 0 129828 0 28029 0 21418 0 2242 0 535875 0 0 0 Theresa Franco Cancer Ctr/Rad/Imag Svcs VP 321990 0 73549 0 0 0 30854 0 36104 0 462497 0 0 0 Harris A Frankel Chief Medical Officer 0 506946 0 186985 0 8400 0 40547 0 5709 0 748587 0 0 Brian J Lancaster Information Technology VP 319398 0 75136 0 864 0 19668 0 23703 0 438769 0 0 0 Julie Lazure Acute Care/Path Svcs VP 293301 0 68940 0 3540 0 29998 0 27492 0 423271 0 0 0 Thomas C Macy Amb Clinics/Clinical Prog VP 311305 0 71561 0 1138 0 25844 0 30298 0 440146 0 0 0 Suzanne Nuss Chief Nursing Officer 364772 0 137225 0 11177 0 32555 0 29792 0 575521 0 0 0 Aubray D Orduna Interim Pres Clarkson College 251245 0 2220 0 423 0 13965 0 6877 0 274730 0 0 0 Matthew E Pospisil Periop Svs/Bellevue VP 269025 0 59621 0 2413 0 28900 0 24581 0 384540 0 0 0 Cory D Shaw Chief Operations Officer 575982 0 202611 0 9480 0 35138 0 32910 0 856121 0 0 0 Frank V Venuto Chief Human Capital Officer 378828 0 142362 0 11400 0 22319 0 28550 0 583459 0 0 0 Jay C Anderson Staff Physician-Primary 256858 0 49304 0 0 0 21671 0 778 0 328611 0 0 0 Jennifer L Brown Staff Physician-Primary 268540 0 65345 0 0 0 24476 0 23682 0 382043 0 0 0 Michael A Donner Staff Physician-Primary 240506 0 71624 0 610 0 18699 0 31407 0 362846 0 0 0 Kenneth Follett Emeritus, Neurosurgery 0 473809 0 118861 0 2991 0 15650 0 0 0 611311 0 0 Frank S Lococo Corp Marketing & Comm VP 267562 0 55414 0 0 0 12712 0 8901 0 344589 0 0 0 Dennis D Bierle System Clinical Operations COO 0 0 0 0 279996 0 0 0 0 0 279996 0 279996 0 Schedule J, Part I, Line 4a Severance Payments The following employees were termed prior to fiscal year 2020 and received severance payments during calendar year 2019: Daniel DeBehnke: $752,470 Schedule J, Part I, Line 4b Nonqualified Retirement Plans Certain executives do participate in supplemental nonqualified retirement plans. No payout occurred during the year from a supplemental nonqualified plan to current or former* individuals. In addition, TNMC has a supplemental executive retirement plan (amended and restated January 1, 2008) which constitutes an unfunded, unsecured plan to provide supplemental retirement benefits to a select group of management or highly compensated employees upon separation of service, subject to the terms and conditions of the plan. The benefit is paid in full one year after employment separation, and the amount is based on the participant's annual compensation, value of the participant's TNMC qualified retirement plan benefit, social security benefit, and number of years of service. A payout occurred during the year from the supplemental nonqualified retirement plan to the following current and former* individuals: Dennis D. Bierle: $279,996 Daniel Bebehnke: $196,700 Schedule J, Part I, Line 6a Contingent Compensation The organization's financial results are taken into consideration when calculating compensation in addition to other non-financial factors. Executive incentive compensation is determined by several key metrics that are established by the Nebraska medical center governing body. These metrics are inclusive of strategic, financial, operational and quality outcomes. On an annual basis, the Nebraska Medical Center governing body reviews achievement of preset targets and approves incentives when warranted. These performance payments are set in consideration of total compensation vs. compared to market for similar positions. As it was determined that it is in the best interest of the organization to have a portion of their base pay subject to forfeiture unless the pre-determined financial and non-financial factors discussed above are achieved. Incentive compensation related to FY20 performance were paid to the following individuals: David W. Mercer: $68,409 Deborah Romberger: $109,661 Stephanie Daubert: $193,580 James Linder: $464,400 Michael A. Ash: $209,884 Anna L. Cramer: $129,828 Theresa Franco: $73,549 Harris Frankel: $186,985 Brian J. Lancaster: $75,136 Julie Lazure: $68,940 Thomas Macy: $71,561 Suzanne Nuss: $137,225 Aubray Orduna: $2,220 Matthew E. Pospisil: $59,621 Cory D. Shaw: $202,611 Frank Venuto: $142,362 Jay C. Anderson: $49,304 Jennifer L. Brown: $65,345 Michael Donner: $71,624 Kenneth Follett: $118,861 Frank S. Lococo: $55,414 A HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE 521440769 259230MV9 2016-08-23 157496093 CAPITAL PROJECT & REFUND PRIOR LEA false false false B HOSPITAL AUTH NO 1 OF SARPY COUNTY NE 470834151 80372PAR7 2016-08-23 147968496 Capital Project & refund prior lea false false false A 16160000 0 157516214 0 0 0 0 0 0 115024453 42491761 0 2016 true false true true B 0 0 147968496 0 0 0 0 0 0 130156459 17812037 0 2016 true false true true A false true true true true true 0.00000 0.00000 0.00000 false false false true B false true true true true true 0.00000 0.00000 0.00000 false false false true A false true true false false false 0 false 0 false true B false true true false false false 0 false 0 false A true B true SCHEDULE K, PART II, LINE 3, COLUMN A THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, LINE A, COLUMN (E) DUE TO INVESTMENT EARNINGS. Bruce Grewcock Kiewit Construction, President 1017500 Construction Services false Stephanie Daubert NOH, LLC Board Member 113401 Services and Supplies false James T Canedy Wife is employee 54598 Employment false Eric Keen CEO HDR, Inc. 130731 Employment false Schedule L, Part IV Business Transactions Involving Interested Persons 1.) The services that are provided by Kiewit Construction consist of fees earned on construction contracts for projects throughout the campus. 2.) The services provided to/from NOH LLC are comprised of rent, supplies and services. 3.) The services that are provided by HDR, Inc. consist of Architect and Engineer Services. X 8860 2009619 FMV false true false Schedule M, Part I, Column(b) Column b, line 9 represents the number of shares contributed. Form 990, Part III, Line 4D NEUROLOGICAL SCIENCES SERVICE LINE The core services include precise diagnosis and treatment of stroke and vascular disease, movement and memory disorders, multiple sclerosis brain and spinal tumors, spine as well as epilepsy. The epilepsy center is the only level 4 center in the region and treats patients from the state of Nebraska and the region. TNMC has one of the few magnetoencephalograph (meg) scanners and trained meg scientists in the region. The meg can detect brain activity in much greater detail and with more accuracy than previous methods and advances patient care and research opportunities greatly. In July of 2018, TNMC opened the twin creek health center, a dedicated neurological sciences ambulatory clinic in Bellevue. TNMC has earned the American heart association/American stroke association's get with the guidelines stroke gold plus achievement award. Get with the guidelines is a hospital-based, quality-improvement program designed to ensure hospitals consistently care for cardiac and stroke patients following the most up-to-date guidelines and recommendations. TNMC also hosts the only young adult stroke support group to address the emotion and physical challenges of recovering from stroke. During fiscal year 2020, neurosciences incurred 5,552 inpatients with 28,027 patient days and over 155,902 outpatient billing units. Approximately 49% of the revenue was derived from inpatient cases. Form 990, Part VI, Line 2 Business And Family Relationships Mr. Bruce Grewcock and Mr. Mogens bay have a business relationship (through board of directors relationship). Dr. James T. Canedy, Ms. Stephanie Daubert, and Dr. Harris Frankel have a business relationship (through board of directors relationship, Nebraska Orthopedic Hospital). Dr. James T. Canedy and Ms. Stephanie Daubert have a business relationship (through board of directors relationship, Nebraska Health Partners and Nebraska Health Network). Form 990, Part VI, Line 6 MEMBERS Nebraska Medicine is the sole member of TNMC. Form 990, Part VI, Line 7a Effective 2017, TNMC has one member, Nebraska medicine, a nonprofit organization that has been recognized as exempt from tax under section 501(c)(3) of the internal revenue code. TNMC'S bylaws provide that the members of TNMC'S board of directors shall be the same persons who serve as members of the board of Nebraska medicine. The TNMC board is comprised of 11 directors, specifically 9 voting directors and 2 ex-officio non-voting directors. Form 990, Part VI, Line 7b The following powers are reserved to TNMC'S sole member, Nebraska medicine: - amendment to TNMC'S articles of incorporation; - a merger or consolidation of TNMC with or into any other entity; - sale, transfer, lease, disposition, or change in use of (a) more than 50% of the assets of the clinical operations of TNMC; or (b) such other assets as the TNMC board designates; - entry into a joint operating agreement, integration agreement, or similar agreement, or amendment to any existing similar agreement; - issuance or incurrence of indebtedness resulting in a debt/equity ratio in excess of 40% or a debt coverage ratio less than 1.25; - liquidation or dissolution of TNMC; - admission of one or more additional members of TNMC; - entry into any affiliations that would change the size of the board, a change to the quorum requirements, or change in the supermajority voting requirements; - approval of any amendment to the bylaws; or - a gift, pledge, donation, or grant in excess of one million dollars. Form 990, Part VI, Line 11b Review Of 990 Prior To Filing A copy of the form 990 was presented to the audit committee of the board of directors. In addition, the board of directors were provided a copy of the form 990 to review on the secured board portal called board effect before it was filed. Form 990, Part VI, Line 12c Monitoring And Enforcement Of Board Independence Each member of the board of directors, officers and key employees discloses annually that he/she is either an officer, director, member, owner, agent or associated in some manner with delineated business entities that either have or might reasonably be expected to have a business relationship with TNMC. Each board member agrees to make conflicts known and withdraw from participation in deliberations if a subsequent conflict arises. Disclosure statements are distributed annually and monitored by the corporate compliance officer for completion. Any disclosed conflicts are brought to the attention of the chairman of the board for board members and officers or to the officers for key employees. Form 990, Part VI, Line 15a & 15b Policies - Compensation The executive and physician compensation committee of the TNMC board of directors is comprised of a chair, appointed by the board of directors, a vice chair, and not less than two (2) additional directors from the board, all of whom are determined by the board to be independent from the university of Nebraska medical center and Nebraska medicine, which includes UNMC physicians and TNMC. The compensation committee is responsible for overseeing the performance and compensation of the CEO, assessing the appropriateness and reasonableness of the executive compensation and benefit programs, and monitoring compensation programs with senior executives and physicians to confirm compliance with regulations and business need. The committee reviews all proposed compensation for physicians and senior executives including the CEO. All compensation submitted for review must be supported by appropriate documentation, including, but not limited to, comparability data (i.e., association of American medical colleges (AAMC)) relevant for the occupation and corporation position. Such data is compared to similarly situated AAMC organizations of comparable revenue. The executive compensation data is provided by an independent compensation consulting firm hired by the committee and are reported directly to the committee. The committee ensures that its review and approval qualifies for the rebuttable presumption of reasonableness under the intermediate sanctions regulations (26 C.F.R. 53.4958-6, as amended). To ensure such compliance, the committee: 1. Ensures committee members are free from any relationships or conflicts of interest that may impair, or appear to impair, a committee member's ability to make independent judgments; 2. Receives and relies upon appropriate data as to comparability from internal or external resources prior to making its determination; and 3. Documents the basis for its determination of reasonableness concurrently with making that determination. Such documentation includes: a) the terms of the arrangement that was approved and the date it was approved; b) the members of the committee who were present and those who voted on it (quorum is required for any approval); c) the comparability data obtained and relied upon by the committee and how such material was obtained; and d) the action(s) taken by the committee. All compensation and benefits for the CEO is reviewed and recommended by the committee to the board of directors for final approval. Form 990, Part VI, Line 19 Public Disclosure Of Documents The governing documents, conflict of interest policy and financial statements are typically not made available to the public. However, if someone comes into the accounting department and requests to view the documents, they would be made available to view in the office. Form 990, Part XI, Line 9 RECONCILIATION OF NET ASSETS INVESTMENT IN CLARKSON COLLEGE $ 8,367,116 CHANGE IN PENSION ACCOUNTS $ 1,051,823 NET ASSETS RELEASED $ (1,400,860) OTHER $ 940 ------------------ TOTAL $ 8,019,019 Bellevue Medical Ctr 2500 BMC DR Bellevue NE 68123 204305186 Acute Care NE 88327741 170018491 TNMC UNMC Physicians 988145 NEBRASKA MEDICAL CENTER OMAHA NE 68198 470785575 Healthcare NE 501(C)(3) Line 3 NM false CLARKSON COLLEGE 101 SOUTH 42ND STREET OMAHA NE 68131 363649217 COLLEGE NE 501(C)(3) LINE 2 TNMC true Nebraska Medicine 987400 Nebraska Medical Center Omaha NE 68198 813158267 SUPPORT NE 501(C)(3) 12, Type 1 NA false NE HEALTH NETWORK 8511 DODGE RD OMAHA NE 68114 271784907 HEALTHCARE NE NH PARTNERS Related 0 0 false false NHS ORTHOPAEDIC SERVICES INC 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 470845238 INVESTMENT SVC NE TNMC C Corp 4850188 11686409 1.00000 true NEBRASKA HEALTH PARTNERS INC 988145 NEBRASKA MEDICAL CENTER OMAHA NE 681988145 470816463 MANAGEMENT NE TNMC C Corp 2183713 2895883 1.00000 true false true false true false false false false false true false true true true true true true false false CLARKSON COLLEGE b 8844411 BOOK CLARKSON COLLEGE j 15489736 BOOK CLARKSON COLLEGE l 3750951 BOOK NEBRASKA HEALTH PARTNERS o 902219 BOOK