Form990
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 06-01-2012 , 2012, and ending 05-31-2013
BCheck if applicable:
CName of organization
BRYAN MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1600 SOUTH 48TH STREET
 
Room/suite
City or town, state or country, and ZIP + 4
LINCOLN, NE685061299
D Employer identification number

47-0376552
E Telephone number

G Gross receipts $ 502,456,308
F Name and address of principal officer:
RUSSELL GRONEWOLD
1600 SOUTH 48TH STREET
LINCOLN,NE685061299
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.BRYANHEALTH.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: 1926
M State of legal domicile: NE
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE EXCELLENT CARE AND PROMOTE HEALTH WITH A FOCUS ON QUALITY, COLLABORATION AND COMPASSION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 3,796
6 Total number of volunteers (estimate if necessary) ............. 6 772
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,065,189
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 703,882 670,776
9 Program service revenue (Part VIII, line 2g) ......... 471,281,397 468,673,568
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -16,535 13,478,373
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 9,731,585 8,670,793
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 481,700,329 491,493,510
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 196,070 199,907
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) 202,762,685 200,064,209
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet4,334    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 231,385,723 232,766,478
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 434,344,478 433,030,594
19 Revenue less expenses. Subtract line 18 from line 12....... 47,355,851 58,462,916
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 753,899,819 771,115,785
21 Total liabilities (Part X, line 26)............. 322,775,865 261,456,167
22 Net assets or fund balances. Subtract line 21 from line 20..... 431,123,954 509,659,618
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 PROVIDE EXCELLENT CARE AND PROMOTE HEALTH WITH A FOCUS ON QUALITY, COLLABORATION AND COMPASSION.
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 $ 400,652,020 including grants of $ 199,907 ) (Revenue $ 468,473,679 )
BRYAN MEDICAL CENTER IS A NON-PROFIT, ACUTE CARE HOSPITAL, PROVIDING EXEMPLARY COMPREHENSIVE PATIENT CARE SERVICES, MEDICAL EDUCATION, AND COMMUNITY SERVICES TO RESIDENTS OF THE LINCOLN COMMUNITY, STATE OF NEBRASKA, AND OTHER STATES IN THE REGION. BRYAN MEDICAL CENTER IS PART OF BRYAN HEALTH, ONE OF THE LARGEST NON-PROFIT HEALTH CARE ORGANIZATIONS IN THE REGION WITH OVER 4,000 EMPLOYEES. BRYAN MEDICAL CENTER IS THE LARGEST HOSPITAL IN LINCOLN, LICENSED FOR 664 BEDS AT TWO SEPARATE LOCATIONS. PREMIER SERVICES INCLUDE CARDIOLOGY, ORTHOPEDICS, TRAUMA, NEUROSCIENCE, MENTAL HEALTH, WOMEN'S HEALTH AND CHILDREN'S HEALTH AND ONCOLOGY. BRYAN MEDICAL CENTER IS THE COMMUNITY'S ONLY PROVIDER OF INPATIENT MENTAL HEALTH SERVICES AND HAS HELPED THOUSANDS OF INDIVIDUALS OVER THE YEARS THROUGH THE BRYAN INDEPENDENCE CENTER RESIDENTIAL SUBSTANCE ABUSE TREATMENT PROGRAM. DURING THE FISCAL YEAR ENDED MAY 31, 2013, BRYAN MEDICAL CENTER ADMITTED 21,834 INPATIENTS, DELIVERED 2,739 BABIES, AND HAD 70,784 EMERGENCY ROOM VISITS. BRYAN MEDICAL CENTER IS COMMITTED TO PROVIDING HEALTH CARE SERVICES FOR THOSE IN NEED REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2013, BRYAN MEDICAL CENTER PROVIDED LIFE-SAVING PROCEDURES AND MEDICATIONS FOR OVER 8,090 INDIVIDUALS WHO WERE NOT ELIGIBLE FOR ANY GOVERNMENT OR STATE SUPPORT, AND DID NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR HEALTH CARE SERVICES. UNREIMBURSED COST FOR CHARITY CARE TOTALED $12.6 MILLION. BRYAN MEDICAL CENTER ALSO INCURRED $36.5 MILLION IN UNREIMBURSED MEDICARE COSTS, AND $12.5 MILLION IN MEDICAID COSTS AND SUPPORT OF OTHER PUBLIC PROGRAMS. BRYAN MEDICAL CENTER PROVIDED $1.9 MILLION IN THE SUPPORT OF HEALTH PROFESSIONALS' EDUCATION, THROUGH RESIDENCY PROGRAMS AND IN SUPPORT OF THE BRYAN COLLEGE OF HEALTH SCIENCES. DURING SPRING 2013, THERE WERE 660 STUDENTS ENROLLED IN GRADUATE AND UNDERGRADUATE DEGREE PROGRAMS THROUGH BRYAN'S SCHOOL OF NURSING, HEALTH PROFESSIONS AND NURSE ANESTHESIA PROGRAMS. COMMUNITY EDUCATION, SUPPORT PROGRAMS AND SERVICES SUBSIDIZED BY THE MEDICAL CENTER, TOTALED MORE THAN $1.5 MILLION. DONATIONS TO OTHER NON-PROFIT ORGANIZATIONS TOTALED MORE THAN $443,000. BRYAN MEDICAL CENTER'S QUANTIFIABLE COMMUNITY BENEFIT FOR FISCAL YEAR 2013 TOTALED MORE THAN $65.4 MILLION. DURING 2013, BRYAN MEDICAL CENTER WAS RECOGNIZED FOR ITS DEDICATION TO QUALITY AND OUTSTANDING PATIENT CARE BY NUMEROUS ACCREDITING AGENCIES.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet400,652,020
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 I..........
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 III
............................
5
 
 
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 I........................
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 II
...
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 IV..............
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 VII.......
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 VIII.......
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
Yes
 
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 .................
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.........
14b
 
No
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 IV
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...
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)....
17
 
No
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
Yes
 
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...................
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........
22
 
No
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 attachment
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........
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...................
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
Yes
 
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.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
.....................
28b
 
No
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..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
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........
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
 
No
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...
35b
 
No
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.............
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 VI
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
1,065
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
3,796
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
19
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
14
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
Yes
 
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
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NE
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:
MediumBulletRUSSELL GRONEWOLD1600 SOUTH 48TH STREETLINCOLNNE685061299 (402) 481-3190
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) GENE STOHS MD........................................................................
CHAIRPERSON
2.00
.......................1.00
X   X       0 0 0
(2) JOHN WOODRICH........................................................................
CHIEF OPERATING OFFICER
69.00
.......................1.00
X   X       541,829 0 37,906
(3) KATHY CAMPBELL........................................................................
TREASURER
2.00
.......................0
X   X       0 0 0
(4) KIMBERLY RUSSEL........................................................................
PRESIDENT & CHIEF EXECUTIVE OFFICER
35.00
.......................36.00
X   X       0 1,072,081 31,245
(5) NICHOLAS CUSICK........................................................................
SECRETARY
2.00
.......................0
X   X       0 0 0
(6) RICHARD EVNEN........................................................................
VICE CHAIRPERSON
2.00
.......................0
X   X       0 0 0
(7) ARDEN BEAU REID III........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(8) BRENDA FRANKLIN RN........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(9) C REX BEVINS........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(10) CAROLYN CODY MD........................................................................
VP MEDICAL AFFAIRS
24.00
.......................0
X           244,050 0 23,623
(11) DAVID KECK PHD........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(12) GARY HUSTAD MD........................................................................
TRUSTEE
2.00
.......................0
X           17,500 0 0
(13) GENE BRAKE........................................................................
TRUSTEE
2.00
.......................1.00
X           0 0 0
(14) JAMES GRIESEN PHD........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(15) JOHN DECKER JR........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(16) JOHN DITTMAN........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(17) JOHN TRAPP MD........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
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) MARTIN MASSENGALE PHD........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(19) RON HARRIS........................................................................
TRUSTEE
2.00
.......................0
X           0 0 0
(20) RUSSELL GRONEWOLD........................................................................
VP FINANCE & CHIEF FINANCIAL OFFICER
28.00
.......................32.00
    X       0 521,047 37,802
(21) DAVID REESE........................................................................
VP - CLINICAL & SUPPORT SERVICES
60.00
.......................0
      X     229,472 0 40,599
(22) SHIRLEY TRAVIS........................................................................
VP - CLINICAL SERVICES
36.00
.......................24.00
      X     295,626 0 35,360
(23) DAVID BINGHAM MD........................................................................
VASCULAR SURGEON
70.00
.......................0
        X   779,609 0 32,590
(24) JEROME WOHLEB........................................................................
PHARMACY DIRECTOR
50.00
.......................0
        X   194,901 0 30,782
(25) MATTHEW GOETTSCH MD........................................................................
VASCULAR SURGEON
70.00
.......................0
        X   377,232 0 30,611
(26) STUART MYERS MD........................................................................
VASCULAR SURGEON
70.00
.......................0
        X   650,256 0 36,472
(27) WILLIAM CORKLE........................................................................
STAFF PHARMACIST
50.00
.......................0
        X   196,729 0 20,922
(28) KATHLEEN CAMPBELL........................................................................
VP PATIENT CARE SERVICES/CNO, RESIGNED 4/6/2012
0.00
.......................0
          X 127,476 0 4,673




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,654,680 1,593,128 362,585
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet89
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
INPATIENT PHYSICIAN ASSOCIATES2300 SOUTH 16TH STREETLINCOLNNE68502 MEDICAL SERVICES 2,895,902
AIR METHODS CORPORATION7301 SOUTH PEORIA STREETENGLEWOODCO80112 AIR AMBULANCE SERVICES 1,746,216
ASSOCIATED ANESTHESIOLOGIST6911 VAN DORN SUITE 2LINCOLNNE68506 MEDICAL SERVICES 1,454,896
NEBRASKA TRAUMA & ACUTE CARE2300 S 16TH STREETLINCOLNNE68502 MEDICAL SERVICES 1,302,810
DIALYSIS CENTER OF LINCOLN7910 O STREETLINCOLNNE68510 MEDICAL SERVICES 1,038,059
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet44
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 177,071
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
493,705
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 670,776
 Program Service Revenue Business Code
2a NET PATIENT REVENUE 621990 457,796,227 457,596,338 199,889  
b BRYAN COLLEGE OF HEALTH SCIENCES REV 611600 7,671,414 7,671,414    
c PROGRAM RENTAL REVENUE 531190 3,090,616 3,090,616    
d PHARMACY 446110 115,311 115,311    
e     0      
f All other program service revenue . 0 0 0 0
g Total. Add lines 2a–2f........MediumBullet 468,673,568
 Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 5,212,873     5,212,873
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 25,055  
b Less: rental expenses 45,103  
c Rental income or (loss) -20,048 0
d Net rental income or (loss).......MediumBullet -20,048   -20,048  
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 19,088,040 60,006
b Less: cost or other basis and sales expenses 10,842,698 39,848
c Gain or (loss) 8,245,342 20,158
d Net gain or (loss)..........MediumBullet 8,265,500     8,265,500
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a 50,775
b Less: direct expenses ...b 35,149
c Net income or (loss) from fundraising events..MediumBullet 15,626   15,626
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 CAFETERIA 722210 2,825,496   133,531 2,691,965
b PURHCASE DISCOUNTS/REBATES 900099 1,651,003     1,651,003
c CHILD CARE 624410 1,506,450     1,506,450
d All other revenue .... 2,692,266 0 1,751,817 940,449
e Total. Add lines 11a–11d ...... MediumBullet 8,675,215
12 Total revenue. See Instructions......MediumBullet 491,493,510 468,473,679 2,065,189 20,283,866
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 21 199,907 199,907
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
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 .... 1,624,948 942,470 682,478  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 876   876  
7 Other salaries and wages 145,350,656 143,853,544 1,497,112  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 9,955,622 9,853,079 102,543  
9 Other employee benefits ....... 32,674,646 32,338,097 336,549  
10 Payroll taxes ........... 10,457,461 10,349,749 107,712  
11 Fees for services (non-employees):        
a Management ...... 154,446   154,446  
b Legal ......... 54,279   54,279  
c Accounting ........... 35,035   35,035  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 1,084,880   1,084,880  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 40,412,160 39,078,551 1,333,609 0
12 Advertising and promotion .... 1,045,801   1,045,801  
13 Office expenses ....... 88,698,955 87,785,356 913,599  
14 Information technology ...... 7,134,897 7,061,408 73,489  
15 Royalties .. 0      
16 Occupancy ........... 7,819,111 7,738,574 80,537  
17 Travel ............ 428,743 411,865 16,878  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 143,431 140,258 3,173  
20 Interest ........... 6,407,064 6,341,071 65,993  
21 Payments to affiliates ....... 0   0  
22 Depreciation, depletion, and amortization ..... 36,024,641 35,653,587 371,054  
23 Insurance .............. 1,163,834 1,151,847 11,987  
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 BAD DEBT 15,922,986 15,922,986    
b RECRUITMENT EXPENSES 420,743 416,409 4,334  
c CORPORATE COST ALLOCATION 24,153,742   24,153,742  
d
e All other expenses 1,661,730 1,413,262 244,134 4,334
25 Total functional expenses. Add lines 1 through 24e 433,030,594 400,652,020 32,374,240 4,334
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). 0      
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 .............   1  
2 Savings and temporary cash investments ......... 105,201,038 2 107,095,804
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 57,283,744 4 57,088,947
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
52,083 5 10,423
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
  6 0
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 9,421,856 8 9,603,322
9 Prepaid expenses and deferred charges .......... 4,515,786 9 4,881,098
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 683,531,343
b Less: accumulated depreciation ..... 10b 354,248,465 337,575,727 10c 329,282,878
11 Investments—publicly traded securities .......... 175,538,040 11 196,310,071
12 Investments—other securities. See Part IV, line 11 ..... 15,478,000 12 17,536,000
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 48,833,545 15 49,307,242
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 753,899,819 16 771,115,785
Liabilities 17 Accounts payable and accrued expenses ......... 37,634,132 17 34,299,290
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities ............. 167,140,000 20 160,895,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
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..........   22 0
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
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.................... 118,001,733 25 66,261,877
26 Total liabilities. Add lines 17 through 25......... 322,775,865 26 261,456,167
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 .............. 419,910,040 27 497,008,878
28 Temporarily restricted net assets ........... 6,375,596 28 7,514,844
29 Permanently restricted net assets ........... 4,838,318 29 5,135,896
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 ........... 431,123,954 33 509,659,618
34 Total liabilities and net assets/fund balances ........ 753,899,819 34 771,115,785
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
491,493,510
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
433,030,594
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
58,462,916
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
431,123,954
5
Net unrealized gains (losses) on investments ...............
5
12,185,801
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
7,886,947
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
509,659,618
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
Yes
 
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
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID: 12000266
Software Version: v2012.1.0
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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: 12000266
Software Version: v2012.1.0
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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: 12000266
Software Version: v2012.1.0
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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? ........
Yes
 
0
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
13,161
j
Total. Add lines 1c through 1i ...............................
13,161
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
Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 BRYAN MEDICAL CENTER IS A MEMBER OF THE NEBRASKA HOSPITAL ASSN (NHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR MEMBERSHIP DUES TO THE NHA OF $108,845; OF THIS AMOUNT THE NHA REPORTED THAT 9.77% OR $10,634 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES. BRYAN MEDICAL CENTER IS ALSO A MEMBER OF THE ASSOCIATION OF INDEPENDENT COLLEGES AND UNIVERSITIES OF NEBRASKA (AICUN). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR MEMBERSHIP DUES TO THE ASSOCIATION OF INDEPENDENT COLLEGES AND UNIVERSITIES (AICUN) OF $18,048; OF THIS AMOUNT AICUN REPORTED THAT 14.0% OR $2,527 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES. ON VARIOUS OCCASIONS THROUGHOUT THE YEAR, THE CEO MET WITH STATE AND LOCAL LEGISLATORS TO DISCUSS ISSUES RELATED TO HEALTHCARE. WHILE SOME RELATED TO HEALTHCARE REFORM, OTHER ISSUES DISCUSSED INCLUDED MEETING THE NEEDS OF INDIGENT/UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS THE ONGOING NEED FOR HEALTH SERVICES INCLUDING MENTAL HEALTH SERVICES FOR THE COMMUNITY.
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID: 12000266
Software Version: v2012.1.0

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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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 $ 0
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $ 0
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 $  
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 .... 748,893 753,846 1,194,316 1,190,240 1,184,822
b Contributions ........ 1,619 1,628 -447,554 761 647
c Net investment earnings, gains, and losses 6,348 8,660 12,092 13,872 19,961
d Grants or scholarships ..... 53,000        
e Other expenditures for facilities
and programs ........
15,675 12,038 2,690 10,557 15,190
f Administrative expenses .... 3,150 3,203 2,318    
g End of year balance ...... 685,035 748,893 753,846 1,194,316 1,190,240
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet0 %
c
Temporarily restricted endowment SchDMd Bullet100.000 %
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 .................   9,443,053 9,443,053
b Buildings ................   415,372,907 168,435,559 246,937,348
c Leasehold improvements ............   321,677 242,064 79,613
d Equipment ................   249,494,449 182,762,437 66,732,012
e Other .................   8,899,257 2,808,405 6,090,852
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 329,282,878
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
(1) DEFERRED FINANCING COSTS, NET 1,158,744
(2) RECS FROM CRETE AREA MEDICAL 15,025,253
(3) HOSPITALIST SVCS CONTRACT REC 5,294,941
(4) FAS 109 DEFERRED TAX ASSET 353,833
(5) OTHER ACCOUNTS RECEIVABLE 356,078
(6) INTEREST IN AFFILIATES 25,352,249
(7) CRETE AREA MEDICAL-2008C BONDS 2,444
(8) RECEIVABLE ON UNASSERTED CLAIMS 1,763,700

Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 49,307,242
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
SELF INSURANCE LIABILITY 2,589,200
INTEREST RATE SWAP LIABILITY 11,610,273
HOSPITALIST SVCS CTRT PAYABLE 5,133,960
CRETE AREA MEDICAL 2008C BOND 1,915,876
ORIGINAL ISSUE PREMIUM 1,291,213
ACCRUED PENSION BENEFIT OBLIGATION 29,644,207
OTHER LIABILITIES 11,246,139
CURRENT PORTION INTEREST RATE SWAPS 2,831,009

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 66,261,877
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
Collections of art - description of collections Schedule D, Part III, Line 4 BRYAN MEDICAL CENTER IS THE OWNER OF THE WILLIAM JENNINGS BRYAN HOUSE, ALSO KNOW AS FAIRVIEW. FAIRVIEW IS A HISTORIC HOUSE BUILT IN 1902-1903 IN LINCOLN, NEBRASKA, IN 1922, THE HOUSE AND SURROUNDING LAND WAS DONATED TO THE NEBRASKA METHODIST CONFERENCE, WHICH THEN FORMED A SEPARATE NONPROFIT ORGANIZATION FOR PURPOSES OF ESTABLISHING BRYAN MEMORIAL HOSPITAL AND AFFILIATED SCHOOL OF NURSING. FAIRVIEW WAS DECLARED A NATIONAL HISTORIC LANDMARK IN 1963. THE HOUSE IS NOW USED FOR BRYAN MEETINGS AND FUNCTIONS. IN ADDITION, OVER 1,000 VISITORS TOUR THE HOME ANNUALLY. THIS ASSET IS FULLY DEPRECIATED, AND REPORTED ON THE BALANCE AT A NET AMOUNT OF ZERO
Intended uses of endowment funds Schedule D, Part V, Line 4 BRYAN MEDICAL CENTER'S ("MEDICAL CENTER") ENDOWMENT FUNDS ARE ESTABLISHED TO PROVIDE FOR LOANS FOR THE STUDENTS WHO ATTEND THE BRYAN COLLEGE OF HEALTH SCIENCES. BRYAN COLLEGE OF HEALTH SCIENCES PROVIDES HEALTHCARE PROFESSIONAL EDUCATION WITH PROGRAMS LEADING TO GRADUATE AND UNDERGRADUATE ACADEMIC DEGREES. BRYAN COLLEGE OF HEALTH SCIENCES IS PART OF THE MEDICAL CENTER AND ITS OPERATIONS ARE INCLUDED IN THE MEDICAL CENTER'S FORM 990.
FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 BRYAN HEALTH AND AFFILIATES ("THE HEALTH SYSTEM") FOLLOW THE PROVISIONS OF ASC 740, INCOME TAXES. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY UPON THE ADOPTION OF ASC 740 OR AT MAY 31, 2013 AND 2012. THE HEALTH SYSTEM DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS.
Schedule D (Form 990) 2012

Additional Data


Software ID: 12000266
Software Version: v2012.1.0




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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
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

SPIRIT WEAR SALE
(event type)
(b) Event #2

BOOK SALE
(event type)
(c) Other events

 
(total number)
(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 33,915 10,215   44,130
2 Less: Contributions . .       0
3 Gross income (line 1
minus line 2) . . .
33,915 10,215 0 44,130
VerticalDirectExpenses 4 Cash prizes . . .       0
5 Noncash prizes . .       0
6 Rent/facility costs . .       0
7 Food and beverages .       0
8 Entertainment . . .       0
9 Other direct expenses . 22,597 8,773   31,370
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 31,370
11 Net income summary. Combine line 3, column (d), and line 10. .......... right arrow 12,760
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: 12000266
Software Version: v2012.1.0
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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) ..
    12,631,918   12,631,918 3.030 %
b Medicaid (from Worksheet 3,
column a) ....
    43,987,023 31,172,275 12,814,748 3.070 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
    1,132,369 1,159,584 -27,215 0 %
d Total Financial Assistance
and Means-Tested
Government Programs .
0 0 57,751,310 32,331,859 25,419,451 6.100 %
Other Benefits
    1,237,842 1,685 1,236,157 0.300 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    12,589,742 10,672,700 1,917,042 0.460 %
g Subsidized health services
(from Worksheet 6) ..
    326,151 141,975 184,176 0.040 %
h Research (from Worksheet 7)         0 0 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    443,231   443,231 0.110 %
j Total. Other Benefits .. 0 0 14,596,966 10,816,360 3,780,606 0.910 %
k Total. Add lines 7d and 7j . 0 0 72,348,276 43,148,219 29,200,057 7.010 %
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         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and training for community members         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 0 0 0 0 %
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
5,651,068
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
0
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
137,662,406
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
174,142,265
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-36,479,859
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 %
1
2
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 BRYAN MEDICAL CENTER EAST
1600 SOUTH 48TH ST
LINCOLN,NE68506
X X   X     X     A
2 BRYAN MEDICAL CENTER WEST
2300 SOUTH 16TH ST
LINCOLN,NE68502
X X   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)
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) 1
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 Yes  
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?11
Name and address Type of Facility (describe)
1 BRYAN MEDICAL CENTER
1500 SOUTH 48TH STREET SUITE 400
LINCOLN,NE68506
CATH LAB SERVICES
2 BRYAN MEDICAL CENTER
1500 SOUTH 48TH STREET 1ST FLOOR
LINCOLN,NE68506
LAB & RADIOLOGY SERVICES
3 BRYAN MEDICAL CENTER
2222 S 16TH ST TOWER B SUITE 110
LINCOLN,NE68502
RADIOLOGY SERVICES
4 BRYAN MEDICAL CENTER
2221 SOUTH 17TH STREET SUITE 100
LINCOLN,NE68502
LABORATORY SERVICES
5 BRYAN MEDICAL CENTER
1600 S 48TH ST SUITE 600 ROOM 1
LINCOLN,NE68506
CARDIAC OUTPATIENT SERVICES
6 BRYAN MEDICAL CENTER
3901 PINE LAKE ROAD SUITE 110
LINCOLN,NE68516
OUTPATIENT RADIOLOGY SERVICES
7 BRYAN MEDICAL CENTER
1600 SOUTH 48TH STREET SUITE 500
LINCOLN,NE68506
VASCULAR OUTPATIENT SERVICES
8 BRYAN MEDICAL CENTER
2221 SOUTH 17TH ST SUITE 201 310
LINCOLN,NE68502
COUNSELING SERVICES
9 BRYAN MEDICAL CENTER
2222 S 16TH ST TOWER B SUITE 100
LINCOLN,NE68502
MRI SERVICES
10 BRYAN MEDICAL CENTER
7501 S 27TH STREET
LINCOLN,NE68512
THERAPY SERVICES
11 BRYAN MEDICAL CENTER
3901 PINE LAKE ROAD SUITE 111
LINCOLN,NE68516
LINEAR ACCELERATOR & CT SCANNER SERVICES
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
PATIENT ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART I, LINE 3C BRYAN MEDICAL CENTER IS COMMITTED TO DELIVERING COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND TO ALWAYS BE THERE FOR ALL PATIENTS WHO TURN TO US FOR CARE, INCLUDING THOSE WHO ARE UNABLE TO PAY. CONSISTENT WITH OUR COMMITMENT, BRYAN OFFERS A FINANCIAL ASSISTANCE POLICY TO ENSURE THAT FINANCIAL CONCERNS DO NOT PREVENT INDIVIDUALS FROM SEEKING OR RECEIVING HEALTH CARE SERVICES. IN ORDER TO PROVIDE THE APPROPRIATE LEVEL OF ASSISTANCE TO THE GREATEST NUMBER OF INDIVIDUALS IN NEED, BRYAN HEALTH'S FINANCE COMMITTEE OF THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE OVERSIGHT OF THE FINANCIAL ASSISTANCE POLICY. THE FINANCE COMMITTEE IS COMPRISED OF VOLUNTEER BOARD MEMBERS WHO ALL RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, AND ARE DEEPLY CONCERNED ABOUT THE NEEDS OF THE COMMUNITY. BRYAN PROVIDES FINANCIAL COUNSELORS TO HELP PATIENTS FIND WAYS TO MEET THEIR FINANCIAL OBLIGATIONS FOR THE SERVICES PROVIDED TO THEM. UNINSURED PATIENTS WHO ARE ADMITTED TO BRYAN WILL AUTOMATICALLY RECEIVE FINANCIAL COUNSELING SERVICES. BRYAN'S FINANCIAL COUNSELORS WILL REVIEW FINANCIAL ASSISTANCE OPTIONS, AS APPLICABLE, WITH PATIENTS, INCLUDING: 1) GOVERNMENT SPONSORED AND COMMUNITY BASED ASSISTANCE; 2) AN AUTOMATIC 35% DISCOUNT FOR SELF-PAY PATIENTS WHO DO NOT HAVE INSURANCE; 3) PAYMENT PLANS THAT DO NOT CHARGE INTEREST; AND 4) FINANCIAL ASSISTANCE, OR CHARITY CARE, RANGING FROM A PARTIAL DISCOUNT TO A 100% DISCOUNT BASED ON THE PATIENTS INDIVIDUAL FINANCIAL SITUATION. THE POLICY PROVIDES FOR FULL CHARITY CARE TO LOW INCOME UNINSURED PATIENTS EARNING LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES ("FPG"). THIS POLICY ALSO PROVIDES DISCOUNTED CARE FOR OUR LOW INCOME UNINSURED PATIENTS EARNING BETWEEN 200% AND 400% OF THE FPG. THESE DISCOUNTS ARE APPLIED BY USING A SLIDING SCALE FEE SCHEDULE TO CALCULATE THE PERCENTAGE OF THE BALANCE DUE. UNDER THE CATASTROPHIC SECTION OF THE POLICY, A PATIENT'S BILL WILL NEVER EXCEED 30% OF THEIR ANNUAL INCOME. PATIENTS WHO DO NOT HAVE INSURANCE ARE NEVER CHARGED MORE FOR SERVICES THAN THE AMOUNT GENERALLY BILLED TO THOSE WHO HAVE INSURANCE.
Community benefit report prepared by related organization Schedule H, Part I, Line 6a BRYAN MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS PREPARED ANNUALLY BY BRYAN HEALTH, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. BRYAN HEALTH'S COMMUNITY BENEFIT REPORT DESCRIBES THE PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITIES THAT ARE SERVED BY BRYAN MEDICAL CENTER AND ITS RELATED ORGANIZATIONS. THE REPORT IS MAILED TO VARIOUS HOUSEHOLDS IN EASTERN NEBRASKA AND THE SURROUNDING AREA. THE REPORT ALSO IS AVAILABLE ONLINE AT WWW.BRYANHEALTH.ORG/COMMUNITYBENEFIT. FOR THE PURPOSE OF SCHEDULE H, ONLY FINANCIAL INFORMATION FOR BRYAN MEDICAL CENTER IS REPORTED.
Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 BRYAN MEDICAL CENTER'S UNCOMPENSATED CARE COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE AMOUNT ON LINE 7A. DIRECT AND INDIRECT COSTS WERE DEDUCTED FROM PAYMENTS TO CALCULATE THE AMOUNTS ON 7B AND 7C. FOR LINES 7E, 7F, 7G AND 7I, ANY OFFSETTING REVENUE WAS DEDUCTED FROM EXPENSES DIRECTLY ATTRIBUTABLE TO THE COMMUNITY BENEFIT ACTIVITY.
Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 15,922,986
CASH AND IN-KIND CONTRIBUTIONS SCHEDULE H, PART I, LINE 7I SOME OF THE IN-KIND CONTRIBUTIONS PROVIDED ARE NOT REPORTED IN THE STATEMENT OF FUNCTIONAL EXPENSES AND SCHEDULE I.
Bad debt expense - methodology used to estimate amount Schedule H, Part III, Line 2 THE COST OF BAD DEBT EXPENSE WAS DETERMINED BY TAKING THE MEDICAL CENTER'S BAD DEBT COST-TO-CHARGE RATIO TIMES THE BAD DEBT EXPENSE THAT WAS STATED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDED MAY 31, 2013.
Bad debt expense - methodology used to estimate amount as community benefit Schedule H, Part III, Line 3 THE AMOUNT OF THE MEDICAL CENTER'S BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE MEDICAL CENTER'S CHARITY CARE POLICY IS ESTIMATED TO BE ZERO BASED ON THE FOLLOWING: (1) BRYAN MEDICAL CENTER HAS ESTABLISHED POLICIES THAT DEFINE CHARITY CARE AND PROVIDE GUIDELINES FOR ASSESSING A PATIENTS ABILITY TO PAY; AND ONCE ELIGIBILITY IS VERIFIED, THE MEDICAL CENTER WILL WRITE ACCOUNTS OFF TO CHARITY CARE AND NO LONGER PURSUE DEBT COLLECTION PROCEDURES; (2) BRYAN MEDICAL CENTER HAS COUNSELORS WHO WORK INDIVIDUALLY WITH EACH PATIENT BOTH PRE AND POST DISCHARGE TO ASSESS FINANCIAL NEED AND RECOMMEND APPROPRIATE ASSISTANCE; (3) BRYAN MEDICAL CENTER PROVIDES PRESUMPTIVE FINANCIAL ASSISTANCE WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO THE LACK OF SUPPORTING DOCUMENTATION. ONCE DETERMINED, DUE TO THE INHERENT NATURE OF PRESUMPTIVE CIRCUMSTANCES, THE ONLY DISCOUNT THAT CAN BE GRANTED IS A 100% WRITE-OFF OF THE ACCOUNT BALANCE.
Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 AS STATED ON PAGES 9 AND 10 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS, BRYAN MEDICAL CENTER MAINTAINS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS OF ACCOUNTS RECEIVABLE, TAKING INTO ACCOUNT BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFFS EXPERIENCE BY MAJOR PAYOR CATEGORY. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS DOES NOT INCLUDE AMOUNTS FOR PATIENTS WHO ARE KNOWN TO QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 THE ENTIRE MEDICARE SHORTFALL AS REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT. BRYAN MEDICAL CENTER PROVIDES CARE TO MEDICARE PATIENTS, AND MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE ENTIRE COST OF PROVIDING CARE TO THESE PATIENTS CAUSING A SHORTFALL, OR LOSS TO THE ORGANIZATION. THE FUNDS BRYAN MEDICAL CENTER USES TO COVER THIS SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING THE GOVERNMENT OF THE FINANCIAL BURDEN OF PAYING THE FULL COSTS OF CARE FOR MEDICARE BENEFICIARIES. THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICAL CENTER'S MEDICARE COST REPORT IS THE STEP-DOWN METHOD OF COST ALLOCATION.
Collection practices for patients eligible for financial assistance Schedule H, Part III, Line 9b IT IS BRYAN'S POLICY TO OFFER PATIENTS A PAYMENT PLAN AND/OR FINANCIAL ASSISTANCE WHEN IT BECOMES KNOWN THAT A PATIENT IS IN NEED OF ASSISTANCE TO HELP PAY FOR THEIR HOSPITAL BILL. IF BRYAN IS AWARE THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THIS ACCOUNT WILL NEVER BE REFERRED TO A COLLECTION AGENCY. IF AN ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY, AND THE COLLECTION AGENCY OBTAINS DOCUMENTATION TO DETERMINE THAT THE PATIENT IS ELIGIBLE FOR CHARITY, THE ACCOUNT IS RETURNED TO BRYAN FOR A CHARITY ADJUSTMENT AND NO FURTHER COLLECTION EFFORT IS MADE.
Community Served by Needs Assessment Schedule H, Part V Section B, Line 3 (1) BRYAN MEDICAL CENTER EAST - IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT, REPRESENTATIVES FROM BRYAN MEDICAL CENTER PARTICIPATED IN THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS UNDER THE GUIDANCE OF THE LINCOLN LANCASTER COUNTY HEALTH DEPARTMENT. THE 25 MEMBER MAPP COMMITTEE IS A BROAD-BASED REPRESENTATION OF THE HEALTH DEPARTMENT'S COMMUNITY PARTNERS AND STAKEHOLDERS. MEMBERS OF THE MAPP COMMITTEE INCLUDED REPRESENTATIVES FROM BRYAN MEDICAL CENTER, CEDARS YOUTH SERVICES, CLINIC WITH A HEART, EL CENTRO DE LAS AMERICAS, INDIAN CENTER, LANCASTER COUNTY MEDICAL SOCIETY, LANCASTER COUNTY COMMUNITY MENTAL HEALTH CENTER, LINCOLN COMMUNITY FOUNDATION, LINCOLN POLICE DEPARTMENT, LINCOLN PUBLIC SCHOOLS, NEBRASKA HEART INSTITUTE, PARKS AND RECREATION DEPARTMENT, PARTNERSHIP FOR A HEALTHY LINCOLN, PEOPLE'S CITY MISSION, PEOPLE'S HEALTH CENTER, SAFE KIDS, SAINT ELIZABETH REGIONAL MEDICAL CENTER, SENIORS FOUNDATION OF LINCOLN AND LANCASTER COUNTY, UNITED WAY OF LINCOLN, AND THE UNIVERSITY OF NEBRASKA-HEALTH CENTER.;
Other Hospital Facilities included in Needs Assessment Schedule H, Part V Section B, Line 4 (1) BRYAN MEDICAL CENTER EAST - SEE SCHEDULE H, PART V, SECTION B, LINE 3.;
Needs assessment. Schedule H, Part VI, Line 2 AS A HEALTHCARE LEADER IN NEBRASKA, BRYAN MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY CONTINUALLY WORKING WITH COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. DURING THE FISCAL YEAR ENDED MAY 31, 2013, REPRESENTATIVES FROM BRYAN PARTICIPATED IN THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) PROCESS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE CITY OF LINCOLN AND LANCASTER COUNTY, NEBRASKA. THE 25 MEMBER MAPP STEERING COMMITTEE INCLUDED REPRESENTATIVES FROM THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT, COMMUNITY HEALTH ENDOWMENT OF LINCOLN, LOCAL HOSPITALS, COMMUNITY STAKEHOLDERS AND LOCAL CONSULTANTS. THE ROLE OF THE MEMBERS WAS TO ASSIST THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT IN THE IDENTIFICATION OF COMMUNITY PRIORITY HEALTH NEEDS, AND IN THE DEVELOPMENT AND IMPLEMENTATION OF STRATEGIES TO MEET THE IDENTIFIED PRIORITY HEALTH NEEDS. THE MAPP STEERING COMMITTEE IDENTIFIED FOUR PRIORITY COMMUNITY HEALTH NEEDS: 1) ACCESS TO CARE; 2) BEHAVIORAL HEALTH CARE, 3) CHRONIC DISEASE PREVENTION; 4) AND INJURY PREVENTION. BRYAN USED THE PRIORITIES FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT TO DEVELOP A DETAILED IMPLEMENTATION STRATEGY TO ENSURE THAT OUR STRENGTHS AND AVAILABLE RESOURCES ARE ALIGNED WITH THE HEALTH NEEDS OF OUR COMMUNITY. BRYAN MEDICAL CENTER'S BOARD OF TRUSTEES ADOPTED THIS IMPLEMENTATION STRATEGY ON MARCH 25, 2013. THIS IMPLEMENTATION STRATEGY WILL SERVE AS THE FOUNDATION FOR BRYAN'S COMMUNITY HEALTH IMPROVEMENT PLANNING EFFORTS OVER THE NEXT TWO YEARS. BRYAN HAS ALSO PARTICIPATED OVER THE PAST FIFTEEN YEARS IN COMMUNITY NEEDS ASSESSMENTS IN COOPERATION WITH OTHER HEALTH CARE PROVIDERS AND THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT THROUGH A COLLABORATIVE GROUP CALLED HEALTH PARTNERS INITIATIVE. THE GROUP HAS HELD COMMUNITY FORUMS AND CONDUCTED COMMUNITY NEEDS ASSESSMENTS OVER THE YEARS AND HAS PARTICIPATED IN THE DEVELOPMENT OF HEALTHY PEOPLE 2020 PLAN FOR LINCOLN-LANCASTER COUNTY. IN ADDITION TO PARTICIPATION IN COMMUNITY HEALTH NEEDS ASSESSMENTS, BRYAN CONDUCTS AN ANNUAL PERCEPTION SURVEY BOTH LOCALLY, IN LINCOLN-LANCASTER COUNTY AND REGIONALLY ACROSS THE STATE. THE SURVEY ASSESSES PERCEPTION OF THE QUALITY AND AVAILABILITY OF HEALTH CARE PROVIDERS IN THE REGION. AS PART OF THE ANNUAL STRATEGIC PLANNING PROCESS, BRYAN ALSO ASSESSES MARKET SHARE AND UTILIZATION TRENDS AS WELL AS CHANGES IN POPULATION DEMOGRAPHICS.
Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 IN KEEPING WITH BRYAN MEDICAL CENTER'S MISSION TO TREAT ALL PATIENTS WITH COMPASSION, BRYAN OFFERS A FINANCIAL ASSISTANCE PROGRAM TO PATIENTS WHO CANNOT AFFORD TO PAY FOR PART OR ALL OF THE CARE THEY RECEIVE. EDUCATION REGARDING OUR FINANCIAL ASSISTANCE PROGRAM IS PROVIDED AT EACH NEW EMPLOYEE ORIENTATION SO THAT EACH EMPLOYEE WILL HAVE A CLEAR UNDERSTANDING OF THE FINANCIAL ASSISTANCE THAT IS AVAILABLE TO OUR PATIENTS. BRYAN HAS TRAINED FINANCIAL COUNSELORS WHO WORK INDIVIDUALLY WITH PATIENTS PRE-REGISTRATION AND POST-DISCHARGE; OR AT ANY OTHER TIME THE STAFF ENCOUNTERS INFORMATION DETAILING THE PATIENTS FINANCIAL NEED. UNINSURED PATIENTS WHO ARE ADMITTED TO BRYAN WILL AUTOMATICALLY RECEIVE A CONSULTATION WITH A FINANCIAL COUNSELOR. THE COUNSELORS RECOMMEND APPROPRIATE ASSISTANCE SUCH AS FEDERAL, STATE OR LOCAL PROGRAMS, OR ELIGIBILITY FOR ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. WHEN APPLICABLE, THE FINANCIAL COUNSELORS PROVIDE ASSISTANCE FOR QUALIFYING FOR THE FINANCIAL ASSISTANCE POLICY OR VARIOUS GOVERNMENT PROGRAMS, SUCH AS MEDICAID. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY; INCLUDING THE PHONE NUMBER TO CONTACT A BILLING CUSTOMER SERVICE REPRESENTATIVE, IS PROVIDED: 1) ON BRYAN'S WEBSITE, 2) IN ALL HOSPITAL REGISTRATION AREAS, INCLUDING THE EMERGENCY DEPARTMENT, 3) IN BILLING OFFICES, 4) IN ALL INPATIENT ADMISSION PACKETS; AND 5) ON EACH BILLING STATEMENT. THE ORGANIZATION'S PROCEDURE IS TO MAIL THE FINANCIAL ASSISTANCE POLICY AND APPLICATION FORM TO PATIENTS FREE OF CHARGE UPON REQUEST. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY POINT FROM PRE-ADMISSION TO THE FINAL PAYMENT OF THE BILL, AS WE RECOGNIZE THAT A PATIENTS ABILITY TO PAY OVER AN EXTENDED PERIOD OF TIME MAY BE SUBSTANTIALLY ALTERED DUE TO ILLNESS OR FINANCIAL HARDSHIP, RESULTING IN A NEED FOR FINANCIAL ASSISTANCE.
Community information. Schedule H, Part VI, Line 4 BRYAN MEDICAL CENTER PROVIDES A NETWORK OF COMPREHENSIVE HEALTH CARE SERVICES TO THE RESIDENTS OF THE COMMUNITIES WE SERVE. BRYAN IS LOCATED IN THE CAPITAL CITY OF LINCOLN, NEBRASKA, THE STATE'S SECOND LARGEST METROPOLITAN AREA. WHILE BRYAN SERVES A REGIONAL GEOGRAPHIC AREA EXTENDING BEYOND THE COUNTY, LANCASTER COUNTY RESIDENTS ACCOUNT FOR 66.6% OF PATIENTS SERVED. IN FISCAL YEAR 2013, BRYAN ADMITTED 21,834 PATIENTS AND CARED FOR 70,784 EMERGENCY ROOM PATIENTS. APPROXIMATELY 16.4% OF THE PATIENTS ADMITTED WERE MEDICAID, AND 38.4% WERE MEDICARE. IN 2013, THE MEDIAN INCOME IN LANCASTER COUNTY WAS ESTIMATED AT $50,269, AND 8.71% OF THE POPULATION HAD FAMILY INCOMES BELOW THE POVERTY LEVEL. THE PERCENT OF UNINSURED ADULTS AGED 18 TO 64 HAS INCREASED STEADILY SINCE 2005, WITH AN OVERALL ESTIMATED UNINSURED RATE OF 17.3% IN 2012. CANCER REMAINED THE LEADING CAUSE OF DEATH FOR LANCASTER COUNTY IN 2012, FOLLOWED BY HEART DISEASE, CHRONIC LUNG DISEASE, CEREBROVASCULAR DISEASE, AND ACCIDENTAL DEATH. BRYAN AND ST. ELIZABETH REGIONAL MEDICAL CENTER ARE THE PRIMARY HOSPITALS SERVING LANCASTER COUNTY. THE CENSUS BUREAU REPORTED THAT THE COUNTY'S POPULATION GREW OVER THE DECADE BY OVER 14%, FROM 250,291 TO 285,407, WITH VERY HIGH GROWTH IN MINORITY POPULATIONS. DOUBLE DIGIT GROWTH IS EXPECTED TO CONTINUE OVER THE NEXT FOUR DECADES. BY AGE, THE LARGEST RATE OF GROWTH IS PROJECTED FOR THE 65+ AGE GROUP. BECAUSE OF LINCOLN'S SIZE, RELATIVE STABLE ECONOMY, AND EDUCATIONAL OPPORTUNITIES, THE U.S. STATE DEPARTMENT DESIGNATED LINCOLN AS "REFUGEE FRIENDLY" IN THE 1970S. SINCE THE 70S, WAVES OF IMMIGRANTS FROM ACROSS THE WORLD HAVE RESETTLED IN LINCOLN. LINCOLN PUBLIC SCHOOLS NOW INCLUDE CHILDREN SPEAKING APPROXIMATELY 56 LANGUAGES OTHER THAN ENGLISH. LANCASTER COUNTY'S DEMOGRAPHIC CHANGES SINCE 2000 REFLECT THE INCREASED DIVERSITY AS OVER THE LAST DECADE, THE MINORITY POPULATION IN LANCASTER COUNTY INCREASED BY 16,481, OR BY 58.4%. IN 2010, THE MINORITY POPULATION REPRESENTS 15.7% OF THE TOTAL POPULATION, AN INCREASE IN REPRESENTATION FROM 11.3% OF THE TOTAL 2000 POPULATION. OVER THE LAST DECADE, PERSONS OF HISPANIC ORIGIN (MAY BE OF ANY RACE) NEARLY DOUBLED IN SIZE AS THERE WAS A 97.8% INCREASE IN LATINO/LATINA POPULATION OVER THE DECADE. THE AFRICAN AMERICAN AND ASIAN POPULATIONS THAT ESSENTIALLY TIE AS THE SECOND LARGEST RACIAL GROUPS HAVE ALSO GROWN OVER THE DECADE. PROJECTED GROWTH IN MINORITY POPULATIONS CHALLENGES US TO ACCOMMODATE DIVERSE LANGUAGE AND CULTURAL NEEDS. WITH THE SERVICE AREA RAPIDLY EXPANDING, AND THE OVER 65 POPULATION EXPECTED TO GROW BY OVER 16% IN THE NEXT FIVE YEARS, BRYAN RECOGNIZES THE IMMENSE NEEDS OF OUR SERVICE AREA ARE EXPANDING AND CHANGING.
Promotion of community health Schedule H, Part VI, Line 5 BRYAN MEDICAL CENTER HAS PROVIDED HIGH QUALITY, COMPREHENSIVE MEDICAL SERVICES TO BENEFIT THE COMMUNITY FOR OVER 86 YEARS, AND IS COMMITTED TO IDENTIFYING AND ADDRESSING NEEDS IN THE COMMUNITY IN ORDER TO PROMOTE THE PHYSICAL, EDUCATIONAL AND ECONOMIC HEALTH OF OUR COMMUNITY IN THE FUTURE. FUNDAMENTAL TO OUR COMMUNITY COMMITMENT IS THE LEADERSHIP OF OUR LOCAL GOVERNING BOARD. BRYAN'S GOVERNING BOARD CONSISTS OF MEDICAL PROFESSIONALS, BUSINESS PROFESSIONALS, AND COMMUNITY LEADERS ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA, AND UNDERSTAND THE NEEDS OF THE COMMUNITY. THESE VOLUNTEERS DEDICATE THEIR TIME, WISDOM, INSIGHTS, AND EXPERTISE TO SET POLICY AND STRATEGIC DIRECTION TO ENSURE THAT BRYAN'S VISION, MISSION AND STRATEGIC PLANS ARE ALIGNED WITH ITS CHARITABLE PURPOSE. THE MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT BOARD MEMBERS WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION. THE MEDICAL STAFF OF THE ORGANIZATION IS OPEN TO ALL PHYSICIANS IN THE COMMUNITY WHO MEET MEMBERSHIP AND CLINICAL PRIVILEGES REQUIREMENTS. AS OF MAY 31, 2013, BRYAN HAD AN ORGANIZED MEDICAL STAFF OF 624 PHYSICIANS AND 18 DENTISTS AND DENTAL SPECIALISTS, FROM MORE THEN 32 MEDICAL AND SURGICAL FIELDS. AS A NON-PROFIT MEDICAL CENTER, SURPLUS FUNDS ARE CONTINUOUSLY UTILIZED TO MAINTAIN ACCESS TO LIMITED PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY; INCLUDING BUT NOT LIMITED TO: 1) PROVIDING A COMPLETE DIAGNOSTIC AND INTERVENTIONAL CARDIAC PROGRAM; 2) PROVIDING A COMPREHENSIVE LEVEL II TRAUMA CENTER FOR SOUTHEAST NEBRASKA WHICH PROVIDES 24-HOUR COVERAGE OF EMERGENCY SERVICES; 3) FUNDING FOR AN AIR AMBULANCE SERVICE THAT IS AVAILABLE 24-HOURS A DAY TO TRANSPORT PATIENTS TO THE HOSPITAL WITHIN A 160-MILE RADIUS OF LINCOLN; 4) PROVIDING A HOSPITAL-BASED RESIDENTIAL TREATMENT SUBSTANCE ABUSE FACILITY IN LINCOLN, WHICH SERVES PATIENTS THAT STRUGGLE WITH ADDICTION TO DRUGS AND ALCOHOL FROM SOUTHEAST NEBRASKA AND MANY OTHER STATES 5) PROVIDING HOSPITAL-BASED MENTAL HEALTH CARE TO LINCOLN AND SURROUNDING COMMUNITIES (DURING FISCAL YEAR 2013, SURPLUS FUNDS, IN ADDITION TO FUNDS RAISED IN A CAPITAL CAMPAIGN, ARE BEING USED TO BUILD NEW FACILITIES FOR MENTAL HEALTH AND SUBSTANCE ABUSE); AND 6) PROVIDING A STATE-OF-THE-ART WOMEN AND CHILDREN'S TOWER WHICH INCLUDES A NEONATAL INTENSIVE CARE UNIT. BRYAN IS COMMITTED TO TEACHING AND TRAINING THE HEALTH CARE PROFESSIONALS OF TOMORROW. OUR COLLEGE OF HEALTH SCIENCES OFFERS GRADUATE AND UNDERGRADUATE DEGREES THROUGH ITS SCHOOL OF NURSING, SCHOOL OF HEALTH PROFESSIONALS, AND SCHOOL OF NURSE ANESTHESIA PROGRAMS. MANY OF THE GRADUATES STAY IN LINCOLN OR THE SURROUNDING AREA, THEREBY PROVIDING A CONTINUOUS SUPPLY OF MEDICAL PROFESSIONALS FOR THE COMMUNITY. IN ADDITION, THE MEDICAL CENTER ASSURES CONTINUING QUALITY HEALTH IN OUR COMMUNITY THROUGH RESIDENCY PROGRAMS, WORKSHOPS AND SEMINARS, AND CLINICAL EDUCATION PROGRAMS.
Affiliated health care system Schedule H, Part VI, Line 6 BRYAN MEDICAL CENTER IS PART OF BRYAN HEALTH, ONE OF THE LARGEST NON-PROFIT HEALTH CARE ORGANIZATIONS IN THE REGION. BRYAN HEALTH EXISTS TO: PROMOTE AND PROVIDE ACCESS TO QUALITY HEALTH CARE; PROVIDE MEDICAL EDUCATION, AND COMMUNITY SERVICE. THE COMMUNITY BENEFITS PROVIDED BY BRYAN HEALTH INCLUDE: 1) PROVIDING FREE OR DISCOUNTED HEALTH CARE TO THE UNINSURED AND UNDERINSURED, 2) PROVIDING GOVERNMENTAL SPONSORED PROGRAMS SUCH AS MEDICARE AND MEDICAID; 3) HEALTH PROFESSIONALS' EDUCATION 4) COMMUNITY HEALTH IMPROVEMENT SERVICES AND 5) CASH AND IN-KIND CONTRIBUTIONS TO OTHER NON-PROFIT ORGANIZATIONS. BRYAN HEALTH PROVIDES A FULL SPECTRUM OF PREVENTION, WELLNESS, ACUTE CARE AND REHABILITATION SERVICES TO URBAN, SUBURBAN AND RURAL COMMUNITIES IN NEBRASKA, KANSAS, IOWA, MISSOURI AND SOUTH DAKOTA. BRYAN HEALTH CONSISTS OF THREE ACUTE-CARE HOSPITALS, NUMEROUS OUTPATIENT CLINICS, A PHYSICIAN NETWORK, A COLLEGE, AN URGENT CARE CENTER, A HEALTH AND WELLNESS FACILITY, A PHILANTHROPIC FOUNDATION AND OTHER HEALTHCARE PROVIDERS. PREMIER SERVICES INCLUDE CARDIOLOGY, NEUROSCIENCE, ORTHOPEDICS, VASCULAR, TRAUMA AND EMERGENCY CENTERS, INTENSIVE CARE, WOMEN'S AND CHILDREN'S HEALTH, ONCOLOGY, IMAGING AND MENTAL HEALTH.
Schedule H (Form 990) 2012
Additional Data


Software ID: 12000266
Software Version: v2012.1.0
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
BRYAN MEDICAL CENTER
 
Employer identification number
47-0376552
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) CLINIC WITH A HEART
1701 S 17TH ST STE 4G
LINCOLN,NE68502
20-2850139 501(C)(3) 25,500 0 N/A N/A SUPPORT FOR GENERAL OPERATIONS
(2) PARTNERSHIP FOR HEALTHY LINCOLN
4600 VALLEY ROAD STE 250
LINCOLN,NE68510
36-3832796 501(C)(3) 15,000 0 N/A N/A SUPPORT FOR GENERAL OPERATIONS
(3) AMERICAN RED CROSS
220 OAK CREEK DRIVE
LINCOLN,NE68528
53-0196605 501(C)(3) 13,500 0 N/A N/A EMERGENCY RESPONSE AT HUSKER SPORT EVENTS
(4) NEBRASKA STATE STROKE ASSOCIATION
6900 L STREET
LINCOLN,NE68510
36-3428710 501(C)(3) 11,000 0 N/A N/A STROKE CAMP
(5) MADDONA COMMUNITIY MEDICAL TRANSPORTATION
5401 SOUTH STREET
LINCOLN,NE68506
23-7159940 501(C)(3) 10,000 0 N/A N/A SUPPORT FOR GENERAL OPERATIONS
(6) LINCOLN CHILDREN'S MUSEUM
1420 P STREET
LINCOLN,NE68508
47-0716636 501(C)(3) 10,000 0 N/A N/A SUPPORT OF HEALTHCARE EXHIBIT
(7) LINCOLN CHILDREN'S ZOO
1222 S 27TH STREET
LINCOLN,NE68502
47-0482255 501(C)(3) 10,000 0 N/A N/A SUPPORT FOR GENERAL OPERATIONS
(8) LINCOLN MEDICAL EDUCATION PARTNERSHIP
4600 VALLEY ROAD NO 225
LINCOLN,NE68510
47-0553011 501(C)(3) 8,000 0 N/A N/A SUPPORT FOR GENERAL OPERATIONS
(9) AMERICAN CANCER SOCIETY
5733 S 34TH STREET
LINCOLN,NE68516
74-1185665 501(C)(3) 7,875 0 N/A N/A MAKING STRIDES WALK TO SUPPORT GEN OPERATIONS
(10) SOLIDARITY BRIDGE INC
1577 FLORENCE AVE
EVANSTON,IL60202
36-4481213 501(C)(3) 0 111,000 FMV MEDICAL SUPPLIES SUPPORT FOR GENERAL OPERATIONS
(11) NORTHEAST EVANGELISM OF MOBERLY MO
900 SOUTH CLARK STREET
MOBERLY,MO65270
20-5248156 501(C)(3) 0 83,420 FMV MEDICAL SUPPLIES & EQUIPMENT SUPPORT FOR GENERAL OPERATIONS
(12) MATT TALBOT KITCHEN & OUREACH INC
PO BOX 80935
LINCOLN,NE68501
36-3945814 501(C)(3) 0 9,000 FMV FOOD SUPPLIES SUPPORT FOR GENERAL OPERATIONS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
12
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












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
Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 THE CONTRIBUTIONS COMMITTEE OF BRYAN HEALTH OVERSEES THE GRANT ALLOCATION AND MANAGEMENT FOR THIS ORGANIZATION. EACH POTENTIAL RECIPIENT IS REQUIRED TO APPLY FOR A GRANT. THE CONTRIBUTIONS COMMITTEE REVIEWS AND DISCUSSES ALL SUBMITTED REQUESTS IN DETAIL. GRANTS ARE AWARDED BASED ON NEED AND ELIGIBILITY.
Schedule I (Form 990) 2012


Additional Data


Software ID: 12000266
Software Version: v2012.1.0


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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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
 
No
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
 
No
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
Yes
 
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)CAROLYN CODY MDVP MEDICAL AFFAIRS (i)
(ii)
166,722
0
21,311
0
56,017
0
10,725
0
12,898
0
267,673
0
0
0
(2)DAVID BINGHAM MDVASCULAR SURGEON (i)
(ii)
519,756
0
257,595
0
2,258
0
13,750
0
18,840
0
812,199
0
0
0
(3)DAVID REESEVP - CLINICAL & SUPPORT SERVICES (i)
(ii)
175,705
0
28,140
0
25,627
0
17,673
0
22,926
0
270,071
0
0
0
(4)JEROME WOHLEBPHARMACY DIRECTOR (i)
(ii)
170,755
0
0
0
24,146
0
7,990
0
22,792
0
225,683
0
0
0
(5)JOHN WOODRICHCHIEF OPERATING OFFICER (i)
(ii)
328,036
0
65,774
0
148,019
0
13,234
0
24,672
0
579,735
0
0
0
(6)KATHLEEN CAMPBELLVP PATIENT CARE SERVICES/CNO, RESIGNED 4/6/2012 (i)
(ii)
61,490
0
0
0
65,986
0
2,002
0
2,671
0
132,149
0
0
0
(7)KIMBERLY RUSSELPRESIDENT & CHIEF EXECUTIVE OFFICER (i)
(ii)
0
660,445
0
152,545
0
259,091
0
13,750
0
17,495
0
1,103,326
0
0
(8)MATTHEW GOETTSCH MDVASCULAR SURGEON (i)
(ii)
374,514
0
0
0
2,718
0
7,500
0
23,111
0
407,843
0
0
0
(9)RUSSELL GRONEWOLDVP FINANCE & CHIEF FINANCIAL OFFICER (i)
(ii)
0
336,228
0
61,244
0
123,575
0
13,750
0
24,052
0
558,849
0
0
(10)SHIRLEY TRAVISVP - CLINICAL SERVICES (i)
(ii)
190,799
0
25,589
0
79,238
0
26,250
0
9,110
0
330,986
0
0
0
(11)STUART MYERS MDVASCULAR SURGEON (i)
(ii)
490,969
0
153,464
0
5,823
0
13,750
0
22,722
0
686,728
0
0
0
(12)WILLIAM CORKLESTAFF PHARMACIST (i)
(ii)
153,041
0
12,898
0
30,790
0
12,809
0
8,113
0
217,651
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
Travel for companions Schedule J, Part I, Line 1a SEVERAL OF THE MEMBERS OF THE BOARD OF THE TRUSTEES ARE INDEPENDENT COMMUNITY MEMBERS WHO ARE VOLUNTEER BOARD MEMBERS, AND DO NOT RECEIVE ANY COMPENSATION FOR THEIR TIME AND DUTIES AS MEMBERS OF THE BOARD OF TRUSTEES. RESPONSIBILITIES OF TRUSTEES ARE COMPLEX, AND EFFECTIVE GOVERNANCE DEPENDS UPON HAVING BOARD MEMBERS THAT ARE WELL EDUCATED ABOUT ALL ASPECTS OF HEALTH CARE AND HEALTH CARE GOVERNANCE. BRYAN MEDICAL CENTER ENCOURAGES ONGOING EDUCATION OF ITS TRUSTEES BY PROVIDING REIMBURSEMENT FOR REASONABLE TRAVEL EXPENSES THAT FURTHER THE MISSION OF BRYAN MEDICAL CENTER. REIMBURSEMENT FOR COMPANIONS OF VOLUNTEER TRUSTEES IS LIMITED BY THE BOARD OF TRUSTEES' TRAVEL POLICY TO AIR TRAVEL AT THE COACH LEVEL. ALL TRAVEL OF COMPANIONS IS APPROVED IN ADVANCE BY THE CHIEF EXECUTIVE OFFICER OF BRYAN HEALTH, AND SUBSTANTIATION OF ALL TRAVEL RELATED EXPENSES IS REQUIRED BEFORE PAYMENT. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION TO THE TRUSTEES.
Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF THE LARGEST PRIVATE EMPLOYER IN LINCOLN/LANCASTER COUNTY, BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN HEALTH'S COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED IS REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON AUGUST 9, 2012. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE.
Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b IN ORDER TO ATTRACT AND RETAIN TALENTED, EXPERIENCED EXECUTIVES, BRYAN HEALTH OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO ELIGIBLE EMPLOYEES. THE FOLLOWING PEOPLE LISTED IN FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN, OR RECEIVED A PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE TAX YEAR: KATHLEEN CAMPBELL: $45,084; CAROLYN CODY, M.D.: $38,944; RUSSELL GRONEWOLD: $95,262; DAVID REESE: $9,337; KIMBERLY RUSSEL: $207,226; SHIRLEY TRAVIS: $32,734; AND JOHN WOODRICH: $111,939.
Compensation contingent on revenues of the organization Schedule J, Part I, Line 5a IN THE CASE OF CERTAIN PHYSICIAN EMPLOYEE AGREEMENTS, COMPENSATION IS PAID ON A PERCENTAGE OF PROFESSIONAL COLLECTIONS PERFORMED ABOVE A PREDETERMINED THRESHOLD.
Non-fixed payments Schedule J, Part I, Line 7 BRYAN HEALTH OFFERS A MARKET COMPETITIVE INCENTIVE COMPENSATION PROGRAM FOR MEMBERS OF MANAGEMENT. INCENTIVE COMPENSATION IS BASED ON ACHIEVING OBJECTIVE ORGANIZATIONAL AND INDIVIDUAL GOALS. THE WEIGHTS ASSIGNED TO EACH GOAL MAY CHANGE ON AN ANNUAL BASIS.
COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES SCHEDULE J, PART II IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARD OF TRUSTEES IS COMPENSATED FOR THEIR SERVICE AS A BOARD MEMBER. COMPENSATION AMOUNTS REPORTED ARE FOR SERVICES PROVIDED AS MEDICAL PROFESSIONALS OR EXECUTIVES OF THE ORGANIZATION, OR A RELATED ORGANIZATION. COMPENSATION AMOUNTS REPORTED ON SCHEDULE J, PART II ARE BASED ON THE CALENDAR YEAR ENDED DECEMBER 31, 2012.
Schedule J (Form 990) 2012

Additional Data


Software ID: 12000266
Software Version: v2012.1.0
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
BRYAN MEDICAL CENTER
 
Employer identification number
47-0376552
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 AUTHORITY NO 1 OF LANCASTER COUNTY NE
 
47-0490169 513886RR4 12-21-2006 61,381,548 SERIES 2006 BONDS REFUNDED PRIOR ISSUES - (09/18/1997), (10/31/1997)   X   X   X
B HOSPITAL AUTHORITY NO 1 OF LANCASTER COUNTY NE
 
47-0721900 513886SR3 05-27-2008 115,216,759 SERIES 2008 A & B BONDS REFUNDED PRIOR ISSUES - (12/20/2002), (02/08/2007)   X   X   X
C HOSPITAL AUTHORITY NO 1 OF SALINE COUNTY NE
 
47-0843167 79517TAW6 05-27-2008 13,480,000 SERIES 2008C BONDS REFUNDED PRIOR ISSUE - (2/8/2007)   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 9,915,000 16,310,000 685,000  
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0  
3 Total proceeds of issue . . . . . . . . . . . . . . 63,974,522 115,220,438 13,480,597  
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0  
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0  
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0  
7 Issuance costs from proceeds . . . . . . . . . . . . 555,587 981,595 88,670  
8 Credit enhancement from proceeds . . . . . . . . . . . 0 859,107 141,505  
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0  
10 Capital expenditures from proceeds . . . . . . . . . . . 0 0 0  
11 Other spent proceeds . . . . . . . . . . . . . . 63,418,935 113,379,736 13,250,422  
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0  
13 Year of substantial completion . . . . . . . . . . . . 2001 2008 2003
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 0.0000% 0.0000% 0.0000%   %
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 0.0000% 0.0000% 0.0000%   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . . 0.0000% 0.0000% 0.0000%   %
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. 0.0000% 0.0000% 0.0000%   %
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   X    
b Exception to rebate? . . . . . . . .   X X   X      
c No rebate due? . . . . . . . . . .
X     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 . . . . . . . . . PIPER JAFFRAY
 
PIPER JAFFRAY
 
PIPER JAFFRAY
 
 
 
c Term of hedge . . . . . . . . . . 0.0 23.0 23.0  
d Was the hedge superintegrated? . . . . . .   X   X   X    
e Was a hedge terminated? . . . . . . .   X   X   X    
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 . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . . 0.0 0.0 0  
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .   X   X   X    
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
LINE B, COLUMN (C) CUSIP NUMBERS SCHEDULE K, PART I THE BOND FROM HOSPITAL AUTHORITY NO. 1 OF LANCASTER COUNTY, NE HAS 3 SEPARATE CUSIP NUMBERS: A: 513886SR3; B-1: 513886SS1; B-2: 513886ST9
TOTAL PROCEEDS OF ISSUE SCHEDULE K, PART II, LINE 3 THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
PRIVATE BUSINESS USE SCHEDULE K, PART III PART III HAS NOT BEEN COMPLETED GIVEN THAT ALL BONDS LISTED IN ROWS A THROUGH C OF PART I, WERE ISSUED SOLELY TO REFUND BONDS ISSUED PRIOR TO 2003.
ISSUER NAME: HOSPITAL AUTHORITY NO. 1 OF LANCASTER COUNTY, NE: No Rebate Due. Schedule K, Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 11/30/2011. AS DESCRIBED IN THE ESCROW VERIFICATION REPORT, THE BOND PROCEEDS WERE HELD IN A YIELD RESTRICTED ESCROW THAT WAS INVESTED BELOW THE YIELD ON THE REFUNDING BONDS. AS NO REBATABLE ARBITRAGE WAS EARNED ON THE ESCROW AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE ANALYSIS IS NECESSARY.
Schedule K (Form 990) 2012

Additional Data


Software ID: 12000266
Software Version: v2012.1.0

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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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
(1) MATTHEW GOETTSCH MD
 
EMPLOYEE COMPENSATION PACKAGE   X 125,000 10,423   No   No Yes  
Total ......Small Bullet $ 10,423
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) NEBRASKA PULMONARY SPECIALTIES
 
JOHN TRAPP, M.D. IS A PARTNER IN NEBRASKA PULMONARY SPECIALTIES 407,000 PAYMENT FOR PHYSICIAN SERVICES   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
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID: 12000266
Software Version: v2012.1.0




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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
Identifier Return Reference Explanation
Family/business relationships amongst interested persons Form 990, Part VI, Section A, Line 2 KIMBERLY RUSSEL AND CAROLYN CODY, M.D. - BUSINESS RELATIONSHIP, KIMBERLY RUSSEL AND RUSSELL GRONEWOLD - BUSINESS RELATIONSHIP, KIMBERLY RUSSEL AND DAVID REESE - BUSINESS RELATIONSHIP, KIMBERLY RUSSEL AND SHIRLEY TRAVIS, R.N. - BUSINESS RELATIONSHIP, KIMBERLY RUSSEL AND JOHN WOODRICH - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND C. REX BEVINS - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND GENE BRAKE - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND KATHY CAMPBELL - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND NICHOLAS CUSICK - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND JOHN DITTMAN - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND RICHARD EVNEN - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND BRENDA FRANKLIN, R.N. - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND JAMES GRIESEN, PH.D. - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND RON HARRIS - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND GARY HUSTAD, M.D. - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND DAVID KECK, PH.D. - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND MARTIN MASSENGALE, PH.D. - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND ARDEN (BEAU) REID, III - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND JOHN TRAPP, M.D. - BUSINESS RELATIONSHIP, CAROLYN CODY, M.D. AND JOHN WOODRICH - BUSINESS RELATIONSHIP, MANY OF THE PERSONS LISTED IN PART VII, SECTION A HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF THEIR EMPLOYMENT BY A BRYAN HEALTH SYSTEM ENTITY. -
Significant changes to organizational documents Form 990, Part VI, Section A, Line 4 THE BOARD OF TRUSTEES OF BRYAN MEDICAL CENTER ADOPTED A RESOLUTION TO THE ORGANIZATION'S ARTICLES OF INCORPORATION, EFFECTIVE JULY 11, 2012, CHANGING THE NAME OF BRYANLGH MEDICAL CENTER TO BRYAN MEDICAL CENTER. BRYAN MEDICAL CENTER RECEIVED AN IRS AFFIRMATION LETTER IN SEPTEMBER, 2012 CONFIRMING THE ORGANIZATION'S NAME CHANGE. THE ORGANIZATION'S BYLAWS WERE ALSO AMENDED DURING THE TAX YEAR TO REFLECT THE NAME CHANGE OF THE ORGANIZATION.
Classes of members or stockholders Form 990, Part VI, Section A, Line 6 AS STATED IN THE CORPORATION'S ORGANIZING DOCUMENTS, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS BRYAN HEALTH. BRYAN HEALTH HAS THE RIGHTS UNDER THE ORGANIZING DOCUMENTS TO: (1) APPROVE SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY; (2) ELECT THE MEMBERS OF THE GOVERNING BODY; AND (3) RECEIVE ANY REMAINING ASSETS AFTER DISSOLUTION OF THE ORGANIZATION.
Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a BRYAN HEALTH AS SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE RIGHT UNDER THE ORGANIZING DOCUMENTS TO REMOVE ANY TRUSTEE FROM OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE BY A VOTE OF AT LEAST TWO-THIRDS (2/3) OF ALL THE VOTING TRUSTEES OF BRYAN HEALTH.
Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b BRYAN HEALTH IS THE SOLE MEMBER OF BRYAN MEDICAL CENTER ("MEDICAL CENTER"). PURSUANT TO THE GOVERNING DOCUMENTS, THE BOARD OF THE MEDICAL CENTER MAY MANAGE THE AFFAIRS OF THE CORPORATION; HOWEVER, THE BOARD MAY NOT, WITHOUT THE PRIOR APPROVAL OF THE HEALTH SYSTEM (1) ADOPT ANY LONG-TERM CAPITAL OR OPERATIONAL BUDGET; (2) ADOPT ANY CHANGES IN ANY ANNUAL OR LONG-TERM CAPITAL BUDGET OR OPERATIONAL EXPENSE BUDGET EXCEEDING $5,000,000 IN ANY SINGLE TRANSACTION OR $10,000,000 IN ANY CORPORATION FISCAL YEAR; (3) APPROVE OR IMPLEMENT AMENDMENTS TO ITS MISSION STATEMENT OR STRATEGIC PLAN; (4) APPROVE ANY INDEBTEDNESS OR INCUR A MORTGAGE OR LIEN OF ANY KIND OR NATURE ON ASSETS OF THE CORPORATION WHERE THE BORROWING OR INDEBTEDNESS EXCEEDS $5,000,000 IN ANY SINGLE TRANSACTION OR A TOTAL OF $10,000,000 IN ANY CORPORATION FISCAL YEAR; (5) ENGAGE IN OR ENTER INTO ANY TRANSACTION OR TRANSACTIONS PROVIDING FOR THE TRANSFER, SALE OR OTHER DISPOSITION OF CAPITAL ASSETS IN ANY SINGLE TRANSACTION OF $5,000,000 OR A TOTAL OF $10,000,000 IN ANY CORPORATION FISCAL YEAR; (6) APPROVE THE ELECTION OF MEMBERS OF THE BOARD; (7) APPROVE THE APPOINTMENT OF THE SYSTEM PRESIDENT/CHIEF EXECUTIVE OFFICER; (8) APPROVE PARTICIPATION IN OTHER HEALTH CARE SYSTEMS BY AFFILIATION OR MERGER; (9) APPROVE ITS LIQUIDATION OR DISSOLUTION; (10) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF ANY INTEREST IN, AS ALLOWED BY THE CODE, OF ANY CORPORATION, ASSOCIATION, LIMITED LIABILITY COMPANY, PARTNERSHIP; TRUST, SHARED SERVICE ARRANGEMENT; JOINT VENTURE OR OTHER ENTITY, DIRECTLY OR INDIRECTLY, WHERE THE CAPITAL EXPENDITURES OR OPERATING EXPENSES BY THE CORPORATION IN CONNECTION WITH SUCH ORGANIZATION OR ACQUISITION IN ANY SINGLE TRANSACTION EXCEEDS $5,000,000 OR A TOTAL OF $10,000,000 IN ANY CORPORATION FISCAL YEAR; (11) AMEND THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; OR (12) TAKE ANY OTHER ACTIONS WHICH MAY BE INCONSISTENT WITH THE SYSTEM'S GOALS AND OBJECTIVES.
Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THIS 990 WAS PREPARED BY BRYAN HEALTH'S TAX DIVISION. DURING THE RETURN PREPARATION PROCESS, THE TAX DIVISION WORKS DILIGENTLY WITH OTHER DEPARTMENTS INCLUDING HUMAN RESOURCES, FINANCE, LEGAL, AND DEVELOPMENT TO GATHER INFORMATION TO COMPLETE FORM 990 AND ATTACHED SCHEDULES IN AN ACCURATE AND THOROUGH MANNER. THIS 990 WAS REVIEWED BY THE CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, AND OTHER KEY OFFICERS OF BRYAN HEALTH. THIS 990 WAS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. BRYAN HEALTH'S BOARD OF TRUSTEES HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE BOARD'S AUDIT COMMITTEE. EACH MEMBER OF THE AUDIT COMMITTEE RECEIVED A COMPLETE COPY OF THIS 990, PRIOR TO FILING THE FORM WITH THE INTERNAL REVENUE SERVICE.
Conflict of interest policy Form 990, Part VI, Section B, Line 12c BRYAN MEDICAL CENTER HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY THAT IS MONITORED AND ENFORCED BY THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES OF BRYAN HEALTH. BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE QUESTIONNAIRE TO IDENTIFY ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS, OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT. THE QUESTIONNAIRE REQUIRES EACH COVERED PERSON TO SIGN A STATEMENT CERTIFYING THAT HE/SHE: (1) HAS REPORTED INFORMATION THAT IS CORRECT AND COMPLETE TO THE BEST OF THEIR KNOWLEDGE; (2) HAS READ THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE POLICY, AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY. COVERED PERSONS ARE ALSO REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME SUCH CONFLICTS ARISE. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. FAILURE TO COMPLETE THE QUESTIONNAIRE CAN RESULT IN DISCIPLINARY ACTIONS. THE QUESTIONNAIRES ARE REVIEWED IN DETAIL BY THE GOVERNANCE COMMITTEE OF BRYAN HEALTH. CONFLICTS ARE CLOSELY MONITORED BY MEMBERS OF THE GOVERNANCE COMMITTEE. THE CONFLICT OF INTEREST POLICY HAS RESTRICTIONS FOR ANY BOARD MEMBER WITH A CONFLICT OF INTEREST; SUCH AS, PROHIBITING THEM FROM PARTICIPATING IN DELIBERATIONS AND VOTING WITH REGARD TO CERTAIN TRANSACTIONS IN WHICH THEY HAVE AN INTEREST.
Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF THE LARGEST PRIVATE EMPLOYER IN LINCOLN/LANCASTER COUNTY, BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN HEALTH'S COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED IS REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON AUGUST 9, 2012. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE.
Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b SEE FORM 990, PART VI, SECTION B, LINE 15A.
Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION AND AMENDMENTS ARE AVAILABLE TO THE PUBLIC ON THE NEBRASKA SECRETARY OF STATE'S WEBSITE AT WWW.SOS.NE.GOV. ALSO, THIS ORGANIZATION IS INCLUDED WITHIN THE CONSOLIDATED FINANCIAL STATEMENTS OF BRYAN HEALTH THAT ARE MADE AVAILABLE TO THE PUBLIC BY THE POSTING OF THESE DOCUMENTS THROUGH THE MUNICIPAL SECURITIES RULEMAKING BOARD WEBSITE AT EMMA.MSRB.ORG. THE ORGANIZATION'S OTHER GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. FEDERAL TAX LAWS DO NOT REQUIRE THAT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION.
COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES FORM 990, PART VII, SECTION A IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON BRYAN MEDICAL CENTER'S BOARD IS COMPENSATED FOR THEIR SERVICES AS BOARD MEMBERS. COMPENSATION AMOUNTS REPORTED ARE FOR SERVICES PROVIDED AS MEDICAL PROFESSIONALS OR EXECUTIVES OF THE ORGANIZATION, OR A RELATED ORGANIZATION. COMPENSATION AMOUNTS REPORTED ON FORM 990, PART VII, SECTION A, COLUMNS (D),(E) AND (F) ARE BASED ON THE CALENDAR YEAR ENDED DECEMBER 31, 2012.
Other changes in net assets or fund balances Form 990 , Part XI, Line 9 TRANSFERS FROM RELATED ENTITY - -35559032; PENSION LIABILITY ADJUSTMENT - 17993764; CHANGE IN TEMP RESTRICTED INTEREST IN BRYAN FOUNDATION - 1203105; OTHER CHANGES IN TEMP RESTRICTED NET ASSETS - -10858; DEFERRED TAX, NET - -191351; CORPORATE COST ALLOCATION TRANSFERS - 24153742; CHANGE IN PERMANENTLY RESTRICTED INTEREST IN BRYAN FOUNDATION - 297577;
OVERSIGHT OF CONSOLIDATED AUDIT FORM 990, PART XII, LINE 2C BRYAN MEDICAL CENTER'S FINANCIAL STATEMENTS WERE AUDITED AS PART OF A CONSOLIDATED FINANCIAL STATEMENT FOR BRYAN HEALTH, THE ORGANIZATION'S SOLE MEMBER. THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES OF BRYAN HEALTH IS RESPONSIBLE FOR OVERSEEING THE AUDIT OF THE FINANCIAL STATEMENTS, AND THE SELECTION OF THE INDEPENDENT ACCOUNTING FIRM THAT PERFORMS THE AUDIT.
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: 12000266
Software Version: v2012.1.0
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
BRYAN MEDICAL CENTER
 
Employer identification number

47-0376552
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) BRYAN HEALTH

1600 SOUTH 48TH STREET

LINCOLN,NE68506
HEALTHCARE NE 501(C)(3) 11 - Type III - FI BRYAN HEALTH
 
 
No
(2) CRETE AREA MEDICAL CENTER

2910 BETTEN DRIVE

CRETE,NE68333
HEALTHCARE NE 501(C)(3) 3 BRYAN HEALTH
 
 
No
(3) BRYAN FOUNDATION

1600 SOUTH 48TH STREET

LINCOLN,NE68506
FUNDRAISING NE 501(C)(3) 7 BRYAN HEALTH
 
 
No
(4) BRYAN PHYSICIAN NETWORK

1600 SOUTH 48TH STREET

LINCOLN,NE68506
HEALTHCARE NE 501(C)(3) 9 BRYAN HEALTH
 
 
No






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












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) BRYAN ENTERPRISES INC

1600 SOUTH 48TH STREET
LINCOLN,NE68506
47-0701037
MEDICAL SERVICES NE BRYAN HEALTH
 
C CORPORATION 0 0 0 %    
(2) INTEGRATED CARDIOLOGY GROUP LLC

1600 SOUTH 48TH STREET
LINCOLN,NE68506
47-0844961
CARDIOLOGY NE BRYAN HEALTH
 
C CORPORATION 0 0 0 %    










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
 
No
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
 
No
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
Yes
 
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
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
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





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


Software ID: 12000266
Software Version: v2012.1.0