COVID Stimulus Watch: Governmental Program Summary

Program:
Medicare Accelerated and Advance Payment Program ($500,000 and up)

Note: does not include refunded awards.

Grant Total: $0
Loan Face Value Total: $102,411,397,518
Contract Total: $0
Number of Awards: 13,667
Top 10 Parent Companies
Grant Total
Loan Face Value Total
Contract Total
Number of Awards
HCA Healthcare
$0
$3,375,672,402
$0
207
CommonSpirit Health
$0
$2,293,829,533
$0
138
Providence St. Joseph Health
$0
$1,548,588,104
$0
105
Ascension Health
$0
$1,357,873,916
$0
42
Trinity Health
$0
$1,101,579,437
$0
31
University of California
$0
$1,077,986,113
$0
38
Northwell Health
$0
$1,001,067,068
$0
26
Sutter Health
$0
$979,972,626
$0
61
Mass General Brigham
$0
$943,070,601
$0
14
Mayo Clinic
$0
$914,179,070
$0
44

Individual Award Records:

CSV XML (max 5,000 records)

Company
State Sort ascending
Parent
Parent Sector
Grant Amount
Loan Face Value
Contract Amount
Award Date
HOQUIAM HEALTHCARE, INC.
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$968,662
Contract Amount:
Award Date:Dec 9, 2020
INLAND NORTHWEST HEALTH SERVICES
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$4,434,000
Contract Amount:
Award Date:Dec 9, 2020
INLAND NORTHWEST RENAL CARE GROUP, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$577,643
Contract Amount:
Award Date:Dec 9, 2020
INLAND NORTHWEST RENAL CARE GROUP, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$687,404
Contract Amount:
Award Date:Dec 9, 2020
INLAND NORTHWEST RENAL CARE GROUP, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$731,683
Contract Amount:
Award Date:Dec 9, 2020
INLAND NORTHWEST RENAL CARE GROUP, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$907,755
Contract Amount:
Award Date:Dec 9, 2020
ISLAND EYE PHYSICIANS & SURGEONS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$500,000
Contract Amount:
Award Date:Dec 9, 2020
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$601,367
Contract Amount:
Award Date:Dec 9, 2020
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$16,439,756
Contract Amount:
Award Date:Dec 9, 2020
KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT NO 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,116,827
Contract Amount:
Award Date:Dec 9, 2020
KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT NO1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,137,841
Contract Amount:
Award Date:Dec 9, 2020
KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT NO 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$3,737,474
Contract Amount:
Award Date:Dec 9, 2020
LAKEWOOD OAKS, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$666,587
Contract Amount:
Award Date:Dec 9, 2020
LEGACY SALMON CREEK HOSPITAL
State:WA
Parent:Legacy Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$22,197,000
Contract Amount:
Award Date:Dec 9, 2020
LEWIS COUNTY HOSPITAL DISTRICT NO. 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,543,411
Contract Amount:
Award Date:Dec 9, 2020
LEWIS COUNTY HOSPITAL DISTRICT NO 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,574,897
Contract Amount:
Award Date:Dec 9, 2020
LINCOLN COUNTY HOSPITAL DISTRICT 3
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$644,143
Contract Amount:
Award Date:Dec 9, 2020
LINCOLN COUNTY HOSPITAL DISTRICT 3
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,428,988
Contract Amount:
Award Date:Dec 9, 2020
LINCOLN COUNTY HOSPITAL DISTRICT 3
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,500,000
Contract Amount:
Award Date:Dec 9, 2020
LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$977,356
Contract Amount:
Award Date:Dec 9, 2020
LOOKOUT POST ACUTE, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$530,700
Contract Amount:
Award Date:Dec 9, 2020
LOURDES HOSPITAL LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$19,254,621
Contract Amount:
Award Date:Dec 9, 2020
LYNNWOOD HEALTH SERVICES, INC.
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$683,518
Contract Amount:
Award Date:Dec 9, 2020
MAI PHAM, MD PS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$533,030
Contract Amount:
Award Date:Dec 9, 2020
MANOR PARK HEALTHCARE LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,021,667
Contract Amount:
Award Date:Dec 9, 2020
MEDICAL IMAGING NORTHWEST - GOOD SAMARITAN HOSPITAL IMAGING ALLIANCE
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$681,687
Contract Amount:
Award Date:Dec 9, 2020
MT BAKER IMAGING LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,010,261
Contract Amount:
Award Date:Dec 9, 2020
NORTH LAKE 5-O, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$615,068
Contract Amount:
Award Date:Dec 9, 2020
OKANOGAN COUNTY PUBLIC HOSPITAL DIST NO 4
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,417,044
Contract Amount:
Award Date:Dec 9, 2020
OKANOGAN COUNTY PUBLIC HOSPITAL DIST NO 4
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,438,455
Contract Amount:
Award Date:Dec 9, 2020
OKANOGAN COUNTY PUBLIC HOSPITAL DISTRICT NO. 3
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$3,931,980
Contract Amount:
Award Date:Dec 9, 2020
OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$690,917
Contract Amount:
Award Date:Dec 9, 2020
OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,792,367
Contract Amount:
Award Date:Dec 9, 2020
OLYMPIC MEDICAL PHYSICIANS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,071,116
Contract Amount:
Award Date:Dec 9, 2020
PACIFIC COUNTY HOSPITAL DISTRICT 2
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$503,022
Contract Amount:
Award Date:Dec 9, 2020
PACIFIC COUNTY HOSPITAL DISTRICT 2
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$4,825,233
Contract Amount:
Award Date:Dec 9, 2020
PACIFIC NORTHWEST RENAL SERVICES LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$882,868
Contract Amount:
Award Date:Dec 9, 2020
PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$691,279
Contract Amount:
Award Date:Dec 9, 2020
PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,288,460
Contract Amount:
Award Date:Dec 9, 2020
PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$3,461,762
Contract Amount:
Award Date:Dec 9, 2020
PINNACLE PAIN CENTER, PS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$596,802
Contract Amount:
Award Date:Dec 9, 2020
PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,458,784
Contract Amount:
Award Date:Dec 9, 2020
PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$3,714,017
Contract Amount:
Award Date:Dec 9, 2020
PROVIDENCE MEDICAL INSTITUTE
State:WA
Parent:Providence Medical Institute
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$713,489
Contract Amount:
Award Date:Dec 9, 2020
PROVIDENCE MEDICAL INSTITUTE
State:WA
Parent:Providence Medical Institute
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$3,803,012
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$9,487,957
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT 1 OF SNOHOMISH COUNTY
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$3,000,000
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT 3 OF PACIFIC COUNTY
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$1,030,690
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT 3 OF PACIFIC COUNTY
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$1,923,053
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT 3 OF PACIFIC COUNTY
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$4,325,420
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$1,264,133
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO.1 OF MASON COUNTY
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$13,207,088
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO 4 KING COUNTY WASHINGTON
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$1,384,566
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO 4 KING COUNTY WA
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$9,337,760
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO 2, KLICKITAT COUNTY, WASHINGTON
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$2,402,189
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO. 2, KLICKITAT COUNTY, WASHINGTON
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$2,957,558
Contract Amount:
Award Date:Dec 9, 2020
QUALICENTERS INLAND NORTHWEST LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$526,381
Contract Amount:
Award Date:Dec 9, 2020
RADIA INC PS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,318,702
Contract Amount:
Award Date:Dec 9, 2020
RADIA INC PS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$3,023,586
Contract Amount:
Award Date:Dec 9, 2020
SAINT CLARE HOSPITAL
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$14,580,643
Contract Amount:
Award Date:Dec 9, 2020
SAINT JOHN'S HEALTH CLINIC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,239,206
Contract Amount:
Award Date:Dec 9, 2020
SEATTLE CANCER CARE ALLIANCE
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$35,852,331
Contract Amount:
Award Date:Dec 9, 2020
SOUNDVIEW REHABILITATION AND HEALTH CARE, INC.
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$736,724
Contract Amount:
Award Date:Dec 9, 2020
SPOKANE BEHAVIORAL HEALTH LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$689,573
Contract Amount:
Award Date:Dec 9, 2020
SPOKANE EYE CLINIC INC, PS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$855,941
Contract Amount:
Award Date:Dec 9, 2020
SPOKANE EYE CLINIC INC, PS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$4,807,899
Contract Amount:
Award Date:Dec 9, 2020
SPOKANE ROYAL PARK CARE, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,178,514
Contract Amount:
Award Date:Dec 9, 2020
SPOKANE UROLOGY, P.S.
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$673,904
Contract Amount:
Award Date:Dec 9, 2020
ST FRANCIS COMMUNTIY HOSPITAL
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$21,210,440
Contract Amount:
Award Date:Dec 9, 2020
SUNBRIDGE HEALTHCARE LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$598,491
Contract Amount:
Award Date:Dec 9, 2020
SUNBRIDGE NURSING HOME LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$606,668
Contract Amount:
Award Date:Dec 9, 2020
SUNSHINE HEALTH FACILITIES, INC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$750,000
Contract Amount:
Award Date:Dec 9, 2020
SYMBOL HEALTHCARE, INC.
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,286,694
Contract Amount:
Award Date:Dec 9, 2020
THC - SEATTLE, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,832,010
Contract Amount:
Award Date:Dec 9, 2020
THE CAROL MILGARD BREAST CENTER
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$573,409
Contract Amount:
Award Date:Dec 9, 2020
TRA-MINW, PS
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$2,356,958
Contract Amount:
Award Date:Dec 9, 2020
TRI STATE MEMORIAL HOSPITAL
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,052,568
Contract Amount:
Award Date:Dec 9, 2020
TRI-STATE MEMORIAL HOSPITAL
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$15,967,317
Contract Amount:
Award Date:Dec 9, 2020
UNION HILL HEALTHCARE, INC.
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$592,304
Contract Amount:
Award Date:Dec 9, 2020
UNIVERSITY PLACE REHABILITATION CENTER, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$607,792
Contract Amount:
Award Date:Dec 9, 2020
VALLEY MEDICAL GROUP-RENTON
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$3,600,000
Contract Amount:
Award Date:Dec 9, 2020
VANTAGE RADIOLOGY & DIAGNOSTIC SERVICES, A PROFESSIONAL SERVICES CORP
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$637,690
Contract Amount:
Award Date:Dec 9, 2020
WASHINGTON GASTROENTEROLOGY PLLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$1,396,920
Contract Amount:
Award Date:Dec 9, 2020
WASHINGTON HOMECARE AND HOSPICE OF CENTRAL BASIN, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$738,942
Contract Amount:
Award Date:Dec 9, 2020
WASHINGTON HOMECARE AND HOSPICE OF CENTRAL BASIN, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$844,079
Contract Amount:
Award Date:Dec 9, 2020
WATERMARK BELLEVUE, LLC
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$570,817
Contract Amount:
Award Date:Dec 9, 2020
WILDWOOD HEALTHCARE, INC.
State:WA
Parent: 
Parent Sector:
Grant Amount:
Face Loan Amount:$716,614
Contract Amount:
Award Date:Dec 9, 2020
HARRISON MEDICAL CENTER
State:WA
Parent:CommonSpirit Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$77,449,000
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DIST NO 1 SKAGIT
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$40,254,782
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DIST NO 1 SKAGIT
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$3,805,106
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$14,002,103
Contract Amount:
Award Date:Dec 9, 2020
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
State:WA
Parent:King County Public Hospital District #1
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$640,420
Contract Amount:
Award Date:Dec 9, 2020
PEACEHEALTH SOUTHWEST MEDICAL CENTER
State:WA
Parent:Peacehealth
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$62,981,092
Contract Amount:
Award Date:Dec 9, 2020
PEACEHEALTH SOUTHWEST MEDICAL CENTER
State:WA
Parent:Peacehealth
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$2,116,910
Contract Amount:
Award Date:Dec 9, 2020
KADLEC REGIONAL MEDICAL CENTER
State:WA
Parent:Providence St. Joseph Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$80,394,079
Contract Amount:
Award Date:Dec 9, 2020
PROVIDENCE HEALTH & SERVICE- WASHINGTON
State:WA
Parent:Providence St. Joseph Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$1,058,713
Contract Amount:
Award Date:Dec 9, 2020
PROVIDENCE HEALTH & SERVICES - OREGON
State:WA
Parent:Providence St. Joseph Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$63,606,499
Contract Amount:
Award Date:Dec 9, 2020
PROVIDENCE HEALTH & SERVICES - OREGON
State:WA
Parent:Providence St. Joseph Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$611,432
Contract Amount:
Award Date:Dec 9, 2020
PROVIDENCE HEALTH & SERVICES - OREGON
State:WA
Parent:Providence St. Joseph Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$571,871
Contract Amount:
Award Date:Dec 9, 2020
PROVIDENCE HEALTH & SERVICES - WASHINGTON
State:WA
Parent:Providence St. Joseph Health
Parent Sector:healthcare services
Grant Amount:
Face Loan Amount:$2,339,782
Contract Amount:
Award Date:Dec 9, 2020

CSV XML (max 5,000 records)

Accountability Issues

Covid Stimulus Watch provides accountability data on CARES Act recipients in the following categories:

Employment iconEmployment Issues

Tax iconTax / Subsidy Issues

Contracting iconContracting Issues

Environment iconEnvironment / Safety Issues

Consumer iconConsumer Protection Issues

CEO pay iconCEO Pay Issues