KAISER HOSPITAL ASSET MANAGEMENT INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
KAISER HOSPITAL ASSET MANAGEMENT INC (EIN 94-3299125)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-10
IRS object ID
201143149349303619
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2011-11-10T16:28:27-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 SECOND STREETAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN943299125EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KAISER HOSPITAL ASSET MANAGEMENT INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKAISNameControl
Phone5102716611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKATHRYN LANCASTERName
TitleEXEC VP & CHIEF FINANCIAL OFFICERTitle
Date Signed2011-10-31DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4159635100Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS R MEIERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Gross Receipts177687741GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1998YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionKAISER HOSPITAL ASSET MANAGEMENT, INC IS A SUPPORTING ORGANIZATION WHICH ACQUIRES MEDICAL EQUIPMENT NECESSARY FOR THE DELIVERY OF MEDICAL CARE AT VARIOUS KAISER PERMANENTE MANAGED CARE FACILITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI361249TotalGrossUBI
Net Unrelated Business Txbl Income248335NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year164589267ProgramServiceRevenuePriorYear
Program Service Revenue CY168857437ProgramServiceRevenueCY
Investment Income Prior Year843967InvestmentIncomePriorYear
Investment Income Current Year1079988InvestmentIncomeCurrentYear
Other Revenue Prior Year463105OtherRevenuePriorYear
Other Revenue Current Year335553OtherRevenueCurrentYear
Total Revenue Prior Year165896339TotalRevenuePriorYear
Total Revenue Current Year170272978TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year645722SalariesEtcPriorYear
Salaries Etc Current Year742003SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year164315276OtherExpensePriorYear
Other Expenses Current Year168791822OtherExpensesCurrentYear
Total Expenses Prior Year164960998TotalExpensesPriorYear
Total Expenses Current Year169533825TotalExpensesCurrentYear
Revenues Less Expenses Prior Year935341RevenuesLessExpensesPriorYear
Revenues Less Expenses CY739153RevenuesLessExpensesCY
Total Assets BOY949506038TotalAssetsBOY
Total Assets EOY920876047TotalAssetsEOY
Total Liabilities BOY81591211TotalLiabilitiesBOY
Total Liabilities EOY52465487TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY867914827NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY868410560NetAssetsOrFundBalancesEOY
Mission DescriptionKAISER HOSPITAL ASSET MANAGEMENT, INC IS A SUPPORTING ORGANIZATION WHICH ACQUIRES MEDICAL EQUIPMENT NECESSARY FOR THE DELIVERY OF MEDICAL CARE AT VARIOUS KAISER PERMANENTE MANAGED CARE FACILITIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense169463785Expense
Grants0Grants
Revenue168857437Revenue
DescriptionKAISER HOSPITAL ASSET MANAGEMENT, INC ACQUIRES AND MANAGES MEDICAL EQUIPMENT USED IN THE DELIVERY OF MEDICAL CARE AT VARIOUS KAISER PERMANENTE MANAGED CARE FACILITIES.Description
Total Program Service Expense169463785TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonVP - NATIONAL TAX COMPLIANCENamePerson
Telephone Number5102716385TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KATHRYN LANCASTER
DIRECTOR1.0XX01558076296474
THOMAS MEIER
DIRECTOR & PRESIDENT1.0XX0647785107439
HONG-SZE YU
DIRECTOR4.0X023874033270
DONNA LYNNE
VICE PRESIDENT1.0X0820658182750
DEBORAH STOKES
SVP, CORPORATE CONTROLLER, CAO0.3X0622642123860
STEVEN ZATKIN
SECRETARY0.5X0124725397716
MARK ZEMELMAN
SECRETARY0.1X0806199150636
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5941353TotalReportableCompFrmRltdOrgs
Total Other Compensation992145TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonNANamePerson
FieldValueIRS element (for citing)
Address Of ContractorAddressOfContractor
FieldValueIRS element (for citing)
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionLEASED MEDICAL EQUIPMENTDescription
Business Code532420BusinessCode
Total Revenue Column168857437TotalRevenueColumn
Related Or Exempt Function Income168857437RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue168857437TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1054292TotalRevenueColumn
Exclusion$1,054,292ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Personal345498Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real
Personal9945Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal335553Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column335553TotalRevenueColumn
Unrelated Business Revenue335553UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other7430514Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other7404818Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other25696Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column25696TotalRevenueColumn
Unrelated Business Revenue25696UnrelatedBusinessRevenue

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column170272978TotalRevenueColumn
Related Or Exempt Function Income168857437RelatedOrExemptFunctionIncome
Unrelated Business Revenue361249UnrelatedBusinessRevenue
Exclusion$1,054,292ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total593518Total
Program Services593518ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total61863Total
Program Services61863ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total56339Total
Program Services56339ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total30283Total
Program Services30283ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3500Total
Program Services3500ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total463Total
Program Services463ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total908449Total
Program Services908449ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total164760995Total
Program Services164760995ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total74461Total
Program Services74461ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
FEDERAL BUSINESS TAX310310
INTER-REGIONAL COST ALLOCATION7004070040
BANK SERVICE CHARGE2524125241
ASSET WRITE-OFF27913632791363
FEDERAL CORPORATE INCOME TAX128000128000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total29000Total
Program Services29000ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total169533825Total
Program Services169463785ProgramServices
Management And General70040ManagementAndGeneral
Fundraising0Fundraising

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY42180887BOY
EOY47623300EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY23056BOY
EOY1593EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1378464513LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec523964222LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY890752719BOY
EOY854500291EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16549376BOY
EOY18750863EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY949506038BOY
EOY920876047EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY54339236BOY
EOY42393195EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY27251975BOY
EOY10072292EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY81591211BOY
EOY52465487EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY865000000BOY
EOY865000000EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY2914827BOY
EOY3410560EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY867914827BOY
EOY868410560EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY949506038BOY
EOY920876047EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses739153ReconcilationRevenueExpenses
Reconcilation Other Changes-243420ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1KAISER FOUNDATION HOSPITALSBusinessNameLine1
FieldValueIRS element (for citing)
EIN941105628EIN
Type Of Organization09TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$169,533,825Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts169533825SumOfAmounts
General Explanationkaiser hospitals asset management supports Kaiser foundation hospitals with procurement and placement of assetsGeneralExplanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1378464513OtherCostOrOtherBasis
Depreciation523964222Depreciation
Book Value854500291BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings854500291TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
INTER-REGIONAL PAYABLE$7,155,476
DUE TO KAISER FDN HEALTH PLAN$2,916,816
FieldValueIRS element (for citing)
Total Of Amounts10072292TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KATHRYN LANCASTER
0615090091990002308602834060130680185455000
DONNA LYNNE
0393534040438402274001692390135110100340800
THOMAS MEIER
03160760297094034615094371013068075522400
DEBORAH STOKES
0313713024955205937701107920130680746502040338
HONG-SZE YU
016601506983302892020202013068027201000
STEVEN ZATKIN
028302809325000317250862390114770134496900
MARK ZEMELMAN
03428520224105023924201379560126800956835057187

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierExplanationExplanation
Schedule J, line 3kaiser hospital asset management relied on Kaiser Foundation Health Plan, Inc. that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - form 990 of other organizations - written employment contract - compensation survey or study - approval by the board or compensation committee
Schedule J, line 4aListed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments.
Schedule J, line 4bMark Zemelman $ 218,741 Deborah Stokes 40,338 Steven Zatkin 5,463 Thomas Meier 609 Kathryn Lancaster 368 TOTAL $ 265,519 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (18 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part I, Line 7bTOTAL UBI (FORM 990-T, LINE 30) $ 361,249 NET OPERATING LOSS (NOL) APPLIED (111,914) SPECIFIC DEDUCTION (1,000) UBTI WITH NOL (FORM 990-T, LINE 34) $ 248,335
Form 990, Part VI, Question 2Family affiliations reported steven r zatkin - spouse: officer of kfhp inc., kfh and subsidiaries victoria zatkin - spouse: senior vp, general counsel and officer of kfh, kfhp inc. and regional health plans
Form 990, Part VI, Question 6KAISER FOUNDATION HOSPITALS (KFH) IS SOLE MEMBER
Form 990, Part VI, Question 7aKFH appoints the directors (and fills vacancies and has authority to remove directors)
Form 990, Part VI, Question 7bThe following actions of the corporation require approval of the sole member. a) removal of the chairman of the board or the president; b) amendment of articles c, d, and h of the bylaws
Form 990, Part VI, Question 11bForm 990 review process 1. key information is obtained and/or confirmed with internal sources including regional finance and executive compensation. 2. Prior to finalization, the return is reviewed with a kpmg tax advisor. 3. Once signed by a KPMG tax advisor, the return and underlying data is reviewed with an officer or a member of management designated by an officer for signature and filing. 4. Copies are then provided to Board members.
Form 990, Part VI, Questions 12cRegularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance office for review and appropriate action. Employees can report anonymously and without fear of retaliation. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. the Chief Compliance Officer and the SVP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. Kaiser Permanente notifies employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. C. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: (I) Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem (II) Written notice, with or without final warning (III) Paid or unpaid suspension, with or without final warning (IV) Termination of employment
Form 990, Part VI, Questions 15a/bThe executive compensation program as administered by Kaiser Foundation Health Plan, Inc is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves prior to payment all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization.
Form 990, Part VI, Question 19Governing documents, Conflict of Interest - are available upon request as disclosed to other regulatory bodies. To request copies contact: VP - NATIONAL TAX COMPLIANCE Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 15L Oakland, CA 94612
Form 990, Part VII, Sec A, Col BIndividuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated.
Form 990, Part XI, Line 5TAX DEPRECIATION $ 6,392 BOOK DEPRECIATION (249,812) BOOK/TAX DIFFERENCE ON NET INCOME $ (243,420)
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:KATHRYN LANCASTER TITLE:DIRECTOR HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:THOMAS MEIER TITLE:DIRECTOR & PRESIDENT HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:HONG-SZE YU TITLE:DIRECTOR HOURS:46FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DONNA LYNNE TITLE:VICE PRESIDENT HOURS:49FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DEBORAH STOKES TITLE:SVP, CORPORATE CONTROLLER, CAO HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:STEVEN ZATKIN TITLE:SECRETARY HOURS:50FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MARK ZEMELMAN TITLE:SECRETARY HOURS:50FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
KAISER FOUNDATION HOSPITALS
ONE KAISER PLAZA 15LOAKLANDCA94612941105628HEALTH CARECA501(C)(3)3KFHP INC
KAISER FOUNDATION HEALTH PLAN OF CO
ONE KAISER PLAZA 15LOAKLANDCA94612840591617HEALTH CARECO501(C)(3)9KFHP INC
KAISER HEALTH PLAN ASSET MANAGEMENT INC
ONE KAISER PLAZA 15LOAKLANDCA94612943299124INSURANCECA501(C)(3)11KFHP INC
KAISER FOUNDATION HEALTH PLAN INC
ONE KAISER PLAZA 15LOAKLANDCA94612941340523HEALTH CARECA501(C)(3)9NA
KAISER FOUNDATION HEALTH PLAN OF GA INC
ONE KAISER PLAZA 15LOAKLANDCA94612581592076HEALTH CAREGA501(C)(3)9KFHP INC
KAISER FOUNDATION HEALTH PLAN OF THE MAS
ONE KAISER PLAZA 15LOAKLANDCA94612520954463HEALTH CAREMD501(C)(3)9KFHP INC
KAISER FOUNDATION HEALTH PLAN OF THE NW
ONE KAISER PLAZA 15LOAKLANDCA94612930798039HEALTH CAREOR501(C)(3)9KFHP INC
KAISER FOUNDATION HEALTH PLAN OF OH INC
ONE KAISER PLAZA 15LOAKLANDCA94612340922268HEALTH CAREOH501(C)(3)9KFHP INC
CAMP BOWIE SERVICE CENTER
ONE KAISER PLAZA 15LOAKLANDCA94612943299123ADMIN SUPPORTCA501(C)(3)11KFHP INC
KAISER HEALTH ALTERNATIVES
ONE KAISER PLAZA 15LOAKLANDCA94612930954562HEALTH CAREOR501(C)(3)9KFHP INC
LOKAHI ASSURANCE LTD
ONE KAISER PLAZA 15LOAKLANDCA94612912171891risk mgmtHI501(C)(3)11KFHP INC
OHP
ONE KAISER PLAZA 15LOAKLANDCA94612930480268LEASINGWA501(C)(3)11KFHP INC
1800 HARRISON FOUNDATION
ONE KAISER PLAZA 15LOAKLANDCA94612943317484FINANCINGCA501(C)(3)11KFHP INC
KAISER HOSPITAL ASSISTANCE CORPORATION
ONE KAISER PLAZA 15LOAKLANDCA94612311779500FINANCINGCA501(C)(3)11KFH

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HCMS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KAISER PLAZA 15LAddressLine1
CityOAKLANDCity
StateCAState
ZIP Code94612ZIPCode
FieldValueIRS element (for citing)
EIN203924985EIN
Primary ActivityCONSULTINGPrimaryActivity
Legal Domicile StateCALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeNONEPredominantIncomeType
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V$0CodeVAmount
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership0.00000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
ARCHIMEDES INC
ONE KAISER PLAZA 15LOAKLANDCA94612203774729CONSULTINGCANAC CORP000.00000
KAISER PERMANENTE INTERNATIONAL
ONE KAISER PLAZA 15LOAKLANDCA94612943245176CONSULTINGCANAC CORP000.00000
KAISER PERMANENTE INSURANCE COMPANY
ONE KAISER PLAZA 15LOAKLANDCA94612943203402INSURANCECANAC CORP000.00000
KAISER PROPERTIES SERVICES INC
ONE KAISER PLAZA 15LOAKLANDCA94612943259432REAL ESTATECANAC CORP000.00000
OAK TREE ASSURANCE LTD
ONE KAISER PLAZA 15LOAKLANDCA94612030329760INSURANCEVTNAC CORP000.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

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