Civic Intelligence

Medical Staff of Evergreen Hospital Medical Center

990 • Fiscal year 2017 • EIN 91-1883302

Jan 01, 2017 to Dec 31, 2017 • Filed on Nov 15, 2018

Organization Profile
12040 NE 128th StKirkland, WA 98034-3013

(425) 899-1891

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

26th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Liabilities / Revenue

26th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Net Margin

78th percentile

21%

Higher net margin than 78% of similar nonprofits.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Top Officer Pay

55th percentile

$22,500

Higher top officer pay than 55% of similar nonprofits.

Top officer pay equals 11.0% of source-year revenue.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2017

Asset Growth

59th percentile

6.8%

Faster asset growth than 59% of similar nonprofits.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2016 to 2017

Revenue Growth

15th percentile

-18%

Faster revenue growth than 15% of similar nonprofits.

2017 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2016 to 2017

Balance Sheet
Liabilities / Assets26th percentile

Assets

Up

$669,463

Up $42,632 (+6.8%) from 2016

Net Assets

Up

$669,463

Up $42,632 (+6.8%) from 2016

Liabilities

Flat

$0

Flat from 2016

Revenue And Expenses
Liabilities / Revenue26th percentileNet Margin78th percentile

Revenue

Down

$204,679

Down $45,510 (-18%) from 2016

Expenses

Down

$162,047

Down $12,263 (-7.0%) from 2016

Net Income

Down

$42,632

Down $33,247 (-44%) from 2016

Historical Trend

Balance Sheet Trend

Asset Growth59th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$800K$600K$400K$200K$0Assets 2011: $408,903Liabilities 2011: $0Net Assets 2011: $408,9032011Assets 2012: $362,592Liabilities 2012: $0Net Assets 2012: $362,5922012Assets 2014: $474,635Liabilities 2014: $0Net Assets 2014: $474,6352014Assets 2015: $550,952Liabilities 2015: $0Net Assets 2015: $550,9522015Assets 2016: $626,831Liabilities 2016: $0Net Assets 2016: $626,8312016Assets 2017: $669,463Liabilities 2017: $0Net Assets 2017: $669,4632017Assets 2018: $582,012Liabilities 2018: $0Net Assets 2018: $582,0122018Assets 2019: $538,722Liabilities 2019: $0Net Assets 2019: $538,7222019Assets 2020: $439,121Liabilities 2020: $0Net Assets 2020: $439,1212020Assets 2021: $314,648Liabilities 2021: $0Net Assets 2021: $314,6482021Assets 2022: $484,799Liabilities 2022: $0Net Assets 2022: $484,7992022Assets 2023: $478,968Liabilities 2023: $0Net Assets 2023: $478,9682023Assets 2024: $545,110Liabilities 2024: $0Net Assets 2024: $545,1102024

Highlighted filing

2017

Assets$669,463
Liabilities$0
Net Assets$669,463
Open 2017 Filing

Operations Trend

Revenue Growth15th percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$600K$400K$200K$0-$200KRevenue 2011: $132,211Expenses 2011: $61,413Net Income 2011: $70,7982011Revenue 2012: $123,085Expenses 2012: $169,396Net Income 2012: -$46,3112012Revenue 2014: $204,167Expenses 2014: $138,673Net Income 2014: $65,4942014Revenue 2015: $219,542Expenses 2015: $143,225Net Income 2015: $76,3172015Revenue 2016: $250,189Expenses 2016: $174,310Net Income 2016: $75,8792016Revenue 2017: $204,679Expenses 2017: $162,047Net Income 2017: $42,6322017Revenue 2018: $209,610Expenses 2018: $297,061Net Income 2018: -$87,4512018Revenue 2019: $268,512Expenses 2019: $312,506Net Income 2019: -$43,9942019Revenue 2020: $326,286Expenses 2020: $425,887Net Income 2020: -$99,6012020Revenue 2021: $302,913Expenses 2021: $427,386Net Income 2021: -$124,4732021Revenue 2022: $362,389Expenses 2022: $192,238Net Income 2022: $170,1512022Revenue 2023: $385,970Expenses 2023: $391,801Net Income 2023: -$5,8312023Revenue 2024: $358,554Expenses 2024: $292,414Net Income 2024: $66,1402024

Highlighted filing

2017

Revenue$204,679
Expenses$162,047
Net Income$42,632
Open 2017 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2017 to Dec 31, 2017
Signed
Nov 15, 2018
Return Version
2017v2.3
Gross Receipts
$204,679
Mission and Program Overview

Mission

Credentialing new care providers, providing continuing medical education, providing mechanisms for corrective actions and hearings, and guarantee quality patient care.

To credential care providers

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$626,831$669,463▲ $42,632
Rtn Earn Endowment Incm Other Fnds$626,831$669,463▲ $42,632
Total Assets$626,831$669,463▲ $42,632
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$626,831$669,463▲ $42,632
Total Liabilities and Net Assets / Fund Balance$626,831$669,463▲ $42,632
Compensation and Service Providers
Top Officer Pay55th percentile

Employees

NameTitleFull / Part TimeOtherTotal
Robert Geise MdPast PresidePT$22,500$22,500
R Scott Burks MdPast PresidePT$20,100$20,100
JAMES O'CALLAGHAN MDPresident MePT$15,000$15,000
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$203,850
Investment Income
$829
Other Revenue
$0
Change in Net Assets
$42,632
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$135,755
Other Expenses$26,292
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$78,155--$78,155
Current Officers, Directors, Trustees, and Key Employees$57,600--$57,600
Fees for Services Legal$18,930--$18,930
Fees for Services Accounting$3,140--$3,140
Office Expenses$3,038--$3,038
Other Expenses$36--$36
Total Functional Expenses$162,047$0$0$162,047
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
No
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Page 6, Part VI, Line 11B

“President signs the return and the board authorizes her/him to sign. A copy of the return is available upon request of the organization.”

Form 990, Page 6, Part VI, Line 19

“Governing documents are available upon request of the organization.”

Filing and Contact Details

Filer

Filer Name
Evergreen Hospital Medical Center
EIN
91-1883302
Phone
4258991891
Address
12040 NE 128TH ST, KIRKLAND, WA 98034-3013

Signing Officer

Name
JAMES O'CALLAGHAN MD
Title
President Med Staff
Phone
4258991891
Signed
2018-11-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
JAMES O'CALLAGHAN MD
Formed
1998
Legal Domicile
Wa
Voting Board Members
730
Independent Board Members
0
Employees
0

Preparer

Firm
Safstrom & Company Ps
Address
1325 4TH AVE STE 1530, SEATTLE, WA 98101-2546
Preparer
Frank M Khalife
Phone
2066226456
Supplemental Narrative

Additional Explanations

Form 990

“Form 990, part ix, lines 4 and 5: evergreen hospital medical center pays and reports compensation of officers and members. The hospital is reimbursed for these stipends by evergreen hospital medical center medical staff.”

Raw XML Appendix285 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/Form990PartVIISectionAGrp/TitleTxt0PAST PRESIDE
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IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt0EVERGREEN HOSPITAL MEDICAL CENTER PAYS AND REPORTS COMPENSATION OF OFFICERS AND MEMBERS. THE HOSPITAL IS REIMBURSED FOR THESE STIPENDS BY EVERGREEN HOSPITAL MEDICAL CENTER MEDICAL STAFF.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt1EVERGREEN HOSPITAL MEDICAL CENTER PAYS AND REPORTS COMPENSATION OF OFFICERS AND MEMBERS. THE HOSPITAL IS REIMBURSED FOR THESE STIPENDS BY EVERGREEN HOSPITAL MEDICAL CENTER MEDICAL STAFF.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt2THE PURPOSES AND ACTIVITIES OF THE ORGANIZATION ARE AS FOLLOWS: TO CREDENTIAL NEW CARE PROVIDERS AT EVERGREEN HOSPITAL MEDICAL CENTER OF KING COUNTY (THE HOSPITAL). TO GUARANTEE QUALITY OF CARE TO PATIENTS OF THE HOSPITAL. TO PROVIDE MECHANISMS FOR CORRECTIVE ACTION AND HEARINGS FOR THE PRACTITIONERS ON THE HOSPITAL STAFF. TO PROVIDE CONTINUING MEDICAL EDUCATION FOR THE BENEFIT OF THE HOSPITAL PRACTITIONERS.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc0PART IV, SECTION A, LINE 1
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc1PART IV, SECTION D, LINE 2
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc2PART IV, SECTION E, LINE 2A
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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1PRESIDENT SIGNS THE RETURN AND THE BOARD AUTHORIZES HER/HIM TO SIGN. A COPY OF THE RETURN IS AVAILABLE UPON REQUEST OF THE ORGANIZATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST OF THE ORGANIZATION.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 19
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ReturnHeader/BuildTS02019-02-21 02:37:17Z
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ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0PRESIDENT MED STAFF
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ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt064.88.174.3
ReturnHeader/FilingSecurityInformation/IPDt02018-11-09
ReturnHeader/FilingSecurityInformation/IPTm011:53:19
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0911190593
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0SAFSTROM & COMPANY PS
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt01325 4TH AVE STE 1530
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0SEATTLE
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0WA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0981012546
ReturnHeader/PreparerPersonGrp/PhoneNum02066226456
ReturnHeader/PreparerPersonGrp/PreparationDt02018-11-09
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0FRANK M KHALIFE
ReturnHeader/ReturnTs02018-11-12T13:45:16-08:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02017-01-01
ReturnHeader/TaxPeriodEndDt02017-12-31
ReturnHeader/TaxYr02017

Document Assets

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Filings

Displayed year

2017 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$669,463
Liabilities
$0
Net assets
$669,463
Revenue
$204,679
Expenses
$162,047
Net income
$42,632
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$5.45$0.00$5.45$3.59$2.92$0.66
2023Summary only. Only limited summary data is available for this year.$4.79$0.00$4.79$3.86$3.92$0.06
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$4.85$0.00$4.85$3.62$1.92$1.70
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$3.15$0.00$3.15$3.03$4.27$1.24
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$4.39$0.00$4.39$3.26$4.26$1.00
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$5.39$0.00$5.39$2.69$3.13$0.44
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$5.82$0.00$5.82$2.10$2.97$0.87
2017Detailed filing. Detailed filing data is available for this year.$6.69$0.00$6.69$2.05$1.62$0.43
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$6.27$0.00$6.27$2.50$1.74$0.76
2015Summary only. Only limited summary data is available for this year.$5.51$0.00$5.51$2.20$1.43$0.76
2014Summary only. Only limited summary data is available for this year.$4.75$0.00$4.75$2.04$1.39$0.65
2012Summary only. Only limited summary data is available for this year.$3.63$0.00$3.63$1.23$1.69$0.46
2011Summary only. Only limited summary data is available for this year.$4.09$0.00$4.09$1.32$0.61$0.71
Peer Organizations

Similar nonprofits based on the same Siviq industry and scale cohort. 2017 filings • 501(c)3 • $500k-$1M nonprofits