2013-06-26T16:30:25-05:00 2011-06-30 KPMG LLP TWO CENTRAL PARK PLAZASUITE 1501 OMAHA NE 68102 990 2010-07-01 470484764 ALEGENT HEALTH- BERGAN MERCY HEALTH SYSTEM ALEG 4023434323 7500 MERCY ROAD OMAHA NE 68124 SCOTT M WOOTEN 4023434323 2013-06-26 1 LORRAINE A EGGER 4023481450 2010 2016-02-24 21:20:13Z X SCOTT M WOOTEN 12809 WEST DODGE ROAD OMAHA NE 68154 544015718 0 X WWW.ALEGENT.COM X 1961 NE TO PROVIDE HIGH QUALITY CARE FOR THE BODY, MIND AND SPIRIT OF EVERY PERSON. 12 10 3557 643 6300799 0 7217626 5756620 489519489 509669237 8837616 14017887 8782526 9852200 514357257 539295944 45561805 49176970 0 0 215854278 211500809 0 0 465738 255705725 256319452 517121808 516997231 -2764551 22298713 621960900 689310700 188123787 192738088 433837113 496572612 X 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. 0 0 376801929 41888769 200134856 BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS PROVIDE A LARGE RANGE OF HOSPITAL SERVICES INCLUDING BUT NOT LIMITED TO: EMERGENCY DEPARTMENT, INPATIENT HOSPITAL FACILITIES, PROCEDURE CENTER, ORTHOPEDIC SERVICES, DIGESTIVE HEALTH CENTER, FAMILY LIFE CENTER, RADIOLOGY, UROLOGY AND PHYSICAL THERAPY. PATIENTS ARE AT THE CENTER OF EVERYTHING DONE AT BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS. 24728518 2749050 129805356 BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS OFFER A WIDE RANGE OF CARDIOVASCULAR SERVICES IN THE REGION, USING A TEAM APPROACH TO ADDRESS THE TOTAL NEEDS OF THE CARDIOVASCULAR PATIENT. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM PROVIDES A COMPREHENSIVE RANGE OF CARDIAC SERVICES, INCLUDING BUT NOT LIMITED TO: VASCULAR AND CARDIAC SURGERY, HEART SCANS AND HEART CHECKS, CARDIAC REHABILITATION, VASCULAR ULTRASOUND, NUCLEAR STRESS TESTS, DUAL SOURCE CT SCANNER AND ANGIOPLASTY. IN 2006, MERCY HOSPITAL OPENED A NEW STATE-OF-THE-ART CARDIAC CATHETERIZATION LAB, ALLOWING PHYSICIANS TO PERFORM PROCEDURES SUCH AS HEART CATHETERIZATIONS, CORONARY INTERVENTIONS INCLUDING BALLOON ANGIOPLASTY AND STENTING, AS WELL AS IMPLANTATION OF PACEMAKERS AND DEFIBRILLATORS. 21828336 2426639 10746956 BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS OFFER EXPECTANT MOMS THE MOST COMFORTABLE AND COMPREHENSIVE MATERNITY SERVICES AVAILABLE WITH SPACIOUS, HOME-LIKE SETTINGS AND FAMILY-FRIENDLY GUEST SLEEPING ACCOMMODATIONS. BOTH OF THE MATERNITY CENTER LOCATIONS ARE BACKED BY THE SUPPORT OF BOTH FULL-SERVICE HOSPITALS. 19002671 2112512 157091648 BERGAN MERCY MEDICAL CENTER IS EQUIPPED WITH THE LATEST TECHNOLOGIES IN THE DIAGNOSTIC CENTER. THE CENTER IS COMPLETELY DIGITAL, SO PATIENTS ARE NEVER WAITING ON FILMS. FEMALE PATIENTS CAN COUNT ON EXPERT IMAGING TESTS INCLUDING ULTRASOUND, BONE DENSITY TESTING, STEREOTACTIC BREAST BIOPSY AND DIGITAL MAMMOGRAPHY. THERE ARE A WIDE RANGE OF AVAILABLE TESTS AT THE DIAGNOSTIC CENTER THAT INCLUDE THE FOLLOWING: DIGITAL MAMMOGRAPHY, MRI AND OPEN MRI, CT, PET CT AND CARDIAC CT, 64-SLICE CT, FLUOROSCOPY, PULMONARY FUNCTION TESTING, ULTRASOUND, CARDIOVASCULAR IMAGING, PHLEBOTOMY, NUCLEAR MEDICINE, DIGITAL IMAGING, EEG, EKG AND EMG, STRESS TESTING AND ARTERIOGRAM. 19002671 2112512 157091648 442361454 1 1 0 1 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 X 225 0 1 3557 1 1 1 0 0 0 0 1 1 0 0 0 0 X 12 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 IA X SCOTT M WOOTEN SENIOR VPCFO 4023434323 12809 WEST DODGE ROAD OMAHA NE 68154 X SR LILLIAN MURPHY RSM 4.00 X 0 0 0 MICHAEL DEFREECE 6.00 X X 0 0 0 PAUL EDGETT III 4.00 X 0 0 0 ERIC GURLEY 4.00 X 0 0 0 H KEITH SCHMODE 4.00 X 0 18500 0 MARTIN MANCUSO MD 4.00 X 0 18500 0 RICHARD VIERK 4.00 X 0 26500 0 ANTOINETTE HARDY-WALLER RN 4.00 X 0 17500 0 GUILLERMO HUERTA MD 4.00 X 0 0 0 LESLIE ANDERSEN 4.00 X 0 0 0 ANTHONY HATCHER DO 6.00 X X 0 430677 31545 JOHN HEWITT 6.00 X X 0 0 0 RICHARD HACHTEN II 29.00 X 790318 817392 278627 KENNETH LAWONN 29.00 X 218025 225496 134712 SCOTT WOOTEN 29.00 X 265835 274944 136617 JOAN NEUHAUS 29.00 X 230538 238433 324164 RICHARD ROLSTON MD 29.00 X 0 0 0 RICK MILLER MD 29.00 X 53107 54927 388614 JANE CARMODY 29.00 X 127062 131416 376202 LARRY BROWN MD 1.00 X 0 380851 51034 MARTIN HICKEY MD 29.00 X 356044 368240 205555 MARIE KNEDLER 29.00 X 181596 187818 153276 SHEREE KEELY 29.00 X 88167 91188 39094 ELIZABETH LLEWELLYN 29.00 X 106921 110585 43049 PATRICIA MASEK 29.00 X 91079 94198 65673 FRANK EMSICK 29.00 X 103010 106540 47892 PAUL EBMEIER 29.00 X 165590 171262 52953 NANCY WALLACE 29.00 X 111246 115056 357417 JOSEPH HOAGBIN MD 60.00 X 267360 0 29289 ENEH OKORUWA MD 60.00 X 454287 0 33561 SRIRAMAMURTHY RAVIPATI MD 60.00 X 394864 0 37873 UMAJYOTHI INDUKURI MD 60.00 X 366457 0 13012 CHAKRAVARTHI PURETI MD 60.00 X 403279 0 12250 ANTONIO SAQUETON JR MD 60.00 X 368482 0 29404 WAYNE SENSOR X 1110213 1148246 13511 THEODORE SCHWAB X 114150 118060 1258 FRED HOSLER MD X 396415 409997 7239 MARGARET BREEN X 134737 139353 5445 DAVID TEW X 88492 91523 1338 AMY PROTEXTER X 122559 126758 9793 ANN JONES X 0 0 0 PATRICIA NADLE X 121708 125878 4772 MARK KESTNER MD X 272231 281558 7402 MICHAEL ANDERSON X 78843 81544 0 7582615 6402940 2892571 85 1 1 0 CASSLING DIAGNOSTIC 13808 F STREET OMAHA NE 68137 DIAGNOSTIC IMAGING SERVICES 2703571 ARUP LABORATORIES 500 CHIPETA WAY SALT LAKE CITY UT 84108 LABORATORY RESEARCH 1209423 DELTA CONSTRUCTION SERVICES INC 1105 S 24TH STREET OMAHA NE 68108 CONSTRUCTION 1112058 CAPITAL EXPRESS 3326 S 67TH STREET OMAHA NE 68106 COURIER SERVICE 797002 PROFESSIONAL ANESTHESIA SERVICES 7500 MERCY ROAD 424 OMAHA NE 68124 ANESTHESIA SERVICES 770757 46 111800 55264 48210 5388122 153224 5756620 NET PATIENT SERV REV 621500 485611799 482951403 2660396 REIMBURSABLE AFFILIATE 900099 14827194 14827194 PHARMACY 446110 7591739 2915093 4676646 FOOD SERVICE 722320 1638286 196906 1441380 HEALTH EDUCATION PRGMS 611710 219 219 509669237 63463 63463 3114094 1372538 1741556 1741556 1741556 14005430 2853847 2904853 14005430 -51006 13954424 13954424 46626 55264 58990 -12364 -12364 7950 7776 174 174 596881 375617 221264 221264 REIMBURSED SERVICES 900099 5641475 5641475 CHILD CARE 624410 1472384 1472384 MISC OPERATING REVENUE 900003 738881 479574 259307 48830 48830 7901570 539295944 497778816 6300799 29459709 44141 44141 49132829 49132829 4039476 3029607 1009869 163174617 130098177 32751983 324457 6978429 5479046 1499383 28079616 18719197 9266815 93604 9228671 7663410 1559197 6064 30390 30390 24689 24689 6578094 3965430 2612664 38527 38527 87642582 85984510 1657751 321 13230256 13230256 418685 181235 236329 1121 77375 77375 6696835 6696835 38782970 28652183 10130787 155131 120004 35127 PURCHASED SERVICES 31116842 17726349 13350322 40171 BAD DEBTS 29267917 29267917 JOA SETTLEMENT 19785000 19785000 MANAGEMENT ALLOCATIONS 11196983 11196983 EQUITY NET LOSS IN ALEG 8277518 8277518 2999658 2970236 29422 516997231 442361454 74170039 465738 1044159 822390 20019456 50019633 50919748 48373165 2975000 2894000 9130447 9918036 111548 2830 577239927 283038458 296800596 294201469 192439888 232670177 16108779 50409000 32411279 0 621960900 689310700 13061612 9849102 526305 74131 171451063 176961161 3084807 5853694 188123787 192738088 X 428915113 491195612 3131000 3586000 1791000 1791000 433837113 496572612 621960900 689310700 X 22298713 40436786 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 1 24689 0 0 0 24689 0 3961188 6001 464742 6642 183950 4241339 3665977 149013 298938 9996 142744 3961188 2688014 1800115 -448721 3875 369556 3665977 0.33000 0.67000 0 1 1 3341409 3341409 253295896 101285190 152010706 1800544 1081039 719505 298119550 172412068 125707482 20682528 8260161 12422367 294201469 INVESTMENT IN HOSPICE OF SWIA 250000 C INVESTMENT IN ALEGENT HEALTH 50159000 C 50409000 PAYABLE UNDER DEFERRED COMP PLANS 56587 3RD PARTY PAYER SETTLEMENT 3673356 INTERCOMPANY RECEIVABLE 2123751 5853694 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. 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. CANDLE LIGHT BALL 101890 55264 46626 6500 19281 31209 2000 101890 55264 46626 6500 19281 31209 2000 58990 -12364 1 1 X 0 0 1 1 0 1 1 15287 16748872 1048583 15700289 0.03220 15287 16748872 1048583 15700289 0.03220 6499 424612 34196 390416 0.00080 140 159884 0 159884 0.00030 9151473 7526728 1624745 0.00330 588785 244231 344554 0.00070 956 445707 162 445545 0.00090 7595 10770461 7805317 2965144 0.00600 22882 27519333 8853900 18665433 0.03820 4293 4293 0.00000 13 505980 505980 0.00100 10776 10776 0.00000 13 521049 521049 0.00100 1 8347210 2234045 98079114 127814917 -29735803 X 1 1 3 1 AH BERGAN MERCY MEDICAL CTR

7500 MERCY ROAD OMAHA NE 68124

X X X 2 AH MERCY HOSPITAL

800 MERCY DRIVE COUNCIL BLUFFS IA 51503

X X X 3 AH LASTING HOPE RECOVERY CTR

415 S 25TH AVENUE OMAHA NE 68131

X X X ALEGENT HEALTH BERGAN MERCY MEDICAL CTR 1 1 0 0 1 X X X X 1 1 X X X X X X X 1 X X 1 X X X X X X 1 X 0 0 ALEGENT HEALTH MERCY HOSPITAL 2 1 0 0 1 X X X X 1 1 X X X X X X X 1 X X 1 X X X X X X 1 X 0 0 ALEGENT HEALTH LASTING HOPE RECOVERY CTR 3 1 0 0 1 X X X X 1 1 X X X X X X X 1 X X 1 X X X X X X 1 X 0 0 3 ALEGENT HEALTH HOSPICE

7070 SPRING STREET OMAHA NE 68106

LICENSED HOSPICE ALEGENT HEALTH AT HOME

7070 SPRING STREET OMAHA NE 68106

HOME HEALTH AGENCY ALEGENT HEALTH HOSPICE

703 ROSARY DRIVE CORNING IA 50041

LICENSED HOSPICE PART I, LINE 3C: BERGAN MERCY HEALTH SYSTEM IS PART OF THE ALEGENT HEALTH SYSTEM. THE AMOUNT OF FINANCIAL ASSISTANCE WRITE-OFF FOR ENTITIES OF THE ALEGENT HEALTH SYSTEM ARE BASED ON A FINANCIAL ASSISTANCE SLIDING FEE SCHEDULE UTILIZING A DERIVATIVE OF THE CURRENT US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) VERY LOW INCOME GUIDELINES, WHICH ARE UPDATED YEARLY.ALL EFFORTS ARE MADE TO ESTABLISH WHETHER PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO SERVICE IF POSSIBLE, OTHERWISE AS SOON AS POSSIBLE FOLLOWING SERVICE. REPRESENTATIVES OF THE ALEGENT HEALTH SYSTEM HELP PATIENTS SEEK REIMBURSEMENT FROM LOCAL, STATE AND FEDERAL PROGRAMS AT NO CHARGE TO THE PATIENT. AFTER THESE EFFORTS AND RESOURCES HAVE BEEN EXHAUSTED, PATIENTS ARE ASSISTED IN THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE CONSISTENT WITH ALEGENT HEALTH'S FINANCIAL ASSISTANCE POLICY. THE APPLICATION PROCESS REQUIRES THAT THE PATIENT COMPLETE A PERSONAL FINANCIAL APPLICATION AND PROVIDE VERIFICATION DOCUMENTS. VERIFICATION INCLUDES EMPLOYMENT VERIFICATION AND OBTAINING DOCUMENTATION OF THE APPLICANT'S FINANCIAL CONDITION SUCH AS FEDERAL TAX RETURN, PAY STUB, NET WORTH AND/OR LIQUID ASSETS AND REASONABLE HOUSEHOLD OR BUSINESS EXPENSES. FINANCIAL ASSISTANCE MAY STILL BE GRANTED IN CERTAIN CIRCUMSTANCES INVOLVING A CATASTROPHIC OCCURRENCE RESULTING IN MEDICAL BILLS GROSSLY EXCEEDING THE PATIENT'S ABILITY TO PAY, AND IN THESE SITUATIONS, THE PATIENT'S RESPONSIBILITY WILL BE LIMITED TO 20% OF THE FAMILY'S GROSS ANNUAL INCOME.PART I, LINE 6A: THE ALEGENT HEALTH SYSTEM PRODUCES A PUBLIC COMMUNITY BENEFIT REPORT THAT IS MAILED TO A CORE CONSTITUENCY AND PLACED IN KEY PLACES THROUGHOUT THE ORGANIZATION. IT IS ALSO AVAILABLE ON THE COMPANY'S INTRANET SITE, AND ON ITS PUBLIC WEBSITE AT WWW.ALEGENT.COM. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WERE WORKSHEETS 1 - 8 PROVIDED WITH THE SCHEDULE H INSTRUCTIONS. THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE TOTAL COMMUNITY BENEFIT EXPENSE FOR CHARITY CARE. PART I, LINE 7G: ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM PROVIDES SUBSIDIZED HEALTH TO THE BROADER COMMUNITY VIA A NEONATIVE INTENSIVE CARE UNIT, HOME HEALTH AND HOSPICE CARE, AND BEHAVIORAL HEALTH SERVICES. PART I, L7 COL(F): BAD DEBT OF $29,267,917 INCLUDED IN THE FUNCTIONAL EXPENSE TOTAL PART IX, LINE 25 IS NOT INCLUDED IN THE TOTAL OPERATING EXPENSE USED TO CALCULATE THE TABLE 7 PERCENTAGES. THE DENOMINATOR USED TO CALCULATE THE COST TO CHARGE RATIO IS $487,729,314. PART II: AS A RESULT OF COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2006 WHICH POINTED TO CHILDHOOD OBESITY AS A SERIOUS HEALTH NEEDS ISSUE ACROSS ALL OMAHA COUNTIES SERVED, THE ALEGENT HEALTH SYSTEM PARTNERED WITH THE COMMUNITY AND MADE A MULTI-YEAR COMMITMENT TO IMPACT CHILDHOOD OBESITY THROUGH COMMUNITY BASED BEST PRACTICE INTERVENTIONS. THIS INITIATIVE HAS HAD A PRIMARY FOCUS OF IMPACT IN DOUGLAS COUNTY, BUT THE FUNDING TO UNDERWRITE HAS COME FROM THE FISCAL PERFORMANCE OF ALL ALEGENT HEALTH HOSPITALS. THE COMMUNITY COALITION KNOWN AS LIVE WELL OMAHA KIDS (LWOK) IS STAFFED AND FUNDED BY ALEGENT HEALTH. EXECUTIVE COMMITTEE, WHICH CONSISTS OF COMMUNITY LEADERS AND POLICY MAKERS, HAVE IMPLEMENTED AN ECOLOGICAL APPROACH THAT IMPROVES PROGRAMS, POLICIES AND PROMOTES PHYSICAL ACTIVITY AND HEALTHY EATING HABITS AT THE INDIVIDUAL AND ORGANIZATIONAL LEVELS. MORE THAN 200 VOLUNTEERS HAVE PARTICIPATED IN THE PLANNING AND IMPLEMENTATION OF LWOK INITIATIVES. A PORTION OF THIS INVESTMENT IN LWOK IS ALLOCATED TO THE ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. PART III, LINE 4: THE AUDITED FOOTNOTES FOR ENTITIES OF THE ALEGENT HEALTH SYSTEM DO NOT CONTAIN FOOTNOTES RELATED TO BAD DEBT EXPENSE. BAD DEBT EXPENSE IS IDENTIFIED ON THE CONSOLIDATED STATEMENT OF OPERATIONS WHICH IS CONSISTENT WITH THE REPORTING PRACTICE OF OTHER HEALTH CARE ORGANIZATIONS.BAD DEBT EXPENSE (AT COST) FOR ENTITIES OF ALEGENT HEALTH ARE DETERMINED BY USING THE COST TO CHARGE RATIO FROM MEDICARE COST REPORTS PER ENTITY AND MULTIPLYING THE RATIO BY THE ACTUAL BAD DEBT CHARGES PER ENTITY.TO DETERMINE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST)ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CAREPOLICY, REPRESENTATIVES OF THE ALEGENT HEALTH SYSTEM DETERMINE IF ANACCOUNT NEEDS TO BE MOVED FROM BAD DEBT TO CHARITY WHEN A PATIENT EITHERCOMES FORWARD AND COMPLETES A CHARITY APPLICATION, WHICH IS APPROVED OR IF IT IS DETERMINED THAT THE PATIENT HAS NO OTHER RESOURCES TO PAY THEACCOUNT BALANCE. PART III, LINE 8: THE ALEGENT HEALTH SYSTEM DOES NOT CONSIDER MEDICARE SHORTFALLS TO BE COMMUNITY BENEFIT, PER THE RECOMMENDATION OF THE CATHOLIC HEALTH ASSOCIATION. THE MEDICARE CHARGES REPORTED ON LINE 5 AND 6 ARE FROM MEDICARE COST REPORTS WHICH USE A COST TO CHARGE RATIO. PART III, LINE 9B: ALEGENT HEALTH'S SELF PAY BILLING AND BAD DEBT POLICY HAS A CLEARLY DELINEATED PROCESS FOR COLLECTION AGENCIES TO FOLLOW, INCLUDING EXPLICIT INSTRUCTIONS THAT ENSURE THE CHARITY CARE PATIENTS WHO HAVE BEEN IDENTIFIED DO NOT GO TO COLLECTIONS. ALEGENT HEALTH BERGAN MERCY MEDICAL CTR PART V, SECTION B, LINE 11H: SIZE OF FAMILY IS ALSO USED IN THE CALCULATION. ALEGENT HEALTH MERCY HOSPITAL PART V, SECTION B, LINE 11H: SIZE OF FAMILY IS ALSO USED IN THE CALCULATION. ALEGENT HEALTH LASTING HOPE RECOVERY CTR PART V, SECTION B, LINE 11H: SIZE OF FAMILY IS ALSO USED IN THE CALCULATION. ALEGENT HEALTH BERGAN MERCY MEDICAL CTR PART V, SECTION B, LINE 13G: INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS MADE AVAILABLE AT WWW.ALEGENT.COM AND THROUGH BROCHURES PROVIDED AT THE MAIN PATIENT REGISTRATION AREAS. LETTERS AND BILLING STATEMENTS SENT OUT TO PATIENTS INCLUDE A STATEMENT THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND HOW TO OBTAIN ADDITIONAL INFORMATION. COUNSELORS OF THE ALEGENT HEALTH SYSTEM ALSO DISSEMINATE INFORMATION ON THE FINANCIAL ASSISTANCE POLICY TO PATIENTS. ALEGENT HEALTH MERCY HOSPITAL PART V, SECTION B, LINE 13G: INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS MADE AVAILABLE AT WWW.ALEGENT.COM AND THROUGH BROCHURES PROVIDED AT THE MAIN PATIENT REGISTRATION AREAS. LETTERS AND BILLING STATEMENTS SENT OUT TO PATIENTS INCLUDE A STATEMENT THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND HOW TO OBTAIN ADDITIONAL INFORMATION. COUNSELORS OF THE ALEGENT HEALTH SYSTEM ALSO DISSEMINATE INFORMATION ON THE FINANCIAL ASSISTANCE POLICY TO PATIENTS. ALEGENT HEALTH LASTING HOPE RECOVERY CTR PART V, SECTION B, LINE 13G: INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS MADE AVAILABLE AT WWW.ALEGENT.COM AND THROUGH BROCHURES PROVIDED AT THE MAIN PATIENT REGISTRATION AREAS. LETTERS AND BILLING STATEMENTS SENT OUT TO PATIENTS INCLUDE A STATEMENT THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND HOW TO OBTAIN ADDITIONAL INFORMATION. COUNSELORS OF THE ALEGENT HEALTH SYSTEM ALSO DISSEMINATE INFORMATION ON THE FINANCIAL ASSISTANCE POLICY TO PATIENTS. PART VI, LINE 2: THE ALEGENT HEALTH SYSTEM APPROACHES COMMUNITY NEEDS ASSESSMENT AS A CORPORATE ACTIVITY THAT DEVELOPS AND INTEGRATES COUNTY BASED HEALTH PROFILES FOR EACH OF THE COUNTIES WHERE THE LICENSED HOSPITALS ARE LOCATED. THE PROCESS TO DEVELOP THE ASSESSMENTS IS COLLABORATIVE IN NATURE AND INVOLVES HEALTH DEPARTMENTS, EXISTING HEALTH COALITIONS, COMMUNITY MEMBERS AND HOSPITAL LEADERSHIP, AS IS SUPPORTED BY THE ALEGENT HEALTH PLANNING AND COMMUNITY BENEFIT DEPARTMENT STAFF. THE ALEGENT HEALTH PLANNING DEPARTMENT CONDUCTS MARKET ASSESSMENTS THAT IDENTIFY THE OMAHA METROPOLITAN STATISTICAL AREA'S POPULATION AND DEMOGRAPHIC CHARACTERISTICS. ADDITIONALLY, IN COOPERATION WITH LOCAL HEALTH DEPARTMENTS AND COALITIONS, THE ALEGENT HEALTH COMMUNITY BENEFIT/HEALTHIER COMMUNITY DEPARTMENT CONDUCTS AN ANNUAL REVIEW OF THE DOCUMENTED COMMUNITY HEALTH NEEDS AND PLANS OF EACH OF THE COMMUNITIES IT SERVES. THIS ASSESSMENT PROCESS INVOLVES SUMMARIZING EXISTING DATA AND RESEARCH FROM LOCAL HEALTH DEPARTMENT REPORTS AND LOCAL COALITION REPORTS INTO A COMPREHENSIVE SUMMARY GRID INCORPORATING A MULTITUDE OF FACTORS INCLUDING- DEMOGRAPHICS, HEALTH STATUS METRICS, BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY DATA, DOCUMENTED HEALTH ISSUES, QUALITATIVE INFORMATION FROM QUALITATIVE AND COMMUNITY BASED PROCESSES AND IDENTIFICATION OF ALEGENT HEALTH'S PARTICIPATION AND SPECIFIC STRATEGIC ACTION PLANS. THE PROFILES ARE INTEGRATED INTO THE GOVERNANCE AND PLANNING FOR ALEGENT HEALTH ON TWO LEVELS: I. REPORTING TO THE COMMITTEE OF THE BOARD OF DIRECTORS CHARGED WITH HEALTH PLANNING OVERSIGHTII. INTO THE ANNUAL STRATEGIC PLANNING PROCESSES OF ALEGENT HEALTH. PARTICULAR TO DOUGLAS COUNTY, WHICH BERGAN MERCY MEDICAL CENTER RESIDES, NEEDS ASSESSMENT AND REPORTING OF THOSE NEEDS IS LED BY LIVE WELL OMAHA, A MEMBERSHIP BASED COALITION. LIVE WELL OMAHA HAS BEEN IN EXISTENCE FOR 14 YEARS AND ALEGENT HEALTH WAS A FOUNDING MEMBER AND IS THE LARGEST FINANCIAL CONTRIBUTOR. THE ALEGENT HEALTH SYSTEM CONTINUES TO PROVIDE LEADERSHIP AND FUNDING FOR LIVE WELL OMAHA COALITION WHICH INCLUDES HEALTHCARE PROVIDERS, PUBLIC HEALTH, SERVICE PROVIDERS, INSURERS, BUSINESSES AND ACADEMIA WHO PARTICIPATE IN A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT CONSISTING OF PRIMARY AND SECONDARY DATA AND KEY INFORMANT INTERVIEWS. THE ASSESSMENT IS SHARED WITH THE PUBLIC THROUGH A REPORT CARD, AT AN ANNUAL COMMUNITY SUMMIT AND ON A COMMUNITY WEBSITE. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS USED BY THE COMMUNITY TO ASSESS HEALTH NEEDS AND IDENTIFY PARTNERSHIP OPPORTUNITIES FOR INTERVENTION. PART VI, LINE 3: THERE ARE SEVERAL FINANCIAL ASSISTANCE ACCESS POINTS THROUGHOUT A PATIENT'S CARE CYCLE. BILLS CONTAIN FINANCIAL ASSISTANCE VERBIAGE; SIGNS ARE POSTED IN CLINICS AND HOSPITAL, AND THERE IS INFORMATION ON FINANCIAL ASSISTANCE POSTED AT REGISTRATION POINTS THROUGHOUT CLINICS AND HOSPITALS. ADDITIONALLY, INFORMATION ON THE ALEGENT HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICIES ARE LOCATED AT WWW.ALEGENT.COM.REPRESENTATIVES OF THE ALEGENT HEALTH SYSTEM HELP PATIENTS SEEK REIMBURSEMENT FROM LOCAL, STATE AND FEDERAL PROGRAMS AT NO CHARGE TO THE PATIENT. AFTER THESE EFFORTS AND RESOURCES HAVE BEEN EXHAUSTED, PATIENTS ARE ASSISTED IN THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCECONSISTENT WITH THE ALEGENT HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICY. PART VI, LINE 4: ALEGENT HEALTH (SYSTEM) SERVES THE OMAHA METROPOLITAN STATISTICAL AREA (MSA), WITH AN ESTIMATED POPULATION OF 865,350, RANKING 60TH OUT OF 366 MSAS IN TOTAL POPULATION. THE MSA CONSISTS OF 3 IOWA AND 5 NEBRASKA COUNTIES ON BOTH SIDES OF THE MISSOURI RIVER. MORE THAN 1.2 MILLION PEOPLE LIVE WITHIN A 60-MILE RADIUS OF OMAHA. CHARACTERIZED BY STEADY GROWTH, THE MSA GREW BY 12.8 PERCENT BETWEEN 2000 AND 2010; THE 2015 PROJECTED POPULATION IS MORE THAN 900,000, A 5.5 PERCENT INCREASE. MORE THAN 36 PERCENT OF THE POPULATION IS 24 YEARS OF AGE OR YOUNGER WITH A MEDIAN AGE OF 34.9 YEARS COMPARED TO A U.S. MEDIAN AGE OF 37.1. 50.5% OF THE POPULATION IS FEMALE. RACIAL MINORITIES COMPRISE ABOUT 18 PERCENT OF GREATER OMAHA'S POPULATION, INCLUDING AN AFRICAN-AMERICAN POPULACE OF 7.9 PERCENT AND APPROXIMATELY 9.0 PERCENT HISPANIC. IN 2010 GREATER OMAHA HAD OVER 360,000 HOUSING UNITS. THE MEDIAN HOUSEHOLD INCOME IS $56,271 WHICH SURPASSES THE NATIONAL AVERAGE OF $51,517, WITH A PER CAPITA INCOME OF $27,876. GREATER OMAHA IS A WELL-EDUCATED COMMUNITY. MORE THAN 91 PERCENT OF ADULTS, AGE 25 AND OLDER, ARE HIGH SCHOOL GRADUATES AND 32.7 PERCENT HAVE A BACHELOR'S DEGREE OR HIGHER. PART VI, LINE 6: THE PRIMARY CARE PHYSICIAN CLINICS THAT ARE PART OF THE ALEGENT HEALTH SYSTEM PARTICIPATES IN MEDICAL STUDENT PRECEPTORSHIPS THAT ADVANCE THE HEALTHCARE PROVIDER EDUCATION PROCESS. THE ALEGENT HEALTH SYSTEM HAS OPEN MEDICAL STAFFS AND THE ALEGENT HEALTH SYSTEM IS ONE OF 3 HEALTH SYSTEMS THAT FUND THE OPERATIONS OF A COALITION THAT EXISTS TO PROVIDE ACCESS FOR THE PATIENTS OF 3 AREA FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS TO SPECIALTY PHYSICIAN SERVICES AND HOSPITAL BASED DIAGNOSTICS AND TREATMENT. THE ALEGENT HEALTH SYSTEM IS THE SOLE COMPREHENSIVE ACUTE MENTAL HEALTH PROVIDER IN THE OMAHA MSA AREA. THE ALEGENT HEALTH SYSTEM IS A JOINT VENTURE PARTNER IN A NOT-FOR-PROFIT HOSPICE INPATIENT HOSPITAL AND PROVIDES THE MANAGEMENT SUPPORT CONTRACT. THE ALEGENT HEALTH SYSTEM BUDGETS FOR AN EMERGENCY FUND AS A SUBSET OF OTHER COMMUNITY DONATIONS TO RESPOND TO CRISIS OR UNPLANNED FUNDING NEEDS OF A VITAL COMMUNITY SERVICE, WHICH WAS FIRST USED IN FY2010 WITH THE ECONOMIC DOWNTURN. THE ALEGENT HEALTH SYSTEM HAS A CURRENT COMMITMENT TO SET ASIDE UP TO 6% OF ITS EBIDA IN A GIVEN FISCAL YEAR FOR COLLABORATIVE INITIATIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES SERVED, WHICH IS THE CATALYST FUND. BOARD OF DIRECTORS - THE ALEGENT HEALTH SYSTEM IS GOVERNED BY A BOARD OF DIRECTORS PRIMARILY COMPRISED OF VOLUNTEER MEMBERS OF OUR LOCAL COMMUNITY WHO ARE LEADERS IN THE FIELDS OF BUSINESS, HEALTHCARE, ACCOUNTING AND MEDICINE AND UNDERSTAND THEIR ROLE IN PROVIDING STRONG CORPORATE GOVERNANCE. EMERGENCY DEPARTMENT - ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM HOSPITALS HAVE FULL-TIME EMERGENCY DEPARTMENTS THAT ARE OPEN TO THE PUBLIC AND PROVIDE MEDICAL SCREENING EXAMINATIONS AND STABILIZING TREATMENT WITHIN THE CAPABILITIES AND CAPACITY OF THE HOSPITALS REGARDLESS OF BUT NOT LIMITED TO THE PATIENT'S RACE, COLOR, SEX, AGE, AND/OR ABILITY TO PAY. THE HOSPITALS ARE IN COMPLIANCE WITH THE FEDERAL EMTALA REGULATIONS.IN ADDITION, ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM, TOGETHER WITH UNRELATED HOSPITALS IN THE AREA, WORKS CLOSELY WITH LOCAL FIRE AND RESCUE DEPARTMENTS TO ENSURE THAT AMBULANCES TAKE PATIENTS TO THE APPROPRIATE HOSPITAL. THIS IS GENERALLY THE HOSPITAL THAT IS CLOSEST GEOGRAPHICALLY WITH EXCEPTIONS BASED ON PATIENT PREFERENCE, PATIENT'S PHYSICIAN PREFERENCE, AND CAPACITY OR THE AVAILABILITY OF SPECIALIZED FACILITIES OR PROGRAMS RELATED TO THE PATIENT'S CONDITION. FINALLY, ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM MAINTAINS DETAILED PROCEDURES REGARDING WHEN AND UNDER WHAT CIRCUMSTANCES A PATIENT CAN BE TRANSFERRED. UNDER THIS POLICY, NO PATIENT WILL BE TRANSFERRED BASED ON RACE, CREED, RELIGION OR ABILITY TO PAY.MEDICAL STAFF - ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM MAINTAINS AN OPEN MEDICAL STAFF. ALL QUALIFIED MDS, DOS, OTHER HEALTHCARE PRACTITIONERS, AND MID-LEVEL PRACTITIONERS ARE ELIGIBLE TO APPLY FOR PRIVILEGES AT THE HOSPITALS. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM'S POLICY ON PHYSICIAN CREDENTIALING IS THAT NO INDIVIDUAL IS TO BE DENIED MEDICAL STAFF APPOINTMENT BASED ON SEX, RACE, CREED, COLOR OR NATIONAL ORIGIN. THE STANDARDS A PHYSICIAN MUST MEET FOR APPOINTMENT RELATE TO (1) EDUCATIONAL QUALIFICATIONS AND LICENSING; (2) PROFESSIONAL COMPETENCE, (3) CHARACTER, (4) ETHICAL STANDING, AND (5) ABILITY TO RELATE TO AND WORK WITH OTHERS. APPLICATIONS ARE REVIEWED AT SEVERAL LEVELS WITHIN THE ORGANIZATION. PHYSICIANS WHO HAVE BEEN GRANTED STAFF PRIVILEGES AUTOMATICALLY BECOME MEMBERS OF THE MEDICAL STAFF AT THE HOSPITAL(S) FOR WHICH PRIVILEGES HAVE BEEN GRANTED. PART VI, LINE 7: THE SENIOR LEADERSHIP OF THE INDIVIDUAL HOSPITALS ARE ENGAGED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS THAT IS CONDUCTED FROM THE CORPORATE OFFICES OF THE ALEGENT HEALTH SYSTEM (SEE PART VI-2/COMMUNITY NEEDS ASSESSMENT). THE HOSPITALS ARE INVOLVED IN SHARED BUDGET DECISION MAKING TO MEET THE PRIORITIZED COMMUNITY HEALTH NEEDS IN COLLABORATION WITH COMMUNITY PARTNERS. THE CORPORATE FUNCTION IS FUNDED FROM THE OPERATIONS OF THE INDIVIDUAL HOSPITALS TO LEVERAGE EXPERTISE AND TIME THAT IS FOCUSED ON PROMOTING HEALTH VERSUS ADDRESSING ACUTE CARE NEEDS. THE INDIVIDUAL HOSPITALS BECOME MORE INVOLVED IN SPECIFIC STRATEGIC RESPONSES THROUGH THE SERVICES THEY PROVIDE AND THEIR PARTICIPATION IN THE COALITIONS ACROSS THE ALEGENT HEALTH SERVICE AREA. PART VI, LINE 7: THE ALEGENT HEALTH SYSTEM FILES REPORTS WITH THE NEBRASKA HOSPITAL ASSOCIATION (NEBRASKA) AND IOWA HOSPITAL ASSOCIATION (IOWA). ADDITIONALLY, ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND ALEGENT HEALTH MERCY HOSPITAL, CORNING REPORT TO CATHOLIC HEALTH INITIATIVES, LOCATED IN COLORADO. 1 HARBOR HOUSE 12809 WEST DODGE ROAD OMAHA NE 68154 364003095 501(C)(3) 17490 GENERAL SUPPORT 1 SCHOLARSHIPS 24 11788 MERCY FUND DISTRIBUTIONS 42 13801 CHARITY CARE 15287 49107240 BOOK REDUCE OR WRITE OFF OF PATIENT SERVICES. PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES OR SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS. THE BERGAN MERCY AUXILIARY TEEN SCHOLARSHIP PROGRAM WAS SET UP IN 1986 BY BERGAN MERCY. THE PURPOSE OF THE SCHOLARSHIP PROGRAM IS TO PROVIDE COLLEGE SCHOLARSHIPS TO TEEN VOLUNTEERS WHO HAVE VOLUNTEERED THEIR SERVICES AT BERGAN MERCY MEDICAL CENTER. IN ORDER TO RECEIVE A SCHOLARSHIP IN THIS PROGRAM, THE APPLICANT MUST BE AN ACTIVE VOLUNTEER THROUGHOUT ALL THE YEARS THEY DO SERVICE, INCLUDING THEIR SENIOR YEAR. IF A STUDENT IS TO DROP OUT OF THE PROGRAM OR IS TO BE DISMISSED, THEY ARE NOT ELIGIBLE FOR THE SCHOLARSHIPS. MERCY FUND DISTRIBUTIONS ARE ESTABLISHED FOR THE DISBURSEMENT OF ALEGENT HEALTH BERGAN MERCY AUXILIARY MONIES FOR PATIENT ASSISTANCE THAT IS COMPLIANT WITH ALEGENT HEALTH POLICIES AND PROCEDURES, INTERNAL REVENUE SERVICE (IRS) REGULATIONS AND OTHER APPLICABLE FEDERAL, STATE, AND LOCAL LAWS AND REGULATIONS. OTHER INFORMATION: PART IV: ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELP 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. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM OCCASIONALLY DISTRIBUTES FUNDS TO OTHER 501(C)(3) ORGANIZATIONS. THESE DISTRIBUTIONS ARE MONITORED TO ENSURE THEY ARE BEING USED AS SPECIFIED BY THE ORGANIZATION. X 1 1 X X X X X 1 1 0 1 0 1 1 0 0 ANTHONY HATCHER DO 0 403550 0 0 0 27127 0 14700 0 18657 0 464034 0 0 RICHARD HACHTEN II 326819 338015 126098 130418 337401 348959 130233 134695 7391 7643 927942 959730 274415 283816 KENNETH LAWONN 139733 144521 52073 53857 26219 27118 59245 61275 7759 8025 285029 294796 0 0 SCOTT WOOTEN 166851 172568 62477 64618 36507 37758 58963 60983 9086 9397 333884 345324 0 0 JOAN NEUHAUS 157396 162787 47822 49459 25320 26187 159352 164811 2397 2479 392287 405723 0 0 RICK MILLER MD 51139 52891 0 0 1968 2036 188354 194807 3039 3143 244500 252877 0 0 JANE CARMODY 30451 31495 94832 98081 1779 1840 184073 190379 966 1000 312101 322795 0 0 LARRY BROWN MD 0 342646 0 8758 0 29447 0 27733 0 25249 0 433833 0 0 MARTIN HICKEY MD 173403 179343 68663 71014 113978 117883 90735 93844 11084 11462 457863 473546 60199 62261 MARIE KNEDLER 137198 141898 29700 30718 14698 15202 66279 68550 9068 9379 256943 265747 0 0 SHEREE KEELY 60192 62255 14547 15045 13428 13888 14364 14857 5535 5723 108066 111768 0 0 ELIZABETH LLEWELLYN 71188 73627 18157 18779 17576 18179 17810 18420 3803 3933 128534 132938 0 0 PATRICIA MASEK 65494 67738 15333 15858 10252 10602 25550 26426 7081 7325 123710 127949 0 0 FRANK EMSICK 74221 76764 18049 18668 10740 11108 14100 14583 9968 10310 127078 131433 0 0 PAUL EBMEIER 123546 127778 27451 28391 14593 15093 16272 16830 10672 11037 192534 199129 0 0 NANCY WALLACE 83943 86818 13803 14276 13500 13962 170272 176106 6469 6690 287987 297852 0 0 JOSEPH HOAGBIN MD 255860 0 0 0 11500 0 22050 0 9334 0 298744 0 0 0 ENEH OKORUWA MD 369651 0 31227 0 53409 0 14838 0 20535 0 489660 0 0 0 SRIRAMAMURTHY RAVIPATI MD 364410 0 0 0 30454 0 17150 0 23945 0 435959 0 0 0 UMAJYOTHI INDUKURI MD 364843 0 0 0 1614 0 4900 0 9091 0 380448 0 0 0 CHAKRAVARTHI PURETI MD 382995 0 0 0 20284 0 12250 0 942 0 416471 0 0 0 ANTONIO SAQUETON JR MD 347571 0 0 0 20911 0 12695 0 17738 0 398915 0 0 0 WAYNE SENSOR 832 860 0 0 1109381 1147386 0 0 6972 7211 1117185 1155457 1107956 1145913 THEODORE SCHWAB 0 0 0 0 114150 118060 618 640 0 0 114768 118700 114150 118060 FRED HOSLER MD 1247 1291 0 0 395168 408706 0 0 3600 3723 400015 413720 390471 403848 MARGARET BREEN 0 0 0 0 134737 139353 334 345 2343 2423 137414 142121 134737 139353 DAVID TEW 0 0 0 0 88492 91523 658 680 0 0 89150 92203 88492 91523 AMY PROTEXTER 0 0 0 0 122559 126758 977 1010 3837 3969 127373 131737 122559 126758 PATRICIA NADLE 29472 30482 24561 25403 67675 69993 0 0 2687 2778 124395 128656 62678 64826 MARK KESTNER MD 2495 2581 0 0 269736 278977 396 409 3274 3385 275901 285352 266251 275372 MICHAEL ANDERSON 0 0 0 0 78843 81544 0 0 0 0 78843 81544 78843 81544 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. SOME OF THE BENEFITS AVAILABLE FOR ELECTION INCLUDE HEALTH CLUB DUES, AUTOMOBILE ALLOWANCE, FINANCIAL PLANNING FEES AND LEGAL FEES. PAYMENT FOR THESE BENEFITS ARE EITHER MADE DIRECTLY BY ALEGENT HEALTH OR REIMBURSED TO THE EXECUTIVE AFTER THE APPROPRIATE SUBSTANTIATION FOR THE EXPENSE IS PROVIDED. THE AMOUNT PAID FOR THESE BENEFITS IS INCLUDED IN THE EXECUTIVE'S WAGES AS TAXABLE INCOME. PART I, LINES 4A-B THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS AS EXECUTIVES OF ALEGENT HEALTH (A RELATED ORGANIZATION) DURING THE 2010 CALENDAR YEAR AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE AS COMPENSATION ON SCHEDULE J: DAVID TEW - $180,015 THEODORE SCHWAB - $232,210 WAYNE SENSOR - $2,253,869 FRED HOSLER, MD - $794,319 MARGARET BREEN - $274,090 AMY PROTEXTER - $249,317 MARK KESTNER, MD - $541,623 MARTIN HICKEY, MD - $122,460 PATRICIA NADLE - $127,504 MICHAEL ANDERSON - $160,387 RICHARD HACHTEN - $558,231 PART I, LINE 4B: THE FOLLOWING REPORTABLE INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FROM ALEGENT HEALTH (A RELATED ORGANIZATION) DURING THE 2010 CALENDAR YEAR. AMOUNTS DEFERRED FROM THE PLAN WERE INCLUDED IN COLUMN C OF THE SCHEDULE J FOR THE FOLLOWING INDIVIDUALS: RICHARD HACHTEN II - $116,268 SCOTT WOOTEN - $48,613 JANE CARMODY - $3,877 NANCY WALLACE - $13,759 RICK MILLER, MD - $9,841 LARRY BROWN, MD - $12,411 KENNETH LAWONN - $39,892 JOAN NEUHAUS - $41,947 MARIE KNEDLER - $22,238 SHEREE KEELY - $10,915 ELIZABETH LLEWELLYN - $12,916 PATRICIA MASEK - $10,956 FRANK EMSICK - $11,534 PAUL EBMEIER - $20,451 MARTIN HICKEY, MD - $50,630. PART I, LINE 5 PHYSICIANS EMPLOYED BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM ARE ELIGIBLE FOR QUARTERLY PRODUCTIVITY BONUSES BASED ON INDIVIDUAL QUALITY MANAGEMENT, WHICH INCLUDE CORE MEASURES, REVENUE, PHYSICIAN REFFERAL AND ATTENDANCE AT MEETINGS. THE CORE MEASURES USED TO DETERMINE THE PHYSICIAN BONUSES ARE NATIONALLY ACCEPTED MEASURES OF PHYSICIAN PRODUCTIVITY. PART I, LINE 6 COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. MEMBERS OF ALEGENT HEALTH MANAGEMENT ARE ELIGIBLE FOR AN ANNUAL INCENTIVE BONUS. INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE MEASURES. ONE OF THE FOUR SYSTEM PERFORMANCE GOALS IS DEPENDENT ON THE FINANCIAL RESULTS OF THE ENTIRE ALEGENT HEALTH SYSTEM FOR THE FISCAL YEAR. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART I, LINE 3: ALEGENT HEALTH GOVERNANCE OF EXECUTIVE COMPENSATION: ACTING AS PRUDENT STEWARDS OF ITS FINANCIAL RESOURCES, THE ALEGENT HEALTH BOARD COMPENSATION COMMITTEE RECOMMENDS AND THE BOARD EXECUTIVE COMMITTEE APPROVES EXECUTIVE COMPENSATION PHILOSOPHY, POLICY AND GUIDELINES. IT DOES SO WITH THE OBJECTIVE OF ATTRACTING AND RETAINING TOP EXECUTIVE TALENT TO ENSURE ALEGENT HEALTH IS ABLE TO FULFILL ITS FAITH-BASED MISSION AND ACHIEVE ITS VISION OF BECOMING WORLD-CLASS. THE ALEGENT HEALTH COMPENSATION COMMITTEE FOLLOWS A THOROUGH AND INTENTIONAL PROCESS THAT INCLUDES CONSULTATION WITH INDEPENDENT, EXPERT COUNSEL AND CAREFULLY COMPARES COMPENSATION LEVELS TO MARKET-BASED COMPENSATION OF SIMILAR SIZED, NON-PROFIT AND FOR-PROFIT HEALTH SYSTEMS AND ALSO UTILIZES A BLEND OF 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. SCHEDULE J, PART II: THE ALEGENT HEALTH EXECUTIVES HAVE A PROVISION IN THEIR COMPENSATION AGREEMENT THAT PROVIDES FOR POTENTIAL SEVERANCE PAYMENTS IN THE EVENT OF TERMINATION WITHOUT CAUSE OR CHANGE OF CONTROL. THE AMOUNT OF SEVERANCE AN EXECUTIVE MAY OR MAY NOT RECEIVE IF TERMINATED ACCORDING TO THE COMPENSATION AGREEMENT IS INCLUDED AS DEFERRED COMPENSATION IN COLUMN C. MICHAEL DEFREECE-BOARD MEMBER H-CARD,LLC - OFFICER 159604 SUPPLIER PAYMENT NETWORK 0 FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF THE ALEGENT HEALTH SYSTEM ARE MADE BY ALEGENT HEALTH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT HEATLH-BERGAN MERCY HEALTH SYSTEM. ALEGENT 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 HEALTH ON BEHALF OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 2 ANTOINETTE HARDY-WALLER AND PAUL EDGETT III - BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM IS CATHOLIC HEALTH INITIATIVES. CATHOLIC HEALTH INITIATIVES DOES NOT HAVE ANY VOTINGS RIGHTS AS A MEMBER OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. INSTEAD CATHOLIC HEALTH INITIATIVES ELECTS 50% OF THE DIRECTORS OF ALEGENT HEALTH. FORM 990, PART VI, SECTION A, LINE 7A THE BUSINESS AND AFFAIRS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM ARE MANAGED BY OR UNDER THE DIRECTION OF THE ALEGENT HEALTH BOARD OF DIRECTORS, AND ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM DELEGATES TO THE ALEGENT BOARD OF DIRECTORS, TO THE EXTENT PERMITTED BY LAW, COMPLETE GOVERNANCE AUTHORITY OVER IT, SUBJECT ONLY TO THE APPROVAL POWERS OF THE ALEGENT CORPORATE MEMBERS SET FORTH IN THE ARTICLES OF INCORPORATION AND BYLAWS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. DIRECTORS SHALL BE APPOINTED BY THE ALEGENT BOARD IMMEDIATELY FOLLOWING THE APPOINTMENT AND RATIFICATION BY ALEGENT CORPORATE MEMBERS OF THE ALEGENT DIRECTORS PURSUANT TO THE ARTICLES OF INCORPORATION AND BYLAWS OF ALEGENT. THE ALEGENT BOARD SHALL APPOINT DIRECTORS SUCH THAT, AT ALL TIMES , ALL OF THE PERSONS SERVING AS ALEGENT DIRECTORS ALSO SHALL BE SERVING AS DIRECTORS OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS SHALL BE EFFECTIVE ONLY IF APPROVED BY THE ALEGENT BOARD AND BY BOTH IMMANUEL HEALTH SYSTEMS (IHS) AND CATHOLIC HEALTH INITIATIVES (CHI) IN THEIR CAPACITIES AS ALEGENT CORPORATE MEMBERS: A. ADOPTION OR AMENDMENT OF THE UNFIIED PHILOSOPHY AND MISSION OF THE CORPORATION; B. SALE, LEASE, TRANSFER, ENCUMBRANCE OR DISPOSITION OF THE TANGIBLE PROPERTY OR INVESTMENTS OF THE CORPORATION HAVING A FAIR MARKET VALUE IN ANY INDIVIDUAL TRANSACTION IN EXCESS OF $3 MILLION OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS, PROVIDED THAT TRANSFERS OF INVESTMENTS BETWEEN THE CORPORATION AND ANOTHER PARTICIPANT SHALL NOT REQUIRE THE APPROVAL OF CHI AND IHS; AND PROVIDED FURTHER THAT APPROVAL OF CHI AND IHS SHALL NOT BE REQUIRED FOR ANY TRANSFER OF ASSETS TO CHI BY THE CORPORATION PURSUANT TO THE TERMS OF THE ALEGENT FINANCING AGREEMENT (AFA); C. INCURRENCE, ASSUMPTION OR GUARANTY BY THE CORPORATION IN ANY INDIVIDUAL TRANSACTION OF LONG-TERM INDEBTEDNESS, INCLUDING CAPITAL LEASES, OUTSTANDING FOR MORE THAN 365 DAYS, IN EXCESS OF THE GREATER OF $2 MILLION OR 2% OF THE TOTAL LONG-TERM INDEBTEDNESS OF ALL THE PARTICIPANTS, OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; D. MERGER, DISSOLUTION, CONSOLIDATION OR SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION EXCEPT FOR A MERGER IN WHICH (I) THE CORPORATION IS THE SURVIVING ENTITY, AND (II) THE TOTAL BOOK VALUE OF THE ASSETS OF THE MERGING ENTITY DOES NOT EXCEED 2% OF THE TOTAL BOOK VALUE OF THE ASSETS OF ALL THE PARTICIPANTS, OR SUCH GREATER VALUE AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; AND E. NOTWITHSTANDING ANY OTHER PROVISIONS IN THE BYLAWS TO THE CONTRARY. THE ACTIONS THAT CAN BE TAKEN WITHOUT THE APPROVAL OF IHS AND CHI INCLUDE, WITHOUT LIMITATION: (I) TERMINATION OF THE AFA IN ACCORDANCE WITH ITS TERMS. (II) FORMATION OF THE UNIFIED ALEGENT HEALTH SYSTEM (AS THAT TERM IS DEFINED IN THE AFA) (III) PREPAYMENT BY THE CORPORATION OF THE FULL AMOUNTS OUTSTANDING ON ITS NOTES TO CHI UNDER THE AFA, FOR PURPOSES OF EXERCISING THE RIGHTS OF TERMINATION OF THE AFA, OR FORMATION OF THE UNIFIED ALEGENT HEALTH SYSTEM CREDIT, AND THE TAKING OF ALL ACTIONS NECESSARY OR APPROPRIATE TO OBTAIN FUNDING OR OTHERWISE MAKE ARRANGEMENTS TO PREPAY SUCH NOTES INCLUDING WITHOUT LIMITATION INCURRENCE OF INDEBTEDNESS NECESSARY OR APPROPRIATE TO PREPAY THE NOTES OUTSTANDING. FORM 990, PART VI, SECTION B, LINE 11 TAX RETURNS FOR ENTITIES OF THE ALEGENT HEALTH SYSTEM ARE PREPARED BY THE SYSTEM TAX DEPARTMENT. FOLLOWING THE PREPARATION OF ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM FORM 990 BY INTERNAL TAX STAFF, THE RETURN IS REVIEWED BY THE TAX DIRECTOR, EXTERNAL TAX ADVISOR AND THE CHIEF FINANCIAL OFFICER. THE FINAL TAX RETURN IS POSTED ON THE ELECTRONIC DIRECTOR'S PORTAL TO BE REVIEWED BY THE BOARD OF DIRECTORS 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 ANY QUESTIONS THE COMMITTEE MAY HAVE. ADDITIONALLY, THE BOARD OF DIRECTORS ARE REFERRED TO THE ALEGENT HEALTH TAX DIRECTOR IF THEY HAVE QUESTIONS AND THE BOARD IS NOTIFIED THAT THE FINAL FORM 990, WILL BE FILED ON MAY 15, 2012. FORM 990, PART VI, SECTION B, LINE 12C WRITTEN CONFLICT OF INTEREST POLICY - ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM HAS ADOPTED THE CONFLICT OF INTEREST POLICY AND CONFLICT INVESTIGATION PROCESS OF ALEGENT HEALTH, THE PARENT CORPORATION OF THE ALEGENT HEALTH SYSTEM. ANNUAL COMPLETION OF THE DISCLOSURE STATEMENT IS REQUIRED BY THE BOARD OF DIRECTORS. STATED DISCLOSURES ARE INVESTIGATED BY THE ALEGENT HEALTH COMPLIANCE OFFICER AND REPORTED TO THE CONFLICTS OF INTEREST COMMITTEE. THE CONFLICTS OF INTEREST COMMITTEE REVIEWS THE INVESTIGATION AND MAKES RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE MAKES THE FINAL DETERMINATION OF WHETHER OR NOT THERE IS A DISQUALIFYING EVENT AND COMMUNICATES IT TO THE BOARD OF DIRECTORS. AT ANY TIME A BOARD MEMBER OR KEY EMPLOYEE MAY DECLARE A CONFLICT OF INTEREST AND RECUSE HIS/HERSELF FROM THE DISCUSSION. THE INDIVIDUAL IS ALSO REQUIRED TO DISCLOSE ANY KNOWN OR POSSIBLE CONFLICTS OF INTEREST THAT ARISE DURING THE CALENDAR YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNING BOARD ENGAGED THE SERVICES OF AN INDEPENDENT CONSULTING FIRM THAT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT THAT IS QUALIFIED TO AND REGULARLY PERFORMS EXECUTIVE AND OFFICER COMPENSATION STUDIES. THE CONSULTING FIRM CONDUCTED A REVIEW AND ANALYSIS OF THE TOTAL COMPENSATION PAID TO THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, BASED ON COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS AND DETERMINED THAT THE COMPENSATION WAS REASONABLE. THE CONSULTING FIRM ISSUED AN OPINION LETTER AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PAID TO EMPLOYEES IDENTIFIED AS DISQUALIFIED PERSONS. THE OPINION LETTER SETTING FORTH THE FINDINGS WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE GOVERNING BOARD. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS WERE MAINTAINED. THIS PROCESS WAS USED FOR THE FOLLOWING EMPLOYEES: PRESIDENT AND CHIEF EXECUTIVE OFFICER SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER CHIEF EXECUTIVE OFFICER ALEGENT HEALTH CLINIC SENIOR VICE PRESIDENT ALEGENT HEALTH SYSTEM CHIEF OPERATIONS OFFICER SENIOR VICE PRESIDENT STRATEGY AND TECHNOLOGY (F/K/A CIO) VICE PRESIDENT OPERATIONS (BERGAN MERCY & MERCY) VICE PRESIDENT OPERATIONS (IMMANUEL) VICE PRESIDENT OPERATIONS (LAKESIDE) VICE PRESIDENT OPERATIONS (MIDLANDS) MEDICAL DIRECTORS FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY IS MADE AVAILABLE TO THE PUBLIC ON THE WEBSITE AT WWW.ALEGENT.COM. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM DOES NOT MAKE THE FINANCIAL STATEMENTS OR GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. HOWEVER, THE ARTICLES OF INCORPORATION ARE AVAILABLE AT WWW.SOS.STATE.NE.US. PART VII, SECTION A: EXECUTIVES OF THE ALEGENT 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 HEALTH SYSTEM: RICHARD HACHTEN II, SCOTT WOOTEN, KENNETH LAWONN, JOAN NEUHAUS, RICHARD ROLSTON, MD, RICK MILLER, MD, JANE CARMODY, MARIE KNEDLER, SHEREE KEELY, ELIZABETH LLEWELLYN, PATRICIA MASEK, FRANK EMSICK, PAUL EBMEIER, MARTIN HICKEY, MD AND NANCY WALLACE. THEREFORE, THEIR AVERAGE NUMBER OF HOURS WORKED PER WEEK FOR THE AFFILAITE ORGANIZATIONS ARE 31. LARRY BROWN, MD IS ALSO AN EXECUTIVE OF THE ALEGENT HEALTH SYSTEM, HOWEVER HIS HOURS ARE SPLIT BETWEEN TWO AFFILIATED ORGANIZATIONS. AVERAGE HOURS PER WEEK FOR AFFILAITE ORGANIZATIONS IS 60. ANTHONY HATCHER, MD IS AN EMPLOYED PHYSICIAN OF THE ALEGENT HEALTH SYSTEM AND HIS HOURS ARE SPLIT BETWEEN THE FILING ORGANIZATION AND AFFILIATE ORGANIZATIONS OF THE SYSTEM. AVERAGE HOURS PER WEEK FOR AFFILIATE ORGANIZATIONS ARE 54. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 19,624,748. PRIOR PERIOD ADJUSTMENTS: -3,257,775. OTHER MISCELLANEOUS CHANGES 172,813. CHANGES IN UNRESTRICTED ASSETS OF ALEGENT HEALTH 45,395,000. TRANSFERS TO AFFILIATED ENTITIES -39,359,000. JOA CAPITAL ADJUSTMENT 17,406,000. TEMP RESTRICTED CHANGES IN ALEGENT HEALTH 455,000. TOTAL TO FORM 990, PART XI, LINE 5: 40,436,786. FORM 990, PART I, LINE 5 AND PART V, LINE 2A: THE EMPLOYEES LISTED IN PART I, LINE 5 AND PART V, LINE 2A ARE EMPLOYED BY ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. HOWEVER, THROUGH A COMMON PAY AGENT AGREEMENT, THE EMPLOYEES ARE PAID BY ALEGENT HEALTH AND PAYROLL EXPENSES ARE ALLOCATED TO ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 16: ALEGENT HEALTH HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, ALEGENT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSE IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNER'S RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. REASON FOR AMENDED FORM 990 PART VII, SECTION A, SCHEDULE J, PART I, LINE 4A AND SCHEDULE J, PART II THE AMENDMENT OF THE JUNE 30, 2011 FORM 990 IS DUE TO A CORRECTION OF SEVERANCE PAYMENTS TO MR. RICHARD HACHTEN II. ON APRIL 17, 2009, MR. HACHTEN WAS SEPARATED FROM EMPLOYMENT AS THE PRESIDENT FOR "GOOD REASON," AS DESCRIBED IN HIS EMPLOYMENT AGREEMENT WITH ALEGENT HEALTH. ON OCTOBER 19, 2009, MR. HACHTEN WAS REHIRED BY ALEGENT HEALTH AS THE CEO/PRESIDENT. AT THE TIME OF HIS SEPARATION, MR. HACHTEN WAS ENTITLED TO RECEIVE SEVERANCE PAY AND RETIREMENT BENEFITS. MR. HACHTEN'S 2010 TAXABLE INCOME SHOULD HAVE INCLUDED ADDITIONAL SEVERANCE PAY ACCORDING TO HIS EMPLOYMENT AGREEMENT WITH ALEGENT HEALTH, THEREFORE, HE WAS ISSUED AMENDED W-2C'S TO CORRECTLY REPORT TAXABLE INCOME. THE FORM 990 HAS BEEN AMENDED TO REFLECT THE COMPENSATION REPORTED ON THE FORM W-2C FOR MR. HACHTEN. THE AMENDMENT AFFECTS PAGES 7, 8, 61 AND 64 OF THIS FORM 990. PART VI, SECTION B, LINE 11: THE AMENDED FORM 990 HAS BEEN PROVIDED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS THROUGH AN ELECTRONIC PORTAL FOR REVIEW PRIOR TO FILING. THE TAX DIRECTOR AND CHIEF FINANCIAL OFFICER WERE PRESENT AT THE COMMITTEE AND BOARD OF DIRECTOR'S MEETING TO ANSWER QUESTIONS ABOUT THE AMENDMENT. 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