2025-11-11T16:25:08+00:00 2024-12-31 440160260 Forvis Mazars LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2024-01-01 873486516 Bryan Hospital Kearney BRYA 3084553600 804 22nd Ave Kearney NE 68845 Derick Lorentz CFO 3084553600 2025-11-11 true MICHAEL J ENGLE P00482834 8162216300 2025-11-11 2024 2025-03-06 01:10:19Z Kearney Regional Medical Center Derick Lorentz 804 22nd Ave Kearney NE 68845 172597761 false X X 2021 NE KEARNEY REGIONAL MEDICAL CENTER ("KRMC") IS DEDICATED TO IMPROVING THE HEALTH OF OUR PATIENTS DELIVERING EXPERT MEDICAL CARE THAT IS PHYSICIAN GUIDED AND PEOPLE CENTERED. IN 2024, KRMC PROVIDED CHARITY CARE TO 1,346 INDIVIDUALS IN THE AMOUNT OF $2.4 MILLION. 11 9 961 9 0 9545 478416 162679504 171779613 51249 44690 513125 289062 163253423 172591781 77139 39787 0 67431044 65681396 0 0 106960235 115571489 174468418 181292672 -11214995 -8700891 363153438 384908443 217167717 247623613 145985721 137284830 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 177073244 39787 171779613 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 HOSPITAL OPERATIONS COMMENCING ON JANUARY 1, 2022. KRMC OPERATES A 93 LICENSED BED HOSPITAL AND A MEDICAL CLINIC THAT PROVIDES ROUTINE CARE AND EXAMS ALONG WITH SPECIALITY CARE AND SURGERY. IN 2024, KRMC PROVIDED HEALTHCARE SERVICES TO THE GENERAL PUBLIC AND OPERATED ROUTINE SERVICE BEDS, TOTALING 14,637 PATIENT DAYS, EMERGENCY ROOM VISITS OF 9,853 AND 661 DELIVERIES. THE HOSPITAL PROVIDED CHARITY CARE TO 1,346 PATIENTS IN THE AMOUNT OF $2,374,259. 177073244 true false false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false false false true true true false false true 107 0 true 961 true false false false false false false false false false false false false X 11 9 true false false false true true true true true false false false true true true true true true true true true true NE X Derick Lorentz 3084553600 804 22ND AVE KEARNEY NE 68845 DAVID BENAVIDES MD SECRETARY 1.0 0 X X 0 0 0 JEFF HINRICHS CHAIR 1.0 0 X X 0 0 0 JOEY COCHRAN TREASURER 1.0 0 X X 0 0 0 BRENDA BENJAMIN DIRECTOR 1.0 0 X 0 0 0 JOHN WOODRICH EX-OFFICIO MEMBER 1.0 51.0 X 0 1259719 43212 KARI NICKMAN DIRECTOR 1.0 0 X 0 0 0 MERLIN WEHLING MD DIRECTOR 1.0 0 X 0 0 0 MIKE MORGAN DIRECTOR 1.0 0 X 0 0 0 RUSSELL GRONEWOLD EX-OFFICIO MEMBER 1.0 53.0 X 0 1727304 50173 SCOTT SMITH MD DIRECTOR 1.0 0 X 0 0 0 SEAN DENNEY MD DIRECTOR 1.0 0 X 0 0 0 DANNY VAN RANKEN KRMC CHIEF OPERATING OFFICER 50.0 0 X 287152 0 41817 DERICK LORENTZ CFO (EFFECTIVE 10/24/2024) 10.0 40.0 X 53415 208807 53963 DOUGLAS KOCH KRMC CHIEF EXECUTIVE OFFICER EFFECTIVE 8/5/2024 50.0 0 X 141456 0 17031 WILLIAM CALHOUN KRMC CHIEF EXECUTIVE OFFICER, RESIGNED 1/26/2024 50.0 0 X 153199 0 15073 DENISE MURRY-PORTER RN RN ANESTHETIST 50.0 0 X 165627 0 20216 KATY FISHER RN RN ANESTHETIST LEAD 50.0 0 X 367800 0 23077 MATTHEW WECKER RN RN ANESTHETIST 50.0 0 X 318676 0 50169 PATRICK DAVIDSON RN RN ANESTHETIST 50.0 0 X 347942 0 33890 THOMAS MCLEOD ADMINISTRATOR OF CLINIC AND PROVIDER 50.0 0 X 270903 0 53138 JON PEPPMULLER CONTROLLER - BRYAN HEALTH 0.0 50.0 X 0 335608 43094 2106170 3531438 444853 96 true true false COMPEHEALTH ASSOC INC 7259 S BINGHAN JUNCTION BLVD MIDVALE UT 84047 PHYSICIAN STAFFING CONSULTING 1294613 WDM ARCHITECTS PA 105 N WASHINGTON ST WICHITA KS 67202 DESIGN CONSULTANTS 1221234 FAMILY PHYSICAL THERAPY 804 22ND AVENUE KEARNEY NE 68845 CONTRACTED SERVICES 1169044 PALM HEALTH RESOURCES 33312 1640 W OAKLAND PARK BLVD SUITE 480 COPPELL TX 75019 PHYSICIAN STAFFING CONSULTING 823837 WILKINS ARCHITECTURE DESIGN PL 151 N 8TH ST STE 340 LINCOLN NE 68508 DESIGN CONSULTANTS 384099 26 1916 476500 478416 NET PATIENT REVENUE 622110 169417077 169417077 VALUE BASED INCOME 622110 1942911 1942911 OTHER OPERATING REVENUE 622110 234113 234113 EMPLOYEE LEASE REVENUE 622110 127476 127476 PROGRAM RENTAL REVENUE 531190 58036 58036 0 0 0 0 171779613 7011 7011 0 0 43659 5980 0 37679 37679 37679 0 CAFETERIA REVENUE 722310 289062 289062 0 0 0 0 289062 172591781 171779613 0 333752 X 39787 39787 718624 599402 119222 50071436 49456207 615229 2331816 2326523 5293 9090077 9069261 20816 3469443 3461567 7876 52177 52177 1406 1406 53184702 52365649 819053 0 234775 222068 12707 1169090 1070740 98350 2614417 2394479 219938 1750868 1656102 94766 474413 448735 25678 96783 94448 2335 3004538 2086538 918000 13502580 13448394 54186 255385 233901 21484 MEDICAL SUPPLIES 23053655 23053655 CORPORATE COST ALLOCATIONS 6405176 5610133 795043 DRUGS 5704951 5704951 REPAIRS 1326564 1161904 164660 2740009 2568800 171209 0 181292672 177073244 4219428 0 1939040 8046954 30517109 38363936 0 0 0 0 479502 4591731 7045823 1393263 1215791 46079167 11745656 23103750 34333511 0 0 137775784 136656487 163832761 158766439 363153438 384908443 19266425 10906756 0 0 197901292 236716857 217167717 247623613 X 145985721 137284830 145985721 137284830 363153438 384908443 -8700891 0 X false true true false X false false false false false false false false true 10895 10895 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) AND AMERICAN HOSPITAL ASSOCIATION (AHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE NHA AND AHA IN THE AMOUNT OF $36,464 AND $19,213. OF THIS AMOUNT THE NHA REPORTED THAT 13.02% OR $4,747 OF THE DUES PAID WERE USED FOR LOBBYING ACTIVITIES. OF THE AMOUNT AHA REPORTED THAT 32% OF $6,148 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES. 4310880 4310880 7078733 704051 6374682 3886732 512806 3373926 21759733 10528799 11230934 2400 9040689 9043089 34333511 RIGHT OF USE ASSETS 155720761 CLOUD COMPUTING ARRANGEMENTS 2431541 DUE FROM BRYAN MEDICAL CENTER 593977 DUE FROM INTERCOMPANY 20160 158766439 Federal Income Taxes LONG TERM DEBT - RIGHT OF USE 161114292 RIGHT OF USE 5402565 DUE TO BRYAN HEALTH 70200000 236716857 X 0 0 0 0 0 0 0 0 0 0 0 0 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, 2024. 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. true true X true X true X 1346 2374259 2374259 0.01310 13450 10039015 7436133 2602882 0.01436 0 0.0 0 14796 12413274 7436133 4977141 0.02745 94676 94676 0.00052 0 0.0 196810 178325 18485 0.00010 0 0.0 44113 44113 0.00024 0 0 335599 178325 157274 0.00087 0 14796 12748873 7614458 5134415 0.02832 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 42071878 50719031 -8647153 X true true 1 1 BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER 804 22nd AVENUE KEARNEY NE 68845 https://www.bryanhealth.com/locations/profile/krmc/ H00141 X X X BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER 1 false false true X X X X X X X X X 24 true true true true X https://www.bryanhealth.com/locations/hospitals/krmc/about-us/krmc-community-health-needs-assessment X true 25 true https://www.bryanhealth.com/locations/hospitals/krmc/about-us/krmc-community-health-needs-assessment false true X 200.0 400.0 X X X X X X true true X X X true X https://www.bryanhealth.com/locations/hospitals/krmc/for-patients/billing-and-insurance/ X https://www.bryanhealth.com/locations/hospitals/krmc/for-patients/billing-and-insurance/ X https://www.bryanhealth.com/locations/hospitals/krmc/for-patients/billing-and-insurance/ 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 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 AND SUBMITTED THE COMMUNITY HEALTH NEEDS ASSESSMENT, FULFILLING THE REQUIREMENTS ESTABLISHED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT REQUIRING NON-PROFIT HOSPITALS CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS AT LEAST EVERY THREE YEARS. THE HEALTH ASSESSMENT REPRESENTS A COLLABORATIVE EFFORT BETWEEN KRMC, TWO RIVERS PUBLIC HEALTH DEPARTMENT (TRPHD), BUFFALO COUNTY COMMUNITY PARTNERS, AND CHI GOOD SAMARITAN HOSPITAL, GATHERING INPUT REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. TWO RIVERS PUBLIC HEALTH DEPARTMENT DEVELOPED AND DISTRIBUTED A COMMUNITY HEALTH ASSESSMENT SURVEY TO GATHER INPUT FROM COMMUNITY MEMBERS ON VARIOUS HEALTH-RELATED TOPICS. THE SURVEY WAS REVIEWED BY KEARNEY REGIONAL MEDICAL CENTER, CHI HEALTH GOOD SAMARITAN, BUFFALO COUNTY COMMUNITY PARTNERS, GOTHENBURG MEMORIAL HEALTH, AND KEARNEY COUNTY HEALTH SERVICES. TRPHD PREPARED LINKS AND QR CODES FOR DISTRIBUTION, AND COMMUNITY MEMBERS WERE ENCOURAGED TO PARTICIPATE THROUGH IN PERSON INTERVIEWS, FLYERS WITH QR CODES IN HOSPITAL AND CLINIC WAITING ROOMS, ONLINE SURVEYS SHARED VIA SOCIAL MEDIA AND COMMUNITY WEBSITES, AS WELL AS LINKS IN HOSPITALS NEWSLETTERS. ADDITIONALLY, LOCAL ORGANIZATIONS AND LEADERS WERE ENGAGED TO HELP SPREAD THE WORD ABOUT THE SURVEY. THE GOAL WAS TO COLLECT A COMPREHENSIVE AND DIVERSE RANGE OF RESPONSES THAT ACCURATELY REPRESENT THE HEALTH NEEDS AND PRIORITIES OF THE COMMUNITY. KRMC AND TRPHD UTILIZED QUALTRICS TO GATHER DEMOGRAPHICS AND HEALTH INFORMATION FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. OUT OF THE INITIAL 973 RESPONSES, 120 SURVEYS WITH A COMPLETION RATE BELOW 505 WERE EXCLUDED FROM ANALYSIS, RESULTING IN A TOTAL SAMPLE SIZE OF 853. OF THE RESPONSES, 24% OF THE RESPONDENTS WERE RESIDENTS OF BUFFALO COUNTY. OF THE TOTAL RESPONDENTS, 21% WERE FROM THE CITY OF KEARNEY, 18% FROM ALMA, AND LESS THAN 5% EACH FROM THE REMAINING CITIES IN THE DISTRICT. 58% OF THE RESPONDENTS IDENTIFIED AS FEMALE, AND THE MEDIAN AGE WAS 32 YEARS. AMONG THE 853 RESPONDENTS, 1 INIDIVIDUAL IDENTIFIED AS NON-BINARY AND 411 INDIVIDUALS IDENTIFIED AS NON-WHITE AND 311 AS HISPANIC OR LATINO ORIGIN. THE COMMUNITY HEALTH ASSESSMENT TEAM FACILITATED THREE FOCUS GROUPS TO GATHER INSIGHTS, OPINIONS AND PERCEPTIONS FROM PARTICIPANTS REGARDING TOPICS SUCH AS: HOW PEOPLE ACCESS RELIABLE HEALTH INFORMATION, AND WHAT COMMUNITY RESOURCES THEY UTILIZE. THESE INSIGHTS CAN HELP INFORM KRMC PRIORITIZE HEALTH NEEDS AND PLANS FOR IMPROVING THE COMMUNITY'S HEALTH OUTCOMES. OF KRMC'S 852 TOTAL COMPLETED RESPONSES REPORTED IN THE 2024 COMMUNITY HEALTH NEEDS SURVEY, THE FOLLOWING TOPICS WERE IDENTIFIED AS THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY: 1. LACK OF EXERCISES AND PHYSICAL ACTIVITY 2. CHALLENGES TO ACCESSING HEALTHCARE 3. CANCER CARE 4. FOOD QUALITY AND ACCESS TO HEALTH NUTRITION 5. DIABETES AND METABOLIC DISORDERS OF THESE NEEDS, KRMC LEADERSHIP SELECTED THREE OF THESE AREAS TO FOCUS ITS EFFORTS ON, BASED ON ABILITY TO POSITIVELY AFFECT CHANGE FOR THE PATIENTS AND COMMUNITY. 1. CHALLENGES TO ACCESSING HEALTHCARE 2. CANCER CARE 3. DIABETES AND METABOLIC DISORDERS 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 BUFFALO COUNTY'S VITAL STATISTICS, KRMC'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 KRMC AND THE COMMUNITY'S CURRENT EFFORTS 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 6a Facility , 1 Facility , 1 - BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER. THE HOSPITAL FACILITY THAT PARTICIPATED INCLUDED CHI GOOD SAMARITAN. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - TWO RIVERS PUBLIC HEALTH DEPARTMENT. TWO RIVERS PUBLIC HEALTH DEPARTMENT SERVES A SEVEN COUNTY AREA INCLUDING BUFFALO COUNTY. TWO RIVERS PUBLIC HEALTH DEPARTMENT ENGAGES COLLABORATIVE PARTNERS, COMMUNITY LEADERS, AND THE PUBLIC TO PROMOTE HEALTH LIFESTYLES, PROVIDE PREVENTATIVE EDUCATION, ASSURE ENVIRONMENTAL QUALITY, AND CREATE MORE HEALTHY AND SAFE COMMUNITIES FOR ALL WHO LIVE WITHIN THE DISTRICT. TWO RIVERS PUBLIC HEALTH DEPARTMENT ENVISIONS A HEALTH DISTRICT WHERE ALL ARE ABLE TO SAFELY AND ACTIVELY LIVE, LEARN, WORK, AND PLAY IN THEIR COMMUNITIES. TWO RIVERS PUBLIC HEALTH DEPARTMENT FACILITATES COLLABORATIVE PARTNERSHIPS, AND UNIQUE APPROACHES THAT EDUCATE, EMPOWER, AND ENGAGE LOCAL COMMUNITY PARTNERS, HEALTH PROVIDERS, POLITICAL DECISION-MAKERS, COMMUNITY LEADERSHIP, AND THE PUBLIC. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER. FROM THE RESULTS OF THE 2024 COMMUNITY HEALTH NEEDS SURVEY, THE FOLLOWING TOPICS WERE SELECTED BY THE BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER (KRMC) LEADERS AS THE TOP THREE IMPORTANT AREAS TO FOCUS ON BASED ON THE PATIENTS AND THE COMMUNITY. THE TOP THREE AREAS ARE: 1.) CHALLENGES TO ACCESSING HEALTHCARE 2.) CANCER CARE 3.) DIABETES AND METABOLIC DISORDERS. 1.) CHALLENGES TO ACCESSING HEALTHCARE - ACCESSING HEALTHCARE CAN BE CHALLENGING FOR MANY PEOPLE DUE TO VARIETY OF COMMON AND PREVALENT BARRIERS. DURING THE FOCUS GROUPS CONDUCTED WITH TWO RIVERS PUBLIC HEALTH DEPARTMENT, FINANCIAL BARRIERS AND TRANSPORTATION ISSUES WERE THE TOP TWO CHALLENGES NAMED RELATED TO HEALTHCARE ACCESS CHALLENGES. a. FINANCIAL BARRIERS - NATIONAL POLLING DATA FROM 2022 FOUND 43% OF ADULTS REPORT THAT THEY OR A FAMILY MEMBER IN THEIR HOUSEHOLD PUT OFF OR POSTPONED NEEDED HEALTHCARE DUE TO COST. UNINSURED ADULTS, ADULTS IN WORSE HEALTH (REPORTED AS FAIR OR POOR HEALTH STATUS, AND HISPANIC ADULTS ARE MUCH MORE LIKELY THAN OTHER TO DELAY OR FOREGO HEALTHCARE DUE TO COST. UNINSURED ADULTS AND ADULTS WHO ARE IN WORSE HEALTH ARE TWICE AS LIKELY TO REPORT THAT THEY OR A FAMILY MEMBER HAD DIFFICULTY PAYING MEDICAL BILLS. UNISURED ADULTS ARE NEARLY FIVE TIMES AS LIKELY THAN INSURED ADULTS TO HAVE NO USUAL SOURCE OF CARE. WHILE THE SHARE OF ADULTS WITHOUT A USUAL SOURCE OF CARE IS SIMILAR ACROSS MOST RACE AND ETHNIC GROUPS, HISPANIC ADULTS 17% ARE MORE LIKELY THAN OTHERS TO REPORT NOT HAVING A USUAL SOURCE OF CARE. b. TRANSPORTATION ISSUES - INDIVIDUALS WITHOUT ACCESS TO A VEHICLE OR RELIABLE PUBLIC TRANSPORTATION MAY STRUGGLE TO REACH HEALTHCARE FACILITIES, ESPECIALLY IN AREAS WHERE PUBLIC TRANSIT IS LIMITED OR NONEXISTENT. WHILE THERE IS A GROWING FOCUS ON THE SOCIAL DETERMINANTS OF HEALTH WITH HEALTHCARE DRIVING MORE ATTENTION TOWARD THE ROLE OF TRANSPORTATION TO MEDICAL AND NON-MEDICAL SITES, THERE IS LIMITED RESEARCH ON TRANSPORTATION'S ROLE IN SUPPORTING ACCESS TO NONMEDICAL SITES AND ON HOW IMPROVED NONEMERGENCY TRANSPORTATION IMPROVES PEOPLE'S HEALTH. IF TRANSPORTATION SERVICES TO NONMEDICAL SITES ARE TO MATURE INTO A COMMONLY AVAILABLE SERVICE TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, MEDICARE AND MEDICAID WILL BE IMPORTANT VEHICLES FOR TRANSFORMING THE GREATER US HEALTH CARE LANDSCAPE. TRANSPORTATION USE IS POSITIVELY CORRELATED WITH AN AVERAGE 1.5 TIMES MORE PRIMARY CARE PHYSICIAN VISITS THAN FOR NONUTILIZERS AND HIGHER GENERIC DRUG UTILIZATION. BOTH BEHAVIORS ARE ASSOCIATED WITH APPROPRIATE AND COST-EFFECTIVE HEALTHCARE. c. AVAILABILITY OF PROVIDERS - ACCESS TO HEALTHCARE IS DIRECTLY IMPACTED BY THE AVAILABILITY OF PROVIDERS, EXPECIALLY IN RURAL AREAS LIKE CENTRAL AND WESTERN NEBRASKA. ACCORDING TO A 2022 REPORT BY UNMC, THE TOTAL NUMBER OF PHYSICIANS PRACTICING IN NEBRASKA DECREASED IN 2021 COMPARED TO 2019, A REVERSAL OF INCREASE BETWEEN 2017 AND 2019. COMPARED TO 2019, THE MOST SIGNIFICANT DECLINE IN THE NUMBER OF ACTIVELY PRACTICING PHYSICIANS OCCURRED FOR THE PRIMARY CARE SPECIALTIES WITH A LOSS OF 99 PRIMARY CARE PHYSICIANS. BUFFALO COUNTY HAS MODERATE ACCESS TO PRIMARY CARE PROVIDERS, BUT MANY COUNTIES SERVICED BY KRMC HAVE LIMITED OR NO ACCESS TO PRIMARY CARE PROVIDERS IN THEIR AREA AND MUST TRAVEL TO RECEIVE CARE. 2.) CANCER CARE - CANCER IS THE SECOND-LEADING CAUSE OF DEATH FOR BUFFALO COUNTY RESIDENTS. BETTER ACCESS TO CARE, TRIALS AND TREATMENTS WERE IDENTIFIED AS TOP ISSUES AMONG THE COMMUNITY HEALTH AWARENESS SURVEY RESPONDENTS AS WELL AS THE FOCUS GROUP PARTICIPANTS. THE 2022 CANCER BURDEN IN NEBRASKA REPORT STATES THAT NEBRASKANS ARE AT HIGHER RISK OF DEVELOPING CANCER THAN THE OVERALL U.S. POPULATION. THE FOLLOWING CANCER INCIDENCE RATES ARE SIGNIFICANTLY HIGHER IN NEBRASKA COMPARED TO THE UNITED STATES: BRAIN AND OTHER NERVOUS SYSTEM CANCER IN FEMALES, BREAST CANCER IN FEMALES, COLON AND RECTUM CANCER IN MALES AND FEMALES, KIDNEY CANCER IN MALES, MELANOMA SKIN CANCER IN MALES AND FEMALES, PROSTATE CANCER IN MALES, AND THYROID CANCER IN FEMALES. THE FOLLOWING CANCER MORTALITY RATES ARE SIGNIFICANTLY HIGHER IN NEBRASKA COMPARED TO UNITED STATES: ESOPHAGEAL CANCER IN MALES, KIDNEY CANCER IN MALES, AND LEUKEMIA IN MALES. a. HEALTH DISPARITIES - NEBRASKA HAS EXPERIENCED CANCER HEALTH DISPARITIES IN THE FOLLOWING AREAS: i. THE BREAST CANCER MORTALITY RATE WAS SIGNIFICANTLY HIGHER IN AFRICAN AMERICAN WOMEN COMPARED TO NON-HISPANIC WHITE WOMEN IN BOTH NEBRASKA AND THE UNITED STATES. ii. THE PROSTATE CANCER INCIDENCE AND MORTALITY RATES WERE SIGNIFICANTLY HIGHER AMONG AFRICAN AMERICAN PERSONS COMPARED TO NON-HISPANIC WHITE PERSONS IN BOTH NEBRASKA AND THE UNITED STATES. iii. IN NEBRASKA, THE PROPORTION OF HISPANIC PERSONS UP TO DATE ON COLORECTAL CANCER SCREENING IS 46.7% WHICH WAS SIGNIFICANTLY LOWER THAN THE PROPORTION OF NON-HISPANIC WHITE PERSONS WHO WERE UP TO DATE AT 74.7%. iv. IN NEBRASKA, THE PROPORTION OF ADULTS WHO CURRENTLY SMOKE WAS SIGNIFICANTLY HIGHER AMONG AFRICAN AMERICAN PERSONS AT 22% AND AMERICAN INDIAN/ALASKA NATIVE PERSONS AT 35.4% COMPARED TO NON-HISPANIC WHITE PERSONS AT 14.9%. v. IN NEBRASKA, THE PROPORTION OF ADULTS WITH OBESITY WAS SIGNIFICANTLY HIGHER AMONG AFRICAN AMERICAN PERSONS AT 41.1% AND AMERICAN INDIAN/ALASKA NATIVE PERSONS AT 41% COMPARED TO NON-HISPANIC WHITE PERSONS AT 33.1%. vi. AMONG NON-HISPANIC WHITE PERSONS, THE PEDIATRIC CANCER MORTALITY RATE IN NEBRASKA WAS SIGNIFICANTLY HIGHER AT 3.1 DEATHS PER 100,000 POPULATION THAN THE U.S. RATE OF 2.4 DEATHS PER 100,000 POPULATION. b. CANCER TYPES - THE EXPECTED NUMBER OF NEW CASES IN NEBRASKA IN 2022 BY CANCER TYPE, AS PROJECTED BY THE AMERICAN CANCER SOCIETY WAS 11,280 OF WHICH BREAST, PROSTATE, LUNG, AND COLORECTAL CANCERS WERE THE MOST COMMON. THE EXPECTED NUMBER OF CANCER DEATHS IN NEBRASKA IN 2022 BY CANCER TYPE PROJECTED BY THE AMERICAN CANCER SOCIETY WAS 3,550. DEATHS FROM LUNG, COLORECTAL, PANCREATIC, AND BREAST CANCER WERE THE MOST COMMON. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER. 3.) DIABETES AND METABOLIC DISORDERS - DIABETES AND METABOLIC DISORDERS WERE IDENTIFIED AS A TOP HEALTH CONCERN BY RESPONDENTS OF THE COMMUNITY HEALTH ASSESSMENT. PEOPLE WITH DIABETES ARE MORE LIKELY TO HAVE HEALTH CONDITIONS SUCH AS HYPERTENSION, HIGH CHOLESTEROL, AND OBESITY. THESE CONDITIONS CAN ULTIMATELY LEAD TO SERIOUS HEALTH COMPLICATIONS INCLUDING HEART DISEASE, STROKE, KIDNEY FAILURE, BLINDNESS, NERVE DAMAGE, AND LOWER LIMB AMPUTATIONS. a. PREVALENCE - APPROXIMATELY 145,127 PEOPLE IN NEBRASKA, OR 9.8% OF THE ADULT POPULATION HAVE BEEN DIAGNOSED WITH DIABETES. THERE ARE APPROXIMATELY 522,000 PEOPLE IN NEBRASKA OR ABOUT 36.2% OF THE ADULT POPULATION WHO HAVE PREDIABETES WITH BLOOD GLUCOSE LEVELS THAT ARE HIGHER THAN NORMAL BUT NOT YET HIGH ENOUGH TO BE DIAGNOSED AS DIABETES. EVERY YEAR AN ESTIMATED 11,600 PEOPLE IN NEBRASKA ARE DIAGNOSED WITH DIABETES. ACCORDING TO THE BUFFALO COUNTY COMMUNITY PARTNERS DIABETES REFERRAL NETWORK, 1 IN 3 ADULTS HAVE PREDIABETES YET 90% DO NOT KNOW THEY HAVE IT. WITHOUT MAKING LIFESTYLE CHANGES, 15-30% OF PEOPLE WITH PREDIABETES WILL DEVELOP TYPE 2 DIABETES WITHIN 5 YEARS. ONLY 67.6% OF NEBRASKA ADULTS WITH DIABETES HAVE TAKEN A DIABETES SELF-MANAGEMENT COURSE. b. DISPARITIES - DIABETES AND METABOLIC DISORDERS DISPROPORTIONATELY AFFECT CERTAIN GROUPS, INCLUDING RACIAL AND ETHINC MINORITIES, LOW-INCOME COMMUNITIES, OLDER ADULTS, AND THOSE WITH LIMITED ACCESS TO HEALTHCARE. THESE DISPARITIES ARE OFTEN LINKED TO SOCIAL DETERMINANTS OF HEALTH, SUCH AS ACCESS TO NUTRITIOUS FOOD, SAFE ENVIRONMENTS FOR PHYSICAL ACTIVITY, EDUCATION, AND HEALTHCARE. AMONG U.S. ADULTS AGED 18 YEARS OR OLDER, AGE ADJUSTED DATA FOR 2019-2021 INDICATED THAT: FOR BOTH MEN AND WOMEN, PREVALENCE OF DIAGNOSED DIABETES WAS HIGHEST AMONG AMERICAN INDIAN AND ALASKA NATIVE ADULTS AT 13.6%, FOLLOWED BY NON-HISPANIC BLACK ADULTS AT 12.1%, ADULTS OF HISPANIC ORIGIN AT 11.7%, NON-HISPANIC ASIAN ADULTS AT 9.1%, AND NON-HISPANIC WHITE ADULTS AT 6.9%. PREVALENCE VARIED SIGNIFICANTLY BY EDUCATION LEVEL, WHICH IS AN INDICATOR OF SOCIOECONOMIC STATUS. SPECIFICALLY, 13.1% OF ADULTS WITH LESS THAN A HIGH SCHOOL EDUCATION HAD DIAGNOSED DIABETES COMPARED TO 9.1% OF THOSE WITH A HIGH SCHOOL EDUCATION AND 6.9% OF THOSE WITH MORE THAN A HIGH SCHOOL EDUCATION. ADULTS WITH FAMILY INCOME ABOVE 500% OF THE FEDERAL LEVEL HAD THE LOWEST PREVALENCE FOR BOTH MEN, 6.3%, AND WOMEN, 3.9%. BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER (KRMC) PARTNERS WITH THE COMMUNITY OF KEARNEY AND BUFFALO COUNTY, NEBRASKA THAT PROVIDES A WIDE RANGE OF PERSONAL HEALTH CARE PROVIDERS, MENTAL HEALTH PROVIDERS, FAMILY PRACTICE CLINICS, OTHER HEALTH FACILITIES AND MEDICAL AND DENTAL PROVIDERS THAT ADDRESS THE NEEDS OF THE LOCAL POPULATION AS WELL AS THE RESIDENTS IN THE CENTRAL NEBRASKA REGION. THE SIGNIFICANT HEALTH NEEDS THAT ARE IN THE ASSESSMENT ALONG WITH THEIR EVALUATED AND ADJUSTED OBJECTIVES AND GOALS WILL BE THE BASIS OF KRMC'S IMPLEMENTATION STRATEGY AND BE THE PRIORITY OF THE COMMUNITY'S HEALTH NEEDS TO IMPROVE THE OUTCOMES AT THE HOSPITAL AND IN THE COMMUNITY. 4 PLATTE VALLEY MEDICAL CLINIC 816 22ND AVE STE 100 KEARNEY NE 68845 ALLERGY & IMMUNOLOGY; CARDIOLOGY SERVICES; FAMILY MEDICINE PLATTE VALLEY NEUROLOGY 3003 CENTRAL AVE KEARNEY NE 68847 NEUROLOGY SERVICES PLATTE VALLEY PODIATRY 920 EAST 56TH STREET SUITE C KEARNEY NE 68847 PODIATRY SERVICES PLATTE VALLEY SPECIALTY CLINIC 3712 28TH AVE KEARNEY NE 68845 PLASTIC & RECONSTRUCTIVE SURGERY; GYNECOLOGY 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 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 THE UNREIMBURSED MEDICAID AMOUNTS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, BRYAN HOSPITAL 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. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENT THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 18-19 OF BRYAN HEALTH'S 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: https://www.bryanhealth.com/locations/hospitals/krmc/for-patients/billing-and-insurance/; Schedule H, Part V, Section B, Line 16b FAP Application website - BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER: Line 16b URL: https://www.bryanhealth.com/locations/hospitals/krmc/for-patients/billing-and-insurance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER: Line 16c URL: https://www.bryanhealth.com/locations/hospitals/krmc/for-patients/billing-and-insurance/; Schedule H, Part VI, Line 2 Needs assessment BRYAN HOSPITAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER (KRMC) IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY BY CONTINUALLY WORKING WITH THE COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. KRMC PARTNERED WITH TWO RIVERS DISTRICT HEALTH DEPARTMENT AND OTHERS WHO DEVELOPED AND DISTRIBUTED A COMMUNITY HEALTH ASSESSMENT SURVEY TO GATHER INPUT FROM THE COMMUNITY. THROUGH THE RESULTS OF THE COMMUNITY HEALTH SURVEY AND THROUGH THREE FOCUS GROUPS, KRMC IDENTIFIED THREE SIGNIFICANT HEALTH NEEDS THAT THEY WILL PRIORITIZE OVER THE NEXT FEW YEARS THROUGH THEIR COMMUNITY HEALTH IMPROVEMENT PLAN. 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 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 EMEREGENCY 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 PATIENT'S FREE OF CHARGE UPON REQUEST. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY POINT FROM PRE-ADMISSION TO THE FINAL PAYMENT OF THE BILL, AS WE RECOGNIZE THAT A PATIENT'S ABILITY TO PAY OVER AN EXTENDED PERIOD OF TIME MAY BE SUBSTANTIALLY ALTERED DUE TO ILLINESS 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 KEARNEY REGIONAL MEDICAL CENTER (KRMC) IS IN THE CITY OF KEARNEY LOCATED IN BUFFALO COUNTY, NEBRASKA. BUFFALO COUNTY IS THE 2ND MOST POPULOUS COUNTY IN NEBRASKA OUTSIDE THE LINCOLN-OMAHA REGION. THE THREE LARGEST CITIES IN BUFFALO COUNTY ARE KEARNEY, GIBBON, AND RAVENNA. 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. BUFFALO COUNTY IS ALSO HOME TO THE THIRD HIGHEST NUMBER OF ASSISTED LIVING/LONG TERM CARE FACILITIES IN NEBRASKA AFTER DOUGLAS AND LANCASTER COUNTIES." ACCORDING TO THE U.S. CENSUS BUREAU'S 2018-2022 ACS 5-YEAR NARRATIVE PROFILE, BUFFALO COUNTY HAD A TOTAL POPULATION OF 50,103. OF THESE, 24,976 OR 49.8% WERE FEMALE AND 25,127 OR 50.2% WERE MALES. THE MEDIAN AGE WAS 34.2 YEARS. AN ESTIMATED 22.8% OF THE POPULATION WAS UNDER 18 YEARS OLD, 40.4 % WAS 18 TO 44 YEARS, 21.1% WAS 45 TO 64 YEARS, AND 15.6% WAS 65 YEARS OLD AND OLDER. ACCORDING TO THE U.S. CENSUS BUREAU'S 2018-2022 ACS 5-YEAR NARRATIVE PROFILE FOR BUFFALO COUNTY, FOR PEOPLE REPORTING ONE RACE ALONE, 88.7% WERE WHITE, 0.9% WERE BLACK OR AFRICAN AMERICAN, 0.4% WERE AMERICAN INDIAN AND ALASKA NATIVE, 1.6% WERE ASIAN, AND 4.5% WERE SOME OTHER RACE. AN ESTIMATED 3.9% REPORTED TWO OR MORE RACES. AN ESTIMATED 9.7% OF THE PEOPLE IN BUFFALO COUNTY, NEBRASKA WERE HISPANIC OR LATINO. AN ESTIMATED 85.5% OF THE PEOPLE IN BUFFALO COUNTY, NEBRASKA WERE WHITE ALONE, NON-HISPANIC. ACCORDING TO THE U.S. CENSUS BUREAU'S ACS 5-YEAR NARRATIVE PROFILE, IN BUFFALO COUNTY, IN 2018-2022, 11.8% OF PEOPLE WERE IN POVERTY. AN ESTIMATED 11.3% OF CHILDREN UNDER 18 WERE BELOW THE POVERTY LEVEL, COMPARED WITH 10.2% OF PEOPLE 65 YEARS OLD AND OVER. AN ESTIMATED 12.4% OF PEOPLE 18 TO 64 YEARS WERE BELOW THE POVERTY LEVEL. IN 2018-2022, 8.0% OF HOUSEHOLDS RECEIVED SNAP (THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM). AN ESTIMATED 56.6% OF HOUSEHOLDS THAT RECEIVED SNAP HAD CHILDREN UNDER 18, AND 24.9% OF HOUSEHOLDS THAT RECEIVED SNAP HAD ONE OR MORE PEOPLE 60 YEARS AND OVER. AN ESTIMATED 39.3% OF ALL HOUSEHOLDS RECEIVING SNAP WERE FAMILIES WITH A FEMALE HOUSEHOLDER AND NO SPOUSE PRESENT. AN ESTIMATED 24.0% OF HOUSEHOLDS RECEIVING SNAP HAD TWO OR MORE WORKERS IN THE PAST 12 MONTHS. KEARNEY HAS ONE OF THE LOWEST UNEMPLOYMENT RATES IN THE NATION. ACCORDING TO THE NEBRASKA DEPARTMENT OF LABOR, KEARNEY'S UNEMPLOYMENT RATE IN JANUARY 2024 WAS 2.1%, UP SLIGHTLY FROM 1.8% IN JANUARY 2023. ACCORDING TO 2022 CENSUS DATA 68.7% OF BUFFALO COUNTY'S POPULATION 16 AND OVER ARE EMPLOYED AND 29.0% ARE NOT CURRENTLY IN THE LABOR FORCE. AS OF 2022, THE TOP ECONOMIC SECTOR IN BUFFALO COUNTY IS HEALTHCARE/SOCIAL ASSISTANCE WITH TWO OF KEARNEY'S TOP EMPLOYERS BEING KEARNEY REGIONAL MEDICAL CENTER AND CHI GOOD SAMARITAN. OTHER TOP EMPLOYERS INCLUDE THE UNIVERSITY OF NEBRASKA - KEARNEY, KEARNEY PUBLIC SCHOOLS, THE BUCKLE, PARKER HANNIFIN, AND EATON CORPORATION. THE MEDIAN HOUSEHOLD INCOME IN BUFFALO COUNTY IN 2021 WAS $65,810, MORE THAN $5,000 ABOVE THE STATE OF NEBRASKA'S MEDIAN HOUSEHOLD INCOME. IN 2018-2022, 92.6% OF PEOPLE 25 YEARS AND OVER HAD AT LEAST GRADUATED FROM HIGH SCHOOL AND 35.2% HAD A BACHELOR'S DEGREE OR HIGHER. AN ESTIMATED 7.5% DID NOT COMPLETE HIGH SCHOOL. THE TOTAL SCHOOL ENROLLMENT IN BUFFALO COUNTY, NEBRASKA WAS 14,555 IN 2018-2022. NURSERY SCHOOL ENROLLMENT WAS 769 AND KINDERGARTEN THROUGH 12TH GRADE ENROLLMENT WAS 8,260. COLLEGE OR GRADUATE SCHOOL ENROLLMENT WAS 5,526. ACCORDING TO TWO RIVERS PUBLIC HEALTH DISTRICT REPORT, THE PROPORTION OF PEOPLE WITH A HIGH SCHOOL OR COLLEGE DEGREE IN BUFFALO COUNTY IS COMPARABLE TO THAT OF THE WHOLE STATE OF NEBRASKA. IN 2024, BUFFALO COUNTY RESIDENTS REPORTED THESE LESS-HEALTHY BEHAVIORS THAN NATIONAL AVERAGES: ADULT OBESITY, PHYSICAL INACTIVITY, AND EXCESSING DRINKING. THE RESIDENTS IN BUFFALO COUNTY HAVE LESS ACCESS TO PRIMARY CARE PHYSICIANS, DENTISTS, AND MENTAL HEALTH PROVIDERS COMPARED TO BOTH STATEWIDE AND NATIONAL AVERAGES. THERE IS ONE PRIMARY CARE PHYSICIAN PER 1,140 PEOPLE IN BUFFALO COUNTY, NEBRASKA AND ONLY ONE MENTAL HEALTH PROVIDER PER 230 PEOPLE. ACCORDING TO THE 2024 BUFFALO COUNTY COMMUNITY PROFILE, THE TOP CAUSES OF DEATH FOR RESIDENTS ARE HEART DISEASE, CANCER, CHRONIC LUNG DISEASE, AND UNINTENTIONAL INJURY. THERE IS ONE CITY LOCATED IN BUFFALO COUNTY, NEBRASKA, THAT IS IDENTIFIED BY HEALTH RESOURCES & SERVICES AS A MEDICALLY UNDERSERVED AREA AND MEDICALLY UNDERSERVED POPULATION DESIGNATION AND IT'S THE CITY OF RAVENNA. 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 HOSPTIAL KEARNEY DBA KEARNEY REGIONAL MEDICAL CENTER (KRMC) 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 THE COMMUNITY IN THE FUTURE. KRMC IS DEDICATED TO BRING THE COMMUNITY MODERN FACILITIES WITH THE NEWEST TECHNOLOGY AND PRACTICES FOR IMPROVED DIAGNOSIS, SURGERIES, TREATMENTS, AND OUTCOMES. AS A NON-PROFIT HOSPITAL, THE SURPLUS FUNDS ARE USED TO UPDATE THE FACILITIES AND REPLACE THE EQUIPMENT WITH THE NEWEST TECHNOLOGY TO BETTER SERVICE THE PATIENTS AND COMMUNITIES. KRMC ALSO PROVIDES FREE CLASSES FOR FAMILIES THAT ARE EXPECTING SIBLINGS TO HELP TEACH THE BIG BROTHERS AND SISTERS WHAT TO EXPECT WHEN THEY ARE A BIG SIBLING. IN 2024, KRMC BOARD CONSISTED OF 11 VOTING BOARD MEMBERS, 9 OF WHOM RESIDE WITHIN A 25 MILE RADIUS OF THE FACILITY. THE MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT BOARD MEMBERS WHO NEITHER ARE EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION. 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 FIVE URGENT CARE CENTERS, 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 true AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 5500 GENERAL SUPPORT KEARNEY HIGH SCHOOL 2702 WEST 11TH STREET KEARNEY NE 68845 476001393 GOVERNMENT 5640 ATHLETICS, GENERAL SUPPORT 2 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds THE CONTRIBUTIONS COMMITTEE OF BRYAN HEALTH OVERSEES THE GRANT ALLOCATION AND MANAGEMENT FOR THIS ORGANIZATION. EACH POTENTIAL RECIPIENT IS REQUIRED TO APPLY FOR A GRANT. THE CONTRIBUTIONS COMMITTEE REVIEWS AND DISCUSSES ALL SUBMITTED REQUESTS IN DETAIL. THE COMMITTEE EVALUATES REQUESTS ON THESE CRITERIA: DOES THE PROJECT OR AGENCY ADDRESS NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, IS THE REQUESTING AGENCY LOCAL, IS THE REQUEST RELATED TO HEALTH IN THE COMMUNITIES WE SERVE & DOES THE REQUEST HELP KIDS. GRANTS ARE AWARDED BASED ON NEED AND ELIGIBILITY. false true false false false false false true false RUSSELL GRONEWOLD EX-OFFICIO MEMBER 0 1052649 0 328847 0 345808 0 24150 0 26023 0 1777477 0 0 JOHN WOODRICH EX-OFFICIO MEMBER 0 727342 0 209946 0 322431 0 21350 0 21862 0 1302931 0 0 JON PEPPMULLER CONTROLLER - BRYAN HEALTH 0 271282 0 35708 0 28618 0 16779 0 26315 0 378702 0 0 DANNY VAN RANKEN KRMC CHIEF OPERATING OFFICER 254507 0 29699 0 2946 0 14535 0 27282 0 328969 0 0 0 DOUGLAS KOCH KRMC CHIEF EXECUTIVE OFFICER EFFECTIVE 8/5/2024 135614 0 0 0 5842 0 6851 0 10180 0 158487 0 0 0 WILLIAM CALHOUN KRMC CHIEF EXECUTIVE OFFICER, RESIGNED 1/26/2024 47536 0 56840 0 48823 0 11108 0 3965 0 168272 0 0 0 DERICK LORENTZ CFO (EFFECTIVE 10/24/2024) 52677 183020 0 13666 738 12121 2600 10373 6881 34109 62896 253289 0 0 DENISE MURRY-PORTER RN RN ANESTHETIST 159629 0 5250 0 748 0 7574 0 12642 0 185843 0 0 0 KATY FISHER RN RN ANESTHETIST LEAD 297335 0 44280 0 26185 0 17250 0 5827 0 390877 0 0 0 MATTHEW WECKER RN RN ANESTHETIST 270108 0 27025 0 21543 0 14500 0 35669 0 368845 0 0 0 PATRICK DAVIDSON RN RN ANESTHETIST 279809 0 28647 0 39486 0 16795 0 17095 0 381832 0 0 0 THOMAS MCLEOD ADMINISTRATOR OF CLINIC AND PROVIDER 222573 0 30835 0 17495 0 18405 0 34733 0 324041 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 EMPOLYERS 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 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, 2024. 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 2024: JOHN WOODRICH $234,417 AND RUSS GRONEWOLD $284,573. 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 BEHAVIORS REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THE BOARDS 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. Schedule J, Part II, Column (B)(ii) COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES A TOTAL OF $44,623 BONUSES ACCRUED IN 2023 AND IN 2024 ARE REPORTED ON THE 2024 SCHEDULE J COLUMN (BII) AND A TOTAL OF $54,591 BONUSES ACCRUED IN 2024 WILL BE PAID IN 2025 WHICH WILL BE REPORTED ON THE 2025 SCHEDULE J COLUMN (BII). 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, SECRETARY AND TREASURER OF THE BOARD. 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 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 OF 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 OR 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 THE FORM 990 AND ATTACHED SCHEDULES IN AN ACCURATE AND THOROUGH MANNER. THIS 990 WAS REVIEWED BY THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND OTHER KEY OFFICERS OF BRYAN HEALTH. THIS 990 WAS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. BRYAN HEALTH'S BOARD OF TRUSTEES HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE BOARD'S AUDIT COMMITTEE. EACH MEMBER OF THE AUDIT COMMITTEE HAS THE OPPORTUNITY TO REVIEW A COMPLETE COPY OF THIS FORM 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 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 A 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 MANAGMENT 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 MANAGMENT 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, 2024. 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 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: 2468344, Program Service Expense: 2359428, Management and General Expenses: 108916, Fundraising Expenses: ; RECRUTING - Total Expense: 507438, Program Service Expense: 485047, Management and General Expenses: 22391, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 2454074, Program Service Expense: 2343334, Management and General Expenses: 110740, Fundraising Expenses: ; MISCELLANEOUS FEES - Total Expense: 6050016, Program Service Expense: 5695667, Management and General Expenses: 354349, Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 10038643, Program Service Expense: 9815986, Management and General Expenses: 222657, Fundraising Expenses: ; PHYSICIAN SERVICES - Total Expense: 31666187, Program Service Expense: 31666187, Management and General Expenses: , Fundraising Expenses: ; BRYAN HEALTH 1600 SOUTH 48TH STREET LINCOLN NE 68506 363414823 HEALTHCARE NE 501(c)(3) Type III-FI NA false CRETE AREA MEDICAL CENTER 2910 BETTEN DRIVE CRETE NE 68333 470841285 HEALTHCARE NE 501(c)(3) 3 BRYAN HEALTH true BRYAN FOUNDATION 1600 SOUTH 48TH STREET LINCOLN NE 68506 237005720 FUNDRAISING NE 501(c)(3) 7 BRYAN HEALTH true BRYAN PHYSICIAN NETWORK 1600 SOUTH 48TH STREET LINCOLN NE 68506 201357375 HEALTHCARE NE 501(c)(3) 10 BRYAN HEALTH true 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 688269501 470710738 FUNDRAISING NE 501(c)(3) Type I MERRICK MEDICAL CENTER true BRYAN MEDICAL CENTER 1600 SOUTH 48TH STREET LINCOLN NE 68506 470376552 HEALTHCARE NE 501(c)(3) 3 BRYAN HEALTH true GRAND ISLAND REGIONAL MEDICAL CENTER 3533 PRAIRIEVIEW STREET GRAND ISLAND NE 68803 352621082 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 1600 SOUTH 48TH STREET LINCOLN NE 68506 364835603 HEALTHCARE NE NA N/A HEAD AND NECK SURGICAL PARTNERS LLC 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 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 TELEMEDICINE LLC 2222 S 16TH ST STE 401A LINCOLN NE 68502 383932523 HEALTHCARE NE NA N/A BRYAN HEART MARY LANNING CARDIOLOGY LLC 1600 SOUTH 48TH STREET LINCOLN NE 68506 464822260 CARDIOLOGY SERVICES NE NA N/A KHL-RO LLC 4101 TIGER LILY RD STE 100 LINCOLN NE 68516 883562359 MEDICAL SERVICES NE BRYAN HOSPITAL KEARNEY Related -494 false true 0.36 KPT&G LLC C/O MDM 300 N MEAD STE 210 WICHITA KS 67202 363414823 RENTAL REAL ESTATE NE NA N/A BRYAN ENTERPRISES INC 1600 SOUTH 48TH STREET LINCOLN NE 68508 470701037 MEDICAL SERVICES NE NA C Corporation true INTEGRATED CARIOLOGY GROUP LLC 1600 SOUTH 48TH STREET LINCOLN NE 68506 470844961 CARDIOLOGY NE NA C Corporation true BRYAN HEALTH CONNECT 1600 SOUTH 48TH STREET LINCOLN NE 68506 364771145 PHYSICIAN HOSPITAL ORGANIZATION NE NA C Corporation true false false true true false false false false false false false true true true true true true true false BRYAN MEDICAL CENTER O 733845 FMV BRYAN MEDICAL CENTER N 543433 FMV GRAND ISLAND REGIONAL MEDICAL CENTER O 129859 FMV BRYAN MEDICAL CENTER M 2452013 FMV