2024-11-15T10:59:03+00:00 2023-12-31 440160260 Forvis Mazars LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2023-01-01 470841285 Crete Area Medical Center CRET 4024811111 2910 Betten Drive Crete NE 683330220 JULIE LACY INTERIM PRESIDENT/CEO 4024811111 2024-11-15 true true Michael Engle P00482834 8162216300 2024-11-15 2023 2024-10-15 13:58:12Z JULIE LACY 2910 Betten Drive Crete NE 683330220 35938545 false X WWW.BRYANHEALTH.ORG/CAMC X 2001 NE CRETE AREA MEDICAL CENTER IS COMMITTED TO ADVANCING THE HEALTH OF THE COMMUNITIES AND REGION WE SERVE. DURING 2023, CRETE AREA MEDICAL CENTER HAS PROVIDED CHARITY CARE TO 859 PATIENTS AT A COST OF $850,894. 8 4 211 59 0 0 476031 440074 32195341 33877826 96686 714982 678468 897432 33446526 35930314 0 0 0 17137211 18447105 0 0 12996793 12799780 30134004 31246885 3312522 4683429 50272708 54729424 5479255 5253539 44793453 49475885 CRETE AREA MEDICAL CENTER'S (CAMC) MISSION IS TO ADVANCE THE HEALTH OF THE COMMUNITIES AND REGION WE SERVE, THROUGH COLLABORATION, PREVENTION, INNOVATION, AND EXCEPTIONAL CARE. CAMC'S VISION IS TO ELEVATE QUALITY OF LIFE THROUGH BETTER HEALTH. CAMC IS COMMITTED TO THE FOLLOWING FUNDAMENTAL BELIEFS: INTEGITY - OUR FOUNDATION; SERVICE - OUR STANDARD; EXCELLENCE - OUR DISTINCTION; COLLABORATION - OUR INVESTMENT; AND LEADERSHIP - OUR FUTURE. false false 29205850 33877826 CRETE AREA MEDICAL CENTER ("CAMC") IS A PART OF BRYAN HEALTH. CAMC, LOCATED IN CRETE, NEBRASKA, IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS RECEIVED DETERMINATION THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE IN ORDER TO PROVIDE HEALTH CARE SERVICES. CAMC WAS INCORPORATED IN APRIL 2001 AND OPERATES A 15-LICESED BED CRITICAL ACCESS HOSPITAL AND THREE PHYSICIAN CLINICS SERVING PATIENTS AND RESIDENTS PRINCIPALLY FROM SALINE AND LANCASTER COUNTIES. DURING THE YEAR ENDING DECEMBER 31, 2023, CAMC PROVIDED INPATIENT ACUTE, SWING BED AND NURSERY SERVICES TO 221 PATIENTS. CAMC PERFORMED 813 SURGICAL PROCEDURES AND PROVIDED PRIMARY CARE PHYSICIAN SERVICES WITH 27,442 VISITS. IN 2023, CAMC ALSO PROVIDED CHARITY CARE TO 859 PATIENTS AND SERVICED 1,947 MEDICAID PATIENTS. 29205850 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false true false false false false false false true true false false false true 44 0 true 211 true false false false false false false false false false false false false X 8 4 true false false false true true true true true false false false true true true true true true true false NE X JULIE LACY 4028267948 2910 BETTEN DRIVE CRETE NE 68333 DAVID REESE CHAIR 1.0 50.0 X X 0 435927 61926 LINDA STONES VICE CHAIR 1.0 0 X X 0 0 0 LUPE AVELAR SECRETARY 1.0 0 X X 0 0 0 MARIA ISQUIERDO TREASURER 1.0 50.0 X X 0 556589 42388 STEPHANIE BOLDT PRESIDENT/CEO CRETE AREA MEDICAL CENTER 50.0 0 X X 329619 0 42371 ERIC POST DVM DIRECTOR 1.0 0 X 0 0 0 JASON HESSER MD PHYSICIAN/EX-OFFICIO MEMBER 50.0 0 X 449875 0 16805 JUSTIN KOZISEK DIRECTOR 1.0 0 X 0 0 0 JULIE LACY CFO - CRETE AREA MEDICAL CENTER 50.0 1.0 X 162202 0 23351 AMY VERTIN MD PHYSICIAN 50.0 0 X 312870 0 46694 KATE HESSER MD PHYSICIAN 50.0 0 X 385905 0 44250 MITCHELL EBKE MD PHYSICIAN 50.0 0 X 335864 0 51310 RUSSELL EBKE MD PHYSICIAN 50.0 0 X 359376 0 49632 RYAN BUSE MD PHYSICIAN 50.0 0 X 381276 0 49248 2716987 992516 427975 35 false true false LANGUAGE LINE SOLUTIONS ONE LOWER RAGSDALE DR BLDG TWO MONTEREY CA 93940 LANGUAGE TRANSLATION 136504 EIDE BAILLY LLP 18081 BURT ST STE 200 ELKHORN NE 68022 CONSULTING SERVICES 120373 2 153935 263011 23128 440074 NET PATIENT CARE REVENUE 622110 30254796 30254796 PHARMACY 446110 3436458 3436458 CONTRACTED ER PROVIDER SERVICES 621990 185328 185328 HEALTH INFORMATION SERVICES 621300 1244 1244 0 0 0 0 33877826 714982 714982 28421 8231 20190 0 20190 20190 0 0 CAFETERIA SALES 722310 76777 76777 PURCHASE DISCOUNTS 900099 29728 29728 770737 0 0 770737 877242 35930314 33877826 0 1612414 1024223 371990 652233 13535254 13304232 231022 702349 692114 10235 2207626 2019431 188195 977653 915083 62570 1997 1997 98811 98811 2195262 2045984 149278 0 56800 53165 3635 1620731 1494314 126417 3807 3807 348126 320972 27154 28630 26397 2233 88374 78373 10001 2385276 2099260 286016 154540 142486 12054 DRUGS 2553472 2553472 CORPORATE COST ALLOCATIONS 1873407 1727281 146126 MEDICAL SUPPLIES 799717 799717 590830 557772 33058 0 31246885 29205850 2041035 0 10294057 12207723 3798688 4582865 0 0 174988 141193 169793 217179 43871098 29374902 16214448 14496196 14937894 20437972 0 0 4682840 2646296 50272708 54729424 3865920 3937079 0 0 1613335 1316460 5479255 5253539 X 44793453 49475885 44793453 49475885 50272708 54729424 4683429 -997 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true false true 2483 2483 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY 1) G) ON VARIOUS OCCASIONS THROUGHOUT THE YEAR, THE CEO MET WITH SOME STATE AND LOCAL LEGISLATORS TO DISCUSS ISSUES RELATED TO HEALTHCARE. WHILE SOME RELATED TO HEALTHCARE REFORM, OTHER ISSUES DISCUSSED INCLUDED MEETING THE NEEDS OF INDIGENT/UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS THE ONGOING NEED FOR HEALTH SERVICES FOR THE COMMUNITY. 1) I) CRETE AREA MEDICAL CENTER PAID ANNUAL DUES TO THE NEBRASKA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THESE DUES WERE DETERMINED TO BE USED FOR LOBBYING ACTIVITIES. THE RELATED AMOUNT HAS BEEN REPORTED IN PART II-B, LINE 1I. 61247 61247 22486382 11777675 10708707 10347 10347 0 18930999 15942028 2988971 608873 1773250 1644852 737271 14496196 RIGHT OF USE LIABILITY 1316460 1316460 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote CRETE AREA MEDICAL CENTER IS A NOT-FOR-PROFIT AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(A) OF THE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THEY ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE CRETE AREA MEDICAL CENTER TO MEET A COMMUNITY BENEFIT STANDARD AND COMPY WITH VARIOUS LAWS AND REGULATIONS. CRETE AREA MEDICAL CENTER ACCOUNTS FOR UNCERTAINITIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUDIANCE INCLUDED IN FASB ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. CRETE AREA MEDICAL CENTER RECOGNIZIES THE EFFECT OF INCOME TAX PROVISIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2023, AND 2022, CRETE AREA MEDICAL CENTER HAD NO UNCERTAIN TAX POSITIONS ACCRUED. true true X true X true X true true true false true true 850894 850894 0.0272 3994944 3355545 639399 0.0205 0 0.0 0 0 4845838 3355545 1490293 0.0477 333088 333088 0.0107 0 0.0 63516 63516 0.0020 0 0.0 4334 4334 0.0001 0 0 400938 0 400938 0.0128 0 0 5246776 3355545 1891231 0.0605 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 6653713 6645729 7984 X true true 1 1 CRETE AREA MEDICAL CENTER 2910 BETTEN DRIVE CRETE NE 68333 WWW.BRYANHEALTH.ORG 670001NE X X X CRETE AREA MEDICAL CENTER 1 false false true X X X X X X X X X 21 true true true true X https://www.bryanhealth.com/about-bryan-health/community-health-needs-assessment/ Needs Assessment | X true 22 true https://www.bryanhealth.com/about-bryan-health/community-health-needs-assessment/ Needs Assessment | false true X 200.0 400.0 X X X X X X true true X X X X true X www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/ X www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/ X www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE IDENTIFIED AND PRIORITIZED THROUGH THE CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - CRETE AREA MEDICAL CENTER. THROUGHOUT 2021 , REPRESENTATIVES FROM CAMC PARTICIPATED IN THE PUBLIC HEALTH SOLUTIONS' (PHS) REGIONAL STEERING COMMITTEE FOR THE PARTNERS FOR A HEALTHY COMMUNITY. PHS IS A DISTRICT HEALTH DEPARTMENT RESPONSIBLE FOR PROMOTING AND PROTECTING THE HEALTH OF THE RESIDENTS OF GAGE, JEFFERSON, FILLMORE, THAYER AND SALINE COUNTIES IN NEBRASKA. THIS COMMITTEE'S PURPOSE WAS TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT AND DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN FOR LOW INCOME HOUSEHOLDS AND MINORITY POPULATIONS IN THE FIVE COUNTIES THEY SERVE, WHICH INCLUDES SALINE COUNTY. THE THREE LARGEST COMMUNITIES IN SALINE COUNTY ARE CRETE, WILBER AND FRIEND. THE COMMITTEE USED A SEVEN STEP PROCESS UTILIZING COMMITTEE FEEDBACK, EXTERNAL DATA SOURCES, AS WELL AS A PUBLIC SURVEY. IN ORDER TO ZERO IN ON THE NEEDS OF SALINE COUNTY, CAMC HOSTED COMMUNITY ROUNDING SESSIONS IN CRETE, WILBER, AND FRIEND. THE ROUNDING SESSIONS WERE HELD WITH VARIOUS STAKEHOLDERS IN SALINE COUNTY. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - CRETE AREA MEDICAL CENTER. HOSPITAL FACILITIES THAT PARTICIPATED INCLUDE CRETE AREA MEDICAL CENTER AND BRYAN MEDICAL CENTER. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - PUBLIC HEALTH SOLUTIONS. PUBLIC HEALTH SOLUTIONS (PHS) IS A DISTRICT HEALTH DEPARTMENT RESPONSIBLE FOR PROMOTING AND PROTECTING THE HEALTH OF THE RESIDENTS OF GAGE, JEFFERSON, FILLMORE, THAYER AND SALINE COUNTIES IN NEBRASKA. PHS WORKS TO IDENTIFY HEALTH THREATS AND ACTIONS NEEDED TO PROMOTE WELLNESS. PHS WORKS WITH OTHER COMMUNITY AGENCIES, ORGANIZATIONS, HEALTHCARE PROVIDERS AND CITIZENS TO DETERMINE PRIORITIES AND STRATEGIES FOR ADDRESSING HEALTH PROBLEMS. PHS ASSURES THAT PRIORITIES AND STRATEGIES ARE IMPLEMENTED WITHIN THE COMMUNITY. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - CRETE AREA MEDICAL CENTER. IN 2021, CAMC PARTICIPATED IN THE PUBLIC HEALTH SOLUTIONS REGIONAL STEERING COMMITTEE FOR THE PARTNERS FOR A HEALTHY COMMUNITY. THIS COMMITTEE'S PURPOSE WAS TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT AND DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN FOR THE FIVE COUNTIES THEY SERVE, WHICH INCLUDES SALINE COUNTY. THE COMMITTEE USED A SEVEN STEP PROCESS UTILIZING COMMITTEE FEEDBACK, EXTERNAL DATA SOURCES, AS WELL AS A PUBLIC SURVEY. IN ORDER TO ZERO IN ON THE NEEDS OF SALINE COUNTY, CAMC HOSTED COMMUNITY ROUNDING SESSIONS IN CRETE, WILBER, AND FRIEND. THE ROUNDING SESSIONS WERE HELD WITH VARIOUS STAKEHOLDERS IN SALINE COUNTY. FROM THIS TWO-FOLD PROCESS, THE FOLLOWING THREE KEY AREAS WERE IDENTIFIED: 1 ) REDUCE OPIOID AND SUBSTANCE ABUSE 2) INCREASE ACCESS TO HEALTHCARE SERVICES 3) INCREASE PREVENTION METHODS FOR CANCER. CRETE AREA MEDICAL CENTER UTILIZES HEALTH STATUS INFORMATION IN DEVELOPMENT OF ITS STRATEGIC PLAN. THE PLANNING PROCESS BEGINS WITH REVIEW OF THE MISSION AND VISION OF CAMC AND THEN AN ENVIRONMENTAL ASSESSMENT IS CONDUCTED TO IDENTIFY COMMUNITY NEEDS AND HOW THE SERVICES AND RESOURCES OF CAMC CAN BEST BE UTILIZED TO HELP ADDRESS THOSE NEEDS. THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH WAS DEVELOPED FOR SALINE COUNTY, HAS BEEN A VALUABLE RESOURCE IN THE HOSPITAL'S PLANNING PROCESS. INFORMATION FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT HAS BEEN SHARED WITH ALL TEAM MEMBERS OF CAMC, INCLUDING THE MEDICAL PROVIDERS. IN ADDITION, A CAMC BOARD PLANNING RETREAT WAS CONDUCTED AND COMMUNITY HEALTH NEEDS WERE REVIEWED IN DETAIL. AS A RESULT OF THESE PLANNING EFFORTS, THE FOLLOWING ACTION PLANS HAVE BEEN PREPARED. CAMC LEADERSHIP, STAFF AND BOARD HAVE A HISTORY OF WORKING WITH THE COMMUNITY TO ADDRESS COMMUNITY HEALTH NEEDS. THE HOSPITAL WILL CONTINUE TO ADDRESS COMMUNITY NEEDS BY PROVIDING CARE TO THOSE IN NEED REGARDLESS OF THEIR ABILITY TO PAY, IN KEEPING WITH THE CHARITABLE MISSION OF CAMC. THE FOLLOWING IMPLEMENTATION STRATEGIES REPRESENT CRETE AREA MEDICAL CENTER'S COMMITMENT TO IMPROVING THE HEALTH OF SALINE COUNTY OVER THE NEXT THREE YEARS. 1) OPIOID AND SUBSTANCE ABUSE: CAMC WILL PARTICIPATE IN THE PUBLIC HEALTH SOLUTIONS RURAL COMMUNITIES OPIOID RESPONSE PROGRAM. THE PROGRAM'S GOAL IS TO INCREASE AWARENESS OF SUBSTANCE ABUSE WHILE PROVIDING RESOURCES TO MANAGE AND DECREASE SUBSTANCE ABUSE. THE PLAN INCLUDES EDUCATION, CREATING AND USING SCREENING TOOLS, INCREASING RESOURCES, DECREASING BARRIERS TO RECEIVE SUBSTANCE ABUSE TREATMENT. CAMC WILL CREATE PROCESSES TO ENSURE SUBSTANCE ABUSE PATIENTS RECEIVE THE CARE NEEDED. THIS INCLUDES INITIAL CARE AS WELL AS FOLLOW-UP CARE. 2) ACCESS TO CARE CAMC WILL COLLABORATE WITH THE COMMUNITIES AND COUNTY TO ENSURE ADEQUATE TRANSPORTATION FOR COMMUNITY MEMBERS TO ACCESS HEALTHCARE. CAMC WILL EVALUATE TELEHEALTH OPTIONS AND IMPLEMENT ADDITIONAL TELEHEALTH SERVICES AS APPLICABLE. CAMC WILL EXPLORE OPTIONS TO COLLABORATE WITH LOCAL BUSINESSES TO ASSIST IN HEALTHCARE NEEDS OF THEIR EMPLOYEES. 3) CANCER CARE AND PREVENTION CAMC WILL CREATE AN EDUCATIONAL MARKETING CAMPAIGN FOR CANCER PREVENTION AND PROMOTE CANCER AWARENESS. CAMC WILL INCREASE CARE MANAGEMENT SERVICES TO ASSIST PATIENTS WITH APPROPRIATE CARE AND EVALUATE A PROCESS WHEN CHILDREN COME TO CAMC TO ENSURE IMMUNIZATIONS ARE REVIEWED AND PROVIDED AS APPLICABLE. CAMC WILL COLLABORATE WITH THE SCHOOLS AND PUBLIC HEALTH SOLUTIONS TO ASSIST IN INCREASING THE NUMBER OF CHILDREN VACCINATED IN THE COMMUNITY. THE PROCESS FOR IDENTIFYING THE COMMUNITY HEALTH NEEDS WAS MULTIFACETED AS DEMONSTRATED BY VARIOUS GROUP DISCUSSIONS. MANY DATA RESOURCES AND COMMUNITY GROUPS ASSISTED IN THE CREATION OF THE ASSESSMENT AND PROVIDED VALUABLE INFORMATION. THE SELECTIONS MADE FOR THE CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT DOES NOT IMPLY THAT OTHER NEEDS ARE NOT WORTHY OF ATTENTION OR THAT EFFORTS IN OTHER AREAS SHOULD BE DIVERTED TO THESE SELECTIONS. IN FACT, OTHER AREAS OF NEED MIGHT BE REPORTED AS LOWER PRIORITY BECAUSE OF CRETE AREA MEDICAL CENTER'S AND THE COMMUNITY'S CURRENT EFFORTS TO ALLEVIATE THEM. THE SELECTED NEED PRIORITIES APPEAR TO BE 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. 3 WILBER MEDICAL CLINIC 203 W 4TH STREET WILBER NE 68465 RURAL HEALTH CLINIC CRETE MEDICAL CLINIC 2910 BETTEN DRIVE CRETE NE 68333 RURAL HEALTH CLINIC FRIEND MEDICAL CLINIC 1210 2ND STREET FRIEND NE 68359 RURAL HEALTH CLINIC Schedule H, Part I, Line 6a COMMUNITY BENEFIT REPORT CRETE AREA MEDICAL CENTER'S COMMUNITY BENEFIT REPORT WAS INCLUDED IN THE BRYAN HEALTH CONSOLIDATED REPORT TO THE COMMUNITY. 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 CRETE AREA 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 BENEFIT 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. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE AMOUNT OF CRETE AREA MEDICAL CENTER'S ("CAMC") BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER CAMC'S CHARITY CARE POLICY IS ESTIMATED TO BE ZERO BASED ON THE FOLLOWING: (1) CRETE AREA MEDICAL CENTER HAS ESTABLISHED POLICIES THAT DEFINE CHARITY CARE AND PROVIDE GUIDELINES FOR ASSESSING A PATIENT'S ABILITY TO PAY; AND ONCE ELIGIBILITY IS VERIFIED, THE MEDICAL CENTER WILL WRITE ACCOUNTS OFF TO CHARITY CARE AND NO LONGER PURSUE DEBT COLLECTION PROCEDURES; (2) CRETE AREA MEDICAL CENTER HAS COUNSELORS AVAILABLE TO WORK WITH ANY PATIENT BOTH PRE AND POST DISCHARGE TO ASSESS FINANCIAL NEED AND RECOMMEND APPROPRIATE ASSISTANCE; (3) CRETE AREA MEDICAL CENTER PROVIDES PRESUMPTIVE FINANCIAL ASSISTANCE WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO THE LACK OF SUPPORTING DOCUMENTATION. ONCE DETERMINED, DUE TO THE INHERENT NATURE OF PRESUMPTIVE CIRCUMSTANCES, THE ONLY DISCOUNT THAT CAN BE GRANTED IS A 100% WRITE-OFF OF THE ACCOUNT BALANCE. 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 - CRETE AREA 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 - CRETE AREA 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 - CRETE AREA MEDICAL CENTER: Line 16c URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/; Schedule H, Part VI, Line 2 Needs assessment CRETE AREA MEDICAL CENTER ("CAMC") IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY CONTINUALLY WORKING WITH COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. DURING THE YEAR ENDED DECEMBER 31, 2021, CAMC PARTNERED WITH PUBLIC HEALTH SOLUTIONS, LOCATED IN CRETE, TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT FOR SALINE COUNTY. THE HEALH NEEDS IDENTIFIED FROM THE ASSESSMENT WERE PRIORITIZED BY A REPRESENTATIVE GROUP OF STAKEHOLDERS FROM THROUGHOUT THE COUNTY AND UTILIZED TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT FOR SALINE COUNTY. CAMC'S COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION STRATEGY WAS DEVELOPED TO ENSURE THAT OUR STRENGTHS AND AVAILABLE RESOURCES ARE ALIGNED WITH THE HEALTH NEEDS OF OUR COMMUNITY. CAMC ALSO REVIEWS INFORMATION ON THE APPROPRIATE NUMBER OF PHYSICIANS FOR OUR SERVICE AREA AND WILL ACTIVELY RECRUIT PHYSICIANS OR OTHER PROVIDERS AS NEEDED TO THE COMMUNITY. THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL MEETS WITH VARIOUS COMMUNITY LEADERS THROUGHOUT THE YEAR TO DISCUSS COMMUNITY NEEDS. ALSO, MANY OF THE SENIOR TEAM MEMBERS AND BOARD MEMBERS LIVE IN THE COMMUNITY AND ACTIVELY PARTICIPATE IN LOCAL ORGANIZATIONS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance CRETE AREA MEDICAL CENTER ("CAMC") OFFERS A FINANCAL 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 TO EACH NEW EMPLOYEE ORIENTATION AND THEN YEARLY 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 AT 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 ELIGIBILITY 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 CRETE AREA MEDICAL CENTER ("CAMC") IS LOCATED IN CRETE, NEBRASKA. CRETE IS SERVED BY THE CRETE AREA MEDICAL CENTER AND CRETE MEDICAL CLINIC AS WELL AS SALINE MEDICAL SPECIALTIES. CRETE AREA MEDICAL CENTER ALSO OPERATES THE WILBER MEDICAL CLINIC IN WILBER AND THE FRIEND MEDICAL CLINIC IN FRIEND. FRIEND IS ALSO SERVED BY THE FRIEND COMMUNITY HEALTHCARE SYSTEM. CRETE HAS AN ESTIMATED POPULATION OF 7,179 PEOPLE AND INCLUDES DIVERSE ETHNIC BACKGROUNDS. THE 2020 AMERICAN COMMUNITY SURVEY ESTIMATES INDICATE THAT HISPANIC OR LATINO PERSONS COMPRISE 42.7% OF THE POPULATION IN CRETE, VERSUS 11.0% IN NEBRASKA OVERALL. 2020 CENSUS ESTIMATES THAT INCOME LEVELS IN CRETE ARE APPROXIMATELY $51,502 PER HOUSEHOLD, WITH AN ESTIMATED 20.6% OF THE COMMUNITY LIVING AT OR BELOW POVERTY LEVELS AND 19.3% OF THE POPULATION UNDER THE AGE 65 YEARS DO NOT HAVE HEALTH INSURANCE. CRETE HAS THREE PRIMARY EMPLOYERS: BUNGE MILLING, SMITHFIELD FOODS, AND NESTLE/PURINA. IN ADDITION, CRETE IS HOME TO DOANE UNIVERSITY, A PRIVATE, LIBERAL ARTS COLLEGE. CAMC SERVES PEOPLE IN CRETE AND THE SURROUNDING COMMUNITIES IN SALINE AND LANCASTER COUNTIES. OUR PRIMARY SERVICE AREA IS A 30-MILE RADIUS OF CRETE. Schedule H, Part VI, Line 5 Promotion of community health CRETE AREA MEDICAL CENTER ("CAMC") IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CAMC OPERATES A 15-LICENSED BED CRITICAL ACCESS HOSPITAL AND THREE PHYSICIAN CLINICS. CAMC HAS AN OPEN MEDICAL STAFF. THE MAJORITY OF THE HOSPITAL BOARD OF TRUSTEES THAT ARE NOT EMPLOYEES OF BRYAN HEALTH OR CAMC RESIDE IN CRETE & WILBER. THE BOARD OF TRUSTEES OF BRYAN HEALTH, THE SOLE CORPORATE MEMBER OF CAMC, MUST APPROVE CAMC'S TRUSTEES. THE MAJORITY OF BRYAN'S HEALTH'S BOARD OF TRUSTEES ARE INDEPENDENT. CAMC IS COMMITTED TO SERVING OUR PATIENTS AND OUR COMMUNITY BY INVESTING FUNDS IN FACILITIES, TECHNOLOGY, PHYSICIANS, AND STAFF TO DELIVER PREMIUM HEALTHCARE IN OUR FACILITIES. CAMC PARTICIPATES IN LOCAL ORGANIZATIONAL EVENTS AND PROVIDES UNCOMPENSATED AND CHARITY CARE TO OUR PATIENTS. CAMC SUPPORTS EDUCATIONAL OPPORTUNITIES FOR STAFF, HIGH SCHOOL STUDENTS, LOCAL EMS VOLUNTEERS, AND COMMUNITY MEMBERS. PUBLIC ASSISTANCE WITH TRANSLATION SERVICES, AND HEALTHY LIFESTYLE PROGRAMS ARE ALSO OFFERED AT CAMC. Schedule H, Part VI, Line 6 Affiliated health care system CRETE AREA 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 COMMUNITY 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, THREE URGENT CARE CENTERS, 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 MARIA ISQUIERDO TREASURER 0 355522 0 58037 0 143030 0 18150 0 24238 0 598976 0 0 DAVID REESE CHAIR 0 318981 0 48224 0 68722 0 33699 0 28227 0 497854 0 0 STEPHANIE BOLDT PRESIDENT/CEO CRETE AREA MEDICAL CENTER 256865 0 67193 0 5561 0 18127 0 24244 0 371990 0 0 0 JASON HESSER MD PHYSICIAN/EX-OFFICIO MEMBER 193777 0 221866 0 34232 0 15753 0 1052 0 466680 0 0 0 JULIE LACY CFO - CRETE AREA MEDICAL CENTER 133338 0 24506 0 4358 0 10668 0 12683 0 185553 0 0 0 MITCHELL EBKE MD PHYSICIAN 330997 0 4000 0 867 0 18150 0 33160 0 387174 0 0 0 RUSSELL EBKE MD PHYSICIAN 209661 0 138369 0 11346 0 21450 0 28182 0 409008 0 0 0 KATE HESSER MD PHYSICIAN 187447 0 167947 0 30511 0 15655 0 28595 0 430155 0 0 0 RYAN BUSE MD PHYSICIAN 230016 0 121941 0 29319 0 17996 0 31252 0 430524 0 0 0 AMY VERTIN MD PHYSICIAN 305555 0 0 0 7315 0 17231 0 29463 0 359564 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, INCLUDING THIS ORGANIZATIONS 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 HEALTH'S COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED IS REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON MARCH 21, 2023. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan IN ORDER TO ATTRACT AND RETAIN TALENTED, EXPERIENCED EXECUTIVES, BRYAN HEAL TH 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 AND RECEIVED A PAYMENT DURING 2023: MARIA ISQUIERDO-$126,888, DAVID REESE - $57,320. Schedule J, Part I, Line 7 Non-fixed payments CRETE AREA MEDICAL CENTER OFFERS AN INCENTIVE COMPENSATION PROGRAM FOR ALL LEADERS. INCENTIVE COMPENSATION IS BASED ON ACHIEVING OBJECTIVE ORGANIZATIONAL, DEPARTMENTAL, AND INDIVIDUAL GOALS. THE WEIGHTS ASSIGNED TO EACH GOAL MAY CHANGE ON AN ANNUAL BASIS. 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 EMPLOYED PHYSICIANS AND EXECUTIVES; AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS. KATE HESSER MD FAMILY RELATIONSHIP WITH JASON HESSER, MD, EX-OFFICIO MEMBER 430155 COMPENSATION false Form 990, Part VI, Line 2 DESCRIPTION OF FAMILY OR BUSINESS RELATIONSHIPS 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 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 CRETE AREA 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 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 CRETE AREA MEDICAL CENTER, HAS THE RIGHT UNDER THE ORGANIZING DOCUMENTS TO REMOVE ANY TRUSTEE FROM OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE BY A 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 CRETE AREA MEDICAL CENTER("CAMC"). PURSUANT TO THE GOVERNING DOCUMENTS, THE BOARD OF CAMC 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 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 ACQUITION 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) INCUR ANY INDEBTEDNESS INVOLVING A MORTGAGE OR LIEN OF ANY KIND OR NATURE ON ASSETS OF THE CORPOATION 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, AND (12) TAKE ANY OTHER ACTIONS WHICH MAY BE INCONSISTENT WITH BRYAN HEALTH'S GOALS AND OBJECTIONS. 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 CRETE AREA MEDICAL CENTER'S CFO 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 THE CEO AND CFO OF CRETE AREA MEDICAL CENTER. IN ADDITION, THIS 990 WAS REVIEWED BY THE CEO AND CFO OF BRYAN HEALTH. THIS 990 WAS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM 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 CRETE AREA MEDICAL CENTER ("CAMC") HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY THAT IS MONITORED AND ENFORCED BY THE CAMC 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 RELATIONSHIPS 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 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, INCLUDING THIS ORGANIZATIONS CEO AND ALL RURAL HOSPITAL CEOS EMPLOYED BY BRYAN HEALTH, MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHTOUT 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 STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVES 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 INDPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON MARCH 21, 2023. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. Form 990, Part VI, Line 15b Process to establish compensation of other employees SEE THE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATIONS' 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 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 CRETE AREA MEDICAL CENTER AND BRYAN HEALTH AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS INCOME - Total Revenue: 770737, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 770737; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; BRYAN HEALTH 1600 S 48TH STREET LINCOLN NE 68506 363414823 HEALTHCARE NE 501(c)(3) Type III-FI NA false BRYAN PHYSICIAN NETWORK 1600 S 48TH STREET LINCOLN NE 68506 201357375 HEALTHCARE NE 501(c)(3) 10 BRYAN HEALTH true BRYAN MEDICAL CENTER 1600 S 48TH STREET LINCOLN NE 68506 470376552 HEALTHCARE NE 501(c)(3) 3 BRYAN HEALTH true BRYAN FOUNDATION 1600 S 48TH STREET LINCOLN NE 68506 237005720 FUNDRAISING NE 501(c)(3) 7 BRYAN HEALTH true CRETE AREA HEALTH CARE FOUNDATION 2910 BETTEN DRIVE CRETE NE 68333 470846080 FUNDRAISING NE 501(c)(3) Type III-FI NA false MERRICK MEDICAL CENTER 2802 28TH STREET CENTRAL CITY NE 68826 820906268 HEALTHCARE NE 501(c)(3) 3 BRYAN HEALTH true MERRICK MEDICAL CENTER FOUNDATION 2802 28TH STREET CENTRAL CITY NE 68826 470710738 FUNDRAISING NE 501(c)(3) 7 MERRICK MEDICAL CENTER true GRAND ISLAND REGIONAL MEDICAL CENTER 3533 PRAIRIEVIEW ST GRAND ISLAND NE 68803 352621082 HEALTHCARE NE 501(c)(3) 3 BRYAN HEALTH true BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER 804 22ND AVENUE KEARNEY NE 688452206 873486516 HEALTHCARE NE 501(c)(3) 3 BRYAN HEALTH true BRYAN HOSPITAL KEARNEY FOUNDATION 1600 SOUTH 48TH STREET LINCOLN NE 68506 923387978 FUNDRAISING NE 501(c)(3) Type II BRYAN FOUNDATION true GRAND ISLAND REGIONAL MEDICAL CENTER FOUNDATION 1600 SOUTH 48TH STREET LINCOLN NE 68506 931718948 FUNDRAISING NE 501(c)(3) Type II BRYAN FOUNDATION true LINCOLN DIGESTIVE HEALTH CENTER LLC 1600 SOUTH 48TH STREET LINCOLN NE 68506 371833798 HEALTHCARE NE NA N/A DOCTOR'S OUTPATIENT SURGERY CENTER LLC 5055 A STREET LINCOLN NE 68510 364835603 HEALTHCARE NE NA N/A HEAD AND NECK SURGICAL PARTNERS 1600 SOUTH 48TH STREET LINCOLN NE 68506 911824787 HEALTHCARE NE NA N/A GRAND ISLAND HOSPITAL HOLDINGS LLC 3533 PRAIRIEVIEW STREET GRAND ISLAND NE 68803 475381241 LEASING PROPERTY, HOLDING COMPANY NE NA N/A SEWARD URGENT CARE PARTNERSHIP LLC 2222 SOUTH 16TH STREET SUITE 400A LINCOLN NE 68502 923319265 HEALTHCARE NE NA N/A BRYAN HEART MARY LANNING CARDIOLOGY LLC 1600 SOUTH 48TH STREET SUITE 600 LINCOLN NE 68506 464822260 CARDIOLOGY SERVICES NE NA N/A BRYAN TELEMEDICINE LLC 2222 S 16TH ST STE 401A LINCOLN NE 68502 383932523 HEALTHCARE NE NA N/A BRYAN ENTERPRISES INC 1600 S 48TH STREET LINCOLN NE 68506 470701037 MEDICAL SERVICES NE NA C Corporation true INTEGRATED CARDIOLOGY GROUP LLC 1600 SOUTH 48TH STREET LINCOLN NE 68506 470844961 CARDIOLOGY NE NA C Corporation true BRYAN HEALTH CONNECT 1600 S 48TH STREET LINCOLN NE 68506 364771145 PHYSICIAN HOSPITAL ORGANIZATION NE NA C Corporation true false false true false false false false false false false false false true false true true true true false