2014-04-29T10:40:51-05:00 2013-06-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2012-07-01 916057438 NORTHWEST KIDNEY CENTERS NORT 2062922771 700 BROADWAY SEATTLE WA 981224310 JOYCE F JACKSON 2062922771 2014-04-28 1 SARA ELIZABETH J HYRE P00235495 4254544919 2014-04-28 2012 2015-11-30 17:44:51Z JOYCE F JACKSON 700 BROADWAY SEATTLE WA 981224310 105095403 0 X WWW.NWKIDNEY.ORG X 1962 WA KIDNEY DISEASE PATIENT CARE, EDUCATION AND RESEARCH TO PROMOTE OPTIMAL HEALTH, QUALITY OF LIFE, AND INDEPENDENCE. 17 14 614 563 0 0 2024173 1599036 67259518 85458237 664013 1054007 17441176 2206152 87388880 90317432 464802 2475323 0 0 49500221 51101594 0 0 644338 33552971 33317243 83517994 86894160 3870886 3423272 81318951 89700708 18886704 23752208 62432247 65948500 X NORTHWEST KIDNEY CENTERS' MISSION IS TO PROMOTE THE OPTIMAL HEALTH, QUALITY OF LIFE AND INDEPENDENCE OF PEOPLE WITH KIDNEY DISEASE THROUGH PATIENT CARE, EDUCATION AND RESEARCH. THE ORGANIZATION KEEPS PEOPLE ALIVE WITH DIALYSIS CARE, EDUCATES THE PUBLIC ABOUT KIDNEY HEALTH, AND COLLABORATES WITH UW MEDICINE IN THE PROVISION OF SUPPORT FOR THE KIDNEY RESEARCH INSTITUTE. NORTHWEST KIDNEY CENTERS IS ONE OF VERY FEW COMMUNITY-BASED, NONPROFIT DIALYSIS PROVIDERS IN THE COUNTRY. FOUNDED IN SEATTLE IN 1962, NORTHWEST KIDNEY CENTERS PROVIDED THE FIRST OUT-OF-HOSPITAL DIALYSIS PROGRAM IN THE WORLD, AND CONTINUES TO SERVE AS A MODEL FOR THE DELIVERY OF KIDNEY DISEASE CARE. 0 0 70821682 87695580 DIALYSIS: NORTHWEST KIDNEY CENTERS PROVIDED 240,095 DIALYSIS TREATMENTS (AS PROVIDED IN THE CARE OF PATIENTS SUFFERING FROM CHRONIC KIDNEY DISEASE AND ACUTE RENAL FAILURE) IN THE YEAR ENDING JUNE 30, 2013. AT YEAR END, NORTHWEST KIDNEY CENTERS SERVED AS THE CHRONIC KIDNEY DISEASE DIALYSIS TREATMENT PROVIDER FOR 1,526 PATIENTS. THE ORGANIZATION PROVIDED PATIENT CARE IN FIFTEEN (15) FREE-STANDING DIALYSIS CENTERS, SUPERVISED DIALYSIS TREATMENTS PROVIDED IN THE HOMES OF PATIENTS THROUGHOUT THE COMMUNITY, AND IN ELEVEN (11) LOCAL HOSPITALS. NORTHWEST KIDNEY CENTERS PROVIDED CARE FOR PATIENTS INSURED THROUGH MEDICARE AND MEDICAID PROGRAMS AT A COST THAT EXCEEDED REIMBURSEMENT BY APPROXIMATELY $15.5 MILLION. IN ADDITION, NORTHWEST KIDNEY CENTERS PROVIDED CHARITY CARE IN EXCESS OF $34,000 IN THE COURSE OF THE YEAR.NORTHWEST KIDNEY CENTERS' RENAL SPECIALTY PHARMACY, A RARITY IN THE NATION, SERVED IN EXCESS OF 1,623 PATIENTS DURING THE YEAR. 2408000 2408000 KIDNEY DISEASE RESEARCH: NORTHWEST KIDNEY CENTERS PROVIDED FIVE NEPHROLOGY FELLOWSHIPS FOR PHYSICIANS ENGAGED IN THE STUDY OF KIDNEY DISEASE AND RENAL CARE AT THE UNIVERSITY OF WASHINGTON, ENDEAVORING TO ASSURE PROFESSIONAL CARE WILL CONTINUE TO BE AVAILABLE FOR PATIENTS WHO MAY SUFFER FROM KIDNEY DISEASE IN THE FUTURE.NORTHWEST KIDNEY CENTERS PROVIDED SIGNIFICANT SUPPORT FOR THE KIDNEY RESEARCH INSTITUTE, WHICH AT YEAR-END HAD 20 STUDIES UNDER WAY, FOCUSING ON THE ROLE OF GENETICS, IMPACT OF LIFESTYLE, AND DIABETES IN KIDNEY DISEASE, AS WELL AS WAYS TO IMPROVE DIALYSIS OUTCOMES. NORTHWEST KIDNEY CENTERS' INVESTMENT IN THE KIDNEY RESEARCH INSTITUTE HAS HELPED TO LEVERAGE NEARLY $20 MILLION IN FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH. 632632 EDUCATION: NORTHWEST KIDNEY CENTERS EDUCATES THROUGH CHOICES, A PATIENT-FOCUSED, EVIDENCE-BASED CLASS TO HELP PEOPLE UNDERSTAND THE IMPLICATIONS OF THEIR KIDNEY DISEASE DIAGNOSIS. ATTENDANCE IN THE PAST YEAR EXCEEDED 748, INCLUDING 405 PATIENTS. THE ORGANIZATION ALSO PROVIDED ONE-TO-ONE EDUCATION FOR 7 NEW DIALYSIS PATIENTS IN THE HOSPITAL SETTING, AND PROVIDED CLASSES CONCERNING GOOD NUTRITION FOR PEOPLE WITH KIDNEY DISEASE, ATTENDED BY 327 PATIENTS AND FAMILY MEMBERS. NORTHWEST KIDNEY CENTERS ALSO ADDED NEXT STEP CLASSES & LIVING WELL WITH A TRANSPLANT TO ITS ROSTER OF FREE CLASSES WHICH TARGET COMMUNITY MEMBERS WITH KIDNEY DISEASE WHO ARE NOT ON DIALYSIS, ATTENDED BY 275 PARTICIPANTS, INCLUDING 264 PATIENTS. THE CLASSES HELP PRESERVE KIDNEY FUNCTION, CHOOSE APPROPRIATE TREATMENT, TAKE CARE OF A TRANSPLANTED KIDNEY AND IN GENERAL BE AN EMPOWERED PARTNER IN THEIR KIDNEY HEALTH CARE. NORTHWEST KIDNEY CENTERS PARTICIPATED IN 48 COMMUNITY HEALTH EDUCATION AND OUTREACH ACTIVITIES, REACHING A TOTAL OF 11,341 PEOPLE, DURING FISCAL YEAR 7/12-6/13. THESE ACTIVITIES INCLUDED 10 PUBLIC SPEAKING ENGAGEMENTS REACHING 980 PEOPLE, AND 38 COMMUNITY EVENTS REACHING 10,361 PEOPLE. THE LARGEST SINGLE COMMUNITY EVENT THAT NKC PARTICIPATED IN WAS THE DIABETES EXPO, DURING WHICH THE ORGANIZATION REACHED 650 ATTENDEES. THE LARGEST EVENT PRODUCED BY NORTHWEST KIDNEY CENTERS WAS THE 11TH ANNUAL KIDNEY HEALTH FEST FOR AFRICAN AMERICAN FAMILIES, WITH A TOTAL OF 600 ADULTS AND CHILDREN IN ATTENDANCE. 49056 49056 EMERGENCY ASSISTANCE PROGRAMS: FINANCIAL ASSISTANCE WAS PROVIDED TO NEEDY PATIENTS TO ASSIST WITH FOOD, HOUSING, AND OTHER EXPENSES. (266 PATIENTS) 18267 18267 SCHOLARSHIP PROGRAMS: SCHOLARSHIPS WERE PROVIDED TO NEEDY DIALYSIS AND KIDNEY TRANSPLANT PATIENTS. (4 PATIENTS AND 4 STAFF) 67323 67323 73929637 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 114 0 1 614 1 0 0 0 0 0 1 1 0 0 0 0 X 17 14 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X SCOTT STRANDJORD 2067208508 700 BROADWAY SEATTLE WA 98122 DAVID WILDE 2.00 X X 0 0 0 CRAIG GOODRICH 4.00 X X 0 0 0 VIRGINIA BROUDY MD 1.00 X 0 0 0 BONNIE COLLINS MD 8.00 X 47917 0 0 CYRUS CRYST MD 1.50 X 50000 0 0 JOSEPH C ESCHBACH CFA 3.00 X 0 0 0 LISA FLORENCE MD 0.30 X 0 0 0 RICHARD GREAVES 3.50 X 0 0 0 GARY R HOULAHAN 2.00 X 0 0 0 ROBERT JAFFE MD 1.50 X 0 0 0 ROBERT LEMON 2.00 X 0 0 0 JAMES A MANNING 3.00 X 0 0 0 VILMA QUIJADA MD 3.00 X 90000 0 0 CLINTON RANDOLPH 2.00 X 0 0 0 STUART SHANKLAND MD 1.00 X 0 0 0 KELLY WALLACE 1.00 X 0 0 0 ROBERT WALERIUS 0.50 X 0 0 0 JOYCE F JACKSON 50.00 X 437856 0 33373 SCOTT STRANDJORD 50.00 X 245303 0 38352 CONSTANCE ANDERSON 50.00 X 251551 0 23919 LEANNA B TYSHLER 50.00 X 250226 0 24860 EMERY POLLOCK 50.00 X 196997 0 29237 MARY MCHUGH 50.00 X 188023 0 20394 ASHOK VARMA 40.00 X 168003 0 18176 THOMAS MONTEMAYOR 40.00 X 167119 0 18137 2092995 0 206448 117 0 1 0 ALDRICH & ASSOCIATES 810 240TH ST SE BOTHELL WA 98021 GENERAL CONTRACTOR 4276630 PATHOLOGY ASSOCIATES MEDICAL LABS PO BOX 2670 SPOKANE WA 99220 LABORATORY SERVICES 917581 UNIVERSITY OF WASHINGTON MEDICINE DIVI 1959 NE PACIFIC BB1263 BOX 356521 SEATTLE WA 98195 MEDICAL CONSULTING 791363 DAVIS WRIGHT TREMAINE LLP 1201 THIRD AVENUE SUITE 2200 SEATTLE WA 981013045 LEGAL SERVICES 342105 GA CREATIVE INC 10900 NE 8TH STREET SUITE 1660 BELLEVUE WA 980044405 BRANDING/CREATIVE 286711 9 6149 783626 25000 784261 180811 1599036 DIALYSIS 621400 81833757 81833757 LABORATORY REVENUE 612140 2131928 2131928 INSUR PREMIUM REIMBURS 612140 836875 836875 OTHER MEDICAL RELATED 621400 655677 655677 85458237 503743 503743 6157304 5504167 102873 653137 -102873 550264 550264 186374 783626 419785 -233411 -233411 15400 6924 8476 8476 10976144 8744222 2231922 2231922 INT. CAPITALIZATION 900099 193658 193658 MEDICAL RECORDS 900099 5421 5421 MISC REVENUE 900099 86 86 199165 90317432 87695580 0 1022816 2408000 2408000 67323 67323 1047352 1047352 40777504 34779527 5572595 425382 2045425 1741648 282475 21302 4001457 3361629 598713 41115 3229856 2760508 437658 31690 1298228 1266932 31296 352573 350446 2127 53945 53945 166936 166936 530587 147897 354083 28607 132977 130880 2097 2131513 1757455 333562 40496 593064 593064 5308741 4853463 447605 7673 173502 109534 58043 5925 59449 940 57095 1414 5128993 3989789 1118327 20877 315449 224602 90847 SUPPLIES 13810781 13729920 68970 11891 LAB TESTING 1308758 1308758 REPAIR AND MAINTENANCE 277401 238201 38128 1072 COMMUNITY PROGRAMS 217956 92683 122603 2670 1456390 1090828 365562 86894160 73929637 12320185 644338 1391773 4672371 1776869 4470047 593669 303177 21538638 17818421 1211510 1120852 373060 486431 89677122 48580439 35428200 41096683 18268922 18860625 736310 872101 81318951 89700708 6752748 7643418 1899935 3158000 7520337 10223047 2713684 2727743 18886704 23752208 X 58073592 63168106 3215227 1584222 1143428 1196172 62432247 65948500 81318951 89700708 X 3423272 69571 23410 X 0 1 X 1 0 X 2606526 5816472 2057926 2024173 1599036 14104133 83135261 89352648 91748052 93649072 96439802 454324835 85741787 95169120 93805978 95673245 98038838 468428968 74453 74070 273049 168042 101469 691083 0 74453 74070 273049 168042 101469 691083 467737885 403228 427134 644505 593645 503743 2572255 403228 427134 644505 593645 503743 2572255 230 193658 193888 86145015 95596254 94450483 96267120 98736239 471195111 0.99270 0.99270 0.00550 0.00580 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISC INCOME - 2011 AMOUNT: $ 230. INTEREST CAPITALIZATION - 2012 AMOUNT: $ 193,658. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 166936 0 0 166936 0 PART IV, SUPPLEMENTAL INFORMATION: THE NORTHWEST KIDNEY CENTERS ENGAGED IN LOBBYING AT THE STATE AND FEDERAL LEVEL DURING THE FISCAL YEAR ENDED 6/30/13. OUR STAFF MEMBERS TRAVELED TO WASHINGTON D.C. TO MEET WITH MEMBERS OF CONGRESS AS AN ONGOING EFFORT TO KEEP THEM INFORMED OF THE NEEDS AND CONCERNS OF KIDNEY PATIENTS. STAFF AND VOLUNTEERS VISIT STATE LEGISLATORS ONE DAY EACH YEAR TO EDUCATE THE LEGISLATORS ON THE PREVALENCE OF KIDNEY DISEASE AND TO ADVOCATE FOR BILLS THAT WOULD SUPPORT OPTIMAL CARE FOR KIDNEY PATIENTS. THE GROUP TRAVELED TO OLYMPIA, WA TO ADVOCATE FOR ISSUES THAT HELP KIDNEY PATIENTS. 3956364 27191 410338 40839 4353054 4034699 5027 -1234 47199 34929 3956364 3420755 28756 617092 31904 4034699 577339 2768170 91462 5440 10776 3420755 1106308 -350444 178525 577339 0.77000 0.15310 0.07690 0 0 4924602 4924602 29635626 16128490 13507136 27893102 11816041 16077061 27223792 20635908 6587884 41096683 DEFERRED COMPENSATION 236116 DEFERRED TENANT LEASEHOLD ALLOWANCE 1280892 DEFERRED RENT 1210735 2727743 99613131 69571 31786 23410 124767 99488364 -9170931 -9170931 90317433 96096878 31786 9170931 9202717 86894161 0 86894161 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: FUNDS ARE USED FOR KIDNEY DISEASE RESEARCH, PATIENT SCHOLARSHIPS AND PATIENT EMERGENCIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT 23,410. PART XI, LINE 4B - OTHER ADJUSTMENTS: PHARMACY COST OF GOODS SOLD -8,744,222. SPECIAL EVENT EXPENSES REPORTED ON PART VIII -426,709. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REPORTED ON PART VIII 426,709. PHARMACY COST OF GOODS SOLD 8,744,222. BREAKFAST OF HOPE 335532 314532 21000 263 28054 227 64788 GALA 634468 469094 165374 1177 67238 4993 253045 970000 783626 186374 1440 95292 5220 317833 419785 -233411 15400 6924 0 15400 6924 6924 8476 WA 1 0 0 0 0.00000 1.00000 0 0 1 UNIVERSITY OF WASHINGTON 3917 UNIVERSITY WAY NE SEATTLE WA 98105 916001537 GOVT - UNIVERSITY 2408000 SEE SCHEDULE I, PART IV. 1 0 SCHOLARSHIPS 8 18267 BOOK SCHOLARSHIPS TO NORTHWEST KIDNEY CENTERS DIALYSIS PATIENTS AND EMPLOYEES. EMERGENCY GRANTS TO COVER FOOD, HOUSING, UTILITIES AND TRANSPORTATION. 266 49056 BOOK SUPPORT FOR SELECT NORTHWEST KIDNEY CENTERS PATIENTS WHO RESIDE WITHIN WASHINGTON STATE. PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GIFT TO THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE/DIVISION OF NEPHROLOGY: AS DESCRIBED IN THE "GIFT AGREEMENT BETWEEN NORTHWEST KIDNEY CENTERS AND UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE/DIVISION (UWSOM) OF NEPHROLOGY" (DATED AUGUST 21, 2006), AND "FIRST EXTENSION" (DATED AUGUST 8, 2007) AND "SECOND EXTENSION" (DATED AUGUST 1, 2008), "THIRD EXTENSION" (DATED JULY 6, 2009), "FOURTH EXTENSION" (DATED JUNE 30, 2010), "FIFTH EXTENSION" (DATED JULY 7, 2011) AND "SIXTH EXTENSION" (DATED JULY 13, 2012); THE FOLLOWING PROVISIONS WERE ESTABLISHED IN REGARD TO PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: PARAGRAPH A-FOR FISCAL YEAR 2013 (FISCAL YEAR STARTS IN JULY 2012 AND ENDS IN JUNE 2013.) NKC WILL PROVIDE GIFTS DIRECTED TO THE UW DIVISION OF NEPHROLOGY TO A) ENHANCE THE TRAINING OF FELLOWS IN NEPHROLOGY, AND B) TO SUPPORT BASIC RESEARCH INTO THE CAUSES AND CURES OF KIDNEY DISEASE, AND TO SUPPORT THE ACTIVITIES OF THE KIDNEY RESEARCH INSTITUTE AT THE UNIVERSITY OF WASHINGTON. PARAGRAPH B-NKC AND UWSOM AGREE THAT THESE GIFTS WILL NOT BE USED TO PAY UWSOM OVERHEAD, DEPARTMENT ASSESSMENTS, OR INDIRECT COSTS ON STUDIES. THE PARTIES FURTHER AGREE THAT THE UWSOM IS REPONSIBLE FOR STEWARDSHIP OF THESE FUNDS AND WILL DIRECTLY UTILIZE THE FULL AMOUNT OF THE GIFTS. THERE ARE NO CONTRACTUAL ARRANGEMENTS ASSOCIATED WITH THE FUNDS, WHICH REQUIRE OR PROVIDE FOR COMPLIANCES WITH PROTOCOLS, PATIENT RIGHTS, TECHNOLOGY TRANSFER OR OTHER SIMILAR CONDITIONS OR PROPRIETARY INFORMATION WITH NKC. PARAGRAPH D-PERIODICALLY UWSOM WILL PROVIDE NKC WRITTEN AND VERBAL REPORTS AND INFORMATIONAL PRESENTATIONS REGARDING THE ACTIVITIES OF THE FUNDED FELLOWS, THE BASIC RESEARCH CONDUCTED WITH NKC FUNDING, AND ACTIVITIES OF THE KIDNEY RESEACH INSTITUTE, AT A SCHEDULE MUTUALLY AGREED UPON BETWEEN THE NKC PRESIDENT AND CEO AND THE UW HEAD, DIVISION OF NEPHROLOGY. PARAGRAPH E-UPON REQUEST UWSOM SHALL PROVIDE NKC INFORMATION REGARDING THE AMOUNT AND TYPE OF EXPENDITURES ASSOCIATED WITH GIFTS TO THE UWSOM. PARAGRAPH F AT THE END OF THE PERIOD COVERED BY THIS GIFT AGREEMENT ANY UNSPENT NKC GIFT FUNDS TO UWSOM SHOULD REMAIN DESIGNATED FOR USE BY THE NEPHROLOGY FELLOWSHIP PROGRAM, BASIC RESEARCH ENDEAVORS, OR KIDNEY RESEARCH INSTITUTE FOR USE IN SUBSEQUENT FISCAL YEARS. ALL FUNDS REMAIN WITH UWSOM AS A GIFT FOR THE KRI. PATIENT EMERGENCY FUND GRANTS: THE EMERGENCY FUND PROGRAM PROVIDES SUPPORT FOR SELECT NORTHWEST KIDNEY CENTERS (NKC) PATIENTS CURRENTLY RECEIVING DIALYSIS, OR PATIENTS OF NKC WHO HAVE RECEIVED A KIDNEY TRANSPLANT WITHIN THE PREVIOUS THREE YEARS, AND RESIDES WITHIN WASHINGTON STATE. GRANTS OF UP TO $250 PER PATIENT MAY BE AWARDED IN A GIVEN TWELVE MONTH PERIOD. REQUESTS FOR LARGER AMOUNTS WILL BE CONSIDERED INDIVIDUALLY ON AN EXCEPTION BASIS. NKC SOCIAL WORKERS ARE RESPONSIBLE FOR OBTAINING DOCUMENTATION OF THE PATIENT'S NEED AND INVESTIGATION OF ALL OTHER POSSIBLE COMMUNITY RESOURCES AVAILABLE TO MEET THE NEED. EACH GRANT MUST BE APPROVED BY THE PATIENT'S SOCIAL WORKER, AND THE SOCIAL SERVICES MANAGER. THE GRANT WILL BE PAID TO A THIRD PARTY FOR THE SERVICE OR MATERIAL NEEDED BY THE PATIENT. CHECKS WILL NOT BE MADE OUT TO THE PATIENT DIRECTLY. WHERE POSSIBLE, A COPY OF A BILL SHOULD BE SUBMITTED WITH THE APPLICATION. THE NORTHWEST KIDNEY CENTERS' (NKC) REHABILITATION SCHOLARSHIPS ARE AWARDED TO NKC DIALYSIS PATIENTS OR FORMER DIALYSIS PATIENTS WHO HAVE RECEIVED A KIDNEY TRANSPLANT IN THE PREVIOUS FIVE YEAR PERIOD. APPLICANTS MUST BE 18 YEARS OLD OR OLDER, LIVE IN WASHINGTON STATE AND PLAN TO STUDY AT AN ACCREDITED SCHOOL OR TRAINING PROGRAM WITHIN WASHINGTON STATE. APPLICANTS SHOULD HAVE A CLEAR EMPLOYMENT GOAL AND BE ABLE TO DEMONSTRATE FINANCIAL NEED. THE MAXIMUM YEARLY AWARD IS $3,000. SCHOLARSHIP RECIPIENTS MAY APPLY EACH YEAR UNTIL THEY HAVE USED A TOTAL OF $6,000 IN SCHOLARSHIP FUNDS. THE APPLICANT'S ACADEMIC PROGRESS IS MONITORED DURING THE YEAR FOLLOWING THE AWARD OF THE SHOLARSHIP. SCHEDULE I, PART II, LINE 1, COLUMN H: RESEARCH GRANTS ARE AWARDED TO UNIVERSITY PHYSICIANS WHO ARE CONDUCTING STUDIES, WHICH ARE DEDICATED TO RESEARCHING CAUSES AND CURES OF CONDITIONS RELATING TO KIDNEY DISEASES. FELLOWSHIPS ARE AWARDED TO THE UNIVERSITY OF WASHINGTON TO PROVIDE SALARY FUNDS FOR PHYSICIANS IN TRAINING TO BECOME NEPHROLOGISTS WHO WILL CARE FOR PATIENTS WITH KIDNEY DISEASE. THE KIDNEY RESEARCH INSTITUTE IS A UNIVERSITY OF WASHINGTON BASED ORGANIZATION THAT IS DEDICATED TO THE RESEARCH OF KIDNEY DISEASE. SCHEDULE I, PART III, SCHOLARSHIPS, COLUMN F: EMPLOYEE SCHOLARSHIP APPLICATIONS ARE REVIEWED BY DEVELOPMENT STAFF TO ENSURE APPLICATIONS ARE COMPLETE, AND BY HR TO ENSURE APPLICANTS MEET MINIMUM QUALIFICATIONS (EMPLOYED AT LEAST ONE YEAR, FULL-TIME OR REGULAR PART-TIME (AT LEAST 24 HOURS PER WEEK)). THOSE WHO MEET MINIMUM QUALIFICATIONS ARE SENT TO THE EMPLOYEE SCHOLARSHIP COMMITTEE TO BE RATED USING A SCORING MATRIX OF SPECIFIC CRITERIA. THE COMMITTEE CURRENTLY IS COMPRISED OF A VOLUNTEER, TWO CLINICAL MANAGERS, HR REPRESENTATIVE AND VP DEVELOPMENT & PR OR DESIGNEE. THE HIGHEST RATED APPLICANTS THEN INTERVIEW WITH THE COMMITTEE. AFTER THAT, THE COMMITTEE DECIDES WHO WILL RECEIVE A SCHOLARSHIP AND HOW MUCH. THE ACTUAL AMOUNTS AWARDED DEPEND ON RESTRICTIONS PLACED BY THE DONORS ABOUT HOW THE SCHOLARSHIP FUNDS CAN BE USED AND THE AMOUNT AVAILABLE IN ANY GIVEN YEAR. X X X X X X 0 0 0 0 0 0 0 1 0 JOYCE F JACKSON 362064 0 40072 0 35720 0 14983 0 18390 0 471229 0 0 0 SCOTT STRANDJORD 233736 0 72 0 11495 0 14024 0 24328 0 283655 0 0 0 CONSTANCE ANDERSON 240019 0 72 0 11460 0 14401 0 9518 0 275470 0 0 0 LEANNA B TYSHLER 250154 0 72 0 0 0 15000 0 9860 0 275086 0 0 0 EMERY POLLOCK 187951 0 72 0 8974 0 11277 0 17960 0 226234 0 0 0 MARY MCHUGH 187951 0 72 0 0 0 11277 0 9117 0 208417 0 0 0 ASHOK VARMA 167931 0 72 0 0 0 9196 0 8980 0 186179 0 0 0 THOMAS MONTEMAYOR 153624 0 72 0 13423 0 9217 0 8920 0 185256 0 0 0 PART I, LINE 7 THE PRESIDENT/CHIEF EXECUTIVE OFFICER PARTICIPATES IN AN INCENTIVE PLAN DESIGNED FOR THIS OFFICE-HOLDER ALONE. THE PURPOSE OF THIS PLAN IS TO ALIGN THE PRESIDENT'S INTERESTS WITH THOSE OF THE BOARD AND NKC'S BROADER CONSTITUENTS AND TO RECOGNIZE SPECIAL CONTRIBUTIONS TO NKC'S FINANCIAL AND OPERATIONAL SUCCESS. THE EXECUTIVE COMMITTEE OF THE BOARD SHALL MEET ANNUALLY TO ESTABLISH REASONABLE FINANCIAL AND OTHER GOALS FOR THE COMING YEAR. AT THE CONCLUSION OF EACH YEAR, THE EXECUTIVE COMMITTEE WILL MEET IN EXECUTIVE SESSION TO REVIEW PERFORMANCE COMPARED TO THE PREDETERMINED GOALS, TO SET APPROPRIATE INCENTIVE COMPENSATION AS REASONABLY DETERMINED BY THE COMMITTEE AT ITS DISCRETION, AND TO APPROVE GOALS FOR THE FOLLOWING YEAR. THE CHAIR OR HIS OR HER DESIGNATE WILL THEN MEET WITH THE CEO TO DISCUSS PERFORMANCE AND ANNOUNCE THE INCENTIVE COMPENSATION AWARDED BY THE EXECUTIVE COMMITTEE. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2012-12-21 10400000 CAPITAL IMPROVEMENTS 0 0 0 A 176953 10400000 149412 2964745 7285843 2012 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 X 3 3474 FMV X AUCTION ITEMS 68 170191 FMV X VARIOUS ITEMS 10 7147 FMV 0 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: PART I, COLUMN (B): THE NUMBER IN COLUMN B IS BASED ON THE NUMBER OF CONTRIBUTIONS. FORM 990, PART I, LINE 6: NORTHWEST KIDNEY CENTERS SPONSORS MANY EVENTS EVERY YEAR. TO MAKE THESE EVENTS SUCCESSFUL, NWKC UTILIZES HUNDREDS OF VOLUNTEERS FOR REGISTRATION, GREETING, SET-UP, TAKE-DOWN, TALKING TO THE PUBLIC ABOUT KIDNEY DISEASE AND MORE. OCCASIONALLY, VOLUNTEER OPPORTUNITIES ARE AVAILABLE IN OUR ADMINISTRATIVE OFFICES AND COMMUNITY DIALYSIS CENTERS. THERE WERE ALSO 17 VOLUNTEER BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 4 THE NUMBER OF NEPHROLOGISTS ON THE BOARD IS CHANGED FROM "NOT FEWER THAN 3 NOR MORE THAN 6" TO "NOT FEWER THAN 2 NOR MORE THAN 4". THE BOARD CHAIR APPOINTS COMMITTEE CHAIRS. THERE IS NO LONGER A BOARD TREASURER. CORPORATE OFFICERS ARE ENUMERATED: PRESIDENT/CEO, VICE PRESIDENT, SECRETARY AND TREASURER. THE BOARD APPOINTS PRESIDENT/CEO. THE PRESIDENT /CEO APPOINTS OTHER CORPORATE OFFICERS. FORM 990, PART VI, SECTION B, LINE 11 THE 2012 FORM 990 WAS REVIEWED BY THE BOARD'S FINANCE AND AUDIT COMMITTEE AND BY THE BOARD OF TRUSTEES BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO AND THE ORGANIZATION ASKS ALL BOARD MEMBERS, OFFICERS AND OTHER DECISION MAKING STAFF MEMBERS TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED EACH YEAR ALONG WITH A LIST OF VENDORS AND ORGANIZATIONS WITH WHICH WE CONTRACT. WE REQUIRE AND ACHIEVE 100% COMPLIANCE WITH RETURN OF CONFLICT OF INTEREST DISCLOSURES. ALL DISCLOSURES ARE REVIEWED BY THE BOARD CHAIR, THE CHAIR OF THE BOARD'S COMPLIANCE COMMITTEE, AND THE PRESIDENT/CEO WHO DECIDE IF A CONFLICT EXISTS AND THEN FOLLOW UP WITH SPECIFIC INDIVIDUALS IS PERFORMED AS NEEDED. THE REVIEW PROCESS IS REPORTED TO THE BOARD WHEN COMPLETE. INDIVIDUALS ARE REMINDED TO ABSTAIN FROM VOTES IF THERE IS A POTENTIAL CONFLICT OF INTEREST. THE CONFLICT OF INTEREST POLICY IS SHARED WITH ALL NEW EMPLOYEES AND NEW BOARD MEMBERS AND IS AVAILABLE AT ALL TIMES VIA ON-LINE POLICIES. FORM 990, PART VI, SECTION B, LINE 15 THE NORTHWEST KIDNEY CENTERS BOARD OF TRUSTEES' COMPENSATION COMMITTEE DOES REVIEW THE COMPARABILITY OF THE PRESIDENT/CEO'S COMPENSATION. THE COMMITTEE CONSISTS OF 3 INDEPENDENT BOARD MEMBERS WHO DO NOT RECEIVE ANY COMPENSATION FROM NKC. THIS COMMITTEE CONTRACTS WITH ANOTHER INDEPENDENT FIRM TO PROVIDE AN INTERMEDIATE SANCTIONS LETTER (DETERMINING THE ORGANIZATION IS IN COMPLIANCE) FOR THE COMMITTEE AND TO MEET FIDUCIARY AND IRS RESPONSIBILITIES. THIS OUTSIDE REVIEW USES HOSPITAL AND HEALTHCARE COMPENSATION DATA TO REVIEW TOTAL COMPENSATION RELATIVE TO SIZE, COMPLEXITY, MARKET LOCATION, AND NATURE OF THE ORGANIZATION AND TO THEN OPINE ON THE COMPENSATION PACKAGE. THE COMPENSATION COMMITTEE MAKES A RECOMMENDATION REGARDING THE PRESIDENT/CEO'S COMPENSATION TO THE NKC BOARD OF TRUSTEES' EXECUTIVE COMMITTEE WHICH THEN ACTS ON THAT RECOMMENDATION. THE PROCESS WAS PERFORMED IN OCTOBER 2012 AND NOVEMBER 2013. DATA REGARDING THE VICE PRESIDENTS' PAY HISTORY, CURRENT PAY AND PROPOSED ADJUSTMENTS HAVE BEEN PROVIDED TO THE NKC COMPENSATION COMMITTEE, WHICH IS MADE UP OF 3 INDEPENDENT BOARD MEMEBERS, WHO DETERMINE THAT SUCH AMOUNTS ARE CONSISTENT WITH MARKET PARAMETERS. THIS PROCESS WAS LAST PERFORMED IN OCTOBER 2012 AND NOVEMBER 2013. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S BYLAWS, ARTICLES OF INCORPORATION, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE ON THE NKC WEBSITE IN THE "ABOUT US" SECTION. THE ANNUAL FISCAL YEAR FINANCIAL RESULTS ARE PUBLISHED IN THE ANNUAL REPORT WHICH IS AVAILABLE ON THE WEBSITE AND DISTRIBUTED IN HARD COPY TO 7,500 INDIVIDUALS INCLUDING PATIENTS, DOCTORS, DONORS AND THE GENERAL PUBLIC. ADDITIONAL COPIES ARE BEING HANDED OUT INDIVIDUALLY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT 23,410. PERPETUAL TRUST (1) INVESTMENT WA N/A T 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0