2025-05-07T13:06:07-05:00 2024-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2023-07-01 910653422 BENAROYA RESEARCH INSTITUTE AT VIRGINIA BENA 2063426500 1201 NINTH AVENUE SEATTLE WA 98101 MICHAEL LABOSIER TREASURER 2063426500 2025-05-07 1 1 HEATHER ADKINS P01725376 3032989100 2023 2025-03-06 01:10:19Z JANE BUCKNER MD 1201 NINTH AVENUE SEATTLE WA 981012795 93579246 0 X HTTP://WWW.BENAROYARESEARCH.ORG X 1956 WA TO ADVANCE THE SCIENCE THAT WILL PREDICT, PREVENT, REVERSE, AND CURE DISEASES OF THE IMMUNE SYSTEM. 12 12 320 0 0 0 75771314 87693245 5702614 4770955 282812 407521 708503 707525 82465243 93579246 31762808 37832305 0 0 34326207 34729212 0 0 0 17237972 14954605 83326987 87516122 -861744 6063124 94354363 96038082 42735678 40329397 51618685 55708685 X TO ADVANCE THE SCIENCE THAT WILL PREDICT, PREVENT, REVERSE, AND CURE DISEASES OF THE IMMUNE SYSTEM SUCH AS AUTOIMMUNE DISEASE, ALLERGY, AND ASTHMA. 0 0 53492397 36122063 0 INTERVENTIONAL IMMUNOLOGY AND ADVANCEMENTS OF THE IMMUNE TOLERANCE NETWORK (ITN) ARE HIGHLIGHTED BELOW:FUNDING FOR THE IMMUNE TOLERANCE NETWORK (ITN) WAS INITIALLY AWARDED TO DR. JERRY NEPOM AT BRI IN 2014 BY THE NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID) OF THE NATIONAL INSTITUTES OF HEALTH (NIH). IT WAS LATER RENEWED FOR A SECOND GRANT CYCLE IN 2021, PROVIDING APPROXIMATELY $27 MILLION ANNUALLY TO SUPPORT THE ITN. THIS RESEARCH CONSORTIUM, ESTABLISHED IN 1999, PRIMARILY FOCUSES ON DEVELOPING NEW TOLEROGENIC APPROACHES FOR TREATING AND PREVENTING DISEASES IN THREE CLINICAL AREAS: ASTHMA AND ALLERGIC DISEASES, AUTOIMMUNE DISEASES, AND IMMUNE-MEDIATED REJECTION OF TRANSPLANTED SOLID ORGANS, TISSUES, AND CELLS. BRI, AS THE PRIME RECIPIENT OF THIS GRANT, IS RESPONSIBLE FOR MANAGING THE OVERALL GRANT FROM NIAID, INCLUDING OVERSEEING ALL ASPECTS OF THE NETWORK'S INFRASTRUCTURE. AS OF 2022 FOLLOWING THE RETIREMENT OF DR. JERRY NEPOM, DR. JANE BUCKNER, PRESIDENT OF BRI, ASSUMED THE ROLE OF PRINCIPAL INVESTIGATOR OF THE ITN GRANT. DR. BUCKNER SERVES ON THE ITN STEERING COMMITTEE (NSC) AND THE ITN NETWORK EXECUTIVE COMMITTEE (NEC), AND PLAYED AN ACTIVE ROLE IN BOTH COMMITTEES AT OUR BIANNUAL IN-PERSON MEETINGS, PLAYING A CRITICAL ROLE IN TRACKING PROGRESS TOWARDS NETWORK GOALS AND DEVELOPING STRATEGIES TO MEET NETWORK OBJECTIVES.KEY OUTCOMES DURING THIS PERIOD INCLUDE:THE ITN CROSS-NETWORK INTEGRATION: SINCE 2014, THE ITN HAS EXCELLED WITH A STRONG FOCUS ON METICULOUS PLANNING AND COLLABORATION ACROSS THE ITN'S MAJOR CENTERS, LOCATED IN SEATTLE (BRI), SAN FRANCISCO (UNIVERSITY OF CALIFORNIA SAN FRANCISCO), DURHAM, NC (DUKE), BOSTON (BRIGHAM WOMEN'S HOSPITAL), ATLANTA (EMORY), AND ANN ARBOR (U OF MICHIGAN). THAT SUCCESSFUL COLLABORATION CONTINUED WITH THE FOLLOWING KEY OUTCOMES DURING THIS PERIOD:1. EFFECTIVE COLLABORATION WAS PARTICULARLY EVIDENT THIS PAST YEAR WITH THE PUBLICATION OF THE PRIMARY MANUSCRIPT FROM THE LEAP TRIO STUDY, THE SECOND FOLLOW-UP TO THE ITN'S GROUNDBREAKING LEAP STUDY, WHICH DEMONSTRATED THAT EARLY INTRODUCTION OF PEANUTS EFFECTIVELY HELPS PREVENT THE DEVELOPMENT OF PEANUT ALLERGY. THE FIRST FOLLOW-UP STUDY, LEAP-ON (2016), SHOWED THAT THIS PROTECTION PERSISTED EVEN AFTER A YEAR OF PEANUT AVOIDANCE (BETWEEN AGES 5 AND 6). NOW, DATA FROM THE LEAP TRIO STUDY, WHICH EXAMINED THE DURABILITY OF PEANUT TOLERANCE AT 144 MONTHS (AGE 12) AFTER YEARS OF AD LIBITUM PEANUT CONSUMPTION, DEMONSTRATE THAT TOLERANCE TO PEANUTS LASTS INTO ADOLESCENCE, IRRESPECTIVE OF SUBSEQUENT PEANUT CONSUMPTION. THESE FINDINGS HIGHLIGHT THAT LONG-TERM PREVENTION AND TOLERANCE IN FOOD ALLERGY CAN BE ACHIEVED.2. IN LINE WITH THE NIH DATA SHARING POLICY, THE ITN COORDINATING CENTER REVIEWED AND APPROVED 14 SAMPLE AND DATA SHARING REQUESTS THROUGH ITN TRIALSHARE, THE ITN'S DATA-SHARING PORTAL.3. OPERATIONS AND CLINICAL TRIAL SUPPORT: THE ITN COORDINATING CENTER AT BRI ISSUED OVER 275 SUBAWARDS DURING THIS REPORTING PERIOD TO SUPPORT 23 ACTIVE ITN CLINICAL TRIALS AND NUMEROUS SUPPORTING ITN MECHANISTIC TRIALS. DURING THIS REPORTING PERIOD, THE COORDINATING CENTER ALSO COMPLETED THE CONTRACTING COMPONENT FOR ONE OF THE TWO NIAID-SPONSORED COVID-19 CLINICAL TRIALS THEY HAD SUPPORTED AND FUNDED THROUGH ADMINISTRATIVE SUPPLEMENTS, WITH THE FINAL STUDY SET TO CONCLUDE IN Q3 2025.4. SUPPLEMENTAL FUNDING / PARTNERSHIPS: THE ITN COORDINATING CENTER CONTINUED TO FOCUS ON IDENTIFYING ADDITIONAL OPPORTUNITIES FOR SUPPLEMENTAL FUNDING AND FUNDING PARTNERSHIPS.A) SUPPLEMENTAL FUNDING: THE ITN COORDINATING CENTER AT BRI SUCCESSFULLY SUBMITTED ONE SUPPLEMENTAL FUNDING REQUEST IN 2023, WHICH WILL PROVIDE AN ADDITIONAL $1 MILLION PER YEAR THROUGH 2027. B) PARTNERSHIPS: THE ITN SUCCESSFULLY FULFILLED ITS PARTNERSHIP WITH A PHARMACEUTICAL COMPANY FOR PARTIAL FUNDING FOR AN ITN STUDY THAT ENDED IN LATE 2023. C) PARTNERSHIPS: SUCCESSFULLY NEGOTIATED COMMITMENTS FOR PARTIAL FINANCIAL SUPPORT FOR THREE ITN TRIALS TOTALING $7.3 MILLION. THOSE FUNDING AGREEMENTS WILL BE FINALIZED IN EARLY 2025. 5. PUBLICATION ACTIVITY: IN TOTAL, 35 ITN PUBLICATIONS WERE PUBLISHED DURING THIS REPORTING PERIOD IN PRESTIGIOUS RESEARCH JOURNALS AND PRESENTED AT DOMESTIC AND INTERNATIONAL RESEARCH CONFERENCES. THESE PUBLICATIONS REPRESENTED ITN RESEARCH IN ALL THERAPEUTIC FOCUS AREAS: AUTOIMMUNITY, TRANSPLANTATION, AND ALLERGY. 12744134 934337 0 SCREENING FOR AUTOIMMUNE DISEASESIN 2024, BRI LAUNCHED ONE OF THE FIRST-EVER SCREENING INITIATIVES FOR AUTOIMMUNE DISEASES IN PRIMARY CARE. WHILE SCREENING IS COMMONPLACE FOR CANCER AND HEART DISEASE, SCREENING FOR AUTOIMMUNE DISEASES HAS NOT BEEN WIDELY AVAILABLE. A TEAM FROM BRI'S CENTER FOR INTERVENTIONAL IMMUNOLOGY LED BY CATE SPEAKE, PHD, AND SANDRA LORD, MD, LAUNCHED A STUDY TO IMPLEMENT SCREENING FOR TYPE 1 DIABETES, RHEUMATOID ARTHRITIS AND CELIAC DISEASE IN PRIMARY CARE. THE RESEARCH TEAM HAS NOW LAUNCHED SCREENING EFFORTS IN TWO VIRGINIA MASON FRANCISCAN HEALTH PRIMARY CARE CLINICS, EXAMINING HOW TO MAKE TESTING AS EASY AND EFFICIENT AS POSSIBLE FOR PATIENTS AND PROVIDERS. ONCE THIS STUDY IS COMPLETE, RESEARCHERS HOPE TO IMPLEMENT THIS SCREENING ACROSS VIRGINIA MASON FRANCISCAN HEALTH AND ULTIMATELY MAKE IT A STANDARD PART OF PRIMARY CARE. THIS COULD HELP VAST NUMBERS OF PEOPLE ACROSS THE COUNTRY UNDERSTAND THEIR RISK, START TREATMENT EARLY AND AVOID SEVERE COMPLICATIONS LIKE DIABETIC KETOACIDOSIS IN T1D.THIS STUDY IS FUNDED BY A GENEROUS DONATION FROM THE JOLENE MCCAW FAMILY FOUNDATION. NEW FRONTIERS IN TISSUE-SPECIFIC IMMUNOLOGYTRADITIONALLY, SCIENTISTS HAVE STUDIED IMMUNE SYSTEM DISEASES BY LOOKING AT BLOOD SAMPLES. BUT THEY'VE ALSO KNOWN THAT STUDYING THE ACTUAL TISSUE THAT THOSE DISEASES AFFECT THE JOINTS IN RHEUMATOID ARTHRITIS (RA) OR THE SKIN IN SCLERODERMA COULD PROVIDE EVEN MORE INFORMATION. THE PROBLEM IS, TISSUE IS HARD TO COME BY. IT'S MORE FEASIBLE TO COLLECT AND STUDY BLOOD SAMPLES THAN IT IS TO DO THE SAME WITH TISSUE FROM JOINTS OR THE SKIN. THAT'S WHY TISSUE-SPECIFIC IMMUNOLOGY HAS BECOME A CORE FOCUS FOR BRI, EXPLORING NEW WAYS TO STUDY TISSUES IN THE DISEASES WHERE THEY HAPPEN. THANKS TO OUR PARTNERSHIP WITH VIRGINIA MASON FRANCISCAN HEALTH, BRI'S EDDIE JAMES, PHD, IS STUDYING RHEUMATOID ARTHRITIS (RA) IN TISSUE SAMPLES FROM PEOPLE WHO HAVE HAD JOINT REPLACEMENTS. INSTEAD OF DISCARDING THE JOINT TISSUE REMOVED DURING SURGERY, SOME PATIENTS OPT TO DONATE THAT TISSUE TO RESEARCH. DR. JAMES AND HIS TEAM CAN THEN STUDY THAT TISSUE TO BETTER UNDERSTAND EXACTLY WHY IMMUNE SYSTEM CELLS ARE ATTACKING THE JOINTS IN RA AND HOW WE CAN STOP THAT ATTACK TO TREAT OR PREVENT RA. BRI'S PETER MORAWSKI, PHD, AND HIS TEAM STUDY AUTOIMMUNE DISEASES THAT AFFECT THE SKIN INCLUDING PSORIASIS AND SCLERODERMA. THEY STUDY SKIN TISSUE IN THREE DIFFERENT FORMS: 3D ENGINEERED MODELS, DONATED TISSUE SAMPLES FROM PEOPLE WHO HAVE HAD TUMMY TUCKS, AND DONATED PUNCH BIOPSIES (TISSUE SAMPLES ABOUT THE SIZE OF A PENCIL ERASER) FROM PEOPLE WITH AND WITHOUT SCLERODERMA. A GROUNDBREAKING TOOL CALLED SPATIAL TRANSCRIPTOMICS IS HELPING THE TEAM BETTER UNDERSTAND HOW SCLERODERMA STARTS AND PROGRESSES. THIS TECHNOLOGY LETS THE RESEARCHERS LOOK DEEP INTO THE TISSUE AND SEE THE EXACT LOCATIONS OF INDIVIDUAL CELLS, HOW THEY INTERACT, AND EVEN THEIR INDIVIDUAL GENE EXPRESSION. THEY'LL USE THIS TOOL TO STUDY ONE AREA OF SKIN THAT SHOWS SYMPTOMS (SKIN THAT'S THICK, WAXY AND SOMETIMES A DIFFERENT COLOR THAN UNAFFECTED SKIN) AND ANOTHER AREA NOT SHOWING SIGNS OF DISEASE IN THE SAME PERSON. THEN THEY'LL DIRECTLY COMPARE THEM SIDE-BY-SIDE. THIS WILL HELP THE RESEARCH TEAM BETTER UNDERSTAND HOW THE DISEASE STARTS AND PROGRESSES AND MOVE CLOSER TO BETTER TREATMENTS AND PREVENTION. BRI'S JAMES LORD, MD, PHD, IS A PHYSICIAN-RESEARCHER FOCUSED ON INFLAMMATORY BOWEL DISEASES (IBD). ONE OF THE BIGGEST CHALLENGES OF TREATING IBD IS THAT THERE ARE MANY DIFFERENT TREATMENTS AND NO WAY TO KNOW WHICH ONE WILL WORK BEST FOR WHICH PERSON. HIS TEAM IS WORKING TO CHANGE THAT BY STUDYING SMALL BIOPSY SAMPLES FROM COLONOSCOPIES FROM PEOPLE TAKING A MEDICINE CALLED VENDOLIZUMAB FOR IBD. THOSE SAMPLES WILL HELP HIS TEAM BETTER UNDERSTAND EXACTLY WHICH CELLS THE TREATMENT AFFECTS AND WHY IT WORKS FOR SOME PEOPLE BUT NOT OTHERS. 7001171 775905 0 STUDYING DOWN SYNDROME AND TYPE 1 DIABETES (T1D) TO UNDERSTAND HOW AUTOIMMUNE DISEASES STARTIN OCTOBER 2023, BRI RECEIVED THE IMMUNE DRIVERS OF AUTOIMMUNE DISEASE (IDAD) GRANT. THIS STUDY IS EXAMINING PEOPLE AT HIGHER RISK FOR DEVELOPING AUTOIMMUNE DISEASES THOSE WITH DOWN SYNDROME (DS) AND THOSE WITH AUTOANTIBODIES FOR TYPE 1 DIABETES (T1D) TO BETTER UNDERSTAND HOW AND WHY AUTOIMMUNE DISEASES DEVELOP. THIS WORK BUILDS ON PREVIOUS FINDINGS FROM BERNARD KHOR, MD, PHD, WHICH FOUND THAT INDIVIDUALS WITH DS EXPERIENCE PREMATURE IMMUNE AGING AND ARE SIGNIFICANTLY MORE LIKELY TO DEVELOP CONDITIONS LIKE AUTOIMMUNITY AND INFECTIONS. THE IDAD GRANT WILL SUPPORT A MULTIDISCIPLINARY EFFORT LED BY BRI SCIENTISTS TO IDENTIFY THE GENETIC, MOLECULAR, AND ENVIRONMENTAL FACTORS THAT DRIVE AUTOIMMUNE DISEASE PROGRESSION. RESEARCHERS WILL COMPARE IMMUNE PROFILES OF INDIVIDUALS WITH DS WITH THOSE AT RISK FOR T1D TO UNCOVER COMMON MECHANISMS OF IMMUNE DYSFUNCTION. THE STUDY WILL DRAW FROM BRI'S EXTENSIVE BIOREPOSITORIES, PROVIDING A VALUABLE RESOURCE FOR ADVANCING KNOWLEDGE IN THIS FIELD. THIS RESEARCH HAS THE POTENTIAL TO INFORM NEW TREATMENTS AND PREVENTION FOR AUTOIMMUNE DISEASES IN PEOPLE WITH AND WITHOUT DS. 409078 0 4770955 UNDERSTANDING HOW LUPUS STARTS AND PROGRESSESSCIENTISTS HAVE LONG KNOWN THAT AN ANTIBODY CALLED IGG PLAYS A BIG ROLE IN LUPUS. BUT BRI'S HAYLEY WATERMAN, PHD, WANTED TO KNOW - DO OTHER ANTIBODIES PLAY A ROLE IN LUPUS TOO? SHE LAUNCHED A STUDY EXAMINING WHETHER AN ANTIBODY CALLED IGA MAY ALSO PLAY A ROLE. SHE FOUND THAT IGA PLAYED A SMALL ROLE IN LUPUS. BUT WHEN SHE TESTED IGA AND IGG TOGETHER, SHE FOUND A MUCH BIGGER IMMUNE SYSTEM RESPONSE THAN EITHER ANTIBODY ACTING ALONE. DR. WATERMAN'S FINDINGS COULD LEAD TO BREAKTHROUGHS IN BOTH DIAGNOSING AND TREATING LUPUS. LUPUS IS OFTEN DIFFICULT TO DIAGNOSE BECAUSE IT HAS A WIDE RANGE OF SYMPTOMS THAT OFTEN COME AND GO. AND CURRENTLY AVAILABLE TREATMENTS DON'T WORK EQUALLY WELL FOR EVERYONE. SO RESEARCH INTO SIGNS OF IGA AND IGG WORKING TOGETHER - AND FINDING WAYS TO DISRUPT THAT - HOLDS TREMENDOUS PROMISE FOR ADVANCING CARE FOR THIS DEBILITATING DISEASE.AFTER THIS INITIAL FINDING, DR. WATERMAN AND HER MENTOR, JESSICA HAMERMAN, PHD, RECEIVED SIGNIFICANT NIH FUNDING TO FURTHER EXPLORE THESE FINDINGS. THEY PLAN TO STUDY EXACTLY HOW IGA AND IGG WORK TOGETHER TO CAUSE THIS SIGNIFICANT IMMUNE SYSTEM RESPONSE IN LUPUS. THEY'RE ALSO INTERESTED IN STUDYING WHETHER THE PRESENCE OF IGA MIGHT EXPLAIN WHY LUPUS CAN HAVE SUCH A WIDE ARRAY OF SYMPTOMS. LUPUS CAN CAUSE EVERYTHING FROM A SKIN RASH TO ARTHRITIS TO KIDNEY AND LUNG PROBLEMS, BUT SCIENTISTS DON'T FULLY UNDERSTAND WHY IT AFFECTS PEOPLE IN DIFFERENT WAYS. THE RESEARCH TEAM WANTS TO FIND OUT IF IGA IS ASSOCIATED WITH CERTAIN SYMPTOMS OR MORE SEVERE DISEASE.CLINICAL RESEARCH PROGRAM BRI OVERSEES THE CLINICAL RESEARCH PROGRAM AT VIRGINIA MASON MEDICAL CENTER, UNIQUELY COMBINING THE EXPERTISE OF A WORLD-RENOWNED MEDICAL RESEARCH INSTITUTE WITH THE CARE OF A HEALTHCARE QUALITY LEADER. THE CLINICAL RESEARCH PROGRAM SUPPORTS VIRGINIA MASON CLINICAL INVESTIGATORS IN STUDIES ACROSS A WIDE VARIETY OF AUTOIMMUNE AND IMMUNE-MEDIATED DISEASES AND CONDITIONS, AS WELL AS A BROAD RANGE OF OTHER DISEASES SUCH AS CANCER AND CARDIAC DISEASE. THE CLINICAL RESEARCH PROGRAM STAFF ANNUALLY ENROLLS APPROXIMATELY 2,264 STUDY PARTICIPANTS INTO VIRGINIA MASON TRIALS.INNOVATION FUND AWARDESTABLISHED IN 2023, THE INNOVATION FUND AWARD IS GIVEN TWICE A YEAR TO INTERNAL RECIPIENTS AT BRI. THE OBJECTIVE IS TO FACILITATE DEVELOPMENT AND IMPLEMENTATION OF NEW TECHNOLOGIES THAT WILL ADVANCE WORK ACROSS OUR INSTITUTION, THROUGH THE FUNDING OF COLLABORATIVE PROJECTS. EACH AWARD IS FUNDED BY PHILANTHROPY. BRI'S REGULAR TRACK AND RESEARCH TRACK FACULTY ARE AWARD ELIGIBLE. PROJECTS ARE REQUIRED TO INCLUDE TWO OR MORE BRI FACULTY AND ADDRESS INNOVATIONS USEFUL TO MULTIPLE RESEARCH GROUPS WITHIN THE INSTITUTE. FURTHER, IT IS REQUIRED THAT THE PROTOCOLS AND RESULTS GENERATED IN THE PROJECT WILL BE MADE AVAILABLE TO ALL BRI INVESTIGATORS. AT THE END OF 2023, EDDIE JAMES, PHD, AND CAROLINE STEFANI, PHD, EARNED AN INNOVATION FUND GRANT TO COMBINE TWO GROUNDBREAKING TECHNOLOGIES: LAB-GROWN HUMAN BETA CELLS AND A STATE-OF-THE-ART MICROSCOPE. BETA CELLS ARE PANCREAS CELLS THAT THE IMMUNE SYSTEM ATTACKS IN T1D. PREVIOUSLY, THE ONLY WAY TO STUDY THESE CELLS WAS IF SOMEONE DIED AND DONATED THEIR BODY TO SCIENCE. IN 2023, BRI'S AISHA CALLEBAUT, PHD, TRAVELED TO BELGIUM TO LEARN A NEW WAY TO ACCESS THESE CELLS: GROWING THEM FROM HUMAN BETA CELLS. THE INNOVATION FUND GRANT SUPPORTED THE IMPLEMENTATION OF TOOLS AND TECHNOLOGY NEEDED TO GROW THESE CELLS AT BRI. NOW, DRS. JAMES AND STEFANI ARE EXAMINING THESE LAB-GROWN CELLS TO BETTER UNDERSTAND WHY IMMUNE SYSTEM CELLS ATTACK BETA CELLS IN T1D AND HOW THEY MIGHT MAKE BETA CELLS MORE RESILIENT TO THAT ATTACK. THIS TECHNIQUE AND INFRASTRUCTURE CAN ALSO BE USED TO ENGINEER OTHER TYPES OF IMMUNE CELLS - FROM NEURONS, TO SKIN CELLS TO GUT CELLS - OPENING THE DOOR TO ANSWER NEW AND IMPORTANT QUESTIONS ABOUT A WIDE VARIETY OF DISEASES. IN 2024, BRI PRESIDENT JANE BUCKNER, MD, AND OLIVER HARRISON, DPHIL, EARNED AN INNOVATION FUND GRANT TO IMPLEMENT NEW METHODS OF GENOME ENGINEERING IN HUMAN T CELLS AND MICE, USING CRISPR/CAS9 AND ADENO-ASSOCIATED VIRUS TECHNOLOGY. THIS COLLABORATION BETWEEN THE HARRISON AND BUCKNER LABS AIMS TO CREATE ADVANCED MODELS FOR STUDYING AUTOIMMUNE DISEASE.DR. BUCKNER'S TEAM WILL ENGINEER HUMAN T CELLS BY REINTRODUCING T CELL RECEPTOR SEQUENCES, ALLOWING RESEARCHERS TO STUDY AUTOREACTIVE T CELLS. MEANWHILE, DR. HARRISON'S GROUP WILL DEVELOP NEW TRANSGENIC MOUSE MODELS, INCLUDING MICE WITH B CELL RECEPTORS THAT RECOGNIZE BACTERIAL ANTIGENS. THESE INNOVATIVE APPROACHES WILL ENHANCE BRI'S ABILITY TO STUDY IMMUNE RESPONSE, IMPROVE DISEASE MODELS, AND BETTER UNDERSTAND THE ROLE OF B AND T CELLS IN AUTOIMMUNITY. 409078 0 4770955 73646780 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 1 1 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 65 0 1 320 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WA X HELEN CLAGETT 2063426503 1201 NINTH AVENUE SEATTLE WA 98101 KETUL PATEL CHIEF EXECUTIVE OFFICER VMFH 10.00 2.00 X 2613387 0 32903 JANE BUCKNER MD PRESIDENT 40.00 0.00 X 501678 0 32412 MARGARET MCCORMICK PHD EXECUTIVE DIRECTOR & COO 40.00 0.00 X 303699 0 35478 WILLIAM KWOK PHD RESEARCH MEMBER 40.00 0.00 X 286471 0 33612 DANIEL CAMPBELL PHD DIRECTOR, CENTER FOR FUNDAMENTAL IMMUNOLOGY 40.00 0.00 X 230355 0 20619 JESSICA HAMERMAN PHD DIRECTOR, ACADEMIC AFFAIRS 40.00 0.00 X 229026 0 18505 CARMEN MIKACENIC MD ASSOCIATE RESEARCH MEMBER 40.00 0.00 X 224166 0 29448 PETER LINSLEY PHD MEMBER, PRINCIPAL INVESTIGATOR 40.00 0.00 X 220411 0 33924 MICHAEL LABOSIER CFO 40.00 0.00 X 186969 0 27689 CHUCK ARNOLD DIRECTOR 2.00 2.00 X 0 0 0 BOB CARLILE DIRECTOR 2.00 2.00 X 0 0 0 MIRIAM CHAMBLISS CORPORATE SECRETARY / VP DIV GENERAL COUNSEL 2.00 2.00 X 0 0 0 ULI CHI PHD DIRECTOR/CHAIR 2.00 2.00 X X 0 0 0 SISTER JUDE CONNELLY OSF DIRECTOR (PARTIAL YEAR) 2.00 2.00 X 0 0 0 CAROLYN CORVI DIRECTOR 2.00 2.00 X 0 0 0 SISTER RUTH GOODWIN OSF DIRECTOR 2.00 2.00 X 0 0 0 TOD HAMACHEK DIRECTOR 2.00 2.00 X 0 0 0 DENNIS HUNTHAUSEN DIRECTOR 2.00 2.00 X 0 0 0 KAREN LEE DIRECTOR 2.00 2.00 X 0 0 0 ROBERT LEMON DIRECTOR/VICE CHAIR 2.00 2.00 X X 0 0 0 GREGG MEYER MD MSC DIRECTOR 2.00 2.00 X 0 0 0 DAVID NOSACKA TREASURER / SVP & CFO VMFH 0.00 2.00 X 0 0 0 JOHN OPPENHEIMER DIRECTOR 2.00 2.00 X 0 0 0 MARVIN O'QUINN DIRECTOR (PARTIAL YEAR) 2.00 2.00 X 0 0 0 DIANN PULS DIRECTOR 2.00 2.00 X 0 0 0 4796162 0 264590 91 0 1 1 INFINITY BIOLOGIX LLC PO BOX 23532 NEW YORK NY 100873532 LABORATORY SERVICES 351620 NORTH FORK HOLDINGS LLC 1933 N MEACHAM RD STE 220 SCHAUMBURG IL 60173 SOFTWARE CONSULTING 160957 FINLEY & COOK CPA 1421 E 45TH ST PO DRAWER 1447 SHAWNEE OK 74802 SOFTWARE CONSULTING 142417 3 64307227 23386018 87693245 COMMERCIAL STUDIES 621500 4450908 4450908 0 0 EXTERNAL CORE INCOME 621500 320047 320047 0 0 4770955 407521 407521 707525 0 707525 707525 707525 93579246 4770955 0 1115046 35991061 35991061 1841244 1841244 890702 541345 349357 26358556 18309091 8049465 2384735 1632470 752265 3057160 2092778 964382 2038059 1395152 642907 25958 25958 2118084 1590061 528023 90948 26067 64881 2013182 793016 1220166 3442015 3006423 435592 202649 157940 44709 46713 41750 4963 889305 773695 115610 1390067 1182456 207611 203970 63314 140656 MEDICAL SUPPLIES 3394018 3295310 98708 0 PATIENT COSTS 593883 593883 0 0 RESEARCH PARTICIPANTS E 234768 234286 482 0 OTHER PURCHASED SERVICE 226020 85438 140582 0 83025 83025 87516122 73646780 13869342 0 8265497 4930235 1478988 1603243 8245451 10949904 984414 358536 0 0 0 0 937229 996445 31629991 3732240 28627035 27897751 11284790 12095276 33041866 35963558 0 0 1489093 1243134 94354363 96038082 6437799 6125525 0 6319599 4908061 28272047 27524602 0 0 0 0 1706233 1771209 42735678 40329397 X 16899685 17770685 34719000 37938000 51618685 55708685 94354363 96038082 6063124 -1973124 0 X 0 1 X 1 1 1 X VIRGINIA MASON MEDICAL CENTER SEATTLE WA 60664155 34152956 78966994 75771314 87693245 337248664 60664155 34152956 78966994 75771314 87693245 337248664 24183121 313065543 1174418 525133 8844594 929807 1115046 12588998 6105766 3157242 5286187 5702614 4770955 25022764 374860426 0.83520 0.82020 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: CLINICAL RESEARCH PROGRAM REVENUE - 2019 AMOUNT: $ 5,569,393. 2020 AMOUNT: $ 2,665,138. 2021 AMOUNT: $ 4,732,659. 2022 AMOUNT: $ 4,631,252. 2023 AMOUNT: $ 4,450,908. COLLABORATIVE RESEARCH AGREEMENT PROJECTS - EXTERNAL CORE INCOME - 2019 AMOUNT: $ 430,308. 2020 AMOUNT: $ 394,817. 2021 AMOUNT: $ 553,528. 2022 AMOUNT: $ 1,071,362. 2023 AMOUNT: $ 320,047. MISCELLANEOUS INCOME - 2019 AMOUNT: $ 106,065. 2020 AMOUNT: $ 97,287. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 157006 12373 169379 1277668784 1277838163 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 205420 219020 153865 169379 747684 1000000 250000 250000 250000 1750000 2625000 126542 203020 142625 157006 629193 0 1 14110000 14110000 12362749 1219375 11143374 4912695 2512865 2399830 244547 244547 27897751 INTEREST IN NET ASSETS OF VIRGINIA MASON MEDICAL CENTER 35963558 F 35963558 LEASE LIABILITY (RELATES TO RIGHT-OF-USE ASSET) 1354084 DUE TO RELATED PARTIES 417125 1771209 X PART X, LINE 2: BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. PART X, LINE 1 IN ACCORDANCE WITH ASC TOPIC 842 LEASES, THE RESEARCH INSTITUTE ADOPTED THE LEASE STANDARD AND RECORDED LEASE LIABILITIES OVER THE LEASE TERMS BETWEEN 3 AND 10 YEARS. THE LEASES ARE PRIMARILY FOR REAL ESTATE, INCLUDING OFF-CAMPUS OUTPATIENT FACILITIES, MEDICAL OFFICE BUILDINGS, AND CORPORATE AND ADMINISTRATIVE OFFICES. PART V ENDOWMENT FUNDS BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON'S (BRI) SOLE CORPORATE MEMBER IS VIRGINIA MASON FRANCISCAN HEALTH (VMFH). VMFH IS A SUPPORTING ORGANIZATION OF BRI AND VIRGINIA MASON MEDICAL CENTER (VMMC). VMMC HOLDS ENDOWMENT FUNDS THAT SUPPORT BRI RESEARCH AIMED AT DIABETES, RHEUMATOLOGY, IMMUNOLOGY, AND OTHER RESEARCH. THE BALANCE OF THESE ENDOWMENTS WAS $33.0 MILLION AND $36.0 MILLION ON JUNE 30, 2023 AND JUNE 30, 2024, RESPECTIVELY. 1 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 GRANT MEDICAL RESEARCH 1738204 NORTH AMERICA 0 0 GRANT MEDICAL RESEARCH 103040 0 0 0 0 0 0 1841244 0 1841244 EUROPE (INCLUDING ICELAND AND GREENLAND) GENERAL SUPPORT 72244 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) GENERAL SUPPORT 1543197 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) GENERAL SUPPORT 115311 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) GENERAL SUPPORT 7452 WIRE TRANSFER 0 NORTH AMERICA GENERAL SUPPORT 103040 WIRE TRANSFER 0 0 5 0 0 0 0 0 0 PART I, LINE 2: SUB-RECIPIENT MONITORING POLICY -MEDICAL RESEARCH SUB AWARD BRI HAS FORMAL POLICIES AND PRODECURES TO ASSURE FULL COMPLIANCE WITH APPLICABLE POLICIES AND LAWS GOVERNING FEDERAL GRANTS. THE SUB-RECIPIENT MONITORING POLICY PROVIDES ASSURANCE THAT SUB-RECIPIENTS COMPLY WITH FEDERAL GRANT REGULATIONS. THIS POLICY SETS THE CRITERIA TO ESTABLISH ELIGIBILITY OF SUB-RECIPIENTS TO PROVIDE ANNUAL AUDITED FINANCIAL REPORTS AND THE ANNUAL OMB SINGLE AUDIT REPORT THAT IDENTIFY COMPLIANCE WITH FEDERAL LAWS AND REGULATIONS. THE REPORTS ARE ANALYZED WITH EMPHASIS ON AUDITOR'S ASSESSMENT OF SUB-RECIPIENT INTERNAL CONTROLS AND A STANDARDIZED RISK ASSESSMENT IS PRESENTED TO MANAGEMENT ON EACH SUB-RECIPIENT. A MANAGEMENT LETTER IS ISSUED TO EACH SUB-RECIPIENT SHOWING ANY FINDINGS ON THEIR OMB SINGLE AUDIT REPORT, AND MEASUREMENTS ARE SET FOR INCREASED MONITORING WHEN AN ELEVATED LEVEL OF RISK IS ESTABLISHED. MANAGEMENT HAS COMMUICATED WITH AN EDUCATED ADMINISTRATIVE STAFF REGARDING IMPLEMENTATION OF THIS POLICY. THE DIRECTOR OF GRANTS AND CONTRACTS IS RESPONSIBILE FOR MONITORING SUB-RECIPIENT ADHERENCE TO FINANCIAL REGULATIONS. THE PRINCIPAL INVESTIGATOR IS RESPONSIBLE FOR OVERSEEING THE SATISFACTORY PERFORMANCE OF THE SUB-AWARD TO ENSURE THAT GOALS ARE ACHIEVED. IF THERE ARE UNUSUAL OR UNFORESEEN ITEMS, THESE WILL BE INVESTIGATED. PART 1, LINE 3F THE EXPENDITURES WERE ACTUAL EXPENSES INCURRED IN THE REGION BASED ON INDIVIDUAL EXPENSE REPORTS AND TRACKING OF EXPENDITURES BY GRANT OR DEPARTMENT ON THE ACCRUAL BASIS OF ACCOUNTING. PART II, LINE 1 THE EXPENDITURES WERE EXPENSES INCURRED IN THE REGION BASED ON AWARD GOALS ON THE ACCRUAL BASIS OF ACCOUNTING. 1 ADVARRA INC PO BOX 74008070 CHICAGO IL 606748070 311358981 357835 0 MEDICAL FND SUPPORT ALLEN INSTITUTE 615 WESTLAKE AVE N SEATTLE WA 981094307 912155317 501C3 172923 0 MEDICAL FND SUPPORT ARKANSAS CHILDREN'S RESEARCH INSTITUTE ONE CHILDRENS WAY FINANCIAL SVCS SLOT 663 LITTLE ROCK AR 722023591 710694931 509C3 39424 0 MEDICAL FND SUPPORT AZENTA LIFE SCIENCES PO BOX 3865 CAROL STEAM IL 601323865 200628587 501C3 2405904 0 MEDICAL FND SUPPORT BAYLOR COLLEGE OF MEDICINE ONE BAYLOR PLAZA SUITE 600-D HOUSTON TX 770303411 741613878 501C3 5767 0 MEDICAL FND SUPPORT BRIGHAM AND WOMEN'S HOSPITAL BANK OF AMERICA NA PO BOX 3887 BOSTON MA 022413887 042312909 501C3 1246280 0 MEDICAL FND SUPPORT CEDARS-SINAI MEDICAL CENTER 6500 WILSHIRE BLVD SUITE 1150 LOS ANGELES CA 90048 951644600 501C3 80327 0 MEDICAL FND SUPPORT CHILDREN'S HOSPITAL OF PHILADELPHIA PO BOX 8550 LOCKBOX 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THE SUB-RECIPIENT MONITORING POLICY PROVIDES ASSURANCE THAT SUB-RECIPIENTS COMPLY WITH FEDERAL GRANT REGULATIONS. THIS POLICY SETS THE CRITERIA TO ESTABLISH ELIGIBILITY OF SUB-RECIPIENTS TO PROVIDE ANNUAL AUDITED FINANCIAL REPORTS AND THE ANNUAL OMB SINGLE AUDIT REPORT THAT IDENTIFY COMPLIANCE WITH FEDERAL LAWS AND REGULATIONS. THE REPORTS ARE ANALYZED WITH EMPHASIS ON AUDITOR'S ASSESSMENT OF SUB-RECIPIENT INTERNAL CONTROLS AND A STANDARDIZED RISK ASSESSMENT IS PRESENTED TO MANAGEMENT ON EACH SUB-RECIPIENT. A MANAGEMENT LETTER IS ISSUED TO EACH SUB-RECIPIENT SHOWING ANY FINDINGS ON THEIR OMB SINGLE AUDIT REPORT, AND MEASUREMENTS ARE SET FOR INCREASED MONITORING WHEN AN ELEVATED LEVEL OF RISK IS ESTABLISHED. MANAGEMENT HAS COMMUICATED WITH AN EDUCATED ADMINISTRATIVE STAFF REGARDING IMPLEMENTATION OF THIS POLICY. THE DIRECTOR OF GRANTS AND CONTRACTS IS RESPONSIBILE FOR MONITORING SUB-RECIPIENT ADHERENCE TO FINANCIAL REGULATIONS. THE PRINCIPAL INVESTIGATOR IS RESPONSIBLE FOR OVERSEEING THE SATISFACTORY PERFORMANCE OF THE SUB-AWARD TO ENSURE THAT GOALS ARE ACHIEVED. IF THERE ARE UNUSUAL OR UNFORESEEN ITEMS, THESE WILL BE INVESTIGATED. X X X X 0 1 0 0 0 0 0 0 0 KETUL PATEL CHIEF EXECUTIVE OFFICER VMFH 1393552 0 959840 0 259995 0 19350 0 13553 0 2646290 0 0 0 JANE BUCKNER MD PRESIDENT 501678 0 0 0 0 0 30000 0 2412 0 534090 0 0 0 MARGARET MCCORMICK PHD EXECUTIVE DIRECTOR & COO 303699 0 0 0 0 0 30000 0 5478 0 339177 0 0 0 WILLIAM KWOK PHD RESEARCH MEMBER 285671 0 800 0 0 0 30000 0 3612 0 320083 0 0 0 DANIEL CAMPBELL PHD DIRECTOR, CENTER FOR FUNDAMENTAL IMM 228955 0 1400 0 0 0 15219 0 5400 0 250974 0 0 0 JESSICA HAMERMAN PHD DIRECTOR, ACADEMIC AFFAIRS 227626 0 1400 0 0 0 11701 0 6804 0 247531 0 0 0 CARMEN MIKACENIC MD ASSOCIATE RESEARCH MEMBER 223366 0 800 0 0 0 22500 0 6948 0 253614 0 0 0 PETER LINSLEY PHD MEMBER, PRINCIPAL INVESTIGATOR 219611 0 800 0 0 0 30000 0 3924 0 254335 0 0 0 MICHAEL LABOSIER CFO 186169 0 800 0 0 0 22617 0 5072 0 214658 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED BY COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. PART I, LINE 4B CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2023, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: KETUL J PATEL, $246,662. SCHEDULE J, PART II: BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023. KETUL PATEL WAS COMPENSATED BY COMMONSPIRIT HEALTH FOR HIS SERVICES TO BENAROYA RESEARCH INSTITUTE. FOR 990 PURPOSES, COMMONSPIRIT HEALTH IS AN UNRELATED ORGANIZATION, SO COMPENSATION HAS BEEN PRESENTED AS PAID BY BENAROYA RESEARCH INSTITUTE. A WA ECON DEVEL FIN AUTH-2019 SERIES A 911493002 000000000 2019-02-26 25716490 SEE PART VI 0 1 0 B WA ECON DEVEL FIN AUTH-2019 SERIES B 911493002 000000000 2019-02-26 6000000 SEE PART VI 0 1 0 A 3503018 25716490 25716490 1 0 1 1 B 452789 6000000 6000000 2022 1 0 1 1 A 0 0 0 1 1 0.03840 0.03840 0 0 1 B 0 0 0 1 1 0.03840 0.03840 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 PART 1, LINE A, COLUMN F PURPOSES: TO REFUND WEDFA SERIES 2012 B BONDS ISSUED 06/01/2012, AND WEDFA SERIES 2016 BONDS ISSUED ON 06/01/2016. PART 1, LINE B, COLUMN F PURPOSES: TO FUND RESEARCH FACILITY IMPROVEMENTS AND EQUIPMENT PURCHASES ON A DRAW-DOWN BASIS OVER A THREE-YEAR PERIOD ENDING IN 2022. FORM 990, PART III, LINE 4: AT BRI, WE INTEGRATE THREE TYPES OF MEDICAL RESEARCH - LABORATORY RESEARCH, TRANSLATIONAL RESEARCH, AND CLINICAL RESEARCH - TO IMPROVE LIVES. ALL OUR SCIENTISTS COLLABORATE TO EXPLORE BASIC SCIENCE AS WELL AS CLINICAL APPLICATIONS, WHICH WE BELIEVE IS THE BEST WAY TO DESIGN STUDIES WITH THE HIGHEST POTENTIAL FOR SUCCESS. AT BRI, DISCOVERY STARTS IN THE LABORATORY BUT IS SPARKED BY THE NEEDS AND EXPERIENCES OF PATIENTS. FORM 990, PART III, LINE 1: BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON (BRI) IS ONE OF THE FEW RESEARCH INSTITUTES IN THE WORLD DEVOTED TO FINDING CAUSES AND CURES FOR AUTOIMMUNE AND IMMUNE SYSTEM DISEASES, INCLUDING TYPE 1 DIABETES, MULTIPLE SCLEROSIS, RHEUMATOID ARTHRITIS, LUPUS, INFLAMMATORY BOWEL DISEASE, CANCERS, ALLERGIES AND INFECTIOUS DISEASES. BRI IS AFFILIATED WITH COMMONSPIRIT HEALTH AND VIRGINIA MASON FRANCISCAN HEALTH, WHICH PROVIDES GOVERNANCE AND OVERSIGHT, AND THE VIRGINIA MASON FOUNDATION, WHICH PROVIDES DEVELOPMENT SUPPORT. BRI'S BOLD MISSION IS TO ADVANCE THE SCIENCE TO PREDICT, PREVENT, REVERSE AND CURE DISEASES OF THE IMMUNE SYSTEM TO ACHIEVE OUR VISION OF A HEALTHY IMMUNE SYSTEM FOR EVERYONE. BRI IS LED BY PRESIDENT JANE H. BUCKNER, MD, AND EXECUTIVE DIRECTOR/COO MARGARET MCCORMICK, PHD. DISCOVERIES AT BRI ARE ACCELERATED BY OUR TALENTED RESEARCHERS, COLLABORATIVE CULTURE AND APPLICATION OF NEW TECHNOLOGIES AND DATA ANALYTICS IN A QUEST TO UNDERSTAND WHAT CAN CAUSE THE IMMUNE SYSTEM TO FALL OUT OF BALANCE AND HOW TO RESTORE IT TO HEALTH. TO THAT END, OUR SCIENTIFIC ACTIVITIES ARE ORGANIZED INTO FOUR CENTERS OF DISCOVERY TO FACILITATE KNOWLEDGE SHARING AND FOR CENTERS AND CORE LABS TO BUILD ON DISCOVERIES FROM INDIVIDUAL LABS: - TRANSLATIONAL IMMUNOLOGY, DIRECTED BY KAREN CEROSALETTI, PHD - INTERVENTIONAL IMMUNOLOGY, DIRECTED BY CARLA GREENBAUM, MD - FUNDAMENTAL IMMUNOLOGY, DIRECTED BY DANIEL CAMPBELL, PHD - SYSTEMS IMMUNOLOGY, DIRECTED BY ADAM LACY-HULBERT, PHD THE CENTER FOR TRANSLATIONAL IMMUNOLOGY (CTI) INVOLVES STUDYING BLOOD AND TISSUE SAMPLES FROM PEOPLE WITH IMMUNE SYSTEM DISEASES INCLUDING AUTOIMMUNE DISEASES, ALLERGIES, INFECTIOUS DISEASES AND CANCER. CTI USES ADVANCED SYSTEMS IMMUNOLOGY TOOLS TO EXAMINE GENES, CELLS AND MOLECULES INVOLVED IN THESE DISEASES. ITS STUDIES AIM TO DISCOVER HOW DISEASES START AND PROGRESS; IDENTIFY BIOLOGICAL CHARACTERISTICS TIED TO CERTAIN DISEASES OR RESPONSE TO THERAPY; AND TO FIND NEW DRUG TARGETS. THE BRI BIOREPOSITORY IS A COLLECTION OF BLOOD, SERUM AND TISSUE SAMPLES AND MEDICAL HISTORIES FROM VOLUNTEERS WITH AND WITHOUT DISEASE. BRI SCIENTISTS AND PHYSICIAN COLLABORATORS WORK TOGETHER TO STUDY TISSUE, BLOOD AND SERUM SAMPLES ALONG WITH THE MEDICAL AND DEMOGRAPHIC DATA. BRI'S BIOREPOSITORIES DATE BACK TO 2000 AND INCLUDE MULTIPLE DISEASE CATEGORIES AND A BIOREPOSITORY OF HEALTHY PEOPLE FOR PURPOSES OF COMPARISON. THE CENTER FOR INTERVENTIONAL IMMUNOLOGY (CII) USES SMALL AND LARGE-SCALE CLINICAL STUDIES TO TRANSLATE LAB DISCOVERIES TO PATIENT THERAPIES. CII STUDIES ENCOMPASS ALL PHASES OF CLINICAL RESEARCH, FROM BRI'S BIOREPOSITORIES, WHICH ENROLL INDIVIDUALS WITH AND WITHOUT IMMUNE SYSTEM DISEASES, TO MULTI-CENTER CLINICAL TRIALS OF DISEASE-MODIFYING THERAPIES. INVESTIGATOR-INITIATED STUDIES OF SHORT-COURSE IMMUNOTHERAPY OR VACCINES SHOW HOW PERTURBING THE IMMUNE SYSTEM CAN REVEAL THE DIFFERENTIAL FUNCTIONS OF THE IMMUNE SYSTEM IMPACTED BY DISEASE. THE IMMUNE TOLERANCE NETWORK, A GLOBAL CONSORTIUM FOCUSED ON CONDUCTING CLINICAL TRIALS TO PROMOTE TOLERANCE IN AUTOIMMUNITY, ORGAN TRANSPLANT AND ALLERGY/ASTHMA IS PART OF THIS CENTER. THE CENTER FOR FUNDAMENTAL IMMUNOLOGY (CFI) INVESTIGATES THE IMMUNE SYSTEM TO UNDERSTAND HOW IT WORKS IN HEALTH AND DISEASE. INVESTIGATORS IN THE CFI LOOK AT THE CELLULAR AND MOLECULAR PATHWAYS THAT CONTROL THE IMMUNE SYSTEM, FOCUSING ON GENES, CELLS AND MOLECULES TO BUILD COMPLEX MODELS OF AUTOIMMUNE AND INFLAMMATORY DISEASES TO STUDY THEM IN PRECISE DETAIL. THE CENTER FOR SYSTEMS IMMUNOLOGY (CSI) USES THE LATEST COMPUTATIONAL TOOLS TO COLLECT, PROCESS AND EXAMINE DATA FROM STUDIES ACROSS BRI AND AROUND THE WORLD. CSI SELECTS AND IMPLEMENTS NEW TECHNOLOGIES AND DEVELOPS APPROACHES TO ORGANIZE AND ANALYZE LARGE DATA SETS. ITS GOAL IS TO MAKE NEW INSIGHTS ABOUT THE IMMUNE SYSTEM AND THE DISEASES THAT AFFECT IT. EXTERNAL AND ACADEMIC AFFAIRS AT BRI WE BUILD THE NEXT GENERATION OF LEADERS IN IMMUNOLOGY BY WORKING ACROSS OUR CENTERS WITH INTERNS, GRADUATE STUDENTS AND POSTDOCS. WE ALSO TEAM UP WITH OTHER RESEARCH INSTITUTES AND INDUSTRY PARTNERS TO TACKLE NEW RESEARCH QUESTIONS AND ACCELERATE DISCOVERIES. JESSICA HAMERMAN, PHD, IS OUR DIRECTOR FOR ACADEMIC AFFAIRS AND STEVEN ZIEGLER, PHD IS OUR DIRECTOR OF EXTERNAL COLLABORATION. IN 2024, BRI'S SUSANA OROZCO, PHD, WAS AWARDED A COMPUTATIONAL SKILLS GRANT FROM THE AMERICAN ASSOCIATION OF IMMUNOLOGISTS (AAI). WITH THIS GRANT, SHE'LL LEARN SOME OF THE LATEST COMPUTATIONAL TECHNIQUES FROM BRI'S HANNAH DEBERG, PHD, AND APPLY THEM TO HER RESEARCH STUDYING INFLAMMATORY HEMOPHAGOCYTES A TYPE OF CELL THAT PLAYS A ROLE IN DEADLY COMPLICATIONS OF RHEUMATIC DISEASES AND MALARIA. BRI PRESIDENT JANE BUCKNER, MD, RECEIVED AAI'S 2024 STEINMAN AWARD FOR HUMAN IMMUNOLOGY RESEARCH, WHICH RECOGNIZES AN INDIVIDUAL WHO HAS MADE SIGNIFICANT CONTRIBUTIONS TO THE UNDERSTANDING OF IMMUNE PROCESSES UNDERLYING HUMAN DISEASE PATHOGENESIS, PREVENTION OR THERAPY. AAI NAMED BRI'S STEVEN ZIEGLER, PHD, A DISTINGUISHED FELLOW, WHICH ACKNOWLEDGES ACTIVE, LONG-TERM AAI MEMBERS WHO HAVE DEMONSTRATED SIGNIFICANT RESEARCH ACCOMPLISHMENT, EXCEPTIONAL LEADERSHIP TO THE IMMUNOLOGY COMMUNITY, AND/OR DISTINCTION IN EDUCATION AND TEACHING. OVER THE PAST FISCAL YEAR, BRI HAS ALSO ENGAGED WITH MANY LOCAL ORGANIZATIONS THAT ENCOURAGE STUDENTS TO CONSIDER CAREERS IN SCIENCE AND HEALTHCARE. BRI HOSTED VIRTUAL SEMINARS FOR WASHINGTON STATE OPPORTUNITY SCHOLARSHIP (WSOS) STEM, CAREER AND TECHNICAL SCHOLARS. THESE SEMINARS INTRODUCE STUDENTS TO OUR INSTITUTE, WHAT WE DO AND HOW STAFF AND RESEARCHERS WORK TOGETHER TO ADVANCE SCIENCE THAT WILL PREDICT, PREVENT, REVERSE AND CURE DISEASES OF THE IMMUNE SYSTEM. OVER THE PAST FISCAL YEAR, BRI HAS ALSO ENGAGED WITH MANY LOCAL ORGANIZATIONS THAT ENCOURAGE STUDENTS TO CONSIDER CAREERS IN SCIENCE AND HEALTHCARE. BRI STAFF TALK TO STUDENTS ABOUT OUR INSTITUTE, WHAT WE DO AND HOW STAFF AND RESEARCHERS WORK TOGETHER TO ADVANCE SCIENCE THAT WILL PREDICT, PREVENT, REVERSE AND CURE DISEASES OF THE IMMUNE SYSTEM. FORM 990, PART VI, SECTION A, LINE 1A 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 CORPORATION; 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 BUSINESS; 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. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON THE ENTITY'S SOLE MEMBER IS VIRGINIA MASON FRANCISCAN HEALTH, A WASHINGTON NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A VIRGINIA MASON FRANCISCAN HEALTH ("VMFH") IS THE SOLE CORPORATE MEMBER OF BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON ("BRI"). ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B VIRGINIA MASON FRANCISCAN HEALTH ("VMFH") IS THE SOLE CORPORATE MEMBER OF BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON ("BRI"). EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION, ELSEWHERE IN THESE BYLAWS, OR IN THE LAWS OF THE STATE OF WASHINGTON, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. THE RIGHTS OF THE CORPORATE MEMBER SHALL BE FURTHER SUBJECT TO THE POWERS RESERVED TO CSH UNDER THE GOVERNANCE MATRIX (SUBJECT TO THE BYLAWS OF THE CORPORATE MEMBER) AND AS OTHERWISE SET FORTH IN THE BYLAWS OF THE CORPORATE MEMBER. IN ADDITION, SUBJECT TO THE BYLAWS OF THE CORPORATE MEMBER, THE RESERVED POWERS OF CSH SET FORTH IN THE GOVERNANCE MATRIX MAY BE UNILATERALLY EXERCISED BY CSH ON BEHALF OF THE CORPORATION, AT CSH'S SOLE DISCRETION, IF THE CORPORATION'S BOARD OF DIRECTORS FAILS TO ACT UPON SUCH MATTERS DESCRIBED IN THESE BYLAWS, OR IF THE CORPORATION'S BOARD OF DIRECTORS ATTEMPTS TO ACT IN A MANNER THAT CONFLICTS WITH OR OVERRIDES THE ACTIONS OR DESIRES OF CSH WITH RESPECT TO SUCH MATTERS. THE GOVERNANCE MATRIX MAY BE AMENDED FROM TIME TO TIME BY CSH, AND SUCH AMENDMENTS SHALL BE DEEMED TO BE A PART OF THESE BYLAWS WITHOUT FURTHER ACTION. THE CORPORATION SHALL BE DEEMED A "SUBSIDIARY" OF CSH FOR PURPOSES OF THE GOVERNANCE MATRIX. IN ADDITION TO THE RIGHTS RESERVED TO CSH UNDER THE GOVERNANCE MATRIX, CSH SHALL HAVE THE POWER TO TRANSFER ASSETS OF THE CORPORATION OR TO REQUIRE THE CORPORATION TO TRANSFER ASSETS TO CSH, TO THE EXTENT NECESSARY TO ACCOMPLISH CSH'S GOALS AND OBJECTIVES, AND TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF CSH OR AN ENTITY CONTROLLED BY, CONTROLLING, OR UNDER COMMON CONTROL WITH CSH (FOR PURPOSES OF THIS SECTION, A "CSH AFFILIATE"), ISSUED OR INCURRED BY OR ON BEHALF OF CSH OR A CSH AFFILIATE IN FURTHERANCE OF CSH'S GOALS AND OBJECTIVES. THE CORPORATION SHALL NOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THESE BYLAWS OR ITS ARTICLES OF INCORPORATION, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS OR OTHER CONTRACTS AS A RESULT OF ANY ASSET TRANSFERS MADE OR DIRECTED BY CSH. EXCEPT FOR TRANSFERS PREVIOUSLY APPROVED BY CSH, EITHER INDIVIDUALLY OR AS PART OF THE CSH HEALTHCARE SYSTEM BUDGET PROCESS, AND EXCEPT FOR TRANSFERS TO AN AFFILIATE OR SUBSIDIARY OF THE CORPORATION, THE CORPORATION SHALL NOT TRANSFER ASSETS TO ENTITIES OTHER THAN CSH OR CSH AFFILIATES WITHOUT THE APPROVAL OF CSH. FORM 990, PART VI, SECTION B, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15 THE VMMC 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 THE PRESIDENT AND CHIEF EXECUTIVE CONSISTENT WITH BRI'S COMPENSATION 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 EMPLOYEE'S DUTIES AND RESPONSIBILITIES. CONSISTENT WITH THE 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 COMMITTEE'S DECISIONS REGARDING COMPENSATION FOR EACH EXECUTIVE ARE DOCUMENTED IN WRITTEN RESOLUTIONS AND MINUTES OF THE COMMITTEE. THE COMMITTEE PROMPTLY REPORTS ITS ACTIONS TO THE VMMC BOARD WHICH REPORTS ARE REFLECTED IN THE BOARD'S MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES, BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. 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