Instrumentl eFile Render
Object ID: 202342169349301564 - Rendered 2024-12-26
TIN: 91-0564748
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
21
Open to Public Inspection
Name of the organization
SEATTLE CHILDREN'S HOSPITAL
Employer identification number
91-0564748
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
Payments for business use of personal residence
Tax idemnification and gross-up payments
Health or social club dues or initiation fees
Discretionary spending account
Personal services (e.g., maid, chauffeur, chef)
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain
.....
1b
Yes
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a?
....
2
Yes
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
Compensation committee
Written employment contract
Independent compensation consultant
Compensation survey or study
Form 990 of other organizations
Approval by the board or compensation committee
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment?
.............
4a
Yes
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
.........
4b
Yes
c
Participate in, or receive payment from, an equity-based compensation arrangement?
.........
4c
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization?
....................
5a
No
b
Any related organization?
.......................
5b
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
..................
6a
No
b
Any related organization?
......................
6b
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III
............
7
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III
..........................
8
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)?
.........................
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021
Schedule J (Form 990) 2021
Page
2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A)
Name and Title
(B)
Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC
(C)
Retirement and other deferred compensation
(D)
Nontaxable
benefits
(E)
Total of columns
(B)(i)-(D)
(F)
Compensation in column (B) reported as deferred on prior Form 990
(i)
Base
compensation
(ii)
Bonus & incentive
compensation
(iii)
Other
reportable compensation
1
JEFF SPERRING MD
CEO/NON-VOTING EX-OFFICIO TRUSTEE
(i)
(ii)
880,631
-------------
293,543
0
-------------
0
10,463
-------------
1,725
11,141
-------------
220,780
19,180
-------------
6,393
921,415
-------------
522,441
0
-------------
0
2
JAMES HENDRICKS PHD
PRESIDENT - RESEARCH INSTITUTE
(i)
(ii)
15,895
-------------
0
0
-------------
0
1,385,912
-------------
0
259
-------------
0
23,220
-------------
0
1,425,286
-------------
0
0
-------------
0
3
DOUGLAS PICHA
PRESIDENT - FOUNDATION
(i)
(ii)
51,903
-------------
467,130
0
-------------
0
11,896
-------------
394,225
1,492
-------------
13,433
2,302
-------------
20,713
67,593
-------------
895,501
0
-------------
334,178
4
SUZANNE BEITEL
SENIOR VP & CHIEF FINANCIAL OFFICER
(i)
(ii)
531,673
-------------
177,225
0
-------------
0
10,882
-------------
2,861
8,196
-------------
97,392
24,319
-------------
8,107
575,070
-------------
285,585
0
-------------
0
5
JEFFREY OJEMANN MD
SR VP - CHIEF MEDICAL OFFICER
(i)
(ii)
230,719
-------------
0
0
-------------
430,548
4,257
-------------
0
10,954
-------------
73,975
1,180
-------------
3,960
247,110
-------------
508,483
0
-------------
0
6
MICHAEL ASTION MD PHD
MEDICAL DIRECTOR - LABORATORIES
(i)
(ii)
602,392
-------------
0
49,126
-------------
0
3,470
-------------
0
20,057
-------------
0
31,917
-------------
0
706,962
-------------
0
0
-------------
0
7
ZAFAR CHAUDRY MD
SR VP - CHIEF INFORMATION OFFICER
(i)
(ii)
533,232
-------------
0
5
-------------
0
15,165
-------------
0
10,738
-------------
69,207
12,200
-------------
0
571,340
-------------
69,207
0
-------------
0
8
MYRA GREGORIAN
SR VP - CHIEF PEOPLE OFFICER
(i)
(ii)
511,478
-------------
0
9
-------------
0
15,019
-------------
0
10,902
-------------
65,797
34,258
-------------
0
571,666
-------------
65,797
0
-------------
0
9
RUSSELL WILLIAMS
SR VP-STRATEGY, CAPITAL, REG NETWORK
(i)
(ii)
515,585
-------------
0
0
-------------
0
7,556
-------------
0
17,078
-------------
60,082
34,982
-------------
0
575,201
-------------
60,082
0
-------------
0
10
JEFFREY AVANSINO MD
VP - MEDICAL AFFAIRS
(i)
(ii)
384,701
-------------
167,763
0
-------------
0
5,874
-------------
0
13,725
-------------
15,099
30,875
-------------
0
435,175
-------------
182,862
0
-------------
0
11
MARK EGBERT DDS
CHIEF - ORAL & MAXILLOFACIAL SURGERY
(i)
(ii)
522,299
-------------
0
1,300
-------------
0
20,790
-------------
0
20,300
-------------
0
33,070
-------------
0
597,759
-------------
0
0
-------------
0
12
CORY NOEL MD
CARDIOLOGIST
(i)
(ii)
443,239
-------------
0
64,000
-------------
0
8,133
-------------
0
14,500
-------------
0
33,684
-------------
0
563,556
-------------
0
0
-------------
0
13
ERIC THAM MD
SR VP & CHIEF RESEARCH OPS OFFICER
(i)
(ii)
446,916
-------------
0
40,885
-------------
0
8,362
-------------
0
14,701
-------------
0
33,956
-------------
0
544,820
-------------
0
0
-------------
0
14
PAUL SHAREK MD
VP - CHIEF QUALITY & SAFETY OFFICER
(i)
(ii)
490,712
-------------
0
32
-------------
0
8,949
-------------
0
10,746
-------------
0
18,497
-------------
0
528,936
-------------
0
0
-------------
0
15
KEVIN KOLLINS MD
CARDIOLOGIST
(i)
(ii)
421,410
-------------
0
51,000
-------------
0
1,756
-------------
0
14,500
-------------
0
30,252
-------------
0
518,918
-------------
0
0
-------------
0
16
RUTH MCDONALD MD
VP-CHIEF MEDICAL OPERATIONS OFFICER
(i)
(ii)
472,373
-------------
0
0
-------------
0
14,204
-------------
0
14,433
-------------
0
14,578
-------------
0
515,588
-------------
0
0
-------------
0
17
MADLYN MURREY
SR VP - CHIEF CLINICAL & NURSING OFF
(i)
(ii)
266,047
-------------
0
0
-------------
0
177,100
-------------
31,553
19,705
-------------
0
12,970
-------------
0
475,822
-------------
31,553
0
-------------
28,072
18
KIMBERLY BAGGETT
VP - CENTER BUSINESS OPERATIONS
(i)
(ii)
145,928
-------------
0
0
-------------
0
316,867
-------------
0
9,187
-------------
0
12,517
-------------
0
484,499
-------------
0
0
-------------
0
19
MICHAEL JENSEN MD
VP-SC THERAPEUTICS, CHIEF THERAP OFF
(i)
(ii)
405,405
-------------
0
0
-------------
0
8,589
-------------
0
14,500
-------------
0
30,980
-------------
0
459,474
-------------
0
0
-------------
0
20
ERIK LAUSUND
VP - RESEARCH OPERATIONS & LOGISTICS
(i)
(ii)
380,025
-------------
0
0
-------------
0
8,235
-------------
0
14,713
-------------
0
27,955
-------------
0
430,928
-------------
0
0
-------------
0
21
STANLEY RA
CHIEF INVESTMENT OFFICER
(i)
(ii)
340,588
-------------
0
51,400
-------------
0
312
-------------
0
19,203
-------------
0
17,692
-------------
0
429,195
-------------
0
0
-------------
0
22
JOHN SAAVEDRA
VP - PEOPLE OPERATIONS
(i)
(ii)
347,689
-------------
0
0
-------------
0
28,628
-------------
0
6,847
-------------
0
27,524
-------------
0
410,688
-------------
0
0
-------------
0
23
PRADIPTA KOMANDURI
VP - CLINICAL SUPPORT SERVICES
(i)
(ii)
363,924
-------------
0
0
-------------
0
7,224
-------------
0
8,417
-------------
0
23,547
-------------
0
403,112
-------------
0
0
-------------
0
24
TRINH PHAM-DEMBINSKI
VP - THERAPEUTICS OPERATIONS
(i)
(ii)
344,657
-------------
0
25,024
-------------
0
5,007
-------------
0
10,110
-------------
0
5,312
-------------
0
390,110
-------------
0
0
-------------
0
25
BONNIE FRYZLEWICZ
SR VP & CHIEF NURSING OFFICER
(i)
(ii)
297,690
-------------
0
30,000
-------------
0
3,447
-------------
0
15,842
-------------
0
30,413
-------------
0
377,392
-------------
0
0
-------------
0
26
VICTORIA CLEATOR
VP-RES FACILITIES OPS, CAP PROJECTS
(i)
(ii)
346,549
-------------
0
0
-------------
0
7,241
-------------
0
13,846
-------------
0
1,773
-------------
0
369,409
-------------
0
0
-------------
0
27
WARREN HEWITT
FORMER KEY EMPLOYEE
(i)
(ii)
232,997
-------------
77,666
4
-------------
0
7,495
-------------
1,068
11,550
-------------
3,850
18,651
-------------
6,217
270,697
-------------
88,801
0
-------------
0
28
JODI LONG
VP & DEPUTY GENERAL COUNSEL
(i)
(ii)
60,861
-------------
0
8
-------------
0
268,909
-------------
0
2,717
-------------
0
2,665
-------------
0
335,160
-------------
0
0
-------------
0
29
SCOTT BINGHAM
FORMER KEY EMPLOYEE
(i)
(ii)
252,349
-------------
0
30,953
-------------
0
1,065
-------------
0
18,750
-------------
0
17,786
-------------
0
320,903
-------------
0
0
-------------
0
30
PAMELA ROCK
FORMER KEY EMPLOYEE
(i)
(ii)
283,148
-------------
0
0
-------------
0
5,841
-------------
0
16,102
-------------
0
12,931
-------------
0
318,022
-------------
0
0
-------------
0
31
SUZANNE PETERSEN
FORMER KEY EMPLOYEE
(i)
(ii)
138,364
-------------
0
0
-------------
0
6,706
-------------
0
7,663
-------------
0
5,979
-------------
0
158,712
-------------
0
0
-------------
0
32
CHRISTINE KESSLER
FORMER KEY EMPLOYEE
(i)
(ii)
122,743
-------------
0
0
-------------
0
3,112
-------------
0
6,941
-------------
0
6,908
-------------
0
139,704
-------------
0
0
-------------
0
Schedule J (Form 990) 2021
Schedule J (Form 990) 2021
Page
3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference
Explanation
PART I, LINE 1A
BUSINESS OR FIRST CLASS TRAVEL IS PROVIDED TO EMPLOYEES IN THE EVENT OF MEDICAL NECESSITY OR ON CERTAIN INTERNATIONAL FLIGHTS OF LONG DURATION. THIS IS NOT TREATED AS COMPENSATION. THE CHIEF EXECUTIVE OFFICER IS PROVIDED MEMBERSHIP TO THE RAINIER CLUB. ANNUAL DUES ARE REPORTED AS TAXABLE COMPENSATION.
PART I, LINES 4A-B
THE FOLLOWING EMPLOYEES PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: JEFF SPERRING MD - $217,067 EMPLOYER CONTRIBUTIONS DOUGLAS PICHA - $37,786 EMPLOYER CONTRIBUTIONS, $371,964 TAXABLE PAYMENT SUZANNE BEITEL - $94,661 EMPLOYER CONTRIBUTIONS JEFFREY OJEMANN MD - $23,448 EMPLOYER CONTRIBUTIONS ZAFAR CHAUDRY MD - $69,208 EMPLOYER CONTRIBUTIONS MYRA GREGORIAN - $65,797 EMPLOYER CONTRIBUTIONS RUSSELL WILLIAMS - $60,082 EMPLOYER CONTRIBUTIONS MADLYN MURREY - $3,481 EMPLOYER CONTRIBUTIONS, $31,553 TAXABLE PAYMENT THE FOLLOWING RECEIVED A SEVERANCE PAYMENT: JAMES HENDRICKS PHD - $1,378,057 MADLYN MURREY - $153,283 KIMBERLY BAGGETT - $314,868 JODI LONG - $266,338
PART II, COLUMN (F):
THE FOLLOWING RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, WHICH IS BEING REPORTED IN COLUMN (B)(III). THIS PORTION OF THAT COMPENSATION WAS REPORTED IN COLUMN (C) IN PRIOR FORMS 990: DOUGLAS PICHA - $334,178 MADLYN MURREY - $28,072
Schedule J (Form 990) 2021
Additional Data
Software ID:
Software Version: