2014-06-23T11:38:38-05:00 2013-12-31 910189318 MOSS ADAMS LLP 1301 A STREET SUITE 600 TACOMA WA 984024205 990 2013-01-01 262377858 THE CAROL MILGARD BREAST CENTER CARO 2537592622 4525 S 19TH ST TACOMA TACOMA WA 98405 JACQUELYN OSTROM EXECUTIVE DIRECTOR 2533831099 2014-06-17 1 NANCY J SCHAUER P01326437 2535724100 2013 2015-11-30 17:44:51Z JACQUELYN OSTROM PO BOX 1535 TACOMA WA 98401 14455963 0 X WWW.CAROLMILGARDBREASTCENTER.ORG X 2008 WA TO PROVIDE SUSTAINABLE BREAST HEALTH SERVICES TO ALL WOMEN IN OUR COMMUNITY, IN A CARING ENVIRONMENT THAT FOSTERS CONFIDENCE, COMFORT, PEACE AND DIGNITY. 9 9 0 0 0 0 60187 2787140 11834935 11666868 2781 1955 0 0 11897903 14455963 31645 22625 0 0 0 0 0 0 6442 11629143 11589801 11660788 11612426 237115 2843537 12234824 15081063 861719 864420 11373105 14216643 X TO PROVIDE SUSTAINABLE BREAST HEALTH SERVICES TO ALL WOMEN IN OUR COMMUNITY, IN A CARING ENVIRONMENT THAT FOSTERS CONFIDENCE, COMFORT, PEACE AND DIGNITY. 0 0 75852 OUTREACH TO UNDERSERVED POPULATIONS -- THE BREAST CENTER HELD FIVE SCREENING EVENTS, SERVING MORE THAN 125 PATIENTS. ONE WAS HELD SEPTEMBER 7, 2013 IN CONJUNCTION WITH THE WOMEN OF COLOR HEALTH AWARENESS HEALTH FAIR. THE CENTER SCREENED 23 AFRICAN AMERICAN WOMEN ON THAT DAY ALONE. DURING SCREENING EVENTS, THE CENTER PROVIDES FINANCIAL AID TO ATTENDEES WITH THE SUPPORT OF: OWNERS SYSTEMS AND THEIR FOUNDATIONS, INDIVIDUAL GIFTS FROM DONORS, AND THE HELP OF PUBLIC PROGRAMS LIKE THE BREAST COLON AND CERVICAL HEALTH PROGRAM (BCCHP).THE BREAST CENTER CONTINUED ITS WORK WITH THE LEADERS IN WOMENS HEALTH, WHICH IS THE COMMUNITY-BASED GROUP OF AFRICAN AMERICAN LEADERS WHO ARE COMMITTED TO ALTERING THE COURSE OF BREAST DISEASE IN THEIR COMMUNITY. THROUGH CMBC SUPPORT, FUNDING, AND HOSTING, 25 WOMEN HAVE DEVELOPED PLANS TO EDUCATE YOUNG AFRICAN AMERICAN WOMEN ABOUT BREAST DISEASE AND TO PROVIDE TOOLS FOR PROVIDERS TO WORK MORE EFFECTIVELY WITH PEOPLE OF COLOR.THE BREAST CENTER PARTNERED WITH CATHERINE PLACE, A LOCAL RESOURCE FOR WOMEN IN TRANSITION, AND GOODWILL, TO HAVE A SPECIAL ONE DAY GIVE AWAY IN WHICH BREAST CANCER SURVIVORS COULD RECEIVE FREE CAMISOLES, BREAST PROSTHESES AND SPECIALTY ITEMS LIKE SWIMSUITS. MORE THAN 40 WOMEN WERE FITTED WITH BREAST PROSTHESES ON THIS DAY. 73367 BREAST HEALTH EDUCATION -- THROUGH 2013, THE BREAST CENTER PARTICIPATED IN SEVERAL COMMUNITY BASED BREAST HEALTH EDUCATION EVENTS. SPECIFICALLY, THE CENTERS STAFF AND VOLUNTEERS WERE PART OF 25 HEALTH EVENTS, ENGAGING LATINA, GLBTQ, AFRICAN AMERICAN, RUSSIAN, KOREAN, CAMBODIAN, NATIVE AMERICAN, AND VIETNAMESE COMMUNITY MEMBERS.BREAST CENTER STAFF AND RADIOLOGISTS SPOKE AT SIX COMMUNITY EVENTS,TOUCHING MORE THAN 11,000 PEOPLE. IN ADDITION, WITH THE INTRODUCTION OF 3D MAMMOGRAPHY, THE BREAST CENTER CONDUCTED A WIDE RANGING COMMUNICATION EFFORT TO ACQUAINT PROVIDERS, PATIENTS AND THE GENERAL COMMUNITY WITH THE BENEFITS OF 3D MAMMOGRAPHY. THE CENTER HELD A DONOR EVENT AND A REFERRING PROVIDER OPEN HOUSE TO INTRODUCE THIS IMPORTANT NEW TECHNOLOGY WHICH IS FINDING MORE CANCERS, EARLIER. THE CMBC WEBSITE CONTINUES TO BE AN IMPORTANT PORTAL FOR PATIENTS, FAMILIES AND PROVIDERS TO ACCESS BREAST HEALTH INFORMATION. 8932189 22625 11666868 PATIENT CARE SERVICES - IN 2013, THE BREAST CENTER SERVED MORE THAN 34,000 PATIENTS, PROVIDING 119,000 PROCEDURES AND EXAMS. 9081408 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 17 0 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 WA X DENNIS CARTER CO TRA MEDICAL IMAGING 2537614200 1304 FAWCETT AVE STE 100 TACOMA WA 98402 SUSAN PRATT DIRECTOR 1.00 X 0 0 0 SR ANNE MCNAMARA DIRECTOR 1.00 X 0 0 0 SALLY LEIGHTON DIRECTOR 1.00 X 0 0 0 DEEDRA WALKEY VICE CHAIR, BOARD OF DIRECTORS 1.00 X 0 0 0 CARI MILGARD-DEGOEDE DIRECTOR - THRU 7/15/13 1.00 X 0 0 0 CLYDE ADDISON MD DIRECTOR 1.00 X X 0 0 0 SHARON SNUFFIN CHAIR, BOARD OF DIRECTORS 1.00 X X 0 0 0 PETER NORMAN TREASURER, BOARD OF DIRECTORS 1.00 X X 0 0 0 DIANE DIMMER SECRETARY, BOARD OF DIRECTORS 1.00 X 0 0 0 DIANE CECCHETTINI EX-OFFICIO DIRECTOR 1.00 X 0 0 0 JOSEPH WILCZEK EX-OFFICIO DIRECTOR 1.00 X 0 0 0 JACQUELYN OSTROM EXECUTIVE DIRECTOR, EX-OFF 40.00 X X 149240 0 28057 SHELLY MULLIN OWNER REPRESENTATIVE 2.00 X 0 0 0 MARY LAFALCE OWNER REPRESENTATIVE 2.00 X 0 0 0 149240 0 28057 1 0 1 1 TACOMA RADIOLOGICAL ASSOCIATES 1304 FAWCETT AVE STE 100 TACOMA WA 98402 MANAGEMENT, BILLING, PROFESSIONAL SERVIC 7520913 HOLOGIC INC 24506 NETWORK PLACE CHICAGO IL 60673 EQUIPMENT MAINTENANCE 3067072 RUSH PROPERTIES 6622 WOLLOCHET DR NW GIG HARBOR WA 98335 FACILITY LESSOR 818129 MCKESSON PO BOX 98347 CHICAGO IL 60693 EQUIPMENT MAINTENANCE 211856 GE MEDICAL SYSTEMS PO BOX 843553 DALLAS TX 75284 EQUIPMENT MAINTENANCE 178554 5 2787140 2787140 PATIENT SERVICES 621300 12100087 12100087 BAD DEBTS 621300 -433219 -433219 11666868 1955 1955 14455963 11666868 0 1955 X 22625 22625 319047 319047 2022 2022 43419 43419 6603196 5531201 1071995 6367 6367 203126 104342 98709 75 44359 44359 547023 437618 109405 3817 3817 1301988 1275948 26040 78999 78999 REPAIRS & MAINTENANCE 913428 479705 433723 MEDICAL SUPPLIES 714007 714007 COMPASSIONATE CARE 510191 510191 ALL OTHER EXPENSES 202899 5771 197128 95913 95913 11612426 9081408 2524576 6442 347732 769563 5002035 4178870 138183 2153816 1401059 1498123 100887 43477 12004466 5567252 5244928 6437214 12234824 15081063 644190 651994 217529 212426 861719 864420 X 11373105 12216643 2000000 11373105 14216643 12234824 15081063 X 2843537 1 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3851644 1211691 2639953 8029213 4333283 3695930 123609 22278 101331 6437214 DEFERRED LEASE LIABILITY 212426 212426 X 14455963 0 14455963 0 14455963 11612426 0 11612426 0 11612426 PART X, LINE 2: THE CENTER IS A TAX-EXEMPT ORGANIZATION AND IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES, EXCEPT FOR UNRELATED BUSINESS INCOME, IN ACCORDANCE WITH SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IN ADDITION, THE CENTER QUALIFIED FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. UNRELATED BUSINESS INCOME TAX, IF ANY, IS INSIGNIFICANT AND NO TAX PROVISION HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CENTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE CENTER HAS NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2013 AND 2012. 1 AMERICAN CANCER SOCIETY MAKING STRIDES FLAGSHIP SPONSOR 1313 BROADWAY SUITE 100 TACOMA WA 98402 131788491 501 (C) (3) 11000 SPONSORSHIP SUSAN G KOMEN LUNCH FOR THE CURE - GOLD SPONSOR 1900 N NORTHLAKE WAY SUITE 135 SEATTLE WA 98103 751835298 501 (C) (3) 10000 SPONSORSHIP 2 0 PART I, LINE 2: GRANT AMOUNTS ARE AGREED TO BY THE MEMBERS AND REPORTED TO THE BOARD OF DIRECTORS. 0 0 0 0 0 0 0 0 0 JACQUELYN OSTROM EXECUTIVE DIRECTOR, EX-OFF 149240 0 0 0 0 0 10842 0 17215 0 177297 0 0 0 FORM 990 PART VII, SECTION A, LINE 5 DURING 2013, TRA, AN UNRELATED ORGANIZATION, PROVIDED PAYROLL AND ADMINISTRATIVE SERVICES TO THE CAROL MILGARD BREAST CENTER WHICH WERE REIMBURSED ON A REGULAR BASIS. UNDER THE AGREEMENT, TRA ASSIGNED JACQUELYN OSTROM TO THE CAROL MILGARD BREAST CENTER AND PAID FOR HER SALARY TO SERVE AS CURRENT EXECUTIVE DIRECTOR OF THE CAROL MILGARD BREAST CENTER. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS A MANAGEMENT AGREEMENT WITH TACOMA RADIOLOGICAL ASSOCIATES, PS ("TRA" DBA TRA MEDICAL IMAGING). THE ORGANIZATION USES TRA'S EMPLOYEES TO MANAGE AND RUN THE ORGANIZATION, AND PAYS FOR THESE SERVICES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS: FRANCISCAN HEALTH SYSTEM AND MULTICARE HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS HAVE THE RIGHT TO APPOINT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PROVIDES A COPY OF FORM 990 TO THE GOVERNING BODY BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 11 MEETING MINUTES ARE KEPT FOR ALL BOARD AND COMMITTEE MEETINGS. MINUTES ARE APPROVED BY THE BOARD AND EACH COMMITTEE AT ITS NEXT MEETING FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM TO IDENTIFY POSSIBLE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 18 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO PUBLIC UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO PUBLIC UPON WRITTEN REQUEST. FORM 990, PART IX, LINE 11G FEES FOR SERVICES - OUTSIDE LABOR FEES: PROGRAM SERVICE EXPENSES 2,615,041. MANAGEMENT AND GENERAL EXPENSES 535,611. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,150,652. FEES FOR SERVICES - PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,725,439. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,725,439. FEES FOR SERVICES - OTHER: PROGRAM SERVICE EXPENSES 190,721. MANAGEMENT AND GENERAL EXPENSES 536,384. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 727,105. FORM 990, PART XI, LINE 9: ROUNDING 1.