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," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
 
 
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" to 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
non-cash assistance		 (h) Purpose of grant
or assistance
(1)  
10100 J Street Ste A
Omaha,NE68127 		13-5613797 501(C)(3) 10,000       GENERAL SUPPORT
(2)  
101 S 42nd Street
Omaha,NE681312739 		36-3649217 501(C)(3) 1,370,802       General Support GENERAL SUPPORT
(3)  
988145 NE MED CTR
Omaha,NE681988145 		47-0376531 501(C)(3) 6,000,000       General Support GENERAL SUPPORT
(4)  
11126 O Street
Omaha,NE68107 		46-4448686 501(c)(3) 10,000       General Support
(5)  
985950 Nebraska Medical Center
Omaha,NE68198 		47-0809725 501(C)(3) 9,500       General support for clinic operations serving unde GENERAL SUPPORT
(6)  
1301 Harney Street
Omaha,NE68102 		47-0258610 501(C)(3) 15,070       General Support GENERAL SUPPORT
(7)  
7415 Cedar Street
Omaha,NE681242367 		36-4003095 501(C)(3) 100,000       General Support GENERAL SUPPORT
(8)  
4920 S 30th Street
Omaha,NE68107 		47-0548990 501(C)(3) 23,400       support GENERAL SUPPORT
(9)  
2021 U Street
Omaha,NE68107 		27-2460810 501(C)(3) 6,000       General Support GENERAL SUPPORT
(10)  
2200 Dodge St
Omaha,NE68102 		47-0384577 501(C)(3) 51,167       General Support GENERAL SUPPORT
(11)  
4821 South 24th St
Omaha,NE68107 		23-7208431 501(C)(3) 10,000       General Support GENERAL SUPPORT
(12)  
1904 Farnam St 5th
Omaha,NE68102 		47-0483506 501(C)(3) 75,000       General support for lymphoma research and educatio GENERAL SUPPORT
(13)  
12100 W Center Road Building 1 Su
Omaha,NE68144 		13-5644916 501(C)(3) 7,500       General Support GENERAL SUPPORT
(14)  
11926 Arbor St Ste 102
Omaha,NE68144 		47-0671096 501(C)(3) 7,500       General Support GENERAL SUPPORT
(15)  
12401 W Maple Rd
Omaha,NE681641853 		47-0376545 501(C)(3) 19,900       General support of auxiliary's community efforts GENERAL SUPPORT
(16)  
233 S 13 St 1200
Omaha,NE685082026 		47-0372108 501(C)(3) 10,000       General support of society's operations GENERAL SUPPORT
(17)  
1605 Howard St
Omaha,NE68102 		47-6039304 501(C)(3) 25,000       General support of museum operations GENERAL SUPPORT
(18)  
620 S 38th Street
Omaha,NE681051104 		47-0755104 501(C)(3) 10,000       General support of association's operations GENERAL SUPPORT
(19)  
801 S 10th St
Omaha,NE68108 		47-0556061 501(C)(3) 50,000       General operations and support GENERAL SUPPORT
(20)  
1805 Harney St
Omaha,NE68102 		47-0376605 501(C)(3) 6,382       Faculty Support for the University GENERAL SUPPORT
(21)  
986800 Nebraska Medical Center
Omaha,NE681986800 		47-0049123 GOVT 30,572,403       General support (AAA agreement) SUPPORT OPERATIONS
(22)  
988101 Nebraska Medical Center
Omaha,NE681988101 		47-0785575 501(C)(3) 27,068,011       General support SUPPORT OPERATIONS
(23)  
12565 W Center Rd Ste 220
Omaha,NE68144 		47-0642708 501(C)(3) 10,000       General support GENERAL SUPPORT
(24)  
3835 HOLDREGE STREET
LINCOLN,NE68583 		47-0049123 GOVT 6,000,000       General support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
24
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014
Page 2

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to 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
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) Financial Assistance (Charity Care) 5663   45,943,067 BOOK CHARITY CARE
(2) Financial Assistance (Pharmaceuticals) 1120   135,250 BOOK EMERG DRUG FUND










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
REVIEW AND APPROVAL OF CHARITABLE CONTRIBUTIONS SchEDULE I, Part I, LINE 1 THE NEBRASKA MEDICAL CENTER (NMC) HAS A COMMITTEE WHOSE RESPONSIBILITY IS TO REVIEW AND APPROVE OR DISPROVE REQUESTS FOR SPONSORSHIP. THIS COMMITTEE IS COMPRISED OF KEY EXECUTIVES AND OTHER MEMBERS OF THE LEADERSHIP TEAM, AS WELL AS REPRESENTATIVES FROM THE UNIVERSITY OF NEBRASKA MEDICAL CENTER. 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 OUR SPONSORSHIPS AND CHARITABLE CONTRIBUTIONS COMMITTEE FOR CONSIDERATION. THIS COMMITTEE IS COMPRISED OF KEY EXECUTIVES AND OTHER MEMBERS OF THE HOSPITAL LEADERSHIP TEAM. THE COMMITTEE CONSIDERS EACH REQUEST INDIVIDUALLY, AND CONTRIBUTIONS ARE MADE BASED ON THREE PRIMARY OBJECTIVES: 1) TO SUPPORT THE COMMUNITY NEED FOR RESOURCES ADDRESSING NEBRASKA'S LEADING CAUSES OF DEATH; INCLUDING CANCER, STROKE AND HEART DISEASE. 2) TO ALIGN WITH ORGANIZATIONS FURTHERING NMC'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 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 NUMBERS 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, WITH REQUESTS OVER $10,000 BEING SUBMITTED BY MARCH 1 FOR CONSIDERATION IN THE NEXT FISCAL YEAR. GROUPS, PROGRAMS, AND ACTIVITIES NOT SUPPORTED BY NMC: 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 CHAMBERS OF COMMERCE, 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
GRANT MONITORING PROCEDURES SchEDULE I, Part I, Line 2 BASED ON THE DETAILED GIFT POLICY OUTLINED IN PART I, LINE 1, THE FUNDS ARE ONLY PROVIDED FOR CHARITABLE PURPOSES, AND THOSE ORGANIZATIONS THAT RECEIVE MONIES FROM NMC ARE REQUIRED TO FOLLOW THEIR 501(C)(3) REQUIREMENTS SURROUNDING THE USE OF FUNDS RECEIVED.
Schedule I (Form 990) 2014



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