2023-11-15T12:28:27+00:00 2022-12-31 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402413902 990 2022-01-01 873486516 Bryan Hospital Kearney BRYA 804 22nd Ave Kearney NE 68845 JON PEPPMULLER CFO 2023-11-15 false WILLIAM CALHOUN 999009999 KIM SCIFRES P01316095 5023263996 2022 2023-04-26 12:10:37Z X Kearney Regional Medical Center JON PEPPMULLER 804 22nd Ave Kearney NE 68845 147248810 false X WWW.BRYANHEALTH.COM X 2021 NE KEARNEY REGIONAL MEDICAL CENTER IS DEDICATED TO IMPROVING THE HEALTH OF OUR PATIENTS BY DELIVERING EXPERT MEDICAL CARE THAT IS PHYSICIAN GUIDED AND PEOPLE CENTERED. IN 2022, KRMC PROVIDED CHARITY CARE TO 857 INDIVIDUALS IN THE AMOUNT OF $7.1 MILLION. 12 10 935 10 0 0 5000 146777757 9256 456797 0 147248810 0 0 75766984 0 0 84281110 160048094 0 -12799284 176007177 366567769 6007177 209367053 170000000 157200716 KEARNEY REGIONAL MEDICAL CENTER IS DEDICATED TO IMPROVING THE HEALTH OF PATIENTS BY DELIVERING EXPERT MEDICAL CARE THAT IS PHYSICIAN GUIDED AND PEOPLE CENTERED. false false 153551911 146777757 KEARNEY REGIONAL MEDICAL CENTER (KRMC), IS A HOSPITAL ORGANIZATION LOCATED IN KEARNEY, NEBRASKA, AND IS PART OF THE BRYAN HEALTH SYSTEM. KRMC WAS INCORPORATED ON OCTOBER 26, 2021 WITH THE HOPSITAL OPERATIONS COMMENCING ON JANUARY 1, 2022. KRMC OPERATES A 93 - LICENSED BED HOSPITAL AND A MEDICAL CLINIC THAT PROVIDES ROUTINE CARE AND EXAMS, TO SPECIALIST CARE AND SURGERY. IN 2022, KEARNEY REGIONAL MEDICAL CENTER PROVIDED HEALTHCARE SERVICES TO THE GENERAL PUBLIC AND OPERATED ROUTINE SERVICE BEDS, Totaling 13,047 PATIENT DAYS, EMERENCY ROOM VISITS OF 9,334 AND 704 DELIVERIES. THE HOSPITAL PROVIDED CHARITY CARE TO 857 PATIENTS IN THE AMOUNT OF $7,084,419. 153551911 true true false true false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 29 0 true 935 true false false false false false false false false false false false false X 12 10 true false false false true true true true true false false false true true true true true true true true true NE X JON PEPPMULLER 3084553600 804 22nd Ave Kearney NE 68845 David Benavides Secretary (Effective 1/1/2022) 1.0 0 X X 0 0 0 Jeff Hinrichs Chair (Effective 1/1/2022) 1.0 0 X X 0 0 0 Joey Cochran Treasurer (Effective 1/1/2022) 1.0 0 X X 0 0 0 Scott Smith Vice Chair (Effective 1/1/2022) 1.0 0 X X 0 0 0 William Calhoun President/CEO Bryan Hospital Kearney 50.0 0 X X 531038 0 11306 ANNETTE MILLER MD Director (Effective 1/1/2022) 1.0 0 X 0 0 0 Brenda Benjamin Director (Effective 1/1/2022) 1.0 0 X 0 0 0 JOHN WOODRICH President/CEO Bryan Medical Center 2.0 62.0 X 0 1225502 39561 Kari Nickman Director (Effective 1/1/2022) 1.0 0 X 0 0 0 Merlin Wehling Director (Effective 1/1/2022) 1.0 0 X 0 0 0 Mike Morgan Director (Effective 1/1/2022) 1.0 0 X 0 0 0 Sean Denney Director (Effective 1/1/2022) 1.0 0 X 0 0 0 Adrienne Olson Registered Nurse 50.0 0 X 234547 0 7764 Anthony Blake Registered Nurse 50.0 0 X 181820 0 4417 Daniel Van Ranken Director of Clinical Services 50.0 0 X 189683 0 1897 Thomas McLeod Administrator of Clinic and Provider 50.0 0 X 213075 0 4730 Travis Gregg Controller 50.0 0 X 215496 0 4754 1565659 1225502 74429 70 false true false Regional Pathology Services 981180 Nebraska Medical Center Omaha NE 681981180 Pathology Services 1497061 Family Physical Therapy & Sports Center PA 804 22nd Ave Kearney NE 68845 Contracted Services 1122865 CHG Companies Inc 7259 S Bingham Junction Blvd Midvale UT 84047 Temporary Labor 938579 Rutts Heating and Air 1938 Yolande Ave Lincoln NE 68521 Construction Electrical Services 269003 Jackson Physician Search 2655 Northwinds Parkway Alpharetta GA 30009 Recruiting services 264569 12 5000 5000 NET PATIENT REVENUE 622110 145908584 145908584 OTHER OPERATING INCOME 622110 856845 856845 PURCHASE DISCOUNTS 622110 8603 8603 BIRTHING CLASSES 622110 3725 3725 0 0 0 0 146777757 6456 6456 42485 42485 0 42485 42485 2800 0 2800 2800 2800 CAFE REVENUE 722310 369860 369860 GIFT SHOP REVENUE 900099 44452 44452 0 0 0 0 414312 147248810 146777757 0 466053 X 537034 417812 119222 61341044 60218302 1122742 10474076 10243646 230430 3414830 3332874 81956 103191 103191 2151 2151 30170535 29935698 234837 0 175672 140538 35134 1011577 938743 72834 2159846 1727877 431969 2478611 1970010 508601 148010 115448 32562 183186 146549 36637 2903648 2903648 13488050 12449470 1038580 175390 140312 35078 Medical Supplies 21142811 19620529 1522282 Drugs 5821764 5821764 Repairs 1082251 865801 216450 Property Taxes 752086 601669 150417 2482331 1961221 521110 0 160048094 153551911 6496183 0 13037226 3545448 26212769 0 0 0 4754019 4797177 1168972 1440093 22941473 3723431 17032584 19218042 0 0 139512376 138393080 502000 172961160 176007177 366567769 6007177 32596895 0 0 176770158 6007177 209367053 X 170000000 157200716 170000000 157200716 176007177 366567769 -12799284 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 9922 9922 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Bryan Hospital Kearney IS A MEMBER OF THE NEBRASKA HOSPITAL ASSOCIATION (NHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE NHA and AHA IN THE AMOUNT OF $49,051 and $18,110; OF THIS AMOUNT THE NHA REPORTED THAT 10.79% OR $5,293 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES and of the amount AHA reported that 25.56% or $4,629 of the total dues paid were used for lobbying activities. 794500 794500 1513759 60046 1453713 7178454 168656 7009798 8797373 3494729 5302644 4657387 4657387 19218042 Right of Use Assets 172456760 Non Compete Agreement 502000 Other Long Term Assets 2400 172961160 Long Term Debt 171901291 Right of Use 4868867 176770158 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Bryan Hospital Kearney is exempt from federal income taxes under Section 501(c)(3) of the Code. Several of the organizations realized certain income which the Internal Revenue Service (IRS) considers to be unrelated business income subject to income tax. 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, 2022. 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, 2022 . Tax returns filed by the System and its subsidiaries are no longer subject to examination for the years ended December 31, 2018 and prior. true true X true X true X true true false true true 7084419 7084419 0.0443 9548962 6656012 2892950 0.0181 0 0.0 0 0 16633381 6656012 9977369 0.0623 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 0 0 16633381 6656012 9977369 0.0623 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 40397476 58529406 -18131930 X true true 1 1 Bryan Hospital Kearney dba Kearney Regional Medical Center 804 22nd Avenue Kearney NE 68845 https://www.bryanhealth.com/locations/hospitals/krmc/ H00141 X X X Bryan Hospital Kearney dba Kearney Regional Medical Center 1 true true true X X X X X X X X X 22 true true true true X https://www.bryanhealth.com/about-bryan-health/community-health-needs-assessment/ X true 22 true https://www.bryanhealth.com/about-bryan-health/community-health-needs-assessment/ false true X 200.0 400.0 X X X X X X true true X X X X true X See Statement X See Stmt X See Stmt X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 2 Bryan Hospital Kearney was formed on October 26, 2021 as a Nebraska not-for-profit corporation for the purpose of operating a hospital and related healthcare facilities in Kearney, Nebraska. Bryan Medical Center purchased Kearney Regional Medical Center on 1/1/2022 and renamed the hospital Bryan Hospital Kearney dba Kearney Regional Medical Center. Kearney Regional Medical Center was a for-profit hospital. Bryan Hospital Kearney received their determination letter from the Internal Revenue Service with an exemption date of October 28, 2021. Bryan Hospital Kearney started to treat patients on January 1, 2022. 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 - Bryan Hospital Kearney dba Kearney Regional Medical Center. Bryan Hospital Kearney dba Kearney Regional Medical Center (KRMC) has prepared the CHNA, fulfilling the requirements established by the Patient Protection and Affordable Care Act. Several aspects of this health assessment represent a collaborative effort between Kearney Regional Medical Center, Two Rivers Health Department and CHI Good Samaritan, gathering input representing the broad interests of the community. The community served includes the city of Kearney and Buffalo County, Nebraska. Buffalo County is one of seven counties served by Two Rivers Public Health Department. The three largest cities in Buffalo County are Kearney (2020 population 33,790), Gibbon (1,833) and Ravenna (1,441). Beginning in 2019, Two Rivers Public Health Department (TRPHD) embarked on a process to complete a robust community health assessment by asking community partners to participate in a Mobilizing for Action through Planning and Partnerships (MAPP) process in tandem with a community health needs assessment. The MAPP process utilized a six-phase framework to gain a holistic view of the entire community's health. KRMC was a participant in this six-step process. To fully understand the challenges and opportunities in the health district, TRPHD conducted a discussion referred to as SWOT analysis because it includes dialogue that is related to strengths, weaknesses, opportunities, and threats. According to Two Rivers Health Department's county health data report, Buffalo County is the "4th youngest county in Nebraska with a median age of 33.8 years. An estimated 23.5% of the population in Buffalo County is under 18 years, 61.7% are 18-64 years, and 14.8% are 65 years and older. " Buffalo County reports people one race alone being 89.8% White, 9.5% Hispanic, Black/African American 0.8%, American Indian/Alaska Native 0.3%, Asian 1.4% and some other race 4.2%. In Buffalo County 12.1% of people are in poverty and an estimated 10.5% of child under 18 are below the poverty level compared with 10.4% of people 65 years and over. An estimated 13.2% of people 18 to 64 are below the poverty level. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Bryan Hospital Kearney dba Kearney Regional Medical Center. The hospital facility that participated include CHI Good Samaritan. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Two Rivers Health Department. Two Rivers Health Department serves a seven county area including Buffalo County. Two Rivers Health Department facilitates collaboratives, partnerships, and unique approaches to educate, empower, and engage community partners, health providers, political decision makers, community leadership, and the public. Two Rivers Health Department promotes healthy lifestyles, provide preventative education, assure environmental quality, and create more health and safe communities for all who live within the district. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Bryan Hospital Kearney dba Kearney Regional Medical Center. The 2022 CHNA was the initial CHNA prepared for Bryan Hospital Kearney dba Kearney Regional Medical Center and that an Implementation Strategy Plan was developed for 2023-2025. The significant health needs that were selected based on input from Bryan Hospital Kearney's Physician Leadership Committee are 1.) Cardiovascular Disease, 2.) Access to Specialty Care, and 3.) Nursing Shortage. 1.) Cardiovascular Disease According to Two Rivers Health Department, Heart Disease is the leading cause of death in Buffalo County. Annually, 79/100,000 people in Buffalo County die from cardiovascular disease. Of the top ten chronic conditions treated at Bryan Hospital Kearney dba Kearney Regional Medical Center/Platte Valley Medical Clinic from January 1, 2017 to June 30, 2022, four were related to cardiovascular conditions: Hypertension 81,898 visits, Ischemic heart disease 40,035 visits, Heart failure 28,537 visits, Atrial fibrillation 15,343 visits. Bryan Hospital Kearney and Platte Valley Medical Clinic provide a full range of services for the prevention, diagnosis, and treatment of cardiac-related diseases. The following programs and services have been added, or are in the process of being added, to help address cardiovascular disease: Heart Failure Program, Outreach to Critical Access Hospitals, Stroke Program, Transcatheter Aortic Valve Replacement (TAVR) surgery, Cardic Rehab & Pritikin Program, and Watchman Procedure. 2.) Access to Care According to the TRHD 2020 Community Health Needs Assessment, Two Rivers Health Department identified at least five counties with a reported shortage of care professionals in the following areas: Family Practice, Psychiatry and Mental Health, General Internal Medicine, General Surgery, and Primary Care. Hospitals are a core service provider in any community. They are the source of patients for services such as pharmacy and outpatient therapies. When access to care is impacted by a lack of providers it has a ripple effect in the community. The Nebraska Rural Health Association wrote that "When a hospital closes, you see that the community struggles. Pharmacies close, grocery stores close, companies choose not to locate to a place where their employees won't have access to a hospital." Increasing access to care through recruitment of providers is meaningful to more than just patients but to every corner of the community, all the way down to healthy food access at the local grocery store. In 2021, an economic impact study was completed for KRMC to demonstrate the importance of having access to care in Kearney and the surrounding areas. The study further supports the findings of the Nebraska Rural Health Association, showing that access to care and increasing access to cares supports the entire community and their health both directly and indirectly. Bryan Hospital Kearney and Platte Valley Medical Clinic, the provider group that provides services at KRMC, are working on the following strategies to help address provider growth and expanded access to care: Recruitment/Retention of Primary Care Providers, Growth of Gemeral Surgery & Vascular Services, Master Facility Plan, Transportation Services, Virtual Visits, and Telemedicine. 3.) Nursing Shortages According to the Nebraska Center for Nursing, Nebraska will experience a workforce shortage of 5,435 nurses by 2025. In December of 2022 there were 36 open nursing positions at Bryan Hospital Kearney. Each of these roles is critical to providing high quality, safe patient care and insuring access to all who seek care. In 73 of Nebraska's 93 counties there is less than the national average ratio of patients to nurses. 66 Nebraska counties are considered medically underserved from a nursing perspective. The lack of nurses in Buffalo County impacts not only the physical and mental health of the community but also the economic health. This ties in with Bryan Hospital Kearney's priority for increasing access to care because hospitals are economic drivers in their communities. They allow cities to attract and retain talent and employ their non-healthcare family members. Nursing shortages impact patient outcomes in a variety of ways. Studies show that nursing shortages lead to lower patient satisfaction, decrease in the quality of care provided, increase in medical errors in new graduates who may not have senior staff to mentor them, and an increase in patient mortality. Bryan Hospital Kearney is working on the following strategies to help address nursing shortages: Nurse Residency Program, Workforce Incentive Programs, and Recruitment of LPNs. The significant health needs put forth in the CHNA along with their evaluated and adjusted objectives and goals will be the basis of Bryan Hospital Kearney implementation strategy reports, which will identify resources currently committed to the priority community health needs, as well as additional resources needed to secure improved outcomes at the hospital and in the community. In 2019, Two Rivers Health Department identified 3 goals to work on: Access to Care, Safe Environment, and Mental Health and Suicide Prevention. While these goals are a priority, the three priorities that are identified above align with the current Bryan Hospital Kearney's service lines and initiatives. 0 Schedule H, Part V, Section B, Line 16a FAP Available Website https://www.bryanhealth.com/locations/hospitals/girmc/for-patients/billing-insurance-financial-assistance/ Schedule H, Part V, Section B, Line 16b FAP Application Form Website https://www.bryanhealth.com/locations/hospitals/girmc/for-patients/billing-insurance-financial-assistance/ Schedule H, Part V, Section B, Line 16c Plain Language FAP Summary Website https://www.bryanhealth.com/locations/hospitals/girmc/for-patients/billing-insurance-financial-assistance/ 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 Bryan Hospital Kearney was formed on October 28, 2021 as Nebraska not-for-profit corporation for the purpose of operating a hospital and related health care facilities in Kearney, Nebraska. Services started January 1, 2022 under Bryan Hospital Kearney. THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO THE INFOMRATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE Medicare cost report WAS USED TO CALCULATE A COST TO CHARGE RATIO. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET NUMBER 1 TO CALCULATE THE COST OF FINANCIAL ASSISTANCE PROVIDED AND WORKSHEET NUMBER 3 WAS USED TO CALCULATE UNREMIBURSED MEDICAID AMOUNTS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, Bryan Hosptial Kearney HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE ON IRS FORM 990, PART IX. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS OF ACCOUNTS RECEIVABLE CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 9-11 OF THE BRYAN HEALTH CONSOLIDATED AUDIT REPORT. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE ENTIRE MEDICARE SHORTFALL AS REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT. Bryan Hospital Kearney PROVIDES CARE TO MEDICARE PATIENTS, AND MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE ENTIRE COST OF PROVIDING CARE TO THESE PATIENTS CAUSING A SHORTFALL, OR LOSS TO THE ORGANIZATION. THE FUNDS Bryan Hospital Kearney USES TO COVER THIS SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING THE GOVERNMENT OF THE FINANCIAL BURDEN OF PAYING THE FULL COSTS OF CARE FOR MEDICARE BENEFICIARIES. THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICAL CENTER'S MEDICARE COST REPORT IS THE STEP-DOWN METHOD OF COST ALLOCATION. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IT IS BRYAN'S POLICY TO OFFER PATIENTS A PAYMENT PLAN AND/OR FINANCIAL ASSISTANCE WHEN IT BECOMES KNOWN THAT A PATIENT IS IN NEED OF ASSISTANCE TO HELP PAY FOR THEIR HOSPITAL BILL. IF BRYAN IS AWARE THAT A PATIENT QUALIFIES FOR 100% FINANCIAL ASSISTANCE, THIS ACCOUNT WILL NEVER BE REFERRED TO A COLLECTION AGENCY. IF AN ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY, AND THE COLLECTION AGENCY OBTAINS DOCUMENTATION TO DETERMINE THAT THE PATIENT IS ELIGIBLE FOR CHARITY, THE ACCOUNT IS RETURNED TO BRYAN FOR A CHARITY ADJUSTMENT AND NO FURTHER COLLECTION EFFORT IS MADE. Schedule H, Part V, Section B, Line 16a FAP website - Bryan Hospital Kearney dba Kearney Regional Medical Center: Line 16a URL: See Statement; Schedule H, Part V, Section B, Line 16b FAP Application website - Bryan Hospital Kearney dba Kearney Regional Medical Center: Line 16b URL: See Stmt; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Bryan Hospital Kearney dba Kearney Regional Medical Center: Line 16c URL: See Stmt; Schedule H, Part VI, Line 2 Needs assessment Bryan Hospital Kearney dba Kearney Regional Medical Center (KRMC) IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY CONTINUALLY WORKING WITH COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. KRMC survey inpatient, ambulatory surgery, and emergency department patient populations, asking key demographic questions that allow Bryan Hospital Kearney to access the health care needs of specific at risk populations. KRMC partners with the Two Rivers Health Department to develop and implement action plans that target the health care needs of the community. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance IN KEEPING WITH Bryan Hospital Kearney's MISSION TO TREAT ALL PATIENTS WITH COMPASSION, Bryan Hospital Kearney OFFERS A FINANCIAL ASSISTANCE PROGRAM TO PATIENTS WHO CANNOT AFFORD TO PAY FOR PART OR ALL OF THE CARE THEY RECEIVE. EDUCATION REGARDING OUR FINANCIAL ASSISTANCE PROGRAM IS PROVIDED AT EACH NEW EMPLOYEE ORIENTATION and then annually SO THAT EACH EMPLOYEE WILL HAVE A CLEAR UNDERSTANDING OF THE FINANCIAL ASSISTANCE THAT IS AVAILABLE TO OUR PATIENTS. Bryan Hospital Kearney HAS TRAINED FINANCIAL COUNSELORS WHO WORK INDIVIDUALLY WITH PATIENTS PRE-REGISTRATION AND POST-DISCHARGE; OR AT ANY OTHER TIME THE STAFF ENCOUNTERS INFORMATION DETAILING THE PATIENTS FINANCIAL NEED. UNINSURED PATIENTS WHO ARE ADMITTED TO Bryan Hospital Kearney WILL AUTOMATICALLY RECEIVE A CONSULTATION WITH A FINANCIAL COUNSELOR. THE COUNSELORS RECOMMEND APPROPRIATE ASSISTANCE SUCH AS FEDERAL, STATE OR LOCAL PROGRAMS, OR ELIGIBILITY FOR ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. WHEN APPLICABLE, THE FINANCIAL COUNSELORS PROVIDE ASSISTANCE FOR QUALIFYING FOR THE FINANCIAL ASSISTANCE POLICY OR VARIOUS GOVERNMENT PROGRAMS, SUCH AS MEDICAID. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY; INCLUDING THE PHONE NUMBER TO CONTACT A BILLING CUSTOMER SERVICE REPRESENTATIVE, IS PROVIDED: 1) ON Bryan Hospital Kearney's WEBSITE, 2) IN ALL HOSPITAL REGISTRATION AREAS, INCLUDING THE EMERGENCY DEPARTMENT, 3) IN BILLING OFFICES, 4) IN ALL INPATIENT ADMISSION PACKETS; AND 5) ON EACH BILLING STATEMENT. THE ORGANIZATION'S PROCEDURE IS TO MAIL THE FINANCIAL ASSISTANCE POLICY AND APPLICATION FORM TO PATIENTS FREE OF CHARGE UPON REQUEST. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY POINT FROM PRE-ADMISSION TO THE FINAL PAYMENT OF THE BILL, AS WE RECOGNIZE THAT A PATIENTS ABILITY TO PAY OVER AN EXTENDED PERIOD OF TIME MAY BE SUBSTANTIALLY ALTERED DUE TO ILLNESS OR FINANCIAL HARDSHIP, RESULTING IN A NEED FOR FINANCIAL ASSISTANCE. ANNUALLY, ALL HOSPITAL EMPLOYEES ARE REQUIRED TO RECEIVE TRAINING REGARDING THE FINANCIAL ASSISTANCE POLICY INCLUDING HOW TO ANSWER QUESTIONS FROM A PATIENT REGARDING WHERE THE PATIENT CAN RECEIVE ADDITIONAL INFORMATION REGARDING THE POLICY. Schedule H, Part VI, Line 4 Community information Bryan Hospital Kearney dba as Kearney Regional Medical Center is located in Buffalo County, Nebraska, within which is located the city Kearney. Buffalo County (2020 population 50,084) includes the city of Kearney (2020 population 33,790). CHI Good Samaritan Hospital is also located in Kearney. Of Nebraska's 93 counties, Buffalo County is the 5th most populous one in the state. The counties with higher populations are Douglas, Lancaster, Sarpy, and Hall. The three largest cities in Buffalo County are Kearney (2020 population 33,790), Gibbon (1,833) and Ravenna (1,441). Buffalo County has experience steady and consistent growth from 1960 to 2020 (26,236 and 50,084, respectively). From 2010 to 2020, Buffalo County's population grew from 46,102 to 50,084, an increase of 8.6%. The population estimates show Buffalo County continued to increase to 50,339 in 2021. According to TRHD county health data report, Buffalo County is the "4th youngest county in Nebraska with a median age of 33.8 years. Buffalo County is also home to the 3rd highest number of assisted living/long term care facilities in Nebraska, after Dougals and Lancaster counties." In years 2017-2021 23.5% of the population in Buffalo County was under 18 years, 61.7% were 18-64 years, and 14.8% were 65 years and older. According to TRHD "between 2000 and 2010, the population increased 2.3 % in the TRHD district, with some age groups experiencing a population decrease (5-14, 15-24, and 25-44). Between 2010 and 2018 TRHD district experienced a population increase of 2.6%, with significant growth in the 65 years of age and older population. The net growth among 65 years of age and older is estimated at 2,603 individuals between 2010 and 2018." This trend is expected to continue over the coming years as aging individuals in the community increase and younger working age individuals decrease. According to the U.S. Census Bureau's 2017-2021 5 year narrative profile for Buffalo County "people reporting 1 race alone, 89.8% were White, .8% were Black or African American, .3% were American Indian and Alaska Native, 1.4% were Asian, and 4.2% were some other race. An estimated 3.4% reported two or more races. An estimated 9.5% of the people in Buffalo County, NE were Hispanic or Latino. An estimated 85.7% of the people in Buffalo County, NE were White alone, non-Hispanic. People of Hispanic origin may be of any race. The total Hispanic population in the TRHD area increased 1.6 times since 2000, growing from 8,607 individuals to 13,844 by 2018. From the 2017-2021 narrative profile, Buffalo County had "12.1% of people were in poverty. An estimated 10.5% of children under 18 were below the poverty level, compared with 10.4% of people 65 years old and over. An estimated 13.2% of people 18 to 64 years were below the poverty level. In 2017-2021, 7.5% of households received SNAP (Supplemental Nutrition Assistance Program). An estimated 56.1% of households that received SNAP had children under 18, and 25.1% of households that received SNAP had one or more people 60 years and over. An estimated 33.8% of all households receiving SNAP were families with a female householder and no spouse present. An estimated 27.2% of households receiving SNAP had 2 or more workers in the past 12 months. Kearney/Buffalo County has a stable and diverse economy featuring a variety of industries including manufacturing, education hospitality, and healthcare. Kearney has one of the lowest unemployment rates in the nation. According to Nebraska Department of Labor, Kearney's unemployment rate in 2021 was 1.1%. The median household income in Buffalo County in 2020 was $63,513, slightly below the State of Nebraska's average of $66,644. In 2017-2021, the percent of person 25 years and older in TRHD area who had obtained a high school degree or equivalency was slightly higher at 92.3% than that of Nebraska at 91.7%. Also, a 34.5% of persons 25 years and older had obtained a Bachelor's degree or higher in Buffalo County, compared to 32.9% in Nebraska. The three colleges/universities in the city of Kearney are: University of Nebraska-Kearney, University of Nebraska-Medical Center's Kearney Campus, and Central Community College - Kearney. The city of Ravenna in Buffalo County, Nebraska is identified by Health Resources & Services as a medically underserved area and medically underserved population designation. The index of medical underservice score for the city of Ravenna is 47.3. The date of the designation is 5/31/1994. Schedule H, Part VI, Line 5 Promotion of community health Bryan Hospital Kearney dba Kearney Regional Medical Center PROVIDES HIGH QUALITY, COMPREHENSIVE MEDICAL SERVICES TO BENEFIT THE COMMUNITY, AND IS COMMITTED TO IDENTIFYING AND ADDRESSING NEEDS IN THE COMMUNITY IN ORDER TO PROMOTE THE PHYSICAL, EDUCATIONAL AND ECONOMIC HEALTH OF OUR COMMUNITY IN THE FUTURE. THE MEDICAL STAFF OF THE ORGANIZATION IS OPEN TO ALL PHYSICIANS IN THE COMMUNITY WHO MEET MEMBERSHIP AND CLINICAL PRIVILEGES REQUIREMENTS. AS A NON-PROFIT hospital, SURPLUS FUNDS ARE CONTINUOUSLY UTILIZED TO MAINTAIN ACCESS TO LIMITED PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY. In 2022, KRMC board consisted of 12 board members, 11 of who reside within a 25 mile radius of the facility. The majority of the board members are independent board members who are neither employees nor independent contractors of the organization. At this point, the hospital has not accumulated surplus funds to provide improvements in patient, medical education and research. Schedule H, Part VI, Line 6 Affiliated health care system Bryan Hospital Kearney dba Kearney Regional Medical Center IS PART OF BRYAN HEALTH, ONE OF THE LARGEST NON-PROFIT HEALTH CARE ORGANIZATIONS IN THE REGION. BRYAN HEALTH EXISTS TO: PROMOTE AND PROVIDE ACCESS TO QUALITY HEALTH CARE; PROVIDE MEDICAL EDUCATION, AND COMMUNITY SERVICE. THE COMMUNITY BENEFITS PROVIDED BY BRYAN HEALTH INCLUDE: 1) PROVIDING FREE OR DISCOUNTED HEALTH CARE TO THE UNINSURED AND UNDERINSURED, 2) PROVIDING GOVERNMENTAL SPONSORED PROGRAMS SUCH AS MEDICARE AND MEDICAID; 3) HEALTH PROFESSIONALS' EDUCATION 4) COMMUNITY HEALTH IMPROVEMENT SERVICES AND 5) CASH AND IN-KIND CONTRIBUTIONS TO OTHER NON-PROFIT ORGANIZATIONS. BRYAN HEALTH PROVIDES A FULL SPECTRUM OF PREVENTION, WELLNESS, ACUTE CARE AND REHABILITATION SERVICES TO URBAN, SUBURBAN AND RURAL COMMUNITIES IN NEBRASKA, KANSAS, IOWA, AND MISSOURI. BRYAN HEALTH CONSISTS OF Four ACUTE-CARE HOSPITALS, NUMEROUS OUTPATIENT CLINICS, A PHYSICIAN NETWORK, A COLLEGE, AN URGENT CARE CENTER, A HEALTH AND WELLNESS FACILITY, A PHILANTHROPIC FOUNDATION, A PHYSICIAN HOSPITAL ORGANIZATION, AN 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 false true false false false false false true false William Calhoun President/CEO Bryan Hospital Kearney 437699 0 90000 0 3339 0 5310 0 5996 0 542344 0 0 0 JOHN WOODRICH President/CEO Bryan Medical Center 0 650966 0 227633 0 346903 0 19209 0 20352 0 1265063 0 0 Adrienne Olson Registered Nurse 185936 0 46177 0 2434 0 2345 0 5419 0 242311 0 0 0 Travis Gregg Controller 192302 0 20760 0 2434 0 2155 0 2599 0 220250 0 0 0 Thomas McLeod Administrator of Clinic and Provider 190848 0 19843 0 2384 0 2131 0 2599 0 217805 0 0 0 Daniel Van Ranken Director of Clinical Services 188480 0 0 0 1203 0 1897 0 0 0 191580 0 0 0 Anthony Blake Registered Nurse 173536 0 7800 0 484 0 1818 0 2599 0 186237 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF one of THE LARGEST PRIVATE EMPLOYERs IN LINCOLN/LANCASTER COUNTY, BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN HEALTH'S COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED IS REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON May 6, 2022. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan IN ORDER TO ATTRACT AND RETAIN TALENTED, EXPERIENCED EXECUTIVES, BRYAN HEALTH OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO ELIGIBLE EMPLOYEES. THE FOLLOWING PEOPLE LISTED IN FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING 2022: JOHN WOODRICH $248,092. Schedule J, Part I, Line 7 Non-fixed payments BRYAN HEALTH OFFERS A MARKET COMPETITIVE INCENTIVE COMPENSATION PROGRAM FOR MEMBERS OF MANAGEMENT. INCENTIVE COMPENSATION IS BASED ON ACHIEVING OBJECTIVE ORGANIZATIONAL AND INDIVIDUAL GOALS. THE WEIGHTS ASSIGNED TO EACH GOAL MAY CHANGE ON AN ANNUAL BASIS. The goals are set and reviewed for level of accomplishment by the Compensation Committee of the Board of Trustees. Schedule J, Part II COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARD OF TRUSTEES IS COMPENSATED FOR THEIR SERVICE AS A BOARD MEMBER. COMPENSATION AMOUNTS REPORTED ARE FOR SERVICES PROVIDED AS MEDICAL PROFESSIONALS OR EXECUTIVES OF THE ORGANIZATION, OR A RELATED ORGANIZATION. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee shall consist of the Chairperson, Vice-Chairperson, Secretary and Treasurer of the Board, the Chief of Staff, the President/Chief Executive Officer of The System and the President/Chief Operating Officer of the Corporation. The Executive Committee shall have and may exercise all of the authority and powers of the Board when the Board is not in session, except that the Executive Committee shall not have the power to: (a) elect, appoint or remove any member of the Executive Committee or any trustee or officers of the Corporation; (b) amend, alter or repeal any resolution of the Board which by its terms provides that it shall not be amended, altered or repealed by the Executive Committee. The designation and appointment of an Executive Committee and the delegation thereto of authority shall not operate to relieve the Board, or any individual trustee, of any 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 CORPORATE MEMBER OF THE ORGANIZATION IS BRYAN HEALTH. BRYAN HEALTH HAS THE RIGHTS UNDER THE ORGANIZING DOCUMENTS TO: (1) APPROVE SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY; (2) ELECT THE MEMBERS OF THE GOVERNING BODY; AND (3) RECEIVE ANY REMAINING ASSETS AFTER DISSOLUTION OF THE ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body BRYAN HEALTH AS SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE RIGHT UNDER THE ORGANIZING DOCUMENTS TO REMOVE ANY TRUSTEE FROM OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE BY A VOTE OF AT LEAST TWO-THIRDS (2/3) OF ALL THE VOTING TRUSTEES OF BRYAN HEALTH. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders BRYAN HEALTH IS THE SOLE MEMBER OF BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER ("KRMC"). PURSUANT TO THE GOVERNING DOCUMENTS, THE BOARD OF THE KRMC MAY MANAGE THE AFFAIRS OF THE CORPORATION; HOWEVER, THE BOARD MAY NOT, WITHOUT THE PRIOR APPROVAL OF THE HEALTH SYSTEM: (a) ADOPT ANY LONG-TERM CAPITAL OR OPERATIONAL BUDGET; (b) ADOPT ANY CHANGES IN ANY ANNUAL OR LONG-TERM CAPITAL BUDGET OR OPERATIONAL EXPENSE BUDGET EXCEEDING $5,000,000 IN ANY SINGLE TRANSACTION OR $10,000,000 IN ANY CORPORATION FISCAL YEAR; (c) Adopt substantive changes to existing long-term or master institutional plans of the corporation; (d) Amend the Articles of Incorporation or Bylaws of the corporation; (e) ENGAGE IN OR ENTER INTO ANY TRANSACTION OR TRANSACTIONS PROVIDING FOR THE TRANSFER, SALE OR OTHER DISPOSITION OF CAPITAL ASSETS IN ANY SINGLE TRANSACTION OF $5,000,000 OR A TOTAL OF $10,000,000 IN ANY CORPORATION FISCAL YEAR; (f) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF ANY INTEREST IN, AS ALLOWED BY THE CODE, OF ANY CORPORATION, ASSOCIATION, LIMITED LIABILITY COMPANY, PARTNERSHIP; TRUST, SHARED SERVICE ARRANGEMENT; JOINT VENTURE OR OTHER ENTITY, DIRECTLY OR INDIRECTLY, WHERE THE CAPITAL EXPENDITURES OR OPERATING EXPENSES BY THE CORPORATION IN CONNECTION WITH SUCH ORGANIZATION OR ACQUISITION IN ANY SINGLE TRANSACTION EXCEEDS $5,000,000 OR A TOTAL OF $10,000,000 IN ANY CORPORATION FISCAL YEAR; (g) INCUR ANY INDEBTEDNESS OR INCUR A MORTGAGE OR LIEN OF ANY KIND OR NATURE ON ASSETS OF THE CORPORATION WHERE THE BORROWING OR INDEBTEDNESS EXCEEDS $5,000,000 IN ANY SINGLE TRANSACTION OR A TOTAL OF $10,000,000 IN ANY CORPORATION FISCAL YEAR; (h) Elect or appoint trustees of the corporation; (i) APPOINT or terminate the PRESIDENT/CHIEF EXECUTIVE OFFICER of the corporation; (j) Purchase insurance coverage for the corporation and its operations; (k) Select the auditor to perform the annual audit of the books and records of the corporations; or (l) TAKE ANY OTHER ACTIONS WHICH MAY BE INCONSISTENT WITH THE SYSTEM'S tax-exempt purpose or its GOALS AND OBJECTIVES related to improving the health of the communities it serves by providing evidence-based medical care backed by the highest medical ethics and displaying prudent stewardship of resources. Form 990, Part VI, Line 11b Review of form 990 by governing body THIS 990 WAS PREPARED BY BRYAN HEALTH'S TAX DIVISION. DURING THE RETURN PREPARATION PROCESS, THE TAX DIVISION WORKS DILIGENTLY WITH OTHER DEPARTMENTS INCLUDING HUMAN RESOURCES, FINANCE, LEGAL, AND ADVANCEMENT TO GATHER INFORMATION TO COMPLETE FORM 990 AND ATTACHED SCHEDULES IN AN ACCURATE AND THOROUGH MANNER. THIS 990 WAS REVIEWED BY THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND OTHER KEY OFFICERS OF BRYAN HEALTH. THIS 990 WAS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. BRYAN HEALTH'S BOARD OF TRUSTEES HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE BOARD'S AUDIT COMMITTEE. EACH MEMBER OF THE AUDIT COMMITTEE RECEIVED A COMPLETE COPY OF THIS 990, PRIOR TO FILING THE FORM WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Line 12c Conflict of interest policy KEARNEY REGIONAL MEDICAL CENTER HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY THAT IS MONITORED AND ENFORCED BY THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES OF BRYAN HEALTH. BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE QUESTIONNAIRE TO IDENTIFY ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS, OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT. THE QUESTIONNAIRE REQUIRES EACH COVERED PERSON TO SIGN A STATEMENT CERTIFYING THAT HE/SHE: (1) HAS REPORTED INFORMATION THAT IS CORRECT AND COMPLETE TO THE BEST OF THEIR KNOWLEDGE; (2) HAS READ THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE POLICY, AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY. COVERED PERSONS ARE ALSO REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME SUCH CONFLICTS ARISE. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. FAILURE TO COMPLETE THE QUESTIONNAIRE CAN RESULT IN DISCIPLINARY ACTIONS. THE QUESTIONNAIRES ARE REVIEWED IN DETAIL BY THE GOVERNANCE COMMITTEE OF BRYAN HEALTH. CONFLICTS ARE CLOSELY MONITORED BY MEMBERS OF THE GOVERNANCE COMMITTEE. THE CONFLICT OF INTEREST POLICY HAS RESTRICTIONS FOR ANY BOARD MEMBER WITH A CONFLICT OF INTEREST. Form 990, Part VI, Line 15a Process to establish compensation of top management official BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF one of THE LARGEST PRIVATE EMPLOYERs IN LINCOLN/LANCASTER COUNTY, BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN HEALTH'S COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED IS REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON May 6, 2022. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. Form 990, Part VI, Line 15b Process to establish compensation of other employees SEE FORM 990, PART VI, SECTION B, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S ARTICLES OF INCORPORATION AND AMENDMENTS ARE AVAILABLE TO THE PUBLIC ON THE NEBRASKA SECRETARY OF STATE'S WEBSITE AT WWW.SOS.NE.GOV. ALSO, THIS ORGANIZATION IS INCLUDED WITHIN THE CONSOLIDATED FINANCIAL STATEMENTS OF BRYAN HEALTH THAT ARE MADE AVAILABLE TO THE PUBLIC BY THE POSTING OF THESE DOCUMENTS THROUGH THE MUNICIPAL SECURITIES RULEMAKING BOARD WEBSITE AT EMMA.MSRB.ORG. THE ORGANIZATION'S OTHER GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. FEDERAL TAX LAWS DO NOT REQUIRE THAT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. Form 990, Part IX, Line 11g Other Fees Service Contracts - Total Expense: 1882322, Program Service Expense: 1863499, Management and General Expenses: 18823, Fundraising Expenses: ; Recruiting - Total Expense: 160690, Program Service Expense: 159083, Management and General Expenses: 1607, Fundraising Expenses: ; Professional Fees - Total Expense: 3937834, Program Service Expense: 3797957, Management and General Expenses: 139877, Fundraising Expenses: ; Contract Labor - Total Expense: 7453030, Program Service Expense: 7378500, Management and General Expenses: 74530, Fundraising Expenses: ; Physician Services - Total Expense: 16736659, Program Service Expense: 16736659, Management and General Expenses: , Fundraising Expenses: ; Bryan Health 1600 South 48th Street Lincoln NE 68506 363414823 Healthcare NE 501(c)(3) Type III-FI Bryan Health false Crete Area Medical Center 2910 Betten Drive Crete NE 68333 470841285 HealthCare NE 501(c)(3) 3 Bryan Health false Bryan Foundation 1600 South 48th Street Lincoln NE 68506 237005720 Fundraising NE 501(c)(3) 7 Bryan Health false Bryan Physician Network 1600 South 48th Street Lincoln NE 68506 201357375 HealthCare NE 501(c)(3) 10 Bryan Health false Merrick Medical Center 2802 28th St Central City NE 68826 820906268 HealthCare NE 501(c)(3) 3 Bryan Health false Merrick Medical Center Foundation 1715 26th St Central City NE 688269501 470710738 Fundraising NE 501(c)(3) 7 Merrick Medical Center false Bryan Medical Center 1600 South 48th Street Lincoln NE 685061299 470376552 Healthcare NE 501(c)(3) 3 Bryan Health false Grand Island Regional Medical Center 3533 Prairieview St Grand Island NE 68803 352621082 Healthcare NE 501(c)(3) 3 Bryan Health false Bryan Enterprises 1600 South 48th Street Lincoln NE 68506 470701037 Medical Services NE Bryan Health C Corporation 0 false Integrated Cardiology Group LLC 1600 South 48th Street Lincoln NE 68506 470844961 Cardiology NE Bryan Health C Corporation 0 false Bryan Health Connect 1600 South 48th Street Lincoln NE 68506 364771145 Physician Hospital Organization NE Bryan Health C Corporation 0 false false false true false false false false false false false false true false true true true true true false