Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
THE NEBRASKA MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
988145 NEBRASKA MEDICAL CENTER
Suite
Room/suite
City or town, state or country, and ZIP + 4
OMAHA, NE681988145
D Employer identification number

91-1858433
E Telephone number

G Gross receipts $ 781,434,613
F Name and address of principal officer:
WILLIAM DINSMOOR
987400 NEBRASKA MEDICAL CENTER
OMAHA,NE681987400
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.nebraskamed.com
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1997
M State of legal domicile: NE
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: To be the region's premier medical provider by serving our patients and community through extraordinary care, the finest people and academic and private practice medicine.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 8
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 6,601
6 Total number of volunteers (estimate if necessary) ............. 6 758
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,686,961
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 6,021,010 4,951,878
9 Program service revenue (Part VIII, line 2g) ......... 803,756,761 746,303,783
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 8,473,453 10,357,225
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 10,826,695 12,119,720
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 829,077,919 773,732,606
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 114,453,911 113,208,617
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 311,005,305 315,326,031
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 70,742 53,667
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,155,660    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 377,138,177 330,730,497
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 802,668,135 759,318,812
19 Revenue less expenses. Subtract line 18 from line 12....... 26,409,784 14,413,794
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 797,174,434 837,949,195
21 Total liabilities (Part X, line 26)............. 242,689,546 253,733,299
22 Net assets or fund balances. Subtract line 21 from line 20..... 554,484,888 584,215,896
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: TO BE THE REGION'S PREMIER MEDICAL PROVIDER BY SERVING OUR PATIENTS AND COMMUNITY THROUGH EXTRAORDINARY CARE, THE FINEST PEOPLE AND ACADEMIC AND PRIVATE PRACTICE MEDICINE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 155,083,637 including grants of $ 27,582,105 ) (Revenue $ 172,189,424 )
Oncology Service Line Cancer treatment services offered by the Corporation include treatment of lymphoma, leukemia, head and neck, breast, gastrointestinal, lung, prostate, gynecologic, blood, bone marrow, brain and spine cancers. The patients are supported by research that is conducted on the Corporation/UNMC campus. The Corporation and partner UNMC Eppley Cancer Institute is the only clinical cancer center in its service area designated by the National Cancer Institute. In addition to treatment and clinical trials The Corporation offers support groups, social work, pain management, and a variety of additional patient supportive services. In the fall of 2008, the corporation opened a new cancer center near Village Pointe offering outpatient services in effort to serve the growing demand for excellent cancer care closer to patients' homes. In the fall of 2011, the corporation opened a cancer clinic and treatment center at Bellevue Medical Center. In addition, as one of the busiest programs in the world, the Bone Marrow Transplantation program served 136 patients in the year ended June 30, 2013. The program benefits from the research conducted on the Corporation/UNMC campus and the Cooperative Care program which assists patients to prepare for and recover from the transplant in a home-like setting with a care partner of their choosing. The program is housed in the Lied Transplant Center and recognizes the importance of environment to the patient's overall well-being. During fiscal year 2013, the Oncology Service Line incurred over 88,000 cases and over 20,000 patient days. Approximately 40% of the net revenue was derived from inpatient cases.
4b (Code:   ) (Expenses $ 94,831,861 including grants of $ 17,143,729 ) (Revenue $ 98,303,706 )
CARDIOVASCULAR SERVICE LINE The Corporation provides a wide range of Cardiovascular services from diet counseling to surgical procedures and rehabilitation. The Corporation has been successful in recruiting physicians and has the only heart failure specialist in the region and the only heart failure program certified by The Joint Commission in the state of Nebraska. The Congestive Heart Failure program and Acute Myocardial Infarction program each received the "Gold Seal of Approval" certification from American Heart Association and are certified by The Joint Commission. These services are the first and only nationally certified programs of their kind in the state of Nebraska. The Chest Pain Center has received full Chest Pain Center Accreditation from the Society of Chest Pain Centers. The Nebraska Medical Center has been recognized for service excellence under the J.D. Power and Associates Distinguished Hospital Program. We have the only Joint Commission certified Destination Therapy program in the state and are the only hospital in the region performing heart transplants and implanting total artificial hearts. The hospital treats patients from the surrounding region and in the year ended June 30, 2013, approximately 421 open heart surgeries were performed, 20 heart transplants, 33 mechanical circulatory system device implantations, and 3 Total Artificial Heart implantations were performed.
4c (Code:   ) (Expenses $ 72,261,357 including grants of $ 10,284,108 ) (Revenue $ 74,376,555 )
Solid Organ Transplantation Service Line The Corporation operates one of the busiest solid organ transplant programs in the world. In the year ended June 30, 2013, the Corporation performed 265 solid organ transplants including liver, kidney, heart, pancreas and small bowel. The success of the Corporation's solid organ transplant program is heightened by research done on the Corporation/UNMC campus. Patients have come to the Corporation for single-or multiple-organ transplant from all 50 states and five continents. During fiscal year 2013, the Solid Organ Transplantation Service Line incurred over 33,580 cases and 13,100 patient days. Approximately 74% of the revenue was derived from inpatient cases.
(Code:   ) (Expenses $ 71,068,317 including grants of $ 12,855,144 ) (Revenue $ 72,853,606 )
Neurolgy Service Line
(Code:   ) (Expenses $ 255,901,376 including grants of $ 45,343,531 ) (Revenue $ 255,635,796 )
All Other Hospital
(Code:   ) (Expenses $ 107,108,385 including grants of $ 0 ) (Revenue $ 79,551,070 )
Other Program Services
4d Other program services (Describe in Schedule O.)
(Expenses $ 434,078,078 including grants of $ 58,198,675 ) (Revenue $ 408,040,472 )
4e Total program service expensesMediumBullet756,254,933
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
Yes
 
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions).... Click to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............ Click to see attachment
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
486
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
6,601
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
12
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletSTEPHANIE DAUBERT988145 NEBRASKA MEDICAL CENTEROMAHANE681988145 (402) 552-2889
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Bruce R Lauritzen........................................................................
Chairman
 1.0
.......................0.0 		X   X       0 0 0
(2) Mogens C Bay........................................................................
Vice Chairman
 1.0
.......................0.0 		X   X       0 0 0
(3) Bruce Grewcock........................................................................
Treasurer
 1.0
.......................0.0 		X   X       0 0 0
(4) Duane W Acklie........................................................................
Member
 1.0
.......................0.0 		X           0 0 0
(5) James T Canedy........................................................................
MEMBER
 1.0
.......................0.0 		X           0 0 0
(6) Ronald Hollins MD........................................................................
Member
 1.0
.......................0.0 		X           0 0 0
(7) Harold Maurer MD........................................................................
Member
 1.0
.......................0.0 		X           0 0 0
(8) Gail Walling Yanney MD........................................................................
Member
 1.0
.......................0.0 		X           0 0 0
(9) James Young........................................................................
Member
 1.0
.......................0.0 		X           0 0 0
(10) Marlin G Stahl MD........................................................................
Member/CMO-BMC
 1.0
.......................54.0 		X           21,394 0 0
(11) James B Milliken........................................................................
Secretary
 1.0
.......................0.0 		X   X       0 0 0
(12) Bradley E Britigan MD........................................................................
Member
 1.0
.......................0.0 		X           0 0 0
(13) Nancy Keegan........................................................................
Member
 1.0
.......................0.0 		X           0 0 0
(14) James E McClurg PhD........................................................................
Member
 1.0
.......................0.0 		X                
(15) Glenn A Fosdick........................................................................
President
 55.0
.......................0.0 		    X       1,677,825 0 172,976
(16) Stephen Smith MD........................................................................
Chief Medical Officer
 55.0
.......................0.0 		    X       810,770 0 139,559
(17) William Dinsmoor........................................................................
Chief Financial Officer
 54.0
.......................1.0 		    X       714,949 0 139,082
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Joe Graham........................................................................
Chief Operating Officer
 55.0
.......................0.0 		    X       680,032 0 134,570
(19) Rosanna Morris........................................................................
Chief Nursing Officer
 54.0
.......................1.0 		    X       553,474 0 98,659
(20) Randall J Hallett........................................................................
Exec Dir -Development
 55.0
.......................0.0 		      X     305,050 0 24,789
(21) Louis Burgher MD........................................................................
Clarkson College President
 1.0
.......................54.0 		      X     307,565 0 6,642
(22) Thomas Macy........................................................................
Nebraska Orthopaedic Hosp CEO
 55.0
.......................0.0 		      X     236,892 0 35,376
(23) Natale Ponticello........................................................................
VP Human Resources
 55.0
.......................0.0 		      X     302,319 0 26,683
(24) Tadd Pullin........................................................................
VP Marketing and Planning
 55.0
.......................0.0 		      X     409,145 0 81,473
(25) Theresa Franco........................................................................
Exec Dir Cancer Care
 55.0
.......................0.0 		      X     252,285 0 27,690
(26) Deborah Istas........................................................................
Exec Dir Neuro Sciences
 55.0
.......................0.0 		      X     248,592 0 24,586
(27) Jorge Parodi........................................................................
Exec Dir Cardio/Pulmonary
 55.0
.......................0.0 		      X     250,299 0 30,071
(28) Ruta Davidson........................................................................
Exec Dir Organ/Transplant/PC
 55.0
.......................0.0 		      X     329,225 0 28,764
(29) Michael Powell........................................................................
Exec Dir Pharmacy
 55.0
.......................0.0 		      X     204,215 0 33,824
(30) Charles Lakso........................................................................
Exec Dir Radiology/Lab
 55.0
.......................0.0 		      X     221,314 0 24,362
(31) Lisa McClane........................................................................
Exec Dir Women/Children
 55.0
.......................0.0 		      X     192,753 0 10,252
(32) Julie Lazure........................................................................
Exec Dir Ed/Trauma.CCU
 55.0
.......................0.0 		      X     176,634 0 27,915
(33) Connie Ogden........................................................................
Exec Dir Adult Acute Care
 55.0
.......................0.0 		      X     180,469 0 18,760
(34) Jana Danielson........................................................................
Exec Director Revenue Cycle
 55.0
.......................0.0 		      X     188,191 0 16,674
(35) Donald Futrell........................................................................
Exec Dir, Fac & Clin Spc Plng
 55.0
.......................0.0 		      X     192,460 0 25,311
(36) David S Fuller........................................................................
Interim, Chief Process Officer
 55.0
.......................0.0 		      X     254,935 0 28,549
(37) Lianne Stevens........................................................................
VP Info Technology
 55.0
.......................0.0 		        X   264,581 0 25,725
(38) Marcel Devetten MD........................................................................
Physician
 55.0
.......................0.0 		        X   206,327 0 23,467
(39) Michael D Johnson........................................................................
Physician
 55.0
.......................0.0 		        X   306,165 0 19,516
(40) Cynthia Owen........................................................................
VP Corporate Affairs
 55.0
.......................0.0 		        X   265,198 0 26,292
(41) STEVEN J WEES MD........................................................................
PHYSICIAN
 55.0
.......................0.0 		        X   245,085 0 18,169
(42) Martin Carmody........................................................................
FORMER BMC CEO
 0.0
.......................0.0 		          X 243,225 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 10,241,368 0 1,269,736
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet263
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
UNMC PHYSICIANS, 988101 NE MED CTROMAHANE681988101 MEDICAL SERVICES 16,535,492
KIEWIT BUILDING GROUP, 3921 MASON STOMAHANE68105 CONSTRUCTION 6,710,514
CARDINAL HEALTH, 5840 F STREETOMAHANE68117 MANAGEMENT FEE 7,083,512
UNMC, 984290 NE MED CTROMAHANE681984290 MEDICAL SERVICES 18,058,678
EPIC SYSTEMS CORPORATION, 1979 MILKY WAYVERONAWI53593 IT SERVICES / EHR 11,559,288
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet140
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 941,347
f All other contributions, gifts, grants, and
similar amounts not included above1f 		4,010,531
g Noncash contributions included in lines
1a-1f:$ 		305,547
h Total. Add lines 1a-1f.......MediumBullet 4,951,878
Program Service Revenue Business Code
2a NET PATIENT REVENUE 900099 729,906,639 729,906,639    
b LAB ADMINISTRATION 900099 5,709,068 5,709,068    
c EHR INCENTIVE PAYMENTS 900099 4,188,653 4,188,653    
d REMOTE PHARMACY SERVICES 446110 4,080,294 3,606,657 473,637  
e LIED HOSPITALITY 900099 932,001 932,001    
f All other program service revenue . 1,487,128 1,487,128    
g Total. Add lines 2a–2f........MediumBullet 746,303,783
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 9,507,122     9,507,122
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 3,468,086 546,730
b Less: rental expenses    
c Rental income or (loss) 3,468,086 546,730
d Net rental income or (loss).......MediumBullet 4,014,816   2,188,431 1,826,385
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 8,374,274 177,836
b Less: cost or other basis and sales expenses 7,615,174 86,833
c Gain or (loss) 759,100 91,003
d Net gain or (loss)..........MediumBullet 850,103     850,103
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a ENVIRONMENTAL SERVICES 900099 3,123,012 3,123,012    
b ONE CHART FEES 446110 847,529 725,000 122,529  
c CHILD CARE 624410 761,393 761,393    
d All other revenue .... 3,372,970 2,470,606 902,364  
e Total. Add lines 11a–11d ...... MediumBullet 8,104,904
12 Total revenue. See Instructions......MediumBullet 773,732,606 752,910,157 3,686,961 12,183,610
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 72,249,744 72,249,744
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 40,958,873 40,958,873
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 9,830,677 9,491,624   339,053
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 243,946,264 243,584,272   361,992
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 23,445,792 23,417,053   28,739
9 Other employee benefits ....... 20,169,108 20,131,448   37,660
10 Payroll taxes ........... 17,934,190 17,895,102   39,088
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 1,112,758   1,112,758  
c Accounting ........... 795,461   795,461  
d Lobbying ........... 57,839 57,839    
e Professional fundraising services. See Part IV, line 17 53,667 53,667
f Investment management fees ...... 210,216 210,216    
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 54,994,086 54,940,629   53,457
12 Advertising and promotion .... 3,958,826 3,958,826    
13 Office expenses ....... 4,505,139 4,483,402   21,737
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 5,871,053 5,871,053    
17 Travel ............ 975,616 960,404   15,212
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 374,344 371,730   2,614
20 Interest ........... 2,469,458 2,469,458    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 47,269,489 47,260,512   8,977
23 Insurance .............. 3,954,547 3,954,547    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL AND CLINICAL EXPENSE 151,069,237 151,069,237    
b MAINTENANCE/GROUNDS UPKEEP 17,863,953 17,830,470   33,483
c OTHER UNMC/UNMC-P 14,958,062 14,958,062    
d EQUIPMENT RENTALS/LEASES 7,567,277 7,518,221   49,056
e All other expenses 12,723,136 12,612,211   110,925
25 Total functional expenses. Add lines 1 through 24e 759,318,812 756,254,933 1,908,219 1,155,660
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 41,697,888 1 84,597,960
2 Savings and temporary cash investments ......... 185,577,791 2 162,423,912
3 Pledges and grants receivable, net ........... 410,396 3 164,895
4 Accounts receivable, net ............. 101,354,366 4 110,896,687
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 3,085,245 7 4,057,952
8 Inventories for sale or use .............. 4,232,728 8 4,171,169
9 Prepaid expenses and deferred charges .......... 9,157,216 9 11,218,829
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 871,635,625
b Less: accumulated depreciation ..... 10b 500,024,111 366,438,088 10c 371,611,514
11 Investments—publicly traded securities .......... 47,532,017 11 38,777,618
12 Investments—other securities. See Part IV, line 11 ..... 9,053,596 12 9,936,693
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 28,635,103 15 40,091,966
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 797,174,434 16 837,949,195
Liabilities 17 Accounts payable and accrued expenses ......... 115,099,905 17 124,368,293
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 67,544,073 20 77,386,744
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 15,031,181 23 10,353,473
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 45,014,387 25 41,624,789
26 Total liabilities. Add lines 17 through 25......... 242,689,546 26 253,733,299
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 543,173,579 27 572,891,657
28 Temporarily restricted net assets ........... 9,692,282 28 9,672,927
29 Permanently restricted net assets ........... 1,619,027 29 1,651,312
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 554,484,888 33 584,215,896
34 Total liabilities and net assets/fund balances ........ 797,174,434 34 837,949,195
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
773,732,606
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
759,318,812
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
14,413,794
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
554,484,888
5
Net unrealized gains (losses) on investments ...............
5
1,632,757
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
13,684,457
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
584,215,896
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
THE NEBRASKA MEDICAL CENTER
  		Employer identification number

91-1858433
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
THE NEBRASKA MEDICAL CENTER
  		Employer identification number

91-1858433
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
THE NEBRASKA MEDICAL CENTER
  		Employer identification number

91-1858433
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2012


Schedule C (Form 990 or 990-EZ) 2012
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
57,839
j
Total. Add lines 1c through 1i ...............................
57,839
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C, Part II-B, Line 1I Lobbying Expenses This amount consists of hospital lobbying dues paid through annual dues of the National and State Hospital Associations and an amount paid to Bromm & Associates, llc (Law Firms) for lobbying.
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $ 630,351
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 11,324,608 9,728,657 15,906,146 14,503,430 14,479,431
b Contributions ........ 608,313 2,441,330 -3,167,621 1,477,127 1,306,796
c Net investment earnings, gains, and losses 378,953 111,526 274,128 356,880 159,785
d Grants or scholarships .....       0 0
e Other expenditures for facilities
and programs ........ 		976,891 956,905 3,283,996 431,291 1,442,582
f Administrative expenses ....          
g End of year balance ...... 11,334,983 11,324,608 9,728,657 15,906,146 14,503,430
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet15.000 %
c
Temporarily restricted endowment SchDMd Bullet85.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   12,337,152 12,337,152
b Buildings ................   170,897,124 93,211,234 77,685,890
c Leasehold improvements ............   5,464,537 2,543,981 2,920,556
d Equipment ................   678,706,556 400,127,705 278,578,851
e Other .................   4,230,256 4,141,191 89,065
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 371,611,514
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
OTHER LONG TERM LIABILITIES 13,004,867
DUE TO AFFILIATES 15,918,310
EST. THIRD PARTY PAYOR SETTLEMENT 12,701,612






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 41,624,789
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D, Part III, Line 4 Description of Art Collection The hospital displays its collection of art throughout the walls of the organization. It is a collection of images & portraits taken of various cultures around the world & portrays the hospital's culture of providing medical care to people of all cultures.
SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS The majority of the endowment funds held by the hospital are held in order to earn interest in order to provide scholarships or education for employees of the hospital. The term endowment funds include charitable gift annuities. The contributions were made to the hospital and interest is paid back to the contributor as an annuity until the time of their passing. When this occurs, the balance of the annuity is no longer endowed.
SCHEDULE D, PART X FIN 48 FOOTNOTE NMC HAS adopted FASB Interpretation No. 48, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109 (FIN 48). FIN 48 provides specific guidance on how to address uncertainty in accounting for income tax assets and liabilities, prescribing recognition thresholds and measurement attributes. THERE WERE NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2013 OR 2012.
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
North America     Program Services Promote Medical Care 4,705
Europe (Including Iceland and Greenland)     Program Services Promote Medical Care 5,933
Sub-Saharan Africa     Program Services Promote Medical Care 8,335
East Asia and the Pacific     Program Services Promote Medical Care 16,887
South Asia     Program Services Promote Medical Care 21,279
Middle East and North Africa     Program Services Promote Medical Care 7,410
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     64,549
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     64,549
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
International Activities Schedule F, Part 1 INTERNATIONAL ACTIVITIES INCLUDE TRAVEL TO THESE REGIONS FOR MARKETING AND PROMOTION OF INTERNATIONAL PROGRAM OF THE NEBRASKA MEDICAL CENTER INCLUDING PATIENT CARE, TRAINING, AND EDUCATION.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2012
Additional Data


Software ID:  
Software Version:  



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Form 990-EZ filers are not required to complete this part. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Bethany Ochsner Grant Writing   No 5,000 35,667 0
Gobel Philanthropy Chad Gobel Consultant   No 0 18,000 0
             
             
             
             
             
             
             
             
Total .................right arrow 5,000 53,667 0
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

 
(event type) 		(b) Event #2

 
(event type) 		(c) Other events

 
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . .        
2 Less: Contributions . .        
3 Gross income (line 1
minus line 2) . . . 		       
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages .        
8 Entertainment . . .        
9 Other direct expenses .        
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow  
11 Net income summary. Combine line 3, column (d), and line 10. .......... right arrow  
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Identifier Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2012
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		  5,226 13,862,617   13,862,617 1.720 %
b Medicaid (from Worksheet 3,
column a) .... 		  58,705 99,451,285 71,976,607 27,474,678 3.410 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		  1,332 1,877,274 1,223,316 653,957 0.080 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		  65,263 115,191,176 73,199,923 41,991,252 5.210 %
Other Benefits
 14 127,089 2,596,353 1,622,160 974,193 0.120 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		6 670 17,195,311 7,878,051 9,317,260 1.160 %
g Subsidized health services
(from Worksheet 6) .. 		11   33,184,828 27,440,794 5,744,034 0.710 %
h Research (from Worksheet 7) 1   3,250,770 662,113 2,588,657 0.320 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		6 216 54,840,219   54,840,219 6.810 %
j Total. Other Benefits .. 38 127,975 111,067,481 37,603,118 73,464,363 9.120 %
k Total. Add lines 7d and 7j . 38 193,238 226,258,657 110,803,041 115,455,615 14.330 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 1   242,978 14,000 228,978 0.030 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 2 1,000 3,959 0 3,959  
7 Community health improvement advocacy            
8 Workforce development 2 452 199,067 0 199,067 0.020 %
9 Other            
10 Total 5 1,452 446,004 14,000 432,004 0.050 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
21,325,331
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
156,488,166
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
173,487,406
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-16,999,240
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1NEB ORTHO HOSPITAL
  		ORTHOPEDIC HOSPITAL     45.940 %
2BELLEVUE MEDICAL CTR
  		Acute Care Hospital 67.630 %   10.080 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?2
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 The Nebraska Medical Center
987400 NEBRASKA MEDICAL CENTER
OMAHA,NE68198 		X X   X     X     A
2 Bellevue Medical Center LLC
2500 Bellevue Medical Center Drive
Bellevue,NE68123 		X X         X     A
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
GROUP A
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)  
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address Type of Facility (describe)
1 Nebraska Medical Center Radiology
2727 S 144th St Ste 120
Omaha,NE68144 		Provider Based Radiology Department
2 Nebraska Medical Center Laboratory
2727 S 144th St Ste 160
Omaha,NE68144 		Provider Based Laboratory Department
3 NMC - Bellevue Pharmacy
2510 Bellevue Medical Ctr Dr Ste
Bellevue,NE68123 		Pharmacy
4 Cancer Ctr at VillAge Point Med Center
111 N 175th Street
Omaha,NE68118 		ONCOLOGY, RADIOLOGY, PATHOLOGY TREATMENT, RADIATION ONCOLOGY Pharmacy , Treatment
5 NMC - Bellevue Cancer Services
2510 Bellevue Med Ctr Dr
Bellevue,NE68123 		Infusion Services Oncology Clinic
6 NMC Cardiology Imaging
2727 S 144th St STE 290
Omaha,NE68144 		Cardiology Imaging
7 NMC Bellevue Cardiology Imaging
2500 Bellevue Med Ctr Dr STE 250
Bellevue,NE68123 		Cardiology Imaging
8 NMC VILLAGE POINT ENDOSCOPY CENTER
111 NORTH 175TH STREET
OMAHA,NE68118 		ENDOSCOPY SERVICES
9 NMC - BELLEVUE CANCER SERVICES
2500 MEDICAL CENTER DRIVE RMS 224-2
BELLEVUE,NE68123 		INFUSION SERVICES
10
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
Part I, Line 3C   Not applicable as the organization does follow FPG to determine eligibility for providing fee care to low income individuals.
Part I, Line 6A   The Organization's community benefit report can be accessed at http://www.nebraskamed.com/about-us/community/community-benefit-report. Bellevue Medical Center is not a 501(c)(3) tax-exempt hospital and is therefore not required to and does not file a community benefit report.
Part I, Line 7G   Physician Clinics were included in the subsidized health services calculation resulting in additional net community benefit expense of $1,046,264.
Part I, Line 7, Column F   THE PERCENT OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST AS A PERCENT OF TOTAL EXPENSES LESS BAD DEBT IS 14.33%. NMC OWNS APPROXIMATELY 67% OF BMC AND THAT PERCENTAGE OF EXPENSES IS INCLUDED IN ORDER TO PROPERLY CALCULATE THE TABLE 7 PERCENTAGES. THE DENOMINATOR USED TO CALCULATE THE COST TO CHARGE RATIO IS $805,334,354.
Part I, Line 7   These numbers are computed in a cost accounting system that produces a cost for every service the hospital provides. Relative value units, for seven categories of expense, are updated annually for each patient service which keeps the cost accounting current. These costs per unit values are applied to the patient utilization to compute the total cost. The cost accounted total is tied back to the Hospital's financial statements to ensure system integrity. Part II, Community Building Activities Community-building activities are designed to address the root causes of health problems. Poverty, homelessness and environmental problems all contribute to poor health. The types of programs included in this category support workforce development and training programs to provide employment and leadership skills training, job shadowing for students interested in health careers and economic development support grants to help revitalize low-income areas and businesses.
Part III, Line 2 & 4   The organization's footnotes to the consolidated financial statements do not contain a footnote specifically covering bad debt expense. Though patient income may qualify them for financial assistance, the patient has obligations as well to complete financial assistance forms and to submit supporting documentation to qualify. Patients who provide this information and qualify for assistance would never go to bad debt. Therefore, it is reasonable to state that our bad debt expense is for those unwilling to pay or unwilling to work with us to provide financial assistance if available. If an account is completely written off to bad debt, the total cost via the cost accounting system is applied. If only a portion of the account was written off to bad debt, then bad debt as a percentage of charge is then applied to the total cost for the encounter to estimate the cost associated with the bad debt. The amount that goes to collections is patient liability. Not collecting these dollars is a direct expense to the organization. As a not-for-profit healthcare organization, it is our responsibility to help anyone who presents themselves with a health issue; as such we have less control over what gets recognized as bad debt. To compute bad debt at cost, management used all discharged cases in prior fiscal year with bad debt write-off. The write-off was computed as a percentage of charge and then multiplied by the total cost (determined by a detailed cost accounting methodology) to estimate the cost of bad debt.
Part III, Line 8   Overall Medicare patients produce a negative 7% margin on Gross Charges. This is spread across most of our Product lines. Our heaviest losses are from the inpatient Neurology, Oncology and Cardiac product lines and from Oncology and Surgery on the outpatient side. In general Medicare inpatients do cover the direct costs of providing their care. However, the indirect costs to support the hospital must be accounted for and turns the margin negative. These numbers are computed in a cost accounting system that produces a cost for every service the hospital provides. The system is updated annually and tied to our Financial Statements to ensure integrity of the product line profitability statements.
Part III, Line 9B   A patient known to qualify for financial assistance (once all paperwork is received and approved) are flagged in the system and monitored accordingly to ensure financial assistance is "posted" to the patient account. When the 12 month approval expires, patients are contacted if services have been rendered within the last six months to discuss submittal of new information for continuation of assistance. If patients no longer qualify, other payments options are discussed per organizational policy. Reports are utilized for follow up purposes. Patients who qualify for 100% assistance do not receive guarantor statements (bills) from the organization. Patients who qualify for an 80% or 60% discount work with customer service or collection staff to outline payment arrangements according to set policy.
Part V   We do not have rehabilitation, free standing diagnostic facilities, or skilled nursing. Our off site diagnostic services are included on our hospital license and our hospital ancillary services are hospital based and included on our license. Part V, Section B, Line 3 (CHNA) For The Nebraska Medical Center and Bellevue Medical Center For the comprehensive CHNA process, a steering committee comprised of key stakeholders from area health systems, local county health department representatives, and key informants from several community agencies worked collaboratively to oversee the process. The CHNA steering committee retained Professional Research Consultants (PRC), Inc. to conduct the survey. PRC is a nationally recognized health care consulting firm with extensive experience conducting CHNAs such as this in hundreds of communities across the United States since 1994. INPUT FROM COMMUNITY STAKEHOLDERS Key informant focus group discussions included representation from all of the assessed counties. Focus group participants were chosen because of their ability to provide input regarding vulnerable or medically underserved populations, minorities, and/or populations with chronic disease. Eighty-seven community stakeholders, including physicians, other health professionals, social service providers, and business and community leaders participated in focus group sessions: A full list of participating key informant focus groups and their areas of expertise can be found here: http://www.nebraskamed.com/about-us/community/community-health-needs-asses sments CHNA Steering Committee Participant Names Below is a listing of the participants and the sponsoring organizations represented in the original CHNA Steering Committee formed in 2011. Alegent Creighton Health: Beth Llewellyn- Vice President, Mission Integration Mikki Frost- Director, Community Benefit and Healthier Communities Douglas County Health Department: Dr. Adi Pour- Health Director Mary Balluff- Division Chief, Community Health and Nutrition Services Live Well Omaha: Kerri Peterson- Executive Director Methodist Health System: Ken Klaasmeyer- Vice President Ruth Freed- Director of Clinical Alignment Jeff Prochaska- Director, Strategic Planning Visiting Nurses Association/Pottawattamie County: Kris Stapp- Vice President, Community Health Service Sarpy/Cass County Health Department: Diane Kelly- Health Director The Nebraska Medical Center: Tadd Pullin- Senior Vice President, Marketing, Strategic Planning and Network Ops Annette Wolfe- Director, Strategic Planning Leslie Spethman- Gift Officer/Community Relations and Community Benefit Part V, Section B, Line 4 The CHNA was conducted with other hospital and community based facilities as listed below: The Nebraska Medical Center and Bellevue Medical Center Alegent Creighton Health System Methodist Health System Douglas, Sarpy, Cass and Pottawatomie County Health Departments Live Well Omaha Part V, Section B, Line 7 TNMC has current programs and services in place to address each of the nine CHNA- identified community needs. However, in order to make meaningful impact, and to use its finances most effectively and efficiently, TNMC will place a primary focus on Diabetes, Heart and Stroke, and Access to care. However, it has no plans to discontinue other community benefit efforts addressing the remaining CHNA-identified needs, and may touch upon each of these categories within its efforts to address issues surrounding access to care in underserved populations. Further, in order to ensure all identified needs will be addressed in the community, TNMC met with the other local health systems and County health departments to discuss the CHNA-identified community needs and look for opportunities to collaborate. The identified needs not being addressed by TNMC are identified as Nutrition/Weights Status, Maternal, Infant, and Child Health, Mental Disorders and Substance Abuse, Oral Health, and Sexually Transmitted Diseases. Each of these remaining CHNA-identified needs are being addressed by one of the other community health systems, local university medical schools, County health departments, or community-based organizations. A full listing of these are provided in TNMC's CHNA report and can be found here: http://www.nebraskamed.com/about-us/community/community-health-needs-asses sments. BMC is majority owned by the Nebraska Medical Center (NMC). UNMC Physicians has a minority ownership. Both organizations are 501(c)(3) organizations. It was determined that the community had a need for medical services that was not currently being fulfilled. Between the two organizations they own over 80% of BMC. Part V, Section B, Line 12H POLICY FN16: DISCOUNT/FINANCIAL ADJUSTMENTS TALKS ABOUT "DISCOUNTS FOR PATIENTS WITH NON THIRD-PARTY PAYMENT SOURCE," DISCOUNTS, SIMILAR TO DISCOUNTS OFFERED TO MANAGED CARE PLANS, ARE OFFERED FOR MOST PATIENTS THAT DO NOT HAVE THIRD-PARTY INSURANCE AND DO NOT MEET THE GUIDELINES FOR GOVERNMENTAL ASSISTANCE PROGRAMS. THIS DISCOUNT IS SUBJECT TO CHANGE BASED ON THE RATES AGREED UPON THROUGH MANAGED CARE CONTRACTS. THESE DISCOUNTS ARE INDEPENDENT OF THE CHARITY ADJUSTMENTS, AND THAT CHARITY ADJUSTMENTS ARE APPLIED AFTER THE SELF-PAY ADJUSTMENT IS APPLIED TO THE BILLED CHARGES. Part V, Section B, Line 14G INFORMATION ON HOW TO GET FINANCIAL ASSISTANCE IS POSTED ON THE WEBSITE UNDER PATIENT FRIENDLY BILLING WHICH IS LOCATED UNDER THE PATIENT & VISITORS SECTION. THERE ARE DEPARTMENTS LISTED WITH PHONE NUMBERS TO CALL FOR MORE INFORMATION OR TO SET UP AN APPOINTMENT.
Schedule H, Part VI, Line 2 Needs Assessment NMC uses disease incidence and prevalence data, leading causes of death, community health status research and supply and demand analysis to assess the health care needs of the communities it serves. ADDITIONALLY, NMC ENGAGED PROFESSIONAL RESEARCH CONSULTANTS (PRC) TO PERFORM A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN COLLABORATION WITH THE LOCAL HEALTH SYSTEMS AND COUNTY HEALTH DEPARTMENTS.
Schedule H, Part VI, Line 3 Patient Education of Eligibility for Assistance NMC and BMC employ Financial Counselors, Customer Service Staff and Collection Staff, all of whom are trained in assisting our patients with resolution of patient liability. Depending upon individual patient needs, payment arrangements or financial assistance may be offered to assist our customers with resolution of patient balances. Additionally, the organization works with our self pay population to pursue coverage through state, federal or local programs. Charity Care Policy: This policy outlines the guidelines Patient Financial Services (PFS) will use to ensure adequate and appropriate follow up is completed in order for qualifying patients to receive charity care. PFS will work with patients to find payment solutions when available. This policy is written to ensure a fair and comprehensive system of distributing charity care to financially burdened patients within the available resources of NMC in a manner that does not discriminate based on race, creed, color, sex, national origin, religion or age. Policy: A. Charity care is available when all other recovery sources have been exhausted. B. Charity care is provided to patients who have demonstrated inability to meet their financial obligation to NMC. C. Charity care will not be approved for elective and/or cosmetic care. D. Charity care may be approved in the instance of catastrophic care as defined. 1. This could be occasioned by a personal catastrophe or unavoidable crisis affecting an individual who would otherwise be able to pay for service, or a person who has income above poverty level but is still not able to pay the entire cost of service. 2. A patient generally may qualify for catastrophic charity care in instances where the patient liability is in excess of 25% of annual household income. E. All transplant and IRP patients must meet with a Transplant Financial Counselor to secure financial clearance. Transplant and IRP patients must pass financial screening (ACCESS-FIC-082) or must be approved via the Transplant Variance Policy (FN 21) Charity approval for other services prior to consideration for transplant does not meet this requirement. F. Prior approval for charity care does not apply for future elective or cosmetic procedures. GUIDELINES: A. Identification process 1) The hospital maintains a separate policy in order to assure compliance with the emergency medical treatment and active labor act (EMTALA) and a separate patient rights and organizational ethics policy. This charity care policy is subject to the terms of those policies. 2) Financial counselors authorized by NMC will identify patients requiring financial screening. B. Verification of Insurance Eligibility and Benefits 1) The patient will execute an assignment of insurance benefits on behalf of the hospital. 2) Verification of eligibility, benefits, and payer source will be performed in a timely manner according to patient finance and access services departmental procedures. C. Financial Counseling 1) Financial Counselors and contracted vendors will assist patients requiring financial assistance. 2) Financial Counselors and vendors will assist patients in seeking reimbursement from local, state, and federal programs when there is no other source of payment as well as assisting patients with applications or making appointments to qualify for government programs. 3) Patients are responsible for follow up meetings with an agency that may provide financial resources for health care services. Charity assistance may be terminated at any time due to non compliance with this expectation.
Schedule H, Part VI, Line 4 Community Information WE SERVE MANY COMMUNITIES, INTERNATIONAL, REGIONAL, STATE AND LOCAL OMAHA. THE STATISTICS BELOW DESCRIBE OUR "LOCAL" OMAHA COMMUNITY DEFINED AS DOUGLAS AND SARPY COUNTIES IN NEBRASKA. THIS LOCAL AREA REPRESENTS APPROXIMATELY 70% OF OUR INPATIENT AND OUTPATIENT DISCHARGES AND VISITS. THE 2013 ESTIMATED POPULATION FOR THIS LOCAL AREA IS 697,118. THE ESTIMATED RACE BREAKDOWN OF THE POPULATION IS BELOW. WHITE NON-HISPANIC 518,009 74.3% BLACK NON-HISPANIC 69,290 9.9% ASIAN NON-HISPANIC 19,587 2.8% HISPANIC 74,398 10.7% ALL OTHERS 15,834 2.3% THERE ARE ELEVEN HOSPITALS IN NEBRASKA TO SERVE THE LOCAL COMMUNITY. METHODIST HOSPITAL, METHODIST WOMEN'S HOSPITAL, LAKESIDE HOSPITAL, BERGAN MERCY MEDICAL CENTER, MIDLANDS HOSPITAL, CREIGHTON MEDICAL CENTER, CHILDREN'S HOSPITAL, IMMANUEL HOSPITAL, NEBRASKA ORTHOPAEDIC HOSPITAL, BMC AND NMC. THERE ARE FOUR DESIGNATED MEDICALLY UNDERSERVED AREAS IN DOUGLAS COUNTY (THREE AREAS) AND SARPY COUNTY (ONE AREA.) Douglas County Median household income, (2008-2012) = $53,295 Persons below poverty level, percent (2008-2012) = 14.0% (74,377 based on 2012 population estimate) Sarpy County Median household income, (2008-2012) = $69,269 Persons below poverty level, percent (2008-2012) = 6.6% (10,946 based on 2012 population estimate) IN THE 2012 FISCAL YEAR, THERE WERE 12,914 MEDICAID CLAIMS IN THE LOCAL COMMUNITY AND 3,686 UNINSURED OR SELF PAY CLAIMS. OF THESE, NMC SERVED 30.4% OF THE MEDICAID CLAIMS AND 39.0% OF THE UNINSURED (OR SELF PAY).
Schedule H, Part II and Part VI, Line 5 Community Building Activities and Promotion of Health NMC RECOGNIZES THE COMMUNITY BENEFIT OF ADDRESSING ROOT CAUSES OF POOR HEALTH IN ORDER TO IMPROVE COMMUNITY HEALTH. THE HOSPITAL PARTICIPATED IN SEVERAL COMMUNITY BUILDING ACTIVITIES THROUGHOUT THE PAST YEAR DESIGNED TO ADDRESS THESE ROOT CAUSES. INCLUDED IN THIS TOTAL ARE THE HOSPITAL'S EFFORTS TO SUPPORT THE MID-AMERICA HOSPITAL ALLIANCE (MAHA); AN ALLIANCE OF RURAL AND CRITICAL ACCESS HOSPITALS IN THE REGION OF WHICH THE HOSPITAL IS A FOUNDING MEMBER. THE HOSPITAL SPENDS TIME COORDINATING RESOURCES TO ENSURE SMALLER, RURAL HOSPITALS CAN HAVE ACCESS TO THE EXPERTISE AND SERVICES OF A LARGE ACADEMIC MEDICAL CENTER. NMC PROVIDES HUMAN RESOURCE CONSULTING SERVICES TO HELP THESE SMALLER INSTITUTIONS ADDRESS WIDESPREAD HEALTH CARE WORKFORCE SHORTAGES IN RURAL AREAS. THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE PROGRAMS INTENDED TO DRIVE ENTRY INTO HEALTH CAREERS AND NURSING PRACTICE. MANY HOSPITAL STAFF MEMBERS GIVE EDUCATIONAL PRESENTATIONS ON THE HEALTH PROFESSIONS AND PROVIDE MOCK INTERVIEW TRAINING TO AREA STUDENTS. NMC ALSO PROVIDES JOB SHADOWING OPPORTUNITIES TO UNDERGRADUATE STUDENTS WHO WISH TO EXPLORE THE HEALTH CAREERS. ADDITIONALLY, THE HOSPITAL HAS THE ONLY BIO-CONTAINMENT UNIT IN THE STATE, CONTRIBUTING TO DISASTER PREPAREDNESS ABOVE AND BEYOND LICENSURE REQUIREMENTS. MEMBERS OF THE HOSPITAL'S CRITICAL CARE AND TRAUMA STAFF SHARE THE EXPERTISE BY PARTICIPATING IN COMMUNITY COALITIONS TO IMPROVE SAFETY AND REDUCE ACCIDENTS AMONG CHILDREN, TEENS, AND SENIORS. THE HOSPITAL works to ENCOURAGE ECONOMIC GROWTH AND DEVELOPMENT BY SUPPORTING AN ECONOMIC DEVELOPMENT PARTNERSHIP AIMED AT THE DEVELOPMENT OF NEW BUSINESS IN THE CITY'S URBAN AREAS. BMC HAS PARTICIPATED IN, AND HOSTED A NUMBER OF EVENTS DESIGNED TO PROMOTE A HEALTHIER COMMUNITY. IN ADDITION TO FINANCIAL SUPPORT OF SEVERAL COMMUNITY-BASED CHARITABLE ORGANIZATIONS AND THE LOCAL CHAMBER OF COMMERCE, THE HOSPITAL'S LEADERSHIP TEAM IS ACTIVE ON COMMUNITY BOARDS. BMC ALSO HOSTS FREE MONTHLY "HEALTHY REVIEW" TALKS WHERE A PHYSICIAN GIVES AN EDUCATIONAL PRESENTATION ON VARIOUS DISEASES AND CONDITIONS. THESE INITIATIVES DEMONSTRATE BMC'S MISSION TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY BY PROVIDING A HEALING ENVIRONMENT FOCUSED ON QUALITY, COMPASSION, AND PERSONALIZED CARE ALONG WITH ITS ONGOING COMMITMENT TO CREATE A HEALTHIER COMMUNITY THROUGHOUT ITS SERVICE AREA.
Other Information   NMC IS A NONPROFIT HOSPITAL MEETING THE REQUIREMENTS OF REVENUE RULING 69-545. IN SUMMARY, THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS WITHOUT REGARD TO ABILITY TO PAY, THE HOSPITAL ALSO HAS A BOARD COMPRISED OF MEMBERS FROM THE COMMUNITY, THEY HAVE AN OPEN MEDICAL STAFF POLICY, THEY ACCEPT PATIENTS PAYING THEIR BILLS WITH MEDICAID AND MEDICARE, AND THEY USE THE SURPLUS OF THEIR FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH. BMC IS A HOSPITAL, HOWEVER, IT IS NOT A TAX EXEMPT ORGANIZATION, AND THEREFORE THIS QUESTION IS NOT APPLICABLE.
Schedule H, Part VI, Line 6   Neither NMC nor BMC are in an affiliated healthcare system.
Schedule H, Part VI, Line 7   NMC files a community benefit report with the Nebraska Hospital Association annually. BMC is not required to file a community benefit report in any state, but voluntarily files an annual report with the Nebraska Hospital Association.
Schedule H (Form 990) 2012
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number
91-1858433
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) American Heart Association
10100 J Street Ste A
Omaha,NE68127 		13-5613797 501(c)(3) 13,000       General Support
(2) March of Dimes
11840 Nicholas Street
Omaha,NE68154 		13-1846366 501(c)(3) 7,000       General Support
(3) Salvation Army
3612 Cuming Street
Omaha,NE68131 		36-2167910 501(c)(3) 15,000       General Support
(4) Hope Medical Outreach Coalition
4920 S 30th Street
Omaha,NE68107 		47-0548990 501(c)(3) 25,500       General Support
(5) Joslyn Art Museum
2200 Dodge St
Omaha,NE68102 		47-0384577 501(c)(3) 50,000       General Support
(6) The Durham Western Heritage Museum
801 S 10th St
Omaha,NE68108 		47-0556061 501(c)(3) 75,000       General support
(7) UNMC Physicians
988101 Ne Med Ctr
Omaha,NE681988101 		47-0785575 501(c)(3) 28,077,050       Support Operations
(8) University of Nebraska Medical Center
986800 Ne Med Ctr
Omaha,NE681986800 		47-0049123 GOVT 29,930,252       Support Operations
(9) Board of Regents of the Univ of NE
3835 Holdrege
Lincoln,NE68583 		47-0049123 GOVT 6,000,000       General support
(10) Clarkson College
101 S 42nd Street
Omaha,NE681312739 		36-3649217 501(c)(3) 1,797,726       General support
(11) Mid-America Council
12401 W Maple Rd
Omaha,NE681641853 		47-0376545 501(c)(3) 20,000       General support
(12) Wellness Council of the Midlands
12565 W Center Rd Ste 220
Omaha,NE68144 		47-0642708 501(c)(3) 10,000       General support
(13) University of Nebraska Foundation
6901 Dodge Street
Omaha,NE68198 		47-0379839 501(c)(3) 30,000       General support
(14) Legal Aid of Nebraska
1904 Farnam St 5th Floor
Omaha,NE68102 		47-0483506 501(c)(3) 41,643       PATIENTS LEGAL AID
(15) Make a Wish
11926 Arbor St Ste 102
Omaha,NE68144 		47-0671096 501(c)(3) 7,500       General support
(16) Ronald McDonald House
620 S 38th Street
Omaha,NE681051104 		47-0755104 501(c)(3) 6,365       General support
(17) Harbor House (Hospice House)
7415 Cedar Street
Omaha,NE681242367 		36-4003095 501(c)(3) 100,000       General Support
(18) Intercultural Senior Center
2021 U Street
Omaha,NE68107 		27-2460810 501(c)(3) 6,000       General Support
(19) Friends of UNMC Cancer Center
985950 Ne Med Ctr
Omaha,NE68198 		47-0809725 501(c)(3) 9,500       General Support
(20) United Way of the Midlands
1805 Harney St
Omaha,NE68102 		47-0376605 501(c)(3) 8,390       General Support
(21) Clarkson Regional Health Services Inc
988145 Ne Med Ctr
Omaha,NE681988145 		47-0376531 501(c)(3) 6,000,000       General Support
(22) Latino Center of the Midlands
4821 South 24th St
Omaha,NE68107 		23-7208431 501(c)(3) 9,818       General Support
(23) Heart of Ministry Center
2222 Binney Street
Omaha,NE68110 		81-0614816 501(c)(3) 10,000       General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
23
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) Financial Assistance (Charity Care) 5226   40,912,972 Book Charity Care
(2) Financial Assistance (Pharmaceuticals) 475   45,901 Book Emerg Drug Fund










Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
Review and Approval of Charitable Contributions Schedule I, Part I, Line 1 The Nebraska Medical Center (NMC) has a committee whose responsibility is to review and approve or disprove requests for sponsorship. This committee is comprised of key executives and other members of the leadership team, as well as representatives from the University of Nebraska Medical Center. Decisions are made on each request individually based on a set of guidelines established by the organization. In order to effectively evaluate and review the many requests we receive, each request is brought before our Sponsorships and Charitable Contributions Committee for consideration. This committee is comprised of key executives and other members of the hospital leadership team. The committee considers each request individually, and contributions are made based on three primary objectives: 1)To support the community need for resources addressing Nebraska's leading causes of death; including cancer, stroke and heart disease. 2)To align with organizations furthering NMC's charitable mission to support causes which significantly impact the overall health status of the community. 3)To support organizations which impact favorably the public image of the hospital and enhance existing partnerships or initiatives. If a sponsorship or charitable contribution request falls within our three primary objectives, the following criteria are then applied to further assist the committee in making funding decisions: 1)Organization must provide proof of 501(c)(3) status from the IRS, or nonprofit designation as a governmental or tribal entity. 2)All requests must be received in writing- no phone requests will be considered 3)Requestor must be able to provide the organization's Non-Discrimination Policy 4)Must be able to provide an organizational operating budget and project budget upon request 5)Proposal must include a list of board members, directors, and key project staff members and the role they serve in the organization. 6)Request must include a brief narrative of the project, including an estimate of numbers of people served by the request and location of communities impacted by the organization's mission. 7)Requests for sponsorship need to be submitted at least 90 days prior to the event, with requests over $10,000 being submitted by March 1 for consideration in the next fiscal year. Groups, Programs and Activities not supported by NMC: 1)Organizations without IRS 501(c)(3) or equivalent tax exempt status 2)Organizations that discriminate on the basis of age, disability, religion, ethnic origin, gender, or sexual orientation 3)Organizations with divisive or litigious public agendas 4)Member based organizations, including chambers of commerce, rotary clubs or IRS 501(c)(4) legions and associations 5)Municipalities, including fire and police departments or related social service groups and political organizations 6)Religious organizations or sectarian programs for religious purposes 7)Fraternal organizations, social clubs, sports teams or clubs, athletic competitions 8)Endowments 9)Multiyear requests and pledges 10)Individuals requesting loans, debt retirements, scholarship or fellowship assistance 11)Travel- including student trips or tours 12)Marketing activities or promotional merchandise 13)Purchase or maintenance of vehicles 14)Film or video projects, including documentaries 15)Beauty pageants
Grant Monitoring Procedures Schedule I, Part I, Line 2 Based on the detailed gift policy outlined in Part I, Line 1, the funds are only provided for charitable purposes, and those organizations that receive monies from NMC are required to follow their 501(c)(3) requirements surrounding the use of funds received.
Schedule I (Form 990) 2012


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
Yes
 
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Lianne StevensVP Info Technology (i)
(ii)		 195,999
0 		0
0 		68,582
0 		20,253
0 		5,472
0 		290,306
0 		0
0
(2)Glenn A FosdickPresident (i)
(ii)		 656,554
0 		374,000
0 		647,271
0 		165,798
0 		15,415
0 		1,859,038
0 		617,726
0
(3)Stephen Smith MDChief Medical Officer (i)
(ii)		 472,061
0 		210,000
0 		128,709
0 		133,653
0 		9,612
0 		954,035
0 		108,965
0
(4)William DinsmoorChief Financial Officer (i)
(ii)		 418,333
0 		175,000
0 		121,616
0 		135,242
0 		7,054
0 		857,245
0 		115,088
0
(5)Joe GrahamChief Operating Officer (i)
(ii)		 391,329
0 		170,000
0 		118,703
0 		123,741
0 		14,960
0 		818,733
0 		112,258
0
(6)Rosanna MorrisChief Nursing Officer (i)
(ii)		 317,231
0 		140,000
0 		96,243
0 		98,659
0 		624
0 		652,757
0 		90,132
0
(7)Marcel Devetten MDPhysician (i)
(ii)		 204,902
0 		0
0 		1,425
0 		17,588
0 		5,879
0 		229,794
0 		0
0
(8)Michael D JohnsonPhysician (i)
(ii)		 304,959
0 		0
0 		1,206
0 		10,687
0 		9,165
0 		326,017
0 		0
0
(9)Randall J HallettExec Dir -Development (i)
(ii)		 230,760
0 		61,115
0 		13,175
0 		17,611
0 		11,039
0 		333,700
0 		0
0
(10)Louis Burgher MDClarkson College President (i)
(ii)		 307,565
0 		0
0 		0
0 		0
0 		6,642
0 		314,207
0 		0
0
(11)Thomas MacyNebraska Orthopaedic Hosp CEO (i)
(ii)		 235,874
0 		0
0 		1,018
0 		22,125
0 		13,633
0 		272,650
0 		0
0
(12)Natale PonticelloVP Human Resources (i)
(ii)		 251,912
0 		37,298
0 		13,109
0 		25,172
0 		3,569
0 		331,060
0 		0
0
(13)Tadd PullinVP Marketing and Planning (i)
(ii)		 341,476
0 		49,676
0 		17,993
0 		74,216
0 		7,881
0 		491,242
0 		0
0
(14)Theresa FrancoExec Dir Cancer Care (i)
(ii)		 227,999
0 		23,316
0 		970
0 		18,081
0 		9,609
0 		279,975
0 		0
0
(15)Deborah IstasExec Dir Neuro Sciences (i)
(ii)		 229,765
0 		17,265
0 		1,562
0 		23,977
0 		2,097
0 		274,666
0 		0
0
(16)Jorge ParodiExec Dir Cardio/Pulmonary (i)
(ii)		 220,739
0 		17,052
0 		12,508
0 		20,385
0 		10,796
0 		281,480
0 		0
0
(17)Ruta DavidsonExec Dir Organ/Transplant/PC (i)
(ii)		 230,561
0 		97,112
0 		1,552
0 		16,043
0 		13,861
0 		359,129
0 		0
0
(18)Michael PowellExec Dir Pharmacy (i)
(ii)		 197,767
0 		0
0 		6,448
0 		23,199
0 		10,625
0 		238,039
0 		0
0
(19)Charles LaksoExec Dir Radiology/Lab (i)
(ii)		 219,803
0 		0
0 		1,511
0 		16,915
0 		7,447
0 		245,676
0 		0
0
(20)Lisa McClaneExec Dir Women/Children (i)
(ii)		 191,439
0 		0
0 		1,314
0 		7,751
0 		3,989
0 		204,493
0 		0
0
(21)Julie LazureExec Dir Ed/Trauma.CCU (i)
(ii)		 175,452
0 		0
0 		1,182
0 		19,237
0 		10,364
0 		206,235
0 		0
0
(22)Connie OgdenExec Dir Adult Acute Care (i)
(ii)		 179,258
0 		0
0 		1,211
0 		18,760
0 		2,174
0 		201,403
0 		0
0
(23)Jana DanielsonExec Director Revenue Cycle (i)
(ii)		 187,470
0 		0
0 		721
0 		14,673
0 		2,272
0 		205,136
0 		0
0
(24)Donald FutrellExec Dir, Fac & Clin Spc Plng (i)
(ii)		 191,145
0 		0
0 		1,315
0 		15,883
0 		11,834
0 		220,177
0 		0
0
(25)David S FullerInterim, Chief Process Officer (i)
(ii)		 209,399
0 		20,000
0 		25,536
0 		21,436
0 		7,113
0 		283,484
0 		0
0
(26)Martin CarmodyFORMER BMC CEO (i)
(ii)		 0
0 		0
0 		243,225
0 		0
0 		0
0 		243,225
0 		0
0
(27)Cynthia OwenVP Corporate Affairs (i)
(ii)		 257,653
0 		0
0 		7,545
0 		24,928
0 		1,364
0 		291,490
0 		0
0
(28)STEVEN J WEES MDPHYSICIAN (i)
(ii)		 191,930
0 		51,813
0 		1,342
0 		9,756
0 		11,821
0 		266,662
0 		0
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS THE FOLLOWING EMPLOYEES WERE TERMINATED DURING FISCAL YEAR 2013 AND RECEIVED SEVERANCE PAYMENTS DURING CALENDAR YEAR 2012: Lianne Stevens $67,901.39 Martin Carmody $243,225.00
SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLANS Certain executives do participate in supplemental nonqualified retirement plans. A payout occurred during the year from a supplemental nonqualified plan to the following individuals: Glenn Fosdick $617,726 William Dinsmoor $115,088 Stephen Smith $108,965 Joe Graham $112,258 Rosanna Morris $ 90,132
SCHEDULE J, PART I, LINE 5 & 6 CONTINGENT COMPENSATION The organization's revenues and net earnings are taken into consideration when calculating executive incentive compensation in addition to other non-financial factors. Executive incentive compensation is determined by several key metrics that are established by The Nebraska Medical Center Board of Directors. These metrics are inclusive of strategic, financial, operational and quality outcomes. On an annual basis, The Nebraska Medical Center Board of Directors reviews achievement of preset targets and approves incentives when warranted. These performance payments are in lieu of a typical executive's base pay. The board of directors and executives determined it is in the best interest of the organization to have a portion of their base pay subject to forfeiture unless the pre-determined financial and non-financial factors discussed above are achieved. Incentive compensation related to FY12 performance were paid to the following individuals: Glenn Fosdick $374,000.00 Stephen Smith, MD $210,000.00 Joe Graham $170,000.00 William Dinsmoor $175,000.00 Rosanna Morris $140,000.00 Tadd Pullin $ 49,676.00 Randall Hallet $ 61,115.00 Nat Ponticello $ 37,298.00 Theresa Franco $ 23,316.00 Jorge Parodi $ 17,052.00 Deb Istas $ 17,265.00 Paulette Davidson $ 97,112.00 David Fuller $ 20,000.00
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number
91-1858433
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 09-28-2010 10,000,000 HOSPITAL FACILITIES & EQUIPMENT   X   X   X
B HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 12-10-2003 41,762,267 REFUND BOND ISSUE   X   X   X
C HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 06-01-2011 10,000,000 HOSPITAL FACILITIES & EQUIPMENT   X   X   X
D HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 12-01-2011 52,000,000 HOSPITAL FACILITIES & EPIC   X   X   X
HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 04-29-2009 10,000,000 HOSPITAL FACILITIES & EQUIPMENT   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 24,510,000 0  
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0  
3 Total proceeds of issue . . . . . . . . . . . . . . 10,002,474 41,762,267 10,000,115  
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 4,171,305 0  
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0  
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0  
7 Issuance costs from proceeds . . . . . . . . . . . . 0 834,246 0  
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0  
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0  
10 Capital expenditures from proceeds . . . . . . . . . . . 10,002,474 3,768 10,000,115  
11 Other spent proceeds . . . . . . . . . . . . . . 0 36,879,309 0  
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0  
13 Year of substantial completion . . . . . . . . . . . . 2010 1994 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X X     X    
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X    
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X      
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . . X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X      
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? . X   X   X      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0% 0% 0%   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.00000% 0.00000%   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . . 0% 0% 0%   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X    
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X    
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.   %   %   %   %
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X    
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X    
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X        
b Exception to rebate? . . . . . . . . X   X   X      
c No rebate due? . . . . . . . . . .
X   X          
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X   X   X    
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . . . .                
e Was a hedge terminated? . . . . . . .                
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X    
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X      
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
BOND ISSUE - PRIVATE BUSINESS USE 0 SCH. K PART III, Column B PER THE INSTRUCTIONS, THIS PART IS NOT TO BE COMPLETED FOR POST-DECEMBER 31, 2002 BOND ISSUES WHICH REFUND A PRE- JANUARY 2003 ISSUE. BOND ISSUE - PROCEEDS PART II, LINE 3, COLUMN B - THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4 -12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. PART II, LINE 4, COLUMN B THE RESERVE AMOUNT IS HIGHER THAN THE REQUIRED RESERVE DUE TO APPRECIATION OF THE INVESTMENT AT 6/30/2013.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number
91-1858433
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 09-28-2010 10,000,000 HOSPITAL FACILITIES & EQUIPMENT   X   X   X
B HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 12-10-2003 41,762,267 REFUND BOND ISSUE   X   X   X
C HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 06-01-2011 10,000,000 HOSPITAL FACILITIES & EQUIPMENT   X   X   X
D HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 12-01-2011 52,000,000 HOSPITAL FACILITIES & EPIC   X   X   X
HOSPITAL AUTH NO 2 OF DOUGLAS COUNTY NE
  		52-1440769 000000000 04-29-2009 10,000,000 HOSPITAL FACILITIES & EQUIPMENT   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 24,510,000 0  
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0  
3 Total proceeds of issue . . . . . . . . . . . . . . 10,002,474 41,762,267 10,000,115  
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 4,171,305 0  
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0  
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0  
7 Issuance costs from proceeds . . . . . . . . . . . . 0 834,246 0  
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0  
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0  
10 Capital expenditures from proceeds . . . . . . . . . . . 10,002,474 3,768 10,000,115  
11 Other spent proceeds . . . . . . . . . . . . . . 0 36,879,309 0  
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0  
13 Year of substantial completion . . . . . . . . . . . . 2010 1994 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X X     X    
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X    
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X      
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . . X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X      
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? . X   X   X      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0% 0% 0%   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.00000% 0.00000%   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . . 0% 0% 0%   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X    
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X    
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.   %   %   %   %
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X    
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X    
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X        
b Exception to rebate? . . . . . . . . X   X   X      
c No rebate due? . . . . . . . . . .
X   X          
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X   X   X    
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . . . .                
e Was a hedge terminated? . . . . . . .                
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X    
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X      
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
BOND ISSUE - PRIVATE BUSINESS USE 0 SCH. K PART III, Column B PER THE INSTRUCTIONS, THIS PART IS NOT TO BE COMPLETED FOR POST-DECEMBER 31, 2002 BOND ISSUES WHICH REFUND A PRE- JANUARY 2003 ISSUE. BOND ISSUE - PROCEEDS PART II, LINE 3, COLUMN B - THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4 -12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. PART II, LINE 4, COLUMN B THE RESERVE AMOUNT IS HIGHER THAN THE REQUIRED RESERVE DUE TO APPRECIATION OF THE INVESTMENT AT 6/30/2013.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Bruce Lauritzen PRESIDENT 1ST NATL BANK 29,150,355 SUPPLIES, SERVICES, LEASE   No
(2) Bruce Grewcock Kiewit Construction, Pres 6,314,851 CONSTRUCTION SERVICES   No
(3) Canedy Pullin Fosdick Dinsmoor Simplywell Board Members 546,692 Services, supplies, rental   No
(4) SMITHCANEDYDINSMOORPULLINMACY NOH LLC BOARD MEMBERS 1,963,589 SERVICES AND SUPPLIES   No
(5) William Dinsmoor WIFE IS EMPLOYEE 190,766 EMPLOYMENT   No
(6) William Dinsmoor BROTHER IS EMPLOYEE 30,822 EMPLOYMENT   No
(7) Louis Burgher MD DAUGHTER IS EMPLOYEE 62,741 EMPLOYMENT   No
(8) Joe B Graham DAUGHTER IS EMPLOYEE 56,901 EMPLOYMENT   No
(9) Deb Istas SON IS EMPLOYEE 38,193 Employment   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS PART IV 1.) THE SERVICES THAT ARE PROVIDED BY FIRST NATIONAL BANK OF OMAHA CONSIST OF PURCHASED SUPPLIES AND SERVICES AND TAX EXEMPT FINANCING. THE FINANCING IS APPROXIMATELY 99% OF THE TOTAL AMOUNT OF THE TRANSACTION. 2.) THE SERVICES THAT ARE PROVIDED BY KIEWIT CONSTRUCTION CONSIST OF CONSTRUCTION CONTRACTS FOR PROJECTS THROUGHOUT THE CAMPUS. 3.) THE TRANSACTIONS WITH SIMPLYWELL CONSISTS OF RENTAL INCOME TO NMC FOR tHE LEASE OF SPACE AND OTHER INCOME FOR SALE OF SERVICES AND SUPPLIES, SUCH AS PARKING, SUPPLY CHAIN AND PHONE SERVICES. APPROXIMATELY 80% OF THE TOTAL TRANSACTION RELATES TO PAYMENTS TO SIMPLYWELL FOR THE WELLNESS PROGRAM FOR NMC EMPLOYEES. 4.) THE SERVICES PROVIDED TO/FROM NOH LLC ARE COMPRISED OF RENT, SUPPLIES AND SERVICES.
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 2 305,547 Market Value Stock
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2012)
Schedule M (Form 990) (2012)
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
PART I, LINE 32B   TNMC USES FIRST NATIONAL BANK OF OMAHA FOR INVESTMENT SERVICES. PART OF THESE SERVICES IS TO SELL NONCASH CONTRIBUTIONS RECEIVED BY THE CORPORATION.
Schedule M (Form 990) (2012)
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Identifier Return Reference Explanation
Members Form 990, Part VI, Line 6 The corporation has two members, The Board of Regents of the University of Nebraska ("Board of Regents") and Clarkson Regional Health Services, Inc. ("CRHS")
Governing Body Appointment Form 990, Part VI, Line 7a and 7b Board of Regents and CRHS each appoint six members to the Board of Directors. Board of Regents and CRHS are required to approve the following decisions made by the Nebraska Medical Center Board of Directors: a)Amendments to the Corporation's Articles of Incorporation & Bylaws b)Amendments to, or declarations of default under, the Joint Operating Agreement ("JOA") c)Merger, liquidation or dissolution of the Corporation d)Retention of respective ownership of all property, plant and equipment, subject to the terms of the lease or management agreement with the Corporation set forth in the JOA e)Disposition of defined Member assets valued in excess of a stated amount f)Additional capital investments in the Corporation not set forth in the JOA g)Capital expenditures by the Members for defined projects relating to the Corporation in excess of a stated amount h)Debt issuance for defined projects unrelated to the Corporation i)Admission of additional participants in the Corporation if such admission is beyond the powers delegated
Review of 990 Prior to Filing Form 990, Part VI, Line 11B A copy of the Form 990 was presented to the Audit Committee of the Board of Directors. In addition, the Board of Directors were provided a link to Guidestar.org and a password after it was filed.
Monitoring and Enforcement of Board Independence Form 990, Part VI, Line 12c Each member of the Board of Directors, Officers and Key Employees discloses annually that he/she is either an Officer, Director, Member, Owner, Agent or associated in some manner with delineated business entities that either have or might reasonably be expected to have a business relationship with NMC. Each Board Member agrees to make conflicts known and withdraw from participation in deliberations if a subsequent conflict arises. Disclosure statements are distributed annually and monitored by the corporate compliance officer for completion. Any disclosed conflicts are brought to the attention of the Chairman of the Board for Board Members and Officers or to the Officers for Key Employees.
Compensation of Officers, Directors and Key Employees Form 990, Part VI, Line 15a & 15b Senior Executive compensation is governed through the by-laws for NMC. In accordance with provisions set forth in the by-laws for NMC, an Executive Compensation Committee is appointed by the Board of Directors. The Board of Directors engages a third party consultant to provide comparable data for review of executive salaries, assess the overall compensation and benefit package and provide advice to the Executive Compensation Committee on compensation and regulatory matters. The Committee reviews the data and recommendations provided by the consultant which is based on competitive assessments with peer organizations and national trends. The following is a brief summary of the consultant's work: Fact Finding: Collect pertinent information about NMC and its executive total compensation programs (salaries, incentive award levels, benefits and prerequisites). Analysis of Total Compensation: Using NMC's existing compensation philosophy as the basis of the study, analyze all elements of the Executive Compensation Program, both individually and in aggregate. Using a proprietary database and published surveys, compare NMC compensation and benefit program and practices to those in its national peer group of organizations similar in size and complexity. Present a Written Report to the Compensation Committee which summarizes: 1)Best practices and regulatory requirements for governing executive pay 2)Competitive analysis of the cash compensation program 3)Competitive analysis of the levels and provisions of the benefit program 4)Opportunities for strengthening the program 5)Recommendations, as appropiate
Governing Documents, Conflict of Interest Policy, Financial Statements Form 990, Part VI, Line 19 The governing documents, conflict of interest policy and financial statements are typically not made available to the public. However, if someone comes into the Accounting Department and requests to view the documents, they would be made available to view in the office.
Business and Family Relationships Form 990, Part VI, Line 2 Mr. Bruce Grewcock and Mr. Mogens Bay have a business relationship (through board of directors relationship). Mr. William Dinsmoor, Mr. Glenn Fosdick, Dr. James Canedy and Mr. Tadd Pullin have a business relationship (through board of directors relationship). Dr. Marlin Stahl and Dr. James Canedy have a business relationship (through board of directors relationship). Mr. Joe Graham, Mr. William Dinsmoor, Dr. Marlin Stahl, Ms. Ruta Davidson, and Mr. Charles Lakso have a business relationship. MR. GLENN FOSDICK, MR. WILLIAM DINSMOOR, MR. JOE GRAHAM, AND DR. STEPHEN SMITH HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP). Mr. William Dinsmoor, Dr. James Canedy, Mr. Thomas Macy, Mr. Joe Graham, Dr. Stephen Smith, and Dr. Marlin Stahl have a business relationship (through board of directors relationship). Mr. William Dinsmoor and Dr. James Canedy have a business relationship (through board of directors relationship). Mr. William Dinsmoor, Mr. Tadd Pullin, Mr. Tom Macy, and Dr. Stephen Smith have a business relationship (through board of directors relationship). MR. MOGENS BAY AND MR. J.B. MILLIKEN HAVE A BUSINESS RELATIONSHIP (THROUGH BOARD OF DIRECTORS RELATIONSHIP).
OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D Neuroology Service Line The core services include precise diagnosis and treatment of stroke and vascular disease, movement and memory disorders, multiple sclerosis brain and spinal tumors, spine as well as epilepsy. The Epilepsy Center is the only level 4 center in the region and treats patients from the state of Nebraska and the region. The Corporation has one of few magnetoencephalograph (MEG) scanners and trained MEG scientists in the region. The MEG can detect brain activity in much greater detail and with more accuracy than previous methods and will advance patient care and research opportunities greatly. The Corporation has earned the American Heart Association/American Stroke Association's Get With The Guidelines Stroke Gold plus Achievement Award. Get With The Guidelines is a hospital-based, quality-improvement program designed to ensure hospitals consistently care for cardiac and stroke patients following the most up-to-date guidelines and recommendations. The Corporation also hosts the only young adult stroke support group to address the emotion and physical challenges of recovering from stroke. In addition, U.S. News and World Report surveyed the nation's roughly 5,000 hospitals to come up with this year's list of Best Hospitals. Fewer than 150 of those hospitals are nationally ranked. Of the 16 specialties studied by U.S. News and World Report, The Nebraska Medical Center was recognized in 9, including Neurology and Neurosurgery. During fiscal year 2013, Neurosciences incurred over 2,900 inpatients with over 13,700 patient days and over 15,800 outpatient billing units Approximately 67% of the revenue was derived from inpatient cases All Other Hospital Services With a history dating back to 1869, The Nebraska Medical Center was formed with the merging of Bishop Clarkson Memorial Hospital and University Hospital and continues to attract patients from the region and around the world. The Nebraska Medical Center is a tertiary/quaternary academic medical center. The Corporation is the largest health care facility in the state with more than 5,000 employees and over 900 physicians on staff practicing in all major specialties and sub-specialties. Besides several key services in cardiology, oncology, transplant and neurology, the hospital offers comprehensive care in women's services for obstetrics and gynecology, as well as pediatric services, orthopedics, rheumatology, and pulmonary care. In addition, the Corporation has one of the region's largest hyperbaric medicine programs. The medical center also has one of the few biocontainment units in the United States equipped to safely care for those exposed to highly contagious, dangerous diseases. Its diabetes center is a recognized education program by the American Diabetes Association and has earned the Joint Commission's gold Seal of Approval for Advanced Inpatient Diabetes Care. In 2013, The Nebraska Medical Center opened the most comprehensive weight management program in the region, designed and directed by physicians who specialize in medical weight management and bariatric surgery. In partnership with UNMC, The Nebraska Medical Center also embarked on the construction of the Fred & Pamela Buffett Cancer Center, the largest single project ever on campus. The project will be completed in 2016 and scheduled to open in early 2017.
RECONCILIATION OF NET ASSETS 990, PART XI, LINE 9 Change in Noncontrolling Interest (431,786) Equity Changes in Subs. 1,087,263 Change in Pension Accts 14,019,666 Net Assets Released (552,082) Clarkson College Net Income (1,352,242) Clarkson College Fund Balance 264,980 Investment in ACA (36,342) Investment in Midlands Choice 685,000 Total 13,684,457
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE NEBRASKA MEDICAL CENTER
 
Employer identification number

91-1858433
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) Community Hospital Association

PO Box 107 405 East Main St

Fairfax,MO64446
44-0537826 		Acute Care MO 501(c)(3) Line 4 NMC
 
Yes
 
(2) Community Healthcare Foundation Inc

PO Box 107 405 East Main St

Fairfax,MO64446
43-1757553 		Financial Sup MO 501(c)(3) Line 4 Com Hosp Asc
 
Yes
 
(3) NHS Clarkson Hospital Service League

988145 Nebraska Medical Center

Omaha,NE68198
47-6028036 		Support TNMC NE 501(c)(3) L11,TypeIII NA
 
 
No
(4) Clarkson College

101 South 42nd Street

Omaha,NE68131
36-3649217 		College NE 501(c)(3) LINE 2 NMC
 
Yes
 






For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Bellevue Med Ctr

2500 BMC Dr
BELLEVUE,NE68123
20-4305186 		Acute Care NE NMC
  		Related -408,804 28,909,942   No 0 Yes   67.630 %
(2) ACA LLC

8511 WEST DODGE ROAD
OMAHA,NE68114
27-1784907 		HEALTHCARE NE NH PARTNERS
  		related -169,099 174,966   No 0   No 50.000 %
(3) NC LAB LLC

8303 DODGE STREET
OMAHA,NE68114
46-1173104 		DIAGNOSTIC SVC NE NMC
  		RELATED 0 0   No 0 Yes   50.000 %








Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) NHS Orthopaedic Services Inc

988145 Nebraska Medical Center
Omaha,NE681988145
47-0845238 		Investment Sv NE NMC
  		C Corp 3,263,798 14,711,410 100.000 % Yes  
(2) Nebraska Health Partners Inc

988145 Nebraska Medical Center
Omaha,NE681988145
47-0816463 		Management NE NMC
  		C Corp 740,078 3,367,522 100.000 % Yes  










Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) CLARKSON COLLEGE

 b 1,797,726 BOOK
(2) BELLEVUE MEDICAL CENTER

 d 21,313,822 BOOK
(3) BELLEVUE MEDICAL CENTER

 j 24,416,222 BOOK
(4) CLARKSON COLLEGE

 j 11,840,781 BOOK
(5) BELLEVUE MEDICAL CENTER

 L 3,926,752 BOOK
(6) CLARKSON COLLEGE

 L 1,724,985 BOOK
(7) NEBRASKA HEALTH PARTNERS INC

 O 327,767 BOOK
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


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