2025-11-11T11:11:37+00:00 2024-12-31 440160260 Forvis Mazars LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2024-01-01 820906268 Merrick Medical Center MERR 3089463015 2802 28th Street Central City NE 68826 JODI MOHR CEO 3089463015 2025-11-11 true Michael Engle P00482834 8162216300 2025-11-11 2024 2025-03-06 01:10:19Z JODI MOHR 2802 28th Street Central City NE 68826 30175719 false X WWW.BRYANHEALTH.COM X 2017 NE MERRICK MEDICAL CENTER IS COMMITTED TO PROMOTING AND PROVIDING PERSONALIZED, COMPASSIONATE, QUALITY HEALTH SERVICES. DURING 2024, MERRICK MEDICAL CENTER PROVIDED CHARITY CARE TO 329 PATIENTS AT A COST OF $273,343. 6 2 160 2 0 972551 442522 25456801 29053853 211556 531421 188919 138107 26829827 30165903 0 0 0 12760661 14551575 0 0 11892233 11853919 24652894 26405494 2176933 3760409 42493337 46061197 20411076 20218527 22082261 25842670 MERRICK MEDICAL CENTER IS COMMITTED TO PROMOTING AND PROVIDING PERSONALIZED, COMPASSIONATE, QUALITY HEALTH SERVICES. MERRICK MEDICAL CENTER'S VISION IS TO BE THE LEADER IN PATIENT-CENTERED CARE, PROVIDING EXCEPTIONAL SERVICE, QUALITY OUTCOMES AND MAKING A MEASURABLE IMPROVEMENT IN THE HEALTH AND LIVES OF OTHERS. false false 23049933 29073332 MERRICK MEDICAL CENTER (MMC), IS A HOSPITAL ORGANIZATION LOCATED IN CENTRAL CITY, NEBRASKA, AND IS PART OF THE BRYAN HEALTH SYSTEM. MMC WAS INCORPORATED ON MARCH 15, 2017, WITH HOSPITAL OPERATIONS COMMENCING ON JULY 1, 2017. MMC OPERATES A 6 LICENSED BED CRITICAL ACCESS HOSPITAL AND 2 PHYSICIAN CLINICS. MMC IS COMMITTED TO SERVING PATIENTS AND THE COMMUNITY BY INVESTING FUNDS IN FACILITIES, TECHNOLOGY, PHYSICIANS, AND STAFF TO DELIVER PREMIUM HEALTHCARE TO CENTRAL CITY AND THE SURROUNDING COMMUNITIES. MMC SUPPORTS NUMEROUS HEALTH CARE SERVICES, FITNESS AND WELLNESS PROGRAMS, TELEHEALTH TECHNOLOGY AND COMMUNITY PARTNERSHIPS. DURING 2024, MMC PROVIDED INPATIENT ACUTE AND SWING BED SERVICES TO 274 PATIENTS. ALSO, MMC PERFORMED 329 SURGICAL PROCEDURES AND PROVIDED PRIMARY CARE PHYSICIAN SERVICES WITH 15,310 VISITS. IN 2024, MMC PROVIDED CHARITY CARE TO 329 PATIENTS AND SERVED 754 MEDICAID PATIENTS. MMC IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. 23049933 true true false true false 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 true false false false false false false false false false false false false false false false true true true false false true 32 0 true 160 true false false false false false false false false false false false false X 6 2 true false false false true true true true true false false false true true true true true true true true false false NE X KRYS CLAYMORE 3089465976 2802 28TH STREET CENTRAL CITY NE 68826 NATHAN PERRY CHAIR 1.0 0 X X 0 0 0 PAT GANYO SECRETARY/TREASURER 1.0 52.0 X X 0 446004 47424 SHANNON HANNAPPEL VICE CHAIR 1.0 0 X X 0 0 0 BLAKE COVER MD PHYSICIAN/EX-OFFICIO DIRECTOR 50.0 1.0 X 476776 0 48990 JULIE LACY EX-OFFICIO DIRECTOR 1.0 51.0 X 0 229544 29984 RICHARD LLOYD DIRECTOR 1.0 50.0 X 0 506079 46054 JODI MOHR CEO MERRICK MEDICAL CENTER (EFFECTIVE 6/17/2024) 50.0 0 X 116649 0 5266 BRIAN BUHLKE DO PHYSICIAN 50.0 0 X 416232 0 52424 RICHARD POPPE MD PHYSICIAN 50.0 0 X 455560 0 50419 RYAN SANTIN MD PHYSICIAN 50.0 0 X 323326 0 52276 RYAN STAGEMEYER RN RN ANESTHETIST 50.0 0 X 297165 0 51960 TRACI DIECKMANN DO PHYSICIAN 50.0 0 X 410940 0 48001 2496648 1181627 432798 24 false true false FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET SUITE 420 OMAHA NE 68154 TEMPORARY LABOR 645108 SHARED MEDICAL SERVICES INC 209 LIMESTONE PASS COTTAGE GROVE WI 53527 MOBILE IMAGING SERVICES 147477 SIEMENS HEALTHCARE DIAGNOSTICS 511 BENEDICT AVE TARRYTOWN NY 10591 LABORATORY DIAGNOSTICS SERVICES 107072 3 100200 342322 442522 NET PATIENT CARE REVENUE 622110 24463394 24463394 PHARMACY 446110 3943018 3943018 VALUE BASED INCOME 622110 626821 626821 LEASED EMPLOYEES 622110 17675 17675 HEALTH INFORMATION SERVICES 621300 2945 2945 0 0 0 0 29053853 383237 383237 0 0 158000 9816 0 148184 148184 148184 0 CAFETERIA SALES 722310 118628 118628 PURCHASED DISCOUNTS 900099 18048 18048 COMMUNITY WELLNESS INCOME 900099 850 850 581 581 0 0 138107 30165903 29073332 0 650049 X 647681 647681 10800724 10049518 751206 517060 463389 53671 1872988 1268865 604123 713122 639100 74022 88 88 94074 94074 3412498 3133269 279229 0 57583 57583 299307 239446 59861 33893 30375 3518 473749 421637 52112 2675811 2381472 294339 46748 40107 6641 DRUGS 2069797 2069797 CORPORATE COST ALLOCATIONS 1037013 829610 207403 SUPPLIES 763265 701574 61691 EQUIPMENT RENTAL 9549 7215 2334 880544 774559 105985 0 26405494 23049933 3355561 0 705 805 11438394 16110895 2343062 4262615 0 0 0 0 131618 17111 357954 382035 150380 160636 33179638 8556300 27086209 24623338 0 0 985015 503762 42493337 46061197 2271681 1879214 18139395 17373486 0 0 0 965827 20411076 20218527 X 22082261 25842670 22082261 25842670 42493337 46061197 3760409 0 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2990 2990 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY MERRICK MEDICAL CENTER IS A MEMBER OF THE NEBRASKA HOSPITAL ASSOCIATION (NHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE NHA OF $7,587. OF THIS AMOUNT THE NHA REPORTED THAT 13.02% OR $988 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES. DURING THE CURRENT YEAR, THE REPORTING ORGANIZATION MADE PAYMENTS FOR THE MEMBERSHIP DUES TO THE AHA OF $6,255. OF THIS AMOUNT THE AHA REPORTED THAT 32% OR $2,002 OF THE TOTAL DUES PAID WERE USED FOR LOBBYING ACTIVITIES. 626000 626000 23226879 3785008 19441871 7614383 4343708 3270675 1712376 427584 1284792 24623338 Federal Income Taxes THIRD PARTY PAYOR SETTLEMENT 965827 965827 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote UNDER ACCOUNTING STANDARDS CODIFICATION (ASC), SUBTOPIC 740-10, INCOME TAXES, THE SYSTEM MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS "MORE-LIKELY-THAN-NOT" THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES AND ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURE. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AT DECEMBER 31, 2024, AND 2023. THE SYSTEM DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. TAX RETURNS FILED BY THE SYSTEM ARE SUBJECT TO EXAMINATION BY THE IRS UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. THE SYSTEM RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE SYSTEM DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT DECEMBER 31, 2024, AND 2023. true true X true X true X 329 273343 273343 0.01035 754 2108984 1743084 365900 0.01386 0 0.0 0 1083 2382327 1743084 639243 0.02421 124017 850 123167 0.00466 0 0.0 44810 44810 0.00170 0 0.0 1650 1650 0.00006 0 0 170477 850 169627 0.00642 0 1083 2552804 1743934 808870 0.03063 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 6993638 8989237 -1995599 X true true 1 1 MERRICK MEDICAL CENTER 2802 28TH STREET CENTRAL CITY NE 68826 https://www.bryanhealth.com/locations/hospitals/merrick-medical-center/ H000131 X X X MERRICK MEDICAL CENTER 1 false false true X X X X X X X X X 24 true true true true X HTTP://WWW.BRYANHEALTH.COM/ABOUT-BRYAN-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X true 25 true HTTP://WWW.BRYANHEALTH.COM/ABOUT-BRYAN-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ false true X 200.0 400.0 X X X X X X true true X X X X true X 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 ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MERRICK MEDICAL CENTER. THE HEALTH ASSESSMENT AND PRIORITY COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT WAS A COLLABORATIVE EFFORT BETWEEN MERRICK MEDICAL CENTER, MEMORIAL COMMUNITY HEALTH, CHI ST. FRANCIS, GRAND ISLAND REGIONAL MEDICAL CENTER, CENTRAL HEALTH DISTRICT HEALTH DEPARTMENT AND THE NEBRASKA ASSOCIATION OF LOCAL HEALTH DIRECTORS. THE INFORMATION WAS GATHERED BY EXTENSIVE INPUT FROM INDIVIDUALS REPRESENTING A BROAD INTEREST OF CENTRAL CITY, MERRICK COUNTY, HALL COUNTY, AND HAMILTON COUNTY. CENTRAL DISTRICT HEALTH DEPARTMENT DEVELOPED A SURVEY WITH COLLABORATION FROM MULTICULTURAL COALITION, CITY OF GRAND ISLAND, GRAND ISLAND CHAMBER OF COMMERCE, CENTRAL NEBRASKA COUNCIL ON ALCOHOLISM AND ADDICTIONS, AND IDEA BANK. THE DISTRIBUTION METHODS INCLUDED: RADIO PROMOTION, FLYERS AND BUSINESS CARDS WITH QR CODES, DISTRIBUTION AT COMMUNITY EVENTS. THE CENTRAL DISTRICT HEALTH DEPARTMENT ALSO ASSISTED IN COLLECTING ADDITIONAL SURVEY RESPONSES FROM COMMUNITY MEMBERS WHO SPEAK SPANISH, ARABIC, AND SOMALI, AS WELL AS COMMUNITY MEMBERS WITH LOW LITERACY LEVELS WHO MAY NOT HAVE PARTICIPATED IN THE ONLINE SURVEY. THESE ADDITIONAL SURVEY RESPONSES WERE OBTAINED TO BOLSTER THE SURVEY RESPONSES FROM ALL SEGMENTS OF THE CENTRAL DISTRICT COMMUNITY. THE TOPICS THAT WERE INCLUDED IN THE SURVEY WERE: IDENTIFYING TRUSTED SOURCES FOR OBTAINING HEALTH INFORMATION; OVERALL HEALTH, MENTAL HEALTH STATUSES, KNOWLEDGE ON OPIOID CRISIS, AND PREFERRED METHODS OF RECEIVING MENTAL OR BEHAVIORAL HEALTH SUPPORT; PREFERRED METHODS OF OBTAINING AND LEARNING HEALTH INFORMATION FROM SOCIAL MEDIA, NEWS, RADIO, ETC; WHAT WAS THE LAST MAJOR HEALTH ISSUE YOU OR YOUR FAMILY EXPERIENCED?; WHAT WORRIES YOU MOST ABOUT YOUR HEALTH OR THE HEALTH OF YOUR FAMILY?; WHAT ARE YOUR TOP THREE HEALTH CONCERNS?; WHAT IS SOMETHING YOU DO TO BE HEALTHY?; WHAT WOULD MAKE YOUR NEIGHBORHOOD A HEALTHIER PLACE FOR YOU OR YOUR FAMILY? THROUGH THE RESULTS OF THE COMMUNITY HEALTH SURVEY AS WELL AS OTHER PRIMARY RESEARCH AND DATA AVAILABLE, MERRICK MEDICAL CENTER IDENTIFIED THREE SIGNIFICANT HEALTH NEEDS WITHIN CENTRAL CITY AND MERRICK COUNTY THAT REQUIRE PRIORITIZED FOCUS OVER THE NEXT FEW YEARS: 1.) CARDIOVASCULAR DISEASE 2.) CANCER 3.) MENTAL HEALTH. THESE SIGNIFICANT HEALTH NEEDS WERE SELECTED BASED ON A COMBINATION OF FACTORS, INCLUDING RESPONSES FROM THE COMMUNITY HEALTH SURVEY, ANALYSIS OF COMMUNITY DATA SOURCES SUCH AS MERRICK COUNTY'S VITAL STATISTICS, BRYAN HEALTH'S OWN INTERNAL HOSPITALIZATION DATA AND OTHER FORMS OF RESEARCH. THESE SELECTIONS DO NOT IMPLY THAT OTHER HEALTH NEEDS ARE NOT WORTHY OF ATTENTION, OR THAT EFFORTS IN OTHER AREAS SHOULD BE DIVERTED TO THESE. IN FACT, OTHER AREAS OF NEED MIGHT BE REPORTED AS LOWER PRIORITY BECAUSE OF MERRICK MEDICAL CENTER'S AND THE COMMUNITY EFFORT TO ALLEVIATE THEM. THE SELECTED NEED PRIORITIES APPEAR TO BE THE MOST PRESSING AT THE TIME OF ASSESSMENT DUE TO A COMBINATION OF PREVALENCE, SEVERITY, COMMUNITY INTEREST AND THE CURRENT LEVEL AT WHICH THE NEED IS BEING APPROPRIATELY ENGAGED. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - CENTRAL DISTRICT HEALTH DEPARTMENT. CENTRAL DISTRICT HEALTH DEPARTMENT SERVES A THREE COUNTY AREA INCLUDING MERRICK COUNTY. THEIR MISSION IS TO PROTECT AND IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY THEY SERVE, PROMOTE HEALTH BY PROVIDING EDUCATION AND RESOURCES TO PREVENT CHRONIC AND INFECTIOUS DISEASES, PROVIDE CONSISTENT QUALITY CARE AND CUSTOMER FOCUSED SERVICE TO MEET THE HEALTH AND WELLNESS GOALS OF INDIVIDUALS AND THE COMMUNITY AS A WHOLE, SUPPORT OPPORTUNITIES FOR PEOPLE TO BE AS HEALTHY AS POSSIBLE, RECOGNIZE THE VALUE OF INDIVIDUALS BY BEING OPEN, HONEST, AND POLITE AND ACKNOWLEDGE DIVERSITY AND TREAT EVERYONE IN A PROFESSIONAL, COURTEOUS, AND NON-JUDGMENTAL MANNER. SERVICES OFFERED THROUGH CENTRAL DISTRICT HEALTH DEPARTMENT ARE VACCINATIONS, TB TESTING, REFUGEE SUPPORT AND HEALTH, FREE DENTAL CARE TO KIDS IN THE DISTRICT, AND MANY OTHER HEALTH SERVICES. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MERRICK MEDICAL CENTER. THE RESULTS FROM THE COMMUNITY HEALTH SURVEY PRIORITIZED THESE HEALTH FOCUS AREAS OVER THE NEXT FEW YEARS, 1.) CARDIOVASCULAR DISEASE, 2.) CANCER, AND 3.) MENTAL HEALTH. 1.) CARDIOVASCULAR DISEASE - HEART DISEASE HAS BEEN ONE OF THE TWO LEADING CAUSES OF DEATH IN MERRICK COUNTY. MERRICK COUNTY LEADS IN CORONARY HEART DISEASE, HIGH BLOOD PRESSURE, STROKE, OBESITY AND SMOKING IN THE CENTRAL DISTRICT HEALTH DEPARTMENT AREA. MERRICK COUNTY HAS BEEN ABLE TO REDUCE THE PERCENTAGE OF DIABETIC'S OVERALL A1C DUE TO AN ACTIVE ACCOUNTABLE CARE ORGANIZATION (ACO). THROUGH THIS ACTION, DIABETES HAS BEEN REMOVED AS A PRIORTIZED HEALTH NEED. MERRICK MEDICAL CENTER RECOGNIZED THE NEED FOR ADDITIONAL CARDIOVASCULAR DISEASE RESOURCES AS MERRICK MEDICAL CENTER HAS ADDED A VASCULAR SPECIALIST WHILE ENHANCING CARDIOLOGY REHABILITATION SERVICES AND CARDIAC TESTING. 2.) CANCER - CANCER HAS HELD AS ONE OF MERRICK COUNTY'S MOST PROMINENT CAUSES OF DEATH FOR MORE THAN A DECADE. CANCER WAS ONE OF THE LEADING CAUSES OF DEATH IN MERRICK COUNTY FOR 2023. BETWEEN 2016-2020 THERE WERE 462 INCIDENCES OF CANCERS REPORTED IN MERRICK COUNTY AND BREAST CANCER IS THE MOST REPORTED TYPE OF CANCER DURING THAT TIME FRAME. MERRICK MEDICAL CENTER HAS A 3D DIGITAL MAMMORAPHY TO OFFER MAMMOGRAPHY SERVICE TO HELP WITH DETECTING BREAST CANCER EARLY WHEN IT IS MOST TREATABLE. MERRICK MEDICAL CENTER IS A HIGH PERFORMING ACCOUNTABLE CARE ORGANIZATION (ACO) WHICH UTILIZES A CARE COORDINATION MODEL TO CLOSE PATIENT GAPS SUCH AS CANCER SCREENINGS. ACO IS A GROUP OF DOCTORS, HOSPITALS AND/OR OTHER HEALTH CARE PROVIDERS WHO WORK TOGETHER TO IMPROVE THE QUALITY AND EXPERIENCE OF YOUR HEALTH. 3.) MENTAL HEALTH - NEBRASKA YOUTH MENTAL HEALTH RANKING IN 2023 OVERALL IS 49 OUT OF 51 WHICH INDICATES A HIGH PREVALENCE OF MENTAL ILLNESS AND LOWER RATES OF ACCESS TO CARE. THE CENTRAL DISTRICT RANKS ABOVE THE STATE OF NEBRASKA IN FREQUENT MENTAL DISTRESS AND THE AVERAGE NUMBER OF DAYS MENTAL HEALTH WAS NOT GOOD IN ADULTS 18 AND OVER. CENTRAL DISTRICT IS 3.9% HIGHER IN PERSONS TOLD THEY HAD DEPRESSION THAN STATE OF NEBRASKA PERCENTAGE. MERRICK MEDICAL CENTER HAS RECENTLY EMPLOYED A PSYCHIATRIST AND A MENTAL HEALTH NURSE THAT IS HOUSED IN THE RURAL CLINIC TO PROVIDE ADDITIONAL ANONYMITY AND CONFIDENTIALITY. CENTRAL CITY IN MERRICK COUNTY IS HOME TO FOUR FACILITIES WHO OFFER BEHAVIORAL HEALTH AND/OR MENTAL HEALTH HOUSING. MERRICK MEDICAL CENTER ALONG WITH OTHER PERSONAL HEALTH CARE PROVIDERS AND FACILITIES WILL ADDRESS THE NEEDS OF THE LOCAL POPULATION THROUGHOUT THE NEXT FEW YEARS AND CREATE A CHIP PLAN TO BEST PROVIDE THE NEEDED SERVICES TO THE RESIDENTS WITHIN THE TRI-COUNTY AREA. 2 CENTRAL CITY MEDICAL CLINIC 2510 18TH AVENUE CENTRAL CITY NE 68826 RURAL HEALTH CLINIC FULLERTON MEDICAL CLINIC 901 BROADWAY STREET FULLERTON NE 68638 RURAL HEALTH CLINIC Schedule H, Part I, Line 7e COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS HEART DISEASE IS ONE OF THE TWO LEADING CAUSES OF DEATH IN MERRICK COUNTY. MERRICK COUNTY LEADS IN CORONARY HEART DISEASE, HIGH BLOOD PRESSURE, STROKE, OBESITY, AND SMOKING. MERRICK MEDICAL CENTER (MMC) HAS DEVELOPED A CARDIOVASCULAR DISEASE ACTION PLAN. MMC IS USING A CARE COORDINATION MODEL TO CLOSE CARE GAPS BY 1.) ADDING A CARDIAC REHAB REGISTERED NURSE 2.) ALLOCATE ADDITIONAL DIETITIAN AND DIABETIC EDUCATOR HOURS AND 3.) ADD NUTRITION SUPPORT GROUP. THE GOALS WITH THIS ACTION PLAN IS CONTROLLING HIGH BLOOD PRESSURE AND BRINGING DOWN DIABETES GLYCEMIC STATUS ASSESSMENT. CANCER IS THE OTHER LEADING CAUSE OF DEATH IN MERRICK COUNTY. MMC'S CANCER ACTION PLAN TO CLOSE THE CARE GAPS IS 1.) STREAMLINE AND ADD ONCOLOGY RESOURCES BY INCREASING REFERRALS TO ONCOLOGY PROVIDER GROUP, COLLABORATE WITH SYSTEM CANCER CENTERS LOCATED IN LINCOLN AND KEARNEY 2.) ADD CHRONIC CARE MANAGEMENT HOURS 3.) ADD ADDITIONAL RN HOURS TO THE SPECIALTY CLINIC. THE GOAL OF THE ACTION PLAN IS TO LOWER THE THREE MAIN CANCER CAUSES OF DEATH FROM COLORECTAL, BREAST AND CERVICAL CANCER BY EARLY SCREENINGS. THE CENTRAL DISTRICT HAS A HIGH PREVALENCE OF MENTAL HEALTH AND HAS A LOWER RATE OF ACCESS TO CARE. MMC'S ACTION PLAN FOR MENTAL HEALTH IS TO ADD ADDITIONAL RESOURCES TO THE MENTAL HEALTH CLINIC BY 1.) INCREASE MENTAL HEALTH PROVIDER BY ONE FULL TIME PROVIDER 2.) INCREASE THE CAPACITY OF THE SPRAVATO THERAPY CLINIC BY FIVE PATIENTS MAKING THE TOTAL OF TEN PATIENTS. THE GOALS RELATED TO THE MENTAL HEALTH ACTION PLAN ARE TO INCREASE THE DEPRESSION SCREENINGS AND TO INCREASE THE SPRAVATO PATIENT ENCOUNTERS ANNUALLY. Schedule H, Part I, Line 6a Community benefit report prepared by related organization BRYAN HEALTH Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance MERRICK MEDICAL CENTER'S UNCOMPENSATED CARE COST-TO CHARGE RATIO WAS USED TO CALCULATE THE AMOUNT ON LINE 7A. FOR LINE 7E, ANY OFFSETTING REVENUE WAS DEDUCTED FROM EXPENSES DIRECTLY ATTRIBUTABLE TO THE COMMUNITY BENEFITY ACTIVITY. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, BRYAN HEALTH SYSTEM HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. BAD DEBT EXPENSE IS DETERMINED ON BALANCES AFTER DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED TO PATIENT ACCOUNTS. THE REMAINING BALANCE DUE FROM THE PATIENT IS EVALUATED TO DETERMINE IF THE ACCOUNT IS WRITTEN OFF BASED ON THE EXISTING COLLECTION POLICY. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 12-14 OF THE MERRICK MEDICAL CENTER AUDIT REPORT. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE ENTIRE MEDICARE SHORTFALL AS REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT. MERRICK MEDICAL CENTER PROVIDES CARE TO MEDICARE PATIENTS AND MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE ENTIRE COST OF PROVIDING CARE TO THESE PATIENTS CAUSING A SHORTFALL, OR LOSS TO THE ORGANIZATION. THE FUNDS MERRICK MEDICAL CENTER USES TO COVER THIS SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING THE GOVERNMENT OF THE FINANCIAL BURDEN OF PAYING THE FULL COSTS OF CARE FOR MEDICARE BENEFICIARIES. THE COSTING METHODOLODY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT IS THE COST TO CHARGE RATIO. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE ORGANIZATION'S DEBT COLLECTION POLICY PROHIBITS ANY COLLECTION EFFORTS FOR THE PORTION OF THE PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. Schedule H, Part V, Section B, Line 16a FAP website - MERRICK MEDICAL CENTER: Line 16a URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/; Schedule H, Part V, Section B, Line 16b FAP Application website - MERRICK MEDICAL CENTER: Line 16b URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - MERRICK MEDICAL CENTER: Line 16c URL: www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/; Schedule H, Part VI, Line 2 Needs assessment MERRICK MEDICAL CENTER ("MMC") IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY CONTINUALLY WORKING WITH COMMUNITY PARTNERS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. MMC PARTNERED WITH THE CENTRAL DISTRICT HEALTH DEPARTMENT ("CDHD") WHO DEVELOPED A HEALTH SURVEY WITH A JOINT EFFORT FROM THE MULTICULTURAL COALITION, CENTRAL NEBRASKA COUNCIL ON ALCOHOLISM AND ADDICTIONS, AND IDEA BANK. THE SURVEY PROVIDED INFORMATION AND INSIGHTS THAT WERE CRITICAL TO MERRICK MEDICAL CENTER'S 2024 COMMUNITY HEALTH NEEDS ASSESSMENT. THROUGH THE RESULTS OF THE COMMUNITY HEALTH SURVEY AS WELL AS THROUGH OTHER PRIMARY RESEARCH AND DATA AVAILABLE, MMC IDENTIFIED THREE SIGNIFICANT HEALTH NEEDS WITHIN CENTRAL CITY AND MERRICK COUNTY THAT REQUIRED PRIORITIZED FOCUS OVER THE NEXT FEW YEARS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance MERRICK MEDICAL CENTER ("MMC") OFFERS A FINANCIAL ASSISTANCE PROGRAM TO PATIENTS WHO CANNOT AFFORD TO PAY FOR PART OR ALL OF THE CARE THEY RECEIVE. EDUCATION REGARDING THE FINANCIAL ASSISTANCE PROGRAM IS PROVIDED AT EACH NEW EMPLOYEE ORIENTATION AND THEN ANNUALLY SO THAT EACH EMPLOYEE WILL HAVE A CLEAR UNDERSTANDING OF THE FINANCIAL ASSISTANCE THAT IS AVAILABLE TO THE PATIENTS. FINANCIAL ASSISTANCE INFORMATION IS PROVIDED TO PATIENTS DURING ADMISSION IN THEIR INFORMATION PACKET. PATIENTS MAY CONTACT THE HOSPITAL AT ANY TIME TO REQUEST A FINANCIAL ASSISTANCE APPLICATION. HOSPITAL PATIENT ACCOUNT COLLECTORS WILL ALSO INFORM PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM IF THEY ARE UNABLE TO PAY THEIR BILL AND MAY QUALIFY FOR FINANCIAL ASSISTANCE SUCH AS FEDERAL, STATE, OR LOCAL PROGRAMS, OR ELIGIBILTY FOR ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. IN ADDITION, INFORMATION REGARDING FINANCIAL ASSISTANCE IS PROVIDED ON THE WEBSITE, IN ALL HOSPITAL REGISTRATION AREAS, INCLUDING THE EMERGENCY DEPARTMENT, AND ON EACH BILLING STATEMENT. Schedule H, Part VI, Line 4 Community information THE COMMUNITY SERVED BY MERRICK MEDICAL CENTER IS MERRICK COUNTY, NEBRASKA. MERRICK COUNTY IS 487.8 SQUARE MILES AND IS THE 77TH LARGEST COUNTY IN NEBRASKA BY TOTAL AREA. THE POPULATION WITHIN THIS COUNTY IS 7,837 PEOPLE IN 2024. THE FOLLOWING COUMMUNITIES IN MERRICK COUNTY ARE: CENTRAL CITY (POPULATION 3,039 IN 2024), CLARKS (POPULATION 342), CHAPMAN (POPULATION 272), PALMER (404) AND WORMS (UNINCORPORATED). FULLERTON IS LOCATED IN NANCE COUNTY NEBRASKA AND IS ALSO INCLUDED IN MERRICK MEDICAL CENTER'S SERVICE AREA. MERRICK COUNTY HAS A MEDIAN AGE OF 43.0 WHICH IS HIGHER THAN NEBRASKA'S AVERAGE OF AGE 37.4. THE COUNTY ALSO HAS 21.5% OF ITS POPULATION 65 YEARS AND OVER, HIGHER THAN NEBRASKA'S AVERAGE OF 17.2%. MERRICK COUNTY'S POPULATION IS PROJECTED TO DECREASE AMONG ALL AGE GROUPS EXCEPT FOR THE POPULATION OVER THE AGE OF 80. THERE WILL LIKELY BE A STEADY DECLINE FROM POPULATIONS YOUNGER THAN 50. THE PRIMARY RACE/ETHNICITY IS COMPRISED OF 91.2% NON-HISPANIC WHITE, 5.4% HISPANIC AND 3.4% NON-HISPANIC (OTHER RACES). THE PRIMARY LANGUAGE SPOKEN AT HOME IN MERRICK COUNTY IS ENGLISH (95%) FOLLOWED BY SPANISH (3%). MERRICK COUNTY'S POVERTY LEVEL IS LOWER AT 10.2% COMPARED TO NEBRASKA'S AVERAGE 11.2%. MERRICK COUNTY'S CHILDREN IN POVERTY IS 12% WHILE NEBRASKA'S CHILDREN POVERTY IS HIGHER AT 14%. 10.7% OF INDIVIDUALS WHO ARE OVER THE AGE OF 65 YEARS ARE BELOW THE POVERTY LEVEL. THERE ARE THREE FEDERALLY UNDERSERVED AREAS PRESENT IN MERRICK AND HALL COUNTIES. THE SERVICE AREAS ARE CLARKSVILLE SERVICE AREA AND LOUP SERVICE AREA IN MERRICK COUNTY AND LOW INCOME AND MFW POPULATION IN HALL COUNTY NEBRASKA. THEY ARE PARTIALLY RURAL AND NON-RURAL POPULATIONS. MERRICK COUNTY AS WELL AS RESIDENTS IN FULLERTON ARE SERVED BY MERRICK MEDICAL CENTER, CENTRAL CITY MEDICAL CLINIC AND FULLERTON MEDICAL CLINIC. BOONE COUNTY HEALTH SYSTEM ALSO SERVES THE RESIDENTS OF FULLERTON WITH A CLINIC LOCATED IN THEIR COMMUNITY AS WELL AS A HOSPITAL APPROXIMATELY 25 MILES NORTH IN ALBION. GENOA MEDICAL FACILITIES IS THE SOLE HOSPITAL LOCATED IN NANCE COUNTY AND ALSO PROVIDES CARE FOR ITS RESIDENTS. MERRICK COUNTY IS SERVED BY THE CENTRAL DISTRICT HEALTH DEPARTMENT, WHICH HAS A THREE COUNTY SERVICE AREA INCLUDING HALL AND HAMILTON COUNTIES. NANCE COUNTY IS SERVED BY THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT. MERRICK COUNTY HAS 392 EMPLOYERS THAT EMPLOY 3,923. THE TOP INDUSTRIES IN THE COUNTY ARE HEALTH CARE, AGRICULTURE, MANUFACTURING, RETAIL TRADE AND EDUCATIONAL SERVICES. MERRICK MEDICAL CENTER, LOCATED IN CENTRAL CITY, IS ONE OF THE LARGEST EMPLOYERS AND THE PUBLIC SCHOOL BEING THE SECOND LARGEST EMPLOYER. MERRICK COUNTY'S UNEMPLOYMENT RATE IS 1.5%, BELOW THE STATE UNEMPLOYMENT RATE OF 2.9% AND THE NATIONAL RATE OF 4.3%. MERRICK COUNTY'S MEDIAN HOUSEHOLD INCOME IS $57,873 TRAILS COMPARED TO THE STATE AT $69,829 AND NATION AT $72,603. Schedule H, Part VI, Line 5 Promotion of community health MERRICK MEDICAL CENTER ("MMC") IS A NEBRASKA NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MMC OPERATES A 6-LICENSED BED CRITICAL ACCESS HOSPITAL AND TWO PHYSICIAN CLINICS. MMC HAS AN OPEN MEDICAL STAFF. THE MAJORITY OF THE HOSPITAL BOARD OF TRUSTEES THAT ARE NOT EMPLOYEES OF BRYAN HEALTH OR MMC RESIDE IN MERRICK COUNTY. THE BOARD OF TRUSTEES OF BRYAN HEALTH, THE SOLE CORPORATE MEMBER OF MMC, MUST APPROVE MMC'S TRUSTEES. THE MAJORITY OF BRYAN HEALTH'S BOARD OF TRUSTEES ARE INDEPENDENT. MMC IS COMMITTED TO SERVING PATIENTS AND THE COMMUNITY BY INVESTING FUNDS IN FACILITIES, TECHNOLOGY, PHYSICIANS, AND STAFF TO DELIVER PREMIUM HEALTHCARE IN ALL FACILITIES. MMC PROVIDES UNCOMPENSATED AND CHARITY CARE TO ALL ELIGIBLE PATIENTS. MMC SUPPORTS NUMEROUS HEALTH CARE SERVICES, FITNESS AND WELLNESS PROGRAMS, TELEHEALTH TECHNOLOGY AND COMMUNITY PARTNERSHIPS. Schedule H, Part VI, Line 6 Affiliated health care system MERRICK MEDICAL CENTER IS PART OF BRYAN HEALTH, ONE OF THE LARGEST NON-PROFIT, LOCALLY GOVERNED HEALTH CARE ORGANIZATIONS IN THE REGION. BRYAN HEALTH EXISTS TO: PROMOTE AND PROVIDE ACCESS TO QUALITY HEALTH CARE; PROVIDE MEDICAL EDUCATION, AND COMMUNITY SERVICE. THE COMMIUNITY BENEFITS PROVIDED BY THE SYSTEM INCLUDE: 1) PROVIDING FREE OR DISCOUNTED HEALTH CARE TO THE UNINSURED AND UNDERINSURED, 2) PROVIDING GOVERNMENTAL SPONSORED PROGRAMS SUCH AS MEDICARE AND MEDICAID; 3) HEALTH PROFESSIONALS' EDUCATION; 4) COMMUNITY HEALTH IMPROVEMENT SERVICES; AND 5) CASH AND IN-KIND CONTRIBUTIONS TO OTHER NON-PROFIT ORGANIZATIONS. BRYAN HEALTH PROVIDES A FULL SPECTRUM OF PREVENTION, WELLNESS, ACUTE CARE AND REHABILITATION SERVICES TO URBAN, SUBURBAN AND RURAL COMMUNITIES IN NEBRASKA, KANSAS, IOWA, AND MISSOURI. BRYAN HEALTH CONSISTS OF FIVE ACUTE-CARE HOSPITALS, NUMEROUS OUTPATIENT CLINICS, A PHYSICIAN NETWORK, A COLLEGE, FIVE URGENT CARE CENTERS, FOUR PHILANTHROPIC FOUNDATIONS, A PHYSICIAN HOSPITAL ORGANIZATION AND ACCOUNTABLE CARE ORGANIZATION, AND OTHER HEALTHCARE PROVIDERS. PREMIER SERVICES INCLUDE CARDIOLOGY, NEUROSCIENCE, ORTHOPEDICS, VASCULAR, TRAUMA AND EMERGENCY CENTERS, INTENSIVE CARE, WOMEN'S AND CHILDREN'S HEALTH, ONCOLOGY, IMAGING AND MENTAL HEALTH. Schedule H, Part VI, Line 7 State filing of community benefit report NE false true false false false false false false false PAT GANYO SECRETARY/TREASURER 0 284077 0 75412 0 86515 0 8472 0 38952 0 493428 0 0 BLAKE COVER MD PHYSICIAN/EX-OFFICIO DIRECTOR 273483 0 194643 0 8650 0 14260 0 34730 0 525766 0 0 0 JULIE LACY EX-OFFICIO DIRECTOR 0 169524 0 22968 0 37052 0 16068 0 13916 0 259528 0 0 RICHARD LLOYD DIRECTOR 0 276229 0 90144 0 139706 0 16945 0 29109 0 552133 0 0 RYAN SANTIN MD PHYSICIAN 291964 0 11250 0 20112 0 16480 0 35796 0 375602 0 0 0 RICHARD POPPE MD PHYSICIAN 223755 0 204847 0 26958 0 12945 0 37474 0 505979 0 0 0 RYAN STAGEMEYER RN RN ANESTHETIST 284025 0 11875 0 1265 0 15054 0 36906 0 349125 0 0 0 TRACI DIECKMANN DO PHYSICIAN 250943 0 152339 0 7658 0 16471 0 31530 0 458941 0 0 0 BRIAN BUHLKE DO PHYSICIAN 216481 0 166340 0 33411 0 17694 0 34730 0 468656 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 ORGANIZATION'S CEO AND CEOS OF ALL RURAL HOSPITALS OWNED BY BRYAN HEALTH, MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF ONE OF THE LARGEST PRIVATE EMPLOYERS IN LINCOLN/LANCASTER COUNTY. BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN SENIOR LEADERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVEYS, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED IS REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF TOTAL COMPENSATION PAID CONFORMS TO THE OVERALL COMPENSATION PHILOSOPHY. THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON MARCH 21, 2024. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED ON THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan IN ORDER TO ATTRACT AND RETAIN TALENTED, EXPERIENCED EXECUTIVES, BRYAN HEALTH OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO ELIGIBLE EMPLOYEES. THE FOLLOWING PEOPLE LISTED IN THE FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A SUPPLEMENTAL NONQUALIFED RETIREMENT PLAN AND RECEIVED A PAYMENT DURING 2024: RICHARD LLOYD - $75,701 AND PAT GANYO - $49,149 Schedule J, Part II COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THIS ORGANIZATION'S BOARD IS COMPENSATED FOR THEIR SERVICES AS A BOARD MEMBER. COMPENSATION AMOUNTS REPORTED IN SCHEDULE J, PART II ARE FOR SERVICES PERFORMED AS EXECUTIVES OF BRYAN HEALTH AND MERRICK MEDICAL CENTER, AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS. Schedule J, Part II, Column (B)(ii) COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES & KEY EMPLOYEES A TOTAL OF $26,040 BONUSES ACCRUED IN 2024 WILL BE PAID IN 2025 WHICH WILL BE REPORTED ON 2025 SCHEDULE J COLUMN (BII) A CITY OF CENTRAL CITY NERBASKA 476006132 000000000 2020-12-02 9500000 PART 1, LINE A, COLUMN (F): ACQUIRE, CONSTRUCT, IMPROVE, EXTEND, REPAIR, EQUIP AND FURNISH A CAH false false false B THE COUNTY OF MERRICK IN THE STATE OF NEBRASKA 476006488 000000000 2020-12-02 9975000 PART 1, LINE B, COLUMN (F): ACQUIRE, CONSTRUCT, IMPROVE, EXTEND, REPAIR, EQUIP AND FURNISH A CAH false false false A 975954 0 9500000 0 0 0 0 0 0 9500000 0 0 2022 false false true true B 1028314 0 9975000 0 0 0 0 0 0 9975000 0 0 2022 false false true true A false false false true false false 0.0 0.0 0.0 false false 0 false true B false false false true false false 0.0 0.0 0.0 false false 0 false true A false true false false false false 0 false false false 0 false false true B false true false false false false 0 false false false 0 false false true A true B true Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS MANY OF THE PERSONS LISTED IN PART VII, SECTION A, HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF THEIR EMPLOYMENT BY A BRYAN HEALTH ENTITY. Form 990, Part VI, Line 1a Delegate broad authority to a committee THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON AND VICE-CHAIRPERSON OF THE BOARD. IN ADDITION, THE CHIEF EXECUTIVE OFFICER OF THE SYSTEM AND CORPORATION PRESIDENT/CHIEF EXECUTIVE OFFICER SHALL BE EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE ALL OF THE AUTHORITY AND POWER OF THE BOARD. AS DELEGATED THEREBY, WHEN THE BOARD IS NOT IN SESSION. THE DESIGNATION AND APPOINTMENT OF AN EXECUTIVE COMMITTEE AND THE DELEGATION THERETO OF AUTHORITY SHALL NOT OPERATE TO RELIEVE THE BOARD, OR ANY INDIVIDUAL TRUSTEE, OF ANY RESPONSIBILITY IMPOSED UPON IT OR HIM/HER BY LAW. Form 990, Part VI, Line 6 Classes of members or stockholders AS STATED IN THE CORPORATION'S ORGANIZING DOCUMENTS, THE SOLE MEMBER OF MERRICK MEDICAL CENTER IS BRYAN HEALTH. BRYAN HEALTH HAS THE RIGHTS UNDER THE ORGANIZING DOCUMENTS TO: 1) APPROVE SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY; 2) ELECT THE MEMBERS OF THE GOVERNING BODY; AND 3) RECEIVE ANY REMAINING ASSETS AFTER DISSOLUTION OF THE ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body BRYAN HEALTH, AS SOLE CORPORATE MEMBER OF MERRICK MEDICAL CENTER, HAS THE RIGHT UNDER THE ORGANIZING DOCUMENTS TO REMOVE ANY TRUSTEE FROM OFFICE AT ANY TIME. WITH OR WITHOUT CAUSE BY TWO-THIRDS (2/3) VOTE OF THE VOTING TRUSTEES OF BRYAN HEALTH. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders BRYAN HEALTH IS THE SOLE CORPORATE MEMBER OF MERRICK MEDICAL CENTER ("MMC"). PURSUANT TO THE GOVERNING DOCUMENTS, THE BOARD OF MMC MAY MANAGE THE AFFAIRS OF THE CORPORATION. HOWEVER, THE BOARD MAY NOT, WITHOUT THE PRIOR APPROVAL OF BRYAN HEALTH: (1) ADOPT ANY LONG-TERM CAPITAL OPERATIONAL BUDGET; (2) ADOPT ANY CHANGES IN ANY ANNUAL OR LONG-TERM CAPITAL BUDGET OR OPERATIONAL EXPENSE BUDGET EXCEEDING $250,000 IN ANY SINGLE TRANSACTION OR, $1,000,000 IN ANY CORPORATION FISCAL YEAR; (3) ADOPT SUBSTANTIVE CHANGES TO EXISTING LONG-TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; (4) AMEND THE BYLAWS OR ARTICLES OF INCORPORATION; (5) APPROVE THE TRANSFER, SALE OR OTHER DISPOSITION OF CAPITAL ASSETS IN ANY SINGLE TRANSACTION IN EXCESS OF $250,000, OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (6) ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF ANY CORPORATION, SHARED SERVICE ARRANGEMENT, ASSOCIATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, TRUST, JOINT VENTURE OR OTHER ENTITY, DIRECTLY OR INDIRECTLY, WHERE THE CAPITAL EXPENDITURE OR OPERATING EXPENSES BY THE CORPORATION IN CONNECTION WITH SUCH ORGANIZATION OR ACQUISITION WHEN IT EXCEEDS $500,000 IN A SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (7) APPROVE ANY INDEBTEDNESS INVOLVING A MORTGAGE OR LIEN OF ANY KIND OR NATURE ON ASSETS OF THE CORPORATION WHERE THE BORROWING OR INDEBTEDNESS EXCEEDS $250,000 IN ANY SINGLE TRANSACTION OR A TOTAL OF $1,000,000 IN ANY CORPORATION FISCAL YEAR; (8) ELECT OR APPOINT TRUSTEES OF THE CORPORATION; (9) APPOINT OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; (10) PURCHASE INSURANCE COVERAGE FOR THE CORPORATION AND ITS OPERATIONS; (11) SELECT THE AUDITOR TO PERFORM THE ANNUAL AUDIT OF THE RECORDS OF THE CORPORATION; (12) TAKE ANY OTHER ACTIONS WHICH MAY BE INCONSISTENT WITH BRYAN HEALTH'S GOALS AND OBJECTIVES. Form 990, Part VI, Line 11b Review of form 990 by governing body THIS 990 WAS PREPARED BY BRYAN HEALTH'S TAX DIVISION. DURING THE RETURN PREPARATION PROCESS, THE TAX DIVISION WORKS DILIGENTLY WITH MERRICK MEDICAL CENTER'S DIRECTOR OF FINANCE, DIRECTOR OF PROFESSIONAL SERVICES AND OTHER DEPARTMENTS, INCLUDING HUMAN RESOURCES, FINANCE, LEGAL, AND DEVELOPMENT, TO GATHER INFORMATION TO COMPLETE FORM 990 AND ATTACHED SCHEDULES IN AN ACCURATE AND THOROUGH MANNER. THIS 990 WAS REVIEWED BY MERRICK MEDICAL CENTER'S CEO AND BY THE CEO AND CFO OF BRYAN HEALTH. THIS 990 WAS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS AVAILABLE ON BOARD ADVANATAGE FOR REVIEW TO EACH MEMBER OF MERRICK MEDICAL CENTER'S BOARD OF TRUSTEES, AND TO BRYAN HEALTH'S AUDIT COMMITTEE PRIOR TO FILING THE FORM WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Line 12c Conflict of interest policy MERRICK MEDICAL CENTER ("MMC") HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY THAT IS MONITORED AND ENFORCED BY THE MMC BOARD OF TRUSTEES. BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE QUESTIONNAIRE TO IDENTIFY ANY FAMILY AND BUSINESS RELATIONS AND TRANSACTIONS, OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT. THE QUESTIONNAIRES REQUIRES EACH COVERED PERSON TO SIGN A STATEMENT CERTIFYING THAT HE/SHE: (1) HAS REPORTED INFORMATION THT IS CORRECT AND COMPLETE TO THE BEST OF THEIR KNOWLEDGE, (2) HAS READ THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS THE POLICY, AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY. COVERED PERSONS ARE ALSO REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME SUCH CONFLICTS ARISE. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. FAILURE TO COMPLETE THE QUESTIONNAIRE CAN RESULT IN DISCIPLINARY ACTIONS, THE QUESTIONNAIRES ARE REVIEWED IN DETAIL BY THE GOVERNANCE COMMITTEE OF BRYAN HEALTH. CONFLICTS ARE CLOSELY MONITORED BY MEMBERS OF THE GOVERNANCE COMMITTEE. THE CONFLICT-OF-INTEREST POLICY HAS RESTRICTIONS FOR ANY BOARD MEMBER WITH A CONFLICT OF INTEREST. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE PROCESS FOR REVIEWING AND EVALUATING COMPENSATION FOR THIS ORGANIZATION'S CEO AND FOR ALL RURAL HOSPITAL CEOS EMPLOYED BY BRYAN HEALTH, IS OVERSEEN BY BRYAN HEALTH'S HUMAN RESOURCES DEPARTMENT. THE PROCESS INCLUDES AN ANNUAL ASSESSMENT OF CEO COMPENSATION INCLUDING BENCHMARKING SALARIES TO SEVERAL NATIONAL SALARY SURVEYS TO DETERMINE THAT THE COMPENSATION IS CONSISTENT WITH THE ORGANIZATION'S CHARITABLE MISSION AND REASONABLE COMPARED WITH FAIR MARKET VALUE IN THE INDUSTRY. BRYAN HEALTH TARGETS BASE SALARY FOR RURAL HOSPITAL CEOS AT THE 50TH PERCENTILE OF THE MARKET. THE LAST ASSESSMENT WAS COMPLETED IN APRIL 2018. ONE BOARD MEMBER OF THIS ORGANIZATION IS A MEMBER OF THE BRYAN HEALTH SENIOR MANAGEMENT TEAM. BRYAN HEALTH'S BOARD OF TRUSTEES BELIEVES COMPENSATION FOR THE SENIOR MANAGEMENT TEAM MUST REFLECT THE COMPLEXITIES OF LEADING AND MANAGING A MULTI-HOSPITAL HEALTH SYSTEM THAT PROVIDES SERVICES THROUGHOUT MUCH OF THE STATE. RECOGNIZING THAT ITS LEADERS ARE RESPONSIBLE FOR THE QUALITY OF CARE, PATIENT SERVICES AND OVERALL FINANCIAL HEALTH OF ONE OF THE LARGEST PRIVATE EMPLOYERS IN LINCOLN/LANCASTER COUNTY, BRYAN HEALTH'S BOARD HAS ESTABLISHED A COMPENSATION PLAN THAT MATCHES THIS LEVEL OF RESPONSIBILITY. THIS PLAN, KNOWN AS THE SENIOR MANAGEMENT COMPENSATION PHILOSOPHY IS REVIEWED AT LEAST ANNUALLY BY BRYAN HEALTH'S COMPENSATION COMMITTEE. THIS COMPENSATION PHILOSOPHY TARGETS BASE SALARY FOR SENIOR MANAGERS AT THE 50TH PERCENTILE OF THE MARKET. THE COMPENSATION COMMITTEE IS APPOINTED BY BRYAN HEALTH'S BOARD OF TRUSTEES AND IS MADE UP OF INDEPENDENT COMMUNITY LEADERS WHO ALL SERVE VOLUNTARILY, AND WHO MUST ADHERE TO A STRINGENT CONFLICT OF INTEREST POLICY. EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED PURSUANT TO GUIDELINES OUTLINED IN THE INTERMEDIATE SANCTION RULES UNDER IRC SECTION 4958 INCLUDING TAKING STEPS TO MEET THE REBUTTABLE PRESUMPTION STANDARD OF REASONABLENESS UNDER TREASURY REGULATION SECTION 53.4958-6. THE COMPENSATION COMMITTEE CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION PROVIDED BY THE ORGANIZATION TO THE SENIOR MANAGEMENT TEAM. THIS REVIEW IS CONDUCTED BY THE COMMITTEE BY UTILIZING NATIONAL SALARY SURVYES, CONDUCTED BY INDEPENDENT EXTERNAL FIRMS. COMPENSATION FOR SENIOR MANAGERS IS COMPARED TO COMPENSATION OF SENIOR MANAGERS AT LIKE INSTITUTIONS ACROSS THE U.S. TO DETERMINE THAT THE VALUE OF COMPENSATION PROVIDED IS REASONABLE AND AT FAIR MARKET VALUE. THE COMPENSATION COMMITTEE ALSO WORKS DIRECTLY WITH AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE REASONABLENESS OF THE TOTAL COMPENSATION PROVIDED TO THE SENIOR MANAGEMENT TEAM, AND TO ASSURE THAT THE COMPENSATION CONSULTANT PROVIDES WRITTEN OPINIONS TO THE COMPENSATION COMMITTEE THAT ASSESSES THE REASONABLENESS OF THE TOTAL EXECUTIVE COMPENSATION PAID TO SENIOR MANAGERS. THE ANNUAL COMPENSATION REVIEW PROCEDURE WAS COMPLETED BY THE COMPENSATION COMMITTEE ON MARCH 21, 2024. ALL DECISIONS OF THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES WHICH ARE TIMELY REVIEWED AND APPROVED BY THE COMMITTEE. EMPLOYED PHYSICIAN COMPENSATION IS UNDER THE PURVIEW OF THE BRYAN HEALTH COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE HAS ESTABLISHED A POLICY REGARDING PHYSICIAN COMPENSATION WHICH ASSURES THAT PHYSICIAN COMPENSATION MEETS FAIR MARKET VALUE AND ALL OTHER LEGAL REQUIREMENTS. PHYSICIAN COMPENSATION IS BENCHMARKED AGAINST SEVERAL INDEPENDENT PHYSICIAN SPECIALTY - SPECIFIC SALARY SURVEYS AND IS REGULARLY REVIEWED BY THE COMPENSATION COMMITTEE. Form 990, Part VI, Line 15b Process to establish compensation of other employees SEE FORM 990, PART VI, SECTION B, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S ARTICLES OF INCORPORATION AND AMENDMENTS ARE AVAILABLE TO THE PUBLIC ON THE NERBASKA SECRETARY OF STATE'S WEBSITE AT WWW.SOS.NE.GOV. ALSO, THIS ORGANIZATION IS INCLUDED WITHIN THE CONSOLIDATED FINANCIAL STATEMENTS OF BRYAN HEALTH THAT ARE MADE AVAILABLE TO THE PUBLIC BY THE POSTING OF THESE DOCUMENTS THROUGH THE MUNICIPAL SECURITIES RULEMAKING BOARD WEBSITE AT EMMA.MSRB.ORG. THE ORGANIZATION'S OTHER GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. FEDERAL TAX LAWS DO NOT REQUIRE THAT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. Form 990, Part VII, Section A, Line 1a, Column (D) COMPENSATION OF MEMBERS IN KEEPING WITH BRYAN HEALTH'S BELIEFS AND STANDARDS OF BEHAVIOR REGARDING STEWARDSHIP, NO BOARD MEMBER SERVING ON THIS ORGANIZATION'S BOARD IS COMPENSATED FOR THEIR SERVICES AS A BOARD MEMBER. COMPENSATION AMOUNTS REPORTED IN FORM 990, PART VII, SECTION A ARE FOR SERVICES PERFORMED AS PHYSICIANS AND EXECUTIVES OF MERRICK MEDICAL CENTER AND BRYAN HEALTH AND NOT FOR SERVICES PERFORMED AS BOARD MEMBERS. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: 581, Related or Exempt Function Revenue: 581, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees PATIENT CARE SERVICES - Total Expense: 3376723, Program Service Expense: 3105072, Management and General Expenses: 271651, Fundraising Expenses: ; COLLECTION FEES - Total Expense: 14487, Program Service Expense: 13295, Management and General Expenses: 1192, Fundraising Expenses: ; CONSULTING - Total Expense: 21288, Program Service Expense: 14902, Management and General Expenses: 6386, Fundraising Expenses: ; BRYAN HEALTH 1600 SOUTH 48TH STREET LINCOLN NE 68506 363414823 HEALTHCARE NE 501(c)(3) Type III-FI BRYAN HEALTH false BRYAN PHYSICIAN NETWORK 1600 SOUTH 48TH STREET LINCOLN NE 68506 201357375 HEALTHCARE NE 501(c)(3) 10 BRYAN HEALTH true BRYAN MEDICAL CENTER 1600 SOUTH 48TH STREET LINCOLN NE 68506 470376552 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 CRETE AREA MEDICAL CENTER 2910 BETTEN DRIVE CRETE NE 683330220 470841285 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 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 DBA KEARNEY REGIONAL MEDICAL CENTER 804 22ND AVENUE KEARNEY NE 68845 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 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 LEASE 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 KPT&G LLC C/O MDM 300 N MEAD STE 210 WICHITA KS 67202 364886336 RENTAL REAL ESTATE NE NA N/A KHL-RO LLC 4101 TIGER LILY RD STE100 LINCOLN NE 68516 883562359 HEALTHCARE NE NA N/A BRYAN ENTERPRISES INC 1600 SOUTH 48TH STREET LINCOLN NE 68506 470701037 MEDICAL SERVICES NE NA C Corporation true INEGRATED CARDIOLOGY 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 false true false true true true true false MERRICK MEDICAL CENTER FOUNDATION C 100200 FMV BRYAN MEDICAL CENTER O 356987 FMV BRYAN TELEMEDICINE LLC M 133609 FMV CRETE AREA MEDICAL CENTER O 93204 FMV GRAND ISLAND REGIONAL MEDICAL CENTER O 265497 FMV