Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
The Nebraska Medical Center
 
Employer identification number
91-1858433
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) American Cancer Society
8030 Farnam Drive
Omaha,NE68114 		13-1788491 501(C)(3) 210,000       General Support
(2) American Heart Association
9900 Nicholas Street
Omaha,NE68114 		13-5613797 501(C)(3) 27,500       General Support
(3) Father Flanagan's Boys' Home
14100 Crawford Street
Boys Town,NE68010 		47-0376606 501(C)(3) 10,000       General Support
(4) Greater Omaha Chamber Foundation
808 Conagra Drive
Omaha,NE68102 		47-0633685 501(C)(3) 23,125       General Support
(5) Heartland Family Services
2101 South 42nd Street
Omaha,NE68105 		47-0390618 501(C)(3) 23,750       General Support
(6) Juvenile Diabetes Research Foundation
9202 West Dodge Road
Omaha,NE68114 		23-1907729 501(C)(3) 7,072       General Support
(7) Lauritzen Gardens
100 Bancroft Street
Omaha,NE68108 		47-0659701 501(C)(3) 25,000       Scholarship
(8) The Leukemia & Lymphoma Society
11840 Nicholas Street
Omaha,NE68154 		13-5644916 501(C)(3) 25,000       General Support
(9) Make-A-Wish Foundation Nebraska
11836 Arbor Street
Omaha,NE68144 		47-0671096 501(C)(3) 9,500       General Support
(10) March of Dimes
11840 Nicholas Street
Omaha,NE68154 		13-1846366 501(C)(3) 7,500       General Support
(11) National Safety Council
11620 M Circle
Omaha,NE68137 		47-0259720 501(C)(3) 5,300       General Support
(12) Nebraska AIDS Project
250 South 77th St
Omaha,NE68114 		47-0786622 501(C)(3) 10,000       General Support
(13) Project Pink'd Inc
11405 Davenport Street
Omaha,NE68154 		45-5212995 501(C)(3) 11,250       General Support
(14) Ronald McDonald House Charities in Omaha
620 South 38th Avenue
Omaha,NE68105 		47-0755104 501(C)(3) 65,700       General Support
(15) TeamMates Mentoring
6801 O Street
Lincoln,NE68510 		47-0840990 501(C)(3) 6,000       General Support
(16) United Way of the Midlands
2201 Farnam Street
Omaha,NE68102 		47-0376605 501(C)(3) 9,500       General Support
(17) Visiting Nurse Foundation
12565 West Center Road
Omaha,NE68144 		47-0690846 501(C)(3) 9,800       General Support
(18) The Wellbeing Partners
6001 Dodge Street
Omaha,NE68182 		47-0642708 501(C)(3) 20,000       General Support
(19) City of Omaha Blackstone BID
1819 Farnam Street
Omaha,NE68183 		47-6006304 GOVT 10,000       General Support
(20) Omaha Discovery Trust
10050 Regency Circle
Omaha,NE68114 		32-0596113 501(C)(3) 1,500,000       General Support
(21) I-AM-HOME
987810 Nebraska Medical Center
Omaha,NE68198 		47-0049123 GOVT 10,000       General Support
(22) University of Nebraska Medical Center
986800 Nebraska Medical Center
Omaha,NE68198 		47-0049123 GOVT 86,625,364       General Support
(23) Harvard Medical School
25 Shattuck Street
Boston,MA02115 		04-2103580 GOVT 11,554       General Support
(24) National Strategic Research Institute
3835 Holdrege Street
Lincoln,NE68583 		45-5426026 GOVT 225,877       General Support
(25) Clarkson College
101 South 42nd Street
Omaha,NE68131 		36-3649217 501(C)(3) 7,806,912       General Support
(26) Board of Regents - University of Nebraska
3835 Holdrege Street
Lincoln,NE68583 		47-0049123 GOVT 8,000,000       General Support
(27) Clarkson Regional Health Services Inc
9300 Underwood Avenue
Omaha,NE68114 		47-0376531 501(C)(3) 8,000,000       General Support
(28) UNMC Physicians
986800 Nebraska Medical Center
Omaha,NE68198 		47-0785575 501(C)(3) 142,471,071       General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
28
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) Financial Assistance (Charity Care) 9724   63,051,427 Book Charity Care
(2) Financial Assistance (Renal-Indigent Patients) 21   874,736 Book Indigent Dialysis
(3) Financial Assistance (Pharmaceuticals) 4514   8,534,066 Book Pharmaceuticals
(4) Financial Assistance (Utilization Mgmt Patients) 450   199,352 Book Utilization Management
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 1 Review and Approval of Charitable Contributions THE NEBRASKA MEDICAL CENTER (TNMC) HAS A COMMITTEE WHOSE RESPONSIBILITY IS TO REVIEW AND APPROVE OR DISPROVE REQUESTS FOR SPONSORSHIP. THIS COMMITTEE IS COMPRISED OF THE CHIEF MEDICAL OFFICER AND MEMBERS OF THE COMMUNITY ENGAGEMENT TEAM. DECISIONS ARE MADE ON EACH REQUEST INDIVIDUALLY BASED ON A SET OF GUIDELINES ESTABLISHED BY THE ORGANIZATION. IN ORDER TO EFFECTIVELY EVALUATE AND REVIEW THE MANY REQUESTS WE RECEIVE, EACH REQUEST IS BROUGHT BEFORE THE COMMITTEE, AND EACH REQUEST is considered INDIVIDUALLY. CONTRIBUTIONS ARE MADE BASED ON THREE PRIMARY OBJECTIVES: 1) TO SUPPORT THE COMMUNITY NEED FOR RESOURCES ADDRESSING NEBRASKA'S LEADING CAUSES OF DEATH; INCLUDING ACCESS TO HEALTHCARE SERVICES, MENTAL HEALTH, AND INJURY & VIOLENCE PREVENTION. 2) TO ALIGN WITH ORGANIZATIONS FURTHERING TNMC'S CHARITABLE MISSION TO SUPPORT CAUSES WHICH SIGNIFICANTLY IMPACT THE OVERALL HEALTH STATUS OF THE COMMUNITY. 3) TO SUPPORT ORGANIZATIONS WHICH IMPACT FAVORABLY THE PUBLIC IMAGE OF THE HOSPITAL AND ENHANCE EXISTING PARTNERSHIPS OR INITIATIVES. IF A SPONSORSHIP OR CHARITABLE CONTRIBUTION REQUEST FALLS WITHIN OUR THREE PRIMARY OBJECTIVES, THE FOLLOWING CRITERIA ARE THEN APPLIED TO FURTHER ASSIST THE COMMITTEE IN MAKING FUNDING DECISIONS: 1) ORGANIZATION MUST PROVIDE PROOF OF 501(C)(3) STATUS FROM THE IRS, OR NONPROFIT DESIGNATION AS A GOVERNMENTAL OR TRIBAL ENTITY. 2) ALL REQUESTS MUST BE RECEIVED IN WRITING - NO PHONE REQUESTS WILL BE CONSIDERED. 3) REQUESTOR MUST BE ABLE TO PROVIDE, IF REQUESTED, THE ORGANIZATION'S NON-DISCRIMINATION POLICY. 4) MUST BE ABLE TO PROVIDE AN ORGANIZATIONAL OPERATING BUDGET AND PROJECT BUDGET UPON REQUEST. 5) PROPOSAL MUST INCLUDE A LIST OF BOARD MEMBERS, DIRECTORS, AND KEY PROJECT STAFF MEMBERS AND THE ROLE THEY SERVE IN THE ORGANIZATION. 6) REQUEST MUST INCLUDE A BRIEF NARRATIVE OF THE PROJECT, INCLUDING AN ESTIMATE OF PEOPLE SERVED BY THE REQUEST AND LOCATION OF COMMUNITIES IMPACTED BY THE ORGANIZATION'S MISSION. 7) REQUESTS FOR SPONSORSHIP NEED TO BE SUBMITTED AT LEAST 90 DAYS PRIOR TO THE EVENT. GROUPS, PROGRAMS, AND ACTIVITIES NOT SUPPORTED BY TNMC: 1)ORGANIZATIONS WITHOUT IRS 501(C)(3) OR EQUIVALENT TAX EXEMPT STATUS. 2) ORGANIZATIONS THAT DISCRIMINATE ON THE BASIS OF AGE, DISABILITY, RELIGION, ETHNIC ORIGIN, GENDER, OR SEXUAL ORIENTATION. 3) ORGANIZATIONS WITH DIVISIVE OR LITIGIOUS PUBLIC AGENDAS. 4) MEMBER BASED ORGANIZATIONS, INCLUDING ROTARY CLUBS OR IRS 501(C)(4) LEGIONS AND ASSOCIATIONS. 5) MUNICIPALITIES, INCLUDING FIRE AND POLICE DEPARTMENTS OR RELATED SOCIAL SERVICE GROUPS AND POLITICAL ORGANIZATIONS. 6) RELIGIOUS ORGANIZATIONS OR SECTARIAN PROGRAMS FOR RELIGIOUS PURPOSES. 7) FRATERNAL ORGANIZATIONS, SOCIAL CLUBS, SPORTS TEAMS OR CLUBS, ATHLETIC COMPETITIONS. 8) ENDOWMENTS. 9) MULTIYEAR REQUESTS AND PLEDGES. 10) INDIVIDUALS REQUESTING LOANS, DEBT RETIREMENTS, SCHOLARSHIP OR FELLOWSHIP ASSISTANCE. 11) TRAVEL- INCLUDING STUDENT TRIPS OR TOURS. 12) MARKETING ACTIVITIES OR PROMOTIONAL MERCHANDISE. 13) PURCHASE OR MAINTENANCE OF VEHICLES. 14) FILM OR VIDEO PROJECTS, INCLUDING DOCUMENTARIES. 15) BEAUTY PAGEANTS.
Schedule I, Part III Amounts provided to patients are determined by The Nebraska Medical Center's written and published financial assistance policy.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Based on the detailed gift policy in Part I, Line 1, the funds are only provided for charitable purposes, and those organizations that receive monies from The Nebraska Medical Center are required to follow their 501(C)(3) requirements surrounding the use of funds received.
Schedule I (Form 990) 2020



Additional Data


Software ID: 20011424
Software Version: 2020v4.0