2015-05-15T11:13:29-05:00 2014-06-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2013-07-01 911220843 ASSOCIATION OF UNIVERSITY PHYSICIANS ASSO 2065205778 701 5TH AVENUE NO 700 SEATTLE WA 98104 MAUREEN HOOLEY CHIEF FINANCIAL OFFICER 2065205778 2015-05-14 1 SARA ELIZABETH J HYRE P00235495 4254544919 2015-05-14 2013 2016-04-25 22:37:26Z UW PHYSICIANS CATHERINE BOELKE 701 5TH AVENUE NO 700 SEATTLE WA 98104 225212481 0 X SEE SCHEDULE O X 1983 WA PRACTICE PLAN FOR THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE ("UWSOM") FACULTY PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS THAT PROVIDES SUBSTANTIAL SUPPORT TO THE UWSOM. 27 0 1314 212 -164522 -164522 0 0 170697342 181702160 6317312 6693206 0 0 177014654 188395366 0 0 0 0 139353756 152785163 0 0 0 37380452 40927577 176734208 193712740 280446 -5317374 113206197 111113891 113206197 111113891 0 0 X THE ASSOCIATION OF UNIVERSITY PHYSICIANS IS A CLINICAL PRACTICE PLAN FOR THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE ("UWSOM") FACULTY PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS AND PROVIDES SUBSTANTIAL SUPPORT TO THE UWSOM. 0 0 170548884 181702160 THE PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS OF THE ASSOCIATION OF UNIVERSITY PHYSICIANS (TOGETHER, "UWP PRACTITIONERS") PROVIDE CLINICAL CARE AT UNIVERSITY OF WASHINGTON OWNED, OPERATED, AND AFFILIATED FACILITIES. UWP PRACTITIONERS ARE REQUIRED TO BE FACULTY MEMBERS OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE AS A CONDITION OF PRACTICE PLAN MEMBERSHIP AND PRACTICE ONLY AT SITES APPROVED BY THE CEO OF UW MEDICINE, EVP FOR MEDICAL AFFAIRS AND DEAN OF THE UWSOM (UW MEDICINE CEO). UWP PRACTITIONERS ALSO PROVIDE CLINICAL CARE IN OTHER LOCAL AND NATIONAL COMMUNITY SETTINGS AS APPROVED BY THE UW MEDICINE CEO. THESE ACTIVITIES INCREASE COMMUNITY ACCESS TO SPECIALIST AND SUB-SPECIALIST CLINICAL CARE AND EXPERTISE, PROVIDE PRIMARY CARE IN COMMUNITIES THAT MAY NOT HAVE SUFFICIENT LOCAL RESOURCES, AND HELP TO ASSURE SUFFICIENT PRACTICE SITES AND PATIENT POPULATIONS TO MAINTAIN THE UWSOM TEACHING AND RESEARCH ACTIVITIES. PURSUANT TO AN OPERATING AGREEMENT BETWEEN THE ASSOCIATION OF UNIVERSITY PHYSICIANS ("UWP") AND THE UNIVERSITY OF WASHINGTON BOARD OF REGENTS, ALL UWP REVENUES IN EXCESS OF ITS OPERATING EXPENSES AND PHYSICIAN COMPENSATION ARE HELD IN AN ACADEMIC SUPPORT FUND SOLELY FOR THE SUPPORT OF THE UWSOM. THE UW MEDICINE CEO CONTROLS ALL PHYSICIAN COMPENSATION BY UWP AND HIS APPROVAL IS REQUIRED FOR THE SIGNIFICANT ACTIONS OF THE UWP BOARD OF TRUSTEES. 170548884 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 20 0 1 1314 1 0 0 0 0 0 0 0 0 0 0 X 27 0 1 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 WA X MAUREEN HOOLEY 2065205778 701 5TH AVENUE SUITE 700 SEATTLE WA 98104 X NORMAN BEAUCHAMP MD TRUSTEE 40.00 0.00 X 203312 346374 60473 WILLIAM BREMNER MD PHD TRUSTEE 40.00 0.00 X 206772 252005 63036 HOWARD CHANSKY MD TRUSTEE 40.00 0.00 X 135540 70404 26900 JENS CHAPMAN MD TRUSTEE 40.00 0.00 X 557672 297583 243860 CHARLES MICHAEL CROWDER MD TRUSTEE 40.00 0.00 X 0 0 0 RICHARD ELLENBOGEN MD TRUSTEE 40.00 0.00 X 411463 393245 120018 DAVID ESCHENBACH MD TRUSTEE 40.00 0.00 X 192568 234129 59519 PETER ESSELMAN MD TRUSTEE 40.00 0.00 X 69539 309845 63701 JAMES FINE MD TRUSTEE 40.00 0.00 X 152798 236891 85030 NEAL FUTRAN MD DMD TRUSTEE 40.00 0.00 X 177188 367440 78671 BURKHARD MACKENSEN MD TRUSTEE 40.00 0.00 X 207238 274464 57134 NINA MAYER MD TRUSTEE 40.00 0.00 X 122500 265542 36578 THOMAS MONTINE MD PHD TRUSTEE 40.00 0.00 X 133788 292596 56143 THOMAS NORRIS MD TRUSTEE 40.00 0.00 X 176420 193388 52426 JUDITH PAUWELS MD TRUSTEE 40.00 0.00 X 10677 124625 33287 CARLOS PELLEGRINI MD TRUSTEE 40.00 0.00 X 282916 427139 72142 BRUCE RANSOM MD PHD TRUSTEE 40.00 0.00 X 110888 223523 50402 ALEC ROOKE MD PHD TRUSTEE 40.00 0.00 X 204751 86149 54793 BRUDER STAPLETON MD TRUSTEE 40.00 0.00 X 0 236649 39044 APRIL STEMPIEN-OTERO MD TRUSTEE 40.00 0.00 X 58491 107303 37356 JURGEN UNUTZER MD MPH TRUSTEE 40.00 0.00 X 0 290455 42186 RUSSELL VAN GELDER TRUSTEE 40.00 0.00 X 85840 383004 46745 MARC STEWART MD TRUSTEE 40.00 0.00 X 152892 408 27565 MARK WENER MD TRUSTEE 40.00 0.00 X 69014 160946 63318 HUNTER WESSELLS MD TRUSTEE 40.00 0.00 X 56652 337434 51809 GREGORY SCHROEDL MD TRUSTEE 40.00 0.00 X 0 298079 31075 MIKA SINANAN MD PHD PRESIDENT 40.00 0.00 X X 247456 149856 57239 PETER MCGOUGH MD VICE PRESIDENT 40.00 0.00 X X 241799 0 48287 HUGH FOY MD SECRETARY-TREASURER 40.00 0.00 X X 39486 310114 57700 BRUCE MONTGOMERY MD TRUSTEE 40.00 0.00 X 0 213606 32044 RICHARD VEITH TRUSTEE 40.00 0.00 X 158460 212787 53617 CATHERINE BOELKE EXECUTIVE DIRECTOR 40.00 0.00 X 290803 0 46598 MAUREEN HOOLEY CFO 40.00 0.00 X 203941 0 30672 RUTH MAHAN CHIEF BUSINESS OFFICER 40.00 0.00 X 141875 413142 56694 LORI MITCHELL BSC CFO, UW MEDICINE 40.00 0.00 X 130430 400200 56363 PAUL RAMSEY MD CEO, UW MEDICINE 40.00 0.00 X 498160 295039 68654 JOHNESE SPISSO CHSO, UW MEDICINE 40.00 0.00 X 171083 521148 60718 LALIGAM SEKHAR MD PROFESSOR 40.00 0.00 X 575191 542926 75210 LOUIS KIM MD PROFESSOR 40.00 0.00 X 554473 239888 141898 FANGYI ZHANG PROFESSOR 40.00 0.00 X 591521 199841 118054 JORGE DIONISIO REYES PROFESSOR 40.00 0.00 X 265586 521498 75602 CARLO BELLABARBA PROFESSOR 40.00 0.00 X 574381 196089 224131 MARGARET PEYTON FORMER KEY EMPLOYEE 40.00 0.00 X 234852 0 49027 MARK GREEN FORMER KEY EMPLOYEE 40.00 0.00 X 7600 292253 16366 ANNELIESE SCHLEYER FORMER SECRETARY-TREASURER 40.00 0.00 X 0 186875 34436 BRUCE SANGEORZAN FORMER SECRETARY-TREASURER 40.00 0.00 X 204690 264101 129452 8910706 11168983 2985973 399 1 1 0 STATE COLLECTION SERVICE 2509 S STOUGHTON RD MADISON WI 53716 COLLECTION AGENCY 464775 HAYES MANAGEMENT CONSULTING 1320 CENTRE STREET SUITE 402 NEWTON CENTRE MA 02459 CONSULTING 413230 KAYE-SMITH 4101 OAKESDALE AVE SW RENTON WA 98057 STATEMENT PROCESSING 388781 MOSS ADAMS LLP 999 THIRD AVE SUITE 3300 SEATTLE WA 98104 CONSULTING 331099 SDM CONSULTING LLC 3668 MACINTOSH LANE SALT LAKE CITY UT 84121 CONSULTING 196843 10 PATIENT PROF FEES 621110 179017203 179017203 BILLING AND COLLECTION 561000 2684957 2684957 181702160 3296457 -164522 3460979 40213864 36817115 3396749 3396749 3396749 188395366 181702160 -164522 6857728 7171927 6629360 542567 37872 37872 127247886 114392366 12855520 7824556 6678258 1146298 6352693 3670349 2682344 4150229 3137008 1013221 196945 196945 110700 110700 179486 179486 12377516 11321495 1056021 6746 6746 5553158 3765209 1787949 1828974 1828974 1282541 1282541 101875 101875 321025 321025 4458206 4373897 84309 CITY/STATE BUSINESS TAX 5258713 5258713 DEPARTMENT EXPENSES 4829547 4829547 UW MEDICINE ALLOCATIONS 2518346 2518346 PURCHASED SERVICES 1334224 1334224 569575 569575 193712740 170548884 23163856 0 307751 581459 15306419 12676274 7159573 6581795 8540218 5791144 224732 2749074 90137141 88455087 70581 70202 113206197 111113891 22407903 27159242 90798294 83954649 113206197 111113891 X 0 0 113206197 111113891 -5317374 5317374 0 X 0 1 X 1 0 X X X 0 0 0 UNIVERSITY OF WASHINGTON 916001537 GOVERNMENT 1 90408700 1 90408700 SCHEDULE A, PART I, LINE 11H, COLUMN VII: THE AMOUNT OF SUPPORT TO THE UNIVERSITY OF WASHINGTON REPRESENTS REVENUE COLLECTED ON BEHALF OF AND FOR THE BENEFIT OF THE UNIVERSITY OF WASHINGTON FOR PHYSICIAN SERVICES PROVIDED TO PATIENTS. 2358145 146925 2211220 6182073 5644219 537854 2749074 CLINICAL MEDICINE FUND PAYABLE 33930107 DEPARTMENTAL PAYABLES 50024542 83954649 193712740 5317374 5317374 188395366 0 188395366 193712740 0 193712740 0 193712740 0 0 0 0 0 0 0 1 0 NORMAN BEAUCHAMP MD TRUSTEE 203312 310818 0 0 0 35556 18523 19056 6354 16540 228189 381970 0 0 WILLIAM BREMNER MD PHD TRUSTEE 206772 226505 0 0 0 25500 20677 25500 3707 13152 231156 290657 0 0 HOWARD CHANSKY MD TRUSTEE 135540 70404 0 0 0 0 13554 0 3854 9492 152948 79896 0 0 JENS CHAPMAN MD TRUSTEE 202672 272083 355000 0 0 25500 200250 25500 3854 14256 761776 337339 177500 0 RICHARD ELLENBOGEN MD TRUSTEE 286463 367745 125000 0 0 25500 88000 25500 3854 2664 503317 421409 62500 0 DAVID ESCHENBACH MD TRUSTEE 192568 210350 0 0 0 23779 19257 23779 3331 13152 215156 271060 0 0 PETER ESSELMAN MD TRUSTEE 40908 284304 28631 0 0 25541 21479 25541 3121 13560 94139 348946 18955 0 JAMES FINE MD TRUSTEE 97224 212690 55574 0 0 24201 43067 24201 3154 14608 199019 275700 27787 0 NEAL FUTRAN MD DMD TRUSTEE 147188 341940 30000 0 0 25500 32969 25500 6354 13848 216511 406788 15000 0 BURKHARD MACKENSEN MD TRUSTEE 189941 253562 17297 0 0 20902 18652 20902 3854 13726 229744 309092 17297 0 NINA MAYER MD TRUSTEE 122500 251333 0 0 0 14209 12250 14209 2248 7871 136998 287622 0 0 THOMAS MONTINE MD PHD TRUSTEE 133788 267096 0 0 0 25500 13379 25500 3462 13802 150629 331898 0 0 THOMAS NORRIS MD TRUSTEE 176420 173774 0 0 0 19614 17642 19614 2922 12248 196984 225250 0 0 JUDITH PAUWELS MD TRUSTEE 0 111953 10677 0 0 12672 7850 12672 1175 11590 19702 148887 6388 0 CARLOS PELLEGRINI MD TRUSTEE 282916 378647 0 0 0 48492 25500 25500 3854 17288 312270 469927 0 0 BRUCE RANSOM MD PHD TRUSTEE 110888 177740 0 0 0 45783 11089 22783 2730 13800 124707 260106 0 0 ALEC ROOKE MD PHD TRUSTEE 176760 76986 27991 0 0 9163 37677 9163 2469 5484 244897 100796 12121 0 BRUDER STAPLETON MD TRUSTEE 0 214149 0 0 0 22500 0 24200 0 14844 0 275693 0 0 APRIL STEMPIEN-OTERO MD TRUSTEE 36676 98929 21815 0 0 8374 13758 8374 1376 13848 73625 129525 8566 0 JURGEN UNUTZER MD MPH TRUSTEE 0 242455 0 0 0 48000 0 25500 2238 14448 2238 330403 0 0 RUSSELL VAN GELDER TRUSTEE 85840 360632 0 0 0 22372 8443 22372 3774 12156 98057 417532 0 0 MARC STEWART MD TRUSTEE 152892 408 0 0 0 0 15289 0 2784 9492 170965 9900 0 0 MARK WENER MD TRUSTEE 13440 144851 55574 0 0 16095 34797 16095 2934 9492 106745 186533 27787 0 HUNTER WESSELLS MD TRUSTEE 56652 301472 0 0 0 35962 6195 20962 10664 13988 73511 372384 0 0 GREGORY SCHROEDL MD TRUSTEE 0 238856 0 59223 0 0 0 5940 0 25135 0 329154 0 0 MIKA SINANAN MD PHD PRESIDENT 247456 134435 0 0 0 15421 24746 15421 3224 13848 275426 179125 0 0 PETER MCGOUGH MD VICE PRESIDENT 223228 0 17071 0 1500 0 24405 0 23882 0 290086 0 1481 0 HUGH FOY MD SECRETARY-TREASURER 9728 286558 29758 0 0 23556 17075 23556 2813 14256 59374 347926 13976 0 BRUCE MONTGOMERY MD TRUSTEE 0 197160 0 0 0 16446 0 16446 1842 13756 1842 243808 0 0 RICHARD VEITH TRUSTEE 158460 169150 0 0 0 43637 15846 21641 3014 13116 177320 247544 0 0 CATHERINE BOELKE EXECUTIVE DIRECTOR 275600 0 14383 0 820 0 25500 0 21098 0 337401 0 0 0 MAUREEN HOOLEY CFO 191893 0 11228 0 820 0 20954 0 9718 0 234613 0 0 0 RUTH MAHAN CHIEF BUSINESS OFFICER 141875 387642 0 0 0 25500 14188 25500 3854 13152 159917 451794 0 0 LORI MITCHELL BSC CFO, UW MEDICINE 130430 374700 0 0 0 25500 13043 25500 3854 13966 147327 439666 0 0 PAUL RAMSEY MD CEO, UW MEDICINE 498160 254047 0 0 0 40992 25500 25500 3854 13800 527514 334339 0 0 JOHNESE SPISSO CHSO, UW MEDICINE 171083 495648 0 0 0 25500 17108 25500 3854 14256 192045 560904 0 0 LALIGAM SEKHAR MD PROFESSOR 444012 494434 131179 0 0 48492 25500 25500 3854 20356 604545 588782 56468 0 LOUIS KIM MD PROFESSOR 397278 204547 157195 0 0 35341 98635 18349 10658 14256 663766 272493 67428 0 FANGYI ZHANG PROFESSOR 486830 156796 104691 0 0 43045 87246 20050 6354 4404 685121 224295 48240 0 JORGE DIONISIO REYES PROFESSOR 248840 473006 16746 0 0 48492 32617 25500 3854 13631 302057 560629 5646 0 CARLO BELLABARBA PROFESSOR 160436 163571 413945 0 0 32518 190957 15064 3854 14256 769192 225409 193067 0 MARGARET PEYTON FORMER KEY EMPLOYEE 233884 0 0 0 968 0 24336 0 24691 0 283879 0 0 0 MARK GREEN FORMER KEY EMPLOYEE 7600 292253 0 0 0 0 760 0 2454 13152 10814 305405 0 0 ANNELIESE SCHLEYER FORMER SECRETARY-TREASURER 0 172205 0 0 0 14670 0 14670 1554 18212 1554 219757 0 0 BRUCE SANGEORZAN FORMER SECRETARY-TREASURER 72880 218105 131810 0 0 45996 83342 25500 3854 16756 291886 306357 66005 0 PART I, LINE 3 THE UWP GOVERNING BOARD DOES NOT REVIEW COMPENSATION OF ITS EXECUTIVES. INSTEAD, COMPENSATION OF THE UWP EXECUTIVE DIRECTOR AND CHIEF FINANCIAL OFFICER ARE REVIEWED AND SET BY REPRESENTATIVES OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE. 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 THE UWSOM, AS PART OF AN OVERALL REVIEW OF COMPENSATION FOR SIMILARLY SITUATED INDIVIDUALS IN OTHER COMPONENTS OF THE UW MEDICINE SYSTEM. THE REVIEW IS PERFORMED REGULARLY, AND DOCUMENTATION IS MAINTAINED BY THE UWSOM. COMPENSATION OF UWP BOARD MEMBERS, INCLUDING THE UWP PRESIDENT, IN THEIR CAPACITY AS UWP MEMBERS EMPLOYED BY UWP 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 UWSOM FACULTY. FOR UWP MEMBERS, REVIEW OF COMPENSATION ALSO INCLUDES APPLICATION OF THE "UNIVERSITY OF WASHINGTON PHYSICIANS METHOD OR STANDARD REGARDING BASIC INDIVIDUAL CAPS UNDER AMENDED INCOME DISTRIBUTION PLAN, AS OF JULY 1, 1999" (UWP CAP POLICY). THE UWP CAP POLICY LIMITS COMPENSATION OF UWP MEMBERS BY COMPARISON TO OBJECTIVE DATA FOR SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS, SUCH AS THAT ESTABLISHED BY THE AAMC. THE REVIEW IS PERFORMED REGULARLY AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. SCHEDULE J, PART I, LINE 7: UWP IS THE PRACTICE PLAN FOR UNIVERSITY OF WASHINGTON FACULTY PHYSICIANS AND HEALTH CARE PRACTITIONERS WHO PROVIDE CLINICAL CARE PRIMARILY TO ADULT PATIENTS. UWP BILLS AND COLLECTS REVENUE GENERATED BY THE CLINICAL SERVICES OF THESE FACULTY PHYSICIANS. ALL REVENUES COLLECTED BY UWP ARE ALLOCATED IN ACCORDANCE WITH THE ASSOCIATION OF UNIVERSITY PHYSICIANS D/B/A UNIVERSITY OF WASHINGTON PHYSICIANS AMENDED AND RESTATED INCOME DISTRIBUTION PLAN (IDP). UWP MAINTAINS A "MASTER" IDP AND EACH UWP 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 UWSOM. EACH CLINICAL DEPARTMENT OF THE UWSOM HAS A DEPARTMENT CHAIR WHO APPROVES THE IDP FOR THE UWP DEPARTMENT/DIVISION. THE UW MEDICINE CEO ALSO MUST APPROVE EACH DEPARTMENT/DIVISION IDP. 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 UWP OPERATING EXPENSES. OF THE REMAINING REVENUES, A PORTION IS ALLOCATED TO THE UWSOM CLINICAL MEDICINE FUND. 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, AND 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 DEPARTMENTAL TRUSTEE/DEPARTMENTAL CHAIR FOR THE DEPARTMENT 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 UW MEDICINE CEO OR HIS DESIGNEE 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 MAY BE ADJUSTED RETROACTIVELY BY THE CHAIR OF THE DEPARTMENT UPON APPROVAL OF THE UW MEDICINE 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 UWP: THE "UWP 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 MEDICAL 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 UWSOM PRIOR TO THE PERIOD OF RECORD. BEFORE PAYMENT OF ADDITIONAL COMPENSATION FOLLOWING A PERIOD OF RECORD, UWP 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. SUZANNE DINTZIS SEE PART IV SPOUSE OF RUSSELL VAN GELDER, TRUSTEE 37872 EMPLOYMENT 0 FORM 990, PART I, LINE 6 VOLUNTEERS HAVE BOTH UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE FACULTY APPOINTMENTS AS WELL AS A WRITTEN PRACTICE AGREEMENT WITH THE ASSOCIATION OF UNIVERSITY PHYSICIANS ("UWP"). THEY PERFORM CLINICAL SERVICES TO PATIENTS AT UW MEDICINE FACILITIES. VOLUNTEERS ARE TRACKED IN THE PAYROLL SYSTEM EVEN THOUGH NOT PAID BY UWP. FORM 990, SECTION J, WEBSITE WWW.UWMEDICINE.ORG/UW-PHYSICIANS FORM 990, PART VI, SECTION A, LINE 1 NONE OF THE VOTING MEMBERS ARE INDEPENDENT. THE UWP BOARD OF TRUSTEES IS COMPRISED OF THE 18 CLINICAL CHAIRS OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, SIX AT-LARGE MEMBERS ELECTED BY THE VOTING UWP MEMBERSHIP, THE MEDICAL DIRECTOR FOR THE UW PHYSICIANS NETWORK (A NON-PROFIT, TAX EXEMPT CORPORATION CLOSELY AFFILIATED WITH THE UNIVERSITY OF WASHINGTON), THE MEDICAL DIRECTOR FOR UW MEDICINE/NORTHWEST (A COMMUNITY HOSPITAL FOR WHICH THE SOLE CORPORATE MEMBER IS THE UNIVERSITY OF WASHINGTON), THE MEDICAL DIRECTOR FOR THE SEATTLE CANCER CARE ALLIANCE (A TAX EXEMPT ENTITY FOR WHICH THE UNIVERSITY OF WASHINGTON PARTICIPATES AS A ONE OF THREE CORPORATE MEMBERS), A PHYSICIAN-PRESIDENT, AND THREE COMMUNITY TRUSTEES. THE PHYSICIAN MEMBERS OF THE BOARD ARE FACULTY MEMBERS OF THE UNIVERSITY OF WASHINGTON (EXCEPT THE MEDICAL DIRECTOR OF UW MEDICINE/NORTHWEST) AND EMPLOYED BY ONE OF THE FOLLOWING: UWP, THE UNIVERSITY OF WASHINGTON, UW MEDICINE/NORTHWEST (FOR ITS MEDICAL DIRECTOR), SEATTLE CANCER CARE ALLIANCE (FOR ITS MEDICAL DIRECTOR), THE ASSOCIATION OF CHRMC AND UNIVERSITY PHYSICIANS (FOR THE DEPARTMENT OF PEDIATRICS) OR A COMBINATION OF THESE EMPLOYERS. FORM 990, PART VI, SECTION A, LINE 2 PAUL RAMSEY, MD, IS THE CEO OF UW MEDICINE, EXECUTIVE VICE PRESIDENT FOR MEDICAL AFFAIRS AND DEAN OF THE SCHOOL OF MEDICINE, UNIVERSITY OF WASHINGTON. THE FOLLOWING INDIVIDUALS ALSO ARE EMPLOYED BY THE UNIVERSITY OF WASHINGTON AND REPORT DIRECTLY OR INDIRECTLY TO DR. RAMSEY IN THAT CAPACITY: NORMAN BEAUCHAMP, WILLIAM BREMNER, HOWARD CHANSKY, JENS CHAPMAN, RICHARD ELLENBOGEN, DAVID ESCHENBACH, PETER ESSELMAN, JAMES FINE, NEAL FUTRAN, BURKHARD MACKENSE, NINA MAYER, THOMAS MONTINE, THOMAS NORRIS, JUDITH PAUWELS, CARLOS PELLEGRINI, BRUCE RANSOM, ALEC ROOKE, BRUDER STAPLETON, APRIL STEMPIEN-OTERO, JURGEN UNUTZER, RUSSEL VAN GELDER, MARC STEWART, MARK WENER, HUNTER WESSELLS, MIKA SINANAN, HUGH FOY, BRUCE MONTGOMERY, RICHARD VEITH, RUTH MAHAN, LORI MITCHELL, AND JOHNESE SPISSO. FORM 990, PART VI, SECTION A, LINE 7A THE UW MEDICINE CEO APPOINTS THREE NON-VOTING COMMUNITY TRUSTEES TO THE BOARD OF TRUSTEES AND ALSO APPOINTS THE PRESIDENT OF UWP. THE CHAIRS OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE CLINICAL DEPARTMENTS AND THE MEDICAL DIRECTOR FOR UW PHYSICIANS NETWORK SERVE AS EX OFFICO MEMBERS OF THE BOARD. THE UW MEDICINE CEO PARTICIPATES IN THE PROCESS OF APPOINTMENT TO THE CLINICAL DEPARTMENT CHAIR POSITIONS AS WELL AS THE UW PHYSICIANS NETWORK MEDICAL DIRECTOR POSITION. FORM 990, PART VI, SECTION A, LINE 7B MOST DECISIONS OF THE UWP BOARD OF TRUSTEES ARE SUBJECT TO THE APPROVAL OF THE UW MEDICINE CEO. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD HAS BEEN PRESENTED WITH INFORMATION RELATED TO THE PURPOSE AND RELEVANCE OF THE FORM 990 TO TAX EXEMPT ENTITIES SUCH AS UWP, AND BOARD MEMBERS MAY REQUEST A COPY OF THE FORM 990 FROM THE UWP CHIEF FINANCIAL OFFICER. THE COMPLETED FORM 990 IS REVIEWED BY THE UWP EXECUTIVE DIRECTOR, GENERAL COUNSEL, AND THE CHIEF FINANCIAL OFFICER, AS WELL AS THE ASSOCIATE DEAN FOR BUSINESS FOR THE UW SCHOOL OF MEDICINE, AND THE ENTERPRISE FINANCE OFFICER AND ASSOCIATE VICE PRESIDENT OF UW MEDICINE. FORM 990, PART VI, SECTION B, LINE 12C THE UWP BYLAWS CONTAIN A CONFLICT OF INTEREST PROVISION IN ARTICLE III J AND A WRITTEN BOARD POLICY. IN ADDITION, UWP BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES WHO ARE EMPLOYED BY THE UNIVERSITY OF WASHINGTON AND SERVING ON UWP COMMITTEES ARE SUBJECT TO THE STATE OF WASHINGTON ETHICS IN PUBLIC SERVICE ACT, CHAPTER 45.52 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. UWP ADMINISTRATIVE STAFF ARE SUBJECT TO AN ADMINISTRATIVE CONFLICT OF INTEREST POLICY CONTAINED IN THE UWP EMPLOYEE HANDBOOK. UWP CONDUCTS AN ANNUAL SURVEY AS REQUIRED BY THE UWP BOARD OF TRUSTEES CONFLICT OF INTEREST POLICY AND SURVEYS AS PART OF THE FORM 990 PROCESS. UWP ALSO ADDRESSES CONFLICTS AS THEY ARISE AND/OR ARE REPORTED TO UWP MANAGEMENT OR TO THE BOARD OF TRUSTEES. WHEN A CONFLICT IS IDENTIFIED, DISINTERESTED PERSONS ON THE BOARD, COMMITTEE, OR ADMINISTRATION EVALUATE THE POTENTIAL CONFLICT, CONTEMPORANEOUSLY DOCUMENT THE EVALUATION AND DETERMINATION, AND TAKE APPROPRIATE ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE UWP GOVERNING BOARD DOES NOT REVIEW COMPENSATION OF ITS EXECUTIVES. INSTEAD, COMPENSATION OF THE UWP EXECUTIVE DIRECTOR, CHIEF FINANCIAL OFFICER, AND GENERAL COUNSEL IS REVIEWED AND SET BY REPRESENTATIVES OF THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE. 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 THE UWSOM, AS PART OF AN OVERALL REVIEW OF COMPENSATION FOR SIMILARLY SITUATED INDIVIDUALS IN OTHER COMPONENTS OF THE UW MEDICINE SYSTEM. THE REVIEW IS PERFORMED REGULARLY, AND DOCUMENTATION IS MAINTAINED BY THE UWSOM. COMPENSATION OF UWP BOARD MEMBERS, INCLUDING THE UWP PRESIDENT, IN THEIR CAPACITY AS UWP MEMBERS EMPLOYED BY UWP 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 UWSOM FACULTY. FOR UWP MEMBERS, REVIEW OF COMPENSATION ALSO INCLUDES APPLICATION OF THE "UNIVERSITY OF WASHINGTON PHYSICIANS METHOD OR STANDARD REGARDING BASIC INDIVIDUAL CAPS UNDER AMENDED INCOME DISTRIBUTION PLAN, AS OF JULY 1, 1999" (UWP CAP POLICY). THE UWP CAP POLICY LIMITS COMPENSATION OF UWP MEMBERS BY COMPARISON TO OBJECTIVE DATA FOR SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS, SUCH AS THAT ESTABLISHED BY THE AAMC. THE REVIEW IS PERFORMED REGULARLY AND DOCUMENTATION IS MAINTAINED BY THE SCHOOL OF MEDICINE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CORPORATE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST TO THE UWP BUSINESS OFFICE. IN ADDITION, THESE DOCUMENTS MAY BE REQUESTED FROM THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE. FORM 990, PART VII, COLUMN B ALL OF THE KEY EMPLOYEES AND BOARD MEMBERS, EXCEPT THE THREE COMMUNITY TRUSTEES AND THE UWP EXECUTIVE DIRECTOR, CHIEF FINANCIAL OFFICER, AND GENERAL COUNSEL, ARE EMPLOYED FULL TIME BY THE UNIVERSITY OF WASHINGTON AND PARTICIPATE IN UWP'S BUSINESS MATTERS AS A FUNCTION OF THEIR RESPECTIVE POSITIONS WITHIN THE UNIVERSITY OF WASHINGTON. FOR EXAMPLE, BOARD MEMBERS WHO ARE THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE CLINICAL DEPARTMENT CHAIRS ARE REQUIRED AS PART OF THEIR ROLE AS CHAIR TO SERVE ON THE UWP BOARD. OTHER KEY EMPLOYEES EMPLOYED BY THE UNIVERSITY OF WASHINGTON SERVE IN ROLES THAT PROVIDE THE UNIVERSITY OF WASHINGTON OVERSIGHT REQUIRED BY THE UWP ARTICLES OF INCORPORATION AND BYLAWS. FOR THESE INDIVIDUALS, ALTHOUGH EACH MAY ENGAGE IN ACTIVITIES RELATED SOLELY TO THE UNIVERSITY AND UNRELATED TO UWP, WE ARE NOT ABLE TO SEGREGATE THE HOURS DEVOTED TO UWP FROM THE HOURS EACH INDIVIDUAL DEVOTES TO THE UNIVERSITY OF WASHINGTON. THUS, WE ARE REPORTING 40 HOURS FOR EACH INDIVIDUAL, TO REPRESENT THAT INDIVIDUAL'S WORK FOR THE UNIVERSITY OF WASHINGTON. 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