2013-06-13T10:25:48-05:00 2012-12-31 910189318 MOSS ADAMS LLP 1301 A STREET SUITE 600 TACOMA WA 984024205 990 2012-01-01 262377858 THE CAROL MILGARD BREAST CENTER CARO 2537592622 4525 S 19TH ST TACOMA TACOMA WA 98405 JACQUELYN OSTROM 2533831099 2013-06-06 1 NANCY J SCHAUER P01326437 2535724100 2012 2016-03-07 17:11:31Z JACQUELYN OSTROM PO BOX 1535 TACOMA WA 98401 11897903 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 26694 60187 11812731 11834935 6281 2781 0 0 11845706 11897903 29591 31645 1160358 0 0 0 0 0 14671 12164896 11629143 13354845 11660788 -1509139 237115 12091449 12234824 955459 861719 11135990 11373105 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 82950 OUTREACH TO UNDERSERVED POPULATIONS -- THE CENTER HELD 8 MAMMOGRAPHY SCREENING EVENTS DURING 2012, SERVING 131 PATIENTS. ONE OF THESE EVENTS WAS LAMUJER, FOCUSED ON LATINA WOMEN. THIS WAS HELD IN COLLABORATION WITH THE SUSAN G KOMEN FOUNDATION, AND FUNDED BY YOPLAIT. DURING SCREENING EVENTS, THE CENTER PROVIDES FINANCIAL AID TO ATTENDEES WITH THE SUPPORT OF: ITS OWNER SYSTEMS AND THEIR FOUNDATIONS, INDIVIDUAL DONOR GIFTS AND WITH THE HELP OF PROGRAMS LIKE THE BREAST COLON AND CERVICAL HEALTH PROGRAM AND MEDICAID.BASED ON FINDINGS FROM THE NEEDS-BASED COMMUNITY ASSESSMENT REPORT, THE CENTER COMPLETED SEVEN LISTENING SESSIONS ENGAGING 79 WOMEN FROM THE AFRICAN AMERICAN COMMUNITY. THESE SESSIONS WERE HELD IN CHURCHES WITH PREDOMINANTLY AFRICAN AMERICAN CONGREGATIONS. THE QUALITATIVE INFORMATION GATHERED WILL BE USED TO DEVELOP A COMMUNITY-BASED BREAST HEALTH AWARENESS PILOT PROGRAM IN 2013.IN 2012, WITH GRANT FUNDING, THE CENTER TRANSLATED ITS PATIENT HISTORY FORMS AND FINANCIAL AID FORMS INTO FIVE LANGUAGES SPOKEN MOST OFTEN BY THE CENTER'S NON ENGLISH SPEAKING PATIENTS. 77171 31645 BREAST HEALTH EDUCATION -- THROUGH 2012, THE CENTER PARTICIPATED IN SEVERAL COMMUNITY-BASED BREAST HEALTH EDUCATION EVENTS. SPECIFICALLY, THE CENTER'S STAFF AND VOLUNTEERS WERE PART OF 13 HEALTH EVENTS, ENGAGING LANTINA, GLBTQ, AFRICAN AMERICAN, RUSSIAN, MILITARY, KOREAN AND VIETNAMESE COMMUNITY MEMBERS.CENTER RADIOLOGISTS AND PATIENTS SPOKE AT TWO LARGE COMMUNITY EVENTS, WHILE THE EXECUTIVE DIRECTOR WAS INTERVIEWED ON RADIO. THE CENTER LAUNCHED ITS NEW WEBSITE IN OCTOBER OF 2012; THE WEBSITE FEATURES EXTENSIVE INFORMATION ABOUT BREAST HEALTH AND OFFERS A VARIETY OF LINKS TO ITS OWNER SYSTEMS AND OTHER COMMUNITY RESOURCES SUCH AS THE AMERICAN CANCER SOCIETY, SUSAN G KOMEN FOUNDATION, ANGELCARE FOUNDATION AND OTHERS.THE CENTER WORKED WITH THE TACOMA-PIERCE COUNTY HEALTH DEPARTMENT, FRANCISCAN HEALTH SYSTEM AND MULTICARE HEALTH SYSTEM TO REVIEW AND WIDELY DISTRIBUTE A STUDY ABOUT MAMMOGRAPHY UTILIZATION AND BREAST CANCER IN PIERCE COUNTY. 8759155 11834935 PATIENT CARE SERVICES -- IN 2012, THE CENTER SERVED 33,847 PATIENTS, PROVIDING 91,194 EXAMS AND PROCEDURES. 8919276 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 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 6 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 1.00 X 0 0 0 SR ANNE MCNAMARA 1.00 X 0 0 0 SALLY LEIGHTON 1.00 X 0 0 0 DEEDRA WALKEY 1.00 X 0 0 0 CARI MILGARD-DEGOEDE 1.00 X 0 0 0 PAULA SCHULZE MD 1.00 X X 0 0 0 SHARON SNUFFIN 1.00 X X 0 0 0 PETER NORMAN 1.00 X X 0 0 0 DIANE DIMMER 1.00 X 0 0 0 DIANE CECCHETTINI 1.00 X 0 0 0 JOSEPH WILCZEK 1.00 X 0 0 0 JACQUELYN OSTROM 40.00 X X 146443 0 27531 SHELLY MULLIN 2.00 X 0 0 0 MARY LAFALCE 2.00 X 0 0 0 146443 0 27531 1 0 1 1 TACOMA RADIOLOGICAL ASSOCIATES 1304 FAWCETT AVE STE 200 TACOMA WA 98402 MANAGEMENT, BILLING, PROFESSIONAL SERVIC 7260839 HOLOGIC INC 24506 NETWORK PLACE CHICAGO IL 60673 EQUIPMENT MAINTENANCE 406133 RUSH PROPERTIES 6622 WOLLOCHET DR NW GIG HARBOR WA 98335 REPAIRS 242215 GE MEDICAL SYSTEMS PO BOX 843553 DALLAS TX 75284 EQUIPMENT MAINTENANCE 176378 MCKESSON PO BOX 98347 CHICAGO IL 60693 EQUIPMENT MAINTENANCE 168536 5 60187 60187 PATIENT SERVICES 621300 11954613 11954613 BAD DEBTS 621300 -119678 -119678 11834935 2781 2781 11897903 11834935 0 2781 X 31645 31645 179140 179140 10439 10439 50964 50964 6875560 5833828 1027061 14671 44066 44066 151671 26914 124757 50668 50668 307146 307146 1275736 1076721 199015 42381 42381 REPAIRS & MAINTENANCE 1100099 825774 274325 MEDICAL SUPPLIES 643083 643083 COMPASSIONATE CARE 481311 481311 TAXES & LICENSES 244255 244255 172624 172624 11660788 8919276 2726841 14671 608416 347732 3500177 5002035 78148 138183 1468305 1401059 56915 100887 10341243 5096315 6379488 5244928 12091449 12234824 473178 644190 482281 217529 955459 861719 X 11135990 11373105 11135990 11373105 12091449 12234824 237115 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3844082 954064 2890018 6448456 4124761 2323695 48705 17490 31215 5244928 X 11897903 0 11897903 0 11897903 11660788 0 11660788 0 11660788 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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, 2012 AND 2011. 1 AMERICAN CANCER SOCIETY MAKING STRIDES FLAGSHIP SPONSOR 1313 BROADWAY SUITE 100 TACOMA WA 98402 131788491 501 (C) (3) 10000 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 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANT AMOUNTS ARE APPROVED BY THE BOARD OF DIRECTORS. 0 0 0 0 0 0 0 0 0 JACQUELYN OSTROM 146443 0 0 0 0 0 10479 0 17052 0 173974 0 0 0 SUPPLEMENTAL INFORMATION PART III DURING 2012, 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 LOANED 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 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO PUBLIC UPON WRITTEN REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 5,833,828. MANAGEMENT AND GENERAL EXPENSES 1,027,061. FUNDRAISING EXPENSES 14,671. TOTAL EXPENSES 6,875,560.