TY 2020 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) BOB CARLIE...................................................................... DIRECTOR	2.00 ................. 2.00	X
(2) ULI CHI...................................................................... DIRECTOR/CHAIR	2.00 ................. 2.00	X	X
(3) JUDE CONNELLY...................................................................... DIRECTOR	2.00 ................. 2.00	X
(4) CAROLYN CORVI...................................................................... DIRECTOR	2.00 ................. 2.00	X
(5) RUTH GOODWIN...................................................................... DIRECTOR	2.00 ................. 2.00	X
(6) TOD HAMACHEK...................................................................... DIRECTOR	2.00 ................. 2.00	X
(7) MICHAEL HOFFMAN...................................................................... DIRECTOR	2.00 ................. 2.00	X
(8) DENNIS HUNTHAUSEN...................................................................... DIRECTOR	2.00 ................. 2.00	X
(9) KAREN LEE...................................................................... DIRECTOR	2.00 ................. 2.00	X
(10) ROBERT LEMON...................................................................... DIRECTOR/VICE CHAIR	2.00 ................. 4.00	X	X
(11) GREGG MEYER...................................................................... DIRECTOR	2.00 ................. 2.00	X
(12) JOHN OPPENHEIMER...................................................................... DIRECTOR	2.00 ................. 2.00	X
(13) MARVIN O'QUINN...................................................................... DIRECTOR	2.00 ................. 2.00	X
(14) DIANN PULS...................................................................... DIRECTOR	2.00 ................. 2.00	X
(15) CRAIG GOODRICH...................................................................... CFO	50.00 ................. 2.00		X
(16) GARY KAPLAN...................................................................... CEO	50.00 ................. 5.00		X
(17) KATERIE CHAPMAN...................................................................... PRESIDENT	50.00 ................. 0.00		X

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2019. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2020

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2019. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2020

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2020

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2020

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization VIRGINIA MASON MEDICAL CENTER

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization VIRGINIA MASON MEDICAL CENTER		Employer identification number 91-0565539

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization VIRGINIA MASON MEDICAL CENTER			Employer identification number 91-0565539
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2020

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures). Click to see attachment

B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(a) Filing organization's totals	(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................	126,542	126,542
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................	78,878	78,878
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................	205,420	205,420
d	Other exempt purpose expenditures ...............................................................................	580,645,563	619,522,802
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................	580,850,983	619,728,222
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000	1,000,000
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................	250,000	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................	0	0
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................	0	0
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................		Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) Total

2a	Lobbying nontaxable amount	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	294,038	307,100	209,447	205,420	1,016,005

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures	180,464	183,519	129,023	205,420	698,426

Schedule C (Form 990 or 990-EZ) 2020

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2020

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	60,824,476	16,598,779	15,347,139	16,620,892	14,623,410
b	Contributions ...	82,633	38,591,356	82,755	91,648	480,797
c	Net investment earnings, gains, and losses	5,751,452	8,224,212	2,289,886	-756,306	2,089,543
d	Grants or scholarships ...	1,193,438	2,589,871	1,121,001	609,095	572,858
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	65,465,123	60,824,476	16,598,779	15,347,139	16,620,892

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

44.240 %

Permanent endowment SchDMd Bullet

27.360 %

Term endowment SchDMd Bullet

28.400 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .......................

3a(i)

Yes

(ii) Related organizations .......................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	138,522,760		138,522,760
b	Buildings ....	313,385,223	7,062,887	306,322,336
c	Leasehold improvements	28,100,749	1,265,462	26,835,287
d	Equipment ....	88,511,412	10,981,356	77,530,056
e	Other .....	14,055,773	16,087	14,039,686
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				563,250,125

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)PARKING RIGHTS				346,926
(2)CURRENT PORTION OF ASSETS WHOSE USE IS LIMITED				196
(3)LONG-TERM RECEIVABLE				303,750
(4)CEMETERY PLOTS/NICHES - BBH				15,200
(5)BENEFICIAL INTEREST				2,078,670
(6)RIGHT OF USE ASSET				103,546,061
(7)SPS REGION				399,069
(8)CONTRIBUTION RECEIVABLE				1,661,174
(9)PLEDGES ALLOWANCE				-432,499
(10)DISCOUNT ON PLEDGES				-9,031
(11)EQUITY INVESTMENT - HCSA				3,943,151
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				111,852,667

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	295,005,842
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2020

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	THE ENDOWMENT FUNDS ARE INTENDED TO SUPPPORT THE HEALTH CARE MISSION OF VIRGINIA MASON MEDICAL CENTER AND THE RESEARCH MISSION OF BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON.
PART X, LINE 2:	VIRGINIA MASON MEDICAL CENTER'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization
VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2020

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 2021 DREAMBUILDERS BALL (event type)	(b) Event #2 2021 BOEING CLASSIC (event type)	(c) Other events 7 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	102,700	341,700	205,956	650,356
2	Less: Contributions . . . .	102,700	116,700	205,956	425,356
3	Gross income (line 1 minus line 2) . . . . . .		225,000		225,000

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	5,060	242,088	69,559	316,707
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				316,707
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-91,707

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2020

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 30000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	4,124,035		4,124,035	0.710 %
b	Medicaid (from Worksheet 3, column a) . . . . .	44,521,929	33,426,047	11,095,882	1.910 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	48,645,964	33,426,047	15,219,917	2.620 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	277,375	25,083	252,292	0.040 %
f	Health professions education (from Worksheet 5) . . .	6,346,046	2,493,247	3,852,799	0.660 %
g	Subsidized health services (from Worksheet 6) . . . .	81,348		81,348	0.010 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	42,194		42,194	0.010 %
j	Total. Other Benefits . .	6,746,963	2,518,330	4,228,633	0.720 %
k	Total. Add lines 7d and 7j .	55,392,927	35,944,377	19,448,550	3.340 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

111,054

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

100,315,466

Enter Medicare allowable costs of care relating to payments on line 5.....

122,488,841

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-22,173,375

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2020

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	VIRGINIA MASON MEDICAL CENTER 1100 NINTH AVENUE SEATTLE,WA98101 VIRGINIAMASON.ORG HAC.FS.00000010	X	X	X	X

Schedule H (Form 990) 2020

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	VIRGINIA MASON MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	VIRGINIA MASON MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.000000000000%
and FPG family income limit for eligibility for discounted care of 0.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, PAGE 8

The FAP application form was widely available on a website (list url):

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	VIRGINIA MASON MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	VIRGINIA MASON MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
VIRGINIA MASON MEDICAL CENTER	PART V, SECTION B, LINE 5: THROUGH THE PUBLIC HEALTH-SEATTLE & KING COUNTY HOSPITALS FOR A HEALTHIER COMMUNITY COLLABORATIVE, VIRGINIA MASON MEDICAL CENTER CONDUCTED KEY INFORMANT INTERVIEWS WITH COMMUNITY COALITIONS AND ORGANIZATIONS, EDUCATION AND GOVERNMENT AGENCIES ABOUT ASSETS AND RESOURCES THAT HELP THEIR COMMUNITIES THRIVE, AS WELL AS CONCERNS AND HEALTH NEEDS WITHIN THEIR COMMNITIES (FULL LIST OF ORGANIZATIONS IN CHNA SUMMARY).
VIRGINIA MASON MEDICAL CENTER	PART V, SECTION B, LINE 6A: VIRGINIA MASON MEDICAL CENTER WORKED WITH THE FOLLOWING OTHER PUGET SOUND-AREA HOSPITALS ON THE CURRENT CHNA: 1) EVERGREEN HEALTH 2) CHI FRANCISCAN HEALTH 3) KAISER PERMAENTE WASHINGTON 4) MULTICARE HEALTH SYSTEM 5) OVERLAKE MEDICAL CENTER 6) SEATTLE CANCER CARE ALLIANCE 7) SEATTLE CHILDREN'S 8) SWEDISH AND 9) UNIVERSITY OF WASHINGTON MEDICINE.
VIRGINIA MASON MEDICAL CENTER	PART V, SECTION B, LINE 11: ACCESS TO DENTAL CARE WAS IDENTIFIED AS A HEALTH NEED, BUT VIRGINIA MASON LACKS THE PERSONNEL TO ADDRESS THIS ISSUE AND IT IS BEING ADDRESSED BY OTHER ORGANIZATIONS, SUCH AS PROJECT ACCESS NORTHWEST AND THE SEATTLE KING COUNTY CLINIC.
VIRGINIA MASON MEDICAL CENTER	PART V, SECTION B, LINE 13H: FULL OR PARTIAL DISCOUNTS MAY BE PROVIDED TO PATIENTS WHO ARE NOT OTHERWISE ELIGIBLE FOR FINANCIAL ASSISTACE, I.E., WITH GROSS FAMILY INCOMES ABOVE THREE HUNDRED PERCENT (300%) OF THE FEDERAL POVERTY GUIDELINES ADJUSTED FOR FAMILY SIZE. SUCH DISCOUNTS MAY BE PROVIDED TO PATIENTS WITH CATASTROPHIC COSTS OR CONDITIONS WHEN CIRCUMSTANCES AS DETERMINED BY THE MEDICAL CENTER INDICATE THAT FULL PAYMENT MAY CAUSE EXTRAORDINARY FINANCIAL HARDSHIP TO THE PATIENT OR THE PATIENT'S FAMILY. THE MEDICAL CENTER SHALL DETERMINE, ON A CASE BY CASE BASIS, WHETHER A PATIENT QUALIFIES AS "MEDICALLY INDIGENT" PURSUANT TO ITS POLICY AND SHALL, THROUGH PATIENT FINANCIAL SERVICES, DETERMINE THE AMOUNT OF THE DISCOUNT, IF ANY. DETERMINATIONS SHALL BE MADE EXPEDITIOUSLY AFTER SUBMISSION OF FINANCIAL INFORMATION BY THE PATIENT BUT SHALL NOT BE SUBJECT TO ANY APPEAL RIGHTS.
PART V, SECTION B, LINE 7A:	HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 10A:	HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 16A:	HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/VM-BILLING-INSURANCE/FINANCIAL-ASSISTANCE.HTML
PART V, SECTION B, LINE 16B:	HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/VM-BILLING-INSURANCE/FINANCIAL-ASSISTANCE.HTML
PART V, SECTION B, LINE 16C:	HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/VM-BILLING-INSURANCE/FINANCIAL-ASSISTANCE.HTML

Schedule H (Form 990) 2020

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address		Type of Facility (describe)
1	1 - VIRGINIA MASON FEDERAL WAY MEDICAL CTR 33501 FIRST WAY S FEDERAL WAY,WA98003	OUTPATIENT MEDICAL CENTER
2	2 - VIRGINIA MASON EDMONDS MEDICAL CENTER 7315 212TH ST SE SUITE 101/207 EDMONDS,WA98026	OUTPATIENT MEDICAL CENTER
3	3 - VIRGINIA MASON BELLEVUE MEDICAL CENTER 11695 NE 4TH ST BELLEVUE,WA98004	OUTPATIENT MEDICAL CENTER
4	4 - VIRGINIA MASON LYNNWOOD MEDICAL CENTER 19116 33RD AVE W LYNNWOOD,WA98036	OUTPATIENT MEDICAL CENTER
5	5 - VIRGINIA MASON ISSAQUAH MEDICAL CENTER 100 NE GILMAN ROAD ISSAQUAH,WA98027	OUTPATIENT MEDICAL CENTER
6	6 - VIRGINIA MASON BAINBRIDGE ISLAND MED CTR 1344 WINTERGREEN LANE NE BAINBRIDGE ISLAND,WA98110	OUTPATIENT MEDICAL CENTER
7	7 - VIRGINIA MASON KIRKLAND MEDICAL CENTER 11800 NE 128TH ST SUITE 300 KIRKLAND,WA98034	OUTPATIENT MEDICAL CENTER
8	8 - VIRGINIA MASON UNIV VILLAGE MEDICAL CTR 2671 NE 46TH ST SEATTLE,WA98105	OUTPATIENT MEDICAL CENTER
9	9 - BAILEY-BOUSHAY HOUSE 2720 EAST MADISON SEATTLE,WA98112	SKILLED NURSING FACILITY
10

Schedule H (Form 990) 2020

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	FULL OR PARTIAL DISCOUNTS MAY BE PROVIDED TO PATIENTS WHO ARE NOT OTHERWISE ELIGIBLE FOR FINANCIAL ASSISTACE, I.E., WITH GROSS FAMILY INCOMES ABOVE THREE HUNDRED PERCENT (300%) OF THE FEDERAL POVERTY GUIDELINES ADJUSTED FOR FAMILY SIZE. SUCH DISCOUNTS MAY BE PROVIDED TO PATIENTS WITH CATASTROPHIC COSTS OR CONDITIONS WHEN CIRCUMSTANCES AS DETERMINED BY THE MEDICAL CENTER INDICATE THAT FULL PAYMENT MAY CAUSE EXTRAORDINARY FINANCIAL HARDSHIP TO THE PATIENT OR THE PATIENT'S FAMILY. THE MEDICAL CENTER SHALL DETERMINE, ON A CASE BY CASE BASIS, WHETHER A PATIENT QUALIFIES AS "MEDICALLY INDIGENT" PURSUANT TO ITS POLICY AND SHALL, THROUGH PATIENT FINANCIAL SERVICES, DETERMINE THE AMOUNT OF THE DISCOUNT, IF ANY. DETERMINATIONS SHALL BE MADE EXPEDITIOUSLY AFTER SUBMISSION OF FINANCIAL INFORMATION BY THE PATIENT BUT SHALL NOT BE SUBJECT TO ANY APPEAL RIGHTS.
PART I, LINE 7:	THE MEDICAL CENTER USED THE DIRECT EXPENSES AND REVENUES OF THE HOSPITAL TO CALCULATE THE COST-TO-CHARGES RATIO FOR THE AMOUNTS INCLUDED IN THE TABLE REFLECTED IN PART I. THE COST-TO-CHARGE RATIO USED WAS DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE RATIO PER THE INSTRUCTIONS.
PART III, LINE 2:	THE MEDICAL CENTER CALCULATES THE BAD DEBT EXPENSE BASED ON THE ACTUAL WRITE-OFFS FOR BAD DEBT EXPENSE INCURRED DURING THE YEAR.
PART III, LINE 4:	AS THE RESULT OF ADOPTING ASU NO. 2014-09, DESCRIBED IN NOTE 2(K), THE MEDICAL CENTER NO LONGER MAINTAINS AN ALLOWANCE FOR PERFORMANCE OBLIGATIONS SATISFIED AFTER JANUARY 1, 2018. ADDITIONALLY, THE MEDICAL CENTER NO LONGER PRESENTS A PROVISION FOR UNCOLLECTIBLE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND BALANCE SHEETS. THE REMAINING PROVISION FOR UNCOLLECTBLE ACCOUNTS IS CONSIDERED IMMATERIAL AS IT IS MAINTAINED ONLY DUE TO UNFORESEEABLE CIRCUMSTANCES, SUCH AS BANKRUPTCY.
PART III, LINE 8:	THE MEDICAL CENTER'S CALCULATION OF THE MEDICARE SHORTFALL RELATED TO HOSPITAL-BASED INPATIENT AND OUTPATIENT SHORTFALL IS $22,173,375. THE MEDICAL CENTER EMPLOYS OVER 437 PHYSICIANS WHO PROVIDE PROFESSIONAL SERVICES TO PATIENTS WHICH ARE NOT COVERED IN THIS NUMBER. IN ADDITION, THE MEDICAL CENTER OPERATES SATELLITE CLINICS AND AMBULATORY SURGERY CENTERS WHICH ARE NOT REPORTED IN THE MEDICARE COST REPORT. FOR ALL OF ITS PATIENT SERVICES, THE MEDICAL CENTER UTILIZES A COMPREHENSIVE ELECTRONIC COST REPORTING PACKAGE WHICH USES THE DIRECTLY ASSIGNED GENERAL LEDGER COSTS AND ALLOCATES ALL OVERHEAD COSTS TO OPERATING COSTS USING A MODEL INSPIRED BY THE MEDICARE COST REPORT. THIS MODEL WITH THE MEDICAL CENTER'S CALCULATION SHOWS A MEDICARE SHORTFALL OF $35.0 MILLION WHICH IS NOT INCLUDED IN THE TRADITIONAL COST REPORT PRIMARILY DUE TO SHORTFALL OF MEDICARE PROFESSIONAL FEES VERSUS COSTS.
PART III, LINE 9B:	VIRGINIA MASON'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PATIENTS WE SERVE. TO ENSURE THE MEDICAL CENTER CONTINUES TO HAVE THE RESOURCES TO FULFILL OUR MISSION, WE MUST BALANCE THE FINANCIAL NEEDS OF OUR PATIENTS WITH THOSE OF THE MEDICAL CENTER. IN ALL INSTANCES, WE WILL TREAT OUR PATIENTS WITH DIGNITY, COMPASSION AND RESPECT. THE MEDICAL CENTER EXPECTS PAYMENT IN FULL UPON RECEIPT OF THE PATIENT'S FIRST BILLING. PATIENTS WILL RECEIVE MONTHLY MEDICAL CENTER STATEMENTS UPON DETERMINATION OF THE PATIENT'S PRIVATE RESPONSIBILITY. A VIRGINIA MASON CLINIC STATEMENT WILL BE SENT REPRESENTING THE PROFESSIONAL COMPONENT OF SERVICES PROVIDED. IF SERVICES WERE PROVIDED OR PROCESSED AT THE DOWNTOWN CAMPUS (EXCEPT THE HEALTH RESOURCES BUILDING, WHICH IS NOT LICENSED AS PART OF THE HOSPTIAL), A HOSPITAL STATEMENT WILL ALSO BE SENT REPRESENTING THE FACILITY/TECHNICAL COMPONENT OF SERVICES. AS OUTSTANDING BALANCES AGE, STATEMENT MESSAGES (DUNNING), COLLECTION LETTERS AND/OR TELEPHONE CALLS MAY BE USED AT APPROPRIATE INTERVALS AS DETERMINED BY THE MEDICAL CENTER. DELINQUENT ACCOUNTS MAY BE FORWARDED TO A THIRD PARTY WHERE A SERIES OF COLLECTION CONTRACTS (LETTERS AND PHONE CALLES) WILL BE INITIATED. DELINQUENT SELF PAY ACCOUNTS THAT HAVE NOT BEEN PAID IN FULL OR ESTABLISHED AN APPROVED INSTALLMENT PAYMENT PLAN MAY BE REFERRED TO A COLLECTION AGENCY. THIS OCCURS APPROXIMATELY 130 DAYS FROM DETERMINATION OF PATIENT RESPONSIBILITY. PATIENT FINANCIAL SERVICES MANAGEMENT TEAM HAS RESPONSIBILITY FOR DETERMINING UNDER WHAT CIRCUMSTANCES A BALANCE MAY BE REFERRED FOR COLLECTION AGENCY RESOLUTION. THE MEDICAL CENTER RECOGNIZES THERE ARE OCCASIONS WHEN A PATIENT IS NOT FINANCIALLY ABLE TO PAY THEIR MEDICAL BILL IN FULL. THOSE PATIENTS WHO INDICATE THEY ARE EXPERIENCING FINANCIAL HARDSHIP WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE. COLLECTION ACTIVITY WILL BE SUSPENDED PENDING ELIGIBILITY DETERMINATION. IF THE PATIENT'S INCOME IS GREATER THAN 300% OF THE CURRENT YEAR'S FEDERAL POVERTY GUIDELINE (FPG), FINANCIAL ASSISTANCE IS DENIED AND ALTERNATIVE PAYMENT ARRANGEMENTS ARE DISCUSSED. IF THE PATIENT'S INCOME IS LESS THAN 300% OF THE CURRENT YEEAR'S FPG, THE PATIENT WILL COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND SEND SUPPORTING DOCUMENTATION. IF FINANCIAL ASSISTANCE DETERMINATION IS APPROVED, THE FINANCIAL ASSISTANCE DISCOUNT IS APPLIED TO THE OUTSTANDING ACCOUNT BALANCE BASED ON THE FPG DETERMINATION AND A CONFIRMATORY LETTER IS SENT TO THE PATIENT. IF FINANCIAL ASSISTANCE IS DENIED, THE MEDICAL CENTER WILL SEND A DENIAL LETTER TO THE PATIENT. A SUMMARY REPORT OF COLLECTION ACTIVITIES TAKEN WILL BE PROVIDED TO THE MEDICAL CENTER BOARD ON AN ANNUAL BASIS PER THE WASHINGTON STATE HOSPITAL ASSOCIATION (WSHA) GUIDELINES.
PART VI, LINE 2:	VIRGINIA MASON CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. THE CHNA CAN BE FOUND AT VIRGINIAMASON.ORG/CONNECTING-WITH-OUR-COMMUNITIES. OUR CHA DRIVES OUR COMMUNITY WORK AND SERVES AS A GUIDELINE TO HELP US ACHIEVE THREE BASIC GOALS: 1) IMPROVE THE COMMUNITY'S HEALTH STATUS AND OVERALL QUALITY OF LIFE; 2) REDUCE HEALTH DISPARITIES WITHIN THE COMMUNITY; AND 3) INCREASE ACCESS TO PREVENTIVE SERVICES. THE LATEST CHNA AS PUBLISHED IN 2018. IT WAS DEVELOPED IN PARTNERSHIP WITH PUBLIC HEALTH - SEATTLE & KING COUNTY. VIRGINIA MASON'S 2018-2021 CHNA IS AN UPDATED AND EXPANDED VERSION OF THE COLLABORATIVE CHNA. IT INCLUDES SECONDARY DATA FROM A VARIETY OF LOCAL, STATE AND FEDERAL AGENCIES, INCLUDING PUBLIC HEALTH - SEATTLE & KING COUNTY. IT ALSO INCLUDES KEY INFORMANT INTERVIEWS WITH INDIVIDUALS REPRESENTING PUBLIC HEALTH, CITY GOVERNMENT, THE HEALTH CARE SAFETY NET, CULTURAL COMMUNITIES, SCHOOLS AND HEALTH ADVOCACY. A 2018-2021 CHNA IMPLEMENTATION STRATEGY WAS ALSO DEVELOPED AND SERVES AS A LIVING DOCUMENT TO GUIDE OUR COMMUNITY BENEFIT PROGRAMS. VIRGINIA MASON'S COMMUNITY BENEFIT PROGRAM FOCUSES OUR RESOURCES ON COMMUNITY NEEDS AND STRENGTHS OF THE MEDICAL CENTER. EXAMPLES INCLUDE: A) SUBSIDIZED HEALTH SERVICES - EVERY COMMUNITY NEEDS CERTAIN HEALTH CARE SERVICES THAT TYPICALLY COST MORE TO DELIVER THAN THE PROVIDER OF THE SERVICES RECEIVES. THESE "SUBSIDIZED HEALTH SERVICES" ARE PART OF THE MEDICAL CENTER'S MISSION BECAUSE THEY ARE NEEDED IN THE COMMUITY AND OTHERWISE WOULD NOT BE AVAILABLE T MEET PATIENT NEEDS. THEY INCLUDE: 1) EMERGENCY DEPARTMENT OPEN TO ALL; 2) BAILEY-BOUSHAY HOUSE (BBH), AN INPATIENT AND OUTPATIENT CENTER FOR PEOPLE LIVING WITH HIV/AIDS AND OTHER COMPLEX DISEASES; 3) PARTNERSHIP WITH PUBLIC HEALTH - SEATTLE & KING COUNTY TO HELP SUPPORT THE EDWARD THOMAS HOUSE MEDICAL RESPITE PROGRAM FOR HOMELESS ADULTS IN KING COUNTY; 4) PARTNERSHIP WITH PROJECT ACCESS NORTHWEST (PANW) TO PROVIDE SPECIALITY CARE SERVICES TO COMMUNITY CLINIC PATIENTS AND PREMIUM ASSISTANCE TO LOW-INCOME PATIENTS; 5) UNCOMPENSATED CARE - AS A NONPROFIT ORGANIZATION, VIRGINIA MASON IS COMMITTED TO SERVING PATIENTS WHO ARE UNINSURED, UNDERINSURED OR OTHERWISE UNABLE TO PAY FOR THEIR MEDICAL ARE; 6) RESEARCH - THE MEDICAL CENTER CONDUCTS MEDICAL RESEARCH THROUGH ITS AFFILIATED BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASO (BRI); 7) EDUCATION - A) VIRGINIA MASON IS A PREMIER TEACHING HOSPITAL THAT OFFERS POSTGRADUATE EDUCATIO PROGRAMS THROUGH ITS GRADUATE MEDICAL EDUCATION (GME) DEPARTMENT. ALL GME POSTGRADUATE TRAINING PROGRAMS ARE ACCREDITED BY THE ACCREDITATION COUNCIL ON GRADUATE MEDICAL EDUCATION (ADGME); B) THE MEDICAL CENTER'S GME PROGRAM PARTNERS WITH PUBLIC HEALTH - SEATTLE & KING COUNTY HEALTH SERVICES DIVISION TO PROVIDE 12 RESIDENTS FOR THE EASTGATE PUBLIC HEALTH CENTER IN BELLEVUE, WASHINGTON; 8) COMMUNITY PARTNERSHIP - THE MEDICAL CENTER IS AN ACTIVE MEMBER OF THE KING COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COLLABORATIVE, A PARTNERSHIP THAT INCLUDES ALL KING COUNTY HOSPITALS, PUBLIC HEALTH - SEATTLE & KING COUNTY AND THE WASHINGTON STATE HOSPITAL ASSOCIATION. IN ADDITION TO COLLABORATING ON FUTURE CHNAS, THIS PARTNERSHIP HAS FORMED HOSPITALS FOR A HEALTHIER COMMUNITY (HHC) AND IS RESEARCHING AND PLANNING COLLABORATIVE COMMUNITY BENEFIT ACTIVITIES THAT COMPREHENSIVELY ADDRESS COMMUNITY HEALTH ISSUES THROUGHOUT KING COUNTY. 9) COMMJUNITY HEALTH IMPROVEMENT SERVICES, INCLUDING A) COMMUNITY HEALTH IMPROVEMENT SERVICES; B) COMMUNITY HEALTH EDUCATION, SUCH AS NUTRITION AND FITNESS FOR LIFE PEDIATRIC PROGRAM AND CLASSES; C) NUTRITION AND FITNESS EDUCATION AT MARY'S PLACE NORTHSHORE IN KENMORE, WASHINGTON, A DAY SHELTER FOR HOMELESS WOMEN AND CHILDREN; D) PROVIDING EDUCATIONAL INFORMATION THROUGH OUR PEDIATRIC DEPARTMENTS AND COMMUNITY EVENTS TO PARENTS REGARDING FIREARM SAFETY IN HOMES WHERE THEIR CHILDRE VISIT AND PLAY; E) SUPPORT OF THE ALLIANCE FOR GUN RESPONSIBILITY; F) SUPPORT OF PLYMOUTH HOUSING'S AND SOLID GROUNDS' EFFORTS TO PROVIDE SAFE HOUSING TO INDIVIDUALS AND FAMILIES WHO ARE HOMELESS; G) HEALTH FAIR SPONSORSHIPS IN THE COMMUNITY; H) FREE FLU SHOTS AND HEALTH SCREENINGS FOR UNINSURED/UNDERINSURED AND THE HOMELESS; I) PARTNERSHIP WITH WITHINREACH TO PROVIDE HEALTH CARE RESOURCES TO FAMILIES AND SOCIAL SERVICE EDUCATION TO COMMUNITY PARTNERS; J) PROVIDING RESOURCES TO REFUGEES NORTHWEST TO ASSIST REFUGEES AND IMMIGRANTS WITH ACCESS TO HEALTH CARE; K) PARTNERSHIP WITH SEATTLE/KING COUNTY CLINIC TO PROVIDE FLU SHOTS DURING THEIR FOUR-DAY FREE HEALTH CLINIC; AND L) BEREAVEMENT SUPPORT THROUGH VIRGINIA MASON'S GRIEF SERVICES DEPARTMENT.
PART VI, LINE 3:	THE MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE MEDICAL CENTER'S CHARITY CARE POLICY AT VARIOUS POINTS BEGINNING AND SCHEDULING AND CONTINUING THROUGH THE PATIENT BILLING PROCESS. AT SCHEDULING, IF A PATIENT INDICATES THEY ARE WITHOUT INSURANCE AND UNABLE TO PAY FOR THE SERVICES, THEIR ACCOUNT IS FLAGGED FOR A FINANCIAL NAVIGATOR TO CONTACT THEM TO DISCUSS ASSISTANCE. AT ARRIVAL FOR AN APPOINTMENT, THE MEDICAL CENTER'S ADMISSIONS LOBBY AREAS HAVE SIGNAGE REGARDING AVAILABILITY OF CHARITY CARE, A COPY OF THE CHARITY CARE POLICY AND INFORMATION REGARDING WHO TO CONTACT FOR ASSISTANCE. DURING THE ARRIVAL PROCESS, THE MEDICAL CENTER'S ADMISSIONS PERSONNEL WILL CONFIRM ABILITY TO PAY. IF FINANCIAL NEED OR FINANCIAL HARDSHIP IS INDICATED, THE MEDICAL CENTER FINANCIAL NAVIGATORS WILL WORK WITH THE PATIENT TO DETERMINE WHETHER MEDICAID, STATE PROGRAM OPTIONS, OR CHARITY CARE WOULD BE APPROPRIATE. THE MEDICAL CENTER'S CHARITY POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS ALSO INCLUDED ON PATIENT BILLS. THE MEDICAL CENTER'S PATIENT GUIDE TO FEES AND BILLING INCLUDES INFORMATION ON CHARITY CAE AVAILABILITY AND CONTACT INFORMATION TO INITIATE AN ASSESSMENT. THE BROCHURE IS AVAILABLE IN ALL LOBBIES FOR PATIENTS TO PICK UP. THE BROCHURE IS ALSO SENT OUT BY PATIENT ACCOUNT SERVICES STAFF BASED ON A PATIENT'S EXPRESSED CONCERNS (EITHER VIA PHONE OR LETTER). THE MEDICAL CENTER'S WEBSITE ALSO INCLUDES INFORMATION ABOUT CHARITY CARE AVAILABILITY AND THE CONTACT NUMBER TO INITIATE AN ASSESSMENT.
PART VI, LINE 4:	VIRGINIA MASON MEDICAL CENTER PROVIDED CARE FOR 60,320 INPATIENT DAYS; 862,486 OUTPATIENT VISITS; AND 19,366 EMERGENCY DEPARTMENT VISITS. THE MEDICAL CENTER'S SERVICE AREA ENCOMPASSES THE COMMUNITIES WHERE ITS FACILITES ARE LOCATED AND WHERE 75 PERCENT OF ITS PATIENTS RESIDE; KING COUNTY, THE SOUTHWEST REGION OF SNOHOMISH COUNTY, AN BAINBRIDGE ISLAND IN KITSAP COUNTY. RESIDENCES OF MEDICAL CENTER PATIENTS INCLUDE: 1) SEATTLE: 68,340; 2) SEATTLE SUBURBS (KING COUNTY OUTSIDE OF SEATTLE): 91,736; 3) SNOHOMISH COUNTY: 7,215; 4) BAINBRIDGE ISLAND: 9,370; 5) SERVICE AREA TOTAL: 176,661; 6) OTHER WASHINGSTON STATE: 45,742; 7) REST OF THE NORTHWEST: 4,367; 8) REST OF UNITED STATES: 2,740; 8) OTHER: 233 FOR A TOTAL OF 229,743. THE SERVICE AREA (KING COUNTY) POPULATION WAS 2,195,502 (2019 U.S. CENSUS BUREA DATA). THE AGE AND RACIAL/ETHNIC PROFILE OF THE TOTAL POPULATION WAS AS FOLLOWS: 1) TOTAL POPULATIO: 2,195,502; 2) UNDER 5 YEARS OLD: 5.8 PERCENT; 3) 18 AND OLDER: 79.6 PERCENT; 4) 65 YEARS OR OLDER: 13 PERCET; 5) WHITE: 64 PERCENT; 6) HISPANIC OR LATINO: 9.7 PERCENT; 7) BLACK OR AFRICAN AMERICAN ALONE: 6.5 PERCENT; 8) ASIAN ALONE: 17.6 PERCENT; 9) AMERICAN INDIAN OR ALASKA NATIVE ALONE: 0.6 PERCENT; 10) NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER ALONE: 0.8 PERCENT; 11) TWO OR MORE RACES: 6.4 PERCENT; 12) SOME OTHER RACE ALONE: 4.2 PERCENT. ACCORDING TO THE UNITED STATES CENSUS BUREAU, THE MEDIAN HOUSEHOLD INCOME FO KING COUNTY AS $94,974 WITH 10.4 PERCENT OF CHILDREN UNDER 18 LIVING IN POVERTY. WITHIN KING COUNTY, MEDIAN INCOME WAS LOWEST FOR BLACKS AND AMERICAN INDIANS/ALASKA NATIVES AND IN URBAN SOUTH KING COUNTY. IN KING COUNTY, POVERTY RATES ARE HIGHEST IN WHITE CENTER/BOULEVARD PARK, SEVERAL CENTRAL AND SOUTHEAST SEATTLE NEIGHBORHODS AND AUBURN. MEDIAN EARNINGS FOR FULL-TIME, YEAR-ROUND WORKERS BY SEX WERE $60,979 FOR FEMALES AND $81,217 OR MALES. KING COUNTY'S EMPLOYMENT RATE AS 67.2 PERCENT, COMPARED TO A NATIONAL AVERAGE OF 59.6 PERCENT.
PART VI, LINE 5:	VIRGINIA MASON'S COMMUNITY BENEFIT PROGRAM IS DESIGNED TO IMPROVE OUR COMMUNITY'S HEALTH STATUS AND OVERALL QUALITY OF LIFE, REDUCE HEALTH DISPARITIES WITHIN THE COMMUNITY AND INCREASE ACCESS TO PREVENTIVE SERVICES. TO ACCOMPLISH THIS, OUR ORGANIZATION CONTRIBUTES TIME, ENERGY AND MONEY IN THE AREAS OF IMPROVING HEALTH, PROVIDING FREE AND SUBSIDIZED CARE, HEALTH PROFESSIONAL'S EDUCATION AND RESEARCH. UNCOMPENSATED CARE. AS A NON-PROFIT ORGANIZATION, VIRGINIA MASON IS COMMITTED TO SERVING PATIENTS WHO ARE UNINSURED, UNDERINSURED OR OTHERWISE UNABLE TO PAY FOR THEIR MEDICAL CARE. UNDER VIRGINIA MASON'S CHARITY CARE POLICY, FREE OR REDUCED-COST MEDICALLY NECESSARY CARE (AFTER ALL HEALTH INSURANCE HAS BEEN EXHAUSTED) IS PROVIDED TO INDIVIDUALS MAKING UP TO 300 PERCENT OF THE FEDERAL POVERTY LEVEL IN KEEPING WITH THE WASHINGTON STATE HOSPITAL ASSOCIATION VOLUNTARY GUIDELINES ON BILLING THE UNINSURED. IN 2021, VIRGINIA MASON PROVIDED CHARITY CARE TO 3,596 PATIENTS AT A COST OF $4,189,033. IN ADDITION, VIRGINIA MASON'S UNREIMBURSED MEDICAID WAS PROVIDED AT A COST OF $17,117,608.COMMUNITY HEALTH IMPROVEMENT SERVICES. IMPROVING HEALTH AND QUALITY OF LIFE EXTENDS BEYOND DIAGNOSIS AND TREATMENT. IT ALSO REQUIRES COMMUNITY HEALTH EDUCATION AND OUTREACH SERVICES. HEALTH IMPROVEMENT AND OUTREACH SERVICES PROVIDED BY VIRGINIA MASON INCLUDE THE FOLLOWING: (1) COMMUNITY HEALTH EDUCATION, SUCH AS CLASSES IN THE DIABETES TEACHING CENTER; (2) FREE HEALTH SCREENINGS AT COMMUNITY HEALTH FAIRS; (3) FREE FLU SHOTS AND HEALTH SCREENINGS FOR THE HOMELESS IN CONJUNCTION WITH UNITED WAY OF KING COUNTY'S COMMUNITY RESOURCE EXCHANGE; (4) SPONSORSHIP OF MANY PROFESSIONALLY FACILITATED SUPPORT GROUPS, INCLUDING DIABETES PREVENTION AND MANAGEMENT; (5) BEREAVEMENT SUPPORT THROUGH OUR SEPARATION AND LOSS SERVICES; AND (6) LEADERSHIP ROLES IN SEVERAL COMMUNITY ORGANIZATIONS, WHICH FOCUS ON HEALTH CARE.HEALTH PROFESSIONS EDUCATION. VIRGINIA MASON STRONGLY SUPPORTS MEDICAL EDUCATION TO ENSURE OUR PATIENTS AND THE COMMUNITY BENEFIT FROM ADVANCES IN MEDICAL CARE. VIRGINIA MASON IS A PREMIER TEACHING HOSPITAL THAT OFFERS POSTGRADUATE EDUCATION PROGRAMS THROUGH ITS GRADUATE MEDICAL EDUCATION DEPARTMENT (GME). ALL GME POSTGRADUATE TRAINING PROGRAMS ARE FULLY APPROVED BY THE ACCREDITATION COUNCIL ON GRADUATE MEDICAL EDUCATION (ACGME). VIRGINIA MASON TRAINS MORE THAN 130 RESIDENTS AND FELLOWS ANNUALLY. VM'S GME PROGRAM IS PARTNERED WITH PUBLIC HEALTH SEATTLE & KING COUNTY HEALTH SERVICES DIVISION, PROVIDING RESIDENTS FOR THE EASTGATE PUBLIC HEALTH CENTER, AS WELL AS PROVIDING RESIDENTS AT THE CAROLYN DOWNS FAMILY MEDICAL CENTER, PIKE MARKET MEDICAL CLINIC AND NORTH PUBLIC HEALTH CENTER.VIRGINIA MASON'S COLLABORATION WITH THE EASTGATE PUBLIC HEALTH CENTER COMBINES THE MEDICAL CENTER'S COMMITMENT TO TEACHING AND COMMUNITY BENEFIT THROUGH AN INNOVATIVE PUBLIC-PRIVATE PROGRAM WHICH ALLOWS RESIDENTS TO BE MORE INVOLVED IN THE CARE OF THE UNDERSERVED AND UNINSURED. THE EASTGATE CLINIC IS THE LARGEST OF THREE COUNTY PUBLIC HEALTH CLINICS IN EAST KING COUNTY AND OFFERS A VARIETY OF PRIMARY CARE SERVICES TO ADULTS AND CHILDREN. APPROXIMATELY 50 PERCENT OF PATIENTS SEEN AT THE CLINIC DO NOT HAVE INSURANCE OR THE MEANS TO PAY, AND APPROXIMATELY THE SAME PERCENTAGE DO NOT SPEAK ENGLISH AND REQUIRE INTERPRETIVE SERVICES. THIS RESIDENT CLINIC IMPROVES OVERALL HEALTH IN THE COMMUNITY AND GIVES BACK TO OUR COMMUNITY IN A MEANINGFUL WAY.VIRGINIA MASON SERVES AS AN INTERNSHIP SITE FOR STUDENTS IN A VARIETY OF OTHER HEALTH PROGRAMS, SUCH AS NURSING, PHARMACY, RESPIRATORY THERAPY AND LABORATORY TECHNOLOGY. SUBSIDIZED HEALTH SERVICES. EVERY COMMUNITY NEEDS CERTAIN HEALTH CARE SERVICES THAT TYPICALLY COST MORE TO DELIVER THAN THE PROVIDER OF THESE SERVICES RECEIVES. THESE SUBSIDIZED HEALTH SERVICES INCLUDE BAILEY-BOUSHAY HOUSE (BBH), A NURSING RESIDENCE AND ADULT DAY HEALTH CENTER FOR PEOPLE LIVING WITH HIV/AIDS AS WELL AS END-OF-LIFE CARE FOR PEOPLE WITH ALS AND OTHER COMPLEX CONDITIONS. SAFETY AND SECURITY WERE KEY DRIVERS FOR OPENING BAILEY-BOUSHAY'S EMERGENCY NIGHT SHELTER IN NOVEMBER 2018, PROVIDING 50 BEDS TO ADDRESS RISING HOMELESSNESS IN THEIR OUTPATIENT POPULATION. IT IS THE FIRST HOMELESS SHELTER IN THE WORLD SPECIFICALLY DESIGNED FOR PEOPLE WITH HIV.RESEARCH. VIRGINIA MASON CONDUCTS MEDICAL RESEARCH THROUGH ITS AFFILIATE, BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON (BRI). BRI IS A NON-PROFIT BIOMEDICAL RESEARCH INSTITUTE THAT WORKS TO UNLOCK THE MYSTERIES OF THE IMMUNE SYSTEM. ITS TEAM OF WORLD-RENOWNED SCIENTISTS IS FOCUSED ON IDENTIFYING CAUSES AND CURES FOR DEVASTATING DISEASES INCLUDING DIABETES, ARTHRITIS, HEART DISEASE AND CANCER. IN 2021, THE MEDICAL CENTER PROVIDED $1,000,000 TO SUPPORT RESEARCH ACTIVITIES AT BRI. ENVIRONMENTAL IMPROVEMENTS. VIRGINIA MASON'S ENVIRONMENTAL STEWARDSHIP PROGRAM, ENVIROMASON, PROVIDES THE FRAMEWORK FOR VARIOUS FOOTPRINT REDUCTION INITIATIVES, SUCH AS CONSERVING ENERGY AND WATER, DESIGNING GREENER BUILDINGS, GENERATING LESS WASTE, AND BUYING ENVIRONMENTALLY PREFERABLE PRODUCTS. VIRGINIA MASON HAS EMPLOYED A FULL TIME SUSTAINABILITY DIRECTOR SINCE 2011. THE PURPOSE OF THIS POSITION AND THE ENVIROMASON PROGRAM IS TO PRESERVE LONG-TERM ENVIRONMENTAL QUALITY THAT WE ALL RELY UPON FOR GOOD HEALTH.IN 2007, VIRGINIA MASON BECAME THE FIRST HOSPITAL IN THE PACIFIC NORTHWEST TO ELIMINATE STYROFOAM USE AND BEGIN COMPOSTING FOOD WASTE. SINCE 2011, OUR ENERGY CONSERVATION PROJECTS HAVE SAVED OVER 4.5 MILLION KILOWATT HOURS PER YEAR. OUR WATER CONSERVATION PROJECTS IN THE SAME PERIOD HAVE SAVED MORE THAN 7 MILLION GALLONS OF WATER PER YEAR.BETWEEN 2011 AND 2021, VIRGINIA MASON DIVERTED MORE THAN 8,900 TONS OF WASTE FROM THE LANDFILL. WE ACCOMPLISHED THIS BY EXPANDING RECYCLING ACROSS OUR FACILITIES; IMPROVING OUR ELECTRONICS RECYCLING; PROVIDING COMPOSTING TO ALL LUNCH AND BREAK ROOMS; IMPLEMENTING A CONSTRUCTION DEBRIS RECYCLING PROGRAM; RECYCLING THE FIBER FROM OUR SHREDDED OFFICE PAPER; AND REPROCESSING MEDICAL SUPPLIES THAT CAN BE REUSED. ADDITIONALLY, VIRGINIA MASON WAS THE FIRST HOSPITAL IN THE REGION TO IMPLEMENT AN OPERATING ROOM (OR) RECYCLING PROGRAM.ENVIROMASON'S TEAM APPROACH EXTENDS FROM STRONG SENIOR LEADERSHIP SUPPORT TO ACTIVE ENGAGEMENT OF OUR TEAM MEMBERS. OUR GOAL IS TO REDUCE THE ENVIRONMENTAL IMPACT OF VIRGINIA MASON'S OPERATIONS BY EDUCATING AND EMPOWERING TEAM MEMBERS TO MAKE MORE SUSTAINABLE CHOICES. IN 2019, THIS APPROACH LED TO THE ANESTHESIOLOGY DEPARTMENT AT THE MAIN CAMPUS SUCCESSFULLY ELIMINATING THE USE OF DESFLURANE, AN ANESTHETIC GAS WITH 20 TIMES THE GLOBAL WARMING POTENTIAL AS ITS PRIMARY ALTERNATIVE GAS.ENVIROMASON SPECIAL EVENTS ALSO HELP US ENGAGE OUR TEAM MEMBERS WITH SUSTAINABILITY EFFORTS. WE SPONSOR EVENTS SUCH AS OUR FARMERS MARKET, COMMUNITY SUPPORTED AGRICULTURE (CSA) PROGRAM, AND ECOCHALLENGE CARBON REDUCTION PROGRAM. VIRGINIA MASON RECENTLY SIGNED ONTO THE NATIONAL COOL FOOD PLEDGE, WHOSE AIM IS TO REDUCE THE GREENHOUSE GAS EMISSIONS ASSOCIATED WITH THE FOOD WE SERVE BY 25% BY 2030. AS AN ORGANIZATION DEDICATED TO PRESERVING HEALTH, VIRGINIA MASON IS REDUCING OUR GREENHOUSE GAS EMISSIONS THROUGH ENERGY EFFICIENCY; COMMUTE TRIP REDUCTION; LANDFILL DIVERSION ACTIVITIES, LIKE RECYCLING, COMPOSTING, AND FOOD DONATION; AND BUYING LOCAL GOODS AND SERVICES.MEDICAL STAFF. VIRGINIA MASON HAS 565 MEMBERS ON ITS ACTIVE HOSPITAL STAFF, INCLUDING VIRGINIA MASON PHYSICIANS, AND OTHER COMMUNITY PROVIDERS.ACCOUNTABILITY TO THE COMMUNITY. THE MEDICAL CENTER IS ACCOUNTABLE TO THE PUBLIC THROUGH ITS BOARD, THE VOTING MEMBERS OF WHICH ARE COMMUNITY MEMBERS WHO REPRESENT THE DIVERSE POPULATIONS AND NEEDS OF COMMUNITIES SERVED BY THE MEDICAL CENTER. BAILEY-BOUSHAY HOUSE, A DIVISION OF THE MEDICAL CENTER WHICH PROVIDES DAY HEALTH AND SKILLED NURSING FACILITY SERVICES TO INDIVIDUALS LIVING WITH HIV/AIDS, ALSO HAS AN ADVISORY BOARD COMPRISED PRIMARILY OF REPRESENTATIVES OF THE COMMUNITY WHO PROVIDE INPUT AND GUIDANCE ON SERVING THE COMMUNITY.USE OF FINANCIAL SURPLUSES. ALL FINANCIAL SURPLUSES FROM THE OPERATION OF THE MEDICAL CENTER ARE USED EXCLUSIVELY TO FURTHER ITS CHARITABLE PURPOSES. NO INDIVIDUAL RECEIVES ANY PORTION OF THE ORGANIZATIONS' RESPECTIVE SURPLUS AS A RESULT OF OWNERSHIP OR ANY OTHER "INSIDER" RELATIONSHIP.
PART VI, LINE 7, REPORTS FILED WITH STATES	WA

Schedule H (Form 990) 2020

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
VIRGINIA MASON MEDICAL CENTER

Employer identification number
91-0565539

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON 1201 NINTH AVENUE SEATTLE,WA98101	91-0653422	501(C)(3)	1,000,000				OPERATING SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2020

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE FUNDS PROVIDED TO VIRGINIA MASON HEALTH SYSTEM ARE FOR OPERATIONAL SUPPORT OR SPECIFIC ACTIVITIES.

Schedule I (Form 990) 2020

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
VIRGINIA MASON MEDICAL CENTER

Employer identification number
91-0565539

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	WASHINGTON HEALTH CARE FACILITIES AUTHORITY	91-1108929	93978HSS5	08-31-2017	287,837,574	REFINANCE OUTSTANDING DEBT		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	287,843,556
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	2,428,792
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	285,412,975
12 Other unspent proceeds .............	1,789
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X
b Exception to rebate? ........		X
c No rebate due? .........	X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
PART I, LINE A, COLUMN C	93978HSD8, 93978HSE6, 93978HSF3, 93978HG1, 93978HSH9, 93978HSJ5, 93978HSK2, 93978HSL0, 93978HSM8, 93978HSN6, 93978HSP1, 93978HSQ9, AND 93978HSR7
PART I, LINE A, COLUMN F	THE PROCEEDS OF THE SERIES 2017 BONDS WILL BE USED FOR THE PURPOSE OF PROVIDING PART OF THE FUNDS NECESSARY TO 1) REFUND, ON AN CURRENT BASIS THE AUTHORITY'S REVENUE BONDS, SERIES 1997B, THE SERIES 2007A, THE SERIES 2007B BONDS, AND THE SERIES 2007C BONDS; AND 2) PAY COSTS OF ISSUANCE OF THE BONDS. THE 1997B BONDS WERE REISSUED DECEMBER 1, 2007. THE ORIGINAL BOND PROCEEDS WERE USED TO 1) FINANCE OR REIMBURSE THE MEDICAL CENTER FOR THE COSTS OF CONSTRUCTING, REMODELING AND/OR ACQUIRING HEALTH CARE FACILITIES; 2) FUND THE INITIAL DEPOSIT TO THE RESERVE ACCOUNTS FOR THE BONDS; 3) PAY THE PREMIUM FOR THE INSURANCE POLICY; AND 4) PAY CERTAIN OF THE OTHER COSTS OF ISSUING THE BONDS. THE SERIES 2007A BONDS, THE SERIES 2007B BONDS AND THE SERIES 2007C BONDS WERE ORIGINALLY ISSUED DECEMBER 1, 2007. THE ORIGINAL BONDS PROCEEDS OF THE REOFFERED 1997B BONDS TOGETHER WITH THE PROCEEDS OF THE SERIES 2007 BONDS WERE TO BE USED FOR THE PURPOSE OF PROVIDING PART OF THE FUNDS NECESSARY TO 1) REFUND, ON AN ADVANCED AND CURRENT BASIS, AND TO REDEEM THE AUTHORITY'S REVENUE BONDS, SERIES 1997A; 2) REISSUE, REFUND, ON A CURRENT BASIS AND REPLACE THE SERIES 1997B BONDS AS A VARIABLE RATE OBLIGATION; 3) REIMBURSE THE MEDICAL CENTER FOR, OR PAY, THE COSTS OF ACQUIRING, CONSTRUCTING, REMODELING, RENOVATING AND EQUIPPING CERTAIN HEALTH CARE FACILITIES; 4) PAY INTEREST ON THE SERIES 2007 BONDS DURING CONSTRUCTION; 5) FUND THE INITIAL DEPOSITS INTO RESPECTIVE DEBT SERIVCE RESERVES FOR THE SERIES 2007 BONDS; 6) PAY THE COST OF CREDIT ENHANCEMENT, IF ANY, AND 7) PAY ISSUANCE COSTS.
PART II, LINE 3 DIFFERENCE	THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE PROCEEDS OF THE BOND ISSUE IS DUE TO INVESTMENT EARNINGS.
PART II, LINE 7 DIFFERENCE	THE DIFFERENCE BETWEEN PART II LINE 7 AND FORM 8038 LINE 24 IS DUE TO LOWER ISSUANCE COSTS THAN THE ESTIMATED COSTS INCLUDED IN THE PROCEEDS.

Schedule K (Form 990) 2020

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2020

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) COLUMBIA HOSPITALITY INC	COMPANY FOUNDED BY JOHN OPPENHEIMER, DIRECTOR	780,919	PROVISION OF MANAGEMENT SERVICES TO THE MEDICAL CENTER		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2020

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	6	46,470	FMV
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	18	1,748	REPLACEMENT COST
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( LODGING/ENTERTINAMENT/EXPERIENCES )	X	22	51,965	REPLACEMENT COST
26 Other ( MEDICAL SUPPLIES )	X	5	18,920	REPLACEMENT COST
27 Other ( ITEMS USED AT AUCTION/EVENT )	X	18	7,826	REPLACEMENT COST
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2020)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 32B:	VIRGINIA MASON USES A BROKERAGE FIRM TO SELL DONATED PUBLICLY TRADED SECURITIES.

Schedule M (Form 990) (2020)

Additional Data

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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Return Reference	Explanation
FORM 990, PART III, LINE 1 (CONTINUED):	THE MEDICAL CENTER ALSO OPERATES BAILEY-BOUSHAY HOUSE, A SKILLED NURSING FACILITY AND DAY HEALTH CENTER SERVING THE HIV/AIDS COMMUNITY. THE MEDICAL CENTER PATIENT CARE SERVICES ARE INTEGRATED WITH AND ENHANCED BY EDUCATION AND RESEARCH ACTIVITIES WHICH INCLUDE A GRADUATE MEDICAL EDUCATION PROGRAM PROVIDING TRAINING TO OVER 130 RESIDENTS, FELLOWS AND MEDICAL STUDENTS EACH YEAR. IN ADDITION, THE MEDICAL CENTER SPONSORS TRAINING PROGRAMS FOR PHARMACY AND A VARIETY OF OTHER HEALTH SERVICES SUCH AS NURSING, RESPIRATORY THERAPY, SPEECH AND LANGUAGE THERAPY AND LABORATORY TECHNOLOGY.
FORM 990, PART VI, SECTION A, LINE 1	THE GOVERNING BODY DELEGATES TO AN EXECUTIVE COMMITTEE COMPRISED OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASUER THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE CORPORATION TO ACT ONLY IN TIME SENSITIVE OR EMERGENCY SITUATIONS AS DETERMINED BY THE EXECUTIVE COMMITTEE, SUCH AUTHORITY TO BE EXERCISED IN TIME PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE GOVERNING BODY OF THE CORPORATION. THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE GOVERNING BODY OF THE CORPORATION. THE EXECUTIVE COMMITTEE DOES NOT HAVE THE AUTHORITY TO AMEND, ALTER OR REPEAL THE BYLAWS, ELECT, APPOINT OR REMOVE ANY MEMBER OF THE EXECUTIVE COMMITTEE OR ANY DIRECTOR OR OFFICER OF THE CORPORATION; AMEND THE ARTICLES OF INCORPORATION; ADOPT A PLAN OF MERGER OR ADOPT A PLAN OF CONSOLIDATION WITH ANOTHER CORPORATION; AUTHORIZE THE SALE, LEASE O EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION NOT IN THE ORDINARY COURSE OF BUSINESS; AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKE PROCEEDINGS THEREFORE; ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION; AMEND, ALTER OR REPEAL ANY RESOLUTION OF THE BOARD WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY THE EXECUTIVE COMMITTEE; OR TERMINATE THE CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO PERIODICALLY EVALUATES THE EFFECTIVEESS OF VIRGINIA MASON MEDICAL CENTER'S ("VMMC") SYSTEMS FOR RESOLVING INTERNAL CONFLICTS. THE BOARD ALSO DELEGATES TO THE EXECUTIVE COMMITTEE THE AUTHORITY OF THE BOARD TO MAKE ALL APPOINTMENTS AND REAPPOINTMENTS TO THE MEDICAL STAFF OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 4	EFFECTIVE JANUARY 1, 2021 FRANCISCAN HEALTH SYSTEM (FHS), VIRGINIA MASON HEALTH SYSTEM (VMHS), AND COMMONSPIRIT HEALTH (COMMONSPIRIT), A MEMBER OF FHS, COMPLETED THE AFFILIATION TRANSACTION (THE AFFILIATION) CONTEMPLATED BY THE AFFILIATION AGREEMENT, DATED AS OF DECEMBER 31, 2020, PURSUANT TO WHICH, AMONG OTHER THINGS, COMMONSPIRIT FORMED VIRGINIA MASON FRANCISCAN HEALTH, A WASHINGTON NONPROFIT CORPORATION (VMFH). AFTER THE EFFECTIVE DATE, COMMONSPIRIT AND VMHS ARE THE SOLE CORPORATE MEMBERS OF VMFH, WHICH IS A CONTROLLED SUBSINDARY OF COMMONSPIRIT AND WILL BE CONSOLIDATED WITH COMMONSPIRIT FOR ACCOUNTING PURPOSES. AS A RESULT OF THE AFFILIATION, VMFH NOW GOVERNS AND MANAGES THE COMBINED OPERATIONS OF FHS, VIRGINIA MASON MEDICAL CENTER (VMMC) BENAROYA RESEARCH INSTITUE (BRI), AND CERTAIN OTHER AFFILIATES OF FHS AND VMMC (THE COMBINED SYSTEM), SUBJECT TO CERTAIN VMHS PROTECTIVE RESERVED POWERS AND OTHER RESERVED POWERS HELD BY COMMONSPIRIT AND VMFH IS NOW THE SOLE CORPORATE MEMBER OF BOTH VMMC AND BRI.
FORM 990, PART VI, SECTION A, LINE 6	ACCORDING TO THE BYLAWS OF VIRGINIA MASON MEDICAL CENTER THE ENTITY'S SOLE MEMBER IS VIRGINIA MASON FRANCISCAN HEALTH, A WASHINGTON NONPROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A	VIRGINIA MASON FRANCISCAN HEALTH IS THE SOLE CORPORATE MEMBER OF VIRGINIA MASON MEDICAL CENTER. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	VIRGINIA MASON FRANCISCAN HEALTH ("VMFH") IS THE SOLE CORPORATE MEMBER OF VIRGINIA MASON MEDICAL CENTER ("VMMC"). EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION, ELSEWHERE IN THESE BYLAWS, OR IN THE LAWS OF THE STATE OF WASHINGTON, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. THE RIGHTS OF THE CORPORATE MEMBER SHALL BE FURTHER SUBJECT TO THE POWERS RESERVED TO CSH UNDER THE GOVERNANCE MATRIX (SUBJECT TO THE BYLAWS OF THE CORPORATE MEMBER) AND AS OTHERWISE SET FORTH IN THE BYLAWS OF THE CORPORATE MEMBER. IN ADDITION, SUBJECT TO THE BYLAWS OF THE CORPORATE MEMBER, THE RESERVED POWERS OF CSH SET FORTH IN THE GOVERNANCE MATRIX MAY BE UNILATERALLY EXERCISED BY CSH ON BEHALF OF THE CORPORATION, AT CSH'S SOLE DISCRETION, IF THE CORPORATION'S BOARD OF DIRECTORS FAILS TO ACT UPON SUCH MATTERS DESCRIBED IN THESE BYLAWS, OR IF THE CORPORATION'S BOARD OF DIRECTORS ATTEMPTS TO ACT IN A MANNER THAT CONFLICTS WITH OR OVERRIDES THE ACTIONS OR DESIRES OF CSH WITH RESPECT TO SUCH MATTERS. THE GOVERNANCE MATRIX MAY BE AMENDED FROM TIME TO TIME BY CSH, AND SUCH AMENDMENTS SHALL BE DEEMED TO BE A PART OF THESE BYLAWS WITHOUT FURTHER ACTION. THE CORPORATION SHALL BE DEEMED A "SUBSIDIARY" OF CSH FOR PURPOSES OF THE GOVERNANCE MATRIX. IN ADDITION TO THE RIGHTS RESERVED TO CSH UNDER THE GOVERNANCE MATRIX, CSH SHALL HAVE THE POWER TO TRANSFER ASSETS OF THE CORPORATION OR TO REQUIRE THE CORPORATION TO TRANSFER ASSETS TO CSH, TO THE EXTENT NECESSARY TO ACCOMPLISH CSH'S GOALS AND OBJECTIVES, AND TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF CSH OR AN ENTITY CONTROLLED BY, CONTROLLING, OR UNDER COMMON CONTROL WITH CSH (FOR PURPOSES OF THIS SECTION, A "CSH AFFILIATE"), ISSUED OR INCURRED BY OR ON BEHALF OF CSH OR A CSH AFFILIATE IN FURTHERANCE OF CSH'S GOALS AND OBJECTIVES. THE CORPORATION SHALL NOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THESE BYLAWS OR ITS ARTICLES OF INCORPORATION, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS OR OTHER CONTRACTS AS A RESULT OF ANY ASSET TRANSFERS MADE OR DIRECTED BY CSH. EXCEPT FOR TRANSFERS PREVIOUSLY APPROVED BY CSH, EITHER INDIVIDUALLY OR AS PART OF THE CSH HEALTHCARE SYSTEM BUDGET PROCESS, AND EXCEPT FOR TRANSFERS TO AN AFFILIATE OR SUBSIDIARY OF THE CORPORATION, THE CORPORATION SHALL NOT TRANSFER ASSETS TO ENTITIES OTHER THAN CSH OR CSH AFFILIATES WITHOUT THE APPROVAL OF CSH.
FORM 990, PART VI, SECTION B, LINE 11B	NO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PART VI, SECTION B, LINE 12C	THE GOVERNANCE COMMITTEE OF THE BOARD HAS ACCOUNTABILITY FOR OVERSIGHT OF THE PROCESS FOR DISCLOSURE, EVALUATION AND MANAGEMENT OF CONFLICTS OF INTEREST INVOLVING ANY MEMBER OF THE BOARD, EXECUTIVE LEADERSHIP OR KEY EMPLOYEES ("COVERED PERSON"). PURSUANT TO THE CONFLICTS OF INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE IS DISTIBUTED TO ALL COVERED PERSONS. IN ADDITION, A COVERED PERSON HAS AN ON-GOING DUTY TO DISCLOSE THE EXISTENCE O A CONFLICT OF INTEREST AT ANY TIME AN ACTUAL OR POTENTIAL CONFLICT ARISES. EACH COVERED PERSON IS REQUIRED UPON APPOINTMENT AND ANNUALLY THEREAFTER TO ATTEST TO A STATEMENT THAT AFFIRMS THAT SUCH PERSN HAS 1) RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE MEDICAL CENTER IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ITS TAX-EXEMPT PURPOSES. WRITTEN DISCLOSURES ARE REVIEWED BY THE GOVERNANCE COMMITTEE TO DETERMINE IF AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS AND IF SO, HOW SHOULD IT BE MANAGED. THE COVERED PERSO IS INFORMED IN WRITING REGARDING THE DETERMINATION (THE "CONFLICT OF INTEREST MANAGEMENT PLAN"). NO COVERED PERSON WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL ENGAGE IN AN ACTIVITY ON THE MEDICAL CENTER'S BEHALF RELATED TO THE DISCLOSED ACTUAL OR POTENTIAL CONFLICT OF INTEREST UNLESS SUCH ACTIVITY IS PERMITTED BY THE CONFLICT OF INTEREST MANAGEMENT PLAN OR UNTIL THE COVERED PERSON AS UNDERTAKEN ALL STEPS SET FORTH IN THE MANAGEMENT PLAN TO MANAGE, REDUCE OR ELIMINATE THE CONFLICT. ALL COVERED PERSONS HAVE A DUTY TO DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO MEETING AGENDA ITEMS. THE CONFLICTS OF INTEREST POLICY REQUIRES THAT COPIES OF THE CONFLICT OF INTEREST QUESTIONNAIRE COMPLETED ANNUALLY BY EACH COVERED PERSON AND ANY CONFLICT OF INTEREST MANAGEMENT PLAN BE MAINTAINED. IN ADDITION, THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL DOCUMENT THE DISCLOSURE AND RESOLUTION OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST DISCLOSED AT SUCH MEETING.
FORM 990, PART VI, SECTION B, LINE 15	THE VMHS COMPENSATION AND BENEFITS BOARD COMMITTEE, A COMMITTEE COMPOSED SOLELY OF INDEPENDENT DIRECTORS OF VMHS NONE OF WHOM HAVE A CONFLICT OF INTEREST, IS ACCOUNTABLE FOR SETTING REASONABLE TOTAL COMPENSATION PACKAGES FOR EACH MEDICAL CENTER EXECUTIVE, INCLUDING THE CEO, OFFICERS AND KEY EMPLOYEES("EXECUTIVES") CONSISTENT ITH THE MEDICAL CENTER'S PHILOSOPHY AND PRINCIPLES. THE BOARD DEVELOPS AND APPROVES ANNUAL GOALS AND PERFORMANCE CRITERIA WHICH ARE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION OPPORTUNITIES FOR THE MEDICAL CENTER EXECUTIVES. THE COMMITTEE ASSESSES PERFORMANCE AGAINST THESE GOALS. THE COMMITTEE SELECTS AND ENGAGES A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO REVIEW AND ANALYZE THE TOTAL COMPENSATION AND BENEFITS PACKAGES TO THE EXECUTIVES. THE COMMITTEE AS PART OF ITS ANALYSIS OBTAINS FROM THE COMPENSATIO CONSULTANT APPROPRIATE COMPARABILITY DATA INCLUDING TOTAL COMPENSATION PAID BY SIMILARLY SITUATED FOR-PROFIT AND NON-PROFIT HEALTH CARE ORGANIZATIONS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE TO EACH OF THE EXECUTIVES. WITH RESPECT TO THOSE EXECUTIVES BELOW THE LEVEL OF CHAIR/CHIEF EXECUTIVE OFFICER, THE COMMITTEE REQUESTS THAT THE CHAIR/CHIEF EXECUTIVE OFFICER WORK WITH THE COMPENSATION CONSULTANT TO FORMULATE A COMPENSATION RECOMMENDATION FOR EACH SUCH EXECUTIVE, CONSISTENT WITH VMHS'S COMPENSATION PHIOSOPHY AND PRINCIPLES. CONSISTENT WITH VMHS'S COMPENSATION PHILOSOPHY AND PRINCIPLES, THE COMMITTEE APPROVES TOTAL COMPENSATION PACKAGES FOR EACH OF THE EXECUTIVES BASED ON INFORMATION PRESENTED TO THE COMMITTEE, REASONABLENESS AND THE BEST INTERESTS OF THE MEDICAL CENTER. THE COMMITTEE'S DECISIONS REGARDING COMPENSATION FOR EACH EXECUTIVE ARE DOCUMENTED IN WRITTEN RESOLUTIONS AND MINUTES OF THE COMMITTEE. THE COMMITTEE PROMPTLY REPORTS ITS ACTION TO THE BOARD WHOSE REPORTS ARE REFLECTED IN THE BOARD'S MINUTES. THE EXECUTIVES THAT WERE REVIEWED IN 2020 WERE: CHIEF EXECUTIVE OFFICER, PRESIDENT, CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENTS, VICE PRESIDENTS, PHYSICIAN CHIEFS, CLINIC MEDICAL DIRECTOR, HOSPITAL MEDICAL DIRECTOR, AND CHIEF MEDICAL OFFICER.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S ARTICLES, BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:	PENSION ADJUSTMENT 8,098,495. ADDITIONAL RETIREMENT LIABILITY 218,000. INTER-DEPARTMENT CONTRIBUTIONS 2,719,351. CONTRIBUTION OF SERVICES 449,638.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

VIRGINIA MASON MEDICAL CENTER

Employer identification number

91-0565539

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) 1000 MADISON LLC 1100 NINTH AVENUE SEATTLE,WA98101 20-4018216	REAL ESTATE	WA	1,886,884	17,290,579	VMMC
(2) 1005 SPRING STREET LLC 1100 NINTH AVENUE SEATTLE,WA98101 20-4816736	REAL ESTATE	WA	428,230	3,775,075	VMMC
(3) HEALTH RESOURCE SERVICES LLC 1100 OLIVE WAY SEATTLE,WA98101 26-2800994	GROUP PURCHASING	WA	10,273,903	41,956,198	VMMC
(4) PUGET SOUND HIGH VALUE NETWORK LLC 1100 NINTH AVENUE SEATTLE,WA98101 47-2840780	MEDICAL NETWORK	WA	0	-4,168	VMMC
(5) NETWORXHEALTH LLC 1100 OLIVE WAY SEATTLE,WA98101 82-5288717	HEALTHCARE STAFFING	WA	340,312	-39,109	VMMC

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)VIRGINIA MASON FRANCISCAN HEALTH 1149 MARKET STREET TACOMA,WA98402 86-1332353	HEALTH CARE	WA	501(C)(3)	LINE 12B, II	N/A		No
(2)VIRGINIA MASON INSTITUTE 1100 NINTH AVENUE SEATTLE,WA98101 26-3763656	EDUCATION	WA	501(C)(3)	LINE 10	VMMC	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2020

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) NATIONAL PURCHASING PARTNERS LLC 1100 OLIVE WAY SEATTLE,WA98101 20-3470995	GROUP PURCHASING	WA	N/A	UNRELATED	17,857,602	7,354,821		No	18,081,790	Yes		50.000 %
(2) EMERALD CITY OBSTETRICS ALLIANCE LLC 1100 NINTH AVENUE SEATTLE,WA98101 32-0594147	GOVERNANCE OVERSIGHT	WA	N/A	RELATED	-11,301,121	1,053,051		No			No	50.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) CENTER FOR INTEGRATIVE MEDICINE AT VIRGINIA MASON 1100 NINTH AVENUE SEATTLE,WA98101 83-1583223	INTEGRATIVE MEDICINE SERVICES	WA	VMMC	C		176,564	100.000 %		No

Schedule R (Form 990) 2020

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2020

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2020

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: VIRGINIA MASON MEDICAL CENTER'S (THE "MEDICAL CENTER") MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PATIENTS IT SERVES THROUGH THE DELIVERY OF HIGH QUALITY, COST EFFECTIVE CARE. THE MEDICAL CENTER PROVIDES INTEGRATED HEALTH SERVICES THROUGH A TEACHING HOSPITAL AND MULTI-SPECIALITY GROUP PRACTICE, OFFERING BOTH PRIMARY AND SPECIALIZED CARE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	486
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,283,809
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	60,533,449	5,407,888
9	Program service revenue (Part VIII, line 2g) .........	1,029,684,469	560,661,744
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	40,881,723	21,114,450
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,443,105	2,694,086
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,137,542,746	589,878,168
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	8,190,853	1,000,000
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	610,472,170	319,918,677
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 1,750,885
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	522,213,913	259,932,306
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,140,876,936	580,850,983
19	Revenue less expenses. Subtract line 18 from line 12.......	-3,334,190	9,027,185
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,429,584,444	1,475,989,315
21	Total liabilities (Part X, line 26).............	874,015,959	890,283,362
22	Net assets or fund balances. Subtract line 21 from line 20.....	555,568,485	585,705,953

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 530,039,396 including grants of $ ) (Revenue $ 558,196,863 )
	HEALTH CARE SERVICESTHE MEDICAL CENTER IS A TERTIARY REGIONAL REFERRAL CENTER WHICH SERVES A PATIENT COMMUNITY THAT INCLUDES SEATTLE AND ITS SURROUNDING SUBURBS, WESTERN WASHINGTON AND ALASKA. THE MAIN CAMPUS LOCATED IN SEATTLE INCLUDES A HOSPITAL, AN OUTPATIENT CLINIC, CENTERS OF EXCELLENCE INCLUDING THE CENTER FOR HYPERBARIC MEDICINE, DIGESTIVE DISEASE INSTITUTE, FLOYD & DELORES JONES CANCER INSTITUTE, HEART INSTITUTE, NEUROSCIENCE INSTITUTE AND UROLOGY. THE MEDICAL CENTER ALSO OPERATES NINE REGIONAL CLINICS, AND BAILEY-BOUSHAY HOUSE, A 35-BED SKILLED NURSING FACILITY. DURING 2021, THE MEDICAL CENTER RECORDED 5,648 HOSPITAL INPATIENT ADMISSIONS, 9,844 EMERGENCY ROOM VISITS AND 470,112 CLINIC VISITS. THE MEDICAL CENTER PROVIDED CHARITY CARE AND UNREIMBURSED MEDICAID SERVICES TO A TOTAL OF 3,596 PATIENTS.A. SUBSIDIZED HEALTH SERVICESTHE MEDICAL CENTER IS COMMITTED TO SUBSIDIZING CERTAIN HEALTH SERVICES DUE TO THE DEMONSTRATED NEED FOR THESE SERVICES IN THE COMMUNITY. SINCE 1992, THE MEDICAL CENTER HAS ADDRESSED THE TREATMENT OF HIV/AIDS BY OPERATING BAILEY-BOUSHAY HOUSE ("BAILEY-BOUSHAY"), A 35-BED SKILLED NURSING FACILITY. THE FIRST FACILITY IN THE NATION BUILT SPECIFICALLY FOR THE CARE OF PEOPLE LIVING WITH AIDS, BAILEY-BOUSHAY NOW ALSO SERVES OTHER INDIVIDUALS WHO NEED INTENSIVE NURSING CARE, MANY OF WHOM ARE MEDICAID RECIPIENTS. IN ADDITION TO THE CARE PROVIDED TO ITS RESIDENTIAL POPULATION, BAILEY-BOUSHAY PROVIDES DAY HEALTH SERVICES TO 302 CLIENTS ANNUALLY, ALLOWING THEM TO LIVE INDEPENDENTLY WITH HIV/AIDS. IN NOVEMBER 2018, BAILEY-BOUSHAY OPENED THE FIRST HIV HOMELESS SHELTER WHICH SERVICES 50 CLIENTS. IN 2020, BAILEY-BOUSHAY BEGAN THE RENTAL ASSISTANCE PROGRAM, WHICH HELPS TO PROVIDE HOUSING TO INDIVIDUALS WHO ARE LOW-INCOME, DIAGNOSED WITH HIV/AIDS, AND REQUIRE ASSISTANCE IN MAINTAINING OR ACQUIRING APPROPRIATE AFFORDABLE PERMANENT HOUSING, WITH CURRENTLY 49 UNITS OCCUPIED. THE MEDICAL CENTER ALSO OFFERS EMERGENCY SERVICES 24 HOURS A DAY, 7 DAYS A WEEK. THE DEPARTMENT IS STAFFED BY BOARD-CERTIFIED EMERGENCY PHYSICIANS, PHYSICIAN ASSISTANTS AND CERTIFIED EMERGENCY NURSES. B. UNCOMPENSATED CARETHE MEDICAL CENTER IS COMMITTED TO PROVIDING NECESSARY MEDICAL SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY AND WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, RELIGION, SEX, SEXUAL ORIENTATION, DISABILITY, AGE, SOURCE OF INCOME, OR ANY OTHER CLASS PROTECTED BY FEDERAL OR WASHINGTON STATE LAW, OR WHO HAVE AN EMERGENCY MEDICAL CONDITION. THE MEDICAL CENTER IS A PARTICIPATING HOSPITAL IN THE WASHINGTON STATE MEDICAID CONTRACTING PROGRAM. 1. CHARITY CARECHARITY CARE IS PROVIDED ACCORDING TO A PATIENT'S GROSS FAMILY INCOMES AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ADJUSTED FOR FAMILY SIZE. FULL OR PARTIAL CHARITY CARE MAY BE PROVIDED TO PATIENTS WITH GROSS FAMILY INCOMES EXCEEDING 300% OF THE FEDERAL POVERTY LEVEL WHEN CIRCUMSTANCES INDICATE THAT FULL PAYMENT MAY CAUSE FINANCIAL HARDSHIP SO AS TO SIGNIFICANTLY HARM THE PATIENT OR PATIENT'S FAMILY. PATIENTS WITHOUT HEALTH INSURANCE ARE ELIGIBLE FOR A DISCOUNT ON MEDICALLY NECESSARY SERVICES UNDER THE MEDICAL CENTER'S DISCOUNTS FOR UNINSURED PATIENTS POLICY. CHARITY CARE WAS PROVIDED AT A COST OF $4,189,023 DURING THE YEAR, ALONG WITH $17,117,608 OF MEDICAID CONTRACTUAL ALLOWANCES. CHARITY CARE DOES NOT INCLUDE "BAD DEBTS" WHICH IS THE AMOUNT THE MEDICAL CENTER IS NOT PAID BY PATIENTS DEEMED ABLE TO PAY THEIR BILLS.

4b	(Code: ) (Expenses $ 12,224,571 including grants of $ 1,000,000 ) (Revenue $ 14,550 )
	EDUCATION AND RESEARCHTHE MEDICAL CENTER' IS AN INDEPENDENT ACADEMIC MEDICAL CENTER WITH A GRADUATE MEDICAL EDUCATION PROGRAM THAT TRAINS OVER 130 RESIDENTS IN NINE ACCREDITED PROGRAMS IN ANESTHESIOLOGY, INTERNAL MEDICINE, GENERAL SURGERY, DIAGNOSTIC RADIOLOGY, TRANSITIONAL YEAR, AND UROLOGY. IN ADDITION, THE MEDICAL CENTER TRAINS A NUMBER OF FELLOWS IN AREAS SUCH AS PAIN MANAGEMENT, REGIONAL ANESTHESIOLOGY, AND FEMALE PELVIC MEDICINE/RECONSTRUCTIVE SURGERY. THE MEDICAL CENTER IS ALSO AFFILIATED WITH THE UNIVERSITY OF WASHINGTON FOR THE TRAINING OF SUBSPECIALTIES IN THE AREAS OF ANESTHESIOLOGY, ORTHOPEDICS, OBSTETRICS, GYNECOLOGY AND UROLOGY. THE MEDICAL CENTER ALSO PROVIDES TRAINING IN CLINICAL NURSING EDUCATION, ALLIED HEALTH FIELDS, CONTINUING MEDICAL EDUCATION AND GRAND ROUNDS. IN ADDITION, THE MEDICAL CENTER CONDUCTS MEDICAL RESEARCH THROUGH ITS AFFILIATE BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON, A SCIENTIFIC RESEARCH INSTITUTE QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.A. GRADUATE MEDICAL EDUCATIONTHE MEDICAL CENTER'S GRADUATE MEDICAL EDUCATION PROGRAM MAINTAINS EDUCATION AFFILIATION AGREEMENTS WITH COMMUNITY CLINICS UNDER WHICH THE MEDICAL CENTER'S RESIDENTS PROVIDE CARE TO PATIENTS AT CLINICS SERVING LOW-INCOME AND UNINSURED PATIENTS. THE MEDICAL CENTER HAS AN AFFILIATION WITH EASTGATE PUBLIC HEALTH CLINIC (OPERATED BY SEATTLE & KING COUNTY PUBLIC HEALTH) TO PROVIDE A RESIDENT CLINIC 4-DAYS A WEEK UNDER THE SUPERVISION OF MEDICAL CENTER PHYSICIANS. THIS AFFILIATION HAS EXPANDED ACCESS TO HEALTH CARE FOR KING COUNTY RESIDENTS AND ENHANCED THE EDUCATIONAL OPPORTUNITIES OF INTERNAL MEDICINE RESIDENTS.B. CONTINUING NURSING EDUCATIONTHE CLINICAL NURSING EDUCATION ("CNE") PROGRAM OFFERED 11 CNE EVENTS IN 2020 TO 163 ATTENDEES. PARTICIPANTS INCLUDE NURSES (THE PRIMARY AUDIENCE RNS AND LPNS), AS WELL AS PATIENT CARE TECHNICIANS, NURSE TECHNICIANS, AND MEDICAL ASSISTANTS. C. ALLIED HEALTH EDUCATION PROGRAMS THE MEDICAL CENTER ALSO SERVES AS AN INTERNSHIP SITE FOR STUDENTS IN A VARIETY OF ALLIED HEALTH PROGRAMS SUCH AS NURSING, PHARMACY, RESPIRATORY THERAPY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SOCIAL WORK, SLEEP DISORDERS, MEDICAL INSURANCE, SPEECH AND LANGUAGE THERAPY, RADIOLOGY AND LABORATORY TECHNOLOGY. SUCCESSFUL RELATIONSHIPS HAVE BEEN BUILT WITH VOCATIONAL TRAINING PROGRAMS FOR MEDICAL ASSISTANTS AS WELL. D. CONTINUING MEDICAL EDUCATIONTHE MEDICAL CENTER PROVIDES STRONG SUPPORT FOR CONTINUING MEDICAL EDUCATION ("CME"). THE MEDICAL CENTER'S CME PROGRAM IS ACCREDITED BY THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION (ACCME) AND WAS LAST REACCREDITED IN 2016, RECEIVING "ACCREDITATION WITH COMMENDATION". DURING THE PERIOD BETWEEN JANUARY 1ST AND JUNE 30, 2021, THE CME DEPARTMENT SPONSORED 6 COURSES (EITHER FULL-, HALF-, OR MULTI-DAY) INCLUDING 5 THAT WERE INTERNET LIVE COURSES, TOTALING 139.75 HOURS OF INSTRUCTION. THESE ACTIVITIES WERE ATTENDED BY 161 PARTICIPANTS, INCLUDING 90 PHYSICIANS. E. REGULARLY SCHEDULED SERIESDURING THE PERIOD BETWEEN JANUARY 1ST AND JUNE 30TH, 2021, 24 ONE-HOUR GRAND ROUNDS PRESENTATIONS WERE PRESENTED AT THE MEDICAL CENTER, WITH THE LIVE AUDIENCE AVERAGING 45 ATTENDEES WEEKLY. THE GRAND ROUNDS SERIES IS PRESENTED FROM THE AUDITORIUM AND IS SIMULTANEOUSLY BROADCAST VIA LIVESTREAM TO SERVE THE ORGANIZATION'S SATELLITE LOCATIONS AND TO 8 COMMUNITY HEALTH CARE SYSTEMS AND MEDICAL EDUCATION SITES IN WASHINGTON, ALASKA, CALIFORNIA AND WISCONSIN. THE CME DEPARTMENT SUPPORTS ANOTHER 22 REGULARLY SCHEDULED SERIES IN INCLUDING 14 SPECIFIC CANCER CARE TUMOR BOARDS, CLINICAL CARDIOVASCULAR, IMAGING, COMPETENCIES AND INCIDENTS, VASCULAR SURGERY, GI RADIOLOGY, GI PATHOLOGY AND THERAPEUTICS. BETWEEN JANUARY 1ST AND JUNE 30TH, 2021, 343.5 HOURS OF INSTRUCTION WERE OFFERED THROUGH THESE 22 SERIES. CUMULATIVE PARTICIPATION HOURS TRACKED FOR ALL SERIES TOTALED 4,568.25, OF WHICH 3,585.25 WERE AWARDED TO PHYSICIAN PARTICIPANTS. F. RESEARCHAPPROXIMATELY 12 OF OUR INVESTIGATORS HAVE FACULTY APPOINTMENTS AT THE UNIVERSITY OF WASHINGTON. THE MEDICAL CENTER ALSO MAINTAINS A MEDICAL LIBRARY TO SUPPORT ITS EDUCATION AND RESEARCH ACTIVITIES.

4c	(Code: ) (Expenses $ 113,931 including grants of $ ) (Revenue $ 25,083 )
	COMMUNITY HEALTH EDUCATION AND SERVICESTHE MEDICAL CENTER CONTRIBUTES TO IMPROVING THE HEALTH OF THE COMMUNITY THROUGH SPONSORSHIP OF COMMUNITY HEALTH EDUCATION AND SERVICES. A. COMMUNITY HEALTH EDUCATIONCOMMUNITY HEALTH EDUCATION INCLUDES CLASSES, FORUMS, PRESENTATIONS AND OTHER PROGRAMS HELD DURING THE DAY AND EVENING IN THE MEDICAL CENTER NEIGHBORHOOD CLINIC COMMUNITIES AND THE SEATTLE MAIN CAMPUS. B. COMMUNITY HEALTH SERVICESTHE MEDICAL CENTER PROVIDED SUPPORT OF "VIRGINIA MASON GRIEF SERVICES" WHICH PROVIDES SERVICES FOR ADULTS AND CHILDREN (AGES 7-18) WHOSE LOVED ONE HAS DIED AS THE RESULT OF A SUDDEN, VIOLENT DEATH BY CRIMINAL ACT (HOMICIDE), INCLUDING TERRORISM, SUICIDE OR OTHER TYPES OF VIOLENT DEATH. SERVICES AVAILABLE INCLUDE: THERAPY GROUPS, SHORT-TERM THERAPY, PSYCHIATRIC CONSULTATION AND MEDICATION MANAGEMENT, COMMUNITY, WORKPLACE, FAMILY AND SCHOOL CRISIS RESPONSE AND PROFESSIONAL TRAINING. IN 2021, THE MEDICAL CENTER PROVIDED $89,000 TOWARD SUPPORT OF VIRGINIA MASON GRIEF SERVICES.

	(Code: ) (Expenses $ 204,014 including grants of $ ) (Revenue $ )
	FINANCIAL AND IN-KIND CONTRIBUTIONSTHE MEDICAL CENTER PROVIDES FUNDS AND IN-KIND SERVICES TO COMMUNITY ORGANIZATIONS WHICH ARE CONSISTENT WITH THE MEDICAL CENTER'S CHARITABLE PURPOSE. A LIST OF COMMUNITY DONATIONS IS INCLUDED ON SCHEDULE I.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 204,014 including grants of $ ) (Revenue $ )
4e	Total program service expenses542,581,912

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) SUZANNE ANDERSON........................................................................ PRESIDENT THRU JAN 2021	50.00 .......................6.00	X	0	0	0
(19) DAVID BUTCHERITE........................................................................ TREASURER	2.00 .......................2.00	X	0	0	0
(20) ROBERT VALENCIA........................................................................ CORPORATE SECRETARY	2.00 .......................2.00	X	0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1a	Federated campaigns..		1a	8,659
b	Membership dues..		1b
c	Fundraising events..		1c	425,356
d	Related organizations		1d	124,250
e	Government grants (contributions)		1e	40,661

f	All other contributions, gifts, grants, and similar amounts not included above		1f	4,808,962

g	Noncash contributions included in lines 1a - 1f:$		1g	126,929

h Total. Add lines 1a-1f.......		5,407,888

		Business Code
2a	MEDICARE/MEDICAID PAYM	621300	383,549,797	383,549,797
b	NET PATIENT REVENUES	561499	150,641,961	150,641,961
c	PHARMACY	561499	23,860,485	23,860,485
d	RETAIL SERVICES	561499	2,609,501	184,253	2,425,248
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		560,661,744

3 Investment income (including dividends, interest, and othersimilar amounts) ......			9,509,009			9,509,009
4 Income from investment of tax-exempt bond proceeds			196			196
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		880,434	6a
b	Less: rental expenses		1,236,953	6b
c	Rental income or (loss)		-356,519	6c
d	Net rental income or (loss).......			-356,519		-294,223	-62,296
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,640	24,714,928	7a
b	Less: cost or other basis and sales expenses	0	13,112,323	7b
c	Gain or (loss)	2,640	11,602,605	7c
d	Net gain or (loss).........			11,605,245			11,605,245
8a	Gross income from fundraising events (not including $ 425,356of contributions reported on line 1c). See Part IV, line 18 ....
			8a	225,000
b	Less: direct expenses ...		8b	316,707
c	Net income or (loss) from fundraising events..			-91,707			-91,707
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	167,709
b	Less: cost of goods sold ..		10b	141,785
c	Net income or (loss) from sales of inventory..			25,924		25,924
Business Code			Miscellaneous Revenue
11a	PARKING		812930	1,787,813		126,860	1,660,953
b	CAFETERIA		721110	1,213,026			1,213,026
c	MEDICAL RECORDS		561499	110,409			110,409
d	All other revenue ....			5,140			5,140
e	Total. Add lines 11a–11d ......			3,116,388
12	Total revenue. See instructions.....			589,878,168	558,236,496	2,283,809	23,949,975

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,000,000	1,000,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	5,889,300	3,141,187	2,748,113
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	274,954,140	262,059,273	11,803,445	1,091,422
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	10,824,485	10,221,561	602,924
9	Other employee benefits .......	8,019,719	7,573,021	228,593	218,105
10	Payroll taxes ...........	20,231,033	19,104,164	1,126,869
11	Fees for services (non-employees):
a	Management ......	238,540	225,253	13,287
b	Legal .........	2,414,379		2,414,379
c	Accounting ...........	344,390		344,390
d	Lobbying ...........	205,420		205,420
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	27,047,594	25,541,043	1,182,154	324,397
12	Advertising and promotion ....	627,993	593,014	34,979
13	Office expenses .......	137,736,001	130,064,105	7,663,888	8,008
14	Information technology ......	10,034,196	9,475,291	558,905
15	Royalties ..
16	Occupancy ...........	19,856,474	18,750,468	1,105,703	303
17	Travel ............	424,533	400,887	20,883	2,763
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	52,034	49,136	2,173	725
20	Interest ...........	6,850,656	6,469,074	381,582
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	19,439,529	14,456,266	4,982,496	767
23	Insurance ...	4,691,998	4,430,654	261,344
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	TAXES	13,073,513	13,073,513
b	MEDICAL PURCHASED SVCS	2,900,938	2,739,356	161,582
c	DUES AND SUBSCRIPTIONS	1,485,929	1,403,163	82,766
d
e	All other expenses	12,508,189	11,811,483	592,311	104,395
25	Total functional expenses. Add lines 1 through 24e	580,850,983	542,581,912	36,518,186	1,750,885
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			91,192,918	1	41,347,223
2	Savings and temporary cash investments .........			113,976,670	2	101,966,013
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			118,336,538	4	136,192,962
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			22,339,150	8	35,017,684
9	Prepaid expenses and deferred charges ......			5,275,803	9	6,465,938
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	582,575,917
b	Less: accumulated depreciation	10b	19,325,792	567,802,809	10c	563,250,125
11	Investments—publicly traded securities .			396,093,877	11	419,333,407
12	Investments—other securities. See Part IV, line 11 .....			23,919,896	12	27,383,063
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			1,180,233	14	33,180,233
15	Other assets. See Part IV, line 11 ...........			89,466,550	15	111,852,667
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,429,584,444	16	1,475,989,315

17	Accounts payable and accrued expenses .....	160,137,795	17	152,355,887
18	Grants payable ...		18
19	Deferred revenue .........	76,060	19	284,220
20	Tax-exempt bond liabilities .........	279,833,462	20	291,655,614
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	136,642,141	23	150,981,799
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	297,326,501	25	295,005,842
26	Total liabilities. Add lines 17 through 25..	874,015,959	26	890,283,362

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	488,625,886	27	516,580,468
28	Net assets with donor restrictions ...........	66,942,599	28	69,125,485
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	555,568,485	32	585,705,953
33	Total liabilities and net assets/fund balances ........	1,429,584,444	33	1,475,989,315