TY 2023 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) ERIC MOOSS CEO BRYAN MEDICAL CENTER	50.0 ................. 2.0	X	X	670,499	15,147	48,084
(2) JACK HUCK TREASURER	1.0 ................. 0	X	X	0	0	0
(3) KENNETH GROSS MD VICE CHAIR	1.0 ................. 0	X	X	0	0	0
(4) SHANNON HARNER CHAIR	1.0 ................. 1.0	X	X	0	0	0
(5) CONNIE EDMOND DIRECTOR	1.0 ................. 0	X		0	0	0
(6) ELIZABETH LAU MD DIRECTOR	1.0 ................. 0	X		0	0	0
(7) ERIN PEMBERTON JD DIRECTOR	1.0 ................. 0	X		0	0	0
(8) GAYLE PAGE DIRECTOR	1.0 ................. 0	X		0	0	0
(9) JANET CHUNG DIRECTOR	1.0 ................. 0	X		0	0	0
(10) LORENZO BALL DIRECTOR (Effective 1/1/2023)	1.0 ................. 0	X		0	0	0
(11) MARK WALZ DIRECTOR	1.0 ................. 1.0	X		0	0	0
(12) MAX RODENBURG DIRECTOR	1.0 ................. 0	X		0	0	0
(13) PABLO CERVANTES DIRECTOR	1.0 ................. 0	X		0	0	0
(14) ROBERT OAKES MD DIRECTOR	1.0 ................. 50.0	X		10,000	1,607,882	49,954
(15) RUSSELL GRONEWOLD DIRECTOR	1.0 ................. 52.0	X		0	1,558,096	44,823
(16) SCOTT YOUNG DIRECTOR	1.0 ................. 0	X		0	0	0
(17) WILLIAM JOHNSON MD DIRECTOR	1.0 ................. 0	X		22,500	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) DAVID GRIFFITHS VP - CFO BRYAN MEDICAL CENTER	50.0 .......................1.0	X				354,978	9,221	44,142
(19) JOHN TRAPP MD VP & CHIEF MEDICAL OFFICER	50.0 .......................0	X				776,407	0	43,386
(20) TRAVIS GREGG VP & COO BRYAN MEDICAL CENTER	50.0 .......................0	X				317,002	0	42,094
(21) TROY HOTTOVY CHIEF INFORMATION SECURITY OFFICER	50.0 .......................0	X				339,452	0	46,833
(22) RICHARD LLOYD PRESIDENT - BRYAN COLLEGE HEALTH SCIENCES	50.0 .......................1.0		X			449,072	0	43,773
(23) JENNIFER FENCL REGISTERED NURSE	40.0 .......................0			X		222,340	0	47,780
(24) JEROME WOHLEB PHARMACY DIRECTOR	50.0 .......................0			X		253,373	0	43,987
(25) KENT HOXMEIER ANESTHESIA & PERUSION MANAGER	50.0 .......................0			X		249,155	0	34,674
(26) KRISHA ELLINGER IT APPLICATIONS DIRECTOR	50.0 .......................0			X		276,746	0	22,011
(27) SHARON HADENFELDT DEAN OF NURSE ANESTHESIA	50.0 .......................0			X		257,544	0	30,843
(28) ADRIANNE OLSON CNO	50.0 .......................0				X	288,395	0	43,539
(29) DAVID REESE Bryan Health VP & Physician Partnership & Facilities Officer	0.0 .......................51.0				X	12,130	423,797	61,926
(30) JOHN WOODRICH Bryan Health Exec VP & COO	0.0 .......................54.0				X	28,573	1,118,300	41,681
(31) LISA VAIL BRYAN HEALTH CHIEF NURSING OFFICER	0.0 .......................50.0				X	13,182	525,840	45,782

(A) Name and business address	(B) Description of services	(C) Compensation
INPATIENT PHYSICIAN ASSOCIATES LLC 1600 SOUTH 48TH STREET LINCOLN,NE68506	MEDICAL SERVICES	15,374,133
FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET SUITE 420 OMAHA,NE68154	TEMPORARY LABOR	13,105,154
ASSOCIATED ANESTHESIOLOGISTS 2900 S 70TH STREET 250 LINCOLN,NE68506	ANETHESIOLOGY SERVICES	4,855,721
ALLIED UNIVERSAL SECURITY SRVC 161 WASHINGTON STREET SUITE 600 CONSHOHOCKEN,PA19428	SECURITY SERVICES	2,227,194
DIALYSIS CENTER OF LINCOLN 7910 O STREET LINCOLN,NE68510	DIALYSIS FEES	2,216,690
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 79

- TIN:

SCHEDULE A
(Form 990)

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
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)
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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

Bryan Medical Center

Employer identification number

47-0376552

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization Bryan Medical Center

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization Bryan Medical Center			Employer identification number 47-0376552
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), 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.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

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 right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

40,011

Total. Add lines 1c through 1i ....................................................................................................

40,011

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	BRYAN MEDICAL CENTER IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE NEBRASKA HOSPITAL ASSOCIATION (NHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR MEMBERSHIP DUES TO THE AHA OF $71,794 AND THE NHA OF $130,256 AND OF THIS AMOUNT THE AHA REPORTED THAT 32% OR $22,974 AND THE NHA REPORTED THAT 13.08% OR $17,037 OF THE TOTAL DUES PAID WERE 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 THE INDIGENT/UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS THE ONGOING NEED FOR HEALTH SERVICES INCLUDING MENTAL HEALTH SERVICES FOR THE COMMUNITY.

Return Reference

Explanation

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

BRYAN MEDICAL CENTER IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE NEBRASKA HOSPITAL ASSOCIATION (NHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR MEMBERSHIP DUES TO THE AHA OF $71,794 AND THE NHA OF $130,256 AND OF THIS AMOUNT THE AHA REPORTED THAT 32% OR $22,974 AND THE NHA REPORTED THAT 13.08% OR $17,037 OF THE TOTAL DUES PAID WERE 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 THE 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) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

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" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	539,796	572,754	592,994	590,272	587,826
b	Contributions ...
c	Net investment earnings, gains, and losses	1,301	-27,039	-20,240	2,882	5,288
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	2,127	5,919	0	160	2,842
g	End of year balance ......	538,970	539,796	572,754	592,994	590,272

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

0 %

Term endowment right arrow

100 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. 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 .....		21,695,345		21,695,345
b	Buildings ....	1,474,929	645,391,929	347,736,545	299,130,313
c	Leasehold improvements		4,675,256	1,211,371	3,463,885
d	Equipment ....		522,862,767	419,762,655	103,100,112
e	Other .....		19,280,805	6,053,307	13,227,498
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					440,617,153

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........
(3) Other (A) LIMITED PARTNERSHIPS - HEDGE FUND OF FUNDS	65,266,000	C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	65,266,000

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
RIGHT-OF-USE LIABILITY	9,373,364
SELF INSURANCE LIABILITY	7,271,982
OTHER LIABILITIES	14,718,753
ACCRUED PENSION BENEFIT OBLIGATION	3,752,437
COLLEGE GRANTS	1,324,081
THIRD PARTY PAYOR SETTLEMENTS	-5,839,457
DUE TO RELATED PARTIES	1,721,742


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	32,322,902
2. Liability for uncertain tax positions. 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) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) 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. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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

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.

Return Reference	Explanation
Schedule D, Part III, Line 4 Collections of art - description of collections	BRYAN MEDICAL CENTER IS THE OWNER OF THE WILLIAM JENNINGS BRYAN HOUSE, ALSO KNOWN AS FAIRVIEW. FAIRVIEW IS A HISTORICIAL 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 NON-PROFIT ORGANIZATION FOR THE PURPOSES OF ESTABLISHING BRYAN MEMORIAL HOSPITAL AND AFFILATED SCHOOL OF NURSING. FAIRVIEW WAS DECLARED A NATIONAL HISTORIC LANDMARK IN 1963. THE HOUSE IS NOW USED FOR BRYAN MEETINGS AND FUNCTIONS. IN ADDITION, APPROXIMATELY 500 VISITORS TOUR THE HOME ANNUALLY. THIS ASSET IS FULLY DEPRECIATED AND REPORTED ON THE BALANCE SHEET AT A NET AMOUNT OF ZERO.
Schedule D, Part V, Line 4 Intended uses of endowment funds	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.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	UNDER ACCOUNTING STANDARDS CODIFICATION(ASC), SUBTOPIC 740-10, INCOME TAXES, THE SYSTEM MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS "MORE-LIKELY-THAN-NOT" THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT, ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECONGITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES AND ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURE. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AT DECEMBER 31, 2023, AND 2022. TAX RETURNS FILED BY THE SYSTEM ARE SUBJECT TO EXAMINATION BY THE IRS UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. THE SYSTEM RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE SYSTEM DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES ON DECEMBER 31, 2023, AND 2022.

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right arrow

Attach to Form 990. Right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
Bryan Medical Center

Employer identification number

47-0376552

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in the region
	Central America and the Caribbean			Investments	65,304,982
















3a	Sub-total ....	0	0		65,304,982
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		65,304,982

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2023

Schedule F (Form 990) 2023Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation
Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements	CENTRAL AMERICA AND THE CARIBBEAN-Accrual

Schedule F (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

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

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) . . .			12,393,378	0	12,393,378	1.58 %
b	Medicaid (from Worksheet 3, column a) . . . . .			110,161,831	70,755,126	39,406,705	5.02 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	122,555,209	70,755,126	51,800,083	6.60 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			2,008,158	0	2,008,158	0.26 %
f	Health professions education (from Worksheet 5) . . .			19,016,355	13,033,033	5,983,322	0.76 %
g	Subsidized health services (from Worksheet 6) . . . .			1,054,540	793,530	261,010	0.03 %
h	Research (from Worksheet 7) .			0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			516,339	0	516,339	0.07 %
j	Total. Other Benefits . .	0	0	22,595,392	13,826,563	8,768,829	1.12 %
k	Total. Add lines 7d and 7j .	0	0	145,150,601	84,581,689	60,568,912	7.71 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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			1,110		1,110	0 %
2	Economic development			2,000		2,000	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	3,110	0	3,110	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

292,436,533

Enter Medicare allowable costs of care relating to payments on line 5.....

359,609,528

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-67,172,995

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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 %
1DOCTORS OUTPATIENT SURGERY CENTER	OUTPATIENT SURGERY CENTER	51 %	0 %	49 %
2LINCOLN DIGESTIVE HEALTH CENTER LLC	AMBULATORY SURGERY CENTER	51 %	0 %	49 %
3HEAD AND NECK SURGICAL PARTNERS LLC	AMBULATORY SURGERY CENTER	51 %	0 %	49 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

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?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)							Facility reporting group
1	BRYAN MEDICAL CENTER EAST 1600 SOUTH 48TH STREET LINCOLN,NE68506 WWW.BRYANHEALTH.COM 500001	X	X	X	X	X	A
2	BRYAN MEDICAL CENTER WEST 2300 SOUTH 16TH STREET LINCOLN,NE68502 WWW.BRYANHEALTH.COM 500003	X	X	X	X	X	A

Schedule H (Form 990) 2023

Page 4

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 letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.BRYANHEALTH.COM/ABOUT-BRYAN-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.BRYANHEALTH.COM/ABOUT-BRYAN-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/

The FAP application form was widely available on a website (list url):

www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/

A plain language summary of the FAP was widely available on a website (list url):
www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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 individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	A
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 3E	THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
Schedule H, Part V, Section B, Line 5 Facility A, 1	Facility A, 1 - BRYAN MEDICAL CENTER EAST CAMPUS AND BRYAN MEDICAL CENTER WEST CAMPUS. IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT, A COLLABORATION EFFORT BETWEEN BRYAN MEDICAL CENTER, THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT, AND CHI ST. ELIZABETH, GATHERING INPUT REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. PRIORITIZED SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED BY SUBJECT MATTER EXPERTS AT BRYAN HEALTH, BASED ON FINDINGS FROM THE COLLABORATIVE ASSESSMENT. THE LINCOLN COMMUNITY HEALTH SURVEY PROVIDES INFORMATION AND INSIGHT CRITICAL TO BRYAN MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT. THIS SURVEY WAS PLANNED, CONDUCTED, AND ANALYZED AS A JOINT EFFORT BETWEEN THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT, BRYAN HEALTH AND CHI HEALTH. DURING THE FISCAL YEAR ENDED DECEMBER 31, 2021, BRYAN MEDCIAL CENTER, CHI ST. ELIZABETH AND THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT DISTRIBUTED SURVEYS TO ONE IN EVERY SEVEN HOUSEHOLDS THROUGHOUT THE AREA. IN ADDITION TO SURVEYING ONE IN SEVEN HOUSEHOLDS THROUGHOUT LANCASTER COUNTY, OVERSAMPLING WAS PERFORMED WITH LINCOLN'S CULTURAL CENTERS COALITION, THE LINCOLN HOMELESS COALITION, AND ALSO THE NEBRASKA COMMISSION FOR THE BLIND SUPPORTED AND THE FEDERATION FOR THE BLIND. THE LINCOLN COMMUNITY HEALTH SURVEY CONSISTED OF FIVE QUESTIONS: FOUR OPEN-ENDED WRITE-IN QUESTIONS, AND ONE MULTIPLE CHOICE QUESTION. THE LINCOLN COMMUNITY HEALTH SURVEY WAS MAILED WITH A PAPER SURVEY AND BUSINESS REPLY ENVELOPE ENCLOSED. THE SURVEY INVITED PEOPLE TO COMPLETE THE SURVEY EITHER ONLINE OR BY HAND. THE BACK OF THE PAPER SURVEY OFFERED INSTRUCTIONS FOR LANGUAGE HELP IN SEVEN LANGUAGES, INCLUDING SPANISH, ARABIC, KURDISH, VIETNAMESE, AND RUSSIAN. IN ADDITION, INSTRUCTIONS FOR COMPLETING THE SURVEY ONLINE WERE ALSO INCLUDED VIA PICTURES WITH MINIMAL WORDS. THE BOTTOM OF THE SURVEY ALSO OFFERS A CHANCE FOR FURTHER PARTICIPATION IN THE NEEDS ASSESSMENT. THE LINCOLN COMMUNITY HEALTH SURVEY MAILER WAS APPROVED FOR DISTRIBUTION ON SEPTEMBER 22, 2020. 13,946 SURVEYS WERE MAILED TO HOUSEHOLDS. OF THAT DISTRIBUTION, 1,752 RESPONSES WERE RECEIVED - A 12.6% RESPONSE RATE. ALONG WITH OVERALL RESULTS, RESPONSES WERE WEIGHTED WITHIN THEIR CENSUS TRACT. THE TOP THREE HEALTH CONCERNS IN THE CITY OF LINCOLN AND LANCASTER COUNTY ARE BEHAVIORAL HEALTH CARE (MENTAL HEALTH), ALCOHOL, DRUG, AND TOBACCO USE; HEART DISEASE; AND CANCER.
Schedule H, Part V, Section B, Line 6a Facility A, 1	Facility A, 1 - BRYAN MEDICAL CENTER EAST CAMPUS AND BRYAN MEDICAL CENTER WEST CAMPUS. SEE SCHEDULE H, PART V, SECTION B, LINE 5
Schedule H, Part V, Section B, Line 6b Facility A, 1	Facility A, 1 - BRYAN MEDICAL CENTER EAST CAMPUS AND BRYAN MEDICAL CENTER WEST CAMPUS. THE HOSPITAL'S CHNA WAS A COLLABORATIVE EFFORT BETWEEN THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT, BRYAN HEALTH, AND CHI HEALTH (REFERENCED IN SCHEDULE H, PART V, SECTION B, LINE 5).
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - BRYAN MEDICAL CENTER EAST CAMPUS AND BRYAN MEDICAL CENTER WEST CAMPUS. BRYAN HEALTH HAS WORKED DILIGENTLY TO IMPLEMENT AND CONTINUE STRATEGIES THAT WILL ALLOW THE ORGANIZATION TO MEET THE NEEDS OF THE LINCOLN COMMUNITY AS WELL AS THE SURROUNDING LANCASTER COUNTY AREA. THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN, AND 2021 BRYAN HEALTH STRATEGIC PLAN, BRYAN HEALTH CONTINUES TO PARTNER THROUGHOUT THE CITY AND COUNTY TO IMPROVE FOUR MAJOR AREAS OUTLINED IN THE CHNA: 1) BEHAVIORAL HEALTH 2) CARDIOVASCULAR DISEASE 3) CANCER CARE 4) COVID-19 PANDEMIC THROUGH THE RESULTS OF THE LINCOLN COMMIUNITY HEALTH SURVEY AS WELL AS THROUGH OTHER PRIMARY RESEARCH AND DATA AVAILABLE, BRYAN HAS IDENTIFIED 4 SIGNIFICANT HEALTH NEEDS WITHIN LINCOLN AND LANCASTER COUNTY THAT REQUIRED PRIORITIZED FOCUS OVER THE NEXT FEW YEARS. THIS STRATEGY OF PRECISELY FOCUSED NEED PRIORITIES IS A DEPARTURE FROM BRYAN'S PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS, WHOSE BOARD AND ENCOMPASSING NEED PRIORITIES CREATED A MORE OR LESS COMPREHENSIVE LANDSCAPE OF HEALTH NEEDS WITHIN LANCASTER COUNTY. BY TIGHTENING FOCUS TO A FEW SPECIFIC NEEDS, BRYAN HOPES TO MAKE TANGIBLE AND STRATEGIC IMPACTS ON SOME OF OUR COMMUNITY'S MOST PRESSING NEEDS. THESE SIGNIFICANT HEALTH NEEDS WERE SELECTED BASED ON A COMBINATION OF FACTORS, INCLUDING RESPONSES FROM THE LINCOLN COMMUNITY HEALTH SURVEY, ANALYSIS OF COMMUNITY DATA SOURCES SUCH AS LANCASTER COUNTY'S VITAL STATISTICS, BRYAN HEALTH'S OWN INTERNAL HOSPITALIZATION DATA AND OTHER FORMS OF RESEARCH. 1.BEHAVIORAL HEALTH OPTIONS REPRESENTING BEHAVIORAL HEALTH WERE THE TWO MOST-SELECTED ANSWERS IN THE LINCOLN COMMUNITY HEALTH SURVEY. MENTAL HEALTH WAS THE MOST SELECTED OPTION, AND ALCOHOL, DRUG AND TOBACCO USE WAS THE SECOND-MOST SELECTED. ATTEMPTED SUICIDES IN LINCOLN, NEBRASKA HAVE RISEN TO A TWENTY-YEAR HIGH, BOTH AMONG THE 10-24 YEAR OLD AGE GROUP AND AMONG ALL AGES IN GENERAL. REPORTS OF AGGRAVATED DOMESTIC ASSAULT IN LANCASTER COUNTY HAVE RISEN OVER THE PAST 3 YEARS. BETWEEN JANUARY AND MAY 2021, THE LINCOLN POLICE DEPARTMENT RESPONDED TO 1,698 MENTAL HEALTH CALLS FOR SERVICE. THESE CALLS INCLUDED MORE THAN 170 ATTEMPTED SUICIDES. MORE THAN 100 OF THE CALLS FOR SERVICE, REQUIRED EMERGENCY PROTECTIVE CARE. THE LINCOLN POLICE DEPARTMENT REPORTED 133 NON-FATAL OVERDOSES IN 2020, A 76 PERCENT INCREASE OVER THE 5-YEAR AVERAGE. WHILE LANCASTER COUNTY REPRESENTS ROUGHLY 16% OF NEBRASKA'S POPULATION, IT CONTRIBUTES 35% OF THE STATE'S 2019 HERION OVERDOSES. ON AUGUST 19, 2021, THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT ISSUED A HEALTH ALERT REGARDING A SPIKE IN ACCIDENTAL DRUG OVERDOSES CAUSED BY ILLEGAL DRUGS BEING MIXED WITH FENTANYL. THE LINCOLN POLICE DEPARTMENT REPORTED RESPONDING TO 50 OVERDOSE CASES WITHIN A PERIOD OF 30 DAYS. UPON INVESTIGATION, AT LEAST 26 IN THE PRIOR 3 WEEKS HAD BEEN CASUED BY THIS COMBINATION. BRYAN HEALTH CONTINUES TO SUPPORT CHANGE AND INNOVATION IN PILOT PROGRAMS SUCH AS DRUG COURT, AS WELL AS WORKING WITH LAW ENFORCEMENT AND THE CRISIS CENTER TO SUPPORT ENHANCED PRE-CRISIS CARE. OVERALL, BRYAN HEALTH HAS MADE PROGRESS IN SUPPORTING BEHAVIORAL HEALTH IN THE COMMUNITY WITH ITS INDEPENDENCE CENTER FACILITY FOR SUBSTANCE ABUSE TREATMENT. THIS STATE OF THE ART FACILITY PROVIDES A CARING ENVIRONMENT FOR TREATMENT AND HEALING FOR INDIVIDUALS IN LANCASTER COUNTY AND BEYOND WHO ARE SEEKING INPATIENT OR OUTPATIENT TREATMENT FOR SUBSTANCE ABUSE. THE INDEPENDENCE CENTER ALSO CONTINUES TO PROVIDE INTERVENTION NURSES AT BRYAN HEALTH AND OTHER LOCAL MEDICAL FACAILITES TO ASSESS SUBSTANCE ABUSE. WE CONTINUE WORKING WITH DHHS TO PROVIDE INTERVENTION NURSE TELEHEALTH CONSULTS TO 5 RURAL NEBRASKA COMMUNITIES FOR OPIOID USE ASSESSMENT AND REDUCTION. WE ALSO CONTINUE TO COLLABORATE WITH THE SCHOOL COMMUNITY INTERVENTION PROGRAM (SCIP) TO PROVIDE FREE CONTRACTED SUBSTANCE USE EVALUATIONS TO LINCOLN PUBLIC SCHOOL YOUTH. THE INDEPENDENCE CENTER SUPPORTS A POSITION TITLED COMMUNITY OUTREACH LIAISON. THIS INDIVIDUAL HELPS CLIENTS AND THEIR FAMILITES NAVIGATE THE PROVIDER COMMUNITY AND CONNECTS THEM WITH THE SERVICES NEEDED. THIS POSITION ALSO ASSISTS THOSE WHO ARE RETURNING FROM RESIDENTIAL SERVICES BACK INTO THE HOME, SCHOOL, AND COMMUNITY. OUTREACH LIAISON IS TO EDUCATE THE COMMUNITY ABOUT SUBSTANCE USE AND INDEPENDENCE CENTER SERVICES. FURTHERMORE, BRYAN HEALTH SUPPORTS EFFORTS IN THE COMMUNITY TO PROVIDE AN INTEGRATED BEHAVIORAL HEALTH SAFETY NET AND EXPAND ACCESS TO BEHAVIORAL HEALTH PROVIDERS WHO SERVE POOR, UNINSURED, AND MEDICAID ELIGIBLE POPULATIONS. BRYAN HEARTLAND PSYCHIATRY SIGNIFICANTLY INCREASED THEIR NUMBER OF PROVIDERS TO MEET COMMUNITY NEEDS FOR BEHAVIORAL HEALTH SERVICES. THESE EFFORTS INCLUDE PROVIDING A SEGREGATED MENTAL HEALTH EMERGENCY DEPARTMENT STAFFED WITH SPECIALLY TRAINED BEHAVIORAL HEALTH NURSES, AND SOCIAL WORKERS. IN ORDER TO FURTHER LEVERAGE THESE SPECIALLY TRAINED STAFF TO ASSIST WITH THE LACK OF MENTAL HEALTH PROVIDERS AND SERVICES IN THE VAST UNDERSERVED AREAS OF THE STATE, BRYAN HEALTH OFFERS BEHAVIORAL HEALTH EVALUATIONS VIA TELEHEALTH TO 10 EMERGENCY DEPARTMENT SITES ACROSS THE STATE. BY PROVIDING THIS SERVICE WE ASSIST WITH PROVIDING A QUALITY EVALUATION AND PLAN RECOMMENDATIONS THAT REDUCE PREVENTABLE INPATIENT ADMISSIONS AND ASSIGNMENT TO OTHER HIGHER LEVELS OF CARE. IN A SPECIAL PROJECT, BRYAN HEALTH'S MENTAL HEALTH EMERGENCY DEPARTMENT HAS PARTNERED WITH CENTERPOINTE TO PROVIDE IMMEDIATE LINKAGE TO SUBSTANCE USE OUTPATIENT SERVICES FOR PATIENTS NOT BEING ADMITTED TO MEDICAL CENTER HIGHER LEVELS OF CARE. THIS INITIATIVE IS INTENDED TO IMPROVE LOCAL AND STATE PERFORMANCE REGARDING SUBSTANCE USE FOLLOW UP AFTER HOSPITAL VISIT. BRYAN HEALTH UTILIZES PEER SPECIALISTS. THESE PEERS USE PRINCIPLES OF RECOVERY, WELLNESS RECOVERY ACTION PLANNING, WHOLE HEALTH ACTION MANAGEMENT AND OTHER EVIDENCE-BASED PRACTICES IN THEIR WORK. THEY HOLD WEEKLY COMMUNITY WELLNESS GROUPS AT NO COST TO THE PARTICIPANTS; PROVIDE INPATIENT WELLNESS/RECOVERY GROUPS; PAIN MANAGEMENT CONSULTS; STAFF COVID WELLNESS SUPPORT GROUPS; CANCER SUPPORT GROUPS AND RESPOND TO INDIVIDUAL REQUESTS FROM PROVIDERS. BRYAN HAS MADE IT A PRIORITY TO SERVE AS A TRAINING SITE FOR COUNSELORS, SOCIAL WORKERS, NURSES, PHYICIAN ASSISTANTS, AND PRIMARY CARE PHYSICIANS THROUGH THE LINCOLN MEDICAL EDUCATION PROGRAM. SOUTHEAST COMMUNITY COLLEGE, DOANE UNIVERSITY, UNION COLLEGE, BRYAN COLLEGE OF HEALTH SCIENCES, UNIVERSITY OF NEBRASKA AND OTHER EDUCATIONAL INSTITUTIONS. THESE EFFORS HAVE SIGNIFICANT VALUE IN DEVELOPING OUR FUTURE WORKFORCE. ONLINE SCREENING FOR DEPRESSION, ANXIETY, POST-TRAUMATIC STRESS DISORDER, ALCOHOL ABUSE, AND ADOLESCENT DEPRESSION ARE MADE AVAILABLE AT NO COST TO THE PUBLIC ON THE BRYAN HEALTH WEBSITE. IF THE ENDORSED ITEMS SUGGEST THERE IS A CLINCIAL PROBLEM PRESENT, AT COMPLETION OF THE SURVEY, A RECOMMENDATION IS PROVIDED FOR THE INDIVIDUAL TO SEEK PROFESSIONAL HELP. THERE HAS BEEN A STEADY ANNUAL INCREASE IN NUMBER OF SCREENINGS ACCESSED. BRYAN HEALTH WORKS WITH OTHER LINCOLN PROVIDERS AND GROUPS ACROSS THE STATE TO ADDRESS GAPS AND SPECIAL NEEDS IN THE POPULATION AS WELL AS THOSE WHO ARE UNDERSERVED. THESE INCLUDE CENTERPOINT AND THE BRIDGE BEHAVIORAL HEALTH TO IMPROVE COORDINATION OF CARE FOR CLIENTS REQUIRING SPECIALIZED SUBSTANCE USE SERVICES; YOUTH CRISIS RESPONSE COALITION TO PREVENT YOUTH FROM ENTERING THE JUVENILE JUSTICE SYSTEM AND CREATING A 24 HOUR RESPITE SERVICE FOR YOUTH IN CRISIS BUT NOT REQUIRING HOSPITAL OR LEGAL LODGING. WE ARE PROUD TO CONTINUE TO WORK WITH LINCOLN POLICE DEPARTMENT'S MOBILE CRISIS SERVICE; CENTERPOINTE'S CRISIS SERVICES, MENTAL HEALTH ASSOCIATION'S RESPITE SERVICES, AND REGION 5'S TARGETED ADULT SERVICE COORDINATION (TASC) SERVICES. THESE AND OTHER PRE-CRISIS SERVICES HAVE PROVEN VALUABLE IN HELPING INDIVIDUALS TO PREVENT THE NEED FOR HIGHER LEVELS OF CARE.
Schedule H, Part V, Section B, Line 11 Facility A, 2	Facility A, 2 - BRYAN MEDICAL CENTER EAST CAMPUS AND BRYAN MEDICAL CENTER WEST CAMPUS. WE ARE PROUD TO CO-SPONSOR AND HOST MENTAL ILLNESS AWARENESS WEEK TO PROVIDE COMMUNITY EDUCATION WITH ADDITIONAL OFFERINGS THROUGHOUT THE YEAR ON TOPICS SUCH AS SOCIAL MEDIA IMPACT ON ADOLESCENTS; STIGMA; CHRONIC PAIN, HOLISTIC SELF-CARE, ETC. WE HAVE ADDITIONALLY SUPPORTED OUR COMMUNITY THROUGH MULTIPLE MEDIA SUPPORTING STRESS REDUCTION, BURNOUT PREVENTION AND RECOVERY, WELLNESS, FAMILY AND GENERAL SUPPORT TOPICS AS WE WORKED THROUGH THE RAVAGES OF COVID ON OUR COMMUNITY AND PROVIDERS. BRYAN MEDICAL CENTER MENTAL HEALTH HAS BEEN A LEADER IN SUICIDE PREVENTION FOR OUR COMMUNITY AND STATE. ONE OF THE MANAGERS FOR BRYAN MENTAL HEALTH HELPED TO START THE NEBRASKA STATE SUICIDE PREVENTION COALITION IN 1999 AND CONTINUES TO SERVE ON THE EXECUTIVE COMMITTEE. THE DIRECTOR RECENTLY HELPED THE COALITION ACHIEVE 501(C)(3) STATUS. THE LATEST PROJECT IS THE DEVELOPMENT OF A PHONE APP THAT APPEALS TO THE 15-24 Y/O AGE GROUP, WHICH INCLUDES A JOURNALING APP, IMMEDIATE ACCESS TO SUICIDE CRISIS TEXT AND TELEPHONE LINE SERVICE THROUGH BOYS TOWN NATIONAL HOTLINE. SERVED ON THE LEADERSHIP GROUP OF THE LINCOLN SUICIDE PREVENTION COALITION (HOPELINK). IN ADDITION, THIS BRYAN BEHAVIORAL HEALTH DIRECTOR PROVIDED LEADERSHIP IN DEVELOPING THE FIRST LOCAL OUTREACH TO SUICIDE SURVIVORS (LOSS) TEAM IN LINCOLN, NEBRASKA AND HAS CONTINUED TO ASSIST IN THE DEVELOPMENT OF AN ADDITIONAL 10 LOSS TEAMS IN OTHER NEBRASKA COUNTIES. DEVELOPING AND IMPLEMENTING THE LOSS TEAM WAS A COLLABORATIVE EFFORT IN WORKING WITH LAW ENFORCEMENT AND POLICE CHAPLAINS AS WELL AS OTHER COMMUNITY AND COUNTY AGENCIES. A LOSS TEAM IS A GROUP OF 3 PEOPLE WHO ARE ON CALL (2 PEOPLE WHO HAVE LOST SOMEONE FROM SUICIDE AND A CLINICIAN) AND THEY RESPOND TO FAMILIES WHO HAVE LOST SOMEONE TO SUICIDE AND PROVIDE RESOURCES. CONNECTING SUICIDE SURVIVORS TO OTHER SUICIDE SURVIVORS AND RESOURCES IS CONSIDERED SUICIDE POSTVENTION WHICH IS ALSO PREVENTION. IN RESPONSE TO THE GROWING PRESENCE AND AWARENESS OF OPIOID MISUSE AND ABUSE IN THE COMMUNITY AND ACROSS THE NATION, BRYAN HEALTH CREATED THE PAIN MANAGEMENT AND OPIOID STEWARDSHIP PROGRAM IN SUMMER 2018. LOCAL PAIN MANAGEMENT SPECIALIST KELLY ZACH, MD LEADS A 24-MEMBER STEERING TEAM TO RUN THE PROGRAM. THE TEAM INCLUDES REPRESENTATION FROM MEDICAL STAFF, HOSPITAL ADMINISTRATION, PHARMACY, NURSING, BEHAVIORAL HEALTH, SUBSTANCE ABUSE, PHYSICAL THERAPY AND ORGANIZATIONAL QUALITY. THIS ONGOING PROGRAM WILL EVALUATE AND UTLIZE EVIDENCE-BASED BEST PRACTICES TO ACHIEVE SAFE AND APPROPRIATE PAIN MANAGEMENT, WHILE REDUCING THE RISK OF OPIOID ADDICTION, OVERDOSE AND DEATHS. THIS TEAM HAS WORKED THROUGH NUMEROUS PHASE ONE GOALS AND ENTERED PHASE TWO. PHASE TWO GOALS MOVE INTERVENTIONS OUT INTO THE COMMUNITY AT LARGE. THERE HAVE BEEN INDEPENDENT OUTPATIENT PROVIDER EDUCATION, EDUCATION TO NEBRASKA MEDICAL ASSOCIATION MEMBERS; PARTNERING WITH THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT COMMITTEE; LINCOLN POLICE DEPARTMENT; AND SEVERAL OTHERS. 2. CARDIOVASCULAR DISEASE THE PREVALENCE OF CARDIOVASCULAR DISEASE WITHIN LINCOLN AND LANCASTER COUNTY GIVES CREDENCE TO THE COMMUNITY'S CONCERN FOR HEART DISEASE WITHIN THE SURVEY. HEART DISEASE HAS BEEN ONE OF THE TWO LEADING CAUSES OF DEATH IN LANCASTER COUNTY AT LEAST AS FAR BACK AS 2005. IT TRAILS JUST BEHIND CANCER AS THE LEADING CAUSE OF DEATH, AND BOTH ARE FAR AHEAD OF ALL OTHER CAUSES OF DEATH IN THE COUNTY. IN 2020, THE WALL STREET JOURNAL ANALYZED THE CDC'S MORTALITY DATA AMOUNT PEOPLE AGES 45-64 DURING THE YEARS BETWEEN 2010 AND 2016. THE ANALYSIS STUDIED INCREASES IN CARDIOVASCULAR-RELATED DEATHS IN THAT AGE GROUP ACROSS THE NATIONAL CITIES WITH POPULATIONS GREATER THAN 100,000. THE ANALYSIS CITED LINCOLN, NEBRASKA AS HAVING A 25.1% INCREASE IN THAT TIME PERIOD; RANKING FOURTH NATIONALLY. WHILE CARDIOVASCULAR DISEASE IS A MAJOR AND GROWING HEALTH CONCERN FOR LINCOLN AND LANCASTER COUNTY, IT MUST BE NOTED THAT LINCOLN'S CARE FOR CARDIOVASCULAR PATIENTS IS EXCELLENT. LINCOLN FIRE AND RESCUE RECENTLY REPORTED THAT LINCOLN'S SURVIVAL RATE FOR NON-TRAUMATIC CARDIAC ARREST CASES IN 2023 IS 22.4%, COMPARED TO THE NATIONAL AVERAGE OF 10.2%. HYPERTENSION IS THE LARGEST CONTRIBUTOR TO CARDIOVASCULAR DISEASE, AND BRYAN HAS MADE THE CONTROL OF HYPERTENSION AN ORGANIZATION GOAL AMONG ALL BRYAN SITES AND PROVIDERS. AS A RESULT, THE PERCENTAGE OF PATIENTS WITH CONTROLLED HYPERTENSION HAS INCREASED ALMOST 10%. 3. CANCER CARE CANCER HAS HELD AS LANCASTER COUNTY'S MOST PROMINENT CAUSE OF DEATH FOR MORE THAN A DECADE. THE ONLY OTHER SIGNIFICANT CAUSE OF DEATH FOR THE AREA IS HEART DISEASE, WHICH HAS YET TO ECLIPSE IT. WHILE THE CANCER OPTION APPEARS NOT TO BE OFTEN SELECTED IN THE SURVEY, IT MUST BE NOTED THAT THE "CANCER" OPTION WAS ONLY DISPLAYED ON THE ONLINE VERSION, NOT ON THE PAPER VERSION. THIS MISTAKE WAS IDENTIFIED AFTER THE PAPER SURVEY WAS DISTRIBUTED. EVIDENCE STILL SPEAKS TO CANCER BEING A STRONG CONCERN TO THE LINCOLN AND LANCASTER COUNTY COMMUNITY. AS FAR BACK AS 2005, LUNG CANCER HAS BEEN THE DEFINITIVE LEADER AMONG CAUSES OF DEATH BY CANCER IN LANCASTER COUNTY. HOWEVER, THE PERCENTAGE OF CANCER DEATHS BY LUNG CANCER HAS BEEN DECREASING DURING THIS TIME AND IS LIKELY TO CONTINUE. OVER THE LAST FIVE YEARS, THE RECENT TREND IN CASES FOR LANCASTER COUNTY HAS BEEN FALLING BY 1.5 TIMES. BRYAN LEADERS MET ON FOUR OCCASIONS WITH FOCUS GROUPS COMPRISING INDIVIDUALS FROM THE REGION WHO HAVE LIVED OR ARE LIVING WITH CANCER. QUALITATIVE FINDINGS REVEALED CANCER PATIENTS RELY UPON THEIR PHYSICIAN, EXPERIENCE AND THEIR OWN RESEARCH WHEN THEY DECIDE WHERE TO RECEIVE CARE. THIS GROUP ARTICULATED A DEEP UNDERSTANDING OF THE PROTOCOL-DRIVEN NATURE OF CANCER CARE. THEY WERE UNIVERSALLY COMPLIMENTARY OF THE SKILL AND EXPERIENCE OF THEIR PHYSICIANS AND QUALITY OF THE CARE AND OUTCOMES EXPERIENCED IN LINCOLN AND ELSEWHERE. HOWEVER, IT WAS CLEAR THAT THEY DESIRED AND STRONGLY RECOMMENDED THAT BRYAN FACILITATE A BETTER OPTION THAN CURRENTLY EXISTS. THEY ADVISED US TO DO ALL WE CAN TO REMEDY THE DISJOINTED CARE, AND ENHANCE THE CONVENIENCE AND PERSONALIZED CARE THAT WAS LACKING WHEN THEY LEFT LINCOLN FOR SECOND OPINIONS OR ADDITIONAL CARE. BRYAN HEALTH CONDUCTED SPECIFIC RESEARCH INTO THE IMPACT OF CANCER IN THE AREA WHILE IT WAS PLANNING THE APRIL SAMPSON CANCER CENTER. ADDITIONAL CANCER CARE NAVIGATORS HAVE BEEN HIRED AND DEPLOYED TO ASSIST NEW CANCER PATIENTS THROUGH THEIR JOURNEY. THE APRIL SAMPSON CANCER CENTER WAS OPEN IN APRIL 2023 AND STARTED CANCER TREATMENTS FOR PATIENTS. TO SUPPORT THE PREVENTION AND TREATMENT OF CANCER IN THE COMMUNITY, BRYAN HEALTH CONTINUES TO SPONSOR CANCER CONFERENCES WEEKLY, WITH SPECIAL THORACIC CONFERENCES HELD TWICE MONTHLY. LIFESPRING CANCER RECOVERY PROGRAM STILL PROVIDES SUPPORT AND EXPERTISE FOR CANCER PATIENTS AND SURVIVORS WITHIN LINCOLN AND THE SURROUNDING AREA. BRYAN MEDICAL CENTER ALSO PARTICIPATES WITH THE NEBRASKA CANCER RESEARCH CENTER (NCRC) AND THE CANCER ALLIANCE OF NEBRASKA TO OFFER CLINCIAL TRIAL OPPORTUNIITIES LOCALLY TO CANCER PATIENTS. EDUCATION ON CANCER PREVENTION AND SCREENING, AS WELL AS OTHER CANCER-RELATED TOPICS, ARE PRESENTED TO SERVICE GROUPS AND ORGANIZATIONS AS PART OF BRYAN MEDICAL CENTER'S COMMUNITY OUTREACH. BRYAN HOSTS EDUCATION CLASSES ON SMOKING CESSATION, RADON PREVENTION, THE LINKS BETWEEN OBESITY AND CANCER, AND CARING FOR A LOVED ONE WITH CANCER. BRYAN RAISES COMMUNITY AWARENESS SURROUNDING LUNG CANCER EVERY NOVEMBER WITH ITS SHINE A LIGHT ON LUNG CANCER EVENT.
Schedule H, Part V, Section B, Line 11 Facility A, 3	Facility A, 3 - BRYAN MEDICAL CENTER EAST CAMPUS AND BRYAN MEDICAL CENTER WEST CAMPUS. 4. EFFECTS OF THE COVID-19 PANDEMIC RESIDENTS OF LANCASTER COUNTY FIRST STARTED TESTING POSITIVE FOR COVID-19 IN EARLY 2020. THE COVID-19 PANDEMIC HAS HAD SEISMIC EFFECTS ON OUR COMMUNITY AND ACROSS THE WORLD. WITHIN LINCOLN, BUSINESSES HAVE BEEN CLOSED AND REOPENED, REMOTE LEARNING HAS BEEN EMPLOYED IN SCHOOLS, MASK MANDATES HAVE BEEN IMPLEMENTED, LIMITATIONS ON GATHERING SIZES HAVE BEEN ENFORCED, VACCINATION REQUIREMENTS AMONG PRIVATE BUSINESSES HAVE BEEN IMPOSED AND ELECTIVE SURGICAL PROCEDURES HAVE BEEN SUSPENDED OR DELAYED MULTIPLE TIMES. AT THE TIME THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS BEING COMPOSED, LANCASTER COUNTY WAS SEVERAL WEEKS INTO THE DELTA VARIANT WAVE OF THE COVID-19 PANDEMIC. THE STRENGTH OF THE DELTA VARIANT WAVE ILLUSTRATES THE POSSIBILITY OF THE COVID-19 PANDEMIC AS BEING AN ACUTE NEED ALL THROUGHOUT THE CHNA PERIOD, AS THE THREAT OF POSSIBLE FUTURE VARIANT LOOMS. THE LINCOLN COMMUNITY HEALTH SURVEY WAS DISTRIBUTED IN LATE SEPTEMBER 2020. THE DOMINANT RESPONSE CATEGORY FOR QUESTION 2 ("WHAT WORRIES YOU MOST ABOUT YOUR OR YOUR FAMILY'S HEALTH") WAS "INFECTIOUS DISEASE", GARNERING 29.1% OF RESPONSES. OF THOSE RESPONSES, A FULL 99% SPECIFICALLY LISTED COVID-19 AS THEIR PRIMARY HEALTH WORRY. IN ATTEMPT TO MAINTAIN CAPACITY DURING PERIODS OF COVID-19 SURGE OVER THE PAST FEW YEARS, BRYAN HAS EMPLOYED STRATEGIES TO STOP, REDUCE, SUSPEND OR DELAY ELECTIVE SURGERIES MULTIPLE TIMES. DURING 2023, BRYAN MEDICAL CENTER DID NOT NEED TO EMPLOY THESE STRATEGIES AS THE LOCAL COVID-19 RISK LEVEL HAS BEEN LOW ALONG WITH HOSPITALIZATIONS. NATIONALLY, AS OF SEPTEMBER 2020: 36% OF ADULTS REPORTED DELAYING OR FORGOING HEALTH CARE DUE TO WORRY ABOUT EXPOSURE TO COVID-19, OR BECAUSE A PROVIDER LIMITED SERVICES DURING THE PANDEMIC. 76% OF ADULTS WHO DELAYED OR FOREWENT CARE HAD ONE OR MORE CHRONIC HEALTH DISEASE AND CANCER. 32% OF THE ADULTS REPORTING DELAYED OR FORGONE CARE REPORTED THAT DOING SO WORSENED THEIR HEALTH CONDITIONS. DURING 2023, BRYAN MEDICAL CENTER PROVIDED LIFE-SAVING PROCEDURES AND MEDICATIONS FOR 7,773 INDIVIDUALS WHO WERE NOT ELIGIBLE FOR ANY GOVERNMENT OR STATE SUPPORT, AND DID NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR HEALTH CARE SERVICES. THERE ARE MANY REASONS BEHIND LACK OF ACCESS TO HEALTH SERVICES; THE SHORTAGE OF HEALTHCARE PROFESSIONALS IS JUST ONE OF THESE REASONS. BRYAN HEALTH IS A HUGE SUPPORTER OF EDUCATION FOR HEALTH CARE PROFESSIONALS - INCLUDING ONGOING FINANCIAL SUPPORT FOR: 1) THE BRYAN COLLEGE OF HEALTH SCIENCES, WITH 747 STUDENTS ENROLLED IN GRADUATE AND UNDERGRADUATE DEGREE PROGRAMS THROUGH BRYAN'S SCHOOL OF NURSING, HEALTH PROFESSION AND NURSE ANESTHESIA PROGRAMS, AND 2) THE LINCOLN MEDICAL EDUCATION PARTNERSHIP RESIDENCY PROGRAM FOR FUTURE PRIMARY CARE PROVIDERS. IN ADDITION, BRYAN ALSO SERVES AS A CLINICAL TRAINING SITE FOR A LONG LIST OF HEALTH CARE DISCIPLINES; INCLUDING RADIOLOGY, LAB, PHYSICAL THERAPY, PHARMACY, EMTS AND PARAMEDICS, ETC. THIS COMMITMENT TO EDUCATION OF THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS ULTIMATELY IMPROVES ACCESS TO HEALTHCARE IN OUR REGION. MADONNA IS THE DESIGNATED ORGANIZATION IN THE LINCOLN COMMUNITY THAT PROVIDES HANDICAP-ACCESSIBLE BUS TRANSPORTATION FOR COMMUNITY MEMBERS TO/FROM DOCTORS' APPOINTMENTS, THERAPY AND OTHER OUTPATIENT APPOINTMENTS. BRYAN PROVIDES AN ANNUAL CONTRIBUTION OF $25,000 FOR THESE SERVICES SO THAT FINANCIALLY CHALLENGED MEMBERS OF OUR COMMUNITY WILL HAVE ACCESS TO MEDICAL CARE. MANY PRIVATE PRACTICE PHYSICIANS IN LINCOLN HAVE ELECTED NOT TO SERVE MEDICAID AND/OR MEDICARE PATIENTS IN THEIR OUTPATIENT CLINICS FOR FINANCIAL REASONS. BRYAN PHYSICIAN NETWORK PHYSICIANS ACCEPT MEDICAID/MEDICARE PATIENTS INTO THEIR PRACTICE BY POLICY; THEREFORE, AS BRYAN PHYSICIAN NETWORK CONTINUES TO EXPAND WITHIN THE COMMUNITY, SO DOES ACCESS TO PHYSICIAN CARE FOR AREA MEDICAID/MEDICARE PATIENTS. BRYAN PHYSICIAN NETWORK ESTABLISHED BRYAN NORTHPOINTE FAMILY MEDICINE WHICH INCLUDES A TEAM OF 7 FAMILY PRACTICE PHYSICIANS, 20 PHYSICIAN ASSISTANTS, 7 INTERNAL MEDICINE PHYSICIANS, 1 ENDOCRINOLOGY PHYSICIAN, 2 PSYCHIATRY PHYICIANS, AND 2 TRAUMA SURGEONS. FOURTH QUARTER 2020, BRYAN MEDICAL CENTER ESTABLISHED A FREE STANDING IMAGING CENTER AT THE PINE LAKE CAMPUS CALLED THE BRYAN IMAGING AND DIAGNOSTIC. THE BRYAN IMAGING AND DIAGNOSTIC PROVIDES A LOWER COST OPTION FOR OUR PATIENTS. OPENED IN MARCH OF 2020, THE BRYAN TRAUMA OUTPATIENT SERVICES DEPARTMENT PROVIDES A CLINIC HOME FOR BRYAN PHYSICIAN NETWORK'S TRAUMA AND ORTHOPEDIC TRAUMA SERVICE. THE HOSPITAL BASED PRACTICE EMPLOYS 3 GENERAL/TRAUMA SURGEONS AND 3 OTHOPEDIC TRAUMA SURGEONS. A MAJORITY OF THE CLINIC VISITS ARE FOR ORTHOPEDIC INJURIES AND FOLLOW-UP CARE BUT ALSO INCLUDE GENERAL SURGERY AND TRAUMA SURGERY VISITS. IN ADDITION TO PERIOPERATIVE OUTPATIENT CARE, SERVICES INCLUDE CASTING, X-RAY, AND PTSD SCREENING FOR PATIENTS. DOCTORS OUTPATIENT SURGERY CENTER (DOSC) AND LINCOLN DIGESTIVE HEALTH CENTER (LDHC) ARE JOINT VENTURES BETWEEN BRYAN MEDICAL CENTER AND AREA PHYSICIAN GROUPS THAT BEGAN SEEING PATIENTS IN 2018. DOSC WILL PROVIDE A LOWER COST OUTPATIENT ALTERNATIVE TO THE COMMUNITY WHERE GENERAL AND SPECIALTY SURGIES WILL BE PERFORMED, INCLUDING ORTHOPEDICS, GYNECOLOGY, PODIATRY, PLASTICS AND DENTAL. LDHC WILL INCREASE THE CAPACITY OF LOWER COST GASTRONITESTINAL SCREENINGS (COLONOSCOPIES) AND GASTRONITESTINAL SERVICES TO THE COMMUNITY.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. 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 1600 SOUTH 48TH STREET SUITE 600 RO OM 1 LINCOLN,NE68506	CARDIAC OUTPATIENT SERVICES
2	BRYAN MEDICAL CENTER MRI SERVICES 2222 SOUTH 16TH STREET TOWER B SUIT E 10 LINCOLN,NE68502	MRI SERVICES
3	BRYAN MEDICAL CENTER OUTPATIENT RADIOLOGY 3901 PINE LAKE ROAD SUITE 110 LINCOLN,NE68516	OUTPATIENT RADIOLOGY SERVICES
4	BRYAN MEDICAL CENTER LABORATORY 2221 SOUTH 17TH STREET SUITE 100 LINCOLN,NE68502	LABORATORY SERVICES
5	BRYAN MEDICAL CENTER THERAPY SERVICES 7501 SOUTH 27TH STREET LINCOLN,NE68512	THERAPY SERVICES
6	BRYAN MEDICAL CENTER COUNSELING CENTER 2221 SOUTH 17TH STREET SUITE 201 LINCOLN,NE68502	COUNSELING SERVICES
7	BRYAN MEDICAL CENTER OUTPATIENT SERVICES 1500 SOUTH 48TH STREET 1ST FLOOR LINCOLN,NE68506	LAB & RADIOLOGY SERVICES
8	BRYAN MEDICAL CENTER CARDIAC-VASCULAR OUTPATIENTS 1600 SOUTH 48TH STREET SUITE 301 LINCOLN,NE68506	VASCULAR OUTPATIENT SERVICES
9	BRYAN MEDICAL CENTER 2222 SOUTH 16TH STREET TOWER B SUIT E 110 LINCOLN,NE68502	RADIOLOGY SERVICES
10	BRYAN MEDICAL CENTER COUNSELING CENTER 2221 SOUTH 17TH STREET SUITE 310 LINCOLN,NE68502	COUNSELING SERVICES
11	BRYAN MEDICAL CENTER PEDIATRIC REHABILITATION SERV 1500 SOUTH 48TH STREET SUITE 709 LINCOLN,NE68502	PEDIATRIC REHABILITATION SERVICES

Schedule H (Form 990) 2023

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	BRYAN HEALTH
Schedule H, Part I, Line 7g Subsidized Health Services	N/A - THERE ARE NO COSTS ASSOCIATED WITH A PHYSICIAN CLINIC ON LINE 7G.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	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. FOR LINES 7E, 7F, AND 7I, ANY OFFSETTING REVENUE WAS DEDUCTED FROM EXPENSES DIRECTLY ATTRIBUTABLE TO THE COMMUNITY BENEFIT ACTIVITY.
Schedule H, Part II Community Building Activities	THE COSTS REPORTED IN PART II COMMUNITY BUILDING ACTIVITES ARE FOR THE UPKEEP OF A COMMUNITY PARK AND GARDEN.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	FOR FINANCIAL STATEMENT PURPOSES, BRYAN MEDICAL CENTER HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE ON IRS FORM 990, PART IX.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	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 PATIENT'S 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 AVAILABLE TO WORK WITH ANY 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 APPREAR 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.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 18-20 OF THE BRYAN HEALTH CONSOLIDATED AUDIT REPORT.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	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 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 MEDICARE COST REPORT IS THE STEP-DOWN METHOD OF COST ALLOCATION.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	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 100% FINANCIAL ASSISTANCE, THIS ACCOUNT WILL NEVER BE REFERRED TO A COLLECTION AGENCY. IF AN ACCOUNT HAS BEEN SENT TO 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.
Schedule H, Part V, Section B, Line 16a FAP website	A - BRYAN MEDICAL CENTER EAST: Line 16a URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - BRYAN MEDICAL CENTER EAST: Line 16b URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - BRYAN MEDICAL CENTER EAST: Line 16c URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/;
Schedule H, Part VI, Line 2 Needs assessment	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. THE COMMUNITY OF LINCOLN AND LANCASTER COUNTY, NEBRASKA HAS A WIDE RANGE OF PERSONAL HEALTH CARE PROVIDERS, PHYSICIAN CLINICS, OTHER HEALTH FACILITES AND MEDICAL AND DENTAL PROVIDERS THAT ADDRESS THE NEEDS OF THE LOCAL POPULATION, AS WELL AS RESIDENTS THROUGHOUT THE STATE AND REGION. SOME OF THE RESOURCES THAT BRYAN HAS ARE: 1.) ACUTE CARE SERVICES, WHICH INCLUDE CARDIOLOGY, ORTHOPEDICS, TRAUMA, NEUROSCIENCE, MENTAL HEALTH, OBSTETICS, NEONATAL INTENSIVE CARE, REHABILITATION AND ONCOLOGY. BRYAN IS THE COMMUNITY'S ONLY PROVIDER OF INPATIENT MENTAL HEALTH SERVICES AND SUBSTANCE USE TREATMENT. 2) PRIMARY CARE SERVICES, BRYAN PROVIDES URGENT CARE CLINICS THROUGHOUT LINCOLN THAT PROVIDE PRIMARY CARE SERVICES OUTSIDE PHYSICIANS' NORMAL WORKING HOURS. THERE ARE CURRENTLY 5 URGENT CARE CLINICS THROUGHOUT LINCOLN AND MORE WITHIN THE OUTLYING TOWNS AND COMMUNITIES OF LANCASTER COUNTY. 3) BEHAVORIAL HEALTH SERVICE. BRYAN MEDICAL CENTER IS THE ONLY ACUTE CARE HOSPITAL IN THE LINCOLN LANCASTER COUNTY AREA TO PROVIDE BEHAVIORAL HEALTH SERVICES AND IS ONE OF ONLY A FEW ACUTE CARE HOSPITALS IN THE NATION TO SUPPORT A DEDICATED MENTAL HEALTH EMERGENCY DEPARTMENT. THE LINCOLN-LANCASTER COUNTY HEALTH DEPARTMENT HAS SEVERAL PLANNED STAGES OF FURTHER DEVELOPMENT AND ENRICHMENT OF THE LINCOLN COMMUNITY HEALTH SURVEY. THESE SUNSEQUENT STAGES HAVE BEEN DELAYED DUE TO THE EFFECTS OF THE COVID-19 PANDEMIC, BUT WORK ON ALL OF THEM CONTINUES. THE HEALTH DEPARMENT PARTNERED WITH UNIVERSITY OF NEBRASKA MEDICAL CENTER TO DEVELOP PROGRAMMING FOR A SERIES OF COMMUNITY CONVERSATIONS WITH SURVEY RESPONDENTS WHO INDICATED THEY WOULD BE WILLING TO PARTICIPATE IN FURTHER DISCUSSIONS ABOUT HEALTH IN THEIR AREA. THESE COMMUNITY CONVERSATIONS WILL BE HOSTED BY A TECHNOLOGY OF PARTICIPATION CERTIFIED FACILITATOR FROM THE HEALTH DEPARTMENT, AND WILL GATHER ROUGHLY 6 TO 12 MEMBERS OF THE COMMUNITY, 5 GEOGRAPHICALLY-BASED SESSIONS ARE SCHEDULED - ONE FOR EACH QUADRANT OF THE AREA, AND A FIFTH FOR THE CENTRAL AREA. ADDITIONAL CONVERSATIONS ARE SCHEDULED FOR OVERSAMPLED POPULATIONS, INCLUDING LINCOLN'S CULTURAL COALITION, THE LINCOLN HOMELESS COALITION, AND ORGANIZATIONS REPRESENTING LANCASTER COUNTY'S BLIND COMMUNITY. ONCE THE TEAM HAS COMPLETED ANALYSIS OF THE QUANTITATIVE DATA GATHERED THROUGH THE LINCOLN COMMUNITY SURVEY AND ITS RESULTING COMMUNITY CONVERSATIONS, IT WILL HOST A SUMMIT WHERE IT WILL PRESENT ITS FINDINGS TO THE COMMUNITY. MEMBERS OF THE COMMUNITY WILL BE INVITED TO ATTEND, INCLUDING REPRESENTATIVES FROM COMMUNITY ORGANIZATIONS, THE POLICE AND FIRE DEPARTMENTS, THE PUBLIC-SCHOOL DISTRICTS, LOCAL BUSINESSES, LOCAL HEALTHCARE PRACTICES, AND THE COMMUNITY AT LARGE. THE SUMMIT WILL REFLECT THE COLLABORATIVE EFFORT FROM THE HEALTH DEPARTMENT, BRYAN HEALTH, AND CHI HEALTH.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	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 COUSELORS 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 PATIENT'S ABILITY TO PAY OVER AN EXTENDED PERIOD OF TOME MAY BE SUBSTANTIALLY ALTERED DUE TO ILLNESS OR FINANCIAL HARDSHIP, RESULTING IN A NEED FOR FINANCIAL ASSISTANCE. ANNUALLY, ALL HOSPITAL EMPLOYEES ARE REQUIRED TO RECEIVE TRAINING REGARDING THE FINANCIAL ASSISTANCE POLICY INCLUDING HOW TO ANSWER QUESTIONS FROM A PATIENT REGARDING WHERE THE PATIENT CAN RECEIVE ADDITIONAL INFORMATION REGARDING THE POLICY.
Schedule H, Part VI, Line 4 Community information	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 NEBRASKA, LINCOLN, NEBRASKA, WHICH IS THE STATE'S SECOND LARGEST METROPOLITAN AREA. WHILE BRYAN SERVES A REGIONAL GEOGRAPHIC AREA EXTENDING BEYOND THE COUNTY, LANCASTER COUNTY RESIDENTS ACCOUNT FOR NEARLY 67 PERCENT OF THE INPATIENTS AND 83 PERCENT OF OUTPATIENTS. THE MEDIAN HOUSEHOLD INCOME FOR 2023 IN LANCASTER COUNTY, NEBRASKA WAS ESTIMATED AT $70,637 AND 12.2% OF THE POPULATION HAD INCOMES BELOW THE POVERTY LEVEL. THE PERCENT OF UNISURED ADULTS AGED 19 TO 64 IN LANCASTER COUNTY HAS BEEN ESTIMATED AT A RATE OF 5.3% IN 2023. CANCER REMAINED THE LEADING CAUSE OF DEATH FOR LANCASTER COUNTY IN 2020, FOLLOWED BY HEART DISEASE, COVID-19, CHRONIC LUNG DISEASE, ACCIDENTAL DEATHS, CEREBROVASCULAR DISEASE, AND ALZHEIMER'S DISEASE. BRYAN AND CHI HEALTH ST. ELIZABETH ARE THE PRIMARY HOSPITALS SERVING LANCASTER COUNTY. THE CENSUS BUREAU REPORTS THAT THE COUNTY'S POPULATION GREW FROM 250,291 IN 2000 TO AN ESTIMATED 326,716 IN 2023. POPULATION IS PROJECTED TO BE NEARLY 440,000 BY 2050, WITH GROWTH EXPECTED AMONG ALL MAJOR AGE GROUPS. THE 60 AND OVER AGE GROUP IS PROJECTED TO HAVE THE HIGHEST RATE OF GROWTH, INCREASING FROM AN ESTIMATED 64,291 IN 2019 TO AN ESTIMATED 85,000 IN 2050. BECAUSE OF LINCOLN'S SIZE, RELATIVELY STABLE ECONOMY, AND EDUCATIONAL OPPORTUNITIES, THE U.S. STATE DEPARTMENT DESIGNATED LINCOLN AS "REFUGEE FRIENDLY" IN THE 1970S. SINCE THE 70S, WAVES OF IMIGRANTS FROM ACROSS THE WORLD HAVE RESETTLED IN LINCOLN. LINCOLN PUBLIC SCHOOLS CURRENTLY SERVES APPROXIMATELY 2,500 ENGLISH LEARNERS, REPRESENTING 152 DIFFERENT COUNTRIES AND OVER 60 DIFFERENT LANGUAGES. THE MINORITY POPULATION IN LANCASTER COUNTY IS ESTIMATED TO BE 21.7% IN 2023. PERSONS OF HISPANIC ORIGIN (MAY BE OF ANY RACE) ARE ESTIMATED TO BE 8.1% IN 2023, WHILE PERSONS REPORTING AS ASIAN ALONE ARE ESTIMATED TO BE 4.5%. PROJECTED GROWTH IN MINORITY POPULATIONS CHALLENGES US TO ACCOMMODATE DIVERSE LANGUAGE AND CULTURAL NEEDS. WITH THE SERVICE AREA RAPIDLY EXPANDING AND THE OVER 65 AGE GROUP EXPECTED TO INCREASE, BRYAN RECOGNIZES THE IMMENSE NEEDS OF OUR SERVICE AREA ARE EXPANDING AND CHANGING.
Schedule H, Part VI, Line 5 Promotion of community health	BRYAN MEDICAL CENTER HAS PROVIDED HIGH QUALITY, COMPREHENSIVE MEDICAL SERVICES TO BENEFIT THE COMMUNITY FOR OVER 97 YEARS, AND IS COMMITTED TO IDENTIFYING AND ADDRESSING NEEDS IN THE COMMUNITY IN THE FUTURE. FUNDAMENTAL TO OUR COMMUNITY COMMITMENT IS THE LEADERSHIP OF OUR LOCAL GOVERNING BOARD. THE MAJORITY OF BRYAN'S GOVERNING BOARD CONSISTS OF MEDICAL PROFESSIONALS, BUSINESS PROFESSIONALS, AND COMMUNITY LEADERS WHO ARE INDEPENDENT, AND 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 REQUIRMENTS. AS OF DECEMBER 31, 2023, BRYAN HAD AN ORGANIZED MEDICAL STAFF OF OVER 800 PHYSICIANS. 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) PROVIDING A HOSPITAL-BASED RESIDENTAL TREATMENT SUBSTANCE ABUSE FACILITY IN LINCOLN, WHICH SERVES PATIENTS THAT STRUGGLE WITH ADDICTION TO DRUGS AND ALCOHOL FROM SOUTHEAST NEBRASKA AND MANY OTHER STATES; 4) PROVIDING HOSPITAL-BASED MENTAL HEALTH CARE TO LINCOLN AND SURROUNDING COMMUNITIES; AND 5) PROVIDING A STATE-OF-THE-ART WOMENS AND CHILDREN'S TOWER WHICH INCLUDES A NEONATAL INTENSIVE CARE UNIT; 6) MAJOR RENOVATION AND EXPANSION AIMED AT MODERIZING THE MEDICAL CENTER'S OPERATION AND RECOVERY ROOMS ON THE EAST CAMPUS WHICH WAS COMPLETED IN JUNE OF 2022. 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.
Schedule H, Part VI, Line 6 Affiliated health care system	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, AND MISSOURI. BRYAN HEALTH CONSISTS OF FIVE ACUTE-CARE HOSPITALS, NUMEROUS OUTPATIENT CLINICS, A PHYSICIAN NETWORK, A COLLEGE, FIVE URGENT CARE CENTERS, THREE PHILANTHROPIC FOUNDATIONS, A PHYSICIAN HOSPITAL ORGANIZATION, AN ACCOUNTABLE CARE ORGANIZATION, AND OTHER HEALTHCARE PROVIDERS. PREIMER 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, Part VI, Line 7 State filing of community benefit report	NE

Schedule H (Form 990) 2023

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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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Bryan Medical Center

Employer identification number
47-0376552

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) MADONNA REHAB HOSPITAL 5401 SOUTH STREET LINCOLN,NE68506	47-0439599	501(C)(3)	25,000	GENERAL OPERATIONS
(2) CLINIC WITH A HEART 1701 S 17TH ST 4G LINCOLN,NE68502	20-2850139	501(C)(3)	20,000	GENERAL OPERATIONS
(3) MALONE COMMUNITY CENTER 2032 U STREET LINCOLN,NE68506	47-0376577	501(C)(3)	12,500	GENERAL OPERATIONS
(4) AMERICAN HEART ASSOCIATION 9900 NICHOLAS ST 200 OMAHA,NE68114	13-5613797	501(C)(3)	10,000	GENERAL OPERATIONS
(5) KEARNEY AREA CHAMBER COMMERCE 1007 2ND AVENUE KEARNEY,NE68847	47-0208070	501(C)(6)	10,000	GENERAL OPERATIONS
(6) PROJECT PINK'D 11405 DAVENPORT STREET OMAHA,NE68154	45-5212995	501(C)(3)	10,000	GENERAL OPERATIONS
(7) NEBRASKA HOSPITAL ASSOCIATION 3255 SALT CREEK CIR 100 LINCOLN,NE68504	47-0384546	501(C)(6)	8,700	GENERAL OPERATIONS
(8) HEARTLAND CANCER FOUNDATION PO BOX 5203 LINCOLN,NE68505	20-5952202	501(C)(3)	8,500	GENERAL OPERATIONS
(9) LINCOLN CHAMBER OF COMMERCE 1128 LINCOLN MALL 100 LINCOLN,NE68508	94-1506195	501(C)(6)	6,711	GENERAL OPERATIONS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

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. THE COMMITTEE EVALUATES REQUESTS ON THESE CRITERIA: DOES THE PROJECT OR AGENCY ADDRESS NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, IS THE REQUESTING AGENCY LOCAL, IS THE REQUEST RELATED TO HEALTH IN THE COMMUNITIES WE SERVE & DOES THE REQUEST HELP KIDS. GRANTS ARE AWARDED BASED ON NEED AND ELIGIBILITY.

Schedule I (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Bryan Medical Center

Employer identification number

47-0376552

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

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 on 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, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ADRIANNE OLSON CNO	(i) (ii)	259,027 ------------- 0	26,765 ------------- 0	2,603 ------------- 0	9,068 ------------- 0	34,471 ------------- 0	331,934 ------------- 0	0 ------------- 0
2ERIC MOOSS CEO BRYAN MEDICAL CENTER	(i) (ii)	481,594 ------------- 15,112	62,137 ------------- 0	126,768 ------------- 35	17,299 ------------- 0	30,424 ------------- 361	718,222 ------------- 15,508	0 ------------- 0
3RUSSELL GRONEWOLD DIRECTOR	(i) (ii)	0 ------------- 1,001,357	0 ------------- 162,356	0 ------------- 394,383	0 ------------- 21,450	0 ------------- 23,373	0 ------------- 1,602,919	0 ------------- 0
4ROBERT OAKES MD DIRECTOR	(i) (ii)	10,000 ------------- 969,121	0 ------------- 595,478	0 ------------- 43,283	0 ------------- 18,150	0 ------------- 31,804	10,000 ------------- 1,657,836	0 ------------- 0
5JOHN WOODRICH Bryan Health Exec VP & COO	(i) (ii)	28,573 ------------- 672,662	0 ------------- 109,951	0 ------------- 335,688	1,790 ------------- 18,982	804 ------------- 20,105	31,167 ------------- 1,157,388	0 ------------- 0
6DAVID REESE Bryan Health VP & Physician Partnership & Facilities Officer	(i) (ii)	12,130 ------------- 306,851	0 ------------- 48,224	0 ------------- 68,722	1,292 ------------- 32,407	1,086 ------------- 27,141	14,508 ------------- 483,346	0 ------------- 0
7TROY HOTTOVY CHIEF INFORMATION SECURITY OFFICER	(i) (ii)	231,416 ------------- 0	98,756 ------------- 0	9,280 ------------- 0	18,150 ------------- 0	28,683 ------------- 0	386,285 ------------- 0	0 ------------- 0
8JOHN TRAPP MD VP & CHIEF MEDICAL OFFICER	(i) (ii)	543,709 ------------- 0	86,799 ------------- 0	145,899 ------------- 0	18,150 ------------- 0	25,236 ------------- 0	819,793 ------------- 0	0 ------------- 0
9DAVID GRIFFITHS VP - CFO BRYAN MEDICAL CENTER	(i) (ii)	322,079 ------------- 9,179	21,043 ------------- 0	11,856 ------------- 42	17,623 ------------- 528	24,992 ------------- 999	397,593 ------------- 10,748	0 ------------- 0
10TRAVIS GREGG VP & COO BRYAN MEDICAL CENTER	(i) (ii)	259,862 ------------- 0	23,877 ------------- 0	33,263 ------------- 0	7,334 ------------- 0	34,760 ------------- 0	359,096 ------------- 0	0 ------------- 0
11LISA VAIL BRYAN HEALTH CHIEF NURSING OFFICER	(i) (ii)	13,182 ------------- 285,585	0 ------------- 56,487	0 ------------- 183,768	863 ------------- 20,587	936 ------------- 23,396	14,981 ------------- 569,823	0 ------------- 0
12RICHARD LLOYD PRESIDENT - BRYAN COLLEGE HEALTH SCIENCES	(i) (ii)	272,771 ------------- 0	80,755 ------------- 0	95,546 ------------- 0	18,150 ------------- 0	25,623 ------------- 0	492,845 ------------- 0	0 ------------- 0
13SHARON HADENFELDT DEAN OF NURSE ANESTHESIA	(i) (ii)	240,154 ------------- 0	15,087 ------------- 0	2,303 ------------- 0	26,875 ------------- 0	3,968 ------------- 0	288,387 ------------- 0	0 ------------- 0
14KENT HOXMEIER ANESTHESIA & PERUSION MANAGER	(i) (ii)	233,737 ------------- 0	12,853 ------------- 0	2,565 ------------- 0	10,837 ------------- 0	23,837 ------------- 0	283,829 ------------- 0	0 ------------- 0
15JENNIFER FENCL REGISTERED NURSE	(i) (ii)	213,551 ------------- 0	6,550 ------------- 0	2,239 ------------- 0	17,337 ------------- 0	30,443 ------------- 0	270,120 ------------- 0	0 ------------- 0
16KRISHA ELLINGER IT APPLICATIONS DIRECTOR	(i) (ii)	158,301 ------------- 0	91,267 ------------- 0	27,178 ------------- 0	11,780 ------------- 0	10,231 ------------- 0	298,757 ------------- 0	0 ------------- 0
17JEROME WOHLEB PHARMACY DIRECTOR	(i) (ii)	225,116 ------------- 0	23,465 ------------- 0	4,792 ------------- 0	16,279 ------------- 0	27,708 ------------- 0	297,360 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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.

Return Reference	Explanation
Schedule J, Part I, Line 1a Travel for companions	THE MAJORITY 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 OR THE EXTENDED COACH/EXTENDED LEG ROOM 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.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	THE ORGANIZATION PROVIDES SOCIAL CLUB MEMBERSHIPS FOR SELECT EMPLOYEES IF THERE IS A BUSINESS NEED FOR THE MEMBERSHIP. THE CLUB MEMBERSHIP IS TREATED AS TAXABLE COMPENSATION TO THE EMPLOYEE. THE ORGANIZATION REQUIRES SUBSTANTIATION OF ALL BUSINESS USE EXPENSES. ONE OFFICER LISTED IN FORM 990, PART VII, SECTION A, RECEIVED THIS BENEFIT DURING THE TAX YEAR.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	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 ONE OF THE LARGEST PRIVATE EMPLOYERS 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 MARCH 21, 2023. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	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 A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING 2023: RUSSELL GRONEWOLD $316,077, RICHARD LLOYD $82,589, ERIC MOOSS $87,943, JOHN TRAPP $100,975, DAVID REECE $57,320, JOHN WOODRICH $264,413, AND LISA VAIL $122,742.
Schedule J, Part I, Line 7 Non-fixed payments	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. THE GOALS ARE SET AND REVIEWED FOR LEVEL OF ACCOMPLISHMENT BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES.
Schedule J, Part II COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES	IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THIS ORGANIZATION'S BOARD IS COMPENSATED FOR THEIR SERVICES AS A BOARD MEMBER. COMPENSATION AMOUNTS REPORTED IN SCHEDULE J, PART II ARE FOR SERVICES PERFORMED AS EXECUTIVES OF BRYAN HEALTH AND BRYAN MEDICAL CENTER, AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	THE COUNTY OF LANCASTER NEBRASKA	47-6006482	000000000	09-01-2022	99,045,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	99,319,562
4 Gross proceeds in reserve funds .............	0
5 Capitalized interest from proceeds .............	0
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	411,439
8 Credit enhancement from proceeds .............	0
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	35,000,000
11 Other spent proceeds .............	59,302,600
12 Other unspent proceeds .............	4,605,523
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	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
c Are there any research agreements that may result in private business use of bond-financed property? .............		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?
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 ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........
c No rebate due? .........
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
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

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Schedule K, Part I, Column (f) DESCRIPTION OF PURPOSE	THE SERIES 2022C BONDS WERE ISSUED TO (1) ACQUIRE, CONSTRUCT, IMPROVE, EXTEND, REPAIR, EQUIP AND FURNISH A NEW SURGERY CENTER; (2) ACQUIRE, CONSTRUCT, IMPROVE, EXTEND, REPAIR, EQUIP AND FURNISH AN ADMINISTRATION AND MEDICAL CARE FACILITIES; (3) MAKE IMPROVEMENTS TO THE CORPORATION'S WEST CAMPUS; AND (4) REFUND THE SERIES 2008B-1, 2008B-2 AND SERIES 2008C BONDS.
Schedule K, Part II, Line 3 TOTAL PROCEEDS OF ISSUE	THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART 1, LINE A, COLUMN (E) DUE TO INVESTMENT EARNINGS.

Schedule K (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Bryan Medical Center

Employer identification number

47-0376552

Return Reference	Explanation
Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS	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 ENTITY.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, VICE-CHAIRPERSON, SECRETARY AND TREASURER OF THE BOARD, THE CHIEF OF STAFF, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE SYSTEM AND THE PRESIDENT/CHIEF OPERATING OFFICER OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE ALL OF THE AUTHORITY AND POWERS OF THE BOARD WHEN THE BOARD IS NOT IN SESSION, EXCEPT THAT THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE POWER (A) TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE EXECUTIVE COMMITTEE OR ANY TRUSTEE OR OFFICERS OF THE CORPORATION; (B) TO AMEND, ALTER OR REPEAL ANY RESOLUTION OF THE BOARD WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY THE EXECUTIVE COMMITTEE. THE DESIGNATION AND APPOINTMENT OF AN EXECUTIVE COMMITTEE AND THE DELEGATION THERETO OF AUTHORITY SHALL NOT OPERATE TO RELIEVE THE BOARD, OR ANY INDIVIDUAL TRUSTEE, OF ANY RESPONSIBLITIY IMPOSED UPON IT OR HIM/HER BY LAW.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	ELIZABETH LAU MD AND KEN GROSS MD - Business relationship, GAYLE PAGE AND MARK WALZ - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders	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.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	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.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	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.
Form 990, Part VI, Line 11b Review of form 990 by governing body	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 ADVANCEMENT 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 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 HAS THE OPPORTUNITY TO REVIEW A COPY OF THIS 990, PRIOR TO FILING THE FORM WITH THE INTERNAL REVENUE SERVICE.
Form 990, Part VI, Line 12c Conflict of interest policy	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.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	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 ONE OF THE LARGEST PRIVATE EMPLOYERS 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 MARCH 21, 2023. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	SEE FORM 990, PART VI, SECTION B, LINE 15A.
Form 990, Part VI, Line 19 Required documents available to the public	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.
Form 990, Part VII, Section A COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES	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.
Form 990, Part VIII, Line 2f Other Program Service Revenue	PURCHASE DISCOUNTS - Total Revenue: 1392, Related or Exempt Function Revenue: 1392, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	OTHER NON-OPERATING INCOME - Total Revenue: 3048814, Related or Exempt Function Revenue: 3048814, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; MISCELLANEOUS INCOME - Total Revenue: 2468939, Related or Exempt Function Revenue: 2042173, Unrelated Business Revenue: 426766, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; EPIC COMMUNITY CONNECT - Total Revenue: 119832, Related or Exempt Function Revenue: 119832, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	CONSULTING - Total Expense: 4153825, Program Service Expense: 3456169, Management and General Expenses: 697656, Fundraising Expenses: ; LEASE COMMISSIONS - Total Expense: 94199, Program Service Expense: 7661, Management and General Expenses: 86538, Fundraising Expenses: ; MEDICAL DIRECTOR FEES - Total Expense: 2510905, Program Service Expense: 2442473, Management and General Expenses: 68432, Fundraising Expenses: ; TEST SERVICES - Total Expense: 2777616, Program Service Expense: 2777616, Management and General Expenses: , Fundraising Expenses: ; LABORATORY FEES - Total Expense: 5555882, Program Service Expense: 5555882, Management and General Expenses: , Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 30106754, Program Service Expense: 29386572, Management and General Expenses: 720182, Fundraising Expenses: ; COLLECTION FEES - Total Expense: 1762552, Program Service Expense: 1762552, Management and General Expenses: , Fundraising Expenses: ; PROFESSIONAL FEES - Total Expense: 7386392, Program Service Expense: 7386392, Management and General Expenses: , Fundraising Expenses: ; ANESTHESIOLOGY FEES - Total Expense: 4610961, Program Service Expense: 4610961, Management and General Expenses: , Fundraising Expenses: ; MISCELLANEOUS FEES - Total Expense: 4833079, Program Service Expense: 2750934, Management and General Expenses: 2082145, Fundraising Expenses: ; LAUNDRY SERVICES - Total Expense: 1725345, Program Service Expense: 1725191, Management and General Expenses: 154, Fundraising Expenses: ; SECURITY - Total Expense: 3867767, Program Service Expense: 3313711, Management and General Expenses: 554056, Fundraising Expenses: ; SERVICE AGREEMENTS - Total Expense: 15973949, Program Service Expense: 11772920, Management and General Expenses: 4201029, Fundraising Expenses: ; AMBULANCE SERVICE - Total Expense: 634243, Program Service Expense: 634243, Management and General Expenses: , Fundraising Expenses: ; TEMPORARY LABOR - Total Expense: 12819606, Program Service Expense: 12819606, Management and General Expenses: , Fundraising Expenses: ; MISCELLANEOUS OUTSIDE SERVICE - Total Expense: 6690379, Program Service Expense: 6314892, Management and General Expenses: 375487, Fundraising Expenses: ; JANITORIAL SERVICES - Total Expense: 385712, Program Service Expense: 322644, Management and General Expenses: 63068, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	PENSION LIABILITY - 6763148; TRANSFER TO RELATED ENTITY - -101000000; CHANGE IN TEMPORARILY RESTRICTED INTEREST IN BRYAN FOUNDATION - -850526; CHANGE IN PERMANENTLY RESTRICTED INTEREST IN BRYAN FOUNDATION - 1374476; OTHER - -103531;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

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. DURING 2023, BRYAN MEDICAL CENTER PROVIDED CHARITY CARE TO 7,773 PATIENTS AT A COST OF $12.4 MILLION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	5,510
6	Total number of volunteers (estimate if necessary) .............	6	883
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	574,208
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	444,640

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	21,571,441	18,780,619
9	Program service revenue (Part VIII, line 2g) .........	823,520,655	867,816,468
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	12,703,362	16,002,690
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,731,900	14,418,883
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	865,527,358	917,018,660
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	235,870	211,326
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	367,696,698	388,687,764
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	406,843,962	396,435,824
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	774,776,530	785,334,914
19	Revenue less expenses. Subtract line 18 from line 12.......	90,750,828	131,683,746
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,183,111,274	1,246,236,003
21	Total liabilities (Part X, line 26).............	398,885,546	391,414,084
22	Net assets or fund balances. Subtract line 21 from line 20.....	784,225,728	854,821,919

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 718,620,635 including grants of $ 211,326 ) (Revenue $ 877,686,181 )
	BRYAN MEDICAL CENTER IS A NATIONALLY RECOGNIZED 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. 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 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 2023, BRYAN MEDICAL CENTER ADMITTED 29,978 INPATIENTS, DELIVERED 3,044 BABIES, AND HAD 97,505 EMERGENCY ROOM VISITS. BRYAN MEDICAL CENTER IS COMMITTED TO PROVIDING HEALTH CARE SERVICES FOR THOSE IN NEED REGARDLESS OF THEIR ABILITY TO PAY. DURING 2023, BRYAN MEDICAL CENTER PROVIDED LIFE-SAVING PROCEDURES AND MEDICATIONS FOR OVER 7,773 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 $12.4 MILLION. BRYAN MEDICAL CENTER ALSO INCURRED $67.2 MILLION IN UNREIMBURSED MEDICARE COSTS, AND $39.4 MILLION IN MEDICAID COSTS AND SUPPORT OF OTHER PUBLIC PROGRAMS. BRYAN MEDICAL CENTER SERVED 25,292 MEDICAID PATIENTS IN 2023. BRYAN MEDICAL CENTER PROVIDED $6.0 MILLION IN THE SUPPORT OF HEALTH PROFESSIONALS' EDUCATION, THROUGH RESIDENCY PROGRAMS AND IN SUPPORT OF THE BRYAN COLLEGE OF HEALTH SCIENCES. DURING FALL 2023, THERE WERE 747 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 $2.3 MILLION. DONATIONS TO OTHER NON-PROFIT ORGANIZATIONS TOTALED MORE THAN $516,000. BRYAN MEDICAL CENTER'S QUANTIFIABLE COMMUNITY BENEFIT FOR 2023 TOTALED MORE THAN $127.7 MILLION.

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 expenses718,620,635

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	4,541,348	5,258,284	735,312

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	5,483,866
e	Government grants (contributions)		1e	13,196,569

f	All other contributions, gifts, grants, and similar amounts not included above		1f	100,184

g	Noncash contributions included in lines 1a - 1f:$		1g	23,032

h Total. Add lines 1a-1f.......		18,780,619

		Business Code
2a	NET PATIENT REVENUE	622110	835,136,101	835,136,101
b	BRYAN COLLEGE OF HEALTH SCIENCES REVENUE	611600	11,322,765	11,305,576	17,189
c	PHARMACY	456110	11,397,573	11,397,573
d	PROGRAM RENTAL REVENUE	531190	5,063,503	5,063,503
e	SPECIALTY CARE REVENUE	622110	4,895,134	4,895,134
f	All other program service revenue.		1,392	1,392	0	0
g	Total. Add lines 2a–2f .....		867,816,468

3 Investment income (including dividends, interest, and othersimilar amounts) ......			13,777,179			13,777,179
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	46,282,629	149,980
b	Less: cost or other basis and sales expenses	7b	44,207,098
c	Gain or (loss)	7c	2,075,531	149,980
d	Net gain or (loss).........			2,225,511			2,225,511
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	CAFETERIA		722514	3,974,962			3,974,962
b	LAB REFERRED TESTING		900099	2,335,519	2,205,266	130,253
c	EMPLOYEE LEASED REVENUE		900099	2,470,817	2,470,817
d	All other revenue ....			5,637,585	5,210,819	426,766	0
e	Total. Add lines 11a–11d ......			14,418,883
12	Total revenue. See instructions.....			917,018,660	877,686,181	574,208	19,977,652

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	211,326	211,326
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	3,538,267		3,538,267
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	299,422,307	291,738,782	7,683,525
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	17,693,478	15,129,364	2,564,114
9	Other employee benefits .......	45,714,151	39,039,537	6,674,614
10	Payroll taxes ...........	22,319,561	18,971,627	3,347,934
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	392,325	358,469	33,856
c	Accounting ...........	48,039	41,343	6,696
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	293,815		293,815
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	105,889,166	97,040,419	8,848,747	0
12	Advertising and promotion ....	612,170	79,582	532,588
13	Office expenses .......	26,765,380	21,855,603	4,909,777
14	Information technology ......	21,274,025	12,764,415	8,509,610
15	Royalties ..
16	Occupancy ...........	10,051,217	7,145,022	2,906,195
17	Travel ............	298,132	263,847	34,285
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	363,467	321,668	41,799
20	Interest ...........	10,003,196	57,216	9,945,980
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	50,784,276	43,290,680	7,493,596
23	Insurance ...	826,076	826,076
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	175,596,478	175,596,478
b	RECRUITMENT EXPENSE	1,245,477	1,014,116	231,361
c	MEMBERSHIP DUES	622,558	540,222	82,336
d	CORPORATE COST ALLOCATIONS	-10,054,624	-8,399,895	-1,654,729
e	All other expenses	1,424,651	734,738	689,913	0
25	Total functional expenses. Add lines 1 through 24e	785,334,914	718,620,635	66,714,279	0
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	29,082,093
2	Savings and temporary cash investments .........			123,676,374	2	71,538,509
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			140,765,916	4	165,208,267
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			19,125,985	8	19,689,084
9	Prepaid expenses and deferred charges ......			17,218,100	9	20,000,787
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,215,381,031
b	Less: accumulated depreciation	10b	774,763,878	435,346,384	10c	440,617,153
11	Investments—publicly traded securities .			324,374,880	11	367,187,121
12	Investments—other securities. See Part IV, line 11 .....			60,888,000	12	65,266,000
13	Investments—program-related. See Part IV, line 11 ..			47,565,342	13	49,904,581
14	Intangible assets ...............			636,691	14	48,976
15	Other assets. See Part IV, line 11 ...........			13,513,602	15	17,693,432
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,183,111,274	16	1,246,236,003

17	Accounts payable and accrued expenses .....	92,274,523	17	84,798,488
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	98,287,339	20	98,337,694
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	175,955,000	23	175,955,000
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	32,368,684	25	32,322,902
26	Total liabilities. Add lines 17 through 25..	398,885,546	26	391,414,084

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	753,405,996	27	823,479,063
28	Net assets with donor restrictions ...........	30,819,732	28	31,342,856
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	784,225,728	32	854,821,919
33	Total liabilities and net assets/fund balances ........	1,183,111,274	33	1,246,236,003

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No

(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?
(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	Yes	No
(1)BRYAN HEALTH 1600 SOUTH 48TH STREET LINCOLN,NE68506 36-3414823	HEALTHCARE	NE	501(c)(3)	Type III-FI	BRYAN HEALTH		No
(2)CRETE AREA MEDICAL CENTER 2910 BETTEN DRIVE CRETE,NE68333 47-0841285	HEALTHCARE	NE	501(c)(3)	3	BRYAN HEALTH	Yes
(3)BRYAN FOUNDATION 1600 SOUTH 48TH STREET LINCOLN,NE68506 23-7005720	FUNDRAISING	NE	501(c)(3)	7	BRYAN HEALTH	Yes
(4)BRYAN PHYSICIAN NETWORK 1600 SOUTH 48TH STREET LINCOLN,NE68506 20-1357375	HEALTHCARE	NE	501(c)(3)	10	BRYAN HEALTH	Yes
(5)MERRICK MEDICAL CENTER 2802 28TH STREET CENTAL CITY,NE688269501 82-0906268	HEALTHCARE	NE	501(c)(3)	3	BRYAN HEALTH	Yes
(6)MERRICK MEDICAL CENTER FOUNDATION 2802 28TH STREET CENTRAL CITY,NE68826 47-0710738	FUNDRAISING	NE	501(c)(3)	7	MERRICK MEDICAL CENTER	Yes
(7)GRAND ISLAND REGIONAL MEDICAL CENTER 3533 PRAIRIEVIEW ST GRAND ISLAND,NE68803 35-2621082	HEALTHCARE	NE	501(c)(3)	3	BRYAN HEALTH	Yes
(8)BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER 804 22ND AVENUE KEARNEY,NE68845 87-3486516	HEALTHCARE	NE	501(c)(3)	3	BRYAN HEALTH	Yes
(9)BRYAN HOSPITAL KEARNEY FOUNDATION 1600 SOUTH 48TH STREET LINCOLN,NE68506 92-3387978	FUNDRAISING	NE	501(c)(3)	Type II	BRYAN FOUNDATION	Yes
(10)GRAND ISLAND REGIONAL MEDICAL CENTER FOUNDATION 1600 SOUTH 48TH STREET LINCOLN,NE68506 93-1718948	FUNDRAISING	NE	501(c)(3)	Type II	BRYAN FOUNDATION	Yes

(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) LINCOLN DIGESTIVE HEALTH CENTER LLC 1600 SOUTH 48TH STREET LINCOLN,NE68506 37-1833798	HEALTHCARE	NE	BRYAN MEDICAL CENTER	Related	695,425	783,100		No			No	51 %
(2) DOCTOR'S OUTPATIENT SURGERY CENTER LLC 1600 SOUTH 48TH STREET LINCOLN,NE68506 36-4835603	HEALTHCARE	NE	BRYAN MEDICAL CENTER	Related	977,971	1,079,377		No			No	51 %
(3) HEAD AND NECK SURGICAL PARTNERS LLC 1600 SOUTH 48TH STREET LINCOLN,NE68506 91-1824787	HEALTHCARE	NE	BRYAN MEDICAL CENTER	Related	910,699	76,192		No			No	51 %
(4) GRAND ISLAND HOSPITAL HOLDINGS LLC 3533 PRAIRIEVIEW STREET GRAND ISLAND,NE68803 47-5381241	LEASE PROPERTY, HOLDING COMPANY	NE	NA	N/A
(5) SEWARD URGENT CARE PARTNERSHIP LLC 2222 SOUTH 16TH STREET SUITE 400A LINCOLN,NE68502 92-3319265	HEALTHCARE	NE	NA	N/A
(6) BRYAN TELEMEDICINE LLC 2222 S 16TH ST STE 401A LINCOLN,NE68502 38-3932523	HEALTHCARE	NE	NA	N/A
(7) BRYAN HEART MARY LANNING CARDIOLOGY LLC 1600 SOUTH 48TH STREET SUITE 600 LINCOLN,NE68506 46-4822260	CARDIOLOGY SERVICES	NE	NA	N/A

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) INEGRATED CARDIOLOGY GROUP LLC	A	949,520	FMV
(2) DOCTORS OUTPATIENT SURGERY CENTER	A	611,089	FMV
(3) BRYAN PHYSICIAN NETWORK	A	574,983	FMV
(4) HEAD & NECK SURGICAL PARTNERS LLC	A	387,679	FMV
(5) BRYAN FOUNDATION	C	5,483,866	FMV
(6) DOCTORS OUTPATIENT SURGERY CENTER	C	1,116,900	FMV
(7) HEAD & NECK SURGICAL PARTNERS LLC	C	1,005,720	FMV
(8) LINCOLN DIGESTIVE HEALTH CENTER LLC	C	382,500	FMV

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership