2011-05-11T12:29:53-05:00 2010-06-30 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2009-07-01 260443505 SEATTLE CANCER CARE ALLIANCE HOUSE SEAT 2062881000 825 EASTLAKE AVENUE EAST PO BOX 19023 SEATTLE WA 981091023 JONATHAN TINGSTAD 2062881000 2011-05-05 1 Sara Elizabeth J Hyre 4254544919 2009 2016-02-24 21:20:13Z NORMAN HUBBARD 825 EASTLAKE AVENUE EAST PO BOX 19023 SEATTLE WA 981091023 636624 0 X WWW.SCCAHOUSE.ORG X 2007 WA SEATTLE CANCER CARE ALLIANCE HOUSE (SCCAH) WAS FORMED TO CONSTRUCT AND OPERATE (SEE SCHEDULE O) AN 80 UNIT MEDICAL PATIENT HOUSING FACILITY. SCCAH OPENED FOR OPERATIONS IN SEPTEMBER OF 2009. 15 15 0 18 0 0 43089 142849 493775 0 0 43089 636624 13982 0 212831 0 0 495160 2518488 495160 2745301 -452071 -2108677 30883030 26825102 29124118 26681362 1758912 143740 SEATTLE CANCER CARE ALLIANCE HOUSE (SCCAH) IS A SUBSIDIARY OF SEATTLE CANCER CARE ALLIANCE (SCCA). THE PURPOSE OF SCCAH IS THE CONSTRUCTING, OWNING AND OPERATING OF A FACILITY TO PROVIDE SHORT-TERM HOUSING FOR CANCER PATIENTS RECEIVING TREATMENT AT (SEE SCHEDULE O) SCCA AND THEIR FAMILY MEMBERS WHO LIVE OUTSIDE THE GREATER SEATTLE, WASHINGTON AREA. SCCAH ALSO ENHANCES SCCA'S PROVISION OF INTEGRATED, INNOVATIVE, COST EFFECTIVE, CLINICAL CARE IN THE LEAST STRESSFUL ENVIRONMENT FOR PATIENTS AND PERMITS CANCER PATIENTS TO HAVE THE COMFORT AND SUPPORT OF FAMILY MEMBERS WHILE RECEIVING CANCER TREATMENT AT SCCA. SCCAH OPENED FOR OPERATIONS IN SEPTEMBER OF 2009. SCCA WAS ORGANIZED BY SEATTLE CHILDREN'S HEATHCARE SYSTEM, THE UNIVERSITY OF WASHINGTON, AND FRED HUTCHINSON CANCER RESEARCH CENTER, FOR THE PURPOSE OF DEVELOPING AND OFFERING A COMPREHENSIVE PROGRAM OF INTEGRATED CANCER CARE SERVICES. 0 0 2535464 13982 493775 SEATTLE CANCER CARE ALLIANCE HOUSE WAS UNDER CONSTRUCTION THROUGH JUNE 30, 2009. THE FACILITY BEGAN OFFERING PATIENTS AND THEIR FAMILIES SHORT-TERM HOUSING WHILE RECEIVING CANCER TREATMENTS IN SEPTEMBER 2009. 2535464 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 1 0 0 0 0 0 0 0 0 0 0 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 WA AL AK AZ AR CO CT FL HI IL KS ME MD MA MI MN MS MO NH NY NC ND OH OK OR PA RI SC TN UT VA WV NM NJ X JONATHAN TINGSTAD 2062882260 825 EASTLAKE AVENUE EAST PO BOX SEATTLE WA 98109 X RICH JONES 1.00 X X 0 0 0 BROOKS RAGEN 1.00 X X 0 0 0 SHAN MULLIN 1.00 X X 0 0 0 BOB GERTH 1.00 X X 0 0 0 CARL BEHNKE 1.00 X 0 0 0 MARK GROUDINE 1.00 X 0 0 0 MYRA TANITA 1.00 X 0 0 0 JONELLE JOHNSON 1.00 X 0 0 0 RUTH MAHAN 1.00 X 0 0 0 JOHNESE SPISSO 1.00 X 0 0 0 SUE ALBRECHT 1.00 X 0 0 0 ROBB BAKEMEIER 1.00 X 0 0 0 PAT HAGAN 1.00 X 0 0 0 KATHY RANDALL 1.00 X 0 0 0 BRUDER STAPLETON 1.00 X 0 0 0 NORMAN HUBBARD 5.00 X 0 450280 47059 MADELINE BUELT 1.00 X 0 354894 52664 JONATHAN TINGSTAD 1.00 X 0 370029 52640 FRED APPELBAUM 1.00 X 0 0 0 F MARC STEWART 1.00 X 0 0 0 0 1175203 152363 0 0 1 0 WALSH CONSTRUCTION 509 FAIRVIEW AVE N SEATTLE WA 98109 CONTRACTOR 12707128 WEINSTEIN AU 121 STEWART ST SUITE 200 SEATTLE WA 98101 ARCHITECT 299685 HATCH PURCHASING CORPORATION 1820 38TH AVE E SEATTLE WA 98112 CONTRACTOR 245971 ACCOMODATIONS PLUS INC PO BOX 53446 BELLEVUE WA 98015 STAFFING 167218 4 6000 136849 7200 142849 TEMP MEDICAL HOUSING 624221 493775 493775 493775 636624 493775 0 0 13982 13982 177320 177320 7980 7980 27531 27531 120000 120000 10223 10223 40999 40999 13625 13625 47325 40420 6905 534 534 68602 52216 16386 10657 10657 196475 196475 52547 52547 78 78 576014 576014 1372406 1372406 1699 1699 B&O TAXES 4440 4440 MISCELLANEOUS EXPENSES 2746 2746 VOLUNTEER EXPENSES 118 118 2745301 2535464 209837 0 104164 5128045 222208 43632 17960 10814 27541911 1314162 25715539 26227749 21486 216535 30883030 26825102 3249487 157180 12645 21348625 21030766 4189104 4920036 336902 560735 29124118 26681362 X 1718678 96164 40234 47576 1758912 143740 30883030 26825102 X 0 1 1 X 0 X 2217938 43089 142849 2403876 493775 493775 2217938 43089 636624 2897651 0 0 0 2897651 2217938 43089 636624 2897651 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2217938 2217938 21405606 1069597 20336009 3199198 134758 3064440 271573 33088 238485 447596 76719 370877 26227749 INTEREST PAYABLE TO SCCA 560735 560735 636624 2745301 -2108677 493505 493505 -1615172 679000 160996 160996 518004 118620 118620 636624 2907000 160996 160996 2746004 -703 -703 2745301 Part XI, Line 8 - Other Adjustments: TRANSFER FROM SCCA: 493505. Part XII, Line 4b - Other Adjustments: TEMPORARILY RESTRICTED CONTRIBUTIONS: 120000. ROUNDING: -1380. Part XIII, Line 4b - Other Adjustments: ROUNDING: -703. 1 FREE ROOM NIGHTS 171 12258 FAIR MARKET VALUE HOTEL ROOMS MONTHLY GROCERIES FOR THE PANTRY FOR PATIENTS 4 1724 COST FOOD Other Information: Part IV: SCCAH DETERMINES THE NEED FOR FINANCIAL ASSISTANCE BASED ON A CRITERIA SET BY SCCA'S PATIENT FAMILY SERVICES DEPARTMENT. FUNDS ARE USED TO PAY FOR STAYS AT THE HOUSE. 0 0 0 0 0 0 0 0 0 NORMAN HUBBARD 0 374157 0 74880 0 1243 0 31410 0 15649 0 497339 0 0 MADELINE BUELT 0 305772 0 46800 0 2322 0 31410 0 21254 0 407558 0 0 JONATHAN TINGSTAD 0 320349 0 49140 0 540 0 31410 0 21230 0 422669 0 0 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978EJ29 2008-02-28 21410000 CONST AND EQUIP/MEDICAL PH 0 0 21410000 603333 357603 20449064 2009 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 Form 990, Part VI, Section A, line 6 SEATTLE CANCER CARE ALLIANCE (SCCA) IS THE SOLE MEMBER OF SEATTLE CANCER CARE ALLIANCE HOUSE. Form 990, Part VI, Section A, line 7a THE SOLE MEMBER APPROVES ALL GOVERNING DECISIONS MADE BY THE BOARD OF DIRECTORS. Form 990, Part VI, Section A, line 7b THE BOARD OF DIRECTORS OF THE CORPORATION MAY NOT, EXCEPT BY AFFIRMATIVE VOTE OF SEVENTY-FIVE PERCENT (75%) OF THE DIRECTORS IN OFFICE AND WITH THE APPROVAL OF ITS SOLE MEMBER, (A) AMEND, ALTER OR REPEAL CERTAIN SECTIONS OF THE CORPORATION'S BYLAWS; (B) REMOVE ANY DIRECTOR OR THE CHAIR OF THE CORPORATION; PROVIDED, THAT A MEMBER MAY REMOVE A DIRECTOR APPOINTED BY SUCH MEMBER AT ANY TIME; (C) AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION; (D) ADOPT A PLAN OF MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION; (E) AUTHORIZE THE SALE, LEASE OR EXCHANGE (OR PLEDGING AS SECURITY) OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION OR ANY ASSET NOT IN THE ORDINARY COURSE OF BUSINESS; (F) AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKE PROCEEDINGS THEREFOR; (G) ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION; (H) INITIATE OR RESOLVE LITIGATION IN WHICH THE CORPORATION IS A PARTY IF THE LITIGATION OR RESOLUTION WOULD HAVE A MATERIAL ADVERSE EFFECT ON THE FINANCIAL WELL-BEING OR PUBLIC PERCEPTION OF THE CORPORATION OR ITS MEMBERS; (I) CHANGE THE FUNDAMENTAL PURPOSES OF THE CORPORATION; OR (J) ENTER INTO ANY NEW LINE OF BUSINESS. FINALLY, THE CORPORATION'S ANNUAL BUDGET IS SUBJECT TO APPROVAL BY THE CORPORATION'S SOLE MEMBER. Form 990, Part VI, Section B, line 11 THE FORM 990 WAS PREPARED BY A PUBLIC ACCOUNTING FIRM AND INTERNALLY REVIEWED PRIOR TO PRESENTATION TO THE SCCAH'S SOLE MEMBER, SEATTLE CANCER CARE ALLIANCE, BOARD APPOINTED FINANCE AND AUDIT COMMITTEE. THE RELEVANT SECTIONS OF THE FORM 990 WERE PROVIDED TO THE SCCAH'S SOLE MEMBER FINANCE AND AUDIT COMMITTEE FOR REVIEW BEFORE FILING. THE CHAIR OF THE FINANCE AND AUDIT COMMITTEE REPORTS TO THE SCCAH'S SOLE MEMBERS FULL BOARD. ALL SEATTLE CANCER CARE ALLIANCE BOARD MEMBERS ARE PRESENTED WITH A COPY BEFORE FILING FORM 990. Form 990, Part VI, Section B, line 12c SEATTLE CANCER CARE ALLIANCE HOUSE (SCCAH) RELIES ON THE CONFLICT OF INTEREST POLICY ESTABLISHED BY ITS PARENT CORPORATION, SEATTLE CANCER CARE ALLIANCE (SCCA). THE SCCA'S CONFLICT OF INTEREST POLICY IS ANNUALLY MONITORED THROUGH A QUESTIONNAIRE AND ALSO A SELF-REPORTING REQUIREMENT. THIS SELF REPORTING IS APPLICABLE TO THE BOARD OF DIRECTORS AND ALL MANAGEMENT STAFF. THE DETERMINATION OF WHETHER AN ISSUE EXISTS IS MADE BY THE INTEGRITY OFFICER. THE ESCALATION PROCESS IS TO THE SENIOR MANAGEMENT TEAM, AND IF DEEMED APPROPRIATE TO THE BOARD OF DIRECTORS INTEGRITY COMMITTEE AND LEGAL COUNSEL. ALL OFFICERS OF THE SCCAH ARE PAID BY THE CORPORATION'S SOLE MEMBER. Form 990, Part VI, Section B, line 15 AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORMS A MARKET ANALYSIS OF KEY EXECUTIVE PAY AT COMPARABLE ORGANIZATIONS; A CONSULTANT FROM THIS FIRM PRESENTS THEIR FINDINGS TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS EVERY TWO YEARS. THE ANALYSIS WAS LAST PERFORMED AND PRESENTED IN MAY OF 2009. IN THE INTERVENING YEARS, THE PRIOR YEAR'S MARKET ANALYSIS IS UPDATED USING AN APPROPRIATE INFLATION FACTOR FOR USE BY THE COMPENSATION COMMITTEE IN THEIR ANNUAL REVIEW OF TOTAL COMPENSATION FOR THE KEY EMPLOYEES. BOTH THE BOARD AND THE COMPENSATION COMMITTEE DOCUMENT THEIR DECISIONS IN A TIMELY MANNER. Form 990, Part VI, Section C, line 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART I, LINE 6 THERE ARE 15 VOLUNTEER BOARD MEMBERS AND 3 VOLUNTEER MEMBER REPRESENTATIVES. FORM 990, PART VII, SECTION A NORMAN HUBBARD, MADELINE BUELT, AND JONATHAN TINGSTAD ARE COMPENSATED BY A RELATED ORGANIZATION, SEATTLE CANCER CARE ALLIANCE. FRED APPELBAUM AND F. MARC STEWART ARE COMPENSATED BY FRED HUTCHINSON CANCER RESEARCH CENTER, AN UNRELATED PARTY TO SEATTLE CANCER CARE ALLIANCE. SEATTLE CANCER CARE ALLIANCE 825 EASTLAKE AVE E PO BOX 19083 SEATTLE WA 98109 911935159 OUTPATIENT CANCER CARE CLINIC WA 501(C)(3) 3 - HOSPITAL N/A 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 1 0 0