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        <PersonNm>Homer Lane Jr</PersonNm>
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        <PersonNm>Lynn Rose PhD</PersonNm>
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        <PersonNm>Steven Ziegler PhD</PersonNm>
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        <FormAndLineReferenceDesc>Part I Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Benaroya Researach Institute at Virginia Mason relies upon Virginia Mason Medical Centers a related organization Board Compensation and Benefits Committee, a committee composed of independent board members to whom the Board has delegated the authority to approve all compensation and benefits for the executive leaders of the Medical Center. To ensure that such benefit plans are market competitive and reasonable, the Committee receives support and advice, including appropriate market comparability data. from an independent compensation consultant with expertise in the health care industry and access to relevant market data. See Schedule O for additional disclosure.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Medical Center has a Supplemental Executive Retirement Plan SERP. The SERP is a 457f nonqualified deferred compensation plan pursuant to which plan benefits are subject to a substantial risk of forfeiture, entered into when certain senior executives join the Medical Center. The plan was approved by the Boards Compensation and Benefits Committee, a committee composed of independent board members to whom the Board delegates the authority to approve compensation and benefits for the Medical Centers most senior executives. The Committee receives advice from an independent compensation consultant to ensure that compensation and benefits, including the SERP, are market competitive and reasonable.</ExplanationTxt>
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        <ExplanationTxt>Purposes to currently refund WEDFA Series 2006C bonds issued 11/15/2006, and to fund research facility improvements.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part II Line 3</FormAndLineReferenceDesc>
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        <FormAndLineReferenceDesc>Form 990, Part III, Line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Benaroya Research Institute at Virginia Mason BRI is a world-renowned medical researach institute whose work has resulted in major advances against autoimmune and immune-mediated diseases. One in 20 Americans suffers from one or more autoimmune diseases, such as type 1 diabetes, multiple sclerosis, Crohns disease and rheumatoid arthritis to name a few, and more than one out of every four Americans suffer from diseases of the immune system, such as allergies and asthma. Because these diseases are connected in the way the immune system attacks the body, BRI scientists arent focused on eliminating one or two immune system diseases - they are taking on many more. As a world leader in scientific innovation, BRIs discoveries are having significant impact on people living with these diseases today - by improving the ability to predict disease risk, decreasing disease progression and making therapies safer and better.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>One of the unique qualities of BRI is the close integration of three types of medical research - laboratory research, translational research and clinical research - to improve peoples lives. Our scientists can address both the basic science issues and clinical applications, which is the best way to design studies with the highest potential for success. For BRI, discovery starts in the laboratory. 2013 advancements in translational, immunology, clinical research and other areas are highlighted below.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4a</FormAndLineReferenceDesc>
        <ExplanationTxt>Translational research is the link between laboratory research and clinical research, built upon an exchange of materials and information between these two disciplines. BRI scientists and collaborators work together to study blood and serum samples along with medical and demographic data collected from people with autoimmune and immune-mediated diseases. These include multiple sclerosis, type 1 diabetes, lupus, rheumatoid arthritis, inflammatory bowel disease, allergy and asthma. BRI maintains an extensive biorepository with samples dating back to 2000, including 11 disease categories and a biorepository of healthy people for comparison purposes. Advancements in 2013 include the following 1 Discovery of novel biomarkers of multiple sclerosis MS that may be leveraged to gauge disease activity and as a target for new therapies. Researchers studied patients with more active MS compared to those who have more benign MS. They found that in more aggressive MS, certain T cells in the immune system were able to evade regulation and cause lesions. The research also identified potential target molecules that offer the prospect of reversing this process with novel therapy. 2 In another multiple sclerosis MS advancement, BRI is researching how to identify molecular changes in immune cells known to cause MS. This is the first study to look at the genome, or the genetic information within the specific cells that attack the nervous system of MS patients. 3 Conducted research to enable rapid prediction for patient response to immune therapy. BRI scientists are developing approaches that will allow physicians to match the right pharmaceutical and course of treatment to individual patients based on the biomarkers that exist in that patients immune system. Gaining the ability to choose a therapy that is more likely to be effective from the start by prescreening for these biomarkers has the potential to allow for earlier successful intervention in disease progression and is also likely to bring down health care costs by decreasing the number of unsuccessful treatment attempts. 4 Undertook leadership of a Core and Assay Validation Center for the JDRF Biomarker Working Group to help focus on the identification and utilization of robust biomarkers for type 1 diabetes. Currently, biomarkers are used to identify people at risk for diseases, predict progression rates and assess how well treatments are working. This working group will help advance additional biomarkers from the lab to the clinic, and if different measurements can be combined into a composite-like score, there is the potential for specific assays to be predictive. In this way, it can be determined how fast T1D is going to progress and provide an opportunity for experimental immunologic interventioins to arres the onset of disease. 5 Through application of BRIs tetramer technology, scientists were able to examine whether T cells in rheumatoid arthritis RA patients were increased in number or were unique in other ways. For the first time, scientists were able to demonstrate that T cells that recognize proteins in the joint were increased in the blood of RA patients and that these cells had a unique set of markers. This technology now allows scientists to study how RA starts, how current therapies may impact the immune response directed to the joint and how to specifically target these cells therapeutically.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Immunology research is driving toward individualized treatment for each person with autoimmune and immune-mediated diseases. Each persons genetics, environment and immune system mechanisms are unique, and people react to therapies differently and their responses may change over time. The optimal approach will be to individualize health care for each person and offer the right treatment at the right time. A key 2013 advancement was In a study of the protein, Thymic Stromal Lymphopietin TSLP in allergic responses, the scientific team used lung cancer as a negative control group and surprisingly found very high levels of the protein in people with lung tumors. This led to new research on how blocking a particular molecule in metastatic breast cancer reduces both the growth of primary tumors and the number of lung metastases. BRI scientists have found in models of the disease that blocking this protein can shrink tumors by 60 - 80 and can keep the tumor from metastasizing or spreading to the lung. The goal of this work is to help develop a therapy to reduce primary breast cancer tumors, as well as the spread of this cancer to other areas.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4c</FormAndLineReferenceDesc>
        <ExplanationTxt>Clinical research studies are conducted with volunteers who participate in experimental medical approaches not available outside the clinical trial setting, and play a major role in pushing the boundaries of knowledge about their disease and new therapies. BRI conducts over 450 clinical trials annually involving over 150 investigators in many different diseases through a Diabetes Research Program partnership with Seattle Childrens, TrialNet and the National Institutes of Health NIH trials with the NIH-funded Immune Tolerance Network and the BRI Clincial Research Program with physicians at Virginia Mason Medical Center. Advancements in 2013 include 1 Establishment of the T1D Exchange Biobank Operations Center to coordinate type 1 T1D diabetes clincial study proposals and biobank sample requests including protocol design, sample procurement and distribution. The biobanks goal is to distribute, share and exchange meaningful data and biosamples to drive collaboration and disseminate knowledge across the type 1 diabetes community. 2 Groundbreaking clinical research conducted by two multi-institutional consortia, both led by a BRI clinical investigator, which successfully tested new treatment approaches for hepatitis C. The first study showed that 12 weeks treatment with a multidrug cocktail achieved a cure in more than 93 percent of noncirrhotic HCV genotype 1 patients, incluging those with prior nonresponse to interferon-based therapy. The second study showed that a one-pill once a day regimen combining a fixed dose of two drugs achieved a cure of 94 percent in HCV genotype 1 patients with cirrhosis. Because some patients are nonresponsive to interferon-based therapies, and because the side effects of interferon cannot be tolerated by all patients, these new treatment approaches are a significant advance that will give many hepatitis C patients new hope and a pathway to a cure. It is also hoped that through these discoveries, there is the potential to eradicate heptatis C.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4d</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Advances. Using state-of-the-art techniques, scientists demonstrated that different vaccines lead to immunity via distinct immune response pathways. This study utilized a systems immunology approach and high-throughput profiling techniques to analyze the molecular and cellular responses following vaccination. By understanding the immune pathways by which these vaccines work, scientists can better guide the development of effective vaccines for other infectious diseases. The published results feature interactive figures that allow for dynamic investigation of the primary data from a web portal that was developed as part of this study and could serve as a model for future scientific publishing and data sharing.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing body delegates to an Executive Committee comprised of four officers of the Board and the Chairs of each standing Board Committee, the authority of the Board of Directors in the management of the corporation as may be deemed by the Executive Committee to be appropriate, to be exercised in time periods between regularly scheduled meetings of the Board of Directors provided that the Executive Committee has the authority to act only in time sensitive or emergency situations. The Director and the Executive Director of the corporation serve as ex officio members of the Executive Committee without voting rights. The Executive Committee does not have the authority to amend, alter or repeal the bylaws elect, appoint or remove any member of such Executive Committee or any director or officer of the corpration amend the articles of incorporation adopt a plan of merger or adopt a plan of consolidation with another corporation authorize the sale, lease or exchange of all or substantially all the property and assets of the corporation not in the ordinary course of busines authorize the voluntary dissolution of the corporation or revoke proceedings therefore adopt a plan for the distribution of the assets of the corporation or amend, alter or repeal any resolution of the Board which by its terms provides that it shall not be amended, altered or repealed by such Executive Committee. The Executive Committee also serves as the planning committee for the Board of Directors and oversees any compliance issues raised by the Board of Directors.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization amended its Bylaws to a limit the authority of the Executive Committee to act on time sensitive or emergency situtations, as determined by the Executive Committee b rename the Finance and Audit Committee to the Finance Committee and it will make recommendations regarding acceptance of the audit as presented to the sole voting member c revised the Treasurers duties to provide that he/she shall manage, with the Finance Committee, the Boards review of and action related to its fiduciary responsibilities including overseeing presentation of the annual budget, working with the Chief Financial Officer to ensure appropriate and timely finanical reports are made to the Board, and oversight of presentations to the Board regarding the audit and Form 990 tax return.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6,7</FormAndLineReferenceDesc>
        <ExplanationTxt>Virginia Mason Health System VMHS is the sole corporate member of Benaroya Research Institute at Virginia Mason BRI. VMHS as the sole voting member has the following approval rights a election or appointment of Directors and Officers of the Board of Directors b removal of Directors and Officers of the Board of Directors including any executive officer of the corporation c approval of all long-range and short-range plans proposed by the Board of Directors d approval of the annual capital and operating budgets proposed by the Board of Directors e approval of the borrowing of funds where the amount borrowed is in excess of Five Hundred Thousand Dollars 500,000 f approval of the sale, lease, exchange, mortgage, pledge or disposal of all or substantially all of the property and assets g approval of all amendments to or repeal of the Agreement Association or the Bylaws of the corporation h all other rights and powers as specified in the Washington Nonprofit Corporation Act.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Virginia Mason Health System Audit and Compliance Committee ACC, a committee composed of independent community members has been delegated responsibility for oversight of the annual Form 990 preparation process including a selection, engagement, and review of the performance of the independent tax preparer b review of the annual draft Form 990 tax return, and c recommendation of the final Form 990 tax return for review to the BRI Board of Directors. Annually, at the September meeting, management and the tax preparer provides ACC with an initial draft of the Form 990 and present an overview of the Form 990 preparation process. The final draft Form 990 is reviewed and approved by the ACC in November followed by a Board review of the final Form 990 prior to filing. The final Form 990 tax return is provided to each member of the Board of Directors via electronic delivery.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Virginia Mason Health System Governance Committee has been delegated accountability for oversight of the process for disclosure, evaluation and management of conflict of interest involving any member of the Benaroya Research Institute at Virginia Mason BRI Board of Directors, executive leadership or key employees Covered Person. Pursuant to the Conflict of Interest Policy, an annual conflict of interest questionnaire is distributed to all Covered Persons. In addition, a Covered Person has an on-going duty to disclose the existence of 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 person has a received a copy of the Conflict of Interest Policy b has read and understands the Policy c has agreed to comply with the Policy and d understands that BRI is a charitable organization and that in order to maintain its federal tax exemption must engage 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 it should be managed. The Covered Person 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 BRIs 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 has 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 Conflict of Interest Policy requires that copies of the Conflict of Interest Questionnaires be completed annually by each Covered Person any any Conflict of Interest Management Plan be maintained.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The VMHS Compensation and Benefits Board Committee, a committee composed solely of independent directors none of whom have a conflict of interest, is accountable for setting reasonable total compensation packages for each executive, officer and key employee Executive consistent with VMHS/BRIs philosophy and principles. The Committee approves annual goals and performance criteria which are used in determining merit increases and variable compensation opportunities. 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 of the Executives. The Committee as part of its analysis obtains from the compensation consultant appropriate comparability data including total compensation paid by similarly situated organizations for positions that are functionally comparable to each of the Executives. The Committee will consider the significant terms of the agreement with each Executive including the total compensation to be paid and the employees duties and responsibilities. Consistent with VMHS/BRIs 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 interest of BRI. The Committees decisions regarding compensation for each Executive are documented in written resolutions and minutes of the Committee. The Committee promptly reports its actions to the VMHS board which reports are reflected in the Boards minutes. The individual positions who were reviewed in 2013 were the Board Director, Carla Greenbaum, and Vice President, Research Executive Director and Chief Financial Officer.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organizations Articles, Bylaws, Conflict of Interest Policy and financial statements are made available upon request.</ExplanationTxt>
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