2012-05-15T10:32:28-05:00 2011-06-30 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2010-07-01 911336707 ASSOCIATION OF CHMC AND UNIVERSITY PHYSICIANS ASSO 2069878450 4500 SANDPOINT WAY NE NO 100 SEATTLE WA 98105 PATTI ADAMICH 2069878450 2012-05-14 1 SARA ELIZABETH J HYRE 4254544919 2010 2016-02-24 21:20:13Z CHILDREN'S UNIVERSITY MEDICAL GROUP PATTY ADAMS 4500 SANDPOINT WAY NE NO 100 SEATTLE WA 98105 120589101 0 X N/A X 1986 WA TO ASSIST SEATTLE CHILDREN'S HOSPITAL AND UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE IN CARRYING OUT THEIR PEDIATRIC CARE, CHARITABLE, EDUCATIONAL AND SCIENTIFIC MISSIONS. 12 0 541 13 0 0 0 0 98860209 107233463 467759 2434972 0 0 99327968 109668435 0 0 0 0 94477131 103017847 0 0 0 5772824 6395850 100249955 109413697 -921987 254738 31038929 34395191 30977039 34333301 61890 61890 X THE ASSOCIATION OF CHMC AND UNIVERSITY PHYSICIANS, DBA CHILDREN'S UNIVERSITY MEDICAL GROUP (CUMG) OPERATES A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT BILLS AND COLLECTS FOR THE CLINICAL SERVICES PROVIDED BY APPROXIMATELY 469 UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UWSOM) FACULTY PHYSICIANS AND COMPENSATES THE EMPLOYED PHYSICIANS, PURSUANT TO A 1989 OPERATING AGREEMENT BETWEEN THE UNIVERSITY OF WASHINGTON (UW), SEATTLE CHILDREN'S HOSPITAL (SCH) AND CUMG. UNDER THAT OPERATING AGREEMENT, CUMG PAYS OPERATING EXPENSES AND COMPENSATES FACULTY PHYSICIANS (THE PROFESSIONAL MEMBERS) AS DIRECTED BY UWSOM. ALL REMAINING REVENUES ARE HELD BY CUMG SOLELY FOR THE SUPPORT OF UW MEDICINE. CUMG IS A WASHINGTON STATE NOT FOR PROFIT, FEDERALLY TAX-EXEMPT CORPORATION FORMED IN 1986 TO SUPPORT UWSOM AND SCH IN THE FULFILLMENT OF THEIR RESPECTIVE PEDIATRIC PATIENT CARE, CHARITABLE, ACADEMIC AND SCIENTIFIC MISSIONS. 0 0 103581255 107233463 PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS (TOGETHER, PROFESSIONAL MEMBERS) OF CUMG PROVIDE CLINICAL HEALTH CARE SERVICES TO PEDIATRIC PATIENTS AT SEATTLE CHILDREN'S HOSPITAL, UW MEDICINE FACILITIES, AND OTHER SITES OF PRACTICE APPROVED BY THE DEAN OF THE UW SCHOOL OF MEDICINE AND CEO OF SEATTLE CHILDREN'S HOSPITAL. CUMG PROFESSIONAL MEMBERS PROVIDE PRIMARY, SPECIALTY, AND SUBSPECIALTY CLINICAL CARE TO COMMUNITIES THAT WOULD NOT OTHERWISE HAVE ACCESS TO SUFFICIENT CLINICAL RESOURCES. CUMG PROVIDES SIGNIFICANT UNDERCOMPENSATED AND CHARITY CARE, CONSISTENT WITH THE CHARITY CARE POLICY OF SEATTLE CHILDREN'S HOSPITAL. 103581255 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 10 0 1 541 1 0 0 0 0 0 0 0 0 0 0 X 12 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 WA X PATTI ADAMICH 2069878471 4500 SANDPOINT WAY NE SUITE 100 SEATTLE WA 98105 X ROBERT SAWIN MD 39.50 X X 461415 115572 83788 DENNIS CHRISTIE MD 40.00 X X 281272 0 71527 LYNN MARTIN MD 36.00 X X 312041 180818 42898 F BRUDER STAPLETON MD 32.00 X 249205 234981 40928 RICHARD HOPPER 40.00 X 535287 0 140819 ED WEINBERGER MD 36.00 X 380181 68165 79876 MARTIN KOYLE MD 40.00 X 479405 18171 87342 BRYAN KING MD 32.00 X 2285 259555 13775 MARK DELBECCARO MD 40.00 X 295929 0 55500 WILLIAM WALKER MD 40.00 X 171892 0 42764 KAREN MURRAY MD 40.00 X 38810 170273 67442 ROSS HAYES MD 40.00 X 224237 0 49620 RICK NIELSEN 40.00 X 234578 0 43145 PATTI ADAMICH 40.00 X 102567 0 27581 GORDON COHEN MD 39.50 X 1473713 120888 36790 LESTER PERMUT MD 39.50 X 630654 56892 101570 THOMAS JONES MD 40.00 X 505033 0 79616 SAMUEL BROWD MD 40.00 X 544446 0 111525 WALTER KRENGEL MD 40.00 X 500519 0 163786 7423469 1225315 1340292 238 0 1 0 UNIVERSITY OF WASHINGTON PHYSICIANS 501 EASTLAKE SEATTLE WA 98109 IT, HR, LEGAL SERVICES 701267 1 INSTITUTIONAL SUPPORT 621110 63421067 63421067 PHYSICIAN PROF FEES 621110 27142375 27142375 MEDICAID REVENUE 621110 13645437 13645437 OTHER GOVT AGENCY REV 621110 2283338 2283338 BILLING SERVICES 561000 741246 741246 107233463 511461 511461 12844177 10920666 1923511 1923511 1923511 109668435 107233463 0 2434972 4368713 3931470 437243 86975026 84127042 2847984 4175394 3918366 257028 4421406 3683796 737610 3077308 2778029 299279 129692 129692 43500 43500 111223 111223 440920 78108 362812 151001 151001 953864 953864 330267 330267 6763 6763 45429 45429 879708 879708 STATE/LOCAL TAXES 2896721 2895190 1531 CLINIC DEVELOPMENT 33333 33333 BUSINESS INSURANCE 32927 32927 340502 302349 38153 109413697 103581255 5832442 0 316857 411184 10323322 11222524 8186749 9084781 388146 172025 477569 388587 134412 88982 11615213 13295653 74230 120042 31038929 34395191 13842322 11991402 96549 77239 17038168 22264660 30977039 34333301 X 61890 61890 61890 61890 31038929 34395191 X 254738 -254738 X 0 1 1 X 0 X X X 0 0 0 UWSOM 916001537 2-SCHOOL 1 1 1 11615283 SCH 910564748 3-HOSPITAL 1 1 1 13293856 2 24909139 193099 115860 77239 43804 39871 3933 240666 232856 7810 88982 CLINICAL MEDICINE FUND 5821430 DEPARTMENT PAYABLES 16443230 22264660 109668435 109413697 254738 -254738 -254738 0 109302474 -254738 -254738 109557212 111223 111223 109668435 109302474 0 109302474 111223 111223 109413697 0 0 0 0 0 0 0 1 0 ROBERT SAWIN MD 446615 115572 14800 0 0 0 54398 15000 5390 9000 521203 139572 16594 0 DENNIS CHRISTIE MD 253207 0 28065 0 0 0 46793 0 24734 0 352799 0 17252 0 LYNN MARTIN MD 302275 180818 9766 0 0 0 24500 0 8912 9486 345453 190304 20024 0 F BRUDER STAPLETON MD 249205 234981 0 0 0 0 24500 0 7428 9000 281133 243981 0 0 RICHARD HOPPER 346552 0 188735 0 0 0 116967 0 23852 0 676106 0 95203 0 ED WEINBERGER MD 380181 68165 0 0 0 0 56996 0 22880 0 460057 68165 7036 0 MARTIN KOYLE MD 402056 18171 77349 0 0 0 71801 2400 13141 0 564347 20571 46382 0 BRYAN KING MD 0 259555 2285 0 0 0 1753 0 2544 9478 6582 269033 1711 0 MARK DELBECCARO MD 295929 0 0 0 0 0 29373 0 26127 0 351429 0 5951 0 WILLIAM WALKER MD 171892 0 0 0 0 0 23888 0 18876 0 214656 0 5857 0 KAREN MURRAY MD 3949 170273 34861 0 0 0 22114 32988 3340 9000 64264 212261 13205 0 ROSS HAYES MD 224237 0 0 0 0 0 27649 0 21971 0 273857 0 0 0 RICK NIELSEN 234578 0 0 0 0 0 24500 0 18645 0 277723 0 0 0 GORDON COHEN MD 1398834 120888 74879 0 0 0 22050 0 5740 9000 1501503 129888 53446 0 LESTER PERMUT MD 537942 56892 92712 0 0 0 87505 0 5065 9000 723224 65892 51413 0 THOMAS JONES MD 478613 0 26420 0 0 0 52317 0 27299 0 584649 0 24999 0 SAMUEL BROWD MD 393328 0 151118 0 0 0 99109 0 12416 0 655971 0 0 0 WALTER KRENGEL MD 249173 0 251346 0 0 0 136197 0 27589 0 664305 0 125000 0 PART I, LINE 7 CUMG IS THE PRACTICE PLAN FOR UNIVERSITY OF WASHINGTON (UW) FACULTY PHYSICIANS AND HEALTH CARE PRACTITIONERS WHO PROVIDE CLINICAL CARE PRIMARILY TO PEDIATRIC PATIENTS. CUMG BILLS AND COLLECTS REVENUE GENERATED BY THE CLINICAL SERVICES OF THESE FACULTY PHYSICIANS. ALL REVENUES COLLECTED BY CUMG ARE ALLOCATED IN ACCORDANCE WITH THE ASSOCIATION OF CHMC AND UNIVERSITY PHYSICIANS D/B/A CHILDREN'S UNIVERSITY MEDICAL GROUP AMENDED AND RESTATED INCOME DISTRIBUTION PLAN (IDP). CUMG MAINTAINS A "MASTER" IDP AND EACH CUMG DEPARTMENT OR DIVISION ALSO MAINTAINS A DEPARTMENTAL (OR DIVISIONAL) IDP THAT PROVIDES MORE DETAIL AS TO HOW ADDITIONAL COMPENSATION (INCENTIVE PAYMENT) IS CALCULATED AND PAID TO PARTICIPATING INDIVIDUALS (THE PHYSICIANS AND HEALTH CARE PRACTITIONERS WITH PRACTICE AGREEMENTS MAKING THEM ELIGIBLE FOR INCENTIVE PAYMENTS). DEPARTMENTS AND DIVISIONS ARE COMPRISED OF THE FACULTY PHYSICIANS WITHIN EACH SPECIALTY OR PRIMARY CARE AREA OF CLINICAL PRACTICE. THE DEPARTMENTAL AND DIVISIONAL IDPS ALIGN WITH THE CLINICAL DEPARTMENTS OF THE UW SCHOOL OF MEDICINE. EACH CLINICAL DEPARTMENT OF THE UW SCHOOL OF MEDICINE HAS A DEPARTMENT CHAIR WHO APPROVES THE IDP FOR THE CUMG DEPARTMENT/DIVISION. THE CUMG DIVISION CHIEF ALSO APPROVES THE IDP FOR THE DIVISION. UNDER ALL IDPS, REVENUES GENERATED BY FACULTY ARE ALLOCATED TO THE FACULTY MEMBER'S DEPARTMENT, AND THE FUNDS FLOW IS SUBJECT TO CERTAIN STANDARDIZED DEDUCTIONS AS FOLLOWS: FIRST, REVENUES ARE USED TO PAY CUMG OPERATING EXPENSES. OF THE REMAINING REVENUES, ELEVEN PERCENT (11%) IS DIVIDED EQUALLY AND ALLOCATED TO THE UW SCHOOL OF MEDICINE CLINICAL MEDICINE FUND AND SEATTLE CHILDREN'S HOSPITAL CLINICAL MEDICINE FUND, RESPECTIVELY. THE REMAINING REVENUES ARE USED TO PAY DEPARTMENT DIRECT CLINICAL COSTS, THEN PHYSICIAN/PRACTITIONER SALARY AND BENEFITS. THERE IS A PERCENTAGE CONTRIBUTION TO DEPARTMENT (AND DIVISION) OPERATIONS AND RESERVE FUNDS. PAYMENTS FOR SERVICES PROVIDED TO SEATTLE CHILDREN'S HOSPITAL AND SUPPORT FROM UW SCHOOL OF MEDICINE ARE RECEIVED. FINALLY, A POOL IS CREATED FOR ADDITIONAL COMPENSATION. WHILE SOME ADDITIONAL COMPENSATION MAY BE IN THE FORM OF FIXED PAYMENTS FOR A DEFINED PERIOD, EACH DEPARTMENTAL/DIVISIONAL IDP PROVIDES FOR PARTICIPATING INDIVIDUALS TO RECEIVE VARIABLE ADDITIONAL COMPENSATION. THE METRICS FOR CALCULATING ADDITIONAL COMPENSATION GENERALLY ARE BASED ON WORK PERSONALLY PERFORMED BY THE PRACTICE PLAN PHYSICIAN OR HEALTH CARE PROFESSIONAL DURING THE PERIOD OF RECORD. WHERE PERSONAL WORK IS NOT THE METRIC, THE UWSOM CLINICAL DEPARTMENTAL CHAIR ESTABLISHES A PER CAPITA DISTRIBUTION OF THE POOL TO ALL PARTICIPATING INDIVIDUALS. THE PERCENTAGE OF REVENUES ALLOCATED TO THE DEPARTMENT AND/OR DIVISION OPERATING AND RESERVE FUND IS ESTIMATED BY THE DEPARTMENT AND APPROVED BY THE DEAN OF THE UW SCHOOL OF MEDICINE (DEAN) AND THE CHIEF EXECUTIVE OFFICER (CEO), OR THEIR RESPECTIVE DESIGNEES, IN A BUDGET ESTABLISHED PRIOR TO THE PERIOD OF RECORD. THE PERIOD OF RECORD IS EITHER A 12-MONTH OR SIX-MONTH PERIOD DURING WHICH THE REVENUES AND EXPENSES FOR THE PRACTICE PLAN ARE ALLOCATED. THE ACTUAL PERCENTAGE FOR DEPARTMENTAL/DIVISIONAL OPERATIONS AND RESERVE CONTRIBUTION MAY BE MODIFIED FROM THE ORIGINAL ESTIMATE BASED ON THE OPERATIONAL NEEDS OF THE DEPARTMENT OR DIVISION, AND WHEN THAT OCCURS, THE PERCENTAGE IS ADJUSTED RETROACTIVELY BY THE CHAIR OF THE DEPARTMENT AND THE DIVISION HEAD OF THE CUMG DIVISION, UPON APPROVAL BY THE DEAN AND THE CEO. AT THE END OF THE PERIOD OF RECORD, AMOUNTS REMAINING AFTER ALL ALLOCATIONS HAVE BEEN MADE ARE AVAILABLE TO PAY THE ADDITIONAL COMPENSATION TO PARTICIPATING INDIVIDUALS. ADDITIONAL COMPENSATION IS CALCULATED FOR EACH PARTICIPATING INDIVIDUAL AND THE ADDITIONAL COMPENSATION AMOUNT IS PAID APPROXIMATELY THREE MONTHS LATER. ADDITIONAL COMPENSATION PAYMENTS ARE SUBJECT TO THE COMPENSATION CAP POLICY ADOPTED BY CUMG: THE "CUMG METHOD OR STANDARD REGARDING BASIC INDIVIDUAL CAPS UNDER AMENDED INCOME DISTRIBUTION PLAN, AS OF JULY 1, 1999." THIS COMPENSATION CAP POLICY LIMITS THE AMOUNT OF COMPENSATION TO INDIVIDUAL PHYSICIANS AND HEALTH CARE PROFESSIONALS BY COMPARISON TO OBJECTIVE DATA FOR LIKE ACTIVITIES AND LIKE PHYSICIANS OR PRACTITIONERS, INCLUDING SURVEYS SUCH AS THE ASSOCIATION OF AMERICAN COLLEGE (AAMC) AND MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) COMPENSATION SURVEYS. FOR THE MOST FREQUENTLY USED MEASURE (AAMC SURVEY), THE MAXIMUM "BASIC INDIVIDUAL CAP" GENERALLY IS 90% OF THE APPLICABLE STANDARD OR MEASURE. IF AAMC DATA IS NOT AVAILABLE OR DOES NOT PROVIDE THE MOST APPROPRIATE COMPARATIVE DATA, THE POLICY ALLOWS FOR OTHER COMPARATORS TO BE USED. IN GENERAL, THE 90TH PERCENTILE IS THE MAXIMUM BASIC INDIVIDUAL CAP IMPOSED UNDER ANY SURVEY OR DATA. IN ALL INSTANCES, COMPENSATION IS LIMITED BY A CAP ESTABLISHED USING A COMPARATIVE SURVEY OR DATA DETERMINED BY THE UW SCHOOL OF MEDICINE AND SEATTLE CHILDREN'S HOSPITAL PRIOR TO THE PERIOD OF RECORD. BEFORE PAYMENT OF ADDITIONAL COMPENSATION FOLLOWING A PERIOD OF RECORD, CUMG REVIEWS AND, WHERE NECESSARY, LIMITS INDIVIDUAL COMPENSATION PURSUANT TO THE APPLICABLE CAP. THUS, WHILE THE AMOUNT OF ADDITIONAL COMPENSATION MAY NOT BE FIXED, THE TOTAL COMPENSATION, INCLUDING BASE SALARY AND ADDITIONAL COMPENSATION, IS SUBJECT TO LIMITS ESTABLISHED BY RELEVANT COMPARATORS. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, LINE 3 COMPENSATION OF THE CUMG EXECUTIVE DIRECTOR AND DIRECTOR OF FINANCE IS REVIEWED BY REPRESENTATIVES OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. THE REVIEW RELIES ON COMPARISON OF COMPENSATION TO SIMILARLY SITUATED INDIVIDUALS, IN LIKE-SIZED ORGANIZATIONS ENGAGED IN SIMILAR ACTIVITIES. THE COMPARISON IS PERFORMED BY AN INDEPENDENT CONTRACTOR CONSULTANT WITH EXPERIENCE AND EXPERTISE IN COMPENSATION OF ACADEMIC MEDICAL CENTER PERSONNEL. THE COMPENSATION COMPARISON DATA IS REVIEWED BY DISINTERESTED EMPLOYEES OF UW MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. FOR UW MEDICINE, THIS IS PART OF AN OVERALL REVIEW OF COMPENSATION FOR SIMILARLY SITUATED INDIVIDUALS IN OTHER COMPONENTS OF UW MEDICINE. THE REVIEW IS PERFORMED REGULARLY, AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. FORM 990, PART I, LINE 6 THERE WERE 13 UNPAID FACULTY MEMBERS WHO VOLUNTEERED TO PROVIDE CLINICAL CARE THROUGH CUMG. FORM 990, PART VI, SECTION A, LINE 1 NONE OF THE BOARD MEMBERS ARE INDEPENDENT. THE CUMG BOARD OF DIRECTORS ARE COMPRISED OF TEN PHYSICIANS APPOINTED BY THE CORPORATE MEMBERS OF CUMG: 1) THE UNIVERSITY OF WASHINGTON, THROUGH THE DEAN OF THE SCHOOL OF MEDICINE AND 2) CHILDREN'S PHYSICIANS, THROUGH THE CHIEF EXECUTIVE OFFICER OF SEATTLE CHILDREN'S HOSPITAL. TWO ADDITIONAL BOARD MEMBERS ARE ELECTED BY THE VOTING CUMG MEMBERSHIP. EACH OF THE PHYSICIAN BOARD MEMBERS IS A FACULTY MEMBER OF THE UNIVERSITY OF WASHINGTON AND EMPLOYED BY CUMG, THE UNIVERSITY OF WASHINGTON, OR BOTH. FORM 990, PART VI, SECTION A, LINE 6 THERE ARE TWO MEMBERS OF CHILDREN'S UNIVERSITY MEDICAL GROUP: CHILDREN'S PHYSICIANS, A SUBSIDIARY OF SEATTLE CHILDREN'S HOSPITAL, AND THE UNIVERSITY OF WASHINGTON. FORM 990, PART VI, SECTION A, LINE 7A THE DEAN OF THE SCHOOL OF MEDICINE OF THE UNIVERSITY OF WASHINGTON AND CEO OF SEATTLE CHILDREN'S HOSPITAL TOGETHER APPOINT TEN MEMBERS OF THE BOARD OF DIRECTORS. PROFESSIONAL FACULTY MEMBERS ELECT TWO MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MOST DECISIONS OF THE CUMG BOARD OF DIRECTORS ARE SUBJECT TO THE APPROVAL OF THE DEAN OF THE SCHOOL OF MEDICINE OF THE UNIVERSITY OF WASHINGTON AND CEO OF SEATTLE CHILDREN'S HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS REVIEWED BY THE CUMG EXECUTIVE DIRECTOR, GENERAL COUNSEL FROM THE ASSOCIATION OF UNIVERSITY PHYSICIANS, AND THE CUMG DIRECTOR OF FINANCE, AS WELL AS THE ASSOCIATE DEAN FOR BUSINESS FOR THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, THE CONTROLLER AND ASSOCIATE VICE PRESIDENT OF MEDICAL AFFAIRS FOR THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE AND THE CHIEF FINANCIAL OFFICER FOR SEATTLE CHILDREN'S HOSPITAL. THE BOARD HAS BEEN PRESENTED WITH INFORMATION RELATED TO THE PURPOSE AND RELEVANCE OF THE FORM 990 TO TAX EXEMPT ENTITIES SUCH AS CUMG, AND BOARD MEMBERS MAY REQUEST A COPY OF THE FORM 990 FROM THE CUMG DIRECTOR OF FINANCE. THE MEMBERS OF THE CUMG BOARD OF DIRECTORS ARE EMPLOYED PHYSICIANS OF CUMG, AND AS SUCH, IN THEIR GOVERNANCE ROLE WITH CUMG DO NOT OVERSEE OR REVIEW PHYSICIAN COMPENSATION. ALL COMPENSATION FOR PHYSICIANS AND THE KEY PERSONNEL EMPLOYED BY UW MEDICINE IS REVIEWED AND SET BY BY DISINTERESTED PERSONS THROUGH A PROCESS WITHIN UW MEDICINE (SEE RESPONSE TO FORM 990, PART VI, QUESTION 15 FOR FURTHER DETAIL REGARDING THIS PROCESS). FORM 990, PART VI, SECTION B, LINE 12C THE CUMG BOARD ADOPTED A CONFLICT OF INTEREST POLICY IN NOVEMBER 2009 FOR BOARD MEMBERS AND OTHER INDIVIDUALS WHO SERVE IN SIGNIFICANT ROLES WITH REGARD TO CUMG. CUMG BOARD MEMBERS AND OTHER INDIVIDUALS WHO ARE EMPLOYED BY THE UNIVERSITY OF WASHINGTON AND SERVING ON CUMG COMMITTEES ARE SUBJECT TO THE STATE OF THE CUMG BOARD ADOPTED A CONFLICT OF INTEREST POLICY IN NOVEMBER 2009 FOR BOARD MEMBERS AND OTHER INDIVIDUALS WHO SERVE IN SIGNIFICANT ROLES WITH REGARD TO CUMG. WASHINGTON ETHICS IN PUBLIC SERVICE ACT, CHAPTER 42.52 RCW. THE ACT RESTRICTS ACTIVITIES INCOMPATIBLE WITH THE INDIVIDUAL'S ROLE AS A STATE EMPLOYEE AND ALSO LIMITS THE INDIVIDUAL'S INVOLVEMENT IN TRANSACTIONS WHERE A POTENTIAL CONFLICT MAY EXIST. CUMG BOARD MEMBERS AND OTHERS ARE ANNUALLY REQUIRED TO DISCLOSE CERTAIN RELATIONSHIPS AS PART OF THE PROCESS TO COMPLETE THE FORM 990. CUMG ALSO ADDRESSES CONFLICTS AS THEY ARISE AND/OR ARE REPORTED TO CUMG MANAGEMENT OR THE CUMG BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15: THE CUMG BOARD OF DIRECTORS DOES NOT REVIEW COMPENSATION. COMPENSATION OF THE CUMG EXECUTIVE DIRECTOR AND DIRECTOR OF FINANCE IS REVIEWED BY REPRESENTATIVES OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. THE REVIEW RELIES ON COMPARISON OF COMPENSATION TO SIMILARLY SITUATED INDIVIDUALS, IN LIKE-SIZED ORGANIZATIONS ENGAGED IN SIMILAR ACTIVITIES. THE COMPARISON IS PERFORMED BY AN INDEPENDENT CONTRACTOR CONSULTANT WITH EXPERIENCE AND EXPERTISE IN COMPENSATION OF ACADEMIC MEDICAL CENTER PERSONNEL. THE COMPENSATION COMPARISON DATA IS REVIEWED BY DISINTERESTED EMPLOYEES OF UW MEDICINE AND SEATTLE CHILDREN'S HOSPITAL. FOR UW MEDICINE, THIS IS PART OF AN OVERALL REVIEW OF COMPENSATION FOR SIMILARLY SITUATED INDIVIDUALS IN OTHER COMPONENTS OF UW MEDICINE. THE REVIEW IS PERFORMED REGULARLY, AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. COMPENSATION OF CUMG BOARD MEMBERS AND OFFICERS IN THEIR CAPACITY AS CUMG PROFESSIONAL MEMBERS EMPLOYED BY CUMG AND/OR THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, IS REVIEWED REGULARLY THROUGH A UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE PROCESS THAT INVOLVES DISINTERESTED SCHOOL OF MEDICINE EMPLOYEES WHO REVIEW COMPENSATION OF ALL SCHOOL OF MEDICINE FACULTY. FOR CUMG PROFESSIONAL MEMBERS, REVIEW OF COMPENSATION ALSO INCLUDES APPLICATION OF THE "CHILDREN'S UNIVERSITY MEDICAL GROUP METHOD OR STANDARD REGARDING BASIC INDIVIDUAL CAPS UNDER AMENDED INCOME DISTRIBUTION PLAN, AS OF JULY 1, 1999" (CUMG CAP POLICY). THE CUMG CAP POLICY LIMITS COMPENSATION OF CUMG PROFESSIONAL MEMBERS BY COMPARISON TO OBJECTIVE DATA SUCH AS THAT PUBLISHED BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. THE REVIEW IS PERFORMED REGULARLY AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, LINE 13 CUMG HAS A POLICY THAT REQUIRES MEMBERS AND ADMINISTRATIVE STAFF TO REPORT BILLING COMPLIANCE CONCERNS. THE POLICY EMPHASIZES THAT CUMG DOES NOT TOLERATE RETALIATION AGAINST THOSE REPORTING CONCERNS. THIS POLICY IS AVAILABLE TO ALL CUMG MEMBERS AND ADMINISTRATIVE STAFF, AND IS BROADLY DISSEMINATED. FORM 990, PART VII, SECTION A, COLUMN B THE FOLLOWING BOARD MEMBERS AND HIGHEST COMPENSATED EMPLOYEES ALSO SPENT AVERAGE WEEKLY TIME WORKING FOR RELATED ORGANIZATIONS: ROBERT SAWIN- 0.5 HOURS LYNN MARTIN- 4 HOURS F. BRUDER STAPLETON- 8 HOURS ED WEINBERGER- 4 HOURS BRYAN KING- 8 HOURS GORDON COHEN- 0.5 HOURS LESTER PERMUT- 0.5 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -254,738. UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE BOX 356420 SEATTLE WA 98195 916001537 MEDICAL SCHOOL WA GOVERNMENT N/A 0 SEATTLE CHILDREN'S HOSPITAL PO BOX 5371 MS RC-507 SEATTLE WA 981050371 910564748 PEDIATRIC MEDICAL CARE WA 501(C)(3) 3 N/A 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0