ALEGENT CREIGHTON CLINIC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ALEGENT CREIGHTON CLINIC (EIN 47-0765154)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201301349349300145
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T08:12:06-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470757164 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT CREIGHTON HEALTH | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 W DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470765154 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT CREIGHTON CLINIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ALEG | NameControl |
| Phone | 4023434323 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SCOTT M WOOTEN | Name |
| Title | SENIOR VP/CFO | Title |
| Phone | 4023434323 | Phone |
| Date Signed | 2013-05-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANGELA LEA | Name |
| PTIN | P01051055 | PTIN |
| Phone | 4023434323 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SCOTT M WOOTEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 116713554 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ALEGENTCREIGHTON.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1993 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | CLINIC HEALTHCARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1093 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 7039 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 39139 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 28346 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 99872990 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 115155075 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -747 | InvestmentIncomePriorYear |
| Investment Income Current Year | 15340 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1281832 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1486383 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 101193214 | TotalRevenuePriorYear |
| Total Revenue Current Year | 116685144 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2632317 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 2096188 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 97219937 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 108922030 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 38288038 | OtherExpensePriorYear |
| Other Expenses Current Year | 42408598 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 138140292 | TotalExpensesPriorYear |
| Total Expenses Current Year | 153426816 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -36947078 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -36741672 | RevenuesLessExpensesCY |
| Total Assets BOY | 17033215 | TotalAssetsBOY |
| Total Assets EOY | 16538043 | TotalAssetsEOY |
| Total Liabilities BOY | 167348474 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 203594974 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -150315259 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -187056931 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | FAITHFUL TO THE HEALING MINISTRY OF JESUS CHRIST, OUR MISSION IS TO PROVIDE HIGH QUALITY CARE FOR THE BODY, MIND AND SPIRIT OF EVERY PERSON. OUR COMMITMENT TO HEALING CALLS US TO:CREATE CARING AND COMPASSIONATE ENVIRONMENTS RESPECT THE DIGNITY OF EVERY PERSON CARE FOR THE RESOURCES ENTRUSTED TO US AS RESPONSIBLE STEWARDS COLLABORATE WITH OTHERS TO IMPROVE THE HEALTH OF OUR COMMUNITIES ATTEND ESPECIALLY TO THE NEEDS OF THOSE WHO ARE POOR AND DISADVANTAGED ACT WITH INTEGRITY IN ALL ENDEAVORS TO ACHIEVE THIS MISSION, WE PLEDGE TO BE CREATIVE, VISIONARY LEADERS COMMITTED TO HOLISTIC HEALTHCARE IN THE REGION. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 64470575 | Expense |
| Grants | 1156886 | Grants |
| Revenue | 63894678 | Revenue |
| Description | ALEGENT CREIGHTON CLINIC PRIMARY CARE PHYSICIANS ARE DEDICATED TO PROVIDING PATIENTS WITH EXCELLENT HEALTHCARE. IN FISCAL YEAR 2012, PRIMARY CARE PHYSICIANS CARED FOR 382,617 OUTPATIENT VISITS AT THE CLINICS. ALEGENT CREIGHTON CLINIC HAS 31 PRIMARY CLINICS CONVENIENTLY LOCATED THROUGHOUT THE OMAHA/COUNCIL BLUFFS AREA. A FULL RANGE OF MEDICAL SERVICES ARE PROVIDED TO PATIENTS COVERED BY MEDICARE AND MEDICAID. ALEGENT CREIGHTON CLINIC FOLLOWS A REASONED AND THOUGHTFUL APPROACH TO HELP PATIENTS WHO LACK INSURANCE OR FINANCIAL RESOURCES TO PAY FOR THE MEDICAL CARE THEY NEED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 16243145 | Expense |
| Grants | 292418 | Grants |
| Revenue | 16148519 | Revenue |
| Description | ALEGENT CREIGHTON CLINIC PROVIDES OUR PATIENTS WITH PHYSICIANS THAT SPECIALIZE IN OBSTETRICS AND GYNECOLOGY. EACH PHYSICIAN HAS SPECIAL KNOWLEDGE, SKILLS AND PROFESSIONAL CAPABILITIES IN THE MEDICAL AND SURGICAL CARE OF THE FEMALE REPRODUCTIVE SYSTEM AND ASSOCIATED DISORDERS. IN FISCAL YEAR 2012, OBSTETRICS AND GYNECOLOGY PHYSICIANS CARED FOR 55,643 OUTPATIENT VISITS AT THE CLINICS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 16048325 | Expense |
| Grants | 229323 | Grants |
| Revenue | 12668621 | Revenue |
| Description | ALEGENT CREIGHTON CLINIC PROVIDES A COMPREHENSIVE RANGE OF CARDIAC SERVICES, FROM PREVENTION TO TREATMENT AND REHABILITATION. THE TEAM OF CLINICAL PHYSICIANS INCLUDE HIGHLY TRAINED MEDICAL PROFESSIONALS FROM MANY DISCIPLINES. IN FISCAL YEAR 2012, HEART AND VASCULAR SPECIALISTS CARED FOR 24,530 OUTPATIENT VISITS AT THE CLINICS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 49683054 | Expense |
| Grants | 417561 | Grants |
| Revenue | 23049155 | Revenue |
| Description | ALEGENT CREIGHTON CLINIC IS A NETWORK OF SKILLED PHYSICIANS DEVOTED TO PROVIDING EXCEPTIONAL HEALTHCARE IN ACCORDANCE WITH OUR MISSION. THE SKILLED PHYSICIANS PROVIDE OUTSTANDING CARE IN THE FOLLOWING SERVICES: PLASTIC & RECONSTRUCTIVE SURGERY, NEUROSCIENCE, GENERAL SURGERY, AND OTHER AREAS OF SPECIALTY CARE. EACH CLINIC TEAM IS SUPPORTED BY PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS WHO HAVE THE EXPERTISE TO PREVENT, DIAGNOSE, AND TREAT EACH ONE OF OUR PATIENTS' CONDITIONS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 49683054 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 417561 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 23049155 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 146445099 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 47 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1093 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCOTT M WOOTEN SENIOR VPCFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4023434323 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| JULIE ROTHLISBERGER-CASTILLO MD | ||||||||
| SECRETARY/TREASURER/PHYSIC | 60.00 | X | X | 462030 | 0 | 36210 | ||
| RICHARD HACHTEN II | ||||||||
| DIRECTOR/ACH PRES & CEO | 4.00 | X | X | 119819 | 1606342 | 297951 | ||
| THOMAS PRUSE MD | ||||||||
| CHAIR/PHYSICIAN | 60.00 | X | X | 184804 | 0 | 47049 | ||
| KAREN MILLER MD | ||||||||
| VICE CHAIR/PHYSICIAN | 60.00 | X | X | 360719 | 0 | 27548 | ||
| SCOTT CAROLLO MD | ||||||||
| DIRECTOR/PHYSICIAN | 60.00 | X | 587091 | 0 | 42551 | |||
| JOHN HEWITT | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| SCOTT WOOTEN | ||||||||
| DIRECTOR/ACH SVP/CFO | 4.00 | X | X | 49138 | 658780 | 134300 | ||
| KEVIN NOHNER MD | ||||||||
| DIRECTOR/PHYSICIAN | 60.00 | X | 277583 | 0 | 48415 | |||
| J RUSSELL BOWEN MD | ||||||||
| DIRECTOR/PHYSICIAN | 60.00 | X | 352631 | 0 | 38611 | |||
| PAT HENSLEY | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| RICHARD ROLSTON MD | ||||||||
| ACC CEO | 60.00 | X | X | 32626 | 437395 | 1280141 | ||
| HEATHER TAGGART MD | ||||||||
| DIRECTOR/PHYSICIAN | 60.00 | X | 674289 | 0 | 18374 | |||
| BODO TREU MD | ||||||||
| DIRECTOR/PHYSICIAN | 60.00 | X | 411928 | 0 | 37976 | |||
| RANDY PRITZA MD | ||||||||
| ACC CHIEF MEDICAL OFFICER | 60.00 | X | 590311 | 0 | 37038 | |||
| KENNETH LAWONN | ||||||||
| ACH SVP STRATEGY & TECH | 4.00 | X | 39216 | 525750 | 115906 | |||
| PAUL EBMEIER | ||||||||
| ACC COO | 60.00 | X | 393678 | 0 | 80834 | |||
| JOAN NEUHAUS | ||||||||
| ACH SVP COO | 4.00 | X | 44451 | 595931 | 179065 | |||
| RICK MILLER MD | ||||||||
| ACH SVP CHIEF QUALITY OFF | 4.00 | X | 28268 | 378979 | 86623 | |||
| MICHAEL BARSOOM MD | ||||||||
| PHYSICIAN | 60.00 | 846444 | 0 | 37356 | X | |||
| JOSEPH JARZOBSKI MD | ||||||||
| PHYSICIAN | 60.00 | 847719 | 0 | 32528 | X | |||
| ERIN EVANS MD | ||||||||
| PHYSICIAN | 60.00 | 801349 | 0 | 13248 | X | |||
| JON THOMAS MD | ||||||||
| PHYSICIAN | 60.00 | 782034 | 0 | 45750 | X | |||
| ANN SULLIVAN MD | ||||||||
| PHYSICIAN | 60.00 | 764567 | 0 | 39249 | X | |||
| MARTIN HICKEY MD | ||||||||
| ACC FORMER CEO | 0.00 | 36500 | 489347 | 0 | X | |||
| FRED HOSLER MD | ||||||||
| FORMER ACH CMO | 0.00 | 37505 | 502804 | 889 | X | |||
| LARRY BROWN MD | ||||||||
| MED DIR SRC EXC | 60.00 | 650762 | 0 | 42928 | X | |||
| MARK KESTNER MD | ||||||||
| FORMER SVP CMO | 0.00 | 9133 | 122445 | 1669 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 9384595 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 5317773 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2722209 | TotalOtherCompensation |
| Number Individuals GT100 K | 150 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| NAVIGANT CONSULTING | |||||
| 30 S WACKER DRIVE SUITE 3100 | CHICAGO | IL | 60606 | MANAGEMENT CONSULTING | 432472 |
| MERCHANTS CREDIT ADJUSTERS INC | |||||
| 17055 FRANCES STREET STE 100 | OMAHA | NE | 68130 | DEBT COLLECTION | 411803 |
| EMDEON CORPORATION | |||||
| 3055 LEBANON PIKE | NASHVILLE | TN | 37214 | REVENUE CYCLE MANAGEMENT | 276279 |
| KAUFMAN HALL & ASSOC | |||||
| 5202 OLD ORCHARD ROADSTE N700 | SKOKIE | IL | 60077 | MANAGEMENT CONSULTING | 267802 |
| GENERAL SERVICE BUREAU | |||||
| 8429 BLONDO STREET | OMAHA | NE | 68134 | DEBT COLLECTION | 181284 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| All Other Contributions | 28346 | AllOtherContributions |
| Total Contributions | 28346 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT REVENUE | 621110 | 108648875 | 108648875 | |
| REVENUE FROM AFFILIATE | 900099 | 4851935 | 4851935 | |
| MEANINGFUL USE | 900099 | 1652102 | 1652102 | |
| OTHER REVENUE | 900099 | 2163 | $2,163 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 115155075 | TotalProgramServiceRevenue |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 7039 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 7039 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7039 | TotalRevenueColumn |
| Unrelated Business Revenue | 7039 | UnrelatedBusinessRevenue |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 43750 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 28410 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 15340 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15340 | TotalRevenueColumn |
| Exclusion | $15,340 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| SYSTEM REV ALLOCATION | 900099 | 871283 | $871,283 | |
| OTHER REVENUE | 900099 | 608061 | 608061 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1479344 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 116685144 | TotalRevenueColumn |
| Related Or Exempt Function Income | 115760973 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 7039 | UnrelatedBusinessRevenue |
| Exclusion | $888,786 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28407 | Total |
| Program Services | 28407 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2067781 | Total |
| Program Services | 2067781 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7229405 | Total |
| Program Services | 6867935 | ProgramServices |
| Management And General | 361470 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88815937 | Total |
| Program Services | 84375140 | ProgramServices |
| Management And General | 4440797 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1613470 | Total |
| Program Services | 1532797 | ProgramServices |
| Management And General | 80673 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7072340 | Total |
| Program Services | 6718723 | ProgramServices |
| Management And General | 353617 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4190878 | Total |
| Program Services | 3981334 | ProgramServices |
| Management And General | 209544 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17160 | Total |
| Program Services | 16302 | ProgramServices |
| Management And General | 858 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1394986 | Total |
| Program Services | 1325237 | ProgramServices |
| Management And General | 69749 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55455 | Total |
| Program Services | 52682 | ProgramServices |
| Management And General | 2773 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7356360 | Total |
| Program Services | 6988542 | ProgramServices |
| Management And General | 367818 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7533014 | Total |
| Program Services | 7533014 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 298611 | Total |
| Program Services | 283680 | ProgramServices |
| Management And General | 14931 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 261993 | Total |
| Program Services | 261993 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13373 | Total |
| Program Services | 13373 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3533579 | Total |
| Program Services | 3356900 | ProgramServices |
| Management And General | 176679 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1019243 | Total |
| Program Services | 968281 | ProgramServices |
| Management And General | 50962 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES | 10696089 | 10161285 | 534804 |
| BAD DEBT | 5840439 | 5548417 | 292022 |
| SYSTEM EXP ALLOCATIONS | 2795489 | 2795489 | |
| TAXES AND LICENSES | 589510 | 589510 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1003297 | Total |
| Program Services | 978277 | ProgramServices |
| Management And General | 25020 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 153426816 | Total |
| Program Services | 146445099 | ProgramServices |
| Management And General | 6981717 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165451 | BOY |
| EOY | 423110 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8456870 | BOY |
| EOY | 10305124 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3600 | BOY |
| EOY | 2700 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 450965 | BOY |
| EOY | 598970 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 327119 | BOY |
| EOY | 85703 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 15841312 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 10718876 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7629210 | BOY |
| EOY | 5122436 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17033215 | BOY |
| EOY | 16538043 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8714298 | BOY |
| EOY | 7949324 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 158634176 | BOY |
| EOY | 195645650 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 167348474 | BOY |
| EOY | 203594974 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -150315259 | BOY |
| EOY | -187056931 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -150315259 | BOY |
| EOY | -187056931 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17033215 | BOY |
| EOY | 16538043 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -36741672 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2132534 | OtherCostOrOtherBasis |
| Depreciation | 1926767 | Depreciation |
| Book Value | 205767 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1723449 | OtherCostOrOtherBasis |
| Depreciation | 907110 | Depreciation |
| Book Value | 816339 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10512345 | OtherCostOrOtherBasis |
| Depreciation | 7812004 | Depreciation |
| Book Value | 2700341 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1472984 | OtherCostOrOtherBasis |
| Depreciation | 72995 | Depreciation |
| Book Value | 1399989 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5122436 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTERCOMPANY PAYABLES | Description |
| Amount | $195,645,650 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 195645650 | TotalOfAmounts |
| Total Revenue | 116685144 | TotalRevenue |
| Total Expenses | 153426816 | TotalExpenses |
| Excess Or Deficit For Year | -36741672 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -36741672 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PART X, LINE 2 - ENTITIES OF THE ALEGENT HEALTH SYSTEM RECOGNIZE THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. DURING 2011 AND 2010, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT HEALTH FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 470648586 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 26200 | AmountOfCashGrant |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | CHARITY CARE - ASSISTANCE TO LOW INCOME QUALIFIED INDIVIDUALS. | TypeOfGrant |
| Number Of Recipients | 5427 | NumberOfRecipients |
| Amount Of Non Cash Assistance | 2067781 | AmountOfNonCashAssistance |
| Method Of Valuation | BOOK | MethodOfValuation |
| Description Of Non Cash Assistance | REDUCTION OR WRITE OFF OF PATIENT SERVICES. | DescriptionOfNonCashAssistance |
Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | PART I, LINE 2: | SCHEDULE I, PART I, LINE 2: MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES OR SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS. |
| ALEGENT CREIGHTON CLINIC RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS' ACCOUNTS RECEIVABLE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (25 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JULIE ROTHLISBERGER-CASTILLO MD | |||||||||||||
| 395754 | 0 | 50000 | 0 | 16276 | 0 | 16642 | 0 | 21069 | 0 | 499741 | 0 | 0 | 0 |
| RICHARD HACHTEN II | |||||||||||||
| 47872 | 641788 | 29925 | 401187 | 42022 | 563367 | 19599 | 262751 | 1186 | 15897 | 140604 | 1884990 | 32128 | 430719 |
| THOMAS PRUSE MD | |||||||||||||
| 170547 | 0 | 0 | 0 | 14257 | 0 | 32255 | 0 | 15420 | 0 | 232479 | 0 | 0 | 0 |
| KAREN MILLER MD | |||||||||||||
| 335177 | 0 | 0 | 0 | 25542 | 0 | 4620 | 0 | 24203 | 0 | 389542 | 0 | 0 | 0 |
| SCOTT CAROLLO MD | |||||||||||||
| 526473 | 0 | 45000 | 0 | 15618 | 0 | 14427 | 0 | 29615 | 0 | 631133 | 0 | 0 | 0 |
| SCOTT WOOTEN | |||||||||||||
| 25303 | 339232 | 14886 | 199567 | 8949 | 119981 | 7983 | 107018 | 1521 | 20387 | 58642 | 786185 | 3374 | 45239 |
| KEVIN NOHNER MD | |||||||||||||
| 250963 | 0 | 0 | 0 | 26620 | 0 | 24309 | 0 | 26698 | 0 | 328590 | 0 | 0 | 0 |
| J RUSSELL BOWEN MD | |||||||||||||
| 339260 | 0 | 0 | 0 | 13371 | 0 | 14700 | 0 | 25103 | 0 | 392434 | 0 | 0 | 0 |
| RICHARD ROLSTON MD | |||||||||||||
| 24552 | 329152 | 6147 | 82410 | 1927 | 25833 | 88045 | 1180371 | 1493 | 20014 | 122164 | 1637780 | 0 | 0 |
| HEATHER TAGGART MD | |||||||||||||
| 635206 | 0 | 9966 | 0 | 29117 | 0 | 14700 | 0 | 6017 | 0 | 695006 | 0 | 0 | 0 |
| BODO TREU MD | |||||||||||||
| 331742 | 0 | 50000 | 0 | 30186 | 0 | 14700 | 0 | 24212 | 0 | 450840 | 0 | 0 | 0 |
| RANDY PRITZA MD | |||||||||||||
| 527905 | 0 | 45000 | 0 | 17406 | 0 | 14427 | 0 | 25921 | 0 | 630659 | 0 | 0 | 0 |
| KENNETH LAWONN | |||||||||||||
| 20244 | 271405 | 12041 | 161431 | 6931 | 92914 | 7845 | 105173 | 297 | 3981 | 47358 | 634904 | 2769 | 37123 |
| PAUL EBMEIER | |||||||||||||
| 258789 | 0 | 93516 | 0 | 41373 | 0 | 59855 | 0 | 22797 | 0 | 476330 | 0 | 20451 | 0 |
| JOAN NEUHAUS | |||||||||||||
| 23838 | 319573 | 12829 | 171997 | 7784 | 104361 | 12430 | 166635 | 390 | 5224 | 57271 | 767790 | 2912 | 39035 |
| RICK MILLER MD | |||||||||||||
| 16457 | 220627 | 8799 | 117969 | 3012 | 40383 | 4162 | 55798 | 2138 | 28669 | 34568 | 463446 | 683 | 9158 |
| MICHAEL BARSOOM MD | |||||||||||||
| 684461 | 0 | 130000 | 0 | 31983 | 0 | 12250 | 0 | 26598 | 0 | 885292 | 0 | 0 | 0 |
| JOSEPH JARZOBSKI MD | |||||||||||||
| 528017 | 0 | 300000 | 0 | 19702 | 0 | 14427 | 0 | 19424 | 0 | 881570 | 0 | 0 | 0 |
| ERIN EVANS MD | |||||||||||||
| 758255 | 0 | 0 | 0 | 43094 | 0 | 12250 | 0 | 2489 | 0 | 816088 | 0 | 0 | 0 |
| JON THOMAS MD | |||||||||||||
| 677884 | 0 | 50000 | 0 | 54150 | 0 | 21572 | 0 | 25622 | 0 | 829228 | 0 | 0 | 0 |
| ANN SULLIVAN MD | |||||||||||||
| 741004 | 0 | 0 | 0 | 23563 | 0 | 13475 | 0 | 27265 | 0 | 805307 | 0 | 0 | 0 |
| MARTIN HICKEY MD | |||||||||||||
| 0 | 0 | 0 | 0 | 36500 | 489347 | 0 | 0 | 0 | 0 | 36500 | 489347 | 36501 | 489347 |
| FRED HOSLER MD | |||||||||||||
| 0 | 0 | 0 | 0 | 37505 | 502804 | 0 | 0 | 62 | 827 | 37567 | 503631 | 37470 | 502336 |
| LARRY BROWN MD | |||||||||||||
| 344187 | 0 | 236382 | 0 | 70193 | 0 | 17304 | 0 | 27312 | 0 | 695378 | 0 | 0 | 0 |
| MARK KESTNER MD | |||||||||||||
| 0 | 0 | 0 | 0 | 9133 | 122445 | 116 | 1553 | 0 | 0 | 9249 | 123998 | 9133 | 122445 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | AS PART OF THE EXECUTIVE COMPENSATION ARRANGEMENT, EXECUTIVES ARE PROVIDED WITH A SET SUM, APPROXIMATELY 30 - 40% OF THEIR BASE SALARY, WHICH CAN BE USED TO ELECT VARIOUS BENEFITS. EXECUTIVES WHO RECEIVED THIS BENEFIT WERE RICHARD HACHTEN II, SCOTT WOOTEN, KENNETH LAWONN, PAUL EBMEIER, JOAN NEUHAUS, RICHARD ROLSTON, AND RICK MILLER. SOME OF THE BENEFITS AVAILABLE FOR ELECTION INCLUDE HEALTH CLUB DUES, AUTOMOBILE ALLOWANCE, HOUSING ALLOWANCE, FINANCIAL PLANNING FEES AND LEGAL FEES. PAYMENT FOR THESE BENEFITS ARE EITHER MADE DIRECTLY BY ALEGENT CREIGHTON HEALTH OR REIMBURSED TO THE EXECUTIVE AFTER THE APPROPRIATE SUBSTANTIATION FOR THE EXPENSE IS PROVIDED. THE AMOUNT PAID FOR THESE BENEFITS IS INCLUDED IN THE EXECUTIVE'S WAGES AS TAXABLE INCOME. | |
| PART I, LINES 4A-B | THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM ALEGENT CREIGHTON HEALTH (A RELATED ORGANIZATION) DURING THE 2011 CALENDAR YEAR AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE AS COMPENSATION ON SCHEDULE J: FRED HOSLER, MD - $539,806 MARK KESTNER, MD - $131,578 MARTIN HICKEY, MD - $475,218 RICHARD HACTEN II - $346,579. PART I, LINE 4B: THE FOLLOWING REPORTABLE INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FROM ALEGENT CREIGHTON HEALTH (A RELATED ORGANIZATION) DURING THE 2011 CALENDAR YEAR. AMOUNTS DEFERRED FROM THE PLAN WERE INCLUDED IN COLUMN C OF THE SCHEDULE J: RICHARD HACHTEN II - $141,223 PAUL EBMEIER - $22,752 JOAN NEUHAUS - $53,374 RICHARD ROLSTON - $40,680 RICK MILLER, MD - $36,480 MARTIN HICKEY, MD - $50,630 KENNETH LAWONN - $47,270 SCOTT WOOTEN - $58,678. PART I, LINE 4B: THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED A PAY OUT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FROM ALEGENT CREIGHTON HEALTH (A RELATED ORGANIZATION) DURING THE 2011 CALENDAR YEAR. AMOUNTS PAID OUT FROM THE PLAN WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE WAGES AND REPORTED IN COLUMN E OF THE SCHEDULE J: RICHARD HACTEN II - $116,268 SCOTT WOOTEN - $48,613 RICK MILLER, MD - $9,841 LARRY BROWN, MD - $12,411 KENNETH LAWONN - $39,892 JOAN NEUHAUS - $41,947 PAUL EBMEIER - $20,451 MARTIN HICKETY, MD - $50,630. | |
| PART I, LINE 5 | ALEGENT CREIGHTON CLINIC PHYSICIANS ARE COMPENSATED BASED ON THEIR INDIVIDUAL REVENUES LESS EXPENSES. ABSENT EXTENUATING CIRCUMSTANCES, THERE IS NO GUARANTEED BASE SALARY OR MINIMUM SALARY PAST THEIR INITIAL START-UP PERIOD. SOME PHYSICIANS ARE COMPENSATED BASED ON THEIR WORK RVU PRODUCTION WHICH IS A NATIONALLY ACCEPTED MEASURE OF PHYSICIAN PRODUCTIVITY. | |
| PART I, LINE 6 | COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT CREIGHTON HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. MEMBERS OF ALEGENT CREIGHTON HEALTH MANAGEMENT ARE ELIGIBLE FOR AN ANNUAL INCENTIVE BONUS. INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE MEASURES. ONE OF THE FOUR SYSTEM PERFORMANCE GOALS IS DEPENDENT UPON THE FINANCIAL RESULTS OF THE ENTIRE ALEGENT CREIGHTON HEALTH SYSTEM FOR THE FISCAL YEAR. | |
| PART III | SCHEDULE J, PART I, LINE 3: ALEGENT CREIGHTON HEALTH GOVERNANCE OF EXECUTIVE COMPENSATION: ACTING AS PRUDENT STEWARDS OF ITS FINANCIAL RESOURCES, THE ALEGENT CREIGHTON HEALTH BOARD COMPENSATION COMMITTEE RECOMMENDS AND THE BOARD EXECUTIVE COMMITTEE APPROVES THE EXECUTIVE COMPENSATION PHILOSOPHY, POLICY AND GUIDELINES. IT DOES SO WITH THE OBJECTIVE OF ATTRACTING AND RETAINING TOP EXECUTIVE TALENT TO ENSURE ALEGENT CREIGHTON HEALTH IS ABLE TO FULFILL ITS FAITH-BASED MISSION AND ACHIEVE ITS VISION OF BECOMING WORLD-CLASS. THE ALEGENT CREIGHTON HEALTH COMPENSATION COMMITTEE FOLLOWS A THOROUGH AND INTENTIONAL PROCESS THAT INCLUDES CONSULTATION WITH INDEPENDENT, EXPERT COUNSEL AND CAREFULLY COMPARES COMPENSATION LEVELS TO MARKET-BASED COMPENSATION OF SIMILAR SIZED, NON-PROFIT AND FOR-PROFIT HEALTH SYSTEMS AND ALSO UTILIZES A BLEND OF NON-PROFIT AND GENERAL INDUSTRY DATA FOR EXECUTIVE ROLES WHERE THE RECRUITING MARKET IS ARGUABLY BROADER THAN THE NON-PROFIT SECTOR. TOTAL COMPENSATION INCLUDES BASE COMPENSATION, AND ALSO INCLUDES PERFORMANCE-BASED INCENTIVE COMPENSATION FOR ACHIEVING BOARD-SET GOALS FOR CLINICAL QUALITY, PATIENT SAFETY AND SATISFACTION, PHYSICIAN PERCEPTION, STRATEGIC AND FACILITY PLANNING AND FINANCIAL PERFORMANCE. IT MAY ALSO INCLUDE OTHER CASH PAYMENTS SUCH AS ONE-TIME RELOCATION COSTS, AND/OR CASH PAYMENTS FOR DEFERRED COMPENSATION. SCHEDULE J, PART II: THE ALEGENT CREIGHTON HEALTH EXECUTIVES HAVE A PROVISION IN THEIR COMPENSATION AGREEMENT THAT PROVIDES FOR POTENTIAL SEVERANCE PAYMENTS IN THE EVENT OF TERMINATION WITHOUT CAUSE OR CHANGE OF CONTROL. THE AMOUNT OF SEVERANCE AN EXECUTIVE MAY OR MAY NOT RECEIVE IF TERMINATED ACCORDING TO THE COMPENSATION AGREEMENT IS INCLUDED AS DEFERRED COMPENSATION IN COLUMN C. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART I, LINE 5 AND PART V, LINE 2A: | THE EMPLOYEES LISTED IN PART I, LINE 5 AND PART V, LINE 2A ARE EMPLOYED BY ALEGENT CREIGHTON CLINIC. HOWEVER, THROUGH A COMMON PAY AGENT AGREEMENT, THE EMPLOYEES ARE PAID BY ALEGENT CREIGHTON HEALTH AND PAYROLL EXPENSES ARE ALLOCATED TO ALEGENT CREIGHTON CLINIC. |
| FORM 990, PART V, LINE 1C: | PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF THE ALEGENT CREIGHTON HEALTH SYSTEM ARE MADE BY ALEGENT CREIGHTON HEALTH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT CREIGHTON CLINIC. ALEGENT CREIGHTON HEALTH FILES THE FORM 1099S AND COMPILES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY ALEGENT CREIGHTON HEALTH ON BEHALF OF ALEGENT CREIGHTON CLINIC ARE REPORTED TO THE IRS. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF ALEGENT CREIGHTON CLINIC IS ALEGENT CREIGHTON HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS SHALL BE APPOINTED BY ALEGENT CREIGHTON HEALTH AND SHALL CONSIST OF NO MORE THAN THIRTEEN (13) DIRECTORS. ALEGENT CREIGHTON HEALTH SHALL CONSIDER THE SLATE OF THE NOMINATIONS SUBMITTED TO IT BY ALEGENT CREIGHTON CLINIC'S BOARD OF DIRECTORS. ALEGENT CREIGHTON CLINIC'S BOARD OF DIRECTORS SHALL SOLICIT NOMINATIONS FROM ALEGENT CREIGHTON CLINIC'S PHYSICIAN EMPLOYEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | ALEGENT CREIGHTON HEALTH SHALL HAVE, IN ADDITION TO ALL RIGHTS AND POWERS GRANTED BY LAW WITH RESPECT TO THE GOVERNANCE OF ALEGENT CREIGHTON CLINIC, THE RIGHT TO: A. INITIATE AND APPROVE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS; B. INITIATE AND APPROVE PHYSICIAN COMPENSATION AND BENEFITS AND RECRUITMENT INCENTIVES; C. INITIATE AND APPROVE JOINT VENTURES IN WHICH ALEGENT CREIGHTON CLINIC PROPOSES TO PARTICIPATE, PURSUANT TO GUIDELINES ESTABLISHED FROM TIME TO TIME BY ALEGENT CREIGHTON HEALTH; D. APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, ALL MEMBERS OF THE GOVERNING BOARD; E. APPROVE THE INCURRENCE OF ANY DEBT BY ALEGENT CREIGHTON CLINIC THAT IS IN EXCESS OF A THRESHOLD ESTABLISHED FROM TIME TO TIME BY ALEGENT CREIGHTON HEALTH; F. INITIATE AND APPROVE PHYSICIAN FEE SCHEDULES; G. INITIATE AND APPROVE THE MERGER OR CONSOLIDATION OF ALEGENT CREIGHTON CLINIC INTO OR WITH ANY OTHER CORPORATION, ORGANIZATION, OR ASSOCIATION; H. INITIATE AND APPROVE THE DISSOLUTION OR LIQUIDATION OF ALEGENT CREIGHTON CLINIC; I. APPROVE THE INCORPORATION OR DISSOLUTION OF AFFILIATED ENTITIES, ORGANIZATIONS, OR ASSOCIATIONS; J. INITIATE AND APPROVE THE SALE, LEASE, EXCHANGE, TRANSFER, OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY, OTHER THAN IN THE USUAL AND REGULAR COURSE OF BUSINESS; K. INITIATE AND APPROVE THE MORTGAGE, PLEDGE, DEDICATION TO REPAYMENT OF INDEBTEDNESS, OR OTHER ENCUMBRANCE OF ANY OR ALL OF ALEGENT CREIGHTON CLINIC'S PROPERTY; L. APPROVE ANNUAL CAPITAL AND OPERATING BUDGETS AND ANY DEVIATIONS IN EXCESS OF A THRESHOLD ESTABLISHED FROM TIME TO TIME BY ANY MEMBER; AND M. APPROVE THE PURCHASE OF A MEDICAL PRACTICE. |
| FORM 990, PART VI, SECTION B, LINE 11 | ALEGENT CREIGHTON CLINIC IS PART OF THE ALEGENT CREIGHTON HEALTH SYSTEM. TAX RETURNS FOR ENTITIES OF THE ALEGENT CREIGHTON HEALTH SYSTEM ARE PREPARED BY THE SYSTEM TAX DEPARTMENT. FOLLOWING THE PREPARATION OF ALEGENT CREIGHTON CLINIC FORM 990 BY ALEGENT CREIGHTON HEALTH INTERNAL TAX STAFF, THE RETURN IS REVIEWED BY THE ALEGENT CREIGHTON HEALTH TAX DIRECTOR AND THE CHIEF FINANCIAL OFFICER. THE FINAL TAX RETURN IS POSTED ON THE ELECTRONIC DIRECTOR'S PORTAL TO BE REVIEWED AND PRESENTED AT THE FINANCE AND AUDIT COMMITTEE OF THE BOARD. THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR ARE PRESENT AT THE FINANCE AND AUDIT COMMITTEE MEETING TO ANSWER QUESTIONS. ADDITIONALLY, THE BOARD OF DIRECTORS ARE NOTIFIED THAT THE FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, IS AVAILABLE ON THE ELECTRONIC PORTAL FOR REVIEW AND WILL BE FILED ON MAY 15, 2013. |
| FORM 990, PART VI, SECTION B, LINE 12C | WRITTEN CONFLICT OF INTEREST POLICY - ALEGENT CREIGHTON CLINIC HAS ADOPTED THE CONFLICT OF INTEREST POLICY AND CONFLICT INVESTIGATION PROCESS OF ALEGENT CREIGHTON HEALTH. ANNUAL COMPLETION OF THE DISCLOSURE STATEMENT IS REQUIRED BY THE BOARD OF DIRECTORS. STATED DISCLOSURES ARE INVESTIGATED BY THE ALEGENT CREIGHTON HEALTH COMPLIANCE OFFICER AND REPORTED TO THE CONFLICTS OF INTEREST COMMITTEE. THE CONFLICTS OF INTEREST COMMITTEE REVIEWS THE INVESTIGATION AND MAKES RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE MAKES THE FINAL DETERMINATION OF WHETHER OR NOT THERE IS A DISQUALIFYING EVENT AND COMMUNICATES IT TO THE ALEGENT CREIGHTON CLINIC BOARD OF DIRECTORS. AT ANY TIME A BOARD MEMBER OR KEY EMPLOYEE MAY DECLARE A CONFLICT OF INTEREST AND RECUSE HIS/HERSELF FROM THE DISCUSSION. THE INDIVIDUAL IS ALSO REQUIRED TO DISCLOSE ANY KNOWN OR POSSIBLE CONFLICTS OF INTEREST THAT ARISE DURING THE CALENDAR YEAR. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE GOVERNING BOARD OF ALEGENT CREIGHTON HEALTH ENGAGED THE SERVICES OF AN INDEPENDENT CONSULTING FIRM THAT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT THAT IS QUALIFIED TO AND REGULARLY PERFORMS EXECUTIVE AND OFFICER COMPENSATION STUDIES. THE CONSULTING FIRM CONDUCTED A REVIEW AND ANALYSIS OF THE TOTAL COMPENSATION PAID TO THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, BASED ON COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS AND DETERMINED THAT THE COMPENSATION WAS REASONABLE. THE CONSULTING FIRM ISSUED AN OPINION LETTER AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PAID TO EMPLOYEES IDENTIFIED AS DISQUALIFIED PERSONS. THE OPINION LETTER SETTING FORTH THE FINDINGS WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE GOVERNING BOARD. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS WERE MAINTAINED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CONFLICT OF INTEREST POLICY IS MADE AVAILABLE TO THE PUBLIC ON THE WEBSITE AT WWW.ALEGENTCREIGHTON.COM. ALEGENT CREIGHTON CLINIC DOES NOT MAKE THE FINANCIAL STATEMENTS OR GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. HOWEVER, THE ARTICLES OF INCORPORATION ARE AVAILABLE AT WWW.SOS.STATE.NE.US. |
| PART VII, SECTION A: | EXECUTIVES OF THE ALEGENT CREIGHTON HEALTH SYSTEM HOURS WORKED ARE SPLIT OUT BETWEEN THE FILING ORGANIZATION AND AFFILIATE ORGANIZATIONS OF THE SYSTEM. THE FOLLOWING EMPLOYEES ARE EXECUTIVES OF THE ALEGENT CREIGHTON HEALTH SYSTEM: RICHARD HACHTEN II, SCOTT WOOTEN, KENNETH LAWONN, JOAN NEUHAUS, RICHARD ROLSTON, MD, AND RICK MILLER, MD. THEREFORE, THEIR AVERAGE NUMBER OF HOURS WORKED PER WEEK FOR THE AFFILIATE ORGANIZATIONS ARE 56. |
| FORM 990, SCHEDULE A, PART I, LINE 3: | ALEGENT CREIGHTON CLINIC IS RECOGNIZED AS A HOSPITAL BY THE INTERNAL REVENUE SERVICE UNDER IRC SECTION 170(B)(1)(A)(III). HOWEVER, ALEGENT CREIGHTON CLINIC DOES NOT CURRENTLY OPERATE ANY LICENSED HOSPITAL FACILITIES; THEREFORE, NO SCHEDULE H IS REQUIRED. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT CREIGHTON HEALTH | |||||||||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68154 | 470757164 | LICENSED HOSPITAL/ADMINISTRATIVE SUPPORT | NE | 501(C)(3) | L3 | N/A | 0 | |
| ALEGENT HEALTH FOUNDATION | |||||||||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68154 | 470648586 | SUPPORT OF ALEGENT HEALTH AND AFFILIATES EXEMPT ACTIVITIES | NE | 501(C)(3) | L7 | 0 | ALEGENT CREIGHTON HEALTH | |
| ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM | |||||||||||
| 7500 MERCY ROAD | OMAHA | NE | 68124 | 470484764 | LICENSED HOSPITAL | NE | 501(C)(3) | L3 | 0 | ALEGENT CREIGHTON HEALTH | |
| ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | |||||||||||
| 6901 NORTH 72ND STREET | OMAHA | NE | 68122 | 470376615 | LICENSED HOSPITAL | NE | 501(C)(3) | L3 | 0 | ALEGENT CREIGHTON HEALTH | |
| ALEGENT HEALTH MERCY HOSPITAL CORNING IOWA | |||||||||||
| 603 ROSARY DRIVE | CORNING | IA | 50841 | 420782518 | LICENSED HOSPITAL | IA | 501(C)(3) | L3 | 0 | ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM | |
| MERCY HEALTH CARE FOUNDATION | |||||||||||
| 603 ROSARY DRIVE | CORNING | IA | 50841 | 421461064 | SUPPORT OF ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA EXEMPT ACTIVITIES | IA | 501(C)(3) | L11 I | 0 | ALEGENT HEALTH MERCY HOSPITAL CORNING IOWA | |
| ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER NE | |||||||||||
| 104 WEST 17TH STREET | SCHUYLER | NE | 68661 | 470399853 | LICENSED HOSPITAL | NE | 501(C)(3) | L3 | 0 | ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | |
| SCHUYLER MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 104 WEST 17TH STREET | SCHUYLER | NE | 68661 | 363630014 | SUPPORT OF ALEGENT HEALTH-MEMORIAL HOSPITAL, SCHUYLER EXEMPT ACTIVITIES | NE | 501(C)(3) | L11 I | 0 | ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER NE | |
| AH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA | |||||||||||
| 631 NORTH 8TH STREET | MISSOURI VALLEY | IA | 51555 | 420776568 | LICENSED HOSPITAL | IA | 501(C)(3) | L3 | 0 | ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | |
| COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION | |||||||||||
| 631 NORTH 8TH STREET | MISSOURI VALLEY | IA | 51555 | 421294399 | SUPPORT OF ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, | IA | 501(C)(3) | L11 I | 0 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MO VALLEY IA | |
| MERCY HOSPITAL FOUNDATION | |||||||||||
| 800 MERCY DRIVE | COUNCIL BLUFFS | IA | 51503 | 421178204 | SUPPORT OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM EXEMPT ACTIVITIES | IA | 501(C)(3) | L11 I | 0 | ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM | |
Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| PRAIRIE HEALTH VENTURES LLC | ||||||||||
| 421 SOUTH 9TH STREET SUITE 102 | LINCOLN | NE | 68508 | 204962103 | PROFESSIONAL TECH SERVICES | NE | ALEGENT HEALTH - IMMANUEL MEDICAL CENTER | N/A | 0 | 0 |
| AVANTAS LLC | ||||||||||
| 11128 JOHN GALT BLVD SUITE 400 | OMAHA | NE | 68124 | 392045003 | STAFFING OF NURSES | NE | ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM | N/A | 0 | 0 |
| LAKESIDE AMBULATORY SURGICAL CENTER LLC | ||||||||||
| 17030 LAKESIDE HILLS PLAZA STE 110 | OMAHA | NE | 68116 | 204267902 | AMBULATORY SURGICAL CENTER | NE | ALEGENT CREIGHTON HEALTH | N/A | 0 | 0 |
| LAKESIDE ENDOSCOPY CENTER LLC | ||||||||||
| 17001 LAKESIDE HILLS PLAZA SUITE 20 | OMAHA | NE | 68116 | 205544496 | ENDOSCOPY SERVICES | NE | ALEGENT CREIGHTON HEALTH | N/A | 0 | 0 |
| OMAHA AMBULATORY INVESTMENT COMPANY LLC | ||||||||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68154 | 061786989 | PARENT HOLDING COMPANY ASC | NE | ALEGENT CREIGHTON HEALTH | N/A | 0 | 0 |
| ALEGENT HEALTH NORTHWEST IMAGING CENTER LLC | ||||||||||
| 3606 N 156TH STREET | OMAHA | NE | 68154 | 061786985 | DIAGNOSTIC TESTING FACILITY | NE | ALEGENT CREIGHTON HEALTH | N/A | 0 | 0 |
| BERGAN MERCY SURGERY CENTER LLC | ||||||||||
| 7710 MERCY ROAD SUITE 100 | OMAHA | NE | 68124 | 208671994 | AMBULATORY SURGICAL CENTER | NE | OMAHA AMBULATORY INVESTMENT CO LLC | N/A | 0 | 0 |
| NEBRASKA SPINE LLC | ||||||||||
| 6901 NORTH 72ND STREET STE 20300 | OMAHA | NE | 68122 | 270263191 | SPINE HOSPITAL | NE | ALEGENT CREIGHTON HEALTH | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT HEALTH CREIGHTON ST JOSEPH MANAGED CARE SERVICES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470802306 | EIN |
| Primary Activity | MANAGED CARE SERVICES | PrimaryActivity |
| Legal Domicile State | NE | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT CREIGHTON HEALTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |