2022-05-06T11:24:35-05:00 2021-06-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2020-07-01 916057438 NORTHWEST KIDNEY CENTERS NORT 2062922771 PO BOX 3037 SEATTLE WA 981143037 REBECCA FOX CEO & PRESIDENT 2062922771 2022-05-05 1 REBECCA FOX 999009999 SARA ELIZABETH H JONES P00235495 4254544919 2022-05-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X REBECCA FOX PO BOX 3037 SEATTLE WA 981143037 169382091 0 X WWW.NWKIDNEY.ORG X 1962 WA TO PROMOTE THE OPTIMAL HEALTH, QUALITY OF LIFE AND INDEPENDENCE OF PEOPLE WITH KIDNEY DISEASE THROUGH PATIENT CARE, EDUCATION AND RESEARCH. 16 14 886 498 0 0 6649783 4755779 117894002 120421317 8241385 5406123 1544309 396751 134329479 130979970 3481331 3302134 0 0 68577503 65344700 0 0 604568 51898804 55783043 123957638 124429877 10371841 6550093 219224153 220973324 89668164 73122762 129555989 147850562 X NORTHWEST KIDNEY CENTERS' MISSION IS TO PROMOTE THE OPTIMAL HEALTH, QUALITY OF LIFE AND INDEPENDENCE OF PEOPLE WITH KIDNEY DISEASE THROUGH PATIENT CARE, EDUCATION AND RESEARCH. NORTHWEST KIDNEY CENTERS IS A NOT-FOR-PROFIT, LOCALLY MANAGED PROVIDER OF KIDNEY DIALYSIS, PUBLIC HEALTH EDUCATION AND RESEARCH INTO THE CAUSES AND TREATMENTS OF CHRONIC KIDNEY DISEASE. FOUNDED IN SEATTLE IN 1962, IT WAS THE WORLD'S FIRST DIALYSIS ORGANIZATION. AMONG THE EIGHTH LARGEST DIALYSIS PROVIDERS IN THE COUNTRY, IT IS AN INFLUENTIAL MODEL BECAUSE OF ITS HIGH QUALITY SERVICES, DEEP COMMUNITY CONNECTIONS AND GENEROUS DONOR SUPPORT. 0 0 103964392 3272962 120868101 IN THE YEAR ENDED JUNE 30, 2021 NORTHWEST KIDNEY CENTERS PROVIDED 280,181 DIALYSIS TREATMENTS, ESSENTIAL TO SUSTAIN THE LIVES OF PEOPLE WITH KIDNEY FAILURE. WE SERVED A TOTAL OF 1,940 PATIENTS. THE ORGANIZATION PROVIDED PATIENT CARE IN TWENTY (20) FREE-STANDING CLINICS AND IN EIGHT (8) LOCAL HOSPITALS, AND SUPERVISED SELF-DIALYSIS TREATMENTS IN THE HOMES OF PATIENTS THROUGHOUT THE COMMUNITY. WE SPENT OVER $45 MILLION MORE ON THE CARE OF PATIENTS WITH MEDICARE AND MEDICAID INSURANCE THAN THE PROGRAMS REIMBURSED US FOR. IN ADDITION, WE PROVIDED MORE THAN $1.1 MILLION IN CHARITY CARE. NORTHWEST KIDNEY CENTERS' RENAL SPECIALTY PHARMACY, A RARITY IN THE NATION, SERVED MORE THAN 1,876 DIALYSIS PATIENTS AND KIDNEY TRANSPLANT RECIPIENTS DURING THE YEAR.THE CENTER FOR DIALYSIS INNOVATION RECENTLY LAUNCHED AT THE UNIVERSITY OF WASHINGTON WITH A GRANT FROM NORTHWEST KIDNEY CENTERS FOR $15 MILLION OVER FIVE YEARS. THE MISSION IS TO REVOLUTIONIZE DIALYSIS TECHNOLOGY. 3272962 NORTHWEST KIDNEYS CENTERS PROVIDED NEPHROLOGY FELLOWSHIPS FOR THREE (3) PHYSICIANS TO DO ADVANCED STUDY OF KIDNEY DISEASE AND RENAL CARE AT THE UNIVERSITY OF WASHINGTON. WE AIM TO ENSURE THAT PROFESSIONAL CARE WILL CONTINUE TO BE AVAILABLE FOR FUTURE KIDNEY PATIENTS. WE PROVIDED SIGNIFICANT SUPPORT FOR THE KIDNEY RESEARCH INSTITUTE, A COLLABORATION BETWEEN NORTHWEST KIDNEY CENTERS AND UW MEDICINE. AS OF JUNE 30, 2021, THE KIDNEY RESEARCH INSTITUTE HAD OVER 159 STUDIES UNDERWAY, FOCUSING ON THE ROLE OF GENETICS, IMPACT OF LIFESTYLE, AND DIABETES IN KIDNEY DISEASE, AS WELL AS WAYS TO IMPROVE DIALYSIS OUTCOMES. THE KIDNEY RESEARCH INSTITUTE PUBLISHED OVER 1,460 SCIENTIFIC PAPERS IN PEER-REVIEWED JOURNALS FROM ITS INCEPTION IN 2008 THROUGH JUNE 2021. NORTHWEST KIDNEY CENTERS' INVESTMENT IN THE KIDNEY RESEARCH INSTITUTE HAD HELPED TO LEVERAGE OVER $164 MILLION IN FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH AS OF JUNE 30, 2021. 396764 NORTHWEST KIDNEY CENTERS OFFERS FREE CLASSES THAT HELP PEOPLE WITH CHRONIC KIDNEY DISEASE PRESERVE KIDNEY FUNCTION, CHOOSE APPROPRIATE TREATMENT, TAKE CARE OF A TRANSPLANTED KIDNEY AND IN GENERAL BE AN EMPOWERED PARTNER IN THEIR KIDNEY HEALTH CARE. THE CLASS PROGRAM PROVIDES OUTREACH TO PEOPLE WHO ARE NOT DIALYSIS PATIENTS AND MAY HELP THEM KEEP THEIR KIDNEYS HEALTHY ENOUGH SO THAT THEY NEVER NEED TO GO ON DIALYSIS, OR CAN DELAY ITS ONSET. THE PATIENT-FOCUSED, EVIDENCE-BASED CURRICULUM WAS DEVELOPED BY NORTHWEST KIDNEY CENTERS. THERE WERE 1,488 CHRONIC KIDNEY DISEASE EDUCATION PARTICIPANTS. IN ADDITION TO ITS FREE CLASSES, NORTHWEST KIDNEY CENTERS PARTICIPATED IN 55 COMMUNITY HEALTH EDUCATION AND OUTREACH ACTIVITIES, REACHING A TOTAL OF 4,425 PEOPLE DURING THE YEAR. 29172 29172 EMERGENCY ASSISTANCE PROGRAMS: WE PROVIDED FINANCIAL ASSISTANCE TO NEEDY PATIENTS WITH FOOD, HOUSING, AND OTHER EXPENSES (224 PATIENTS). 29172 29172 107663290 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 51 0 886 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WA X REBECCA FOX 7602126020 12901 20TH AVENUE SOUTH SEATAC WA 98168 CARRIE MCCABE CFO & VP OF FINANCE 50.00 X 400542 0 24102 RAGHU DURVASULA ASSOCIATE CHIEF MEDICAL OFFICER 50.00 X 484117 0 20577 REBECCA FOX CEO & PRESIDENT 50.00 X 488943 0 13537 SUZANNE WATNICK CHIEF MEDICAL OFFICER 50.00 X 393035 0 22206 ELIZABETH MCNAMARA VP OF CLINICAL OPERATIONS 50.00 X 311715 0 15907 JOYCE JACKSON FORMER OFFICER 0.00 X 303292 0 0 AUSTIN ROSS VP OF PLANNING 50.00 X 240224 0 24277 JANE PRYOR VP OF DEVELOPMENT & COMMUNICATIONS 50.00 X 215990 0 25816 THOMAS MONTEMAYOR PHARMACY MANAGER 50.00 X 210374 0 19194 MARY MCHUGH VP OF ADMIN SERVICES THRU 09/20 50.00 X 209275 0 16671 CYRUS CRYST MED DIRECTOR/BOARD MEMBER 12.00 X 78750 0 0 MICHAEL SUTTERS MED DIRECTOR/BOARD MEMBER 16.00 X 78750 0 0 RICHARD BLOCH CHAIR 2.00 X X 0 0 0 MEREDITH MATHEWS VICE-CHAIR 1.00 X X 0 0 0 JENN BRENNER BOARD MEMBER 1.00 X 0 0 0 SARAH CAVE BOARD MEMBER 1.00 X 0 0 0 LISA FLORENCE BOARD MEMBER 1.00 X 0 0 0 KRISTI GAUDREAU BOARD MEMBER 1.00 X 0 0 0 LARA MACKLIN BOARD MEMBER 1.00 X 0 0 0 RAJ MEHROTRA BOARD MEMBER 1.00 X 0 0 0 REX OCHI BOARD MEMBER 1.00 X 0 0 0 MARK OSTROW BOARD MEMBER 1.00 X 0 0 0 DOUG ROSS BOARD MEMBER 1.00 X 0 0 0 CHRIS SEEL BOARD MEMBER 1.00 X 0 0 0 RUSS STEPP BOARD MEMBER 1.00 X 0 0 0 CHARLEEN TACHIBANA BOARD MEMBER 1.00 X 0 0 0 3415007 0 182287 182 1 1 0 ALDRICH & ASSOCIATES INC 810 240TH ST SE BOTHELL WA 98021 CONSTRUCTION 10987293 ASCEND CLINICAL LLC PO BOX 45021 SAN FRANCISCO CA 941450021 LABORATORY SERVICES 1346168 CITY WIDE FACILITY SOLUTIONS OF WA 1201 MONSTER ROAD SW SUITE 420 RENTON WA 98057 HOUSEKEEPING SERVICES 1106756 MAHLUM ARCHITECTS 71 COLUMBIA FLOOR 74 SEATTLE WA 98104 ARCHITECT 485201 DAVIS WRIGHT TREMAINE LLP 920 FIFTH AVE SUITE 3300 SEATTLE WA 981041610 LEGAL 347103 13 798296 1378228 2579255 77069 4755779 DIALYSIS 621400 106082887 106082887 PATIENT LAB REVENUE 621500 11861864 11861864 OTHER MEDICAL RELATED 621400 2435621 2435621 INSUR PREMIUM REIMBURS 621400 40945 40945 120421317 1125308 1125308 28111 28111 67207 26640 40567 40567 40567 37276602 32234938 760849 5041664 -760849 4280815 4280815 36789 798296 168912 -132123 -132123 5651926 5210782 441144 441144 REIMBURSEMENTS 900099 10992 10992 MED RECORDS/COUNSELING 900099 5640 5640 CONSIGNMENT SALES 900099 2112 2112 308 308 19052 130979970 120868101 0 5356090 3272962 3272962 29172 29172 1932179 157500 1774679 50830416 43812846 6667486 350084 2072134 1859265 200859 12010 6221523 5470470 715219 35834 4288448 3668927 590951 28570 1550565 1536385 14180 391261 391261 82553 82553 137500 137500 198481 198481 2314428 794172 1511095 9161 171357 22915 134364 14078 2706430 2450576 236703 19151 4054195 3550258 484882 19055 9826476 9317600 479430 29446 88504 77700 10061 743 35296 14851 20300 145 9111093 7473186 1614335 23572 385362 99642 285720 SUPPLIES 19926246 19813574 106054 6618 LAB TESTING 1391444 1391444 REPAIRS & MAINTENANCE 541209 474820 64329 2060 COMMUNITY PROGRAMS 185395 90539 94856 2685248 2284486 346721 54041 124429877 107663290 16162019 604568 10185248 6162638 1278122 1486691 22567954 22597935 1594430 1540374 1222392 1169720 203396434 91260811 113666567 112135623 66196546 73415623 2512894 2464720 219224153 220973324 12766648 10988185 3297171 2261534 0 198315 57712892 56801035 15891453 2873693 89668164 73122762 X 119283639 138863195 10272350 8987367 129555989 147850562 219224153 220973324 X 6550093 11552493 191987 X X 0 1 X 1 1 0 X 3142407 2772404 3120286 6649783 4755799 20440679 123053165 126235913 129373010 125457680 126078883 630198651 126195572 129008317 132493296 132107463 130834682 650639330 306911 246405 94013 82922 29387 759638 0 306911 246405 94013 82922 29387 759638 649879692 1489189 1869371 1834547 1507117 1220626 7920850 1489189 1869371 1834547 1507117 1220626 7920850 6245 2428 34504 18147 13412 74736 127691006 130880116 134362347 133632727 132068720 658634916 0.98670 0.98650 0.01200 0.01200 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISC INCOME - 2016 AMOUNT: $ 513. 2017 AMOUNT: $ -375. 2018 AMOUNT: $ 7,351. 2019 AMOUNT: $ 1,364. 2020 AMOUNT: $ 308. REIMBURSEMENTS - 2016 AMOUNT: $ 5,130. 2017 AMOUNT: $ 2,803. 2018 AMOUNT: $ 27,153. 2019 AMOUNT: $ 16,783. 2020 AMOUNT: $ 10,992. LI REFUND - 2016 AMOUNT: $ 602. CONSIGNMENT SALES - 2020 AMOUNT: $ 2,112. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 1 137500 0 0 0 137500 0 PART II-B, LINE 1: NORTHWEST KIDNEY CENTERS ENGAGED IN LOBBYING AT THE STATE AND FEDERAL LEVEL DURING THE FISCAL YEAR ENDED 6/30/21. GRANTS TO ORGANIZATIONS FOR LOBBYING PURPOSES INCLUDE PAYMENTS TO KIDNEY RELATED LOBBYING ORGANIZATIONS. NORTHWEST KIDNEY CENTERS ACTIVELY WORK WITH INDUSTRY ORGANIZATIONS SUCH AS NKCA (NON-PROFIT KIDNEY CARE ALLIANCE) AND KKC (KIDNEY CARE COUNCIL) TO WORK WITH POLICY MAKERS AND INDUSTRY REPRESENTATIVES TO GUIDE POLICY AT THE NATIONAL AND STATE LEVELS. 7089980 17221 1520344 268224 8359321 6760332 266203 251217 187772 7089980 6484754 272206 282189 278817 6760332 6471445 42010 129702 158403 6484754 5915778 235671 467692 147696 6471445 0.54260 0.31690 0.14050 0 0 14391003 14391003 86531783 23264749 63267034 49751484 32859882 16891602 48512699 35136180 13376519 4209465 4209465 112135623 DEFERRED COMPENSATION 452488 DEFERRED TENANT LEASEHOLD ALLOWANCE 1229475 DEFERRED RENT 1191730 2873693 148964430 11574502 3364 1198741 12776607 136187823 198481 -5406334 -5207853 130979970 129759818 3364 5904815 5908179 123851639 198481 379757 578238 124429877 PART V, LINE 4: FUNDS ARE USED FOR KIDNEY DISEASE RESEARCH AND PATIENT SUPPORT, SERVICES & EMERGENCIES PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT 170,672. REMOVAL OF NORTHWEST KIDNEY CARE ALLIANCE NET INCOME 1,408,520. BAD DEBT EXPENSE REPORTED ON PART IX -379,757. PRIOR YEAR PLEDGE WRITE-OFF -694. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES REPORTED ON PART VIII -26,640. SPECIAL EVENT EXPENSES REPORTED ON PART VIII -168,912. PHARMACY COST OF GOODS SOLD -5,210,782. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES REPORTED ON PART VIII 26,640. SPECIAL EVENT EXPENSES REPORTED ON PART VIII 168,912. PHARMACY COST OF GOODS SOLD 5,210,782. REMOVAL OF NORTHWEST KIDNEY CARE ALLIANCE EXPENSES 498,481. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE REPORTED ON PART IX 379,757. GALA 604370 567581 36789 2500 105894 HOPEBUILDER'S LUNCHEON 230715 230715 60518 835085 798296 36789 2500 166412 168912 -132123 1 UNIVERSITY OF WASHINGTON 3917 UNIVERSITY WAY NE SEATTLE WA 98105 916001537 GOVT - UNIVERSITY 3272962 SEE SCHEDULE I, PART IV. 1 0 EMERGENCY GRANTS TO COVER FOOD, HOUSING, UTILITIES, AND TRANSPORTATION 224 29172 FAIR MARKET VALUE PART I, LINE 2: GIFT TO THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UWSOM)/DIVISION OF NEPHROLOGY: AS DESCRIBED IN THE "GIFT AGREEMENT BETWEEN NORTHWEST KIDNEY CENTERS AND UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE/DIVISION OF NEPHROLOGY" (DATED AUGUST 21, 2006) ALONG WITH ITS FOLLOWING 15 ANNUAL EXTENSIONS; THE FOLLOWING PROVISIONS WERE ESTABLISHED IN REGARD TO PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: PARAGRAPH A-FOR FISCAL YEAR 2021 (FISCAL YEAR STARTS IN JULY 2020 AND ENDS IN JUNE 2021.) NKC WILL PROVIDE GIFTS DIRECTED TO THE UW DIVISION OF NEPHROLOGY TO A) ENHANCE THE TRAINING OF FELLOWS IN NEPHROLOGY, AND B) TO SUPPORT BASIC RESEARCH INTO THE CAUSES AND CURES OF KIDNEY DISEASE, AND TO SUPPORT THE ACTIVITIES OF THE KIDNEY RESEARCH INSTITUTE AT THE UNIVERSITY OF WASHINGTON. PARAGRAPH B-NKC AND UWSOM AGREE THAT THESE GIFTS WILL NOT BE USED TO PAY UWSOM OVERHEAD, DEPARTMENT ASSESSMENTS, OR INDIRECT COSTS ON STUDIES. THE PARTIES FURTHER AGREE THAT THE UWSOM IS RESPONSIBLE FOR STEWARDSHIP OF THESE FUNDS AND WILL DIRECTLY UTILIZE THE FULL AMOUNT OF THE GIFTS. THERE ARE NO CONTRACTUAL ARRANGEMENTS ASSOCIATED WITH THE FUNDS, WHICH REQUIRE OR PROVIDE FOR COMPLIANCES WITH PROTOCOLS, PATIENT RIGHTS, TECHNOLOGY TRANSFER OR OTHER SIMILAR CONDITIONS OR PROPRIETARY INFORMATION WITH NKC. PARAGRAPH D-PERIODICALLY UWSOM WILL PROVIDE NKC WRITTEN AND VERBAL REPORTS AND INFORMATIONAL PRESENTATIONS REGARDING THE ACTIVITIES OF THE FUNDED FELLOWS, THE BASIC RESEARCH CONDUCTED WITH NKC FUNDING, AND ACTIVITIES OF THE KIDNEY RESEARCH INSTITUTE, AT A SCHEDULE MUTUALLY AGREED UPON BETWEEN THE NKC PRESIDENT AND CEO AND THE UW HEAD, DIVISION OF NEPHROLOGY. PARAGRAPH E-UPON REQUEST UWSOM SHALL PROVIDE NKC INFORMATION REGARDING THE AMOUNT AND TYPE OF EXPENDITURES ASSOCIATED WITH GIFTS TO THE UWSOM. PARAGRAPH F-AT THE END OF THE PERIOD COVERED BY THIS GIFT AGREEMENT ANY UNSPENT NKC GIFT FUNDS TO UWSOM SHOULD REMAIN DESIGNATED FOR USE BY THE NEPHROLOGY FELLOWSHIP PROGRAM, BASIC RESEARCH ENDEAVORS, OR KIDNEY RESEARCH INSTITUTE FOR USE IN SUBSEQUENT FISCAL YEARS. ALL FUNDS REMAIN WITH UWSOM AS A GIFT FOR THE KRI. PATIENT EMERGENCY FUND GRANTS: THE EMERGENCY FUND PROGRAM PROVIDES SUPPORT FOR SELECT NORTHWEST KIDNEY CENTERS (NKC) PATIENTS CURRENTLY RECEIVING DIALYSIS, OR PATIENTS OF NKC WHO HAVE RECEIVED A KIDNEY TRANSPLANT WITHIN THE PREVIOUS THREE YEARS AND RESIDE WITHIN WASHINGTON STATE. GRANTS OF UP TO $250 PER PATIENT MAY BE AWARDED IN A GIVEN TWELVE MONTH PERIOD. PAYMENT IS IN THE FORM OF A CHECK OR GROCERY STORE GIFT CARD. REQUESTS FOR LARGER AMOUNTS WILL BE CONSIDERED INDIVIDUALLY ON AN EXCEPTION BASIS. NKC SOCIAL WORKERS ARE RESPONSIBLE FOR OBTAINING DOCUMENTATION OF THE PATIENT'S NEED AND INVESTIGATION OF ALL OTHER POSSIBLE COMMUNITY RESOURCES AVAILABLE TO MEET THE NEED. EACH GRANT MUST BE APPROVED BY THE PATIENT'S SOCIAL WORKER, AND THE SOCIAL SERVICES DIRECTOR. THE GRANT WILL BE PAID TO A THIRD PARTY FOR THE SERVICE OR MATERIAL NEEDED BY THE PATIENT. CHECKS WILL NOT BE MADE OUT TO THE PATIENT DIRECTLY. SCHEDULE I, PART II, LINE 1, COLUMN H: RESEARCH GRANTS ARE AWARDED TO UNIVERSITY PHYSICIANS WHO ARE CONDUCTING STUDIES, WHICH ARE DEDICATED TO RESEARCHING CAUSES AND CURES OF CONDITIONS RELATING TO KIDNEY DISEASES. FELLOWSHIPS ARE AWARDED TO THE UNIVERSITY OF WASHINGTON TO PROVIDE SALARY FUNDS FOR PHYSICIANS IN TRAINING TO BECOME NEPHROLOGISTS WHO CARE FOR PATIENTS WITH KIDNEY DISEASE. THE KIDNEY RESEARCH INSTITUTE IS A UNIVERSITY OF WASHINGTON BASED ORGANIZATION THAT IS DEDICATED TO THE RESEARCH OF KIDNEY DISEASE. SCHEDULE I, PART III, SCHOLARSHIPS, COLUMN F: EMPLOYEE SCHOLARSHIP APPLICATIONS ARE REVIEWED BY DEVELOPMENT STAFF TO ENSURE APPLICATIONS ARE COMPLETE, AND BY HUMAN RESOURCES (HR) TO ENSURE APPLICANTS MEET MINIMUM QUALIFICATIONS (EMPLOYED AT LEAST ONE YEAR, FULL-TIME OR REGULAR PART-TIME (AT LEAST 24 HOURS PER WEEK)). THOSE WHO MEET MINIMUM QUALIFICATIONS ARE SENT TO THE EMPLOYEE SCHOLARSHIP COMMITTEE TO BE RATED USING A SCORING MATRIX OF SPECIFIC CRITERIA. THE COMMITTEE CURRENTLY IS COMPRISED OF TWO VOLUNTEERS (ONE FROM TRUSTEE BOARD AND ONE FROM FOUNDATION BOARD), HR REPRESENTATIVE, ONE CLINICAL DIRECTOR, CKD PROGRAM MANAGER (MSW) AND VP DEVELOPMENT & PR OR DESIGNEE. THE HIGHEST RATED APPLICANTS THEN INTERVIEW WITH THE COMMITTEE. AFTER THAT, THE COMMITTEE DECIDES WHO WILL RECEIVE A SCHOLARSHIP AND HOW MUCH. THE ACTUAL AMOUNTS AWARDED DEPEND ON RESTRICTIONS PLACED BY THE DONORS ABOUT HOW THE SCHOLARSHIP FUNDS CAN BE USED AND THE AMOUNT AVAILABLE IN ANY GIVEN YEAR. X X X X X X 1 0 0 0 0 0 0 1 0 CARRIE MCCABE CFO & VP OF FINANCE 399325 0 71 0 1146 0 14250 0 9852 0 424644 0 0 0 RAGHU DURVASULA ASSOCIATE CHIEF MEDICAL OFFICER 247217 0 0 0 236900 0 3784 0 16793 0 504694 0 0 0 REBECCA FOX CEO & PRESIDENT 389865 0 98497 0 581 0 0 0 13537 0 502480 0 0 0 SUZANNE WATNICK CHIEF MEDICAL OFFICER 391889 0 0 0 1146 0 12855 0 9351 0 415241 0 0 0 ELIZABETH MCNAMARA VP OF CLINICAL OPERATIONS 309571 0 0 0 2144 0 14250 0 1657 0 327622 0 0 0 JOYCE JACKSON FORMER OFFICER 0 0 0 0 303292 0 0 0 0 0 303292 0 0 0 AUSTIN ROSS VP OF PLANNING 238080 0 0 0 2144 0 12419 0 11858 0 264501 0 0 0 JANE PRYOR VP OF DEVELOPMENT & COMMUNICATIONS 212929 0 0 0 3061 0 10981 0 14835 0 241806 0 0 0 THOMAS MONTEMAYOR PHARMACY MANAGER 209778 0 0 0 596 0 9591 0 9603 0 229568 0 0 0 MARY MCHUGH VP OF ADMIN SERVICES THRU 09/20 207687 0 0 0 1588 0 9157 0 7514 0 225946 0 0 0 PART I, LINE 4A RAGHU DURVASULA, A HIGHLY COMPENSATED EMPLOYEE, RECEIVED $236,051 OF SEVERENCE ON SEPTEMBER 25, 2020. PART I, LINE 7 THE CEO & PRESIDENT PARTICIPATES IN AN INCENTIVE PLAN DESIGNED FOR THIS OFFICE-HOLDER ALONE. THE PURPOSE OF THIS PLAN IS TO ALIGN THE PRESIDENT'S INTERESTS WITH THOSE OF THE BOARD AND NKC'S BROADER CONSTITUENTS AND TO RECOGNIZE SPECIAL CONTRIBUTIONS TO NKC'S FINANCIAL AND OPERATIONAL SUCCESS. THE EXECUTIVE COMMITTEE OF THE BOARD SHALL MEET ANNUALLY TO ESTABLISH REASONABLE FINANCIAL AND OTHER GOALS FOR THE COMING YEAR. AT THE CONCLUSION OF THE YEAR, THE EXECUTIVE COMMITTEE WILL MEET IN EXECUTIVE SESSION TO REVIEW PERFORMANCE COMPARED TO THE PREDETERMINED GOALS, TO SET APPROPRIATE INCENTIVE COMPENSATION AS REASONABLY DETERMINED BY THE COMMITTEE AT ITS DISCRETION, AND TO APPROVE GOALS FOR THE FOLLOWING YEAR. THE CHAIR OR HIS OR HER DESIGNATE WILL MEET WITH THE CEO. SCHEDULE J, PART II: THE AMOUNT LISTED IN COLUMN (B)(III) FOR FORMER OFFICER JOYCE JACKSON IS A FULL DISTRIBUTION OF THE 457(B)-PLAN BALANCE. THIS VALUE CONTAINS INDIVIDUAL CONTRIBUTIONS AS WELL AS INVESTMENT EARNINGS WHILE SHE WAS A PARTICIPANT IN THE PLAN. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 2021 911108929 NONEAVAIL 2021-05-31 79900000 PREVIOUS PAY OFF, CAPITAL IMPROVEMENTS 0 0 0 A 79900000 1190500 985000 51189500 26535000 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 X 4 42277 BOOK VALUE X AUCTION ITEMS 31 27292 BOOK VALUE X VARIOUS ITEMS 2 7500 BOOK VALUE 0 0 1 0 PART I, COLUMN (B): THE NUMBER IN PART I, COL(B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 6: NORTHWEST KIDNEY CENTERS IS LED BY A VOLUNTEER BOARD OF TRUSTEES AND BY A FOUNDATION BOARD THAT HELPS RAISE MONEY AND MAKE CONNECTIONS. THEY ARE JOINED BY SEVERAL HUNDRED OTHER VOLUNTEERS AS NEEDED TO STAFF EVENTS FOCUSED ON FUNDRAISING OR COMMUNITY. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF TRUSTEES' FINANCE AND AUDIT COMMITTEE REVIEWED THE 2020 FORM 990 BEFORE IT WAS FILED. THE 2020 FORM 990 WAS AVAILABLE TO THE FULL BOARD OF TRUSTEES BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL BOARD MEMBERS, OFFICERS AND MANAGERS ANNUALLY TO DISCLOSE FINANCIAL INTERESTS AND PERSONAL RELATIONSHIPS WITH POTENTIAL TO GIVE RISE TO A CONFLICT. EACH OF THEM GETS A COPY OF THE CONFLICT OF INTEREST POLICY ALONG WITH A LIST OF VENDORS AND CONTRACTORS; RECIPIENTS ARE REQUIRED TO INDICATE ANY INTEREST IN THE COMPANIES LISTED. ALL DISCLOSURES ARE REVIEWED BY THE BOARD CHAIR, THE CHAIR OF THE BOARD'S COMPLIANCE COMMITTEE, AND THE PRESIDENT/CEO. THEY DECIDE IF ANY POTENTIAL CONFLICT EXISTS AND THEN FOLLOW UP WITH SPECIFIC INDIVIDUALS AS NEEDED, AND REPORT TO THE BOARD OF TRUSTEES ON THE COMPLETED REVIEW PROCESS. INDIVIDUAL BOARD MEMBERS ARE REMINDED TO ABSTAIN FROM VOTES IF THERE IS A POTENTIAL CONFLICT OF INTEREST. THE CONFLICT OF INTEREST POLICY IS SHARED WITH ALL NEW EMPLOYEES AND NEW BOARD MEMBERS AND IT IS POSTED ON NORTHWEST KIDNEY CENTERS' INTRANET. FORM 990, PART VI, SECTION B, LINE 15 NORTHWEST KIDNEY CENTERS BOARD OF TRUSTEES' COMPENSATION COMMITTEE REVIEWS THE PRESIDENT/CEO'S COMPENSATION. THE COMMITTEE CONSISTS OF THREE INDEPENDENT BOARD MEMBERS WHO DO NOT RECEIVE ANY COMPENSATION FROM NORTHWEST KIDNEY CENTERS. THIS COMMITTEE CONTRACTS WITH AN INDEPENDENT FIRM TO PROVIDE AN INTERMEDIATE SANCTIONS LETTER (DETERMINING THE ORGANIZATION IS IN COMPLIANCE) FOR THE COMMITTEE AND TO MEET FIDUCIARY AND IRS RESPONSIBILITIES. THIS OUTSIDE REVIEW USES HOSPITAL AND OTHER HEALTH CARE COMPENSATION DATA TO FORMULATE A RECOMMENDATION ON TOTAL COMPENSATION RELATIVE TO SIZE, COMPLEXITY, MARKET LOCATION, AND NATURE OF THE ORGANIZATION. THE COMPENSATION COMMITTEE IS DELEGATED BY THE EXECUTIVE COMMITTEE OF THE BOARD TO APPROVE A SALARY FOR THE PRESIDENT/CEO. THE PROCESS WAS PERFORMED IN JANUARY 2020 FOR THE INITIAL COMPENSATION PACKAGE OF THE PRESIDENT/CEO. DATA REGARDING THE VICE PRESIDENTS' PAY HISTORY, CURRENT PAY AND PROPOSED ADJUSTMENTS HAVE BEEN PROVIDED TO THE NORTHWEST KIDNEY CENTERS COMPENSATION COMMITTEE, WHICH IS MADE UP OF THREE INDEPENDENT BOARD MEMBERS, WHO DETERMINE THAT SUCH AMOUNTS ARE CONSISTENT WITH MARKET PARAMETERS. COMPENSATION FOR THE VICE PRESIDENT WAS LAST REVIEWED IN 2020 BUT, DUE TO COVID, NO MARKET ADJUSTMENTS WERE MADE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S BYLAWS, ARTICLES OF INCORPORATION, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE ON REQUEST, CONTACT INFO@NWKIDNEY.ORG. THE FISCAL YEAR FINANCIAL RESULTS ARE PUBLISHED IN THE ANNUAL REPORT, AVAILABLE ON WWW.NWKIDNEY.ORG AND DISTRIBUTED IN HARD COPY TO APPROXIMATELY 7,500 INDIVIDUALS INCLUDING PATIENTS, STAFF, PHYSICIANS, DONORS, VOLUNTEERS AND THE GENERAL PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT 192,681. PRIOR YEAR PLEDGE WRITE-OFF -694. FORM 990, PART XII, LINE 3B: AT THE TIME OF FILING FOR THE JUNE 30, 2021 FORM 990, NORTHWEST KIDNEY CENTERS WAS UNDERGOING THE REQUIRED FY21 PROGRAM-SPECIFIC AUDIT. NORTHWEST KIDNEY CARE ALLIANCE PO BOX 3037 SEATTLE WA 981143037 ENHANCE QUALITY & REDUCE COST OF HEALTH CARE SERVICES WA NORTHWEST KIDNEY CENTERS C 525537 90007 0.50000 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 NORTHWEST KIDNEY CARE ALLIANCE L 513434 ACTUAL AMOUNT