CHI HEALTH FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CHI HEALTH FOUNDATION (EIN 47-0648586)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201341349349300854
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
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 | 470648586 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT HEALTH FOUNDATION MERCY HOSPITAL | 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 | 4023434413 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT HEALTH FOUNDATION | BusinessNameLine1 |
| 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 | 3817954 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ALEGENTCREIGHTON.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1982 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | SUPPORT THE HEALTHCARE MINISTRY OF ALEGENT HEALTH | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 10 | TotalNbrEmployees |
| Total Nbr Volunteers | 71 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1084639 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1919032 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 822421 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1035500 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 955112 | InvestmentIncomePriorYear |
| Investment Income Current Year | 697362 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4692 | OtherRevenuePriorYear |
| Other Revenue Current Year | 15482 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2866864 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3667376 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 775941 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 378165 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 545223 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 604982 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 995154 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 292028 | OtherExpensePriorYear |
| Other Expenses Current Year | 478478 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1613192 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1461625 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1253672 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2205751 | RevenuesLessExpensesCY |
| Total Assets BOY | 15730371 | TotalAssetsBOY |
| Total Assets EOY | 15792860 | TotalAssetsEOY |
| Total Liabilities BOY | 2059562 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 345030 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 13670809 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 15447830 | 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 | 322567 | Expense |
| Grants | 322567 | Grants |
| Revenue | 963015 | Revenue |
| Description | ALEGENT HEALTH FOUNDATION DISTRIBUTED $322,567 TO ALEGENT CREIGHTON HEALTH SERVICE LINES, LAKESIDE HOSPITAL AND MIDLANDS HOSPITAL DURING FISCAL YEAR 2012. THE FOUNDATION PROVIDED SUPPORT IN FOUR PRIMARY AREAS: (1) MISSION INTEGRATION PROGRAMS FOR HEALTHIER COMMUNITIES AND FAITH-BASED HEALTH EDUCATION PROGRAMS; (2) PROFESSIONAL DEVELOPMENT AND SCHOLARSHIPS; (3) GENERAL OPERATING SUPPORT; AND (4) BEHAVIORAL SERVICE PROGRAMS AND EQUIPMENT. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 17759 | Expense |
| Grants | 17759 | Grants |
| Revenue | 51775 | Revenue |
| Description | ALEGENT HEALTH FOUNDATION DISTRIBUTED $17,759 TO BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL-COUNCIL BLUFFS IN FISCAL YEAR 2012. THE FOUNDATION PROVIDED SUPPORT IN THREE PRIMARY AREAS: (1) PROFESSIONAL DEVELOPMENT; (2) ORTHOPEDICS EQUIPMENT; AND (3) ONCOLOGY SERVICES PATIENT ASSISTANCE PROGRAMS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 9323 | Expense |
| Grants | 9323 | Grants |
| Revenue | 20710 | Revenue |
| Description | ALEGENT HEALTH FOUNDATION SUPPORTS THE HEALTHCARE MINISTRY OF ALEGENT CREIGHTON HEALTH SYSTEM. THE FOUNDATION DISTRIBUTED $9,323 TO IMMANUEL MEDICAL CENTER AND RELATED FACILITIES DURING FISCAL YEAR 2012. THE FOUNDATION PROVIDED SUPPORT IN THREE PRIMARY AREAS: (1) CAPITAL CONSTRUCTION AND RENOVATION PROJECTS; (2) GENERAL OPERATING SUPPORT; AND (3) REHABILITATION CENTER EQUIPMENT AND PROGRAMS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 28547 | Expense |
| Grants | 28516 | Grants |
| Revenue | 0 | Revenue |
| Description | IN ADDITION TO SUPPORTING ALEGENT CREIGHTON HEALHT, ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM AND ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ; ALEGENT HEALTH FOUNDATION ALSO GRANTS SCHOLARSHIPS TO QUALIFIED RECIPIENTS AND ACTIVELY ENCOURAGES, RECEIVES AND MANAGES INDIVIDUAL GIFTS, BEQUEST, MEMORIAL, PLANNED OR DEFERRED GIFTS AND CONTRIBUTIONS SUCH AS REAL ESTATE AND OTHER PROPERTY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 28547 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 28516 | TotalOfOtherProgramServiceGrnt |
| Total Program Service Expense | 378196 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 1 | 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 | 1 | 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 | 1 | 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 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 10 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| 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 | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | 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 | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | 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 W 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 (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JOANNE JARVIS | ||||||
| CHAIR | 2.00 | X | X | 0 | 0 | 0 |
| DAN MCKINNEY MD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| THOMAS BELFORD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| THERESA BARRON-MCKEAGNEY PHD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| MATHEW GRONSTAL | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| PATRICK TUCKER | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| BILL BEAVERS | ||||||
| SECRETARY/TREASURER | 2.00 | X | X | 0 | 0 | 0 |
| ALLEN DVORAK MD | ||||||
| VICE CHAIR | 2.00 | X | X | 0 | 0 | 0 |
| PAUL STRAWHECKER | ||||||
| CHIEF DEVELOPMENT OFFICER | 60.00 | X | 0 | 80348 | 330709 | |
| RICHARD HACHTEN II | ||||||
| ACH PRESIDENT & CEO | 2.00 | X | 0 | 1726160 | 297951 | |
| SCOTT WOOTEN | ||||||
| ACH SVP/CFO | 2.00 | X | 0 | 707918 | 134300 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2514426 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 762960 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 159991 | FundraisingEvents |
| Related Organizations | 282598 | RelatedOrganizations |
| All Other Contributions | 1476443 | AllOtherContributions |
| Noncash Contributions | 49385 | NoncashContributions |
| Total Contributions | 1919032 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ADMIN REIMBURSEMENT | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 1035500 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1035500 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1035500 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 384735 | TotalRevenueColumn |
| Exclusion | $384,735 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 312627 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 312627 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 312627 | TotalRevenueColumn |
| Exclusion | $312,627 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 154990 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 159991 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 142824 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12166 | TotalRevenueColumn |
| Exclusion | $12,166 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 11070 | GrossIncomeGaming |
| Gaming Direct Expenses | 7754 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3316 | TotalRevenueColumn |
| Exclusion | $3,316 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3667376 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1035500 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $712,844 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350215 | Total |
| Program Services | 350215 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27950 | Total |
| Program Services | 27950 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 526655 | Total |
| Management And General | 21066 | ManagementAndGeneral |
| Fundraising | 505589 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37522 | Total |
| Management And General | 1501 | ManagementAndGeneral |
| Fundraising | 36021 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40805 | Total |
| Management And General | 1632 | ManagementAndGeneral |
| Fundraising | 39173 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31 | Total |
| Program Services | 31 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48526 | Total |
| Management And General | 48526 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75637 | Total |
| Management And General | 3025 | ManagementAndGeneral |
| Fundraising | 72612 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30884 | Total |
| Fundraising | 30884 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2961 | Total |
| Management And General | 2961 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12808 | Total |
| Fundraising | 12808 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6398 | Total |
| Fundraising | 6398 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9564 | Total |
| Management And General | 9564 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | FundraisingFundraising |
|---|---|---|
| PURCHASED SERVICES | 183608 | 183608 |
| TAXES AND LICENSES | 65041 | 65041 |
| OTHER | 43020 | 43020 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1461625 | Total |
| Program Services | 378196 | ProgramServices |
| Management And General | 88275 | ManagementAndGeneral |
| Fundraising | 995154 | Fundraising |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 944352 | BOY |
| EOY | 780877 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 122871 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 77759 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54676 | BOY |
| EOY | 45112 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14731343 | BOY |
| EOY | 14966871 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15730371 | BOY |
| EOY | 15792860 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6934 | BOY |
| EOY | 5948 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2052628 | BOY |
| EOY | 339082 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2059562 | BOY |
| EOY | 345030 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4961093 | BOY |
| EOY | 5709134 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5128053 | BOY |
| EOY | 6157033 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3581663 | BOY |
| EOY | 3581663 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13670809 | BOY |
| EOY | 15447830 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15730371 | BOY |
| EOY | 15792860 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2205751 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -428730 | 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) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2687943 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2801079 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2085015 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1084639 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1372827 | CurrentTaxYear |
| Total | 10031503 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2687943 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2801079 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2085015 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1084639 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1372827 | CurrentTaxYear |
| Total | 10031503 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 317039 | AmountsSubstContributorsTotal |
| Public Support Total170 | 9714464 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 188347 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 102384 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 264036 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 379184 | CurrentTaxYearMinus1Year |
| Current Tax Year | 384735 | CurrentTaxYear |
| Total | 1318686 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 4692 | CurrentTaxYearMinus1Year |
| Current Tax Year | 35485 | CurrentTaxYear |
| Total | 40177 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 11390366 | TotalSupport |
| Gross Receipts From Admissions Etc | 6242499 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.85290 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.81050 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | 0 | PoliticalExpenditures |
| Volunteer Hours | 0 | VolunteerHours |
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $31 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 31 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8709716 | BeginningOfYearBalance |
| Contributions | 1489425 | Contributions |
| Investment Earnings Or Losses | 90735 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 27950 | GrantsOrScholarships |
| Other Expenditures | 523230 | OtherExpenditures |
| End Of Year Balance | 9738696 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7799364 | BeginningOfYearBalance |
| Contributions | 743105 | Contributions |
| Investment Earnings Or Losses | 945736 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 13283 | GrantsOrScholarships |
| Other Expenditures | 765206 | OtherExpenditures |
| End Of Year Balance | 8709716 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6884246 | BeginningOfYearBalance |
| Contributions | 892471 | Contributions |
| Investment Earnings Or Losses | 606317 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 19993 | GrantsOrScholarships |
| Other Expenditures | 563677 | OtherExpenditures |
| End Of Year Balance | 7799364 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7744172 | BeginningOfYearBalance |
| Contributions | 1259786 | Contributions |
| Investment Earnings Or Losses | -901726 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 7750 | GrantsOrScholarships |
| Other Expenditures | 1210236 | OtherExpenditures |
| End Of Year Balance | 6884246 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.37000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.63000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26803 | OtherCostOrOtherBasis |
| Depreciation | 15860 | Depreciation |
| Book Value | 10943 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 96068 | OtherCostOrOtherBasis |
| Depreciation | 61899 | Depreciation |
| Book Value | 34169 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 45112 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTERCOMPANY LIABILITIES | Description |
| Amount | $339,082 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 339082 | TotalOfAmounts |
| Total Revenue | 3667376 | TotalRevenue |
| Total Expenses | 1461625 | TotalExpenses |
| Excess Or Deficit For Year | 2205751 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -417922 | NetUnrealizedGLOnInvestments |
| Other | -$10,808 | OtherAmount |
| Total Adjustments | -428730 | TotalAdjustments |
| Excess Or Deficit Per FS | 1777021 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ENDOWMENT FUNDS ARE HELD TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF ALEGENT CREIGHTON HEALTH, ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM & ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | TEMPORARY NET ASSETS RELEASED FROM RESTRICTIONS -10,808. | |
| PART X, LINE 2 - ALL RELATED ENTITIES HAVE BEEN RECOGNIZED AS NOT-FOR-PROFIT CORPORATIONS BY THE INTERNAL REVENUE SERVICE AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT THE PARTNERSHIP SPECIFICALLY LISTED. ALEGENT RECOGNIZES 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 2012 AND 2011, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | JEWELS OF AUTUMN | NameOfEvent1 |
| Gross Receipts Event1 | 186440 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 104559 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 81881 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 0 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 46481 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 2834 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 15745 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 500 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 4837 | OtherDirectExpensesEvent1 |
| Name Of Event2 | EVENING WITH FRIENDS | NameOfEvent2 |
| Gross Receipts Event2 | 67091 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 27442 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 39649 | GrossRevenueEvent2 |
| Cash Prizes Event2 | 0 | CashPrizesEvent2 |
| Non Cash Prizes Event2 | 14341 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 0 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 13860 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 0 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 5116 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 61450 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 27990 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 33460 | GrossRevenueOtherEvents |
| Cash Prizes Other Events | 0 | CashPrizesOtherEvents |
| Non Cash Prizes Other Events | 1766 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 6122 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 28551 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 0 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 2671 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 314981 | GrossReceiptsTotal |
| Charitable Contributions Total | 159991 | CharitableContributionsTotal |
| Gross Revenue Total Events | 154990 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 62588 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 8956 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 58156 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 500 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 12624 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 142824 | DirectExpenseSummaryEvents |
| Net Income Summary | 12166 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| AH-BERGAN MERCY HEALTH SYSTEM | |||||||
| 7500 MERCY ROAD | OMAHA | NE | 68124 | 470484764 | 501(C)(3) | 17759 | FURTHER EXEMPT PURPOSE |
| AH-IMMANUEL MEDICAL CENTER | |||||||
| 6901 NORTH 72ND STREET | OMAHA | NE | 68122 | 470376615 | 501(C)(3) | 9323 | FURTHER EXEMPT PURPOSE |
| ALEGENT CREIGHTON HEALTH | |||||||
| 12809 WEST DOGDE ROAD | OMAHA | NE | 68154 | 470757164 | 501(C)(3) | 322567 | FURTHER EXEMPT PURPOSE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 31 | NumberOfRecipients |
| Amount Of Cash Grant | 27950 | AmountOfCashGrant |
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: ALEGENT HEALTH FOUNDATION PROVIDES GRANTS TO ONLY RELATED 501(C)(3) ORGANIZATIONS WHICH SUPPORT THE SAME MISSION AND PURPOSE AS ALEGENT HEALTH FOUNDATION. |
| SCHEDULE I, PART I, LINE 1: THE STEVEN L. CARPER MEMORIAL SCHOLARSHIP IS AWARDED TO STUDENTS WHO MEET THE ELIGIBILITY OF BEING ENROLLED STUDENTS OF THE IMMANUEL SCHOOL OF RESPIRATORY THERAPY CARE. A COMMITTEE WITHIN THE IMMANUEL SCHOOL OF RESPIRATORY THERAPY CARE SHALL SELECT RECIPIENTS OF THESE AWARDS. THE COMMITTEE CHOSEN MAY ESTABLISH REASONABLE CRITERIA FOR THE GRANT WITH ACADEMIC EXCELLENCE AS THE DETERMINING FACTOR. ELIGIBILITY FOR THE GLEN B. EICH EDUCATION FUND FOR RADIOLOGY CONTINUING EDUCATION IS LIMITED TO INDIVIDUALS EMPLOYED IN THE RADIOLOGY FIELD AT IMMANUEL MEDICAL CENTER. A COMMITTEE WITHIN THE IMMANUEL RADIOLOGY DEPARTMENT SHALL SELECT RECIPIENTS OF THESE SCHOLARSHIPS. THE COMMITTEE CHOSEN MAY ESTABLISH REASONABLE CRITERIA FOR THE GRANT FACTOR. HANS M. LINK HEALTHCARE EDUCATION SCHOLARSHIPS ARE FOR STUDENTS PURSUING AN EDUCATION IN HEALTHCARE FIELDS INCLUDING: NURSING, OCCUPATIONAL, PHYSICAL, RESPIRATORY OR RECREATIONAL THERAPY; MEDICAL RECORDS; RADIOLOGICAL TECHNOLOGY; MEDICAL TECHNOLOGY; NURSE PRACTITIONER OR PHYSICIAN'S ASSISTANT. RECIPIENTS MUST ATTEND AN ACCREDITED SCHOOL, BE CONSIDERED FULL TIME STUDENTS BY THE CRITERIA OF THEIR RESPECTIVE SCHOOLS, AND HAVE AN INTEREST AND DESIRE TO SERVE HEALTHCARE NEEDS. APPLICANTS MUST ALREADY BE ACCEPTED INTO THE SCHOOL OR HEALTH DEGREE PROGRAM TO BE ELIGIBLE. STUDENTS PURSUING DOCTORAL DEGREES ARE INELIGIBLE. APPLICANTS WILL BE SELECTED BASED ON SEVERAL CRITERIA INCLUDING BUT NOT LIMITED TO: FINANCIAL NEED, ACADEMIC PERFORMANCE, AND SUBMITTED LETTERS OF RECOMMENDATION. PREFERENCE WILL BE GIVEN TO APPLICANTS WHO ARE PERSONALLY AFFILIATED WITH IMMANUEL MEDICAL CENTER AND THE IMMANUEL HEALTH SYSTEMS OR WHO HAVE FAMILY MEMBERS WHOM ARE AFFILIATED. THE MARY HEUERMANN SCHOLARSHIP IS NOT AVAILABLE BY APPLICATION. THIS IS A DISCRETIONARY SCHOLARSHIP FOR APPLICANTS THAT MERIT, BUT DID NOT RECEIVE THE HANS M. LINK OR HEALTHCARE EDUCATION SCHOLARSHIP. A COMMITTEE OF IMMANUEL MEDICAL CENTER REPRESENTATIVES WILL AWARD SCHOLARSHIPS AT THEIR DISCRETION. PREFERENCE WILL BE GIVEN TO APPLICANTS WHO ARE PERSONALLY AFFILIATED WITH IMMANUEL MEDICAL CENTER AND THE IMMANUEL HEALTH SYSTEMS OR WHO HAVE FAMILY MEMBERS WHOM ARE AFFILIATED. BARBARA K. GOODRICH IMMANUEL AUXILIARY NURSING SCHOLARSHIP IS AVAILABLE TO IMMANUEL MEDICAL CENTER EMPLOYEES WHO ARE ENROLLED IN AN ACCREDITED EDUCATIONAL INSTITUTION ON A FULL-TIME BASIS, AS DETERMINED BY THE SCHOOL. THE APPLICANT MUST BE PURSUING A DEGREE IN A NURSING SPECIFIC PROGRAM AND MAINTAIN A GPA OF AT LEAST 3.2 ON A 4.0 SCALE. THIS SCHOLARSHIP IS A NON-NEED BASED, MERIT SCHOLARSHIP. THE FOLLOWING CRITERIA WILL BE USED TO SELECT RECIPIENTS OF THIS SCHOLARSHIP: COMMITMENT TO NURSING AND PROFESSIONAL DEVELOPMENT, DEMONSTRATION OF OUTSTANDING CHARACTER AND VALUES, VOLUNTEERISM AND COMMUNITY INVOLVEMENT, AND POTENTIAL TO CONTRIBUTE TO IMMANUEL MEDICAL CENTER, THE OMAHA COMMUNITY AND THE PROFESSIONAL PRACTICE OF NURSING. WILLIAM D. VANN AND FAMILY PHYSICAL & OCCUPATIONAL THERAPY AWARD IS AVAILABLE TO STUDENTS WHO ARE FULL-TIME, PART-TIME, OR ON-CALL EMPLOYEES OF ALEGENT HEALTH AND ANY UNDERGRADUATE STUDENTS WHO HAVE ACHIEVED JUNIOR STANDING OR HIGHER WITH A MINIMUM GRADE POINT AVERAGE OF 2.50 STUDYING ONE OF THE FOLLOWING HEALTHCARE FIELDS: OCCUPATIONAL, PHYSICAL, RESPIRATORY, OR RECREATIONAL THERAPY AT AN ACCREDITED EDUCATIONAL INSTITUTION IN OMAHA AND SURROUNDING AREAS, BE CONSIDERED FULL OR PART-TIME STUDENTS BY THE CRITERIA OF THEIR RESPECTIVE SCHOOL, AND HAVE AN INTEREST AND DESIRE TO SERVE HEALTH CARE NEEDS. APPLICANTS MUST ALREADY BE ACCEPTED INTO THE SCHOOL OR HEALTH DEGREE PROGRAM TO BE ELIGIBLE. STUDENTS PURSUING DOCTORAL DEGREES ARE INELIGIBLE. APPLICANTS WILL BE SELECTED BASED ON SEVERAL CRITERIA INCLUDING BUT NOT LIMITED TO: FINANCIAL NEED, ACADEMIC PERFORMANCE, AND LETTERS OF RECOMMENDATION SUBMITTED. PREFERENCE WILL BE GIVEN TO APPLICANTS WHO ARE PERSONALLY AFFILIATED WITH THE IMMANUEL MEDICAL CENTER AND THE IMMANUEL HEALTH SYSTEMS OR WHO HAVE FAMILY MEMBERS WHOM ARE AFFILIATED. LAKESIDE CHARITABLE COUNCIL AWARDS SCHOLARSHIPS ANNUALLY TO RECOGNIZE THE GIFT OF TIME GIVEN BY TEEN VOLUNTEERS. ANY HIGH SHCOOL SENIOR WHO HAS VOLUNTEERED A MINIMUM OF 100 HOURS IN THE PAST YEAR IS ELIGIBLE TO APPLY FOR A $250 SCHOLARSHIP. APPLICANTS MUST BE PERMANENT RESIDENTS OF NEBRASKA AND HIGH SCHOOL SENIORS ATTENDING OMAHA, MILLARD OR ELKHORN SCHOOL DISTRICT. APPLICANTS MUST CURRENTLY BE AN ACTIVE VOLUNTEER AT ALEGENT HEALTH LAKESIDE HOSPITAL. A MINIMUM OF SIX MONTHS SERVICE AS A VOLUNTEER AT ALEGENT HEALTH LAKESIDE HOSPITAL IS REQUIRED. APPLICANTS OF THE MERCY HOSPITAL PROFESSIONAL DEVELOPMENT AND MAGNET SCHOLARSHIP MUST BE CURRENTLY WORKING FOR ALEGENT HEALTH-MERCY HOSPITAL, COUNCIL BLUFFS FOR A MINIMUM OF A YEAR AND IN GOOD STANDING. ONLY STAFF NURSES AND NURSE LEADERS AT MERCY THAT HAVE A RECOMMENDATION FROM THEIR SUPERVISOR ARE ELIGIBLE FOR THE SCHOLARSHIP. APPLICANTS WILL BE SELECTED BASED ON SEVERAL CRITERIA INCLUDING, BUT NOT LIMITED TO: FINANCIAL NEED, ACADEMIC PERFORMANCE, AND LETTERS OF RECOMMENDATION SUBMITTED. APPLICANTS OF THE MIDLANDS HOSPITAL TEEN SCHOLARSHIP MUST BE IN THE HIGH SCHOOL GRADUATING CLASS OF 2012. STUDENTS MUST ALSO BE AN ACTIVE MIDLANDS HOSPITAL VOLUNTEER IN GOOD STANDING AT THE TIME OF THE APPLICATION. APPLICANTS WILL BE SELECTED BASED ON SEVERAL CRITERIA INCLUDING BUT NOT LIMITED TO: APPLICATION RESPONSES, ACADEMIC PERFORMANCE, AND LETTERS OF RECOMMENDATION. SELECTION WILL BE WEIGHTED BASED ON THE APPLICANTS CONTRIBUTIONS OF TIME AND TALENT TO ALEGENT HEALTH MIDLANDS HOSPITAL AND THE COMMUNITY. THE SISTER INGEBORD SCHOLARSHIP IS OFFERED TO ENCOURAGE AND PROVIDE OPPORTUNITIES FOR CONTINUING PROFESSIONAL EDUCATION AND DEVELOPMENT FOR ALEGENT HEALTH-IMMANUEL MEDICAL CENTER EMPLOYEES. ONLY ALEGENT HEALTH-IMMANUEL MEDICAL CENTER EMPLOYEES IN GOOD STANDING WITH SIX MONTHS OR MORE OF FULL TIME OR PART TIME SERVICE MAY APPLY FOR THE SCHOLARHSIP. FULL TIME EMPLOYEES MAY RECEIVE A MAXIMUM AWARD OF $500 AND PART TIME EMPLOYEES MAY RECEIVE A MAXIMUM AWARD OF $250. APPLICANTS MUST INCLUDE A LETTER OF REFERENCE COMPLETED BY A SUPERVISOR OR DEPARTMENT OPERATIONS DIRECTOR. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAUL STRAWHECKER | |||||||||||||
| 0 | 73509 | 0 | 0 | 0 | 6839 | 0 | 329991 | 0 | 1317 | 0 | 411656 | 0 | 0 |
| RICHARD HACHTEN II | |||||||||||||
| 0 | 689659 | 0 | 431112 | 0 | 605389 | 0 | 282350 | 0 | 17083 | 0 | 2025593 | 0 | 462847 |
| SCOTT WOOTEN | |||||||||||||
| 0 | 364536 | 0 | 214452 | 0 | 128930 | 0 | 115000 | 0 | 21907 | 0 | 844825 | 0 | 48613 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINES 4A-B | THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS AS EXECUTIVES OF ALEGENT CREIGHTON HEALTH 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: RICHARD HACHTEN, II - $346,579 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 SCOTT WOOTEN - $58,678 PAUL STRAWHECKER - $4,227. 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 WERE INCLUDED IN TAXABLE WAGES FOR THE INDIVIDUAL AND REPORTED IN COLUMN E OF THE SCHEDULE J: RICHARD HACHTEN II - $116,268 SCOTT WOOTEN - $48,613. | |
| PART I, LINE 6 | COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT CREIGHTON HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. SCOTT WOOTEN, RICHARD HACHTEN II AND PAUL STRAWHECKER ARE MEMBERS OF ALEGENT CREIGHTON HEALTH MANAGEMENT AND 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 CREIGHTON HEALTH SYSTEM FOR THE FISCAL YEAR. | |
| PART III | 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 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. ADDITIONALLY, COMPENSATION FOR NON EXECUTIVE LEVEL MANAGEMENT POSITIONS WITHIN THE ALEGENT CREIGHTON HEALTH SYSTEM ARE DETERMINED BY THE ALEGENT CREIGHTON HEALTH HUMAN RESOURCE DEPARTMENT. THE HUMAN RESOURCE DEPARTMENT COMPARES MANAGEMENT COMPENSATION LEVELS TO SIMILAR POSITIONS WITHIN THE GEOGRAPHICAL AREA IN ORDER TO DETERMINE REASONABLE 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 M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable (147 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | 1.0+ CT. CUSHION DIAMOND | 1 | 5500 | FMV |
| X | JACKSON HOLE SKI PACKAGE | 1 | 4000 | FMV |
| X | RITZ CARLTON & AMERICAN EXPRESS GIFT CARDS | 1 | 3500 | FMV |
| X | ORLANDO VACATION, $500 GC, $500 TEETH WHITENING | 1 | 3400 | FMV |
| X | BILLBOARD FOR 30 DAYS AND PRODUCTION | 1 | 3200 | FMV |
| X | VACATION FOR 2-4 AT MARRIOTT CANYON VILLAS | 1 | 2500 | FMV |
| X | 2 BLEED POSTERS FOR 4 WEEKS | 1 | 1500 | FMV |
| X | 30 MINUTE HELICOPTER RIDE FOR 2 PEOPLE | 1 | 1200 | FMV |
| X | NONPAREIL ADVERTISING | 1 | 1000 | FMV |
| X | PAINTING "HAPPY DAYS" | 1 | 750 | FMV |
| X | LUXURY SUITE FOR 18 | 1 | 675 | FMV |
| X | SILENT AUCTION ITEM DONATIONS-MISC | 1 | 655 | FMV |
| X | TEETH BLEACHING FOR TWO | 1 | 600 | FMV |
| X | APPLE IPAD 2 TABLET | 1 | 600 | FMV |
| X | INSPIRON DUO | 1 | 600 | FMV |
| X | 3 MONTH MEMBERSHIP | 1 | 560 | FMV |
| X | 3 MONTH MEMBERSHIP | 1 | 560 | FMV |
| X | FIRE STATION BIRTHDAY PARTY | 1 | 545 | FMV |
| X | JOHNSON LAKE CABIN WEEKEND TRIP | 1 | 500 | FMV |
| X | GIFT CERTIFICATES | 1 | 500 | FMV |
| X | FOLDOVER CALFSKIN CLUTCH PURSE | 1 | 450 | FMV |
| X | MISCELLANEOUS AUCTION ITEMS | 1 | 420 | FMV |
| X | FREE DESIGN CONSULTATION | 1 | 400 | FMV |
| X | COLLEGE WORLD SERIES TKTS (4) | 1 | 400 | FMV |
| X | (2) MEN'S BASKETBALL SEASON | 1 | 380 | FMV |
| X | NECKLACE & EARRINGS | 1 | 375 | FMV |
| X | PAINTING "BLUE PITCHER" | 1 | 350 | FMV |
| X | US OLYMPIC SWIM TRIALS BOX | 1 | 350 | FMV |
| X | HOODIES,SHIRTS JACKETS | 1 | 310 | FMV |
| X | SERVICE GUARD CERTIFICATE | 1 | 300 | FMV |
| X | PRIVATE TOUR FOR 20 | 1 | 300 | FMV |
| X | (2) ONE NIGHT STAY W/FOOD | 1 | 300 | FMV |
| X | SHERATON DES MOINES-ONE NT | 1 | 300 | FMV |
| X | SHERATON DES MOINE-ONE NT | 1 | 300 | FMV |
| X | AUTO DETAIL | 1 | 300 | FMV |
| X | 4 ROUNDS OF GOLF W/CART | 1 | 260 | FMV |
| X | 2 GC $129 EACH | 1 | 258 | FMV |
| X | PERSONAL CHEF SERVICE | 1 | 250 | FMV |
| X | AUTOGRAPHED CUBS JERSEY | 1 | 250 | FMV |
| X | 1 YEAR SUPPLY OF DAIRY PROD | 1 | 250 | FMV |
| X | PAPIO BAY SEASON PASS | 1 | 240 | FMV |
| X | (2) 6 MONTH MEMBERSHIPS | 1 | 240 | FMV |
| X | 4 NE FOOTBALL TICKETS AND 1 PARKING PASS | 1 | 239 | FMV |
| X | ROUND OF GOLF FOR 4 | 1 | 220 | FMV |
| X | ITEMS FOR CABIN FEVER GIFT BASKET | 1 | 211 | FMV |
| X | AKSARBEN RACE PHOTO | 1 | 200 | FMV |
| X | RUN FOR THE ROSES-RUNNING BASKET | 1 | 200 | FMV |
| X | (2) MEN'S SOCCER SEASON TKTS | 1 | 200 | FMV |
| X | CREAM COLORED NATIVITY AND PEWTER NATIVITY SETS | 1 | 200 | FMV |
| X | WINE GIFT BASKET AND GIFT CERTIFICATES | 1 | 200 | FMV |
| X | DONATED ITEMS FOR SILENT AUCTION | 1 | 195 | FMV |
| X | ONE NIGHT STAY CERTIFICATE | 1 | 189 | FMV |
| X | 18 HOLES OF GOLF W/CART FOR 4 PLAYERS | 1 | 186 | FMV |
| X | SONY CYBERSHOT DIGITAL CAMERA & BEST BUY GC | 1 | 179 | FMV |
| X | SNOCONE,POPCORN,COTTON CDY | 1 | 175 | FMV |
| X | FREE SESSION & 8X10 | 1 | 171 | FMV |
| X | KENTUCKY DERBY BASKET | 1 | 170 | FMV |
| X | BASKETBALL AND FOOTBALL TICKETS | 1 | 168 | FMV |
| X | (2) WOMENS SOCCER SEASON TKTS | 1 | 160 | FMV |
| X | (4) WEEKLY GROUNDS PASSES | 1 | 160 | FMV |
| X | 2 TICKET TO THIS IS OPERA | 1 | 158 | FMV |
| X | DAISY, DAISY, LADY BUG WATERCOLOR, GOLD FRAME | 1 | 150 | FMV |
| X | BIRTHDAY PARTY FOR 10 | 1 | 150 | FMV |
| X | HEART HEALTHY | 1 | 150 | FMV |
| X | VISIT FROM SANTA | 1 | 150 | FMV |
| X | MARGARITA FIESTA PARTY | 1 | 150 | FMV |
| X | 2 TICKETS SESSION 17 | 1 | 137 | FMV |
| X | HAND CRAFTED CEDAR CHEST | 1 | 135 | FMV |
| X | 4 CU MEN'S B-BALL TICKETS | 1 | 135 | FMV |
| X | GARDEN TREASURES | 1 | 130 | FMV |
| X | $130 GIFT CERTIFICATE | 1 | 130 | FMV |
| X | ONE NIGHT STAY CERTIFICATE | 1 | 130 | FMV |
| X | ONE NIGHT STAY CERTIFICATE | 1 | 129 | FMV |
| X | ONE NIGHT STAY CERTIFICATE | 1 | 125 | FMV |
| X | GIFT BASKET FACIAL PRODUCTS | 1 | 125 | FMV |
| X | 14 PC. WURSTHUT KNIFE SET | 1 | 125 | FMV |
| X | 2 OPERA TICKETS | 1 | 120 | FMV |
| X | WINE & WOMEN FASHION PARTY | 1 | 120 | FMV |
| X | POKER & MARTINI PARTY | 1 | 120 | FMV |
| X | HUSKER FOOTBALL TICKETS | 1 | 112 | FMV |
| X | GIFT BASKET | 1 | 110 | FMV |
| X | MULHALLS GIFT CARD | 1 | 100 | FMV |
| X | 4 FREE OIL CHANGES | 1 | 100 | FMV |
| X | FRAMED PHOTOGRAPH-FARM | 1 | 100 | FMV |
| X | LADIES PERSONAL CARE | 1 | 100 | FMV |
| X | HENRY DOORLY ZOO GIFT CARD | 1 | 100 | FMV |
| X | LEGENDS RIVALRY PHOTO | 1 | 100 | FMV |
| X | 12 VISIT CARD TO LAKESIDE WELLNESS CENTER | 1 | 100 | FMV |
| X | 2 $50 GIFT CERTIFICATES | 1 | 100 | FMV |
| X | FOUR $25 GIFT CERTIFICATES & CREIGHTON BASKETBALL | 1 | 100 | FMV |
| X | PEARL & CRYSTAL CROSS NECKLACE | 1 | 95 | FMV |
| X | 4 ROUNDS GOLF & 2 PAPIO PARK WRISTBANDS | 1 | 92 | FMV |
| X | HOME PARTY BASKET | 1 | 90 | FMV |
| X | 2 TICKETS TO "DRACULA" PRESENTATION | 1 | 90 | FMV |
| X | 5 BOOKS (W/BOOK STAND & OTHER THINGS) | 1 | 88 | FMV |
| X | FLORAL ARRNAGEMENT | 1 | 85 | FMV |
| X | HOMEMADE AFGHAN BLANKET | 1 | 75 | FMV |
| X | ANN NYE MINI-HEART W/STAND | 1 | 75 | FMV |
| X | FRAMED PHOTOGRAPH-CHERRIES | 1 | 75 | FMV |
| X | TRIPLE CROWN DRINK KIT | 1 | 75 | FMV |
| X | 4 STORM CHASER TKTS W/PARKING | 1 | 75 | FMV |
| X | GIFT CARD & PASTRY & NOBBIES GIFT CARD | 1 | 75 | FMV |
| X | FALL WREATH | 1 | 75 | FMV |
| X | OUTDOOR BIRDFEEDER AND BIRD SEED | 1 | 70 | FMV |
| X | MASSAGE ENVY GIFT CARD | 1 | 70 | FMV |
| X | GIFT CARD/T-SHIRT | 1 | 69 | FMV |
| X | ONE HOUR MASSAGE & MULHALLS | 1 | 65 | FMV |
| X | WHOLE SMOKED SALMON | 1 | 65 | FMV |
| X | RED CUT GLASS SHAKER & MARTINI GLASSES | 1 | 62 | FMV |
| X | GIFTS & THINGS COFFEE BASKET | 1 | 60 | FMV |
| X | PEGGY KARR "AKSARBEN" PLATE | 1 | 60 | FMV |
| X | NOBBIES GIFT CARD, BOOKS | 1 | 60 | FMV |
| X | CHILD'S FIRE ENGINE AND HEROS | 1 | 55 | FMV |
| X | 4 ADMISSION TICKETS TO ZOO | 1 | 54 | FMV |
| X | (4) OMAHA ZOO PASSES | 1 | 54 | FMV |
| X | BORSHIEMS HEART PAPERWT | 1 | 50 | FMV |
| X | VARIETY GIFT BASKET | 1 | 50 | FMV |
| X | WIRE HORSE/HORSE PRINT | 1 | 50 | FMV |
| X | WINE STOPPER & WINE | 1 | 50 | FMV |
| X | BISTRO BASKET | 1 | 50 | FMV |
| X | JEWELRY TRAYS, NECKLACE | 1 | 50 | FMV |
| X | HOMERUN DERBY PORCH TICKETS, WALMART GC, ZOO GC | 1 | 50 | FMV |
| X | FLEMINGS GIFT CARD | 1 | 50 | FMV |
| X | FLEMINGS GIFT CARD | 1 | 50 | FMV |
| X | GIFT BASKET | 1 | 50 | FMV |
| X | GIFT BASKET | 1 | 50 | FMV |
| X | OMAHA BEEF TKTS (8) | 1 | 50 | FMV |
| X | $45 GIFT CERTIFICATE | 1 | 45 | FMV |
| X | SPA PEDICURE CERTIFICATE | 1 | 45 | FMV |
| X | THERMAL TOTE | 1 | 42 | FMV |
| X | PORTFOLIO/GAS GIFT CARD & OIL CHANGES | 1 | 40 | FMV |
| X | $40 GIFT CERTIFICATE (W/DOME CAKE SET) | 1 | 40 | FMV |
| X | 6 ONE FREE COMBO MEAL CARDS | 1 | 30 | FMV |
| X | $25 GIFT CERTIFICATE | 1 | 25 | FMV |
| X | LUSH GREEN PLANT | 1 | 25 | FMV |
| X | $25 GIFT CARD | 1 | 25 | FMV |
| X | $25 GIFT CERTIFICATE | 1 | 25 | FMV |
| X | $25 GIFT CERTIFICATE | 1 | 25 | FMV |
| X | $25 GIFT CERTIFICATE | 1 | 25 | FMV |
| X | ICE CREAM CAKE 8" & SNO CONES, ETC. | 1 | 22 | FMV |
| X | (2) ACTIVITY WRISTBANDS | 1 | 20 | FMV |
| X | SOARING WINGS WINE (2) | 1 | 20 | FMV |
| X | $20 GIFT CERTIFICATE & HAMPTON | 1 | 20 | FMV |
| X | $20 GIFT CERTIFICATE & HAMPTON | 1 | 20 | FMV |
| X | $20 GIFT CERTIFICATE & KATINAS | 1 | 20 | FMV |
| X | DILLY BAR GIFT CERTIFICATE & 4 ZOO PASS | 1 | 10 | FMV |
| X | $10 GIFT CERTIFICATE | 1 | 10 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ALEGENT HEALTH FOUNDATION HAS ONE MEMBER, ALEGENT CREIGHTON HEALTH. | |
| FORM 990, PART VI, SECTION A, LINE 7A | ALEGENT CREIGHTON HEALTH MAY DESIGNATE ITS BOARD CHAIR AND/OR ITS CHIEF EXECUTIVE OFFICER, OR HIS/HER DESIGNEE, TO SERVE EX OFFICIO WITHOUT VOTE, AS SPONSORSHIP ADVISOR TO THE BOARD. | |
| FORM 990, PART VI, SECTION A, LINE 7B | IN ADDITION TO ALL THE RIGHTS AND POWERS GRANTED BY LAW WITH RESPECT TO THE GOVERNANCE OF THIS CORPORATION, THE MEMBER SHALL HAVE THE RIGHT TO: A. INITIATE AND APPROVE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION. B. INITIATE AND APPROVE JOINT VENTURES IN WHICH CORPORATION PROPOSES TO PARTICIPATE PURSUANT TO GUIDELINES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. C. APPROVE AND REMOVE, WITH OR WITHOUT CAUSE, ALL MEMBERS OF THE BOARD OF DIRECTORS. D. INITIATE AND APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF CORPORATION. E. INITIATE AND APPROVE THE DISSOLUTION, LIQUIDATION, MERGER OR CONSOLIDATION OF CORPORATION. F. INITIATE AND APPROVE THE INCORPORATION OR DISSOLUTION OF AFFILIATED ENTITIES OF CORPORATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | TAX RETURNS FOR ENTITIES OF THE ALEGENT CREIGHTON HEALTH SYSTEM ARE PREPARED BY THE SYSTEM TAX DEPARTMENT. FOLLOWING THE PREPARATION OF ALEGENT HEALTH FOUNDATION 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. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED A WEB LINK THAT DIRECTS THEM TO THE FINAL TAX RETURN AND ALL REQUIRED SCHEDULES. QUESTIONS ARE REFERRED TO THE ALEGENT CREIGHTON HEALTH TAX DIRECTOR AND THE BOARD IS NOTIFIED OF THE DATE THE TAX RETURN WILL BE FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | WRITTEN CONFLICT OF INTEREST POLICY - ALEGENT HEALTH FOUNDATION HAS ADOPTED THE CONFLICT OF INTEREST POLICY AND CONFLICT INVESTIGATION PROCESS OF ALEGENT CREIGHTON HEALTH, THE PARENT CORPORATION OF THE ALEGENT CREIGHTON HEALTH SYSTEM. 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 HEALTH FOUNDATION 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 C, LINE 19 | THE CONFLICT OF INTEREST POLICY IS MADE AVAILABLE TO THE PUBLIC ON OUR WEBSITE AT WWW.ALEGENTCREIGHTON.COM. ALEGENT HEALTH FOUNDATION 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: | RICHARD HACHTEN II AND SCOTT WOOTEN ARE EXECUTIVES OF THE ALEGENT CREIGHTON HEALTH SYSTEM AND AVERAGE HOURS PER WEEK WORKED FOR AFFILIATE ORGANIZATIONS IS 60. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -417,922. TEMPORARY NET ASSETS RELEASED FROM RESTRICTIONS -10,808. TOTAL TO FORM 990, PART XI, LINE 5: -428,730. | CHANGES IN NET ASSETS OR FUND BALANCES: |
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 CREIGHTON CLINIC | |||||||||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68154 | 470765154 | CLINICAL SERVICES | NE | 501(C)(3) | L3 | 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 IA | |||||||||||
| 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 CORNING IA | |||||||||||
| 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 IA | |
| 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 INC | |||||||||||
| 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 SERVICES FOUNDATION | |||||||||||
| 631 NORTH 8TH STREET | MISSOURI VALLEY | IA | 51555 | 421294399 | SUPPORT OF ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA | 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 | 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 S 9TH STREET STE 102 | LINCOLN | NE | 68508 | 204962103 | PROFESSIONAL TECH SERVICES | NE | ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | N/A | 0 | 0 |
| AVANTAS LLC | ||||||||||
| 11128 JOHN GALT BLVD STE 400 | OMAHA | NE | 68124 | 392045003 | STAFFING OF NURSES | NE | ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM | 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 |
| 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 |
| AH NORTHWEST IMAGING CENTER LLC | ||||||||||
| 3606 N 156TH STREET SUITE 104 | OMAHA | NE | 68154 | 061786985 | DIAGNOSTIC TESTING FACILITY | 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 |
| BERGAN MERCY SURGERY CENTER LLC | ||||||||||
| 7710 MERCY ROAD SUITE 100 | OMAHA | NE | 68124 | 208671994 | AMBULATORY SURGICAL CENTER | NE | OMAHA AMBULATORY INVESTMENT COMPANY LLC | N/A | 0 | 0 |
| NEBRASKA SPINE LLC | ||||||||||
| 6901 N 72ND STREET STE 203000 | 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 HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2301 N 117TH AVE SUITE 120 | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68164 | 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 | 1 | 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |