Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 90,831,098 | 120,930,065 | 141,454,444 | 143,250,228 | 160,657,962 | 657,123,797 |
| 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 | 240,721,228 | 255,655,534 | 260,399,080 | 288,225,950 | 326,238,931 | 1,371,240,723 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 331,552,326 | 376,585,599 | 401,853,524 | 431,476,178 | 486,896,893 | 2,028,364,520 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | 0 | 0 | 0 | 0 | 0 |
| 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. | 87,512,615 | 117,164,109 | 137,444,381 | 138,154,267 | 151,880,594 | 632,155,966 |
| c | Add lines 7a and 7b.. | 87,512,615 | 117,164,109 | 137,444,381 | 138,154,267 | 151,880,594 | 632,155,966 |
| 8 | Public support. (Subtract line 7c from line 6.) | 1,396,208,554 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 331,552,326 | 376,585,599 | 401,853,524 | 431,476,178 | 486,896,893 | 2,028,364,520 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | -2,500 | 348 | -2,152 | |||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 295,997 | 271,720 | 284,836 | 200,904 | 159,483 | 1,212,940 |
| c | Add lines 10a and 10b. | 295,997 | 269,220 | 284,836 | 201,252 | 159,483 | 1,210,788 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | 0 | 0 | 0 | 0 | 0 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 331,848,323 | 376,854,819 | 402,138,360 | 431,677,430 | 487,056,376 | 2,029,575,308 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 21014044 |
| Software Version: | 2021v4.2 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part V, Line 1a | The Nebraska Medical Center issues the Form 1099's on behalf of UNMC Physicians (UNMCP) and the expenses are paid by UNMCP through The Nebraska Medical Center (TNMC) acting as their pay agent. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | Mr. Bruce Grewcock and Mr. Mogens Bay - Business relationship, Dr. James T. Canedy, Ms. Stephanie Daubert, and Dr. Harris Frankel - Business relationship |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Nebraska Medicine is the sole member of UNMCP. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | EFFECTIVE 2017, UNMCP HAS ONE MEMBER, NEBRASKA MEDICINE, A NONPROFIT ORGANIZATION THAT HAS BEEN RECOGNIZED AS EXEMPT FROM TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. UNMCP'S BYLAWS PROVIDE THAT THE MEMBERS OF UNMCP'S BOARD OF DIRECTORS SHALL BE THE SAME PERSONS WHO SERVE AS MEMBERS OF THE BOARD OF DIRECTORS OF NEBRASKA MEDICINE. THE UNMCP BOARD IS COMPRISED OF 15 DIRECTORS, SPECIFICALLY 11 VOTING DIRECTORS AND 4 EX-OFFICIO NON-VOTING DIRECTORS. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE FOLLOWING POWERS ARE RESERVED TO UNMCP'S SOLE MEMBER, NEBRASKA MEDICINE: - AMENDMENT TO UNMCP'S ARTICLES OF INCORPORATION; - A MERGER OR CONSOLIDATION OF UNMCP WITH OR INTO ANY OTHER ENTITY; - SALE, TRANSFER, LEASE, DISPOSITION, OR CHANGE IN USE OF (A) MORE THAN 50% OF THE ASSETS OF THE CLINICAL OPERATIONS OR TNMC; OR (B) SUCH OTHER ASSETS AS THE TNMC BOARD DESIGNATES; - LIQUIDATION OR DISSOLUTION OF UNMCP; OR - APPROVAL OF ANY AMENDMENT TO THE BYLAWS. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A COPY OF THE FORM 990 WAS PRESENTED TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. IN ADDITION, THE BOARD OF DIRECTORS WERE PROVIDED A COPY OF THE FORM 990 TO REVIEW ON THE SECURED BOARD PORTAL CALLED BOARD EFFECT BEFORE IT WAS FILED. |
| Form 990, Part VI, Line 12c Conflict of interest policy | EACH MEMBER OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES DISCLOSES ANNUALLY THAT HE/SHE IS EITHER AN OFFICER, DIRECTOR, MEMBER, OWNER, AGENT OR ASSOCIATED IN SOME MANNER WITH DELINEATED BUSINESS ENTITIES THAT EITHER HAVE OR MIGHT REASONABLY BE EXPECTED TO HAVE A BUSINESS RELATIONSHIP WITH TNMC AND UNMCP. EACH BOARD MEMBER AGREES TO MAKE CONFLICTS KNOWN AND WITHDRAW FROM PARTICIPATION IN DELIBERATIONS IF A SUBSEQUENT CONFLICT ARISES. DISCLOSURE STATEMENTS ARE DISTRIBUTED ANNUALLY AND MONITORED BY THE CORPORATE COMPLIANCE OFFICER FOR COMPLETION. ANY DISCLOSED CONFLICTS ARE BROUGHT TO THE ATTENTION OF THE CHAIRMAN OF THE BOARD FOR BOARD MEMBERS AND OFFICERS OR TO THE OFFICERS FOR KEY EMPLOYEES. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The executive and physician compensation committee of the UNMC Physician's Board of Directors is comprised of a chair (appointed by the Board of Directors), a vice chair, and not less than two (2) additional directors from the board, all of whom are determined by the board to be independent from the University of Nebraska Medical Center and Nebraska Medicine, which includes UNMC Physicians and the Nebraska Medical Center. The compensation committee is responsible for overseeing the performance and compensation of the CEO, assessing the appropriateness and reasonableness of the executive compensation and benefit programs, and monitoring compensation programs with senior executives and physicians to confirm compliance with regulations and business need. The committee reviews all proposed compensation for senior executives and physicians, including the CEO. All compensation submitted for review must be supported by appropriate documentation, including, but not limited to, comparability data (I.E., Association of American Medical Colleges (AAMC)) relevant for the occupation and corporation position. This data is compared to similarly situated AAMC organizations of comparable revenue. The executive compensation data is provided by an independent compensation consulting firm hired by the committee, and this firm reports directly to the committee. The committee ensures that its review and approval qualify for the rebuttable presumption of reasonableness under the intermediate sanction's regulations (26 C.F.R. 53.4958-6, as amended). To ensure such compliance, the committee: 1. Ensures committee members are free from any relationships or conflicts of interest that may impair, or appear to impair, a committee member's ability to make independent judgements; 2. Receives and relies upon appropriate data as to comparability from internal or external resources prior to making its determination; and 3. Documents the basis for its determination of reasonableness concurrently with making that determination. Such documentation includes: A) The terms of the arrangement that was approved and the date it was approved; B) The members of the committee who were present and those who voted on it (quorum is required for any approval); C) The comparability data obtained and relied upon by the committee and how such material was obtained; and D) The action(s) taken by the committee. All compensation and benefits for the CEO are reviewed and recommended by the committee to the Board of Directors for final approval. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | The executive and physician compensation committee of the UNMC Physician's Board of Directors is comprised of a chair (appointed by the Board of Directors), a vice chair, and not less than two (2) additional directors from the board, all of whom are determined by the board to be independent from the University of Nebraska Medical Center and Nebraska Medicine, which includes UNMC Physicians and the Nebraska Medical Center. The compensation committee is responsible for assessing the appropriateness and reasonableness of the executive compensation and benefit programs and monitoring compensation programs with senior executives and physicians to confirm compliance with regulations and business need. The committee reviews all proposed compensation for senior executives and physicians. All compensation submitted for review must be supported by appropriate documentation, including, but not limited to, comparability data (I.E., Association of American Medical Colleges (AAMC)) relevant for the occupation and corporation position. This data is compared to similarly situated AAMC organizations of comparable revenue. The executive compensation data is provided by an independent compensation consulting firm hired by the committee, and this firm reports directly to the committee. The committee ensures that its review and approval qualify for the rebuttable presumption of reasonableness under the intermediate sanction's regulations (26 C.F.R. 53.4958-6, as amended). To ensure such compliance, the committee: 1. Ensures committee members are free from any relationships or conflicts of interest that may impair, or appear to impair, a committee member's ability to make independent judgements; 2. Receives and relies upon appropriate data as to comparability from internal or external resources prior to making its determination; and 3. Documents the basis for its determination of reasonableness concurrently with making that determination. Such documentation includes: A) The terms of the arrangement that was approved and the date it was approved; B) The members of the committee who were present and those who voted on it (quorum is required for any approval); C) The comparability data obtained and relied upon by the committee and how such material was obtained; and D) The action(s) taken by the committee. |
| Form 990, Part VI, Line 19 Required documents available to the public | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN THE ADMINISTRATION OFFICES. |
| Software ID: | 21014044 |
| Software Version: | 2021v4.2 |