THE ASSOCIATION OF CHRMC AND UNIVERSITY PHYSICIANS: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- THE ASSOCIATION OF CHRMC AND UNIVERSITY PHYSICIANS (EIN 91-1336707)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201411349349306456
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T15:12:43-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911194016 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK NUBER PS | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4TH STREET SUITE 1700 | AddressLine1 |
| City | BELLEVUE | City |
| State | WA | State |
| ZIP Code | 98004 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911336707 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASSOCIATION OF CHMC AND UNIVERSITY PHYSICIANS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ASSO | NameControl |
| Phone | 2069878450 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4500 SANDPOINT WAY NE NO 100 | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98105 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHRISTINE KESSLER | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 2069878450 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SARA ELIZABETH J HYRE | Name |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | Phone |
| Date Prepared | 2014-05-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S UNIVERSITY MEDICAL GROUP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHRISTINE KESSLER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4500 SANDPOINT WAY NE NO 100 | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 129039671 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1986 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | TO ASSIST SEATTLE CHILDREN'S HOSPITAL ("SCH") AND UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE ("UWSOM") IN CARRYING OUT THEIR PEDIATRIC CARE, CHARITABLE, EDUCATIONAL, AND SCIENTIFIC MISSIONS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 592 | TotalNbrEmployees |
| Total Nbr Volunteers | 17 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 119432317 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 123873735 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1151671 | InvestmentIncomePriorYear |
| Investment Income Current Year | 712471 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 120583988 | TotalRevenuePriorYear |
| Total Revenue Current Year | 124586206 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 112922309 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 116807876 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6911198 | OtherExpensePriorYear |
| Other Expenses Current Year | 7852609 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 119833507 | TotalExpensesPriorYear |
| Total Expenses Current Year | 124660485 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 750481 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -74279 | RevenuesLessExpensesCY |
| Total Assets BOY | 33857006 | TotalAssetsBOY |
| Total Assets EOY | 31952277 | TotalAssetsEOY |
| Total Liabilities BOY | 33795116 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 31890387 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 61890 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 61890 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE ASSOCIATION OF CHMC AND UNIVERSITY PHYSICIANS, DBA CHILDREN'S UNIVERSITY MEDICAL GROUP (CUMG), OPERATES A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT BILLS AND COLLECTS FOR THE CLINICAL SERVICES PROVIDED BY APPROXIMATELY 500 UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UWSOM) FACULTY PHYSICIANS AND COMPENSATES THE EMPLOYED PHYSICIANS, PURSUANT TO A 1989 OPERATING AGREEMENT BETWEEN THE UNIVERSITY OF WASHINGTON (UW), SEATTLE CHILDREN'S HOSPITAL (SCH), AND CUMG. UNDER THAT OPERATING AGREEMENT, CUMG PAYS OPERATING EXPENSES AND COMPENSATES FACULTY PHYSICIANS (THE PROFESSIONAL MEMBERS) AS DIRECTED BY UWSOM. ALL REMAINING REVENUES ARE HELD BY CUMG SOLELY FOR THE SUPPORT OF UW MEDICINE AND SCH. CUMG IS A WASHINGTON STATE NOT FOR PROFIT, FEDERALLY TAX-EXEMPT CORPORATION FORMED IN 1986 TO SUPPORT UWSOM AND SCH IN THE FULFILLMENT OF THEIR RESPECTIVE PEDIATRIC PATIENT CARE, CHARITABLE, EDUCATIONAL, AND SCIENTIFIC MISSIONS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 118064353 | Expense |
| Revenue | 123873735 | Revenue |
| Description | PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS (TOGETHER, PROFESSIONAL MEMBERS) OF CUMG PROVIDE CLINICAL HEALTH CARE SERVICES TO PEDIATRIC PATIENTS AT SEATTLE CHILDREN'S HOSPITAL, UW MEDICINE FACILITIES, AND OTHER SITES OF PRACTICE APPROVED BY THE CEO OF UW MEDICINE, EVP FOR MEDICAL AFFAIRS AND DEAN OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UW MEDICINE CEO) AND CEO OF SEATTLE CHILDREN'S HOSPITAL. CUMG PROFESSIONAL MEMBERS PROVIDE PRIMARY, SPECIALTY, AND SUBSPECIALTY CLINICAL CARE TO COMMUNITIES THAT WOULD NOT OTHERWISE HAVE ACCESS TO SUFFICIENT CLINICAL RESOURCES. CUMG PROVIDES SIGNIFICANT UNDERCOMPENSATED AND CHARITY CARE, CONSISTENT WITH THE CHARITY CARE POLICY OF THE FACILITY IN WHICH THE CLINICAL CARE IS PROVIDED. | Description |
| Total Program Service Expense | 118064353 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 9 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 592 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATTI ADAMICH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2069878450 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4500 SANDPOINT WAY NE SUITE 100 | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| ROBERT SAWIN MD | |||||||||
| BOARD CHAIRMAN | 40.00 | 0.00 | X | X | 493227 | 114588 | 59722 | ||
| LYNN MARTIN MD | |||||||||
| VICE CHAIRMAN | 40.00 | 0.00 | X | X | 250597 | 198732 | 61807 | ||
| F BRUDER STAPLETON MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 272241 | 233724 | 70857 | |||
| ED WEINBERGER MD | |||||||||
| SECRETARY/TREASURER | 40.00 | 0.00 | X | X | 465809 | 75444 | 40057 | ||
| ROSS HAYS MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 234551 | 0 | 53017 | |||
| SUSAN APKON MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 272461 | 0 | 58459 | |||
| ERNEST CONRAD MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 393120 | 251532 | 232314 | |||
| J CRAIG JACKSON MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 71144 | 138410 | 36698 | |||
| RUTH A MCDONALD MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 23032 | 226685 | 46287 | |||
| PAUL MERGUERIAN MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 602202 | 0 | 100590 | |||
| JERRY GEIDUSCHEK MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 342557 | 103488 | 110309 | |||
| JERRY ZIMMERMAN MD | |||||||||
| DIRECTOR | 40.00 | 0.00 | X | 210722 | 93099 | 75858 | |||
| PATTI ADAMICH | |||||||||
| ASSOCIATE DIRECTOR OF FINANCE | 40.00 | 0.00 | X | 125450 | 0 | 23651 | |||
| PATRICIA ADAMS | |||||||||
| INTERIM EXECUTIVE DIRECTOR | 24.00 | 0.00 | X | 0 | 0 | 0 | |||
| GORDON COHEN MD | |||||||||
| DIVISION CHIEF | 40.00 | 0.00 | 690821 | 64865 | 39389 | X | |||
| LESTER PERMUT MD | |||||||||
| PROGRAM DIRECTOR | 40.00 | 0.00 | 862337 | 55536 | 46099 | X | |||
| SAMUEL BROWD MD | |||||||||
| ASSISTANT PROFESSOR | 40.00 | 0.00 | 566680 | 0 | 97737 | X | |||
| D MICHAEL MCMULLAN MD | |||||||||
| MEDICAL STAFF | 40.00 | 0.00 | 839119 | 0 | 48723 | X | |||
| JOHN WALDHAUSEN MD | |||||||||
| DIVISION CHIEF | 40.00 | 0.00 | 564570 | 0 | 78183 | X | |||
| DENNIS CHRISTIE MD | |||||||||
| FORMER VICE PRESIDENT | 40.00 | 0.00 | 244160 | 0 | 59642 | X | |||
| RICK NIELSEN | |||||||||
| FORMER EXECUTIVE DIRECTOR | 0.00 | 0.00 | 110358 | 0 | 17783 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7635158 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1556103 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1357182 | TotalOtherCompensation |
| Number Individuals GT100 K | 303 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| UW PHYSICIANS | |||||
| 701 5TH AVENUE SUITE 700 | SEATTLE | WA | 98104 | IT, HR, LEGAL SERVICES | 2015509 |
| ECG MANAGEMENT CONSULTANTS | |||||
| 1111 THIRD AVENUE SUITE 2700 | SEATTLE | WA | 98101 | MANAGEMENT CONSULTING | 217361 |
| MEDIREVV INC | |||||
| 2600 UNIVERSITY PARKWAY | CORALVILLE | IA | 52241 | ACCOUNTING SERVICES | 145412 |
| HAYES MANAGEMENT CONSULTING | |||||
| 1320 CENTRE STREET SUITE 402 | NEWTON CENTRE | MA | 02459 | MANAGEMENT CONSULTING | 118866 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| INSTITUTIONAL SUPPORT | 621110 | 74817812 | 74817812 |
| NET PHYSICIAN REVENUE | 621110 | 29511878 | 29511878 |
| MEDICAID REVENUE | 621110 | 16474434 | 16474434 |
| OTHER GOVT AGENCY REV | 621110 | 2576606 | 2576606 |
| BILLING SERVICES | 561000 | 493005 | 493005 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 123873735 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 653749 | TotalRevenueColumn |
| Exclusion | $653,749 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4512187 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4453465 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 58722 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 58722 | TotalRevenueColumn |
| Exclusion | $58,722 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 124586206 | TotalRevenueColumn |
| Related Or Exempt Function Income | 123873735 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $712,471 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4156419 | Total |
| Program Services | 4021019 | ProgramServices |
| Management And General | 135400 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97806731 | Total |
| Program Services | 94830131 | ProgramServices |
| Management And General | 2976600 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5779063 | Total |
| Program Services | 5549419 | ProgramServices |
| Management And General | 229644 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5651752 | Total |
| Program Services | 4738612 | ProgramServices |
| Management And General | 913140 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3413911 | Total |
| Program Services | 3146364 | ProgramServices |
| Management And General | 267547 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 477509 | Total |
| Management And General | 477509 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148428 | Total |
| Management And General | 148428 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61000 | Total |
| Management And General | 61000 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88480 | Total |
| Management And General | 88480 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 644256 | Total |
| Program Services | 86929 | ProgramServices |
| Management And General | 557327 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 170774 | Total |
| Management And General | 170774 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 904275 | Total |
| Program Services | 790275 | ProgramServices |
| Management And General | 114000 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 348699 | Total |
| Management And General | 348699 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21015 | Total |
| Management And General | 21015 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25530 | Total |
| Management And General | 25530 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1039362 | Total |
| Program Services | 1039362 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| STATE/LOCAL TAXES | 3294252 | 3288070 | 6182 |
| CLINIC DEVELOPMENT | 123981 | 123981 | |
| BUSINESS INSURANCE | 36581 | 36581 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 468467 | Total |
| Program Services | 450191 | ProgramServices |
| Management And General | 18276 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124660485 | Total |
| Program Services | 118064353 | ProgramServices |
| Management And General | 6596132 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 593325 | BOY |
| EOY | 999194 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11566481 | BOY |
| EOY | 5733692 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7808068 | BOY |
| EOY | 9980340 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122427 | BOY |
| EOY | 527956 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 494892 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 441944 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67752 | BOY |
| EOY | 52948 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13608375 | BOY |
| EOY | 14576050 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90578 | BOY |
| EOY | 82097 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33857006 | BOY |
| EOY | 31952277 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12954297 | BOY |
| EOY | 13778547 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57930 | BOY |
| EOY | 38620 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20782889 | BOY |
| EOY | 18073220 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33795116 | BOY |
| EOY | 31890387 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61890 | BOY |
| EOY | 61890 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61890 | BOY |
| EOY | 61890 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33857006 | BOY |
| EOY | 31952277 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -74279 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 460085 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -385806 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (2 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| UWSOM | |||||
| 916001537 | 2-SCHOOL | 1 | 1 | 1 | $6,748,477 |
| SCH | |||||
| 910564748 | 3-HOSPITAL | 1 | 1 | 1 | $6,745,804 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 2 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 13494281 | SumOfAmounts |
| General Explanation | SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: PART I, LINE 11H(VII): THE ASSOCIATION EMPLOYS UWSOM FACULTY PHYSICIANS WHO PROVIDE CARE TO PEDIATRIC PATIENTS AND BILLS AND COLLECTS THE REVENUES SOLELY FOR THE SUPPORT OF UWSOM AND SCH. | GeneralExplanation |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 494892 | OtherCostOrOtherBasis |
| Depreciation | 441944 | Depreciation |
| Book Value | 52948 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 52948 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CLINICIAL MEDICINE FUND DEPARTMENT PAYABLES | $2,542,678 |
| DEPARTMENT PAYABLES | $15,530,542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 18073220 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 124572005 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 460085 | NetUnrealizedGainsInvestments |
| Other Revenues | -385806 | OtherRevenues |
| Revenue Not Rptd F990 | 74279 | RevenueNotRptdF990 |
| Revenue Subtotal | 124497726 | RevenueSubtotal |
| Investment Expenses Not Included | 88480 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 88480 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 124586206 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 124572005 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 124572005 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 88480 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 88480 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 124660485 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART XI, LINE 2D - OTHER ADJUSTMENTS: | Identifier |
| Explanation | IMPAIRMENT LOSS -385,806. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT SAWIN MD | ||||||||||||||
| BOARD CHAIRMAN | 467088 | 102920 | 26139 | 0 | 0 | 11668 | 32725 | 11668 | 5429 | 9900 | 531381 | 136156 | 7051 | 0 |
| LYNN MARTIN MD | ||||||||||||||
| VICE CHAIRMAN | 217303 | 178576 | 33294 | 0 | 0 | 20156 | 25352 | 20156 | 6034 | 10265 | 281983 | 229153 | 16235 | 0 |
| F BRUDER STAPLETON MD | ||||||||||||||
| DIRECTOR | 272241 | 192929 | 0 | 0 | 0 | 40795 | 25000 | 23920 | 6565 | 15372 | 303806 | 273016 | 0 | 0 |
| ED WEINBERGER MD | ||||||||||||||
| SECRETARY/TREASURER | 354951 | 75444 | 110858 | 0 | 0 | 0 | 25000 | 0 | 15057 | 0 | 505866 | 75444 | 11063 | 0 |
| ROSS HAYS MD | ||||||||||||||
| DIRECTOR | 217001 | 0 | 17550 | 0 | 0 | 0 | 30193 | 0 | 22824 | 0 | 287568 | 0 | 7646 | 0 |
| SUSAN APKON MD | ||||||||||||||
| DIRECTOR | 221869 | 0 | 50592 | 0 | 0 | 0 | 46320 | 0 | 12139 | 0 | 330920 | 0 | 21683 | 0 |
| ERNEST CONRAD MD | ||||||||||||||
| DIRECTOR | 99557 | 226532 | 293563 | 0 | 0 | 25000 | 192354 | 25000 | 5060 | 9900 | 590534 | 286432 | 135205 | 0 |
| J CRAIG JACKSON MD | ||||||||||||||
| DIRECTOR | 48834 | 124301 | 22310 | 0 | 0 | 14109 | 18360 | 14109 | 4229 | 0 | 93733 | 152519 | 10646 | 0 |
| RUTH A MCDONALD MD | ||||||||||||||
| DIRECTOR | 0 | 203900 | 23032 | 0 | 0 | 22785 | 13244 | 22785 | 358 | 9900 | 36634 | 259370 | 10975 | 0 |
| PAUL MERGUERIAN MD | ||||||||||||||
| DIRECTOR | 515202 | 0 | 87000 | 0 | 0 | 0 | 74562 | 0 | 26028 | 0 | 702792 | 0 | 43500 | 0 |
| JERRY GEIDUSCHEK MD | ||||||||||||||
| DIRECTOR | 224485 | 92856 | 118072 | 0 | 0 | 10632 | 84467 | 10632 | 5310 | 9900 | 432334 | 124020 | 51165 | 0 |
| JERRY ZIMMERMAN MD | ||||||||||||||
| DIRECTOR | 149104 | 83580 | 61618 | 0 | 0 | 9519 | 52236 | 9519 | 4203 | 9900 | 267161 | 112518 | 33445 | 0 |
| GORDON COHEN MD | ||||||||||||||
| DIVISION CHIEF | 688321 | 64865 | 2500 | 0 | 0 | 0 | 25000 | 6501 | 2788 | 5100 | 718609 | 76466 | 2500 | 0 |
| LESTER PERMUT MD | ||||||||||||||
| PROGRAM DIRECTOR | 862337 | 55536 | 0 | 0 | 0 | 0 | 25000 | 5837 | 5362 | 9900 | 892699 | 71273 | 33445 | 0 |
| SAMUEL BROWD MD | ||||||||||||||
| ASSISTANT PROFESSOR | 205919 | 0 | 360761 | 0 | 0 | 0 | 71375 | 0 | 26362 | 0 | 664417 | 0 | 82677 | 0 |
| D MICHAEL MCMULLAN MD | ||||||||||||||
| MEDICAL STAFF | 839119 | 0 | 0 | 0 | 0 | 0 | 22500 | 0 | 26223 | 0 | 887842 | 0 | 0 | 0 |
| JOHN WALDHAUSEN MD | ||||||||||||||
| DIVISION CHIEF | 506146 | 0 | 58424 | 0 | 0 | 0 | 51267 | 0 | 26916 | 0 | 642753 | 0 | 16360 | 0 |
| DENNIS CHRISTIE MD | ||||||||||||||
| FORMER VICE PRESIDENT | 198407 | 0 | 45753 | 0 | 0 | 0 | 40248 | 0 | 19394 | 0 | 303802 | 0 | 21973 | 0 |
| RICK NIELSEN | ||||||||||||||
| FORMER EXECUTIVE DIRECTOR | 110358 | 0 | 0 | 0 | 0 | 0 | 11158 | 0 | 6625 | 0 | 128141 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 3 | COMPENSATION OF THE CUMG EXECUTIVE DIRECTOR AND ASSOCIATE DIRECTOR OF FINANCE IS REVIEWED BY REPRESENTATIVES OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. THE REVIEW RELIES ON COMPARISON OF COMPENSATION TO SIMILARLY SITUATED INDIVIDUALS, IN LIKE-SIZED ORGANIZATIONS ENGAGED IN SIMILAR ACTIVITIES. THE COMPARISON IS PERFORMED BY AN INDEPENDENT CONTRACTOR CONSULTANT WITH EXPERIENCE AND EXPERTISE IN COMPENSATION OF ACADEMIC MEDICAL CENTER PERSONNEL. THE COMPENSATION COMPARISON DATA IS REVIEWED BY DISINTERESTED EMPLOYEES OF UW MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. FOR UW MEDICINE, THIS IS PART OF AN OVERALL REVIEW OF COMPENSATION FOR SIMILARLY SITUATED INDIVIDUALS IN OTHER COMPONENTS OF UW MEDICINE. THE REVIEW IS PERFORMED REGULARLY, AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. | |
| PART III | SCHEDULE J, PART I, LINE 7: CUMG IS THE PRACTICE PLAN FOR UNIVERSITY OF WASHINGTON (UW) FACULTY PHYSICIANS AND HEALTH CARE PRACTITIONERS WHO PROVIDE CLINICAL CARE PRIMARILY TO PEDIATRIC PATIENTS. CUMG BILLS AND COLLECTS REVENUE GENERATED BY THE CLINICAL SERVICES OF THESE FACULTY PHYSICIANS. ALL REVENUES COLLECTED BY CUMG ARE ALLOCATED IN ACCORDANCE WITH THE ASSOCIATION OF CHMC AND UNIVERSITY PHYSICIANS D/B/A CHILDREN'S UNIVERSITY MEDICAL GROUP AMENDED AND RESTATED INCOME DISTRIBUTION PLAN (IDP). CUMG MAINTAINS A "MASTER" IDP AND EACH CUMG DEPARTMENT OR DIVISION ALSO MAINTAINS A DEPARTMENTAL (OR DIVISIONAL) IDP THAT PROVIDES MORE DETAIL AS TO HOW ADDITIONAL COMPENSATION (INCENTIVE PAYMENT) IS CALCULATED AND PAID TO PARTICIPATING INDIVIDUALS (THE PHYSICIANS AND HEALTH CARE PRACTITIONERS WITH PRACTICE AGREEMENTS MAKING THEM ELIGIBLE FOR INCENTIVE PAYMENTS). DEPARTMENTS AND DIVISIONS ARE COMPRISED OF THE FACULTY PHYSICIANS WITHIN EACH SPECIALTY OR PRIMARY CARE AREA OF CLINICAL PRACTICE. THE DEPARTMENTAL AND DIVISIONAL IDPS ALIGN WITH THE CLINICAL DEPARTMENTS OF THE UWSOM. EACH CLINICAL DEPARTMENT OF THE UWSOM HAS A DEPARTMENT CHAIR WHO APPROVES THE IDP FOR THE CUMG DEPARTMENT/DIVISION. THE CUMG DIVISION CHIEF ALSO APPROVES THE IDP FOR THE DIVISION. UNDER ALL IDPS, REVENUES GENERATED BY FACULTY ARE ALLOCATED TO THE FACULTY MEMBER'S DEPARTMENT, AND THE FUNDS FLOW IS SUBJECT TO CERTAIN STANDARDIZED DEDUCTIONS AS FOLLOWS: FIRST, REVENUES ARE USED TO PAY CUMG OPERATING EXPENSES. OF THE REMAINING REVENUES, ELEVEN PERCENT (11%) IS DIVIDED EQUALLY AND ALLOCATED TO THE UWSOM CLINICAL MEDICINE FUND AND SEATTLE CHILDREN'S HOSPITAL CLINICAL MEDICINE FUND, RESPECTIVELY. THE REMAINING REVENUES ARE USED TO PAY DEPARTMENT DIRECT CLINICAL COSTS, THEN PHYSICIAN/PRACTITIONER SALARY AND BENEFITS. THERE IS A PERCENTAGE CONTRIBUTION TO DEPARTMENT (AND DIVISION) OPERATIONS AND RESERVE FUNDS. PAYMENTS FOR SERVICES PROVIDED TO SEATTLE CHILDREN'S HOSPITAL AND SUPPORT FROM UW SCHOOL OF MEDICINE ARE RECEIVED. FINALLY, A POOL IS CREATED FOR ADDITIONAL COMPENSATION. WHILE SOME ADDITIONAL COMPENSATION MAY BE IN THE FORM OF FIXED PAYMENTS FOR A DEFINED PERIOD, EACH DEPARTMENTAL/DIVISIONAL IDP PROVIDES FOR PARTICIPATING INDIVIDUALS TO RECEIVE VARIABLE ADDITIONAL COMPENSATION. THE METRICS FOR CALCULATING ADDITIONAL COMPENSATION GENERALLY ARE BASED ON WORK PERSONALLY PERFORMED BY THE PRACTICE PLAN PHYSICIAN OR HEALTH CARE PROFESSIONAL DURING THE PERIOD OF RECORD. WHERE PERSONAL WORK IS NOT THE METRIC, THE UWSOM CLINICAL DEPARTMENTAL CHAIR ESTABLISHES A PER CAPITA DISTRIBUTION OF THE POOL TO ALL PARTICIPATING INDIVIDUALS. THE PERCENTAGE OF REVENUES ALLOCATED TO THE DEPARTMENT AND/OR DIVISION OPERATING AND RESERVE FUND IS ESTIMATED BY THE DEPARTMENT AND APPROVED BY THE UW MEDICINE CEO AND THE CHIEF EXECUTIVE OFFICER OF SCH, OR THEIR RESPECTIVE DESIGNEES, IN A BUDGET ESTABLISHED PRIOR TO THE PERIOD OF RECORD. THE PERIOD OF RECORD IS EITHER A 12-MONTH OR SIX-MONTH PERIOD DURING WHICH THE REVENUES AND EXPENSES FOR THE PRACTICE PLAN ARE ALLOCATED. THE ACTUAL PERCENTAGE FOR DEPARTMENTAL/DIVISIONAL OPERATIONS AND RESERVE CONTRIBUTION MAY BE MODIFIED FROM THE ORIGINAL ESTIMATE BASED ON THE OPERATIONAL NEEDS OF THE DEPARTMENT OR DIVISION, AND WHEN THAT OCCURS, THE PERCENTAGE IS ADJUSTED RETROACTIVELY BY THE CHAIR OF THE DEPARTMENT AND THE DIVISION HEAD OF THE CUMG DIVISION, UPON APPROVAL BY THE DEAN AND THE CEO. AT THE END OF THE PERIOD OF RECORD, AMOUNTS REMAINING AFTER ALL ALLOCATIONS HAVE BEEN MADE ARE AVAILABLE TO PAY THE ADDITIONAL COMPENSATION TO PARTICIPATING INDIVIDUALS. ADDITIONAL COMPENSATION IS CALCULATED FOR EACH PARTICIPATING INDIVIDUAL AND THE ADDITIONAL COMPENSATION AMOUNT IS PAID APPROXIMATELY THREE MONTHS LATER. ADDITIONAL COMPENSATION PAYMENTS ARE SUBJECT TO THE COMPENSATION CAP POLICY ADOPTED BY CUMG: THE "CUMG METHOD OR STANDARD REGARDING BASIC INDIVIDUAL CAPS UNDER AMENDED INCOME DISTRIBUTION PLAN, AS OF JULY 1, 1999." THIS COMPENSATION CAP POLICY LIMITS THE AMOUNT OF COMPENSATION TO INDIVIDUAL PHYSICIANS AND HEALTH CARE PROFESSIONALS BY COMPARISON TO OBJECTIVE DATA FOR LIKE ACTIVITIES AND LIKE PHYSICIANS OR PRACTITIONERS, INCLUDING SURVEYS SUCH AS THE ASSOCIATION OF AMERICAN COLLEGE (AAMC) AND MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) COMPENSATION SURVEYS. FOR THE MOST FREQUENTLY USED MEASURE (AAMC SURVEY), THE MAXIMUM "BASIC INDIVIDUAL CAP" GENERALLY IS 90% OF THE APPLICABLE STANDARD OR MEASURE. IF AAMC DATA IS NOT AVAILABLE OR DOES NOT PROVIDE THE MOST APPROPRIATE COMPARATIVE DATA, THE POLICY ALLOWS FOR OTHER COMPARATORS TO BE USED. IN GENERAL, THE 90TH PERCENTILE IS THE MAXIMUM BASIC INDIVIDUAL CAP IMPOSED UNDER ANY SURVEY OR DATA. IN ALL INSTANCES, COMPENSATION IS LIMITED BY A CAP ESTABLISHED USING A COMPARATIVE SURVEY OR DATA DETERMINED BY THE UWSOM AND SEATTLE CHILDREN'S HOSPITAL PRIOR TO THE PERIOD OF RECORD. BEFORE PAYMENT OF ADDITIONAL COMPENSATION FOLLOWING A PERIOD OF RECORD, CUMG REVIEWS AND, WHERE NECESSARY, LIMITS INDIVIDUAL COMPENSATION PURSUANT TO THE APPLICABLE CAP. THUS, WHILE THE AMOUNT OF ADDITIONAL COMPENSATION MAY NOT BE FIXED, THE TOTAL COMPENSATION, INCLUDING BASE SALARY AND ADDITIONAL COMPENSATION, IS SUBJECT TO LIMITS ESTABLISHED BY RELEVANT COMPARATORS. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART I, LINE 6 | THERE WERE 17 UNPAID FACULTY MEMBERS WHO VOLUNTEERED TO PROVIDE CLINICAL CARE THROUGH CUMG. | |
| FORM 990, PART VI, SECTION A, LINE 3 | DURING THE YEAR, CUMG PAID ECG MANAGEMENT CONSULTANTS $338,826 FOR THE SERVICES OF THE INTERIM EXECUTIVE DIRECTOR, PATRICIA ADAMS. PATRICIA ADAMS IS AN EMPLOYEE OF ECG MANAGEMENT CONSULTANTS AND THE AMOUNT PAID TO HER IS UNKNOWN. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THERE ARE TWO MEMBERS OF CHILDREN'S UNIVERSITY MEDICAL GROUP: SEATTLE CHILDREN'S HEALTHCARE SYSTEM (THE SURVIVING ENTITY OF CHILDREN'S PHYSICIANS) AND THE UNIVERSITY OF WASHINGTON. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE UW MEDICINE CEO AND CEO OF SEATTLE CHILDREN'S HOSPITAL TOGETHER APPOINT TEN MEMBERS OF THE BOARD OF DIRECTORS. PROFESSIONAL FACULTY MEMBERS ELECT TWO MEMBERS OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | MOST DECISIONS OF THE CUMG BOARD OF DIRECTORS ARE SUBJECT TO THE APPROVAL OF THE UW MEDICINE CEO AND CEO OF SEATTLE CHILDREN'S HOSPITAL. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE COMPLETED FORM 990 IS REVIEWED BY THE CUMG EXECUTIVE DIRECTOR, GENERAL COUNSEL FOR THE ASSOCIATION OF UNIVERSITY PHYSICIANS, AND THE CUMG ASSOCIATE DIRECTOR OF FINANCE, AS WELL AS THE ASSOCIATE DEAN FOR BUSINESS FOR THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, THE ENTERPRISE FINANCE OFFICER OF UW MEDICINE AND ASSOCIATE VICE PRESIDENT OF MEDICAL AFFAIRS OF UW, AND THE CHIEF FINANCIAL OFFICER AND CONTROLLER FOR SEATTLE CHILDREN'S HOSPITAL. THE BOARD HAS BEEN PRESENTED WITH INFORMATION RELATED TO THE PURPOSE AND RELEVANCE OF THE FORM 990 TO TAX-EXEMPT ENTITIES, SUCH AS CUMG, AND BOARD MEMBERS MAY REQUEST A COPY OF THE FORM 990 FROM THE CUMG DIRECTOR OF FINANCE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CUMG BOARD ADOPTED A CONFLICT OF INTEREST POLICY IN NOVEMBER 2009 FOR BOARD MEMBERS AND OTHER INDIVIDUALS WHO SERVE IN SIGNIFICANT ROLES WITH REGARD TO CUMG. CUMG BOARD MEMBERS AND OTHER INDIVIDUALS WHO ARE EMPLOYED BY THE UNIVERSITY OF WASHINGTON AND SERVING ON CUMG COMMITTEES ARE SUBJECT TO THE STATE OF WASHINGTON ETHICS IN PUBLIC SERVICE ACT, CHAPTER 42.52 RCW. THE ACT RESTRICTS ACTIVITIES INCOMPATIBLE WITH THE INDIVIDUAL'S ROLE AS A STATE EMPLOYEE AND ALSO LIMITS THE INDIVIDUAL'S INVOLVEMENT IN TRANSACTIONS WHERE A POTENTIAL CONFLICT MAY EXIST. CUMG BOARD MEMBERS AND OTHERS ARE REQUIRED TO DISCLOSE CERTAIN RELATIONSHIPS BOTH TO COMPLETE THE CUMG CONFLICT OF INTEREST SURVEY AND AS PART OF THE PROCESS TO COMPLETE THE FORM 990. CUMG ALSO ADDRESSES CONFLICTS AS THEY ARISE AND ARE REPORTED TO CUMG MANAGEMENT OR THE CUMG BOARD OF DIRECTORS. | |
| THE CUMG BOARD OF DIRECTORS DOES NOT REVIEW COMPENSATION. COMPENSATION OF THE CUMG EXECUTIVE DIRECTOR AND ASSOCIATE DIRECTOR OF FINANCE IS REVIEWED BY REPRESENTATIVES OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. THE REVIEW RELIES ON COMPARISON OF COMPENSATION TO SIMILARLY SITUATED INDIVIDUALS, IN LIKE-SIZED ORGANIZATIONS ENGAGED IN SIMILAR ACTIVITIES. THE COMPARISON IS PERFORMED BY AN INDEPENDENT CONTRACTOR CONSULTANT WITH EXPERIENCE AND EXPERTISE IN COMPENSATION OF ACADEMIC MEDICAL CENTER PERSONNEL. THE COMPENSATION COMPARISON DATA IS REVIEWED BY DISINTERESTED EMPLOYEES OF UW MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. FOR UW MEDICINE, THIS IS PART OF AN OVERALL REVIEW OF COMPENSATION FOR SIMILARLY SITUATED INDIVIDUALS IN OTHER COMPONENTS OF UW MEDICINE. THE REVIEW IS PERFORMED REGULARLY, AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. COMPENSATION OF CUMG BOARD MEMBERS AND OFFICERS IN THEIR CAPACITY AS CUMG PROFESSIONAL MEMBERS EMPLOYED BY CUMG AND/OR THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, IS REVIEWED REGULARLY THROUGH A UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE PROCESS THAT INVOLVES DISINTERESTED SCHOOL OF MEDICINE EMPLOYEES WHO REVIEW COMPENSATION OF ALL SCHOOL OF MEDICINE FACULTY. FOR CUMG PROFESSIONAL MEMBERS, REVIEW OF COMPENSATION ALSO INCLUDES APPLICATION OF THE "CHILDREN'S UNIVERSITY MEDICAL GROUP METHOD OR STANDARD REGARDING BASIC INDIVIDUAL CAPS UNDER AMENDED INCOME DISTRIBUTION PLAN, AS OF JULY 1, 1999" (CUMG CAP POLICY). THE CUMG CAP POLICY LIMITS COMPENSATION OF CUMG PROFESSIONAL MEMBERS BY COMPARISON TO OBJECTIVE DATA SUCH AS THAT PUBLISHED BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. THE REVIEW IS PERFORMED REGULARLY AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. | ||
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990, PART VI, LINE 13 | CUMG HAS A POLICY THAT REQUIRES MEMBERS AND ADMINISTRATIVE STAFF TO REPORT BILLING COMPLIANCE CONCERNS. THE POLICY EMPHASIZES THAT CUMG DOES NOT TOLERATE RETALIATION AGAINST THOSE REPORTING CONCERNS. THIS POLICY IS AVAILABLE TO ALL CUMG MEMBERS AND ADMINISTRATIVE STAFF AND IS BROADLY DISSEMINATED. | |
| FORM 990, PART VII, COLUMN B | ALL OF THE KEY EMPLOYEES AND BOARD MEMBERS, EXCEPT FOR THE ASSOCIATE DIRECTOR OF FINANCE AND THE EXECUTIVE DIRECTOR, ARE CONSIDERED BY THE UNIVERSITY OF WASHINGTON TO BE EMPLOYED FULL TIME BY THE UNIVERSITY OF WASHINGTON REGARDLESS OF WHETHER THEY RECEIVE ALL OF THEIR COMPENSATION FROM ANY COMBINATION OF THE UNIVERSITY, CUMG, OR BOTH ENTITIES. BOARD MEMBERS ARE MEMBERS OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE FACULTY, AND THEY PROVIDE CLINICAL SERVICES IN THEIR ROLE AS FACULTY MEMBERS IN SERVICE TO THE UNIVERSITY. LIKEWISE, A BOARD MEMBER'S SERVICE AS A MEMBER OF THE BOARD IS INCLUDED AS PART OF HIS OR HER ROLE AS A FACULTY MEMBER IN SERVICE TO THE UNIVERSITY AND, FOR THOSE KEY EMPLOYEES WHO ARE NOT BOARD MEMBERS, ALL OF THEIR ACTIVITIES FOR CUMG ARE CONSIDERED TO BE WITHIN THE INDIVIDUAL'S FACULTY ROLE FOR THE UNIVERSITY. WE ARE NOT ABLE TO SEGREGATE THE HOURS DEVOTED TO CUMG FROM THE HOURS EACH INDIVIDUAL DEVOTES TO THE UNIVERSITY. THUS, WE ARE REPORTING 40 HOURS FOR EACH INDIVIDUAL, TO REPRESENT THAT INDIVIDUAL'S WORK FOR THE RELATED PARTY UNIVERSITY OF WASHINGTON. | HOURS FOR RELATED ORGANIZATIONS: |
| FORM 990, PART XI, LINE 9: | IMPAIRMENT LOSS -385,806. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY OF WASHINGTON | |||||||||||
| 1959 NE PACIFIC STREET | SEATTLE | WA | 98195 | 916001537 | EDUCATION AND MEDICAL CARE | WA | GOVERNMENT | N/A | N/A | 0 | |
| SEATTLE CHILDREN'S HOSPITAL | |||||||||||
| PO BOX 5371 MS RC-507 | SEATTLE | WA | 981050371 | 910564748 | PEDIATRIC MEDICAL CARE | WA | 501(C)(3) | 3 | 0 | SEATTLE CHILDREN'S HEALTHCARE SYSTEM | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Comments