2024-09-26T19:09:00-05:00 2023-12-31 911056739 VINE DAHLEN PLLC 3500 188TH STREET SW STE 322 LYNNWOOD WA 98037 990 2023-01-01 911102033 PUGET SOUND KIDNEY CENTERS PUGE 4252595195 1019 PACIFIC AVE EVERETT WA 98201 THOMAS DEBORD PRESIDENT & CEO 4252595195 2024-09-26 1 0 LORI L SCOTT CPA P01452038 4257716055 2024-09-26 2023 2024-08-08 14:25:15Z THOMAS DEBORD 1019 PACIFIC AVE EVERETT WA 98201 56912757 0 X X 1980 WA TO PROVIDE KIDNEY DIALYSIS AND RELATED PATIENT CARE SERVICES IN WASHINGTON STATE. 11 11 344 42 0 0 1811800 132000 35442211 35290152 339894 402617 24253 13666 37618158 35838435 31438 27839 0 0 22027037 22344991 0 0 0 20432207 19958576 42490682 42331406 -4872524 -6492971 94226800 95026477 14881006 19915758 79345794 75110719 TO ENHANCE THE QUALITY OF LIFE FOR THOSE WITH KIDNEY DISEASE THROUGH OUTSTANDING DIALYSIS CARE, EDUCATION AND COMMUNITY SUPPORT. 0 0 32377425 27839 35290332 PATIENT DIALYSIS AND RELATED CARE - PSKC PROVIDES IN-CENTER DIALYSIS TREATMENTS TO PATIENTS. DIALYSIS TREATMENTS ARE ALSO PROVIDED TO HOSPITALIZED PATIENTS AT AREA HOSPITALS. TRAINING, SUPPLIES, EQUIPMENT AND CONTINUING SUPERVISION ARE PROVIDED TO PATIENTS WHO SELF-DIALYZE IN THEIR HOMES. PROFESSIONAL MEDICAL SOCIAL WORKERS WORK WITH EACH OF PSKC'S PATIENTS TO ENSURE EACH PATIENT HAS THE SUPPORT THEY NEED TO MANAGE PHYSICAL, FINANCIAL, AND PSYCHO-SOCIAL NEEDS. RENAL DIETITIANS PROVIDE KIDNEY PATIENTS WITH NUTRITIONAL COUNSELING, SO PATIENTS CAN LEARN TO MANAGE THEIR DIET AND LIVE WELL WITH KIDNEY DISEASE. TREATMENTS ARE APPLIED AT VARIOUS LOCATIONS. 298037 COMMUNITY EDUCATION AND SUPPORT - PSKC PROVIDES AN EDUCATION PROGRAM DESIGNED TO ASSIST THE COMMUNITY REGARDING CHRONIC KIDNEY DISEASE. THIS PROGRAM INCLUDES TEACHING COMMUNITY RESIDENTS ABOUT SHOPPING, PREPARING AND CONSUMING KIDNEY-FRIENDLY FOODS. THE PROGRAM ALSO GIVES THEM AN UNDERSTANDING OF TREATMENT OPTIONS AVAILABLE IF THEIR CONDITION PROGRESSES FROM CHRONIC KIDNEY DISEASE TO KIDNEY FAILURE. 32675462 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 42 0 1 344 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X THE ORGANIZATION 4252595195 1019 PACIFIC AVE EVERETT WA 98201 HAROLD KELLY PRESIDENT & CEO (UNTIL 01/2023) 40.00 X 477430 0 6750 THOMAS DEBORD PRESIDENT & CEO 40.00 X 444587 0 17637 RAGHU DURVASULA CMO 40.00 X 284288 0 19135 AMANDA CRAIN COO 40.00 X 231833 0 24055 CHRISTINA LOGALBO CNO 40.00 X 204668 0 11599 CHRISTINA GROVE HOME PROGRAM DIRECTOR 40.00 X 130562 0 16571 VENKATA RAMANAN SUBRAMANIAM CONTROLLER 40.00 X 129414 0 19240 DANIEL BLATNIK RN 40.00 X 127459 0 18752 KHIEM NGO RN 40.00 X 124674 0 17434 KAREN AYALON DSS 40.00 X 124639 0 14073 GEORGE BOWDEN CHAIR 1.00 X X 2000 0 0 SUHAIL AHMAD DIRECTOR 1.00 X 1900 0 0 BETTY COBBS DIRECTOR 1.00 X 1800 0 0 FONTELLE JONES SECRETARY/TREASURER 1.00 X X 1800 0 0 GENE CHASE DIRECTOR 1.00 X 1600 0 0 KIRSTEN HAUGEN DIRECTOR 1.00 X 1600 0 0 KATHRYN DETUERK DIRECTOR (UNTIL 10/2023) 1.00 X 1600 0 0 DONALD SENTER DIRECTOR (UNTIL 10/2023) 1.00 X 1400 0 0 ROBIN CALLAN DIRECTOR 1.00 X 1000 0 0 SARAH CAVE DIRECTOR 1.00 X 800 0 0 KIM PETERSON DIRECTOR 1.00 X 400 0 0 PATRICIA COCHRELL VICE CHAIR 1.00 X X 400 0 0 DIANNE EASLEY DIRECTOR 1.00 X 400 0 0 ALLEN EAMES DIRECTOR (UNTIL 03/2023) 1.00 X 0 0 0 2296254 0 165246 33 0 1 0 NEPHOLOGY ASSOCIATES OF KITSAP COUNTY 2771 HEMLOCK ST SUITE 201 BREMERTON WA 98310 MEDICAL PROVIDER 195000 WESTERN WASHINGTON MEDICAL GROUP 1330 ROCKEFELLER AVE STE 450 EVERETT WA 98201 MEDICAL PROVIDER 120000 LUMENAL LIGHTING 21706 66TH AVE W MOUNTLAKE TERRRACE WA 98043 BUILDING CONTRACTOR 109471 NSGC LLC PO BOX 2976 EVERETT WA 98213 LANDSCAPING MAINTENANCE 109077 4 132000 132000 DIALYSIS 621400 28664149 28664149 PHARMACY 621400 5634545 5634545 LABORATORY 621500 591518 591518 MEDICATIONS 621400 330094 330094 MEDICAL SUPPLIES 621400 69846 69846 35290152 474243 474243 21002696 21027784 46538 -25088 -46538 -71626 -71626 MISC REVENUE 900099 13666 180 13486 13666 35838435 35290332 0 416103 27839 27839 1738682 1738682 16487532 12459123 4028409 594719 437710 157009 1959541 1491967 467574 1564517 1140149 424368 73826 73826 109018 109018 94388 94388 4157692 3875311 282381 47565 47565 714615 364436 350179 754996 1981 753015 1480441 1303833 176608 53650 19629 34021 24928 5922 19006 108964 -1443 110407 3117666 2820645 297021 253600 253600 MEDICAL SUPPLIES 7294397 7294397 HOUSEKEEPING & LAUNDRY 593961 552605 41356 EQUIPMENT RENTALS & MAI 550490 528766 21724 UNCOMPENSATED CARE 272655 272655 255724 79937 175787 42331406 32675462 9655944 0 1577675 1601430 5981883 2412444 5754468 6456358 1158734 973977 214450 361521 87822713 24242925 62184428 63579788 14915528 17615506 438714 438714 2000920 1586739 94226800 95026477 4909977 5082957 8448362 13944225 1522667 888576 14881006 19915758 X 79322089 75098524 23705 12195 79345794 75110719 94226800 95026477 X -6492971 2089091 168805 X 1 X 0 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12924379 12924379 48459145 15356434 33102711 4156042 1376266 2779776 9141302 6616236 2525066 13141845 893989 12247856 63579788 LEASE LIABILITIES 791076 OTHER LONG TERM LIABILITY 97500 888576 X PART X, LINE 2: THE INFORMATION RETURN IS FILED ANNUALLY AND IS SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THE RETURN IS FILED. THE ORGANIZATION WOULD RECOGNIZE ACCRUED INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX PROVISIONS, IF ANY, AS PART OF SUPPORT EXPENSES ON THE CONSOLIDATED STATEMENTS OF ACTIVITIES. 1 PATIENT ASSISTANCE 498 27839 COST NUTRITIONAL AND FINANCIAL SUPPORT PART I, LINE 2 SUPPORT IS PROVIDED TO PATIENTS BEING TREATED IN-CENTER AND AS SUCH THE ORGANIZATION IS ABLE TO VERIFY THAT IT IS BEING USED FOR THE INTENDED PURPOSE. PSKC, ALONG WITH THE PSKC FOUNDATION AND KAPS, PROVIDED VARIOUS TYPES OF ASSISTANCE TO PATIENTS, INCLUDING NUTRITIONAL SUPPLEMENTS AND VITAMINS, TRANSPORTATION, AND LIVING EXPENSES TO HELP THEM AVOID FINANCIAL HARDSHIP WHILE RECEIVING TREATMENT. X 1 1 X X 0 0 0 0 0 0 0 1 0 HAROLD KELLY PRESIDENT & CEO (UNTIL 01/2023) 427430 0 50000 0 0 0 6750 0 0 0 484180 0 0 0 THOMAS DEBORD PRESIDENT & CEO 419587 0 25000 0 0 0 0 0 17637 0 462224 0 0 0 RAGHU DURVASULA CMO 274288 0 10000 0 0 0 19135 0 0 0 303423 0 0 0 AMANDA CRAIN COO 196833 0 35000 0 0 0 14986 0 9069 0 255888 0 0 0 CHRISTINA LOGALBO CNO 189668 0 15000 0 0 0 0 0 11599 0 216267 0 0 0 PART I, LINE 7 THE CEO AND COO PARTICIPATE IN AN INCENTIVE PLAN TO RECOGNIZE THE CONTRIBUTIONS MADE TO PUGET SOUND KIDNEY CENTER'S FINANCIAL AND OPERATIONAL SUCCESS. EACH YEAR, THE BOARD REVIEWS THE PERFORMANCE OF THE ORGANIZATION AS COMPARED TO ITS PREDETERMINED GOALS AND SETS APPROPRIATE AND REASONABLE INCENTIVE COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BOARD PRIOR TO SUBMISSION WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE INTERVIEWED ANNUALLY AT THE DECEMBER BOARD MEETING REGARDING POTENTIAL CONFLICTS OF INTEREST. A NUMBER OF ADMINISTRATIVE POLICIES ARE IN PLACE ADDRESSING THIS ISSUE. POLICIES NO. 108, 90 AND 355 COVERS AREAS OF CONFLICT OF INTEREST, BUSINESS ETHICS AND CONDUCT, AND FRAUD DETECTION AND PREVENTION RESPECTIVELY. ADDITIONALLY, AN ANNUAL IN-SERVICE IS GIVEN TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS THE PRESIDENT AND CEO'S COMPENSATION PACKAGES AND IT IS APPROVED BY THE SECRETARY/TREASURER. CURRENT MARKET CONDITIONS AT THE TIME IN HEALTH CARE AND REGION WERE USED TO ORIGINALLY DETERMINE COMPENSATION IN 2016. INCREASES IN COMPENSATION SINCE THEN HAVE BEEN MINIMAL AND UNDER INDUSTRY STANDARD. THE PRESIDENT AND CEO REVIEWS AND ADJUSTS AS NECESSARY ALL OTHERS. THE REVIEW USES A STRUCTURED WAGES AND SALARY SCALE, BASED ON CURRENT MARKET CONDITIONS IN HEALTH CARE AND REGION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN PSKC FOUNDATION 168,805. PUGET SOUND KIDNEY CENTERS FOUNDATION 1019 PACIFIC AVE EVERETT WA 98201 454354877 SUPPORT ACTIVITIES OF PUGET SOUND KIDNEY CENTERS WA 501(C)(3) LINE 12 A, I PUGET SOUND KIDNEY CENTERS 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 PUGET SOUND KIDNEY CENTERS FOUNDATION C 132000 FMV PUGET SOUND KIDNEY CENTERS FOUNDATION O 112196 FMV