PUGET SOUND KIDNEY CENTERS: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
PUGET SOUND KIDNEY CENTERS (EIN 91-1102033)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-13
IRS object ID
201733179349307988
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-13T18:09:01-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN911056739PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Vine Dahlen PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13500 188th Street SW Ste 322AddressLine1Txt
CityLynnwoodCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98037ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN911102033EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Puget Sound Kidney CentersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPUGEBusinessNameControlTxt
Phone4252595195PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11019 Pacific AvenueAddressLine1Txt
CityEverettCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98201ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonHarold KellyPersonNm
Person TitlePresident and CEOPersonTitleTxt
Phone4252595195PhoneNum
Signature2017-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKimberly D Fyfe CPAPreparerPersonNm
PTINP01422564PTIN
Phone4257716055PhoneNum
Preparation2017-11-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address68.64.52.10IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-13IPDt
IP Tm10:08:56IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdD08C6E78AF9089008AAAFAE3D7CB9F2EBAEECFC7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerHarold KellyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11019 Pacific AvenueAddressLine1Txt
CityEverettCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98201ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$30,800,090GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.pskc.netWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1980FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionTO PROVIDE KIDNEY DIALYSIS AND RELATED PATIENT CARE SERVICES IN WASHINGTON STATE.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee250TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$169,889PYContributionsGrantsAmt
CY Contributions Grants$164,786CYContributionsGrantsAmt
PY Program Service Revenue$26,879,939PYProgramServiceRevenueAmt
CY Program Service Revenue$28,810,253CYProgramServiceRevenueAmt
PY Investment Income$47,602PYInvestmentIncomeAmt
CY Investment Income$96,809CYInvestmentIncomeAmt
PY Other Revenue$54,338PYOtherRevenueAmt
CY Other Revenue$49,328CYOtherRevenueAmt
PY Total Revenue$27,151,768PYTotalRevenueAmt
CY Total Revenue$29,121,176CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,593,923PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,882,914CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$10,878,692PYOtherExpensesAmt
CY Other Expenses$11,322,959CYOtherExpensesAmt
PY Total Expenses$24,472,615PYTotalExpensesAmt
CY Total Expenses$26,205,873CYTotalExpensesAmt
PY Revenues Less Expenses$2,679,153PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,915,303CYRevenuesLessExpensesAmt
Total Assets BOY$45,692,228TotalAssetsBOYAmt
Total Assets EOY$49,256,696TotalAssetsEOYAmt
Total Liabilities BOY$2,016,726TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,757,390TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$43,675,502NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$46,499,306NetAssetsOrFundBalancesEOYAmt
MissionTO ENHANCE THE QUALITY OF LIFE OF THOSE WITH KIDNEY DISEASE THROUGH OUTSTANDING DIALYSIS CARE, EDUCATION AND COMMUNITY SUPPORT.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$16,146,248ExpenseAmt
Revenue$21,344,023RevenueAmt
DescIN CENTER DIALYSIS TREATMENTS - 68,359 TREATMENTS PROVIDED.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,580,896ExpenseAmt
Revenue$2,089,816RevenueAmt
DescMOBILE DIALYSIS GIVEN TO AREA HOSPITALS - 3,977 TREATMENTS PROVIDED.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$4,067,130ExpenseAmt
Revenue$5,376,414RevenueAmt
DescHOME TREATMENT PROGRAM - PROVIDES SUPERVISION, TRAINING AND EQUIPMENT TO PATIENTS WHO SELF DIALYZE AT HOME - 26,065 TREATMENTS PROVIDED.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$21,794,274TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document30IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee250EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The OrganizationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4252595195PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11019 Pacific AvenueAddressLine1Txt
CityEverettCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98201ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
PETRUCCELLI ANTHONY
Director0.25Yes (X)$1,800$0$0
Johnson Thomas L
director0.25Yes (X)$1,800$0$0
Cobbs Betty
Director0.25Yes (X)$1,400$0$0
Bowden George
director0.25Yes (X)$1,600$0$0
Chase Gene
Director0.25Yes (X)$1,200$0$0
De Tuerk Kathryn
Director0.25Yes (X)$1,400$0$0
Haugen Kirsten Jensen
Director0.25Yes (X)$1,400$0$0
Jones James
Director0.25Yes (X)$1,600$0$0
Jones Fontelle
treasurer0.25Yes (X)$1,400$0$0Yes (X)
Vukich Susan
Director0.25Yes (X)$1,600$0$0
Senter Donald
Director0.25Yes (X)$1,000$0$0
David Beyer
chairman0.25Yes (X)$0$0$0Yes (X)
KELLY HAROLD
PRESIDENT & CEO40.00Yes (X)$411,773$0$46,037Yes (X)
Crain Amanda
COO40.00$127,220$0$16,582Yes (X)
Kouchi Kenneth
CFO40.00$169,198$0$22,295Yes (X)
Keech Pamila
CMO40.00$267,805$0$27,896Yes (X)
Edris Zoe
RN40.00$130,147$0$19,762Yes (X)
Marcos Carmelita
RN40.00$117,229$0$25,110Yes (X)
Peck Patricia
DCM-AM40.00$120,403$0$18,506Yes (X)
Lightfoot Kim
DPA40.00$117,689$0$35,431Yes (X)
AAron Herold
DAS40.00$117,524$0$11,078Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,595,188TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$222,697TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K15IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Newland Construction Co
3300 Chestnut StreetEverettWA98201Building Contractor$2,343,326
Botesch Nash & Hall
2727 OAKES AVENUE SUITE 100EVERETTWA98201Architect$424,905
Spectra Laboratories
PO BOx 360790MilpitasCA95036Laboratory Services$371,847
WESTERN WASHINGTON MEDICAL GROUP
1330 Rockefeller Ave Suite 450EverettWA98201MEDICAL DIRECTORS$200,000
Vanguard
6912 220TH ST SW 306MOUNTLAKE TERRACEWA98043Janitorial$124,740
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Related Organizations$164,786RelatedOrganizationsAmt
Total Contributions$164,786TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
DIALYSIS621492$21,349,336$21,349,336
PHARMACY621492$5,502,828$5,502,828
Renal Medication621492$1,027,990$1,027,990
Laboratory621492$777,245$777,245
Medical Supplies621492$152,854$152,854
FieldValueIRS element (for citing)
Total Program Service Revenue$28,810,253TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$60,480TotalRevenueColumnAmt
Exclusion$60,480ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,715,243SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,676,254SecuritiesAmt
Other$2,660OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$38,989SecuritiesAmt
Other-$2,660OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,329TotalRevenueColumnAmt
Exclusion$36,329ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Hospital Shared Services621492$43,156$43,156
MISC. REVENUE621492$4,950$4,950
Medical Records621492$1,222$1,222
FieldValueIRS element (for citing)
Other Revenue Total$49,328OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,121,176TotalRevenueColumnAmt
Related Or Exempt Func Income$28,859,581RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$96,809ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,105,008TotalAmt
Management And General$1,105,008ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,929,375TotalAmt
Program Services$9,566,021ProgramServicesAmt
Management And General$1,363,354ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$452,601TotalAmt
Program Services$405,905ProgramServicesAmt
Management And General$46,696ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,383,490TotalAmt
Program Services$1,157,949ProgramServicesAmt
Management And General$225,541ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,012,440TotalAmt
Program Services$812,416ProgramServicesAmt
Management And General$200,024ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$72,383TotalAmt
Management And General$72,383ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$48,799TotalAmt
Management And General$48,799ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$13,337TotalAmt
Management And General$13,337ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$649,825TotalAmt
Program Services$394,165ProgramServicesAmt
Management And General$255,660ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$43,189TotalAmt
Management And General$43,189ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$491,554TotalAmt
Program Services$196,404ProgramServicesAmt
Management And General$295,150ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$593,701TotalAmt
Program Services$543,263ProgramServicesAmt
Management And General$50,438ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$24,164TotalAmt
Management And General$24,164ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$49,311TotalAmt
Management And General$49,311ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,474,096TotalAmt
Program Services$1,284,560ProgramServicesAmt
Management And General$189,536ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$114,724TotalAmt
Program Services$99,973ProgramServicesAmt
Management And General$14,751ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$6,479,661$6,479,661
Uncompensated Care$290,227$290,227
Housekeeping and Laundr$285,663$271,050$14,613
Equipment repairs and m$275,428$262,662$12,766

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$416,897TotalAmt
Program Services$30,018ProgramServicesAmt
Management And General$386,879ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,205,873TotalAmt
Program Services$21,794,274ProgramServicesAmt
Management And General$4,411,599ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$292BOYAmt
EOY$8,384EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,175,597BOYAmt
EOY$7,829,080EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,212,613BOYAmt
EOY$4,860,518EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$596,920BOYAmt
EOY$590,034EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$33,524BOYAmt
EOY$56,338EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$41,594,511LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,316,821LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,077,679BOYAmt
EOY$30,277,690EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,979,873BOYAmt
EOY$2,012,638EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$615,730BOYAmt
EOY$3,622,014EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$45,692,228BOYAmt
EOY$49,256,696EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,016,726BOYAmt
EOY$2,743,637EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$13,753EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,016,726BOYAmt
EOY$2,757,390EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$43,675,502BOYAmt
EOY$46,499,306EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$43,675,502BOYAmt
EOY$46,499,306EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$45,692,228BOYAmt
EOY$49,256,696EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,915,303ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$59,531NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$151,030OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (1)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
FS Audited0FSAuditedInd
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,219,748BeginningYearBalanceAmt
Investment Earnings Or Losses$92,890InvestmentEarningsOrLossesAmt
End Year Balance$1,312,638EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,227,260BeginningYearBalanceAmt
Investment Earnings Or Losses-$7,512InvestmentEarningsOrLossesAmt
End Year Balance$1,219,748EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,161,608BeginningYearBalanceAmt
Investment Earnings Or Losses$65,652InvestmentEarningsOrLossesAmt
End Year Balance$1,227,260EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,032,525BeginningYearBalanceAmt
Investment Earnings Or Losses$129,083InvestmentEarningsOrLossesAmt
End Year Balance$1,161,608EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,293,507BeginningYearBalanceAmt
Investment Earnings Or Losses$93,018InvestmentEarningsOrLossesAmt
Grants Or Scholarships$354,000GrantsOrScholarshipsAmt
End Year Balance$1,032,525EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,420,999OtherCostOrOtherBasisAmt
Book Value$6,420,999BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,385,000OtherCostOrOtherBasisAmt
Depreciation$6,692,643DepreciationAmt
Book Value$21,692,357BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$177,726OtherCostOrOtherBasisAmt
Depreciation$62,066DepreciationAmt
Book Value$115,660BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,821,901OtherCostOrOtherBasisAmt
Depreciation$2,618,267DepreciationAmt
Book Value$1,203,634BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,788,885OtherCostOrOtherBasisAmt
Depreciation$1,943,845DepreciationAmt
Book Value$845,040BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,277,690TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
Construction in progress$3,005,990
Interest in Assets of Foundation$616,024
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,622,014TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLong term liabilityDesc
Amt$13,753Amt
FieldValueIRS element (for citing)
Total Liability$13,753TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationPSKC IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND HAS BEEN DESIGNATED AS AN ORGANIZATION WHICH IS NOT A PRIVATE FOUNDATION. THE INFORMATION RETURN IS FILED ANNUALLY AND IS SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE, GENERALLY FOR THREE YEARS AFTER THE RETURNS ARE FILED. PSKC WOULD RECOGNIZE ACCRUED INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX PROVISIONS, IF ANY, AS PART OF OTHER EXPENSE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KELLY HAROLD
PRESIDENT & CEO$284,434$0$127,339$0$0$0$32,303$0$13,734$0$457,810$0$0$0
Kouchi Kenneth
CFO$114,306$0$54,892$0$0$0$11,475$0$10,820$0$191,493$0$0$0
Keech Pamila
CMO$257,805$0$10,000$0$0$0$17,351$0$10,545$0$295,701$0$0$0
Lightfoot Kim
DPA$117,689$0$0$0$0$0$8,301$0$27,130$0$153,120$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 7FormAndLineReferenceDesc
ExplanationThe CEO, COO, and CFO participate in an incentive plan to recognize the contributions made to Puget Sound Kidney Center's financial and operational success. Each year, the board reviews the performance of the Organization as compapared to its predetermined goals and sets appropriate and reasonable incentive compensation.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11bThe board of directors is notified of their right to obtain, review and keep a copy of the 990 prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cBOARD MEMBERS ARE INTERVIEWED ANNUALLY IN THE DECEMBER BOARD MEETING REGARDING POTENTIAL CONFLICTS OF INTEREST. A NUMBER OF ADMINISTRATIVE POLICIES ARE IN PLACE ADDRESSING THIS ISSUE. POLICIES NO. 108, 90, AND 355 COVERS AREAS OF CONFLICT OF INTEREST, BUSINESS ETHICS AND CONDUCT, AND FRAUD DETECTION AND PREVENTION RESPECTIVELY. ADDITIONALLY, AN ANNUAL IN-SERVICE IS GIVEN TO THE BOARD OF DIRECTORS.
Form 990, Part VI, Section B, line 15The board reviews the President and CEO's compensation packages. The President and CEO reviews and adjusts as necessary all others.
Form 990, Part VI, Section C, line 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND THE FORM 990 ARE AVAILABLE UPON REQUEST.
Form 990, Part XI, line 9:Change in Interest in Foundation 42,584. Expenes Incurred for the Benefit of PSKC Foundation -88,945. Education Program Expenses -104,669.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Puget Sound Kidney Centers FoundationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11019 Pacific AveAddressLine1Txt
CityEverettCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98201ZIPCd
FieldValueIRS element (for citing)
EIN454354877EIN
Primary ActivitiesSupport activities of the Puget Sound Kidney CentersPrimaryActivitiesTxt
Legal Domicile StateWALegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity StatusLine 11PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Puget Sound Kidney CentersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Puget Sound Kidney Centers Foundation
O$80,331FMV
Puget Sound Kidney Centers Foundation
C$164,786FMV

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