2013-04-09T15:00:26-05:00 2012-05-31 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2011-06-01 470841285 CRETE AREA MEDICAL CENTER CRET 4024813190 2910 BETTEN DRIVE CRETE NE 683330220 RUSSELL GRONEWOLD 2013-04-10 false John Woodhull P01305268 3128997000 2011 2016-02-25 16:41:14Z RUSSELL GRONEWOLD 1600 SOUTH 48TH STREET LINCOLN NE 68506 20083930 false X WWW.BRYANHEALTH.ORG/CAMC X 2001 NE CRETE AREA MEDICAL CENTER IS COMMITTED TO MAKING A DIFFERENCE IN OUR COMMUNITY AND THE LIVES OF THE INDIVIDUALS WE SERVE THROUGH COMPASSIONATE AND EXCEPTIONAL CARE. 9 5 181 72 112 0 108080 172991 18401907 19626256 117467 106529 166839 129960 18794293 20035736 0 0 0 0 8651627 9002582 0 0 0 9232802 9355215 17884429 18357797 909864 1677939 27119835 29697337 16543284 18604079 10576551 11093258 THE FORMAL MISSION STATEMENT ADOPTED BY THE CRETE AREA MEDICAL CENTER (CAMC) BOARD STATES "CAMC IS COMMITTED TO MAKING A DIFFERENCE IN OUR COMMUNITY AND THE LIVES OF THE INDIVIDUALS WE SERVE THROUGH COMPASSIONATE AND EXCEPTIONAL CARE." CAMC'S VISION IS TO BE A RESPECTED COMMUNITY LEADER AND HEALTH CARE PROVIDER, WHERE PATIENTS SEEK EXCEPTIONAL CARE, PHYSICIANS PREFER TO PRACTICE, AND TEAM MEMBERS DESIRE TO WORK. THE FOCUS OF CAMC IS ON THE PATIENT EXPERIENCE AND MEANINGFUL WORK. CAMC IS COMMITTED TO THE FOLLOWING FUNDAMENTAL BELIEFS: INTEGRITY - OUR FOUNDATION; RESPECT - OUR COMPASSION; SERVICE - OUR STANDARD; EXCELLENCE - OUR DISTINCTION; COLLABORATION - OUR INVESTMENT; AND LEADERSHIP - OUR FUTURE. false false 16298636 0 19626256 CRETE AREA MEDICAL CENTER ("CAMC") IS AN AFFILIATE OF THE BRYAN HEALTH SYSTEM. CAMC, LOCATED IN CRETE, NEBRASKA, IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS RECEIVED DETERMINATION THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE IN ORDER TO PROVIDE HEALTH CARE SERVICES. CAMC WAS INCORPORATED IN APRIL 2001 AND OPERATES A 24-LICENSED BED CRITICAL ACCESS HOSPITAL AND TWO PHYSICIAN CLINICS SERVING PATIENTS AND RESIDENTS PRINCIPALLY FROM SALINE AND LANCASTER COUNTIES. DURING THE FISCAL YEAR ENDING MAY 31, 2012, CAMC PROVIDED INPATIENT ACUTE, SWING BED AND NURSERY SERVICES TO 527 PATIENTS. CAMC PERFORMED 868 SURGICAL PROCEDURES AND PROVIDED PRIMARY CARE PHYSICIAN SERVICES WITH 22,695 VISITS. CAMC'S PHYSICIAN CLINIC IS RECOGNIZED AS A LEVEL 3 PATIENT-CENTERED MEDICAL HOME BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE ("NCQA"). 16298636 true true false true false false false false false true false false false true true true true false false false false false false false false true true false false true false false false false false false true false false false false false false true false false false false true 39 0 true 181 true false false false false false false false false false false X 9 5 true false false false true true true true true false false true true true true true true true true true true NE X BRYCE BETKE 4028267945 2910 BETTEN DRIVE CRETE NE 68333 CAROL FRIESEN 70.00 X X 222585 0 13064 COLLYN FLORENDO 1.00 X X 0 0 0 GARY LOTHROP DVM 1.00 X X 0 0 0 KATHLEEN CAMPBELL 1.00 X X 0 275072 19265 SHIRLEY SIEDHOFF 1.00 X X 0 0 0 WAYNE DRUMMOND 1.00 X X 0 0 0 JACK HUCK 1.00 X 0 0 0 ROBERT RAVENSCROFT 1.00 X 0 365430 37066 RUSSELL EBKE MD 50.00 X 224344 0 37756 TAD EICKMAN 1.00 X 0 0 0 BRYCE BETKE 50.00 X 130380 0 24743 AMY VERTIN MD 50.00 X 228607 0 26945 JASON HESSER MD 50.00 X 186594 0 11475 KATE HESSER MD 50.00 X 172380 0 30784 TAMMY SCHROEDER 50.00 X 144900 0 8260 TROY MILLER MD 50.00 X 242510 0 19895 1552300 640502 229253 10 false true false TODD ALLEY 2525 SOUTH 79TH STREET LINCOLN NE 68506 ANESTHESIA SERVICES 321037 HEALTHLAND 625 SOUTH LAKESHORE DRIVE GLENWOOD MN 56334 MAINTENANCE CONTRACT 239351 GE HEALTHCARE PO BOX 96483 CHICAGO IL 60693 MAINTENANCE CONTRACT 202805 NEBRASKA LABLINC 5440 SOUTH STREET SUITE 100 LINCOLN NE 68506 LAB SERVICES 144552 MARY SINCEBAUGH 7901 FORBES CT LINCOLN NE 68516 EMERGENCY ROOM CALL 135499 7 4827 168164 0 172991 NET PATIENT CARE REVENUE 900099 19458854 19458854 ATHLETIC TRAINING OUTREACH 624100 130031 130031 PATIENT WELLNESS 900099 15824 15824 EDUCATION INCOME 611600 15130 15130 HEALTH INFORMATION SERVICES 621300 6417 6417 0 0 0 0 19626256 106529 106529 0 0 51802 48194 3608 0 3608 3608 0 0 0 0 0 0 CAFETERIA SALES 900099 98723 98723 PURCHASED DISCOUNTS 900099 24237 24237 3392 0 112 3280 126352 20035736 19626256 112 236377 0 0 0 0 663129 391246 271883 0 6713261 6144648 568613 245819 224998 20821 886838 811723 75115 493535 451733 41802 0 28451 28451 40752 40752 939 939 0 0 1618460 1481376 137084 101712 101712 3021716 2970528 51188 146156 133777 12379 0 265062 260572 4490 73367 41345 32022 0 0 17574 17574 0 1591495 1564535 26960 132307 130066 2241 BAD DEBTS 832468 832468 DUES & SUBSCRIPTIONS 54197 35885 18312 ALL OTHER EXPENSES 820055 806162 13893 CORPORATE COST ALLOCATIONS 610504 610504 0 0 0 0 18357797 16298636 2059161 0 0 2700790 4095958 2087386 2673526 197976 199965 116248 151380 24679342 12256902 13229138 12422440 7755378 9778135 0 0 67276 3903 965643 372030 27119835 29697337 1824106 2836625 14719178 15767454 16543284 18604079 X 10576551 11093258 10576551 11093258 27119835 29697337 X 1677939 -1161232 X X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 939 true 0 false false 939 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 CRETE AREA MEDICAL CENTER IS A MEMBER OF THE NEBRASKA HOSPITAL ASSOCIATION (NHA). DURING THE CURRENT YEAR THE REPORTING ORGANIZATION MADE PAYMENTS FOR MEMBERSHIP DUES TO THE NHA IN THE AMOUNT OF $10,641. THE NHA REPORTED THAT 8.82% OF DUES PAID, OR $939, WAS USED FOR LOBBYING ACTIVITIES. ON VARIOUS OCCASIONS THROUGHOUT THE YEAR, THE CEO MET WITH STATE AND LOCAL LEGISLATORS TO DISCUSS ISSUES RELATED TO HEALTHCARE. WHILE SOME RELATED TO HEALTHCARE REFORM, OTHER ISSUES DISCUSSED INCLUDED MEETING THE NEEDS OF INDIGENT/UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS THE ONGOING NEED FOR HEALTH SERVICES FOR THE COMMUNITY. 61247 61247 12699945 4475870 8224075 105470 88083 17387 10505160 7074905 3430255 1307520 618044 689476 12422440 0 SWAP AGREEMENT 2972454 LONG TERM DEBT INTERCOMPANY LOAN 12795000 15767454 20035736 18357797 1677939 -1161232 -1161232 516707 20083930 0 0 20083930 -48194 -48194 20035736 19567223 1209426 1209426 18357797 0 0 18357797 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 CRETE AREA MEDICAL CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. AS OF MAY 31, 2012 AND 2011, CRETE AREA MEDICAL CENTER HAD NO MATERIAL UNRECOGNIZED TAX BENEFITS. true true X true X true X true true true false true true 339566 339566 0.01940 0 0.00000 0 0.00000 0 0 339566 0 339566 0.01940 168714 17197 151517 0.00860 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 168714 17197 151517 0.00860 0 0 508280 17197 491083 0.02800 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 true 562915 112583 5428797 5370298 58499 X true false 1 1 CRETE AREA MEDICAL CENTER

2910 BETTEN DRIVE CRETE NE 68333

X X X 2 CRETE MEDICAL CLINIC

2910 BETTEN DRIVE CRETE NE 68333

RURAL HEALTH CLINIC WILBER MEDICAL CLINIC

203 W 4TH STREET WILBER NE 68465

RURAL HEALTH CLINIC Community benefit report prepared by related organization Schedule H, Part I, Line 6a CRETE AREA MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS MAILED ANNUALLY TO HOUSEHOLDS IN CRETE AND THE SURROUNDING AREA. THIS REPORT DESCRIBES THE PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITIES THAT ARE SERVED BY CRETE AREA MEDICAL CENTER. CRETE AREA MEDICAL CENTER'S COMMUNITY BENEFIT INFORMATION IS ALSO CONTAINED IN A CONSOLIDATED REPORT PREPARED ANNUALLY BY BRYAN HEALTH, THE SOLE MEMBER OF THE ORGANIZATION. THE BRYAN HEALTH SYSTEM COMMUNITY BENEFIT REPORT IS MAILED ANNUALLY TO VARIOUS HOUSEHOLDS IN EASTERN NEBRASKA AND THE SURROUNDING AREA. THE CONSOLIDATED REPORT IS ALSO AVAILABLE ONLINE AT WWW.BRYANHEALTH.COM/COMMUNITYBENEFIT. Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 THE COST OF CRETE AREA MEDICAL CENTER'S CHARITY CARE EXPENSE ON LINE 7A WAS DETERMINED BY APPLYING A RATIO OF PATIENT CARE COST TO CHARGES TO THE CHARITY CARE DEDUCTIONS REPORTED IN THE FINANCIAL STATEMENTS. THE TOTAL EXPENSES DIRECTLY ATTRIBUTABLE TO THE COMMUNITY BENEFIT ACTIVITIES WERE REPORTED ON LINE 7E. Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 832,468 Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 THE COST OF CRETE AREA MEDICAL CENTER'S BAD DEBT EXPENSE WAS DETERMINED BY APPLYING A RATIO OF PATIENT CARE COST TO CHARGES TO THE BAD DEBT EXPENSE REPORTED IN THE FINANCIAL STATEMENTS. DISCOUNTS AND PAYMENTS REDUCE BAD DEBT EXPENSE. ONLY THE REMAINING UNCOLLECTIBLE BALANCE IS WRITTEN-OFF AS BAD DEBT EXPENSE. ABOUT 1 OF 5 FINANCIAL ASSISTANCE (CHARITY CARE) APPLICATIONS IS DENIED BECAUSE THE PATIENT WOULD NOT PROVIDE THE SUPPORTING INFORMATION REQUIRED PER THE POLICY AND PROCEDURE. THE FOLLOWING IS THE FOOTNOTE FROM CRETE AREA MEDICAL CENTER'S AUDITED FINANCIAL STATEMENTS REGARDING BAD DEBT EXPENSE: "THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS HAS BEEN ESTABLISHED FOR THE UNCOLLECTABLE PORTION OF THESE RECEIVABLES AND IS ADJUSTED THROUGHOUT THE YEAR BASED ON A PERCENTAGE OF EACH FUNDING SOURCE'S RECEIVABLE ACCOUNT BALANCE. INDIVIDUAL ACCOUNTS WITH BALANCES OVER NINETY DAYS ARE REVIEWED PERIODICALLY FOR FUNDING SOURCE DENIALS, REBILLS TO DIFFERENT FUNDING SOURCES, SUBMISSIONS TO A COLLECTION AGENCY OR WRITE-OFF AS BAD DEBT." Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 THE MEDICARE ALLOWABLE COST ON LINE 6 IS FROM THE MEDICARE COST REPORT. CRETE AREA MEDICAL CENTER IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND IS CERTIFIED TO RECEIVE COST-BASED REIMBURSEMENT FROM MEDICARE; THEREFORE, CRETE AREA MEDICAL CENTER WILL NOT EXPERIENCE MEDICARE RELATED SHORTFALLS. COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE SCHEDULE H, PART III, LINE 9B THE ORGANIZATION'S DEBT COLLECTION POLICY PROHIBITS ANY COLLECTION EFFORTS FOR THE PORTION OF THE PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. Needs assessment. Schedule H, Part VI, Line 2 CRETE AREA MEDICAL CENTER ("CAMC") IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY CONTINUALLY WORKING WITH COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. DURING FISCAL YEAR 2013, CAMC WILL PARTNER WITH PUBLIC HEALTH SOLUTIONS, LOCATED IN CRETE, TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT FOR SALINE COUNTY. THE HEALTH NEEDS IDENTIFIED FROM THE ASSESSMENT WILL BE PRIORITIZED BY A REPRESENTATIVE GROUP OF STAKEHOLDERS FROM THROUGHOUT THE COUNTY AND UTILIZED TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN FOR SALINE COUNTY. CAMC WILL UPDATE SERVICE LINES AND OVERALL STRATEGIC PRIORITIES FOR THE ORGANIZATION TO ENSURE THAT OUR STRENGTHS AND AVAILABLE RESOURCES ARE ALIGNED WITH THE HEALTH NEEDS OF OUR COMMUNITY. IF SERVICES ARE IDENTIFIED THAT CAMC CAN PROVIDE FOR PATIENTS CLOSER TO HOME, WE WILL EVALUATE THE NEED AND OPTIONS. CAMC ALSO REVIEWS INFORMATION ON THE APPROPRIATE NUMBER OF PHYSICIANS FOR OUR SERVICE AREA AND WILL ACTIVELY RECRUIT PHYSICIANS OR OTHER PROVIDERS AS NEEDED TO THE COMMUNITY. Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 FINANCIAL ASSISTANCE INFORMATION IS PROVIDED TO PATIENTS DURING ADMISSION IN THEIR INFORMATION PACKET. PATIENTS MAY CONTACT THE HOSPITAL AT ANYTIME TO REQUEST A FINANCIAL ASSISTANCE APPLICATION. HOSPITAL PATIENT ACCOUNT COLLECTORS WILL ALSO INFORM PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM IF THEY ARE UNABLE TO PAY THEIR BILL AND MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON INFORMATION PROVIDED. IN ADDITION, INFORMATION REGARDING FINANCIAL ASSISTANCE IS PROVIDED ON THE WEBSITE, IN ALL HOSPITAL REGISTRATION AREAS, INCLUDING THE EMERGENCY DEPARTMENT, AND ON EACH BILLING STATEMENT. Community information. Schedule H, Part VI, Line 4 CRETE AREA MEDICAL CENTER ("CAMC") IS LOCATED IN CRETE, NEBRASKA. CRETE HAS A POPULATION OF 6,801 PEOPLE AND INCLUDES DIVERSE ETHNIC BACKGROUNDS. CRETE HAS A LARGE HISPANIC POPULATION (36.7%). CRETE HAS THREE PRIMARY INDUSTRIAL EMPLOYERS: FARMLAND INDUSTRIES, NESTLE/PURINA, AND BUNGE MILLS. THEY EMPLOY ALMOST 3,000 PEOPLE. CAMC SERVES PEOPLE IN CRETE AND THE SURROUNDING COMMUNITIES IN SALINE AND LANCASTER COUNTIES. OUR PRIMARY SERVICE AREA IS A 30-MILE RADIUS OF CRETE. Promotion of community health Schedule H, Part VI, Line 5 CRETE AREA MEDICAL CENTER ("CAMC") IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CAMC OPERATES A 24-LICENSED BED CRITICAL ACCESS HOSPITAL AND TWO PHYSICIAN CLINICS. CAMC HAS AN OPEN MEDICAL STAFF. THE HOSPITAL BOARD OF DIRECTORS INCLUDES MEMBERS FROM THE COMMUNITY. CAMC IS COMMITTED TO SERVING OUR PATIENTS AND OUR COMMUNITY BY INVESTING FUNDS IN FACILITIES, TECHNOLOGY, PHYSICIANS, AND STAFF TO DELIVER PREMIUM HEALTHCARE IN OUR FACILITIES. CAMC PARTICIPATES IN LOCAL ORGANIZATIONAL EVENTS AND PROVIDES UNCOMPENSATED AND CHARITY CARE TO OUR PATIENTS. CAMC SUPPORTS EDUCATIONAL OPPORTUNITIES FOR STAFF, HIGH SCHOOL STUDENTS, LOCAL EMS VOLUNTEERS, AND COMMUNITY MEMBERS. PUBLIC ASSISTANCE WITH TRANSLATION SERVICES, AND HEALTHY LIFESTYLE PROGRAMS ARE ALSO OFFERED AT CAMC. Affiliated health care system Schedule H, Part VI, Line 6 CRETE AREA MEDICAL CENTER IS PART OF THE BRYAN HEALTH SYSTEM, ONE OF THE LARGEST NON-PROFIT, LOCALLY OWNED HEALTH CARE ORGANIZATIONS IN THE REGION. THE SYSTEM EXISTS TO: PROMOTE AND PROVIDE ACCESS TO QUALITY HEALTH CARE; PROVIDE MEDICAL EDUCATION, AND COMMUNITY SERVICE. THE COMMUNITY BENEFITS PROVIDED BY THE SYSTEM INCLUDE: 1) PROVIDING FREE OR DISCOUNTED HEALTH CARE TO THE UNINSURED AND UNDERINSURED, 2) PROVIDING GOVERNMENTAL SPONSORED PROGRAMS SUCH AS MEDICARE AND MEDICAID; 3) HEALTH PROFESSIONALS' EDUCATION 4) COMMUNITY HEALTH IMPROVEMENT SERVICES AND 5) CASH AND IN-KIND CONTRIBUTIONS TO OTHER NON-PROFIT ORGANIZATIONS. THE SYSTEM PROVIDES A FULL SPECTRUM OF PREVENTION, WELLNESS, ACUTE CARE AND REHABILITATION SERVICES TO URBAN, SUBURBAN AND RURAL COMMUNITIES IN NEBRASKA, KANSAS, IOWA, MISSOURI AND SOUTH DAKOTA. THE SYSTEM CONSISTS OF TWO ACUTE-CARE HOSPITALS, NUMEROUS OUTPATIENT CLINICS, A PHYSICIAN NETWORK, A COLLEGE, AN URGENT CARE CENTER, A HEALTH AND WELLNESS FACILITY, A PHILANTHROPIC FOUNDATION AND OTHER HEALTHCARE PROVIDERS. PREMIER SERVICES INCLUDE CARDIOLOGY, NEUROSCIENCE, ORTHOPEDICS, VASCULAR, TRAUMA AND EMERGENCY CENTERS, INTENSIVE CARE, WOMEN'S AND CHILDREN'S HEALTH, ONCOLOGY, IMAGING AND MENTAL HEALTH. X true true false true false true false false false true false AMY VERTIN MD 227867 0 0 0 740 0 6526 0 20419 0 255552 0 0 0 BRYCE BETKE 128698 0 1541 0 141 0 6714 0 18029 0 155123 0 0 0 CAROL FRIESEN 159834 0 16304 0 46447 0 10388 0 2676 0 235649 0 0 0 JASON HESSER MD 136060 0 25320 0 25214 0 8427 0 3048 0 198069 0 0 0 KATE HESSER MD 136059 0 11955 0 24366 0 8142 0 22642 0 203164 0 0 0 KATHLEEN CAMPBELL 0 198468 0 24512 0 52092 0 11441 0 7824 0 294337 0 0 ROBERT RAVENSCROFT 0 255812 0 27352 0 82266 0 13475 0 23591 0 402496 0 0 RUSSELL EBKE MD 190486 0 31360 0 2498 0 13488 0 24268 0 262100 0 0 0 TAMMY SCHROEDER 100185 0 39012 0 5703 0 6848 0 1412 0 153160 0 0 0 TROY MILLER MD 167193 0 74772 0 545 0 0 0 19895 0 262405 0 0 0 Travel for companions Schedule J, Part I, Line 1a THE ORGANIZATION REIMBURSES VOLUNTEER BOARD MEMBERS CERTAIN REASONABLE TRAVEL EXPENSES ASSOCIATED WITH COMPANION TRAVEL WHERE THE COMPANION'S PRESENCE IS IMPORTANT TO THE EVENT. THESE EVENTS MAY INCLUDE, FOR EXAMPLE, BOARD MEETINGS AND BUSINESS MEETINGS. ALL TRAVEL OF COMPANIONS IS APPROVED IN ADVANCE BY THE CHIEF EXECUTIVE OFFICER OF BRYAN HEALTH. REIMBURSEMENT FOR TRAVEL EXPENSES IS LIMITED TO AIR TRAVEL AT THE COACH LEVEL. ALL COMPANION TRAVEL REIMBURSEMENTS ARE TREATED AS TAXABLE COMPENSATION. SUBSTANTIATION OF ALL TRAVEL RELATED EXPENSES IS REQUIRED BEFORE PAYMENT. Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF THE LARGEST PRIVATE EMPLOYER IN LINCOLN/LANCASTER COUNTY, BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN HEALTH'S BOARD OF TRUSTEES AND THE COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED ARE REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON MAY 22, 2012. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b IN ORDER TO ATTRACT AND RETAIN TALENTED, EXPERIENCED EXECUTIVES, BRYAN HEALTH OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO ELIGIBLE EMPLOYEES. THE FOLLOWING PEOPLE LISTED IN FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN, OR RECEIVED A PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE TAX YEAR: KATHLEEN CAMPBELL, BRYAN MEDICAL CENTER EMPLOYEE: $43,764; CAROL FRIESEN, CRETE AREA MEDICAL CENTER EMPLOYEE: $8,362; AND ROBERT RAVENSCROFT, BRYAN HEALTH EMPLOYEE: $59,255. Compensation contingent on revenues of the organization Schedule J, Part I, Line 5a IN THE CASE OF CERTAIN PHYSICIAN EMPLOYEE AGREEMENTS, INCENTIVE COMPENSATION IS PAID ON A PERCENTAGE OF PROFESSIONAL SERVICES PERFORMED ABOVE A PREDETERMINED THRESHOLD. Non-fixed payments Schedule J, Part I, Line 7 CRETE AREA MEDICAL CENTER OFFERS AN INCENTIVE COMPENSATION PROGRAM FOR ALL EMPLOYEES. INCENTIVE COMPENSATION IS BASED ON ACHIEVING OBJECTIVE ORGANIZATIONAL, DEPARTMENTAL, AND INDIVIDUAL GOALS. THE WEIGHTS ASSIGNED TO EACH GOAL MAY CHANGE ON AN ANNUAL BASIS. COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES SCHEDULE J, PART II IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THIS ORGANIZATION'S BOARD, OR ANY AFFILIATED BOARD, IS COMPENSATED FOR THEIR SERVICES AS A BOARD MEMBER. COMPENSATION AMOUNTS REPORTED IN SCHEDULE J, PART II ARE FOR SERVICES PERFORMED AS EMPLOYED PHYSICIANS AND EXECUTIVES; AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS. COMPENSATION AMOUNTS REPORTED IN SCHEDULE J, PART II ARE BASED ON THE CALENDAR YEAR ENDED DECEMBER 31, 2011. DENISE LOTHROP DENISE LOTHROP'S SPOUSE, GARY LOTHROP, IS A MEMBER OF CRETE AREA MEDICAL CENTER'S BOARD 12065 COMPENSATION false DESCRIPTION OF FAMILY OR BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 MANY OF THE PERSONS LISTED IN PART VII, SECTION A HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF THEIR EMPLOYMENT BY A BRYAN HEALTH SYSTEM ENTITY. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 AS STATED IN THE CORPORATION'S ORGANIZING DOCUMENTS, THE SOLE MEMBER OF CRETE AREA MEDICAL CENTER IS BRYAN HEALTH. BRYAN HEALTH HAS THE RIGHTS UNDER THE ORGANIZING DOCUMENTS TO: 1) APPROVE SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY; 2) ELECT THE MEMBERS OF THE GOVERNING BODY; AND 3) RECEIVE ANY REMAINING ASSETS AFTER DISSOLUTION OF THE ORGANIZATION. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a BRYAN HEALTH AS SOLE CORPORATE MEMBER OF CRETE AREA MEDICAL CENTER, HAS THE RIGHT UNDER THE ORGANIZING DOCUMENTS TO REMOVE ANY TRUSTEE FROM OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE BY A TWO-THIRDS (2/3) VOTE OF THE VOTING TRUSTEES OF BRYAN HEALTH. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b BRYAN HEALTH IS THE SOLE CORPORATE MEMBER OF CRETE AREA MEDICAL CENTER ("CAMC"). PURSUANT TO THE GOVERNING DOCUMENTS, THE BOARD OF CAMC MAY MANAGE THE AFFAIRS OF THE CORPORATION; HOWEVER, THE BOARD MAY NOT, WITHOUT THE PRIOR APPROVAL OF BRYAN HEALTH: (1) ADOPT ANY LONG-TERM CAPITAL OPERATIONAL BUDGET; (2) ADOPT ANY CHANGES IN ANY ANNUAL OR LONG-TERM CAPITAL BUDGET OR OPERATIONAL EXPENSE BUDGET EXCEEDING $250,000 IN ANY SINGLE TRANSACTION OR $1,000,000 IN ANY CORPORATION FISCAL YEAR; (3) ADOPT SUBSTANTIVE CHANGES TO EXISTING LONG-TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; (4) AMEND THE BYLAWS OR ARTICLES OF INCORPORATION (5) APPROVE THE TRANSFER, SALE OR OTHER DISPOSITION OF CAPITAL ASSETS IN ANY SINGLE TRANSACTION IN EXCESS OF $250,000, OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (6) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF ANY CORPORATION, SHARED SERVICE ARRANGEMENT, ASSOCIATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, TRUST, JOINT VENTURE OR OTHER ENTITY, DIRECTLY OR INDIRECTLY, WHERE THE CAPITAL EXPENDITURE OR OPERATING EXPENSES BY THE CORPORATION IN CONNECTION WITH SUCH ORGANIZATION OR ACQUISITION WHEN IT EXCEEDS $500,000 IN A SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (7) APPROVE ANY INDEBTEDNESS INVOLVING A MORTGAGE OR LIEN OF ANY KIND OR NATURE ON ASSETS OF THE CORPORATION WHERE THE BORROWING OR INDEBTEDNESS EXCEEDS $250,000 IN ANY SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (8) ELECT OR APPOINT TRUSTEES OF THE CORPORATION; (9) APPOINT OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; 10) PURCHASE INSURANCE COVERAGE FOR THE CORPORATION AND ITS OPERATIONS; 11) SELECT THE AUDITOR TO PERFORM THE ANNUAL AUDIT OF THE RECORDS OF THE CORPORATION; AND 12) TAKE ANY OTHER ACTIONS WHICH MAY BE INCONSISTENT WITH BRYAN HEALTH'S GOALS AND OBJECTIVES. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THIS 990 WAS PREPARED BY BRYAN HEALTH'S TAX DIVISION. DURING THE RETURN PREPARATION PROCESS, THE TAX DIVISION WORKS DILIGENTLY WITH CRETE AREA MEDICAL CENTER'S CFO AND OTHER DEPARTMENTS INCLUDING HUMAN RESOURCES, FINANCE, LEGAL, AND DEVELOPMENT TO GATHER INFORMATION TO COMPLETE FORM 990 AND ATTACHED SCHEDULES IN AN ACCURATE AND THOROUGH MANNER. THIS 990 WAS REVIEWED BY THE CEO AND CFO OF CRETE AREA MEDICAL CENTER. IN ADDITION, THIS 990 WAS REVIEWED BY THE CEO AND CFO OF BRYAN HEALTH. THIS 990 WAS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 WAS DISTRIBUTED FOR REVIEW TO EACH MEMBER OF CRETE AREA MEDICAL CENTER'S BOARD OF DIRECTORS, AND TO BRYAN HEALTH SYSTEM'S FINANCE COMMITTEE PRIOR TO FILING THE FORM WITH THE INTERNAL REVENUE SERVICE. Conflict of interest policy Form 990, Part VI, Section B, Line 12c CRETE AREA MEDICAL CENTER ("CAMC") HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY THAT IS MONITORED AND ENFORCED BY THE CAMC BOARD OF DIRECTORS. BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE QUESTIONNAIRE TO IDENTIFY ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS, OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT. THE QUESTIONNAIRES REQUIRES EACH COVERED PERSON TO SIGN A STATEMENT CERTIFYING THAT HE/SHE: (1) HAS REPORTED INFORMATION THAT IS CORRECT AND COMPLETE TO THE BEST OF THEIR KNOWLEDGE; (2) HAS READ THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE POLICY, AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY. COVERED PERSONS ARE ALSO REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME SUCH CONFLICTS ARISE. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. FAILURE TO COMPLETE THE QUESTIONNAIRE CAN RESULT IN DISCIPLINARY ACTIONS. CONFLICTS ARE CLOSELY MONITORED BY MEMBERS OF THE BOARD. THE CONFLICT OF INTEREST POLICY HAS RESTRICTIONS FOR ANY BOARD MEMBER WITH A CONFLICT OF INTEREST; SUCH AS, PROHIBITING THEM FROM PARTICIPATING IN DELIBERATIONS AND VOTING WITH REGARD TO CERTAIN TRANSACTIONS IN WHICH THEY HAVE AN INTEREST. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM, WHICH INCLUDES THIS ORGANIZATION'S PRESIDENT & CEO AND OTHER KEY OFFICERS, MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF THE LARGEST PRIVATE EMPLOYER IN LINCOLN/LANCASTER COUNTY, BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN HEALTH'S BOARD OF TRUSTEES AND THE COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED ARE REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON MAY 22, 2012 ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b SEE THE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION AND AMENDMENTS ARE AVAILABLE TO THE PUBLIC ON THE NEBRASKA SECRETARY OF STATE'S WEBSITE AT WWW.SOS.NE.GOV. ALSO, THIS ORGANIZATION IS INCLUDED WITHIN THE CONSOLIDATED FINANCIAL STATEMENTS OF BRYAN HEALTH THAT ARE MADE AVAILABLE TO THE PUBLIC BY THE POSTING OF THESE DOCUMENTS THROUGH THE MUNICIPAL SECURITIES RULEMAKING BOARD WEBSITE AT EMMA.MSRB.ORG. THE ORGANIZATION'S OTHER GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. FEDERAL TAX LAWS DO NOT REQUIRE THAT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. Other changes in net assets or fund balances Form 990, Part XI, Line 5 CHANGE IN VALUE OF SWAP AGREEMENT - -1208276; DEFERRED TAX BENEFIT - -250; OFFICE BUILDING RENT EXPENSES - 48194; TRANSFERS (TO) FROM RELATED ENTITY, NET - -900; RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE OF BRYAN HEALTH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE ORGANIZATION'S AUDIT. COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES FORM 990, PART VII, SECTION A IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THIS ORGANIZATION'S BOARD, OR ANY AFFILIATED BOARD, IS COMPENSATED FOR THEIR SERVICES AS A BOARD MEMBER. COMPENSATION AMOUNTS REPORTED IN FORM 990, PART VII, SECTION A ARE FOR SERVICES PERFORMED AS PHYSICIANS AND EXECUTIVES OF CRETE AREA MEDICAL CENTER, BRYAN HEALTH AND BRYAN MEDICAL CENTER AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS. COMPENSATION AMOUNTS REPORTED IN PART VII, SECTION A ARE BASED ON THE CALENDAR YEAR ENDING DECEMBER 31, 2011. BRYAN HEALTH 1600 SOUTH 48TH STREET LINCOLN NE 68506 363414823 HEALTHCARE NE 501(C)(3) 11 - Type III - FI NA false BRYAN PHYSICIAN NETWORK 1600 SOUTH 48TH STREET LINCOLN NE 68506 201357375 HEALTHCARE NE 501(C)(3) 9 BRYAN HEALTH false BRYAN MEDICAL CENTER 1600 SOUTH 48TH STREET LINCOLN NE 68506 470376552 HEALTHCARE NE 501(C)(3) 3 BRYAN HEALTH false BRYAN FOUNDATION 1600 SOUTH 48TH STREET LINCOLN NE 68506 237005720 FUNDRAISING NE 501(C)(3) 7 BRYAN HEALTH false BRYAN ENTERPRISES INC 1600 SOUTH 48TH STREET LINCOLN NE 68506 470701037 MEDICAL SERVICES NE NA C CORPORATION 0 0 0 INTEGRATED CARDIOLOGY GROUP LLC 1600 SOUTH 48TH STREET LINCOLN NE 68506 470844961 CARDIOLOGY NE NA C CORPORATION 0 0 0 false false true false true false false false false false false true false true true false true false