TY 2024 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET SUITE 420 OMAHA,NE68154	TEMPORARY LABOR	645,108
SHARED MEDICAL SERVICES INC 209 LIMESTONE PASS COTTAGE GROVE,WI53527	MOBILE IMAGING SERVICES	147,477
SIEMENS HEALTHCARE DIAGNOSTICS 511 BENEDICT AVE TARRYTOWN,NY10591	LABORATORY DIAGNOSTICS SERVICES	107,072


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 3

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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.
right arrow

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

OMB No. 1545-0047

2024

Open to Public
Inspection

Name of the organization

Merrick Medical Center

Employer identification number

82-0906268

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) 2024

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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 2024 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2023 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2024. 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—2023. 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—2024. 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—2023. 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) 2024

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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 2024 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2023 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2024 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2023 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2024. 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—2023. 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) 2024

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) 2024

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) 2024

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) 2024

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 2024 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-2024	(iii) Distributable Amount for 2024
1 Distributable amount for 2024 from Section C, line 6
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2024:
a From 2019.......
b From 2020.......
c From 2021.......
d From 2022.......
e From 2023.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2024 distributable amount
i Carryover from 2019 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2024 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2024 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2020.....
b Excess from 2021.....
c Excess from 2022.....
d Excess from 2023.....
e Excess from 2024.....

Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024

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) 2024

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

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Schedule B
(Form 990)
(Rev. January 2025)

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

Name of the organization

Merrick Medical Center

Employer identification number

82-0906268

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 ......... Right Arrow

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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025) Page 2

Name of organization Merrick Medical Center

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 3

Name of organization Merrick Medical Center		Employer identification number 82-0906268

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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 4


Name of organization Merrick Medical Center			Employer identification number 82-0906268
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) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- 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

2024

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.
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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

Merrick Medical Center

Employer identification number

82-0906268

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) 2024

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) 2021	(b) 2022	(c) 2023	(d) 2024	(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) 2024

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

(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)? ........

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

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

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

Yes

2,990

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

2,990

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	MERRICK MEDICAL CENTER IS A MEMBER OF THE NEBRASKA HOSPITAL ASSOCIATION (NHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE NHA OF $7,587. OF THIS AMOUNT THE NHA REPORTED THAT 13.02% OR $988 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES. DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE AHA OF $6,255. OF THIS AMOUNT THE AHA REPORTED THAT 32% OR $2,002 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES.

Return Reference

Explanation

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

MERRICK MEDICAL CENTER IS A MEMBER OF THE NEBRASKA HOSPITAL ASSOCIATION (NHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE NHA OF $7,587. OF THIS AMOUNT THE NHA REPORTED THAT 13.02% OR $988 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES. DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE AHA OF $6,255. OF THIS AMOUNT THE AHA REPORTED THAT 32% OR $2,002 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES.

Schedule C (Form 990) 2024

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- 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

Open to Public Inspection

Name of the organization

Merrick Medical Center

Employer identification number

82-0906268

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
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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) (Rev. 1-2025)

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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 .....	626,000		626,000
b	Buildings ....	23,226,879	3,785,008	19,441,871
c	Leasehold improvements
d	Equipment ....	7,614,383	4,343,708	3,270,675
e	Other .....	1,712,376	427,584	1,284,792
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				24,623,338

Schedule D (Form 990) (Rev. 1-2025)

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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
Federal Income Taxes
THIRD PARTY PAYOR SETTLEMENT	965,827







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	965,827
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) (Rev. 1-2025)

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	0
e	Add lines 2a through 2d .....................			2e	0
3	Subtract line 2e from line 1..................			3	0
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	0
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	0

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	0
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	0
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	0
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	0

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 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 BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, 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, 2024, AND 2023. THE SYSTEM DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. 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 AT DECEMBER 31, 2024, AND 2023.

Schedule D (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- 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

2024

Open to Public Inspection

Name of the organization

Merrick Medical Center

Employer identification number

82-0906268

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

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

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? . . . . . . . . .

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

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) . . .		329	273,343		273,343	1.035 %
b	Medicaid (from Worksheet 3, column a) . . . . .		754	2,108,984	1,743,084	365,900	1.386 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	1,083	2,382,327	1,743,084	639,243	2.421 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			124,017	850	123,167	0.466 %
f	Health professions education (from Worksheet 5) . . .					0	0 %
g	Subsidized health services (from Worksheet 6) . . . .			44,810		44,810	0.170 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			1,650		1,650	0.006 %
j	Total. Other Benefits . .	0	0	170,477	850	169,627	0.642 %
k	Total. Add lines 7d and 7j .	0	1,083	2,552,804	1,743,934	808,870	3.063 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2024

Schedule H (Form 990) 2024

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	0	0	0	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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).....

6,993,638

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

8,989,237

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

-1,995,599

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2024

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?1Name, 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)
1	MERRICK MEDICAL CENTER 2802 28TH STREET CENTRAL CITY,NE68826 https://www.bryanhealth.com/locations/hospitals/merrick-medical-center/ H000131	X	X	X

Schedule H (Form 990) 2024

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)

	MERRICK MEDICAL CENTER
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 24

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): HTTP://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 25

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

Yes

If "Yes" (list url): HTTP://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) 2024

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MERRICK MEDICAL CENTER
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) 2024

Page 6

Part VFacility Information (continued)

Billing and Collections

	MERRICK MEDICAL CENTER
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) 2024

Page 7

Part VFacility Information (continued)

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

	MERRICK MEDICAL CENTER
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) 2024

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 , 1	Facility , 1 - MERRICK MEDICAL CENTER. THE HEALTH ASSESSMENT AND PRIORITY COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT WAS A COLLABORATIVE EFFORT BETWEEN MERRICK MEDICAL CENTER, MEMORIAL COMMUNITY HEALTH, CHI ST. FRANCIS, GRAND ISLAND REGIONAL MEDICAL CENTER, CENTRAL HEALTH DISTRICT HEALTH DEPARTMENT AND THE NEBRASKA ASSOCIATION OF LOCAL HEALTH DIRECTORS. THE INFORMATION WAS GATHERED BY EXTENSIVE INPUT FROM INDIVIDUALS REPRESENTING A BROAD INTEREST OF CENTRAL CITY, MERRICK COUNTY, HALL COUNTY, AND HAMILTON COUNTY. CENTRAL DISTRICT HEALTH DEPARTMENT DEVELOPED A SURVEY WITH COLLABORATION FROM MULTICULTURAL COALITION, CITY OF GRAND ISLAND, GRAND ISLAND CHAMBER OF COMMERCE, CENTRAL NEBRASKA COUNCIL ON ALCOHOLISM AND ADDICTIONS, AND IDEA BANK. THE DISTRIBUTION METHODS INCLUDED: RADIO PROMOTION, FLYERS AND BUSINESS CARDS WITH QR CODES, DISTRIBUTION AT COMMUNITY EVENTS. THE CENTRAL DISTRICT HEALTH DEPARTMENT ALSO ASSISTED IN COLLECTING ADDITIONAL SURVEY RESPONSES FROM COMMUNITY MEMBERS WHO SPEAK SPANISH, ARABIC, AND SOMALI, AS WELL AS COMMUNITY MEMBERS WITH LOW LITERACY LEVELS WHO MAY NOT HAVE PARTICIPATED IN THE ONLINE SURVEY. THESE ADDITIONAL SURVEY RESPONSES WERE OBTAINED TO BOLSTER THE SURVEY RESPONSES FROM ALL SEGMENTS OF THE CENTRAL DISTRICT COMMUNITY. THE TOPICS THAT WERE INCLUDED IN THE SURVEY WERE: IDENTIFYING TRUSTED SOURCES FOR OBTAINING HEALTH INFORMATION; OVERALL HEALTH, MENTAL HEALTH STATUSES, KNOWLEDGE ON OPIOID CRISIS, AND PREFERRED METHODS OF RECEIVING MENTAL OR BEHAVIORAL HEALTH SUPPORT; PREFERRED METHODS OF OBTAINING AND LEARNING HEALTH INFORMATION FROM SOCIAL MEDIA, NEWS, RADIO, ETC; WHAT WAS THE LAST MAJOR HEALTH ISSUE YOU OR YOUR FAMILY EXPERIENCED?; WHAT WORRIES YOU MOST ABOUT YOUR HEALTH OR THE HEALTH OF YOUR FAMILY?; WHAT ARE YOUR TOP THREE HEALTH CONCERNS?; WHAT IS SOMETHING YOU DO TO BE HEALTHY?; WHAT WOULD MAKE YOUR NEIGHBORHOOD A HEALTHIER PLACE FOR YOU OR YOUR FAMILY? THROUGH THE RESULTS OF THE COMMUNITY HEALTH SURVEY AS WELL AS OTHER PRIMARY RESEARCH AND DATA AVAILABLE, MERRICK MEDICAL CENTER IDENTIFIED THREE SIGNIFICANT HEALTH NEEDS WITHIN CENTRAL CITY AND MERRICK COUNTY THAT REQUIRE PRIORITIZED FOCUS OVER THE NEXT FEW YEARS: 1.) CARDIOVASCULAR DISEASE 2.) CANCER 3.) MENTAL HEALTH. THESE SIGNIFICANT HEALTH NEEDS WERE SELECTED BASED ON A COMBINATION OF FACTORS, INCLUDING RESPONSES FROM THE COMMUNITY HEALTH SURVEY, ANALYSIS OF COMMUNITY DATA SOURCES SUCH AS MERRICK COUNTY'S VITAL STATISTICS, BRYAN HEALTH'S OWN INTERNAL HOSPITALIZATION DATA AND OTHER FORMS OF RESEARCH. THESE SELECTIONS DO NOT IMPLY THAT OTHER HEALTH NEEDS ARE NOT WORTHY OF ATTENTION, OR THAT EFFORTS IN OTHER AREAS SHOULD BE DIVERTED TO THESE. IN FACT, OTHER AREAS OF NEED MIGHT BE REPORTED AS LOWER PRIORITY BECAUSE OF MERRICK MEDICAL CENTER'S AND THE COMMUNITY EFFORT TO ALLEVIATE THEM. THE SELECTED NEED PRIORITIES APPEAR TO BE THE MOST PRESSING AT THE TIME OF ASSESSMENT DUE TO A COMBINATION OF PREVALENCE, SEVERITY, COMMUNITY INTEREST AND THE CURRENT LEVEL AT WHICH THE NEED IS BEING APPROPRIATELY ENGAGED.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - CENTRAL DISTRICT HEALTH DEPARTMENT. CENTRAL DISTRICT HEALTH DEPARTMENT SERVES A THREE COUNTY AREA INCLUDING MERRICK COUNTY. THEIR MISSION IS TO PROTECT AND IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY THEY SERVE, PROMOTE HEALTH BY PROVIDING EDUCATION AND RESOURCES TO PREVENT CHRONIC AND INFECTIOUS DISEASES, PROVIDE CONSISTENT QUALITY CARE AND CUSTOMER FOCUSED SERVICE TO MEET THE HEALTH AND WELLNESS GOALS OF INDIVIDUALS AND THE COMMUNITY AS A WHOLE, SUPPORT OPPORTUNITIES FOR PEOPLE TO BE AS HEALTHY AS POSSIBLE, RECOGNIZE THE VALUE OF INDIVIDUALS BY BEING OPEN, HONEST, AND POLITE AND ACKNOWLEDGE DIVERSITY AND TREAT EVERYONE IN A PROFESSIONAL, COURTEOUS, AND NON-JUDGMENTAL MANNER. SERVICES OFFERED THROUGH CENTRAL DISTRICT HEALTH DEPARTMENT ARE VACCINATIONS, TB TESTING, REFUGEE SUPPORT AND HEALTH, FREE DENTAL CARE TO KIDS IN THE DISTRICT, AND MANY OTHER HEALTH SERVICES.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - MERRICK MEDICAL CENTER. THE RESULTS FROM THE COMMUNITY HEALTH SURVEY PRIORITIZED THESE HEALTH FOCUS AREAS OVER THE NEXT FEW YEARS, 1.) CARDIOVASCULAR DISEASE, 2.) CANCER, AND 3.) MENTAL HEALTH. 1.) CARDIOVASCULAR DISEASE - HEART DISEASE HAS BEEN ONE OF THE TWO LEADING CAUSES OF DEATH IN MERRICK COUNTY. MERRICK COUNTY LEADS IN CORONARY HEART DISEASE, HIGH BLOOD PRESSURE, STROKE, OBESITY AND SMOKING IN THE CENTRAL DISTRICT HEALTH DEPARTMENT AREA. MERRICK COUNTY HAS BEEN ABLE TO REDUCE THE PERCENTAGE OF DIABETIC'S OVERALL A1C DUE TO AN ACTIVE ACCOUNTABLE CARE ORGANIZATION (ACO). THROUGH THIS ACTION, DIABETES HAS BEEN REMOVED AS A PRIORTIZED HEALTH NEED. MERRICK MEDICAL CENTER RECOGNIZED THE NEED FOR ADDITIONAL CARDIOVASCULAR DISEASE RESOURCES AS MERRICK MEDICAL CENTER HAS ADDED A VASCULAR SPECIALIST WHILE ENHANCING CARDIOLOGY REHABILITATION SERVICES AND CARDIAC TESTING. 2.) CANCER - CANCER HAS HELD AS ONE OF MERRICK COUNTY'S MOST PROMINENT CAUSES OF DEATH FOR MORE THAN A DECADE. CANCER WAS ONE OF THE LEADING CAUSES OF DEATH IN MERRICK COUNTY FOR 2023. BETWEEN 2016-2020 THERE WERE 462 INCIDENCES OF CANCERS REPORTED IN MERRICK COUNTY AND BREAST CANCER IS THE MOST REPORTED TYPE OF CANCER DURING THAT TIME FRAME. MERRICK MEDICAL CENTER HAS A 3D DIGITAL MAMMORAPHY TO OFFER MAMMOGRAPHY SERVICE TO HELP WITH DETECTING BREAST CANCER EARLY WHEN IT IS MOST TREATABLE. MERRICK MEDICAL CENTER IS A HIGH PERFORMING ACCOUNTABLE CARE ORGANIZATION (ACO) WHICH UTILIZES A CARE COORDINATION MODEL TO CLOSE PATIENT GAPS SUCH AS CANCER SCREENINGS. ACO IS A GROUP OF DOCTORS, HOSPITALS AND/OR OTHER HEALTH CARE PROVIDERS WHO WORK TOGETHER TO IMPROVE THE QUALITY AND EXPERIENCE OF YOUR HEALTH. 3.) MENTAL HEALTH - NEBRASKA YOUTH MENTAL HEALTH RANKING IN 2023 OVERALL IS 49 OUT OF 51 WHICH INDICATES A HIGH PREVALENCE OF MENTAL ILLNESS AND LOWER RATES OF ACCESS TO CARE. THE CENTRAL DISTRICT RANKS ABOVE THE STATE OF NEBRASKA IN FREQUENT MENTAL DISTRESS AND THE AVERAGE NUMBER OF DAYS MENTAL HEALTH WAS NOT GOOD IN ADULTS 18 AND OVER. CENTRAL DISTRICT IS 3.9% HIGHER IN PERSONS TOLD THEY HAD DEPRESSION THAN STATE OF NEBRASKA PERCENTAGE. MERRICK MEDICAL CENTER HAS RECENTLY EMPLOYED A PSYCHIATRIST AND A MENTAL HEALTH NURSE THAT IS HOUSED IN THE RURAL CLINIC TO PROVIDE ADDITIONAL ANONYMITY AND CONFIDENTIALITY. CENTRAL CITY IN MERRICK COUNTY IS HOME TO FOUR FACILITIES WHO OFFER BEHAVIORAL HEALTH AND/OR MENTAL HEALTH HOUSING. MERRICK MEDICAL CENTER ALONG WITH OTHER PERSONAL HEALTH CARE PROVIDERS AND FACILITIES WILL ADDRESS THE NEEDS OF THE LOCAL POPULATION THROUGHOUT THE NEXT FEW YEARS AND CREATE A CHIP PLAN TO BEST PROVIDE THE NEEDED SERVICES TO THE RESIDENTS WITHIN THE TRI-COUNTY AREA.

Schedule H (Form 990) 2024

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?2
Name and address		Type of Facility (describe)
1	CENTRAL CITY MEDICAL CLINIC 2510 18TH AVENUE CENTRAL CITY,NE68826	RURAL HEALTH CLINIC
2	FULLERTON MEDICAL CLINIC 901 BROADWAY STREET FULLERTON,NE68638	RURAL HEALTH CLINIC
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2024

Page 10

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 7e COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS	HEART DISEASE IS ONE OF THE TWO LEADING CAUSES OF DEATH IN MERRICK COUNTY. MERRICK COUNTY LEADS IN CORONARY HEART DISEASE, HIGH BLOOD PRESSURE, STROKE, OBESITY, AND SMOKING. MERRICK MEDICAL CENTER (MMC) HAS DEVELOPED A CARDIOVASCULAR DISEASE ACTION PLAN. MMC IS USING A CARE COORDINATION MODEL TO CLOSE CARE GAPS BY 1.) ADDING A CARDIAC REHAB REGISTERED NURSE 2.) ALLOCATE ADDITIONAL DIETITIAN AND DIABETIC EDUCATOR HOURS AND 3.) ADD NUTRITION SUPPORT GROUP. THE GOALS WITH THIS ACTION PLAN IS CONTROLLING HIGH BLOOD PRESSURE AND BRINGING DOWN DIABETES GLYCEMIC STATUS ASSESSMENT. CANCER IS THE OTHER LEADING CAUSE OF DEATH IN MERRICK COUNTY. MMC'S CANCER ACTION PLAN TO CLOSE THE CARE GAPS IS 1.) STREAMLINE AND ADD ONCOLOGY RESOURCES BY INCREASING REFERRALS TO ONCOLOGY PROVIDER GROUP, COLLABORATE WITH SYSTEM CANCER CENTERS LOCATED IN LINCOLN AND KEARNEY 2.) ADD CHRONIC CARE MANAGEMENT HOURS 3.) ADD ADDITIONAL RN HOURS TO THE SPECIALTY CLINIC. THE GOAL OF THE ACTION PLAN IS TO LOWER THE THREE MAIN CANCER CAUSES OF DEATH FROM COLORECTAL, BREAST AND CERVICAL CANCER BY EARLY SCREENINGS. THE CENTRAL DISTRICT HAS A HIGH PREVALENCE OF MENTAL HEALTH AND HAS A LOWER RATE OF ACCESS TO CARE. MMC'S ACTION PLAN FOR MENTAL HEALTH IS TO ADD ADDITIONAL RESOURCES TO THE MENTAL HEALTH CLINIC BY 1.) INCREASE MENTAL HEALTH PROVIDER BY ONE FULL TIME PROVIDER 2.) INCREASE THE CAPACITY OF THE SPRAVATO THERAPY CLINIC BY FIVE PATIENTS MAKING THE TOTAL OF TEN PATIENTS. THE GOALS RELATED TO THE MENTAL HEALTH ACTION PLAN ARE TO INCREASE THE DEPRESSION SCREENINGS AND TO INCREASE THE SPRAVATO PATIENT ENCOUNTERS ANNUALLY.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	BRYAN HEALTH
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	MERRICK MEDICAL CENTER'S UNCOMPENSATED CARE COST-TO CHARGE RATIO WAS USED TO CALCULATE THE AMOUNT ON LINE 7A. FOR LINE 7E, ANY OFFSETTING REVENUE WAS DEDUCTED FROM EXPENSES DIRECTLY ATTRIBUTABLE TO THE COMMUNITY BENEFITY ACTIVITY.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	FOR FINANCIAL STATEMENT PURPOSES, BRYAN HEALTH SYSTEM 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. BAD DEBT EXPENSE IS DETERMINED ON BALANCES AFTER DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED TO PATIENT ACCOUNTS. THE REMAINING BALANCE DUE FROM THE PATIENT IS EVALUATED TO DETERMINE IF THE ACCOUNT IS WRITTEN OFF BASED ON THE EXISTING COLLECTION POLICY.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 12-14 OF THE MERRICK MEDICAL CENTER 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. MERRICK 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 MERRICK MEDICAL CENTER USES TO COVER THIS SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING THE GOVERNMENT OF THE FINANCIAL BURDEN OF PAYING THE FULL COSTS OF CARE FOR MEDICARE BENEFICIARIES. THE COSTING METHODOLODY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS THE COST TO CHARGE RATIO.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	THE ORGANIZATION'S DEBT COLLECTION POLICY PROHIBITS ANY COLLECTION EFFORTS FOR THE PORTION OF THE PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
Schedule H, Part V, Section B, Line 16a FAP website	- MERRICK MEDICAL CENTER: Line 16a URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- MERRICK MEDICAL CENTER: 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	- MERRICK MEDICAL CENTER: Line 16c URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/;
Schedule H, Part VI, Line 2 Needs assessment	MERRICK MEDICAL CENTER ("MMC") IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY CONTINUALLY WORKING WITH COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. MMC PARTNERED WITH THE CENTRAL DISTRICT HEALTH DEPARTMENT ("CDHD") WHO DEVELOPED A HEALTH SURVEY WITH A JOINT EFFORT FROM THE MULTICULTURAL COALITION, CENTRAL NEBRASKA COUNCIL ON ALCOHOLISM AND ADDICTIONS, AND IDEA BANK. THE SURVEY PROVIDED INFORMATION AND INSIGHTS THAT WERE CRITICAL TO MERRICK MEDICAL CENTER'S 2024 COMMUNITY HEALTH NEEDS ASSESSMENT. THROUGH THE RESULTS OF THE COMMUNITY HEALTH SURVEY AS WELL AS THROUGH OTHER PRIMARY RESEARCH AND DATA AVAILABLE, MMC IDENTIFIED THREE SIGNIFICANT HEALTH NEEDS WITHIN CENTRAL CITY AND MERRICK COUNTY THAT REQUIRED PRIORITIZED FOCUS OVER THE NEXT FEW YEARS.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	MERRICK MEDICAL CENTER ("MMC") OFFERS A FINANCIAL ASSISTANCE PROGRAM TO PATIENTS WHO CANNOT AFFORD TO PAY FOR PART OR ALL OF THE CARE THEY RECEIVE. EDUCATION REGARDING THE FINANCIAL ASSISTANCE PROGRAM IS PROVIDED AT EACH NEW EMPLOYEE ORIENTATION AND THEN ANNUALLY SO THAT EACH EMPLOYEE WILL HAVE A CLEAR UNDERSTANDING OF THE FINANCIAL ASSISTANCE THAT IS AVAILABLE TO THE PATIENTS. FINANCIAL ASSISTANCE INFORMATION IS PROVIDED TO PATIENTS DURING ADMISSION IN THEIR INFORMATION PACKET. PATIENTS MAY CONTACT THE HOSPITAL AT ANY TIME TO REQUEST A FINANCIAL ASSISTANCE APPLICATION. HOSPITAL PATIENT ACCOUNT COLLECTORS WILL ALSO INFORM PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM IF THEY ARE UNABLE TO PAY THEIR BILL AND MAY QUALIFY FOR FINANCIAL ASSISTANCE SUCH AS FEDERAL, STATE, OR LOCAL PROGRAMS, OR ELIGIBILTY FOR ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. IN ADDITION, INFORMATION REGARDING FINANCIAL ASSISTANCE IS PROVIDED ON THE WEBSITE, IN ALL HOSPITAL REGISTRATION AREAS, INCLUDING THE EMERGENCY DEPARTMENT, AND ON EACH BILLING STATEMENT.
Schedule H, Part VI, Line 4 Community information	THE COMMUNITY SERVED BY MERRICK MEDICAL CENTER IS MERRICK COUNTY, NEBRASKA. MERRICK COUNTY IS 487.8 SQUARE MILES AND IS THE 77TH LARGEST COUNTY IN NEBRASKA BY TOTAL AREA. THE POPULATION WITHIN THIS COUNTY IS 7,837 PEOPLE IN 2024. THE FOLLOWING COUMMUNITIES IN MERRICK COUNTY ARE: CENTRAL CITY (POPULATION 3,039 IN 2024), CLARKS (POPULATION 342), CHAPMAN (POPULATION 272), PALMER (404) AND WORMS (UNINCORPORATED). FULLERTON IS LOCATED IN NANCE COUNTY NEBRASKA AND IS ALSO INCLUDED IN MERRICK MEDICAL CENTER'S SERVICE AREA. MERRICK COUNTY HAS A MEDIAN AGE OF 43.0 WHICH IS HIGHER THAN NEBRASKA'S AVERAGE OF AGE 37.4. THE COUNTY ALSO HAS 21.5% OF ITS POPULATION 65 YEARS AND OVER, HIGHER THAN NEBRASKA'S AVERAGE OF 17.2%. MERRICK COUNTY'S POPULATION IS PROJECTED TO DECREASE AMONG ALL AGE GROUPS EXCEPT FOR THE POPULATION OVER THE AGE OF 80. THERE WILL LIKELY BE A STEADY DECLINE FROM POPULATIONS YOUNGER THAN 50. THE PRIMARY RACE/ETHNICITY IS COMPRISED OF 91.2% NON-HISPANIC WHITE, 5.4% HISPANIC AND 3.4% NON-HISPANIC (OTHER RACES). THE PRIMARY LANGUAGE SPOKEN AT HOME IN MERRICK COUNTY IS ENGLISH (95%) FOLLOWED BY SPANISH (3%). MERRICK COUNTY'S POVERTY LEVEL IS LOWER AT 10.2% COMPARED TO NEBRASKA'S AVERAGE 11.2%. MERRICK COUNTY'S CHILDREN IN POVERTY IS 12% WHILE NEBRASKA'S CHILDREN POVERTY IS HIGHER AT 14%. 10.7% OF INDIVIDUALS WHO ARE OVER THE AGE OF 65 YEARS ARE BELOW THE POVERTY LEVEL. THERE ARE THREE FEDERALLY UNDERSERVED AREAS PRESENT IN MERRICK AND HALL COUNTIES. THE SERVICE AREAS ARE CLARKSVILLE SERVICE AREA AND LOUP SERVICE AREA IN MERRICK COUNTY AND LOW INCOME AND MFW POPULATION IN HALL COUNTY NEBRASKA. THEY ARE PARTIALLY RURAL AND NON-RURAL POPULATIONS. MERRICK COUNTY AS WELL AS RESIDENTS IN FULLERTON ARE SERVED BY MERRICK MEDICAL CENTER, CENTRAL CITY MEDICAL CLINIC AND FULLERTON MEDICAL CLINIC. BOONE COUNTY HEALTH SYSTEM ALSO SERVES THE RESIDENTS OF FULLERTON WITH A CLINIC LOCATED IN THEIR COMMUNITY AS WELL AS A HOSPITAL APPROXIMATELY 25 MILES NORTH IN ALBION. GENOA MEDICAL FACILITIES IS THE SOLE HOSPITAL LOCATED IN NANCE COUNTY AND ALSO PROVIDES CARE FOR ITS RESIDENTS. MERRICK COUNTY IS SERVED BY THE CENTRAL DISTRICT HEALTH DEPARTMENT, WHICH HAS A THREE COUNTY SERVICE AREA INCLUDING HALL AND HAMILTON COUNTIES. NANCE COUNTY IS SERVED BY THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT. MERRICK COUNTY HAS 392 EMPLOYERS THAT EMPLOY 3,923. THE TOP INDUSTRIES IN THE COUNTY ARE HEALTH CARE, AGRICULTURE, MANUFACTURING, RETAIL TRADE AND EDUCATIONAL SERVICES. MERRICK MEDICAL CENTER, LOCATED IN CENTRAL CITY, IS ONE OF THE LARGEST EMPLOYERS AND THE PUBLIC SCHOOL BEING THE SECOND LARGEST EMPLOYER. MERRICK COUNTY'S UNEMPLOYMENT RATE IS 1.5%, BELOW THE STATE UNEMPLOYMENT RATE OF 2.9% AND THE NATIONAL RATE OF 4.3%. MERRICK COUNTY'S MEDIAN HOUSEHOLD INCOME IS $57,873 TRAILS COMPARED TO THE STATE AT $69,829 AND NATION AT $72,603.
Schedule H, Part VI, Line 5 Promotion of community health	MERRICK MEDICAL CENTER ("MMC") IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MMC OPERATES A 6-LICENSED BED CRITICAL ACCESS HOSPITAL AND TWO PHYSICIAN CLINICS. MMC HAS AN OPEN MEDICAL STAFF. THE MAJORITY OF THE HOSPITAL BOARD OF TRUSTEES THAT ARE NOT EMPLOYEES OF BRYAN HEALTH OR MMC RESIDE IN MERRICK COUNTY. THE BOARD OF TRUSTEES OF BRYAN HEALTH, THE SOLE CORPORATE MEMBER OF MMC, MUST APPROVE MMC'S TRUSTEES. THE MAJORITY OF BRYAN HEALTH'S BOARD OF TRUSTEES ARE INDEPENDENT. MMC IS COMMITTED TO SERVING PATIENTS AND THE COMMUNITY BY INVESTING FUNDS IN FACILITIES, TECHNOLOGY, PHYSICIANS, AND STAFF TO DELIVER PREMIUM HEALTHCARE IN ALL FACILITIES. MMC PROVIDES UNCOMPENSATED AND CHARITY CARE TO ALL ELIGIBLE PATIENTS. MMC SUPPORTS NUMEROUS HEALTH CARE SERVICES, FITNESS AND WELLNESS PROGRAMS, TELEHEALTH TECHNOLOGY AND COMMUNITY PARTNERSHIPS.
Schedule H, Part VI, Line 6 Affiliated health care system	MERRICK MEDICAL CENTER IS PART OF BRYAN HEALTH, ONE OF THE LARGEST NON-PROFIT, LOCALLY GOVERNED 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 COMMIUNITY BENEFITS PROVIDED BY THE SYSTEM 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, FOUR PHILANTHROPIC FOUNDATIONS, A PHYSICIAN HOSPITAL ORGANIZATION AND ACCOUNTABLE CARE ORGANIZATION, AND OTHER HEALTHCARE PROVIDERS. PREMIER SERVICES INCLUDE CARDIOLOGY, NEUROSCIENCE, ORTHOPEDICS, VASCULAR, TRAUMA AND EMERGENCY CENTERS, INTENSIVE CARE, WOMEN'S AND CHILDREN'S HEALTH, ONCOLOGY, IMAGING AND MENTAL HEALTH.
Schedule H, Part VI, Line 7 State filing of community benefit report	NE

Schedule H (Form 990) 2024

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

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Schedule J
(Form 990)
(Rev. January 2025)

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.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

Merrick Medical Center

Employer identification number

82-0906268

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 .....

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? ....

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

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) (Rev. 1-2025)

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)
1PAT GANYO SECRETARY/TREASURER	(i) (ii)	0 ------------- 284,077	0 ------------- 75,412	0 ------------- 86,515	0 ------------- 8,472	0 ------------- 38,952	0 ------------- 493,428	0 ------------- 0
2BLAKE COVER MD PHYSICIAN/EX-OFFICIO DIRECTOR	(i) (ii)	273,483 ------------- 0	194,643 ------------- 0	8,650 ------------- 0	14,260 ------------- 0	34,730 ------------- 0	525,766 ------------- 0	0 ------------- 0
3JULIE LACY EX-OFFICIO DIRECTOR	(i) (ii)	0 ------------- 169,524	0 ------------- 22,968	0 ------------- 37,052	0 ------------- 16,068	0 ------------- 13,916	0 ------------- 259,528	0 ------------- 0
4RICHARD LLOYD DIRECTOR	(i) (ii)	0 ------------- 276,229	0 ------------- 90,144	0 ------------- 139,706	0 ------------- 16,945	0 ------------- 29,109	0 ------------- 552,133	0 ------------- 0
5RYAN SANTIN MD PHYSICIAN	(i) (ii)	291,964 ------------- 0	11,250 ------------- 0	20,112 ------------- 0	16,480 ------------- 0	35,796 ------------- 0	375,602 ------------- 0	0 ------------- 0
6RICHARD POPPE MD PHYSICIAN	(i) (ii)	223,755 ------------- 0	204,847 ------------- 0	26,958 ------------- 0	12,945 ------------- 0	37,474 ------------- 0	505,979 ------------- 0	0 ------------- 0
7RYAN STAGEMEYER RN RN ANESTHETIST	(i) (ii)	284,025 ------------- 0	11,875 ------------- 0	1,265 ------------- 0	15,054 ------------- 0	36,906 ------------- 0	349,125 ------------- 0	0 ------------- 0
8TRACI DIECKMANN DO PHYSICIAN	(i) (ii)	250,943 ------------- 0	152,339 ------------- 0	7,658 ------------- 0	16,471 ------------- 0	31,530 ------------- 0	458,941 ------------- 0	0 ------------- 0
9BRIAN BUHLKE DO PHYSICIAN	(i) (ii)	216,481 ------------- 0	166,340 ------------- 0	33,411 ------------- 0	17,694 ------------- 0	34,730 ------------- 0	468,656 ------------- 0	0 ------------- 0

Schedule J (Form 990) (Rev. 1-2025)

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 3 Arrangement used to establish the top management official's compensation	BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM, INCLUDING THIS ORGANIZATION'S CEO AND CEOS OF ALL RURAL HOSPITALS OWNED BY BRYAN HEALTH, 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 SENIOR LEADERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP 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 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, 2024. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED ON 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 THE FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A SUPPLEMENTAL NONQUALIFED RETIREMENT PLAN AND RECEIVED A PAYMENT DURING 2024: RICHARD LLOYD - $75,701 AND PAT GANYO - $49,149
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 MERRICK MEDICAL CENTER, AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS.
Schedule J, Part II, Column (B)(ii) COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES	A TOTAL OF $26,040 BONUSES ACCRUED IN 2024 WILL BE PAID IN 2025 WHICH WILL BE REPORTED ON 2025 SCHEDULE J COLUMN (BII)

Schedule J (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

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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

Open to Public
Inspection

Name of the organization
Merrick Medical Center

Employer identification number
82-0906268

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	CITY OF CENTRAL CITY NERBASKA	47-6006132	000000000	12-02-2020	9,500,000	PART 1, LINE A, COLUMN (F): ACQUIRE, CONSTRUCT, IMPROVE, EXTEND, REPAIR, EQUIP AND FURNISH A CAH		X		X		X
B	THE COUNTY OF MERRICK IN THE STATE OF NEBRASKA	47-6006488	000000000	12-02-2020	9,975,000	PART 1, LINE B, COLUMN (F): ACQUIRE, CONSTRUCT, IMPROVE, EXTEND, REPAIR, EQUIP AND FURNISH A CAH		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	975,954		1,028,314
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	9,500,000		9,975,000
4 Gross proceeds in reserve funds .............	0		0
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		0
7 Issuance costs from proceeds ...............	0		0
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	9,500,000		9,975,000
11 Other spent proceeds .............	0		0
12 Other unspent proceeds .............	0		0
13 Year of substantial completion .............	2022		2022
	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		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		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

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

Cat. No. 50193E

Schedule K (Form 990) (Rev. 1-2025)

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		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?		X		X
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 %		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 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0 %		0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X

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		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X
b Exception to rebate? ........		X		X
c No rebate due? .........		X		X
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		X

Schedule K (Form 990) (Rev. 1-2025)

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		X
b Name of provider ..........
c Term of hedge .........	0 %		0 %
d Was the hedge superintegrated? ......		X		X
e Was the hedge terminated? ........		X		X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........	0 %		0 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........		X		X
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		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		X

Part Ⅵ

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

Return Reference	Explanation

Schedule K (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- TIN:

SCHEDULE O
(Form 990)
(Rev. January 2025)
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 instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization

Merrick Medical Center

Employer identification number

82-0906268

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 AND VICE-CHAIRPERSON OF THE BOARD. IN ADDITION, THE CHIEF EXECUTIVE OFFICER OF THE SYSTEM AND CORPORATION PRESIDENT/CHIEF EXECUTIVE OFFICER SHALL BE EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE ALL OF THE AUTHORITY AND POWER OF THE BOARD. AS DELEGATED THEREBY, WHEN THE BOARD IS NOT IN SESSION. 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 RESPONSIBILITY IMPOSED UPON IT OR HIM/HER BY LAW.
Form 990, Part VI, Line 6 Classes of members or stockholders	AS STATED IN THE CORPORATION'S ORGANIZING DOCUMENTS, THE SOLE MEMBER OF MERRICK MEDICAL CENTER 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 MERRICK MEDICAL CENTER, HAS THE RIGHT UNDER THE ORGANIZING DOCUMENTS TO REMOVE ANY TRUSTEE FROM OFFICE AT ANY TIME. WITH OR WITHOUT CAUSE BY TWO-THIRDS (2/3) VOTE OF THE VOTING TRUSTEES OF BRYAN HEALTH.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	BRYAN HEALTH IS THE SOLE CORPORATE MEMBER OF MERRICK MEDICAL CENTER ("MMC"). PURSUANT TO THE GOVERNING DOCUMENTS, THE BOARD OF MMC MAY MANAGE THE AFFAIRS OF THE CORPORATION. HOWEVER, THE BOARD MAY NOT, WITHOUT THE PRIOR APPROVAL OF BRYAN HEALTH: (1) ADOPT ANY LONG-TERM CAPITAL OPERATIONAL BUDGET; (2) ADOPT ANY CHANGES IN ANY ANNUAL OR LONG-TERM CAPITAL BUDGET OR OPERATIONAL EXPENSE BUDGET EXCEEDING $250,000 IN ANY SINGLE TRANSACTION OR, $1,000,000 IN ANY CORPORATION FISCAL YEAR; (3) ADOPT SUBSTANTIVE CHANGES TO EXISTING LONG-TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; (4) AMEND THE BYLAWS OR ARTICLES OF INCORPORATION; (5) APPROVE THE TRANSFER, SALE OR OTHER DISPOSITION OF CAPITAL ASSETS IN ANY SINGLE TRANSACTION IN EXCESS OF $250,000, OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (6) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF ANY CORPORATION, SHARED SERVICE ARRANGEMENT, ASSOCIATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, TRUST, JOINT VENTURE OR OTHER ENTITY, DIRECTLY OR INDIRECTLY, WHERE THE CAPITAL EXPENDITURE OR OPERATING EXPENSES BY THE CORPORATION IN CONNECTION WITH SUCH ORGANIZATION OR ACQUISITION WHEN IT EXCEEDS $500,000 IN A SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (7) APPROVE ANY INDEBTEDNESS INVOLVING A MORTGAGE OR LIEN OF ANY KIND OR NATURE ON ASSETS OF THE CORPORATION WHERE THE BORROWING OR INDEBTEDNESS EXCEEDS $250,000 IN ANY SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (8) ELECT OR APPOINT TRUSTEES OF THE CORPORATION; (9) APPOINT OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; (10) PURCHASE INSURANCE COVERAGE FOR THE CORPORATION AND ITS OPERATIONS; (11) SELECT THE AUDITOR TO PERFORM THE ANNUAL AUDIT OF THE RECORDS OF THE CORPORATION; (12) TAKE ANY OTHER ACTIONS WHICH MAY BE INCONSISTENT WITH BRYAN HEALTH'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 MERRICK MEDICAL CENTER'S DIRECTOR OF FINANCE, DIRECTOR OF PROFESSIONAL SERVICES AND OTHER DEPARTMENTS, INCLUDING HUMAN RESOURCES, FINANCE, LEGAL, AND DEVELOPMENT, TO GATHER INFORMATION TO COMPLETE FORM 990 AND ATTACHED SCHEDULES IN AN ACCURATE AND THOROUGH MANNER. THIS 990 WAS REVIEWED BY MERRICK MEDICAL CENTER'S CEO AND BY THE CEO AND CFO OF BRYAN HEALTH. THIS 990 WAS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS AVAILABLE ON BOARD ADVANATAGE FOR REVIEW TO EACH MEMBER OF MERRICK MEDICAL CENTER'S BOARD OF TRUSTEES, AND TO BRYAN HEALTH'S AUDIT COMMITTEE PRIOR TO FILING THE FORM WITH THE INTERNAL REVENUE SERVICE.
Form 990, Part VI, Line 12c Conflict of interest policy	MERRICK MEDICAL CENTER ("MMC") HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY THAT IS MONITORED AND ENFORCED BY THE MMC BOARD OF TRUSTEES. BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE QUESTIONNAIRE TO IDENTIFY ANY FAMILY AND BUSINESS RELATIONS AND TRANSACTIONS, OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT. THE QUESTIONNAIRES REQUIRES EACH COVERED PERSON TO SIGN A STATEMENT CERTIFYING THAT HE/SHE: (1) HAS REPORTED INFORMATION THT 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	THE PROCESS FOR REVIEWING AND EVALUATING COMPENSATION FOR THIS ORGANIZATION'S CEO AND FOR ALL RURAL HOSPITAL CEOS EMPLOYED BY BRYAN HEALTH, IS OVERSEEN BY BRYAN HEALTH'S HUMAN RESOURCES DEPARTMENT. THE PROCESS INCLUDES AN ANNUAL ASSESSMENT OF CEO COMPENSATION INCLUDING BENCHMARKING SALARIES TO SEVERAL NATIONAL SALARY SURVEYS TO DETERMINE THAT THE COMPENSATION IS CONSISTENT WITH THE ORGANIZATION'S CHARITABLE MISSION AND REASONABLE COMPARED WITH FAIR MARKET VALUE IN THE INDUSTRY. BRYAN HEALTH TARGETS BASE SALARY FOR RURAL HOSPITAL CEOS AT THE 50TH PERCENTILE OF THE MARKET. THE LAST ASSESSMENT WAS COMPLETED IN APRIL 2018. ONE BOARD MEMBER OF THIS ORGANIZATION IS A MEMBER OF THE BRYAN HEALTH SENIOR MANAGEMENT TEAM. 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 REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVYES, 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 THE TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT 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, 2024. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. EMPLOYED PHYSICIAN COMPENSATION IS UNDER THE PURVIEW OF THE BRYAN HEALTH COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE HAS ESTABLISHED A POLICY REGARDING PHYSICIAN COMPENSATION WHICH ASSURES THAT PHYSICIAN COMPENSATION MEETS FAIR MARKET VALUE AND ALL OTHER LEGAL REQUIREMENTS. PHYSICIAN COMPENSATION IS BENCHMARKED AGAINST SEVERAL INDEPENDENT PHYSICIAN SPECIALTY - SPECIFIC SALARY SURVEYS AND IS REGULARLY REVIEWED BY THE COMPENSATION 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 NERBASKA 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, Line 1a, Column (D) COMPENSATION OF MEMBERS	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 FORM 990, PART VII, SECTION A ARE FOR SERVICES PERFORMED AS PHYSICIANS AND EXECUTIVES OF MERRICK MEDICAL CENTER AND BRYAN HEALTH AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	- Total Revenue: 581, Related or Exempt Function Revenue: 581, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	PATIENT CARE SERVICES - Total Expense: 3376723, Program Service Expense: 3105072, Management and General Expenses: 271651, Fundraising Expenses: ; COLLECTION FEES - Total Expense: 14487, Program Service Expense: 13295, Management and General Expenses: 1192, Fundraising Expenses: ; CONSULTING - Total Expense: 21288, Program Service Expense: 14902, Management and General Expenses: 6386, Fundraising Expenses: ;

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

Cat. No. 51056K

Schedule O (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

- TIN:

SCHEDULE R
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

Merrick Medical Center

Employer identification number

82-0906268

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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)BRYAN PHYSICIAN NETWORK 1600 SOUTH 48TH STREET LINCOLN,NE68506 20-1357375	HEALTHCARE	NE	501(c)(3)	10	BRYAN HEALTH	Yes
(3)BRYAN MEDICAL CENTER 1600 SOUTH 48TH STREET LINCOLN,NE68506 47-0376552	HEALTHCARE	NE	501(c)(3)	3	BRYAN HEALTH	Yes
(4)BRYAN FOUNDATION 1600 SOUTH 48TH STREET LINCOLN,NE68506 23-7005720	FUNDRAISING	NE	501(c)(3)	7	BRYAN HEALTH	Yes
(5)CRETE AREA MEDICAL CENTER 2910 BETTEN DRIVE CRETE,NE683330220 47-0841285	HEALTHCARE	NE	501(c)(3)	3	BRYAN HEALTH	Yes
(6)MERRICK MEDICAL CENTER FOUNDATION 2802 28TH STREET CENTRAL CITY,NE688269501 47-0710738	FUNDRAISING	NE	501(c)(3)	Type I	MERRICK MEDICAL CENTER	Yes
(7)GRAND ISLAND REGIONAL MEDICAL CENTER 3533 PRAIRIEVIEW STREET 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

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

Cat. No. 50135Y

Schedule R (Form 990) (Rev. 1-2025)

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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	NA	N/A
(2) DOCTOR'S OUTPATIENT SURGERY CENTER LLC 1600 SOUTH 48TH STREET LINCOLN,NE68506 36-4835603	HEALTHCARE	NE	NA	N/A
(3) HEAD AND NECK SURGICAL PARTNERS LLC 1600 SOUTH 48TH STREET LINCOLN,NE68506 91-1824787	HEALTHCARE	NE	NA	N/A
(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 HEART MARY LANNING CARDIOLOGY LLC 1600 SOUTH 48TH STREET SUITE 600 LINCOLN,NE68506 46-4822260	CARDIOLOGY SERVICES	NE	NA	N/A
(7) KPT&G LLC C/O MDM 300 N MEAD STE 210 WICHITA,KS67202 36-4886336	RENTAL REAL ESTATE	NE	NA	N/A
(8) KHL-RO LLC 4101 TIGER LILY RD STE100 LINCOLN,NE68516 88-3562359	HEALTHCARE	NE	NA	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) BRYAN ENTERPRISES INC 1600 SOUTH 48TH STREET LINCOLN,NE68506 47-0701037	MEDICAL SERVICES	NE	NA	C Corporation				Yes
(2) INEGRATED CARDIOLOGY GROUP LLC 1600 SOUTH 48TH STREET LINCOLN,NE68506 47-0844961	CARDIOLOGY	NE	NA	C Corporation				Yes
(3) BRYAN HEALTH CONNECT 1600 SOUTH 48TH STREET LINCOLN,NE68506 36-4771145	PHYSICIAN HOSPITAL ORGANIZATION	NE	NA	C Corporation				Yes

Schedule R (Form 990) (Rev. 1-2025)

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) MERRICK MEDICAL CENTER FOUNDATION	C	100,200	FMV
(2) BRYAN MEDICAL CENTER	O	356,987	FMV
(3) BRYAN TELEMEDICINE LLC	M	133,609	FMV
(4) CRETE AREA MEDICAL CENTER	O	93,204	FMV
(5) GRAND ISLAND REGIONAL MEDICAL CENTER	O	265,497	FMV

Schedule R (Form 990) (Rev. 1-2025)

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(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

Schedule R (Form 990) (Rev. 1-2025)

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) (Rev. 1-2025)

Additional Data

Software ID:	24020961
Software Version:	2024v5.1

1	Briefly describe the organization’s mission or most significant activities: MERRICK MEDICAL CENTER IS COMMITTED TO PROMOTING AND PROVIDING PERSONALIZED, COMPASSIONATE, QUALITY HEALTH SERVICES. DURING 2024, MERRICK MEDICAL CENTER PROVIDED CHARITY CARE TO 329 PATIENTS AT A COST OF $273,343.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	6
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	2
5	Total number of individuals employed in calendar year 2024 (Part V, line 2a) ......	5	160
6	Total number of volunteers (estimate if necessary) .............	6	2
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	972,551	442,522
9	Program service revenue (Part VIII, line 2g) .........	25,456,801	29,053,853
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	211,556	531,421
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	188,919	138,107
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	26,829,827	30,165,903
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	12,760,661	14,551,575
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	11,892,233	11,853,919
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	24,652,894	26,405,494
19	Revenue less expenses. Subtract line 18 from line 12.......	2,176,933	3,760,409
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	42,493,337	46,061,197
21	Total liabilities (Part X, line 26).............	20,411,076	20,218,527
22	Net assets or fund balances. Subtract line 21 from line 20.....	22,082,261	25,842,670

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 23,049,933 including grants of $ ) (Revenue $ 29,073,332 )
	MERRICK MEDICAL CENTER (MMC), IS A HOSPITAL ORGANIZATION LOCATED IN CENTRAL CITY, NEBRASKA, AND IS PART OF THE BRYAN HEALTH SYSTEM. MMC WAS INCORPORATED ON MARCH 15, 2017, WITH HOSPITAL OPERATIONS COMMENCING ON JULY 1, 2017. MMC OPERATES A 6 LICENSED BED CRITICAL ACCESS HOSPITAL AND 2 PHYSICIAN CLINICS. MMC IS COMMITTED TO SERVING PATIENTS AND THE COMMUNITY BY INVESTING FUNDS IN FACILITIES, TECHNOLOGY, PHYSICIANS, AND STAFF TO DELIVER PREMIUM HEALTHCARE TO CENTRAL CITY AND THE SURROUNDING COMMUNITIES. MMC SUPPORTS NUMEROUS HEALTH CARE SERVICES, FITNESS AND WELLNESS PROGRAMS, TELEHEALTH TECHNOLOGY AND COMMUNITY PARTNERSHIPS. DURING 2024, MMC PROVIDED INPATIENT ACUTE AND SWING BED SERVICES TO 274 PATIENTS. ALSO, MMC PERFORMED 329 SURGICAL PROCEDURES AND PROVIDED PRIMARY CARE PHYSICIAN SERVICES WITH 15,310 VISITS. IN 2024, MMC PROVIDED CHARITY CARE TO 329 PATIENTS AND SERVED 754 MEDICAID PATIENTS. MMC IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE.

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 expenses23,049,933

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) NATHAN PERRY...................................................................... CHAIR	1.0 ................. 0	X	X		0	0	0
(2) PAT GANYO...................................................................... SECRETARY/TREASURER	1.0 ................. 52.0	X	X		0	446,004	47,424
(3) SHANNON HANNAPPEL...................................................................... VICE CHAIR	1.0 ................. 0	X	X		0	0	0
(4) BLAKE COVER MD...................................................................... PHYSICIAN/EX-OFFICIO DIRECTOR	50.0 ................. 1.0	X			476,776	0	48,990
(5) JULIE LACY...................................................................... EX-OFFICIO DIRECTOR	1.0 ................. 51.0	X			0	229,544	29,984
(6) RICHARD LLOYD...................................................................... DIRECTOR	1.0 ................. 50.0	X			0	506,079	46,054
(7) JODI MOHR...................................................................... CEO MERRICK MEDICAL CENTER (EFFECTIVE 6/17/2024)	50.0 ................. 0		X		116,649	0	5,266
(8) BRIAN BUHLKE DO...................................................................... PHYSICIAN	50.0 ................. 0			X	416,232	0	52,424
(9) RICHARD POPPE MD...................................................................... PHYSICIAN	50.0 ................. 0			X	455,560	0	50,419
(10) RYAN SANTIN MD...................................................................... PHYSICIAN	50.0 ................. 0			X	323,326	0	52,276
(11) RYAN STAGEMEYER RN...................................................................... RN ANESTHETIST	50.0 ................. 0			X	297,165	0	51,960
(12) TRACI DIECKMANN DO...................................................................... PHYSICIAN	50.0 ................. 0			X	410,940	0	48,001

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	2,496,648	1,181,627	432,798

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	100,200
e	Government grants (contributions)		1e	342,322

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

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

h Total. Add lines 1a-1f.......		442,522

		Business Code
2a	NET PATIENT CARE REVENUE	622110	24,463,394	24,463,394
b	PHARMACY	446110	3,943,018	3,943,018
c	VALUE BASED INCOME	622110	626,821	626,821
d	LEASED EMPLOYEES	622110	17,675	17,675
e	HEALTH INFORMATION SERVICES	621300	2,945	2,945
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		29,053,853

3 Investment income (including dividends, interest, and othersimilar amounts) ......			383,237			383,237
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		158,000
b	Less: cost or other basis and sales expenses	7b		9,816
c	Gain or (loss)	7c	0	148,184
d	Net gain or (loss).........			148,184			148,184
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..			0
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 SALES		722310	118,628			118,628
b	PURCHASED DISCOUNTS		900099	18,048	18,048
c	COMMUNITY WELLNESS INCOME		900099	850	850
d	All other revenue ....			581	581	0	0
e	Total. Add lines 11a–11d ......			138,107
12	Total revenue. See instructions.....			30,165,903	29,073,332	0	650,049

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
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 ...........	647,681		647,681
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........	10,800,724	10,049,518	751,206
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	517,060	463,389	53,671
9	Other employee benefits .......	1,872,988	1,268,865	604,123
10	Payroll taxes ...........	713,122	639,100	74,022
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	88		88
c	Accounting ...........	94,074		94,074
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	3,412,498	3,133,269	279,229	0
12	Advertising and promotion ....	57,583		57,583
13	Office expenses .......
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	299,307	239,446	59,861
17	Travel ............	33,893	30,375	3,518
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	473,749	421,637	52,112
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,675,811	2,381,472	294,339
23	Insurance ...	46,748	40,107	6,641
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	DRUGS	2,069,797	2,069,797
b	CORPORATE COST ALLOCATIONS	1,037,013	829,610	207,403
c	SUPPLIES	763,265	701,574	61,691
d	EQUIPMENT RENTAL	9,549	7,215	2,334
e	All other expenses	880,544	774,559	105,985	0
25	Total functional expenses. Add lines 1 through 24e	26,405,494	23,049,933	3,355,561	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 ........			705	1	805
2	Savings and temporary cash investments .........			11,438,394	2	16,110,895
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			2,343,062	4	4,262,615
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 ...........			131,618	7	17,111
8	Inventories for sale or use ............			357,954	8	382,035
9	Prepaid expenses and deferred charges ......			150,380	9	160,636
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	33,179,638
b	Less: accumulated depreciation	10b	8,556,300	27,086,209	10c	24,623,338
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			985,015	15	503,762
16	Total assets. Add lines 1 through 15 (must equal line 33)...			42,493,337	16	46,061,197

17	Accounts payable and accrued expenses .....	2,271,681	17	1,879,214
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	18,139,395	20	17,373,486
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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	0	25	965,827
26	Total liabilities. Add lines 17 through 25..	20,411,076	26	20,218,527

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	22,082,261	27	25,842,670
28	Net assets with donor restrictions ...........		28
	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 ...........	22,082,261	32	25,842,670
33	Total liabilities and net assets/fund balances ........	42,493,337	33	46,061,197