2012-04-12T19:55:33-05:00 2011-06-30 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2010-07-01 911935159 SEATTLE CANCER CARE ALLIANCE SEAT 2062881000 825 EASTLAKE AVENUE EAST PO BOX 19023 SEATTLE WA 981091023 JONATHAN TINGSTAD 2062881000 2012-04-09 1 SARA ELIZABETH J HYRE 4254544919 2010 2016-02-24 21:20:13Z FRED APPELBAUM MD 1100 FAIRVIEW AVE N SEATTLE WA 98109 530448732 0 X WWW.SEATTLECCA.ORG X 1998 WA SEATTLE CANCER CARE ALLIANCE (SCCA) IS A CANCER TREATMENT CENTER THAT UNITES (SEE SCHEDULE O) DOCTORS FROM FRED HUTCHINSON CANCER RESEARCH CENTER, UW MEDICINE AND SEATTLE CHILDREN'S. OUR GOAL, EVERY DAY, IS TO TURN CANCER PATIENTS INTO CANCER SURVIVORS. OUR PURPOSE IS TO LEAD THE WORLD IN THE PREVENTION AND TREATMENT OF CANCER. 15 15 1168 250 0 0 3407869 8779628 281020389 318736590 4535126 5409272 0 29158 288963384 332954648 815215 1122767 0 0 71421408 79761116 5874 0 0 191676279 220781365 263918776 301665248 25044608 31289400 351917541 404530310 135125881 160392342 216791660 244137968 X SEATTLE CANCER CARE ALLIANCE UNITES THE DOCTORS FROM FRED HUTCHINSON CANCER RESEARCH CENTER, UW MEDICINE, AND SEATTLE CHILDREN'S. OUR GOAL IS TO TURN CANCER PATIENTS INTO CANCER SURVIVORS. OUR PURPOSE IS TO LEAD THE WORLD IN THE PREVENTION AND TREATMENT OF (SEE SCHEDULE O) CANCER. WITH OUR PARENT ORGANIZATIONS, SCCA IS HOME TO THE WORLD'S BEST SURGEONS, MEDICAL ONCOLOGISTS, RADIATION ONCOLOGISTS, PATHOLOGISTS AND RADIOLOGISTS. PATIENTS RECEIVE THE LATEST CUSTOMIZED COURSE OF TREATMENTS AND THERAPIES FOR CANCER AND HAVE ACCESS TO NEW DRUGS AND ALTERNATIVE TREATMENTS THAT ARE UNDER INVESTIGATION IN CLINICAL STUDIES ONLY AVAILABLE AT SCCA AND LIMITED SITES AROUND THE COUNTRY. THE HUTCHINSON CENTER, WITH ITS PARTNERS UW, SEATTLE CHILDRENS AND SCCA COMPRISE THE FRED HUTCHINSON/UW CANCER CONSORTIUM. THE CONSORTIUM IS ONE OF 40 COMPREHENSIVE CANCER CENTERS DESIGNATED BY THE NATIONAL CANCER INSTITUE (NCI) AND HAS RECEIVED MORE FUNDING FOR CANCER RESEARCH THAN ANY OTHER NCI SITE IN THE COUNTRY. 1 0 225053441 1076731 317359813 SCCA'S FOCUS IS TO SPEED UP THE TRANSFER OF NEW DIAGNOSTIC AND TREATMENT TECHNIQUES FROM THE RESEARCH SETTING TO PATIENT CARE. THE HIGHLY INTEGRATED APPROACH TO CANCER RESEARCH AND TREATMENT AMONG SCCA PARTNER ORGANIZATIONS SUPPORTS THE FLOW OF SCIENTIFIC INFORMATION AMONG RESEARCHERS, CLINICIANS, AND PATIENTS, THEREBY ACCELERATING THE DEVELOPMENT OF NEW KNOWLEDGE AND TREATMENT OF VARIOUS CANCERS. DURING THE YEAR ENDED JUNE 30, 2011, SCCA TREATED 5508 NEW PATIENTS WITHIN THE CANCER AND BONE MARROW/STEM CELL TRANSPLANT PROGRAMS. SCCA ALSO HAD 72,217 CLINIC VISITS, 74,270 INFUSION HOURS, 11,861 RADIATION ONCOLOGY TREATMENTS, AND PERFORMED 44,700 IMAGING SCANS. 1788405 46035 986682 SEATTLE CANCER CARE ALLIANCE (SCCA) HOUSE OPENED IN SEPTEMBER 2009 AS A TEMPORARY MEDICAL HOUSING FACILITY. IT IS AN 80-ROOM FACILITY THAT PROVIDES AN AFFORDABLE HOME FOR CANCER PATIENTS AND THEIR FAMILIES WHO COME TO SEATTLE FOR EXTENDED TREATMENT WITH SCCA. THE SIX-STORY "BUILT GREEN" BUILDING WAS DESIGNED TO ADDRESS PATIENTS' PHYSICIAL, EMOTIONAL, AND LOGISTICAL CHALLENGES. SCCA HOUSE IS LOCATED VERY CLOSE TO THE SCCA OUTPATIENT CLINIC AND OFFERS SHUTTLE SERVICE TO THE SCCA CLINIC, WELLNESS AND EXERCISE ROOMS AS WELL AS A ROOFTOP GARDEN. THE COMMON AREAS SERVE AS MEETING CENTERS FOR OUR COMMUNITY PARTNERS. THE SCCA HOUSE IS AN EXAMPLE OF SCCA'S COMMITTMENT TO THE MISSION OF PROVIDING FAMILY CENTERED PATIENT CARE. 226841846 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 1 1 146 0 1 1168 1 0 0 0 0 0 0 0 0 0 0 X 15 15 1 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 0 AL AK AZ AR CO CT FL HI IL KS KY ME MD MA MI MN MS MO NH NJ NM NY NC ND OH OK OR PA SC TN UT VA WA WV WI X JONATHAN TINGSTAD 2062882260 825 EASTLAKE AVENUE EAST PO BOX SEATTLE WA 98109 RICH JONES 3.00 X 0 0 0 SUE ALBRECHT 1.00 X 0 0 0 BOB GERTH 6.00 X X 0 0 0 SHAN MULLIN 3.00 X X 0 0 0 CARL BEHNKE 3.00 X 0 0 0 MARK GROUDINE MD PHD 2.00 X 0 0 0 MYRA TANITA 3.00 X 0 0 0 JONELLE JOHNSON 2.00 X 0 0 0 RUTH MAHAN 2.00 X 0 0 0 BROOKS RAGEN 7.00 X X 0 0 0 KATHY RANDALL 1.00 X 0 0 0 ROBB BAKEMEIER 6.00 X X 0 0 0 PAT HAGAN 2.00 X 0 0 0 JOHNESE SPISSO 2.00 X 0 0 0 BRUDER STAPLETON MD 1.00 X 0 0 0 FRED APPELBAUM MD 6.00 X 152640 0 0 NORMAN HUBBARD 40.00 X 438652 0 47263 MADELINE BUELT 40.00 X 359536 0 53220 F MARC STEWART MD 20.00 X 253900 0 0 JONATHAN TINGSTAD 40.00 X 376449 0 53191 JOSEPH NORTON 40.00 X 199553 0 40026 CHERYL WYMAN 40.00 X 198815 0 32584 DAVID ACKERSON 40.00 X 195699 0 28665 ALEANA WAITE 40.00 X 177526 0 31997 ZAKARIA RAMADAN-JRADI 40.00 X 173919 0 24824 DEBORAH STENHJEM 40.00 X 163314 0 30296 KRISTINE LOGAN 40.00 X 156020 0 23300 DEBORAH GENTZEN 40.00 X 195406 0 40083 JAN WATTERSON 40.00 X 148894 0 27235 ALPHONSO EMERY 40.00 X 143739 0 19764 MOREEN DUDLEY 40.00 X 141778 0 25870 MICHELLE HALL 40.00 X 137965 0 27141 MARGARET OWENS 40.00 X 149832 0 33091 3763637 0 538550 51 0 1 1 UNIVERITY OF WASHINGTON 1959 NE 59TH AVE SUITE 1005 SEATTLE WA 98104 HEALTHCARE, SERVICES, SUPPLIES, ADMIN 137606981 FRED HUTCHINSON CANCER RESEARCH CENTER 1100 FAIRVIEW AVE N SEATTLE WA 98109 ADMIN, SUPPORT, & SERVICES CONSULTING 16995500 SEATTLE CHILDRENS HOSPITAL PO BOX 50020 SEATTLE WA 98145 HEALTHCARE SERVICES 7784463 NATIONAL MARROW DONOR PROGRAM 3001 BROADWAY ST NE 500 MINNEAPOLIS MN 55413 MARROW TRANSPLANT SERVICES 6965988 PUGET SOUND BLOOD CENTER 921 TERRY AVENUE SEATTLE WA 98104 BLOOD & TISSUE SERVICES 4223724 111 340297 8439331 395205 8779628 CANCER HOSP/OUTPATIENT 621400 244720382 244290326 430056 MEDICARE/MEDICAID PMTS 900099 72544959 72544959 PATIENT HOUSING 900099 986682 986682 INTERAFFILIATE AGREEME 900099 484567 484567 318736590 1188305 1188305 272 272 201479383 61909 197075854 244743 4403529 -182834 4220695 4220695 202645 173487 29158 29158 332954648 318306534 0 5868486 357537 357537 765230 765230 3931391 520598 3410793 58181888 37882452 20299436 3313839 2190605 1123234 9296626 5862756 3433870 5037372 3132086 1905286 41203317 20352763 20850554 1369770 1369770 330229 330229 154973 154973 88237 88237 62933772 60262645 2671127 2619644 2605290 14354 76268504 71424114 4844390 1953419 169692 1783727 373161 373161 4700627 937731 3762896 410184 147876 262308 723360 56029 667331 6458247 6458247 13437617 6520283 6917334 602236 358767 243469 BUSINESS TAXES 5749031 5587210 161821 BAD DEBT 788578 788578 DUES & SUBSCRIPTIONS 312188 20902 291286 MISCELLANEOUS 234725 4379 230346 SHARED RESOURCES 66286 62915 3371 3260 3260 301665248 226841846 74823402 0 1371507 13543965 27250232 64455064 53094164 55740367 2546616 3075374 2460770 2455474 179976861 70360250 88962938 109616611 148740390 105392201 29500000 16010937 14769832 11479987 5981422 351917541 404530310 49249759 54655069 22905 455 85853217 105736818 135125881 160392342 X 214369833 242403683 1621457 833920 800370 900365 216791660 244137968 351917541 404530310 X 31289400 -3943092 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 86289 0 1 68684 154973 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: FRED HUTCHINSON CANCER RESEARCH CENTER GOVERNMENT AFFAIRS OFFICES WORK WITH LOCAL AND NATIONAL GOVERNMENTS FOR ISSUES FACING SEATTLE CANCER CARE ALLIANCE. AMOUNT EXPENDED = $26,250 WASHINGTON STATE HOSPITAL ASSOCIATION REPRESENTS MEMBER INTERESTS ON THE LOCAL AND STATE LEVEL. THIS AMOUNT REFLECTS DUES ALLOCATED TO LEGISLATIVE EFFORTS = $25,616 ASSOCIATION OF DEDICATED CANCER CENTERS REPRESENTS MEMBER INTERESTS AT THE NATIONAL LEVEL. AMOUNT EXPENDED = $16,818 800371 112671 12677 900365 757066 43305 800371 885589 -128523 757066 1.00000 1 0 2217938 2217938 114447191 32221165 82226026 1338495 793534 544961 45156659 30327971 14828688 16816578 7017580 9798998 109616611 INVESTMENT IN SEATTLE PROCURE HOLDINGS, LLC 29500000 F 29500000 332954648 301665248 31289400 -2668833 -1063566 -3732399 27557001 331620000 -2668833 1150896 -1517937 333137937 -183289 -183289 332954648 303328000 1750595 1750595 301577405 88237 -394 87843 301665248 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INCOME FROM PERMANENTLY RESTRICTED ENDOWMENT FUNDS IS USED FOR THE PURPOSE OF PROVIDING UNCOMPENSATED PATIENT CARE. PART XI, LINE 8 - OTHER ADJUSTMENTS: SCCAH CHANGE IN NET ASSETS PER RETURN -1,032,710. IMPAIRMENT LOSSES -143,405. ROUNDING -122. UNREALIZED GAINS ON PERMANENTLY RESTRICTED ASSETS 112,671. PART XII, LINE 2D - OTHER ADJUSTMENTS: IMPAIRMENT LOSS -143,405. REVENUE REPORTED ON SCCAH RETURN 456,208. INVESTMENT EXPENSE -88,237. ROUNDING 161. RESTRICTED REVENUE RELEASES 813,498. UNREALIZED GAINS ON PERMANENTLY RESTRICTED ASSETS 112,671. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST INCOME ELIMINATED UPON CONSOLIDATION 94,644. GAIN/LOSS DISPOSAL OF FIXED ASSETS -182,834. COST OF GOODS SOLD REPORTED ON PART VIII -173,487. RESTRICTED REVENUES RELEASED -807,719. RESTRICTED CONTRIBUTION REVENUE 773,436. UNREALIZED GAINS ON PERMANENTLY RESTRICTED ASSETS 112,671. PART XIII, LINE 2D - OTHER ADJUSTMENTS: GAIN/LOSS ON DISPOSAL OF FIXED ASSETS 182,834. EXPENSE REPORTED ON SCCAH RETURN 1,488,918. COST OF GOODS SOLD REPORTED ON PART VIII 173,487. INTEREST EXPENSE ELIMINATED UPON CONSOLIDATION -94,644. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING -394. EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICE BLOOD/BLOOD PATHOGENS 1500 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICE BLOOD/BLOOD PATHOGENS 1594726 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICE BLOOD/BLOOD PATHOGENS 391054 NORTH AMERICA 0 0 PROGRAM SERVICE BLOOD/BLOOD PATHOGENS 56425 NORTH AMERICA 0 0 SOFTWARE PROCUREMENT N/A 47645 NORTH AMERICA 0 0 STUDY N/A 675 NORTH AMERICA 0 0 SUPPLIES N/A 17594 RUSSIA & THE NEWLY INDEPENDENT STATES 0 0 PROGRAM SERVICE BLOOD/BLOOD PATHOGENS 626 SOUTH AMERICA 0 0 PROGRAM SERVICE BLOOD/BLOOD PATHOGENS 4064 0 0 0 0 0 0 2110245 4064 2114309 0 0 0 0 0 0 PROCEDURE FOR MONITORING GRANTS OUTSIDE THE U.S.: SCHEDULE F, PART I, LINE 2: SCCA SOURCES PERIPHERAL BLOOD STEM CELLS MARROW AND CORD BLOOD FROM ALL OVER THE WORLD TO TREAT TRANSPLANT PATIENTS. IN DELIVERING STEM CELL TRANSPLANT SERVICES, SCCA SEEKS OUT THE MOST APPROPRIATE DONOR BASED ON CRITERIA OF HUMAN LEUKOCYTE ANTIGEN MATCH AND OTHER PERTINENT DONOR CRITERIA. HAVING THE CLOSEST POSSIBLE BONE MARROW DONOR MATCH IS CRUCIAL TO THE SURVIVAL OF THE PATIENT. ALSO, SOME OF THE FOREIGN DONOR ORGANIZATIONS HAVE HIGHER LEVELS OF TYPING ON THEIR DONOR WHICH REDUCED PATIENT COSTS. 1 1 1 X 1 X 1 1 1 0 1 1 3173638 3173638 0.01050 33305759 20690962 12614797 0.04190 3162794 2606526 556268 0.00180 39642191 23297488 16344703 0.05420 1571563 1571563 0.00520 3843352 16090 3827262 0.01270 3334112 3334112 0.01110 1125074 1125074 0.00370 9874101 16090 9858011 0.03270 49516292 23313578 26202714 0.08690 17067 17067 0.00010 1443 1443 0.00000 18510 18510 0.00010 1 2225978 44108021 48380251 -4272230 X 1 1 1 1 SEATTLE CANCER CARE ALLIANCE

1959 NE PACIFIC STREET SEATTLE WA 98195

X X ACUTE CARE HOSPITAL SEATTLE CANCER CARE ALLIANCE 1 3 SEATTLE CANCER CARE ALLIANCE HOUSE

207 PONTIUS AVE N SEATTLE WA 98109

TEMPORARY MEDICAL HOUSING FACILITY SCCA NW HSPTL RADIATION ONCOLOGY CLNC

1560 N 115TH ST - SUITE G-16B SEATTLE WA 981338498

HOSPITAL BASED OUTPATIENT CLINIC SEATTLE CANCER CARE ALLIANCE

825 EASTLAKE AVE E SEATTLE WA 98109

HOSPITAL BASED OUTPATIENT CLINIC PART I, LINE 3C: IN ACCORDANCE WITH WAC 246-453-040 AND SUBJECT TO SCCA FINANCIAL RESOURCES, PATIENTS WILL BE ELIGIBLE TO BE CONSIDERED FOR CHARITY CARE IF THEY SUBMIT THE NECESSARY APPLICATION AND IF THE PARTY RESPONSIBLE FOR PAYMENT HAS A FAMILY INCOME AT OR BELOW 300% OF THE FEDERAL POVERTY STANDARD AS ADJUSTED FOR FAMILY SIZE. IF THE PARTY RESPONSIBLE FOR PAYMENT HAS A FAMILY INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY STANDARD AS ADJUSTED FOR FAMILY SIZE, THE PATIENT WILL BE ELIGIBLE FOR CHARITY CARE IN THE AMOUNT EQUAL TO THE UNPAID BALANCE REMAINING AFTER ALL SOURCES OF THIRD PARTY COVERAGE AND SPONSORSHIP HAVE BEEN EXHAUSTED. IF THE PARTY RESPONSIBLE FOR PAYMENT HAS A FAMILY INCOME BETWEEN 200% AND 300% OF THE FEDERAL POVERTY STANDARD AS ADJUSTED FOR FAMILY SIZE, THE PATIENT WILL BE ELIGIBLE FOR CHARITY CARE BASED ON A SLIDING FEE SCALE FOR THE UNPAID BALANCE REMAINING AFTER ALL SOURCES OF THIRD PARTY COVERAGE AND SPONSORSHIP HAVE BEEN EXHAUSTED. RESPONSIBLE PARTIES WHOSE INCOME EXCEEDS 300% OF THE FEDERAL POVERTY STANDARD AS ADJUSTED FOR FAMILY SIZE BUT WHO HAVE INCURRED CATASTROPHIC ACCOUNT BALANCES AFTER ALL SOURCES OF THIRD PARTY COVERAGE AND SPONSORSHIP WILL BE CONSIDERED FOR CHARITY CARE ON A CASE BY CASE BASIS. PART I, LINE 6A: SCCA COMPLETED AN ANNUAL REPORT FOR FY11 AND IT INCLUDES A COMMUNITY BENEFIT REPORT. IT IS MADE AVAILABLE TO THE PUBLIC AT THE FRONT DESK. PART I, LINE 7: SCCA UTILIZED WORKSHEET 2 TO ARRIVE AT A COST TO CHARGE RATIO FOR COMPLETING LINE 7. PART I, LINE 7G: SCCA DID NOT REPORT AMOUNTS ON LINE 7G. PART I, L7 COL(F): BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX WAS $788,578. IT WAS SUBTRACTED UTILIZING WORKSHEET 1 FROM THE TOTAL ON FORM 990, PART IX TO ARRIVE AT THE DENOMINATOR USED TO CALCULATE THIS COLUMN. PART II: COMMUNITY SUPPORT:SCCA ORGANIZES AND PARTICIPATES IN THE RADIATION INJURY TREATMENT NETWORK (RITN) AS A TREATMENT CENTER, DONOR CENTER AND CORD BLOOD CENTER. THE RITN SERVES AN ESSENTIAL ROLE IN THE UNITED STATES RADIOLOGICAL EMERGENCY RESPONSE PLAN. THE RITN PROVIDES COMPREHENSIVE EVALUATION AND TREATMENT FOR VICTIMS OF RADIATION EXPOSURE OR OTHER MARROW TOXIC INJURIES. RITN DEVELOPS TREATMENT GUIDELINES, EDUCATES HEALTHCARE PROFESSIONALS, WORKS TO EXPAND THE NETWORK, AND COORDINATES SITUATION RESPONSE. AS A RITN PARTICIPANT, WE PROVIDE 'READY' FACILITIES WITH PRACTICING SPECIALIST STAFF FOR INTENSIVE SUPPORTIVE CARE AND TREATMENT EXPERTISE IN THE AFTERMATH OF A MARROW TOXIC INCIDENT RESULTING IN MASS CASUALTIES. THIS PROGRAM EDUCATES THE HEMATOLOGISTS, ONCOLOGISTS AND STEM CELL TRANSPLANT PRACTITIONERS ABOUT THEIR POTENTIAL INVOLVEMENT IN THE RESPONSE TO A RADIOLOGICAL INCIDENT.AS A PARTICIPATING CENTER IN OCTOBER 2010, SCCA LEAD A TABLETOP EXERCISE TO ASSIST THE NETWORK IN DESIGNING AN EFFECTIVE RESPONSE TO A SIMULATED OR HYPOTHETICAL, BUT REALISTIC, SITUATION. THIS YEAR'S PARTICIPATION HAD 50 PARTICIPANTS.COMMUNITY HEALTH IMPROVEMENT ADVOCACY:SCCA'S MAMMOGRAPHY VAN PARTICIPATES IN A COMMUNITY GAY PRIDE PARADE EVENT TO RAISE AWARENESS OF THE NEED FOR MAMMOGRAPHY IN THE FIGHT AGAINST BREAST CANCER AND HIGHLIGHT THE FACT THAT CANCER HAS NO BARRIERS. PART III, LINE 4: THE EXPENSE REPORTED ON PART III SECTION A LINE 2 IS BAD DEBT GROSS CHARGES MULTIPLIED BY THE COST TO CHARGE RATIO CALCULATED ON SCHEDULE H WORKSHEET 1 METHODOLOGY.PART III SECTION A LINE 3 IS BLANK FOR THE SCCA. DISCOUNTS ON ACCOUNTS PRIOR TO BAD DEBT STATUS: FOR A PATIENT WHO HAS INSURANCE, CONTRACTUAL ADJUSTMENTS ARE APPLIED TO THE ACCOUNT BASED ON THE INSURANCE COMPANY CONTRACT IN FORCE. THE REMAINING SELF PAY AMOUNTS ARE NOT FURTHER ADJUSTED. FOR A PATIENT WITH NO INSURANCE, A 10% DISCOUNT IS APPLIED AT TIME OF SERVICE. NO OTHER SPECIFIC DISCOUNTS ARE MADE TO PATIENT ACCOUNTS. AMOUNTS WRITTEN OFF TO BAD DEBT EXPENSE REPRESENT THE UNPAID BALANCE AFTER INSURANCE CONTRACTUAL ADJUSTMENT, OR SELF PAY DISCOUNT, AND ANY PAYMENTS RECEIVED. ONCE AN ACCOUNT IS IN BAD DEBT STATUS, ANY PAYMENTS RECEIVED ON A PATIENT ACCOUNT CONTINUE TO REDUCE THE OUTSTANDING PATIENT ACCOUNT LIABILITY.ESTIMATED AMOUNT FOR PATIENTS WHO 'WOULD QUALIFY' FOR FINANCIAL ASSISTANCE:THE SCCA IDENTIFIES PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE AND THE ACCOUNT IS DESIGNATED AS FINANCIAL ASSISTANCE WITH IN THE PATIENT ACCOUNTING SYSTEM. ALL OTHER ACCOUNTS ARE EVALUATED OVER A PERIOD OF TIME THROUGH A SERIES OF CRITERIA BEFORE DESIGNATION AS BAD DEBT. BECAUSE SCCA IS A SPECIALTY HOSPITAL TREATING CANCER PATIENTS, SCCA MAKES EVERY EFFORT IN COMMUNICATING WITH OUR PATIENTS THE PROGRAMS AND FINANCIAL ASSISTANCE POLICIES AVAILABLE TO ITS PATIENT POPULATION BEFORE, DURING AND AFTER TREATMENT IS RECEIVED.COMMUNITY BENEFIT:SCCA BELIEVES THAT BAD DEBT EXPENSE SHOULD BE INCLUDABLE IN THE CALCULATION OF THE COMMUNITY BENEFIT. DUE TO THE NATURE OF HEALTHCARE, WE DO NOT ASSESS A PATIENT'S ABILITY TO PAY FOR THE SELF PAY PORTION OF THEIR HEALTHCARE EXPENSES PRIOR TO PROVIDING SERVICES. AS A RESULT, WE DO NOT GET PAID FOR A CERTAIN PERCENT OF THE SELF PAY ACCOUNTS RECEIVABLE BALANCES. SOME OF THESE PATIENTS ARE TRULY UNABLE TO PAY FOR THEIR OUT-OF-POCKET LIABILITY AND MAY QUALIFY FOR CHARITY CARE, BUT WE ARE UNABLE TO CLASSIFY THESE AMOUNTS AS CHARITY CARE, AS THESE PATIENTS HAVE NOT PROVIDED US WITH A COMPLETED CHARITY CARE APPLICATION ALONG WITH THE NECESSARY SUPPORTING DOCUMENTATION.PAYMENTS RECEIVED BAD DEBT PT ACCOUNTS:ONCE AN ACCOUNT IS IN BAD DEBT STATUS, ANY PAYMENTS RECEIVED REDUCE THE OUTSTANDING PATIENT ACCOUNT BALANCE DIRECTLY.BAD DEBT FOOT NOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS:THE SCCA'S AUDITED FINANCIAL STATEMENTS DO NOT ADDRESS THE ACCOUNTING FOR BAD DEBT EXPENSE. THE SCCA CALCULATES BAD DEBT EXPENSE BASED ON AN ANALYSIS OF THE ACCOUNTS RECEIVABLE AGING. AFTER CONSIDERATION FOR CONTRACTUAL ALLOWANCES, ACCOUNTS ARE SORTED BY DATE OF SERVICE. A BAD DEBT RESERVE PERCENTAGE IS APPLIED TO OLDER ACCOUNTS. THE OLDER THE ACCOUNT, THE HIGHER THE RESERVE PERCENTAGE. ACCOUNTS OVER 1 YEAR OF AGE ARE FULLY RESERVED AS BAD DEBT. ACCOUNTS THAT ARE SENT TO A COLLECTION AGENCY OR WRITTEN OFF DURING A MONTH LOWER THE BAD DEBT RESERVE. AT THE END OF THE MONTH, THE BAD DEBT RESERVE IS RECALCULATED BASED ON THE ACCOUNT AGING AT THE END OF THE MONTH. THE NEWLY CALCULATED RESERVE IS COMPARED TO THE GENERAL LEDGER ACCOUNT AND A MONTHLY ENTRY IS RECORDED TO RECOGNIZE BAD DEBT EXPENSE. THE SCCA DOES NOT EVALUATE ITS ACCOUNTS RECEIVABLE BALANCES OR MAKE ESTIMATES FOR CHARITY CARE. CHARITY CARE IS ONLY RECOGNIZED AFTER A FULL EVALUATION OF A PATIENT'S ELIGIBILITY FOR CHARITY CARE. ONCE DEEMED ELIGIBLE, THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. PART III, LINE 8: SCCA COMPLETED LINE 6 USING THE ALLOWABLE COSTS FROM THE AS FILED MEDICARE COST REPORT FOR FY11. THE METHODOLOGY USED TO COMPLETE THE MEDICARE COST REPORT WAS BASED ON THE CMS PROVIDER REIMBURSEMENT MANUAL PUB 15.SCCA CONSIDERS THE SHORTFALL ON MEDICARE SERVICES TO BE 100% COMMUNITY BENEFIT. HAD SCCA NOT DELIVERED THE SERVICES, THE SERVICES AND FINANCIAL LOSS WOULD FALL TO ANOTHER COMMUNITY HOSPITAL. PART III, LINE 9B: PATIENTS WHO HAVE BEEN APPROVED FOR 100% CHARITY ARE REMOVED FROM THE COLLECTIONS WORKFLOW SO THEIR ACCOUNTS WILL NOT BE SENT TO COLLECTIONS. PATIENTS WHO HAVE BEEN AWARDED TO PARTIAL CHARITY (40% OR 60%) MAY BE SENT TO COLLECTIONS IF THE REMAINING PATIENT BALANCES ARE NOT PAID OR ARRANGEMENTS MADE WITHIN 91 DAYS OF THE FIRST BILLING CYCLE. PART VI, LINE 2: SCCA IS A SPECIALTY HOSPITAL AND OUTPATIENT CLINIC DEDICATED TO LEADING THE WORLD IN TRANSLATING SCIENTIFIC DISCOVERY INTO THE PREVENTION, DIAGNOSIS, TREATMENT AND CURE OF CANCER. IT BRINGS TOGETHER PHYSICIANS FROM THE FRED HUTCHISON CANCER RESEARCH CENTER, SEATTLE CHILDREN'S HOSPITAL AND UNIVERSITY OF WASHINGTON FOCUSED ON FORMULATING AND DELIVERING THE BEST CANCER TREATMENTS AVAILABLE. OUR NEEDS ASSESSMENT STRATEGY IS TO ANALYZE WHERE AND WHAT TYPE OF CANCER IS OCCURRING, DETERMINE WHERE COMPELLING SCIENCE EXISTS AND MAKE INVESTMENTS TO GROW THESE PROGRAMS. SCCA IN CONJUNCTION WITH FRED HUTCHINSON CANCER RESEARCH CENTER, UNIVERSITY OF WASHINGTON, AND SEATTLE CHILDREN'S REVIEWS THE OCCURRENCE RATES IN THE TYPES OF CANCERS IN COMPARISON TO WHERE RESEARCH DOES NOT EXIST AND MAKES STRATEGIC INVESTMENTS TO DEVELOP SCIENCE AND BREAKTHROUGHS IN AREAS OF CANCER NOT BEING PURSUED BY OTHERS. WITH THE COMBINED EFFORTS OF ALL THREE INSTITUTIONS, STATE OF THE ART RESEARCH IS CONDUCTED, DELIVERED TO OUR PATIENT POPULATION AND SHARED WITH THE COMMUNITY. SCCA SHARES INFORMATION WITH THE LOCAL COMMUNITY THROUGH A 24 HOUR TOLL FREE CONSULTATION SERVICE FOR COMMUNITY PHYSICIANS IN WA, OR, AK, MT AND ID. THE SERVICE PUTS COMMUNITY PHYSICIANS IN TOUCH WITH THE RESOURCES OFFERED BY THE UW AND ITS PRIMARY TEACHING HOSPITALS, ALLOWING THEM TO LEARN MORE ABOUT AND TAKE ADVANTAGE OF THE LATEST RESEARCH AND TREATMENT OPTIONS AVAILABLE TO THEIR PATIENTS. THE EXCHANGE OF INFORMATION WITH LOCAL PHYSICIANS HELPS US TO DEVELOP SUPPORT SERVICES THAT BETTER ADDRESS THE UNIQUE CHALLENGES THEY FACE IN THEIR PRACTICES. SCCA PARTICIPATES IN MANY COMMUNITY EVENTS TO DISCUSS CANCER PREVENTION. SHARING OUR KNOWLEDGE WITH PATIENTS AND OTHER PHYSICIANS IS ONE OF THE MOST IMPORTANT WAYS WE ENHANCE THE QUALITY OF CANCER CARE LOCALLY, REGIONALLY AND BEYOND.SCCA HAS A FORMAL COMMUNITY ASSESSMENT PROCESS UNDERWAY THAT IS IN COMPLIANCE WITH THE PATIENT PROTECTION ACT AND 501(R). SCCA IS WORKING WITH AREA HOSPITALS SEEKING TO COMBINE ITS EFFORTS AS WELL AS WITH PUBLIC OFFICIALS REGIONALLY, WITH KING COUNTY DEPARTMENT OF PUBLIC HEALTH, AND NATIONALLY, WITH THE CENTERS FOR DISEASE CONTROL. PART VI, LINE 3: EACH PATIENT ENTERING INTO THE SCCA CLINIC IS GIVEN A BROCHURE DESCRIBING THE FINANCIAL PROGRAMS AVAILABLE WITH THE CONTACT INFORMATION. A FINANCIAL COORDINATOR IS AVAILABLE FREE OF CHARGE TO HELP PATIENTS SIFT THROUGH THE INFORMATION AND WILL ALSO HELP COMPLETE THE NECESSARY PAPERWORK TO APPLY FOR ASSISTANCE. INTERPRETER SERVICES ARE AVAILABLE IF NEEDED AS WELL. PART VI, LINE 4: SCCA IS LOCATED IN SEATTLE, WA. THE PATIENT POPULATION UTILIZING THE SERVICES OF THE SCCA IS PRIMARILY LOCATED IN THE PACIFIC NORTHWEST. HOWEVER, SCCA HAS PATIENTS FROM ALL OVER WORLD. THE REGIONAL POPULATION ESTIMATE FOR THE STATES COMPRISING THE PACIFIC NORTHWEST [WA, OR, ID, MT, AK,] ACCORDING TO THE US CENSUS BUREAU FOR 2010 IS 13,822,842.THE SCCA NETWORK PROGRAM INCLUDES 11 COMMUNITY CANCER CENTER AFFILIATES IN WASHINGTON, ALASKA AND MONTANA WITH FUTURE RELATIONSHIPS BEING DEVELOPED IN WYOMING AND IDAHO. THE AFFILIATIONS ARE WITH COMMUNITY CANCER CENTERS AND PROVIDE ACCESS TO RESOURCES AND THERAPIES FOR ALL THEIR PATIENTS WHICH INCLUDE THE MEDICALLY UNDERSERVED POPULATIONS. THE MEDICALLY UNDERSERVED POPULATION (MUA) PATIENT POPULATION RECEIVES THE BENEFIT OF SCCA'S EXPERTISE WITHOUT HAVING TO LEAVE HOME. THE LOCAL AREA SCCA RESIDES IN CONSISTS OF KING, SNOHOMISH AND PIERCE COUNTIES. THE METROPOLITAN AREA POPULATION ESTIMATE ACCORDING TO THE US CENSUS BUREAU FOR 2010 WAS 3,439,809. KING, SNOHOMISH AND PIERCE COUNTIES ALL HAVE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED COMMUNITIES. KING COUNTY HAS SEVEN FEDERALLY QUALIFIED HEALTH CENTERS, SNOHOMISH COUNTY HAS ONE, AND PIERCE COUNTY HAS TWO. SCCA IS COMMITTED TO PROVIDING PREMIER PATIENT FOCUSED CANCER CARE, SUPPORTING THE CONDUCT OF CANCER CLINICAL RESEARCH AND EDUCATION, ENHANCING ACCESS TO IMPROVED CANCER INTERVENTIONS AND ADVANCING THE STANDARD OF CANCER CARE REGIONALLY AND BEYOND. SCCA HAS DIRECT RELATIONSHIPS WITH A COUPLE OF FEDERALLY QUALIFIED HEALTH CENTERS THAT ARE LOCATED IN A DESIGNATED MUA IN KING COUNTY, WA. PUBLIC HEALTH SEATTLE KING COUNTY (PHSKC) AND SEA MAR COMMUNITY HEALTH CENTERS HAVE SPECIFIC CONTRACTS WITH SCCA AS PART OF OUR OUTREACH SERVICES TO PROVIDE PREVENTIVE HEALTH SCREENINGS AND ALSO SERVE ITS DESIRE TO REACH THE LOCAL UNDERSERVED COMMUNITIES. THE RELATIONSHIP WITH PHSKC IS PART OF THE WASHINGTON BREAST AND CERVICAL HEALTH PROGRAM (WBCHP). THE PURPOSE OF WBCHP IS TO REDUCE MORTALITY AND MORBIDITY FROM BREAST AND CERVICAL CANCER BY EARLY DETECTION OF CANCER THROUGH REGULAR MAMMOGRAM AND PAP TEST SCREENINGS, DIAGNOSTIC SERVICES AND PROMPT ACCESS TO CANCER TREATMENT. SCCA ACCEPTS REFERRALS FROM PHSKC WHEN THE PRIMARY CARE PHYSICIAN HAS DETECTED SOMETHING OF INTEREST. SCCA PERFORMS DIAGNOSTICS AND IF THE PATIENTS ARE DEEMED TO HAVE CANCER WILL TREAT THESE PATIENTS. IN CALENDAR YEAR 2010, SCCA PERFORMED 239 MAMMOGRAMS, 15 BIOPSIES, 30 DIAGNOSTIC MAMMOGRAMS, 28 ULTRASOUNDS AND 1 FINE NEEDLE ASPIRATION FROM THIS CONTRACT WITH PHSKC. SCCA ALSO HAS THE UNIQUE ABILITY TO HELP ENROLL PATIENTS INTO THE WBCHP PROGRAM. ONCE IDENTIFIED BY SCCA, THEY ARE FAST TRACKED AT THE DEPARTMENT OF SOCIAL HEALTH SERVICES OF WASHINGTON INTO WBCHP. PATIENTS WHO COME TO SCCA DIRECTLY TO HAVE A DIAGNOSTIC COMPLETED AND CANCER IS FOUND CAN BE ENROLLED BY THE SCCA IF THEY MEET THE ELIGIBILITY CRITERIA TO GET INTO THE WBCHP. WBCHP IS FUNDED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION, WASHINGTON STATE, PUGET SOUND AFFILIATE SUSAN G. KOMAN BREAST CANCER FOUNDATION AND THE BREAST CANCER PREVENTION FUND.THE RELATIONSHIP WITH SEA MAR IS TO PROVIDE CLINICAL EDUCATION OPPORTUNITIES FOR PRIMARY CARE PROVIDERS IN THE AREAS OF EARLY DETECTION AND PREVENTION OF CANCER AS WELL AS FOSTER CONTINUITY OF CARE FOR PATIENTS WITH IN THE SEA MAR COMMUNITY WHO ARE DIAGNOSED WITH CANCER BETWEEN SEA MAR, SCCA AND SCCA'S NETWORK MEMBERS. SEA MAR IS A COMMUNITY HEALTH CENTER THAT PROVIDES PRIMARY CARE CLINICS TO THE LATINO COMMUNITY BUT ALSO SERVES OTHER ETHNIC GROUPS FROM SOUTHEAST ASIA AND EASTERN EUROPEAN COMMUNITIES. PART VI, LINE 6: SCCA HAS BEEN A PIONEER IN BONE-MARROW TRANSPLANTS. OVER A TEN YEAR PERIOD, SCCA WAS ABLE TO CUT IN HALF THE NEGATIVE OUTCOMES IN THE BONE MARROW TRANSPLANT PROGRAM. IN STUDYING OUR DATA, WE CONCLUDED THAT THERE WAS NO SINGLE INNOVATION THAT ACCOUNTED FOR THE IMPROVEMENT. INSTEAD, SCCA MADE MULTIPLE ADVANCES ON MANY FRONTS. WE DEVELOPED BETTER ANTI-VIRAL AND ANTI-FUNGAL THERAPIES; WE LEARNED TO DO A BETTER JOB OF DONOR MATCHING; AND BY NOTICING THE DRAMATIC DIFFERENCES IN PATIENTS BLOOD LEVELS, WE HAVE BEEN ABLE TO FINE TUNE DOSAGES OF CHEMOTHERAPY, DEPENDING ON HOW EACH PATIENT METABOLIZES THE DRUG. AS A RESULT OF THE PERSISTENT COMMITMENT TO IMPROVEMENT, SCCA'S OVERALL SURVIVAL RATE HAS DRAMATICALLY IMPROVED. WE HAVE THE OPPORTUNITY TO SAVE SUBSTANTIAL SUMS OF MONEY AND ACTUALLY IMPROVE PATIENTS' EXPERIENCE BY ENHANCING THE UNDERSTANDING OF THE GENETICS OF EACH INDIVIDUAL'S CANCER. KNOWING THE DETAILS OF THE GERM LINE OF A PATIENTS' CELLS AND HOW THEIR DNA HAS BEEN SHAPED BY EXPERIENCE, IT CAN ELIMINATE A LOT OF TRIAL AND ERROR AND PROCEED WITH THE CORRECT TREATMENT RIGHT AWAY. SCCA IS POPULATED WITH A COMMUNITY OF SCIENTISTS WHO CONDUCT RESEARCH AND ALSO SEE PATIENTS IN THE CLINIC. SCCA BELIEVES THAT NEW DIAGNOSTIC TOOLS SUCH AS PROTEOMIC MEASURES OR LEVELS OF MICRO RNAS IN THE PERIPHERAL BLOOD WILL ENABLE US TO DETECT CANCER EARLIER THAN EVER BEFORE. PRIMARY CARE DOCTORS WILL INCLUDE THESE MARKERS FOR CANCER IN THEIR PATIENTS' ANNUAL BLOOD TESTS. FOR EXAMPLE, IF A WOMAN TESTED POSITIVE FOR BREAST CANCER, WE WOULD FIND IT AT AN EARLY STAGE AND REMOVE IT. THEN SHE COULD BE VACCINATED SO THAT HER IMMUNE SYSTEM WOULD ATTACH ANY NEW TUMOR IN THE CARE OF A RECURRENCE. THAT WOULD BE A COST EFFECTIVE WAY TO TREAT CANCER. AND IT'S DOABLE OVER THE NEXT 10 YEARS. IT WON'T BE 100 PERCENT THE FIRST TIME WE DO IT, BUT WE'LL BUILD ON OUR SUCCESS AND KEEP FINDING WAYS TO SOLVE PROBLEMS UNTIL WE'RE SUCCESSFUL ALL THE TIME.SCCA PROMOTES THE HEALTH OF ITS COMMUNITY BY PRACTICING CONSERVATIVE STEWARDSHIP OF ITS RESOURCES. THROUGH OUT ITS HISTORY, SCCA HAS BEEN FINANCIALLY HEALTHY, ENJOYING CONSISTENT GROWTH IN A DYNAMIC INDUSTRY. CONTINUED SUCCESS IN THE MARKETPLACE WILL DEPEND ON A PRUDENTLY MANAGED ORGANIZATION. SCCA WILL CONTINUE TO BUILD SUFFICIENT RESERVES TO ALLOW IT TO WEATHER PERIODIC ECONOMIC STORMS AND TO MAINTAIN AND REPLACE EXISTING INFRASTRUCTURE AND TO INVEST IN NEW TECHNOLOGY. SCCA'S BOARD HAS ESTABLISHED TARGETS TO ENSURE CONTINUED FINANCIAL STABILITY AND ACCESS TO CAPITAL ON FAVORABLE TERMS. SCCA'S STRATEGIC PLAN IDENTIFIES EFFICIENCIES THAT INCREASE BOTH PRODUCTIVITY AND THE UTILIZATION OF ALL RESOURCES. THE POTENTIAL OF IMMINENT SCIENTIFIC BREAKTHROUGHS SIMPLY ADDS TO SCCA'S MANDATE TO USE OUR RESOURCES WISELY. THE PRUDENT MANAGEMENT OF OUR RESOURCES WILL ENABLE US TO CONTINUE THE WORK OF OFFERING THE LATEST TREATMENTS, LEADING-EDGE STUDIES, STATE OF THE ART PREVENTION AND EARLY DETECTION SERVICES, THE BEST HOPE FOR A CURE. PART VI, LINE 7: SCCA IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 FRED HUTCHINSON CANCER RESEARCH CENTER 1100 FAIRVIEW AVE N SEATTLE WA 98109 237156071 501(C)(3) 231955 TO FUND RESEARCH SPECIFIC TO CANCER RESEARCH ACTIVITIES TO SCIENTIST UNIVERSITY OF WASHINGTON FOUNDATION PO BOX 358045 SEATTLE WA 98195 943079432 501(C)(3) 15000 TO SUPPORT UNIVERSITY OF WASHINGTON FOUNDATION EVENTS UNIVERSITY OF WASHINGTON PO BOX 359505 SEATTLE WA 98104 916001537 GOVERNMENT 53432 TO FUND CANCER RESEARCH ACTIVITIES TO PHYSICIANS PRACTICING AT THE UNIVERSITY OLYMPIC MEDICAL CENTER FOUNDATION 939 CAROLINE PORT ANGELES WA 98362 911285758 501(C)(3) 10000 TO SUPPORT OLYMPIC MEDICAL CENTER SUSAN G KOMEN RACE FOR THE CURE 112 FIFTH AVENUE NORTH SEATTLE WA 98103 911624040 501(C)(3) 10000 TO SUPPORT BREAST CANCER RESEARCH ROTARY CLUB OF MERCER ISLAND FOUNDATION PO BOX 1 MERCER ISLAND WA 98040 911058004 501(C)(3) 10000 TO SUPPORT HALF MARATHON RACE NATIONAL BONE MARROW TRANSPLANT LINK 20411 W 12 MILE ROAD SUITE 108 SOUTHFIELD MI 48076 383027625 501(C)(3) 5000 TO SUPPORT NATIONAL BONE MARROW TRANSPLANT LINK 7 CASH 151 17050 FUNERAL 5 2417 TRANSPORTATION 54 7477 FOOD 711 72960 269 FMV GIFT CARDS PROVIDED TO PATIENTS FOR FOOD AND GROCERY STORES MEDICAL 14 5363 SHELTER 296 201560 12525 COST RENTS PAID FOR PATIENTS PARKING 52 9068 UTILITIES 26 3809 WIGS 341 3174 7264 FMV HATS & WIGS FOR CANCER PATIENTS YOGA CLASSES 37 4420 PROSTHESIS 8 780 FMV PARTS & SUPPLIES FOR PROSTHETICS SUNDRIES 518 11401 FMV GIFTS, CANDY, BOOKS, MAGAZINES, & BLANKETS TICKETS 5093 375492 FMV EVENT TICKETS TO SPORTS GAMES, ART PERFORMANCES, AND LOCAL ATTRACTIONS OTHER 12 1455 PEGGY MEANS SCHOLARSHIP 5 27801 STEINBERG SCHOLARSHIP 1 945 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: WITH REGARD TO GRANTS TO ORGANIZATIONS REPORTED ON SCHEDULE I, PART II, THE SCCA VERIFIES THE GRANTEES ARE QUALIFIED 501(C)(3) ORGANIZATIONS WITH A MISSION COMPATIBLE WITH THAT OF SCCA. THE SCCA RELIES ON THE GRANTEE ORGANIZATION MAINTAINING ITS TAX EXEMPT STATUS WITH THE IRS AND DOES NOT IMPOSE THE BURDEN OF REPORTING BACK TO SCCA AS TO THE EXPENDITURE OF GRANT FUNDS. WITH REGARD TO GRANTS OR OTHER ASSISTANCE TO INDIVIDUALS REPORTED ON SCHEDULE I, PART III, MOST OF THE REQUESTS FOR ASSISTANCE ARE MADE THROUGH PATIENT FAMILY SERVICES. THESE REQUESTS ARE CONSIDERED IN ACCORDANCE WITH A MODIFICATION TO SCCA'S CHARITY CARE POLICY AND ASSISTANCE IS PROVIDED IN RESPONSE TO SPECIFIC NEEDS OF INDIVIDUALS FOR THE INTENDED PURPOSE BY PAYING FOR CERTAIN ASSISTANCE DIRECTLY ON BEHALF OF THE INDIVIDUAL. ALSO, PATIENT FAMILY SERVICES MAINTAINS CONTACT WITH PATIENTS RECEIVING ASSISTANCE THROUGHOUT THEIR TREATMENT AT SCCA. WITH REGARD TO SCHOLARSHIPS GIVEN, AN APPLICATION IS MADE AND REVIEWED BY THE SENIOR MANAGEMENT STAFF. VERY SPECIFIC CRITERIA ARE REQUIRED. ONLY BONA FIDE TUITION AND FEES QUALIFY FOR FUNDING. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 FRED APPELBAUM MD 152640 0 0 0 0 0 0 0 0 0 152640 0 0 0 NORMAN HUBBARD 384233 0 54419 0 0 0 31410 0 15853 0 485915 0 0 0 MADELINE BUELT 316574 0 42962 0 0 0 31410 0 21810 0 412756 0 0 0 F MARC STEWART MD 253900 0 0 0 0 0 0 0 0 0 253900 0 0 0 JONATHAN TINGSTAD 328832 0 47617 0 0 0 31410 0 21781 0 429640 0 0 0 JOSEPH NORTON 180718 0 18835 0 0 0 19623 0 20403 0 239579 0 0 0 CHERYL WYMAN 180222 0 18593 0 0 0 19339 0 13245 0 231399 0 0 0 DAVID ACKERSON 178060 0 17639 0 0 0 18474 0 10191 0 224364 0 0 0 ALEANA WAITE 160844 0 16682 0 0 0 16250 0 15747 0 209523 0 0 0 ZAKARIA RAMADAN-JRADI 173919 0 0 0 0 0 4590 0 20234 0 198743 0 0 0 DEBORAH STENHJEM 148247 0 15067 0 0 0 14719 0 15577 0 193610 0 0 0 KRISTINE LOGAN 141731 0 14289 0 0 0 13628 0 9672 0 179320 0 0 0 DEBORAH GENTZEN 176444 0 18962 0 0 0 19690 0 20393 0 235489 0 0 0 JAN WATTERSON 134688 0 14206 0 0 0 13466 0 13769 0 176129 0 0 0 ALPHONSO EMERY 130740 0 12999 0 0 0 11966 0 7798 0 163503 0 0 0 MOREEN DUDLEY 128631 0 13147 0 0 0 12214 0 13656 0 167648 0 0 0 MICHELLE HALL 125112 0 12853 0 0 0 11704 0 15437 0 165106 0 0 0 MARGARET OWENS 149832 0 0 0 0 0 13184 0 19907 0 182923 0 0 0 PART I, LINE 1A SCCA LEADERSHIP TEAM HAS MEMBERSHIPS AT LOCAL CLUBS TO ENABLE MEETINGS AND RECRUITMENT TO TAKE PLACE. SCCA HAS A DETAILED EXPENSE REIMBURSEMENT POLICY FOR TRAVEL AND ENTERTAINMENT. THE HEALTH/SOCIAL CLUB DUES ARE NOT SPECIFICALLY INCLUDED IN THE WRITTEN POLICY. SCCA REIMBURSES FOR THESE EXPENSES SUBJECT TO THE TERMS OF THE OVERALL POLICY. ANY PAYMENTS WHICH ARE A TAXABLE FRINGE BENEFIT ARE INCLUDED IN THE TAXABLE INCOME REPORTABLE ON FORM W-2 FOR THE RECIPIENT. ALL RELATED CORPORATE EXPENSES ARE MONITORED BY THE AP SUPERVISOR AND REVIEWED BY THE CONTROLLER FOR PERSONAL/BUSINESS USE FOR COMPLIANCE WITH THE ACCOUNTABLE PLAN AND REIMBURSEMENT POLICY. SUPPLEMENTAL INFORMATION PART III FRED APPELBAUM, MD RECEIVED COMPENSATION OF $152,640 FROM FRED HUTCHINSON CANCER RESEARCH CENTER, AN UNRELATED ORGANIZATION FOR SERVICES PROVIDED TO SEATTLE CANCER CARE ALLIANCE. F. MARC STEWART, MD RECEIVED COMPENSATION OF $253,900 FROM FRED HUTCHINSON CANCER RESEARCH CENTER, AN UNRELATED ORGANIZATION FOR SERVICES PROVIDED TO SEATTLE CANCER CARE ALLIANCE. WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978E2C5 2009-02-03 87819178 CAPITAL ACQUISITION, REFINANCE OLD DEBT ISSUED 3/6/2001 0 0 0 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 2010-11-18 21415000 TO REFUND 2008 WEEKLY RATE 0 0 0 2470000 87819179 7392081 43483521 1671200 33433182 2010 1 0 0 1 370000 21415000 21090000 325000 2009 1 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 X 11401 COST/SELLING PRICE X 2 269 COST/SELLING PRICE X 8 780 COST/SELLING PRICE X EVENT TICKETS 5093 375492 COST/SELLING PRICE X HATS/WIGS 338 7264 COST/SELLING PRICE 0 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): BOTH NUMBERS OF CONTRIBUTORS AND NUMBER OF ITEMS RECEIVED WERE USED TO DETERMINE THE AMOUNTS IN COLUMN B. FORM 990, PART I, LINE 6 THE VOLUNTEERS OFFER DIRECT SUPPORT IN SOCIAL, EMOTIONAL AND PRACTICAL WAYS TO CONNECT WITH PATIENTS AND FAMILIES THROUGHOUT EACH PHASE OF A PATIENT'S EXPERIENCE WITH SCCA. THE SCCA HAS 16 ROLES THAT VOLUNTEERS PARTICIPATE IN; BREAST CENTER, CHILD LIFE, DRIVERS, EVENTS COMMITTEE, HUTCH SCHOOL, GIFT SHOP, GUEST SERVICES, SCCA HOUSE KITCHEN HOST, PATIENT EDUCATION, LABYRINTH HOSTS, RESOURCES CENTER, WOMEN'S CENTER LOBBY, PATIENT/FAMILY SERVICES, PHYSICAL THERAPY, COMFORT MASSAGE, AND THE GENERAL ONCOLOGY LOBBY. NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 THE SCCA HOUSE LEGAL ENTITY MERGED INTO THE SCCA EFFECTIVE NOVEMBER 18, 2010. ALL ASSETS WERE TRANSFERRED INTO THE SCCA LEGAL ENTITY AND THE SCCA HOUSE LEGAL ENTITY WAS DISSOLVED. THE SCCA 2010 FORM 990 INCLUDES THE SCCA HOUSE ACTIVITIES FOR THE FIRST TIME. FORM 990, PART VI, SECTION A, LINE 2 MARK GROUDINE, RICH JONES, MYRA TANITA, FRED APPLEBAUM AND F. MARC STEWART HAVE BUSINESS RELATIONSHIPS. EACH NAMED INDIVIDUAL SERVES AS A SCCA BOARD MEMBER AND ARE ALSO BOARD MEMBERS, OFFICERS, DIRECTORS OR KEY EMPLOYEES OF ANOTHER ORGANIZATION. SUE ALBRECHT, ROBB BAKEMEIER, PAT HAGAN, AND BRUDER STAPLETON HAVE BUSINESS RELATIONSHIPS. EACH NAMED INDIVIDUAL SERVES AS A SCCA BOARD MEMBER AND ARE ALSO BOARD MEMBERS, OFFICERS, DIRECTORS OR KEY EMPLOYEES OF ANOTHER ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 4 THE SCCA BYLAWS WERE AMENDED ON 3/10/2011 EFFECTIVE 07/01/2011. THE BOARD AMENDED AND RESTATED THE CORPORATION'S BYLAWS TO REVISE FOR THE FOLLOWING: NEW PROCEDURES FOR HOLDING THE ANNUAL MEETING OF THE MEMBERS AND THE BOARD; EXPAND THE SIZE OF THE BOARD FROM 15 DIRECTORS TO 18 DIRECTORS; REVISE THE REQUIRED QUALIFICATIONS OF THE DIRECTORS; REVISE THE PROCEDURES FOR SELECTING AND APPOINTING DIRECTORS; ELIMINATE AN EX OFFICIO DIRECTOR POSITION PREVIOUSLY HELD BY THE EXECUTIVE DIRECTOR OF THE UNIVERSITY OF WASHINGTON MEDICAL CENTER; IMPOSE TERM LIMITS ON DIRECTORS WHO SERVE AS COMMUNITY REPRESENTATIVES; REVISE THE PROCEDURES FOR APPOINTING MEMBERS OF BOARD COMMITTEES, EXPAND THE DUTIES OF THE NOMINATING COMMITTEE TO INCLUDE GOVERNANCE AND RENAME THE NOMINATING COMMITTEE; AND REQUIRE THAT THE BOARD ADOPT A CONFLICT OF INTEREST POLICY AS A SEPARATE POLICY AND DELETE THE POLICY SPECIFIED IN THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 6 SCCA HAS THREE MEMBERS. MEMBERS MUST BE GOVERNMENTAL ENTITIES OR ORGANIZATIONS EXEMPT UNDER IRC SECTION 501(C)(3). EACH MEMBER CURRENTLY HAS A 33 1/3% VOTING INTEREST. NO NEW MEMBER MAY BE ADMITTED TO THE CORPORATION WITHOUT THE APPROVAL OF EXISTING MEMBERS HOLDING AGGREGATE VOTING INTERESTS OF AT LEAST 75%. FORM 990, PART VI, SECTION A, LINE 7A EACH MEMBER APPOINTS FIVE OF THE FIFTEEN DIRECTORS OF THE ORGANIZATION. EFFECTIVE 7/1/2011, EACH MEMBER WILL APPOINT SIX MEMBERS OF THE EIGHTEEN DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS OF THE CORPORATION MAY NOT, EXCEPT BY AFFIRMATIVE VOTE OF SEVENTY-FIVE PERCENT (75%) OF THE DIRECTORS IN OFFICE AND WITH THE APPROVAL OF THE MEMBERS HOLDING AGGREGATE VOTING INTERESTS OF AT LEAST SEVENTY-FIVE PERCENT (75%), (A) AMEND, ALTER OR REPEAL CERTAIN SECTIONS OF THE CORPORATION'S BYLAWS; (B) REMOVE ANY DIRECTOR OR THE CHAIR OF THE CORPORATION; PROVIDED, THAT A MEMBER MAY REMOVE A DIRECTOR APPOINTED BY SUCH MEMBER AT ANY TIME; (C) AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION; (D) ADOPT A PLAN OF MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION; (E) AUTHORIZE THE SALE, LEASE OR EXCHANGE (OR PLEDGING AS SECURITY) OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION OR ANY ASSET NOT IN THE ORDINARY COURSE OF BUSINESS; (F) AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKE PROCEEDINGS THEREFOR; (G) ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION; (H) AMEND, ALTER OR REPEAL ANY RESOLUTION OF THE MEMBERS OF THE CORPORATION; (I) INITIATE OR RESOLVE LITIGATION IN WHICH THE CORPORATION IS A PARTY IF THE LITIGATION OR RESOLUTION WOULD HAVE A MATERIAL ADVERSE EFFECT ON THE FINANCIAL WELL-BEING OR PUBLIC PERCEPTION OF THE CORPORATION OR ITS MEMBERS; (J) CHANGE THE FUNDAMENTAL PURPOSES OF THE CORPORATION; (K) ENTER INTO ANY NEW LINE OF BUSINESS; (L) OR AUTHORIZE THE RELOCATION FROM THE UNIVERSITY OF WASHINGTON MEDICAL CENTER TO ANOTHER HOSPITAL FACILITY OF THE TWENTY INPATIENT BEDS FOR WHICH THE CORPORATION HAS BEEN GRANTED A HOSPITAL LICENSE. FINALLY, THE FOLLOWING IS SUBJECT TO APPROVAL BY THE CORPORATION'S MEMBERS: - THE CORPORATION'S ANNUAL BUDGET - APPOINTMENT OF THREE ADDITIONAL DIRECTORS TO THE BOARD EXECUTIVE COMMITTEE (IN ADDITION TO THE CORPORATION'S CHAIR, IMMEDIATE PAST CHAIR, VICE CHAIR, TREASURER, AND SECRETARY) - APPOINTMENT OF DIRECTORS TO THE BOARD GOVERNANCE COMMITTEE - APPOINTMENT OF TWO DIRECTORS TO THE BOARD FINANCE COMMITTEE (IN ADDITION TO THE TREASURER) - SELECTION OF INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS TO CONDUCT AN ANNUAL FINANCIAL AUDIT OF THE CORPORATION FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS PREPARED BY A PUBLIC ACCOUNTING FIRM AND INTERNALLY REVIEWED PRIOR TO PRESENTATION TO THE BOARD APPOINTED FINANCE AND AUDIT COMMITTEE. THE FORM 990 WAS PROVIDED TO THE FINANCE AND AUDIT COMMITTEE FOR REVIEW BEFORE FILING. THE CHAIR OF THE FINANCE AND AUDIT COMMITTEE REPORTS TO THE FULL BOARD. ALL BOARD MEMBERS ARE PRESENTED WITH A COPY BEFORE FILING FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS ANNUALLY MONITORED THROUGH A QUESTIONNAIRE. IT IS A POLICY OF THE SCCA FOR SELF REPORTING. THIS SELF REPORTING IS APPLICABLE TO THE BOARD OF DIRECTORS AND ALL MANAGEMENT STAFF. THE DETERMINATION OF WHETHER AN ISSUE EXISTS IS MADE BY THE INTEGRITY OFFICER. THE ESCALATION PROCESS IS TO THE SENIOR MANAGEMENT TEAM, AND IF DEEMED APPROPRIATE TO THE BOARD OF DIRECTORS INTEGRITY COMMITTEE, BOARD OF DIRECTORS GOVERNANCE COMMITTEE, AND LEGAL COUNSEL. CONFLICTS OF INTEREST ARE ADDRESSED IF AND WHEN THEY ARISE. THE CONFLICTED BOARD MEMBER RECUSES HIM OR HERSELF FROM DISCUSSION AND VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORMS A MARKET ANALYSIS OF EXECUTIVE PAY AT COMPARABLE ORGANIZATIONS; A CONSULTANT FROM THIS FIRM PRESENTS ITS FINDINGS TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS EVERY TWO YEARS. THE ANALYSIS WAS LAST PERFORMED AND PRESENTED IN MAY OF 2011. IN THE INTERVENING YEARS, THE PRIOR YEAR'S MARKET ANALYSIS IS UPDATED USING AN APPROPRIATE INFLATION FACTOR FOR USE BY THE COMPENSATION COMMITTEE IN ITS ANNUAL REVIEW OF TOTAL COMPENSATION FOR THE OFFICERS. THE COMPENSATION COMMITTEE DOCUMENTS ITS MEETINGS AND DECISIONS IN A TIMELY MANNER. THE COMPENSATION COMMITTEE PROMPTLY REPORTS TO THE BOARD ALL ACTIONS TAKEN AND SIGNIFICANT ISSUES DISCUSSED AT ITS MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 THE SCCA DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. AS REQUIRED BY THE IRS, THE SCCA'S AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990, WHICH IS A PUBLIC DISCLOSURE DOCUMENT. FORM 990, PART VI, LINE 16A WHILE SCCA DID NOT HAVE A JOINT VENTURE POLICY IN PLACE FOR FY11, THE RECENT JOINT VENTURE SCCA ENTERED INTO CONTAINED SPECIFIC LANGUAGE TO SAFEGUARD ITS TAX EXEMPT STATUS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -2,556,000. BEGINNING NET ASSETS - RELATED ORGANIZATION 143,740. CHANGE IN NET ASSETS - RELATED ORGANIZATION -1,032,710. BEGINNING NET ASSETS - ELIMINATIONS -355,510. IMPAIRMENT LOSSES -143,405. ROUNDING 793. TOTAL TO FORM 990, PART XI, LINE 5: -3,943,092. SEATTLE CANCER CARE ALLIANCE HOUSE 825 EASTLAKE AVE E SEATTLE WA 98109 260443505 TEMPORARY MEDICAL HOUSING WA 501(C)(3) LINE 9 SEATTLE CANCER CARE ALLIANCE 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 SEATTLE CANCER CARE ALLIANCE HOUSE A 94644 FAIR MARKET VALUE SEATTLE CANCER CARE ALLIANCE HOUSE D 9051000 COST SEATTLE CANCER CARE ALLIANCE HOUSE R -888567 COST SEATTLE PROCURE HOLDINGS LLC 192 LEXINGTON AVE FLOOR 4 NEW YORK NY 10016 270817057 PROTON BEAM THERAPY CENTER DE 0 0 0 SCHEDULE R, PART VI, COLUMNS (E) AND (G) SCCA ENTERED INTO ITS JOINT VENTURE REPORTED ON PART III DURING FY 2011. BECAUSE THE JOINT VENTURE HAS A CALENDAR YEAR END, NO FINANCIAL RESULTS HAVE BEEN RECEIVED TO BE REPORTED.