OVERLAKE MEDICAL CENTER & CLINICS: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- OVERLAKE MEDICAL CENTER & CLINICS (EIN 91-0652651)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-12
- IRS object ID
- 202121329349302612
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-12T12:09:23-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK NUBER PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4TH STREET SUITE 1400 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910652651 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE HOSPITAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OVER | BusinessNameControlTxt |
| Phone | 4256885000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 116TH AVENUE NE | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW TOKAR | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4256885000 | PhoneNum |
| Signature | 2021-05-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SARA ELIZABETH J HYRE | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Preparation | 2021-05-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | J MICHAEL MARSH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 116TH AVENUE NE | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $605,505,222 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OVERLAKEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | THE PURPOSE IS TO OPERATE A HOSPITAL FOR THE CARE OF PERSONS, TO PARTICIPATE IN EDUCATION, RESEARCH AND OTHER ACTIVITIES DESIGNED TO PROMOTE GENERAL HEALTH OF THE COMMUNITY. THE HOSPITAL'S MISSION IS TO PROVIDE COMPASSIONATE CARE FOR EVERY LIFE WE TOUCH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 3667 | TotalEmployeeCnt |
| Total Volunteers | 217 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,968,633 | PYContributionsGrantsAmt |
| CY Contributions Grants | $35,731,629 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $562,043,343 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $543,289,574 | CYProgramServiceRevenueAmt |
| PY Investment Income | $32,387,340 | PYInvestmentIncomeAmt |
| CY Investment Income | $22,321,323 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,676,272 | PYOtherRevenueAmt |
| CY Other Revenue | $4,013,172 | CYOtherRevenueAmt |
| PY Total Revenue | $610,075,588 | PYTotalRevenueAmt |
| CY Total Revenue | $605,355,698 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,277,968 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,115,907 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $304,352,109 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $327,136,542 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $265,233,789 | PYOtherExpensesAmt |
| CY Other Expenses | $268,572,221 | CYOtherExpensesAmt |
| PY Total Expenses | $571,863,866 | PYTotalExpensesAmt |
| CY Total Expenses | $597,824,670 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $38,211,722 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,531,028 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $959,048,510 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,038,955,191 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $390,370,885 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $472,809,344 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $568,677,625 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $566,145,847 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE PURPOSE IS TO OPERATE A HOSPITAL FOR THE CARE OF PERSONS, TO PARTICIPATE IN EDUCATION, RESEARCH AND OTHER ACTIVITIES DESIGNED TO PROMOTE GENERAL HEALTH OF THE COMMUNITY. THE HOSPITAL'S MISSION IS TO PROVIDE COMPASSIONATE CARE FOR EVERY LIFE WE TOUCH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $481,953,866 | ExpenseAmt |
| Revenue | $543,161,260 | RevenueAmt |
| Desc | SEE SCHEDULE O. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,115,907 | ExpenseAmt |
| Grant | $2,115,907 | GrantAmt |
| Desc | OTHER GRANTS AND ALLOCATIONS: GRANTS TO OVERLAKE HOSPITAL FOUNDATION AND OVERLAKE HOSPITAL AUXILIARIES TO COVER EXPENSES AND GRANTS TO SUPPORT OTHER COMMUNITY NONPROFIT ORGANIZATIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,254,562 | ExpenseAmt |
| Revenue | $128,314 | RevenueAmt |
| Desc | EDUCATION SERVICES:IN ADDITION TO THE EXCELLENT CARE WE PROVIDE OUR PATIENTS, THE HOSPITAL FIRMLY BELIEVES EDUCATION IS CRITICAL TO OVERALL WELLNESS. THE HOSPITAL REACHES OUT TO THE COMMUNITY TO ENGAGE AND EMPOWER ITS PATIENTS IN BECOMING EDUCATED HEALTHCARE CONSUMERS BY OFFERING FREE AND LOW-COST CLASSES FOR ALL AGE GROUPS. HEALTH EDUCATION IS AN IMPORTANT PART OF PREVENTATIVE CARE. THE EDUCATION PROGRAM PROVIDED 15,832 FAMILY CONTACT HOURS OFFERING CLASSES OF A WIDE RANGE OF HEALTH RELATED TOPICS INCLUDING WOMEN'S HEALTH, PRENATAL CARE, COPING SKILLS, DEALING WITH CANCER, POSITIVE PARENTING, SAFETY, ASTHMA, HEART DISEASE, DIABETES, LIVING WILLS, INCONTINENCE, WEIGHT LOSS, MAINTAINING BALANCE, BABYSITTING FOR TEENS, CPR AND HEALTHY LIFESTYLES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $487,324,335 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 241 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3667 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | Yes (1) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LINDSEY SOBOLOSKI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4256885552 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 116TH AVE SUITE 600 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|---|
| J MICHAEL MARSH | ||||||||||
| PRESIDENT & CEO | 45.00 | 15.00 | Yes (X) | $1,701,661 | $0 | $130,722 | ||||
| ABHNEET CHOWDHARY MD | ||||||||||
| NEUROSURGEON | 40.00 | 0.00 | $1,158,242 | $0 | $31,021 | Yes (X) | ||||
| DEREK M RODRIGUES MD | ||||||||||
| CARDIOLOGIST | 40.00 | 0.00 | $1,048,294 | $0 | $41,403 | Yes (X) | ||||
| DAVID KNOEPFLER | ||||||||||
| VP/CHIEF MEDICAL OFFICER | 55.00 | 0.00 | $872,437 | $0 | $83,103 | Yes (X) | ||||
| DAVID W NELSON MD | ||||||||||
| CARDIOLOGIST | 40.00 | 0.00 | $831,959 | $0 | $41,403 | Yes (X) | ||||
| ROBERT WOOCHUL RHO MD | ||||||||||
| CARDIOLOGIST | 40.00 | 0.00 | $813,043 | $0 | $30,031 | Yes (X) | ||||
| THOMAS A DEBORD | ||||||||||
| COO | 55.00 | 0.00 | Yes (X) | $614,569 | $0 | $72,165 | ||||
| KELAN R KOENIG MD | ||||||||||
| OMC PHYSICIAN EXECUTIVE | 55.00 | 0.00 | $516,158 | $0 | $90,983 | Yes (X) | ||||
| ANDREW J TOKAR | ||||||||||
| CFO | 50.00 | 7.00 | Yes (X) | $492,695 | $0 | $74,836 | ||||
| CAITILN HILLARY MOULDING | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 0.00 | $396,116 | $0 | $622 | Yes (X) | ||||
| VALERIE CHRUSCIEL | ||||||||||
| OMC COO | 60.00 | 0.00 | $302,348 | $0 | $63,615 | Yes (X) | ||||
| MICHELLE CURRY | ||||||||||
| VP/CHIEF NURSING OFFICER | 55.00 | 0.00 | $308,952 | $0 | $53,424 | Yes (X) | ||||
| RUSSELL STOCKDALE | ||||||||||
| CHAIR | 8.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| ROBERT CAMPBELL | ||||||||||
| SECRETARY, CHAIR ELECT | 4.00 | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| JASON THOMPSON | ||||||||||
| TREASURER | 3.50 | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| PATRICIA BEDIENT | ||||||||||
| IMMEDIATE PAST CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| JORGE CERDA | ||||||||||
| TRUSTEE | 3.50 | 3.50 | $0 | $0 | $0 | Yes (X) | ||||
| GREG COLLINS | ||||||||||
| TRUSTEE | 3.00 | 1.00 | $0 | $0 | $0 | Yes (X) | ||||
| TOM EVERT | ||||||||||
| TRUSTEE FROM 05/20 | 2.00 | 1.00 | $0 | $0 | $0 | Yes (X) | ||||
| JANINE FLORENCE | ||||||||||
| TRUSTEE | 0.50 | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| TED HERB | ||||||||||
| TRUSTEE | 1.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| RAJESH JHA | ||||||||||
| TRUSTEE FROM 01/20 | 2.00 | 1.00 | $0 | $0 | $0 | Yes (X) | ||||
| TIFFANY KOENIG | ||||||||||
| TRUSTEE | 1.00 | 3.00 | $0 | $0 | $0 | Yes (X) | ||||
| JIM LADD | ||||||||||
| TRUSTEE | 2.00 | 1.00 | $0 | $0 | $0 | Yes (X) | ||||
| MARTHA LEE | ||||||||||
| TRUSTEE | 3.00 | 1.00 | $0 | $0 | $0 | Yes (X) | ||||
| LINDA MAHAFFEY | ||||||||||
| TRUSTEE | 1.50 | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| UMA RAGHAVAN | ||||||||||
| TRUSTEE | 4.00 | 4.00 | $0 | $0 | $0 | Yes (X) | ||||
| THOMAS STOLL | ||||||||||
| TRUSTEE | 2.00 | 0.30 | $77,000 | $0 | $0 | Yes (X) | ||||
| LISA WISSNER-SLIVKA | ||||||||||
| TRUSTEE | 3.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| DILIP WAGLE | ||||||||||
| TRUSTEE | 2.00 | 0.50 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $9,133,474 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $713,328 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 669 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GALL LANDAU YOUNG CONST CO | |||||
| PO BOX 6728 | BELLEVUE | WA | 98008 | CONSTRUCTION | $61,328,261 |
| EPIC SYSTEMS CORP | |||||
| PO BOX 88314 | MILWAUKEE | WI | 53288 | SOFTWARE DEVELOPMENT | $3,194,815 |
| AYA HEALTHCARE INC | |||||
| PO BOX 123519-DEPT 3519 | DALLAS | TX | 75312 | STAFFING | $3,043,122 |
| BLOODWORKS NORTHWEST | |||||
| 921 TERRY AVENUE | SEATTLE | WA | 98104 | LABORATORY SERVICES | $2,809,902 |
| NBBJ | |||||
| PO BOX 742088 | LOS ANGELES | CA | 90074 | ARCHITECT FEES | $2,024,218 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 122 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $11,767,336 | RelatedOrganizationsAmt |
| Government Grants | $23,964,293 | GovernmentGrantsAmt |
| Total Contributions | $35,731,629 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NON GOVERNMENT PAYMENT | 622110 | $347,081,352 | $347,081,352 |
| MEDICARE/MEDICAID | 622110 | $198,315,802 | $198,315,802 |
| OTHER PROGRAM SERVICES | 900099 | $857,876 | $857,876 |
| EDUCATION SERVICES | 611710 | $128,314 | $128,314 |
| PROGRAM RELATED INV. | 900099 | -$3,093,770 | -$3,093,770 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $543,289,574 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,230,128 | TotalRevenueColumnAmt |
| Exclusion | $13,230,128 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $432,735 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $432,735 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $432,735 | TotalRevenueColumnAmt |
| Exclusion | $432,735 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,184,268 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $93,073 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,184,268 | SecuritiesAmt |
| Other | -$93,073 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,091,195 | TotalRevenueColumnAmt |
| Exclusion | $9,091,195 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $146,808 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $56,451 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90,357 | TotalRevenueColumnAmt |
| Exclusion | $90,357 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/CATERING | 722514 | $2,280,821 | $2,280,821 |
| QUALITY INCENTIVES | 900099 | $612,409 | $612,409 |
| PARKING REVENUE | 812930 | $311,439 | $311,439 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $285,411 | TotalRevenueColumnAmt |
| Exclusion | $285,411 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,490,080 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $605,355,698 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $543,289,574 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $26,334,495 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,115,907 | TotalAmt |
| Program Services | $2,115,907 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,843,623 | TotalAmt |
| Program Services | $1,346,172 | ProgramServicesAmt |
| Management And General | $2,497,451 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,312,156 | TotalAmt |
| Program Services | $217,964,567 | ProgramServicesAmt |
| Management And General | $41,347,589 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,157,683 | TotalAmt |
| Program Services | $13,121,749 | ProgramServicesAmt |
| Management And General | $2,035,934 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,831,324 | TotalAmt |
| Program Services | $24,762,415 | ProgramServicesAmt |
| Management And General | $6,068,909 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,991,756 | TotalAmt |
| Program Services | $14,986,959 | ProgramServicesAmt |
| Management And General | $3,004,797 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,311,162 | TotalAmt |
| Program Services | $97,876 | ProgramServicesAmt |
| Management And General | $1,213,286 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,269 | TotalAmt |
| Management And General | $148,269 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,060 | TotalAmt |
| Management And General | $67,060 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,539 | TotalAmt |
| Management And General | $307,539 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,779,861 | TotalAmt |
| Program Services | $45,321,726 | ProgramServicesAmt |
| Management And General | $13,458,135 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,470,533 | TotalAmt |
| Program Services | $764 | ProgramServicesAmt |
| Management And General | $1,469,769 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,340,899 | TotalAmt |
| Program Services | $7,110,746 | ProgramServicesAmt |
| Management And General | $4,230,153 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,618,328 | TotalAmt |
| Management And General | $13,618,328 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,864,409 | TotalAmt |
| Program Services | $13,731,839 | ProgramServicesAmt |
| Management And General | $4,132,570 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $494,691 | TotalAmt |
| Program Services | $321,460 | ProgramServicesAmt |
| Management And General | $173,231 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $582,022 | TotalAmt |
| Program Services | $395,426 | ProgramServicesAmt |
| Management And General | $186,596 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,976,922 | TotalAmt |
| Program Services | $6,976,922 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,597,310 | TotalAmt |
| Program Services | $23,360,301 | ProgramServicesAmt |
| Management And General | $8,237,009 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,434,399 | TotalAmt |
| Program Services | $6,810,200 | ProgramServicesAmt |
| Management And General | $1,624,199 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $91,574,443 | $88,782,359 | $2,792,084 |
| MEDICAID ASSESSMENT | $12,968,693 | $12,968,693 | |
| B&O TAX | $5,960,933 | $4,922,502 | $1,038,431 |
| LICENSE & MEMBERSHIP | $1,538,298 | $770,293 | $768,005 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,536,450 | TotalAmt |
| Program Services | $1,455,459 | ProgramServicesAmt |
| Management And General | $2,080,991 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $597,824,670 | TotalAmt |
| Program Services | $487,324,335 | ProgramServicesAmt |
| Management And General | $110,500,335 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,088,963 | BOYAmt |
| EOY | -$3,093,168 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,468,599 | BOYAmt |
| EOY | $47,167,209 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,667,364 | BOYAmt |
| EOY | $76,015,044 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,968,063 | BOYAmt |
| EOY | $9,195,643 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,944,443 | BOYAmt |
| EOY | $10,453,530 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $692,270,740 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $342,290,910 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $262,709,971 | BOYAmt |
| EOY | $349,979,830 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $496,081,426 | BOYAmt |
| EOY | $499,602,773 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,900,667 | BOYAmt |
| EOY | $2,754,993 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,786,161 | BOYAmt |
| EOY | $3,834,175 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,432,853 | BOYAmt |
| EOY | $43,045,162 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $959,048,510 | BOYAmt |
| EOY | $1,038,955,191 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,010,992 | BOYAmt |
| EOY | $97,957,840 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $35,000,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $292,503,810 | BOYAmt |
| EOY | $289,389,817 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,856,083 | BOYAmt |
| EOY | $50,461,687 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $390,370,885 | BOYAmt |
| EOY | $472,809,344 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $567,702,607 | BOYAmt |
| EOY | $564,807,442 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $975,018 | BOYAmt |
| EOY | $1,338,405 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $568,677,625 | BOYAmt |
| EOY | $566,145,847 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $959,048,510 | BOYAmt |
| EOY | $1,038,955,191 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,531,028 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$10,062,806 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $67,060 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $67,060 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | PART OF MEMBERSHIP DUES THAT ARE PAID TO WASHINGTON STATE HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,151,141 | OtherCostOrOtherBasisAmt |
| Book Value | $2,151,141 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $252,629,123 | OtherCostOrOtherBasisAmt |
| Depreciation | $129,214,743 | DepreciationAmt |
| Book Value | $123,414,380 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,691,709 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,145,944 | DepreciationAmt |
| Book Value | $545,765 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $260,868,545 | OtherCostOrOtherBasisAmt |
| Depreciation | $208,930,223 | DepreciationAmt |
| Book Value | $51,938,322 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $171,930,222 | OtherCostOrOtherBasisAmt |
| Book Value | $171,930,222 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $349,979,830 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| LIABILITY INSURANCE RESERVE | $11,174,599 |
| WORKERS COMPENSATION RESERVE | $2,386,984 |
| OTHER LONG TERM LIABILITY | $101,316 |
| CAPITAL LEASE OBLIGATION | $36,798,788 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $50,461,687 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,314,426 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,314,426 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,084,134 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,475,950 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,608,184 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03450 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $57,398,560 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,475,950 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,922,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04510 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $970,708 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $120,087 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $850,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,463,774 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $235 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,463,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,537,143 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,374,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,162,393 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00530 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $465,912 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $465,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,437,537 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,495,072 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,942,465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00990 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $64,836,097 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,971,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,865,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05500 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,659,292 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,370,998 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $67,986,847 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $76,840,816 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$8,853,969 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 OVERLAKE SURGERY CENTER LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | AMBULATORY SURGICAL SVCS | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.30160 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.18830 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE HOSPITAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 116TH AVE NE | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | OVERLAKE HOSPITAL.ORG/ABOUT-OVERLAKE | WebsiteAddressTxt |
| State License | HAC.FS.00000131 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Research Facility | Yes (X) | ResearchFacilityInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE HOSPITAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | OVERLAKEHOSPITAL.ORG/ABOUT-OVERLAKE | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | OVERLAKEHOSPITAL.ORG/ABOUT-OVERLAKE | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.OVERLAKEHOSPITAL.ORG/FINANCIAL-ARRANGEMENTS | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.OVERLAKEHOSPITAL.ORG/FINANCIAL-ARRANGEMENTS | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.OVERLAKEHOSPITAL.ORG/FINANCIAL-ARRANGEMENTS | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| OVERLAKE HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 5: OVERLAKE MEDICAL CENTER SOLICITED COMMUNITY INPUT THROUGH KEY STAKEHOLDER INTERVIEWS TO IDENTIFY RESOURCES POTENTIALLY AVAILABLE TO ADDRESS THE SIGNIFICANT HEALTH NEEDS. OVERLAKE MEDICAL CENTER PARTICIPATED IN A COLLABORATIVE PROCESS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF THE KING COUNTY HOSPITALS FOR A HEALTHIER COMMUNITY (HHC). HHC IS A COLLABORATIVE OF ALL 11 HOSPITALS AND/OR HEALTH SYSTEMS IN KING COUNTY AND PUBLIC HEALTH-SEATTLE & KING COUNTY. THE HHC MEMBERS JOINED TOGETHER TO IDENTIFY IMPORTANT HEALTH NEEDS AND ASSETS IN THE COMMUNITIES THEY SERVE. HHC RECOGNIZES THAT PARTNERSHIPS BETWEEN HOSPITALS, PUBLIC HEALTH, COMMUNITY ORGANIZATIONS AND COMMUNITIES ARE KEY TO SUCCESSFUL STRATEGIES TO ADDRESS COMMON HEALTH NEEDS. THE COMMUNITY HEALTH NEEDS ASSESSMENT INCORPORATED EXISTING DEMOGRAPHIC AND HEALTH DATA FOR THE COMMUNITIES SERVED BY THE HOSPITAL. IT INCLUDED COLLECTION AND ANALYSIS OF INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH. THE HEALTH NEEDS WERE IDENTIFIED FROM ISSUES SUPPORTED BY PRIMARY AND SECONDARY DATA SOURCES GATHERED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE NEEDS WERE INDICATED BY STAKEHOLDER INTERVIEWS, FOCUS GROUPS, AND SECONDARY DATA SOURCES. THE NEEDS WERE CONFIRMED BY MORE THAN ONE INDICATOR OR DATA SOURCE. COMMUNITY STAKEHOLDERS, IDENTIFIED BY THE HOSPITAL, WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEW PARTICIPANTS INCLUDED LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, AS WELL AS THE LOCAL HEALTH DEPARTMENT THAT HAS "CURRENT DATA OR INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY," PER IRS REQUIREMENTS. THE INTERVIEWS TOOK INTO ACCOUNT INPUT FROM A BROAD RANGE OF PERSONS LOCATED IN OR SERVING ITS COMMUNITY INCLUDING, HEALTH CARE CONSUMERS, NONPROFIT AND COMMUNITY-BASED ORGANIZATIONS, ACADEMIC EXPERTS, LOCAL GOVERNMENT OFFICIALS, LOCAL SCHOOL DISTRICTS, HEALTH CARE PROVIDERS AND COMMUNITY HEALTH CENTERS. |
| OVERLAKE HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 6A: EVERGREEN HEALTHCHI FRANCISCAN HEALTHKAISER PERMANENTEMULTICARE HEALTH SYSTEMNAVOSSEATTLE CANCER CARE ALLIANCESEATTLE CHILDREN'SSWEDISH MEDICAL CENTERUW MEDICINEVIRGINIA MASON |
| OVERLAKE HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 6B: PUBLIC HEALTH-SEATTLE & KING COUNTYWASHINGTON STATE HOSPITAL ASSOCIATION |
| OVERLAKE HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 11: OVERLAKE HOSPITAL MEDICAL CENTER WILL ADDRESS THE FOLLOWING HEALTH NEEDS THROUGH COMMITMENT OF COMMUNITY BENEFIT PROGRAMS AND CHARITABLE RESOURCES. GOALS HAVE BEEN ESTABLISHED THAT INDICATE THE ANTICIPATED IMPACT ON THESE HEALTH NEEDS AS A RESULT OF THE RESOURCES THE HOSPITAL WILL COMMIT TO MEETING THE HEALTH NEEDS. STRATEGIES TO ADDRESS THE PRIORITY HEALTH NEEDS ARE IDENTIFIED AND IMPACT MEASURES WILL BE TRACKED. THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE DETERMINED AND PRIORITIZED WITH INPUT FROM THE COMMUNITY:MENTAL HEALTH - INCREASE ACCESS TO MENTAL HEALTHCARE RESOURCES AND SERVICES. OVERLAKE WILL IMPLEMENT A MENTAL HEALTH COMMUNITY PROGRAM TO DELIVER A SUICIDE PREVENTION CURRICULUM IN CONJUNCTION WITH LOCAL SCHOOLS AND COMMUNITY MENTAL HEALTH SERVICES. EXPAND ACCESS TO EARLY INTERVENTION AND SCREENING AND OTHER MENTAL HEALTH SERVICES- ESPECIALLY TO YOUTH THROUGH OUR PARTNERSHIP WITH YOUTH EASTSIDE SERVICES. DEVELOP A PROGRAM TO OFFER DEMENTIA AND ALZHEIMER'S DISEASE PREVENTION EDUCATION. CONTINUE AND EXPAND CAREGIVER SUPPORT PROGRAMS THROUGH COLLABORATION WITH AEGIS, SEAMAR AND YMCA. PROVIDE SUPPORTIVE SERVICES FOR CAREGIVERS OF PERSONS WITH DEMENTIA. SUPPORT COMMUNITY ORGANIZATIONS THAT PROVIDE MENTAL HEALTH SERVICES.ACCESS TO CARE - INCREASE ACCESS TO HEALTHCARE FOR THE MEDICALLY UNDERSERVED WITH A FOCUS ON THE CULTURALLY DIVERSE POPULATIONS OF THE EASTSIDE. OVERLAKE WILL EXPAND OUTREACH ACTIVITIES WITH SOUTH ASIAN AND SOUTHEAST ASIAN POPULATIONS IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS. OVERLAKE WILL PROVIDE FINANCIAL ASSISTANCE BY OFFERING FREE AND DISCOUNTED CARE FOR HEALTHCARE SERVICES, CONSISTENT WITH OVERLAKE'S FINANCIAL ASSISTANCE POLICY.CARDIOVASCULAR DISEASE - DECREASE HEART DISEASE AMONG VULNERABLE EASTSIDE POPULATIONS. OVERLAKE WILL: IMPLEMENT EDUCATION AND OUTREACH PROGRAMS TARGETED TO THE SOUTH ASIAN POPULATION (IDENTIFIED WITH A HIGHER RELATIVE RISK), CONTINUE TO OFFER OVERLAKE'S WOMEN AND HEART SYMPOSIUM, AND PARTICIPATE IN AND SPONSOR EDUCATION PROGRAMS WITH THE AMERICAN HEART ASSOCIATION.PREVENTIVE HEALTHCARE - INCREASE ACCESS TO CLINICAL PREVENTIVE SERVICES TO REDUCE DEATH, DISABILITY, AND DISEASE. OVERLAKE WILL COMMIT THE FOLLOWING RESOURCES TO ADDRESS THIS HEALTH NEED BY PROVIDING FREE FLU AND PNEUMOCOCCAL VACCINES TO THE MEDICALLY UNDERSERVED, OFFER SENIOR WELLNESS PROGRAMS, OFFER COLORECTAL CANCER SCREENINGS TARGETED TO THE HIGH RISK MEMBERS OF THE SOUTHEAST ASIAN COMMUNITY, PROVIDE FREE DISEASE PREVENTION AND AWARENESS PROGRAMS THROUGH PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY AND THE AMERICAN HEART ASSOCIATION, AND CONDUCT EDUCATION FOCUSED ON SMOKING AND VAPING PREVENTION AMONG YOUTH.OTHER HEALTH NEEDS - OVERLAKE HOSPITAL MEDICAL CENTER HAS CHOSEN NOT TO ACTIVELY ADDRESS THE REMAINING HEALTH NEEDS OF OVERWEIGHT AND OBESITY AND SEXUALLY TRANSMITTED INFECTIONS AS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, OVERLAKE WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT WE CAN MOST EFFECTIVELY ADDRESS GIVEN OUR AREAS OF FOCUS AND EXPERTISE. THEREFORE, THE HOSPITAL'S CHARITABLE RESOURCES WILL BE PLACED ON THE SELECTED PRIORITY HEALTH NEEDS. |
| PART V, SECTION B, LINE 3E: | THE IDENTIFIED SIGNIFICANT HEALTH NEEDS WERE PRIORITIZED WITH INPUT FROM THE COMMUNITY.THE FOLLOWING CRITERIA WERE USED TO PRIORITIZE THE HEALTH NEEDS: CHANGE OVER TIME - DETERMINATION IF THE HEALTH NEED HAS IMPROVED, STAYED THE SAME OR WORSENED.RESOURCES - AVAILABILITY OF RESOURCES IN THE COMMUNITY TO ADDRESS THE HEALTH NEED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 26 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (26 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - OMC-CARDIOLOGY BELLEVUE | ||||
| 1135 116TH AVE NE STE 600 | BELLEVUE | WA | 98004 | CARDIOLOGY |
| 2 - OMC-URGENT & PRIMARY CARE ISSAQUAH | ||||
| 5708 E LK SAMMAMISH PKWY SE STE 100 | ISSAQUAH | WA | 98029 | URGENT/PRIMARY CARE |
| 3 - OMC-PULMENDOCRINOLOGYPRIMARY CARE | ||||
| 1231 116TH AVE NE STE 400 | BELLEVUE | WA | 98004 | PULMONOLOGY/ENDOCRINOLOGY/ PRIMARY CARE |
| 4 - OMC-NEUROLOGY | ||||
| 1135 116TH AVE NE STE 500 | BELLEVUE | WA | 98004 | NEUROLOGY/NEUROSURGERY/ NEUROHOSPITAL |
| 5 - OMC-DT BELLEVUE PRIMARYURGENT CARE | ||||
| 400 108TH AVE NE STE 100 | BELLEVUE | WA | 98004 | PRIMARY/URGENT CARE |
| 6 - OMC-RAD ONCOLOGY PHYSGYNMEDICALBREAST | ||||
| 1135 116TH AVE NE STE 200 | BELLEVUE | WA | 98004 | ONCOLOGY/BREAST SURGERY/GYNECOLOGY |
| 7 - OMC-URGENT CARE REDMOND | ||||
| 17209 REDMOND WAY | REDMOND | WA | 98052 | URGENT CARE |
| 8 - OMC-MUSCULOSKELETAL MED ISSAQUAH | ||||
| 1740 NW MAPLE ST STE 111 | ISSAQUAH | WA | 98027 | MUSCULOSKELETAL MEDICINE |
| 9 - OMC-OP PHYSSPEECHOCCUP THERAPY | ||||
| 1417 116TH AVE NE STE 110 | BELLEVUE | WA | 98004 | PHYSICAL/SPEECH/OCCUPATIONAL |
| 10 - OMC-REDMOND PRIMARY & CARDIOLOGY | ||||
| 7345 164TH AVE NE STE 1-105 | REDMOND | WA | 98052 | PRIMARY CARE/CARDIOLOGY |
| 11 - OMC-CARDIACTHORACIC SURGERY | ||||
| 1135 116TH AVE NE STE 605 | BELLEVUE | WA | 98004 | CARDIACTHORACIC SURGERY |
| 12 - OMC-OP PSYCH | ||||
| 1750 112TH AVE NE STE B-102 | BELLEVUE | WA | 98004 | PSYCH SERVICES |
| 13 - OMC-URGENT & PRIMARY CARE LAKE HILL | ||||
| 619 156TH AVE SE | BELLEVUE | WA | 98007 | URGENT CARE/PRIMARY CARE |
| 14 - OMC-KIRKLAND PRIMARY CARECARDIOLOGY | ||||
| 290 CENTRAL WAY | KIRKLAND | WA | 98033 | PRIMARY CARE/CARDIOLOGY |
| 15 - OMC-SAMMAMISH PRIMARY & URGENT CARE | ||||
| 22630 SE 4TH ST STE 300 | SAMMAMISH | WA | 98074 | PRIMARY CARE/URGENT CARE |
| 16 - OMC-CONCIERGE SERVICES | ||||
| 1231 116TH AVE NE STE 525 | BELLEVUE | WA | 98004 | CONCIERGE SERVICES |
| 17 - OMC-SPECIALTY CLINIC BELLEVUE | ||||
| 1231 116TH AVE NE SUITE 515 | BELLEVUE | WA | 98004 | BARIATRIC/METABOLIC SURGERY/MEDICAL WEIGHT LOSS |
| 18 - OMC-SENIOR HEALTH CLINIC BELLEVUE | ||||
| 1750 112TH AVE NE STE A101 | BELLEVUE | WA | 98004 | SENIOR HEALTH SERVICES |
| 19 - OMC-CARDIOLOGYPULMSPECIALTY SERVICESN | ||||
| 1740 NW MAPLE STE 207 | ISSAQUAH | WA | 98027 | CARDIOLOGY/PULM/SPECIALTY/ NUTRITION/ENDOCRINOLOGY |
| 20 - OMC-COLORECTAL SURGERY | ||||
| 1135 116TH AVE NE STE 550 | BELLEVUE | WA | 98004 | COLORECTAL |
| 21 - OMC-PELVIC HEALTH | ||||
| 1135 116TH AVE NE STE 510 | BELLEVUE | WA | 98004 | PELVIC HEALTH |
| 22 - OMC-INFECTIOUS DISEASE | ||||
| 1135 116TH AVE NE STE 140 | BELLEVUE | WA | 98004 | INFECTIOUS DISEASE |
| 23 - OMC-URGENT & PRIMARY CARE NEWCASTLE | ||||
| 13167 NEWCASTLE COMMONS DR | NEWCASTLE | WA | 98059 | URGENT CARE/PRIMARY CARE |
| 24 - OMC-EXPEDIA PRIMARY CARE | ||||
| 333 108TH AVE NE | BELLEVUE | WA | 98004 | PRIMARY CARE |
| 25 - OMC-PULM REDMOND | ||||
| 16315 NE 74TH STREET | REDMOND | WA | 98052 | PULMONOLOGY |
| 26 - OMC-INTERNAL MEDICINE ASSOCIATES | ||||
| 1407 116TH AVENUE NE E-200 | BELLEVUE | WA | 98004 | INTERNAL MEDICINE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | IN ADDITION TO THE FPL CRITERIA, THERE IS A RESIDENCY REQUIREMENT TO EITHER BE A RESIDENT OF THE STATE OF WASHINGTON OR MEET AN EXCEPTION FOR NON-RESIDENTS. NON-RESIDENTS MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE WHILE RECEIVING SERVICES WITHIN THE EMERGENCY DEPARTMENT OR AS A RESULT OF A DIRECT ADMISSION FROM THE EMERGENCY DEPARTMENT. EXCEPTIONS TO THE WASHINGTON STATE RESIDENCY REQUIREMENT ALSO INCLUDE REFUGEES, ASYLEES, AND THOSE SEEKING ASYLUM THAT POSSESS AND CAN PRESENT INS DOCUMENTATION. |
| PART I, LINE 7: | THE COSTING METHODOLOGY FOR CHARITY CARE AND UNREIMBURSED MEDICAID WAS THE COST TO CHARGE METHOD USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. THE COMMUNITY HEALTH IMPROVEMENT COST, HEALTH PROFESSIONAL EDUCATION, RESEARCH AND CASH AND IN-KIND CONTRIBUTIONS ARE DIRECT COST AND DO NOT INCLUDE ANY INDIRECT COST. THE COST FOR SUBSIDIZED HEALTH SERVICES IS DERIVED FROM A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS. |
| PART III, LINE 2: | PATIENT BILLS ARE REDUCED BY PAYMENTS, CONTRACTUAL ADJUSTMENTS, CHARITY ADJUSTMENTS, AND OTHER ADJUSTMENTS AS APPLICABLE. PATIENTS ARE THEN RESPONSIBLE FOR ANY REMAINING BALANCE. IF A PATIENT DOES NOT PAY THE BALANCE OR MAKE PAYMENT ARRANGEMENTS ACCORDING TO THE COLLECTION POLICY, THE BALANCE IS WRITTEN OFF TO BAD DEBT. THE BAD DEBT EXPENSE ON SCHEDULE H, PART III, LINES 2 AND 3 ARE ESTIMATED BASED ON THE COST TO CHARGE RATIO. |
| PART III, LINE 3: | THE HOSPITAL BELIEVES THAT APPROXIMATELY 72% OF THE BAD DEBT EXPENSE ARE RELATED TO PATIENTS THAT WOULD BE ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE GUIDELINES HAD THE PATIENT PROVIDED THE FINANCIAL INFORMATION NECESSARY TO MAKE THE DETERMINATION. THIS PERCENTAGE IS BASED ON RUNNING CREDIT CHECKS ON A SAMPLE OF ACCOUNTS THAT WERE BEING SENT TO BAD DEBTS. |
| PART III, LINE 4: | PROVISION FOR BAD DEBT FOOTNOTE ON ATTACHED AUDITED FINANCIAL STATEMENT PAGE 15, SECTION E. |
| PART III, LINE 8: | THE COSTING METHODOLOGY FOR MEDICARE ALLOWABLE COST IS DERIVED FROM FY20 MEDICARE COST REPORT. THE HOSPITAL BELIEVES THAT ALL THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO MEDICARE PATIENTS AND THE HOSPITAL CONTINUES PROVIDING CARE TO THE MEDICARE BENEFICIARIES REGARDLESS OF THE SHORTFALL. BY ABSORBING THE MEDICARE SHORTFALL, THE HOSPITAL THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. |
| PART III, LINE 9B: | THE HOSPITAL WILL PLACE A PATIENT'S ACCOUNT ON HOLD WHEN A PATIENT'S ACCOUNT IS BEING CONSIDERED FOR CHARITY. ONCE A DETERMINATION HAS BEEN MADE THAT A PATIENT QUALIFIES FOR CHARITY CARE, THE PATIENT'S ACCOUNT IS REDUCED BY THE CHARITY AMOUNT GRANTED AND A LETTER IS SENT TO THE PATIENT NOTING THE CHARITY ADJUSTMENT. THE PATIENT MAY APPEAL THE DECISION IF HE/SHE BELIEVES THERE IS ADDITIONAL INFORMATION THAT SHOULD HAVE BEEN CONSIDERED OR THE FINANCIAL SITUATION HAS CHANGED. THE PATIENT IS RESPONSIBLE FOR ANY BALANCE REMAINING AFTER THE CHARITY ADJUSTMENT, IF ANY, AND THE COLLECTION PROCESS WILL CONTINUE IN THE NORMAL PROCESS. |
| PART VI, LINE 2: | IN 2018, THE HOSPITAL PARTICIPATED IN A COLLABORATIVE PROCESS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF THE KING COUNTY HOSPITALS FOR A HEALTHIER COMMUNITY (HHC). HHC IS A COLLABORATIVE OF ALL 11 HOSPITALS AND HEALTH SYSTEMS IN KING COUNTY AND PUBLIC HEALTH-SEATTLE & KING COUNTY. THE HHC'S VISION IS TO PARTICIPATE IN A COLLABORATIVE APPROACH THAT IDENTIFIES COMMUNITY NEEDS, ASSETS, RESOURCES, AND STRATEGIES TOWARD ASSURING BETTER HEALTH AND HEALTH EQUITY FOR ALL KING COUNTY RESIDENTS. THIS SHARED APPROACH AVOIDS DUPLICATION AND FOCUSES AVAILABLE RESOURCES ON A COMMUNITY'S MOST IMPORTANT HEALTH NEEDS. HHC RECOGNIZES THAT PARTNERSHIPS BETWEEN HOSPITALS, PUBLIC HEALTH, COMMUNITY ORGANIZATIONS AND COMMUNITIES ARE KEY TO SUCCESSFUL STRATEGIES TO ADDRESS COMMON HEALTH NEEDS.DATA ANALYSES WERE CONDUCTED AT THE MOST LOCAL LEVEL POSSIBLE FOR THE MEDICAL CENTER'S PRIMARY SERVICE AREA, GIVEN THE AVAILABILITY OF THE DATA. IN SOME CASES, DATA WERE ONLY AVAILABLE AT THE COUNTY LEVEL.SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED AND ANALYZED THROUGH A REVIEW OF THE SECONDARY HEALTH DATA PRIOR TO THE INTERVIEWS. HEALTH NEEDS WERE IDENTIFIED USING THE SIZE OF THE PROBLEM (RELATIVE PORTION OF POPULATION AFFLICTED BY THE PROBLEM) AND THE SERIOUSNESS OF THE PROBLEM (IMPACT AT INDIVIDUAL, FAMILY, AND COMMUNITY LEVELS). TO DETERMINE SIZE OR SERIOUSNESS OF THE PROBLEM, THE HEALTH NEED INDICATORS WERE MEASURED AGAINST BENCHMARK DATA (COUNTY RATES, STATE RATES AND/OR HEALTHY PEOPLE 2020 OBJECTIVES). INDICATORS RELATED TO THE HEALTH NEEDS THAT PERFORMED POORLY AGAINST ONE OR MORE OF THESE BENCHMARKS MET THE CRITERION TO BE CONSIDERED. SECONDARY DATA WAS COLLECTED FROM A VARIETY OF LOCAL, COUNTY AND STATE SOURCES TO PRESENT A COMMUNITY PROFILE, BIRTH INDICATORS, LEADING CAUSES OF DEATH, ACCESS TO CARE, CHRONIC DISEASE, COMMUNICABLE DISEASE, HEALTH BEHAVIORS, SOCIAL ISSUES AND SCHOOL AND STUDENT CHARACTERISTICS. WHEN AVAILABLE, THESE DATA SETS WERE PRESENTED IN THE CONTEXT OF KING COUNTY AND WASHINGTON, FRAMING THE SCOPE OF AN ISSUE AS IT RELATES TO THE BROADER COMMUNITY.IN ADDITION, THE HOSPITAL CONDUCTED TARGETED INTERVIEWS TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL. THE REPORT INCLUDES BENCHMARK COMPARISON DATA, COMPARING THE HOSPITAL COMMUNITY DATA FINDINGS WITH HEALTH PEOPLE 2020 OBJECTIVES. |
| PART VI, LINE 3: | INFORMATION ABOUT ASSISTANCE PROGRAMS STARTS AT THE POINT OF REGISTRATION. PLACARDS DESCRIBING THE FINANCIAL ASSISTANCE PROGRAMS ARE AT ALL ADMITTING REGISTRATION DESKS. FINANCIAL ASSISTANCE CAN TAKE THE FORM OF ASSISTANCE IN QUALIFYING FOR MEDICAID, CHARITY, OR PROMPT PAY DISCOUNTS. FINANCIAL COUNSELORS ARE AVAILABLE TO DISCUSS THE FINANCIAL ARRANGEMENTS FOR ALL PATIENTS AND THEY DISCUSS THE FINANCIAL ASSISTANCE PROGRAM. THE FINANCIAL COUNSELORS WILL ALSO ASSIST PATIENTS IN COMPLETING THE HOSPITAL'S CHARITY CARE APPLICATION IF THE PATIENT BRINGS IN INFORMATION AND NEEDS HELP COMPLETING THE APPLICATION. THE HOSPITAL ENGAGES AN OUTSIDE COMPANY TO ASSIST PATIENTS WITH APPLYING FOR MEDICAID. GENERAL INFORMATION ABOUT THE ASSISTANCE PROGRAMS IS THEN INCLUDED AS PART OF EACH PATIENT STATEMENT THAT IS SENT TO A PATIENT AND INCLUDES THE PHONE NUMBER OF THE PATIENT FINANCIAL SERVICES DEPARTMENT TO CALL FOR ASSISTANCE. IN ADDITION, AS PART OF THE ACCOUNT FOLLOW UP, PATIENT FINANCIAL SERVICE REPRESENTATIVES WILL CALL PATIENTS AFTER THEIR SECOND STATEMENT AND WILL DISCUSS PATIENT FINANCIAL ASSISTANCE AS PART OF THE CALL. OVERLAKE'S CHARITY CARE POLICY IS POSTED ON THE WASHINGTON STATE DEPARTMENT OF HEALTH'S WEBSITE AND ON THE HOSPITAL'S WEBSITE. |
| PART VI, LINE 4: | THE SERVICE AREA FOR OVERLAKE IS DIVIDED INTO TWO MARKETS - LOCAL AND OUTLYING - WITH THE LOCAL MARKET DIVIDED INTO FIVE SERVICE AREAS (BELLEVUE, EAST, ISSAQUAH/SAMMAMISH, REDMOND/KIRKLAND AND SW) AND THE OUTLYING MARKET DIVIDED INTO TWO SERVICE AREAS (NORTH AND SOUTH). THE POPULATION OF THE OVERLAKE SERVICE AREA IS 897,978. CHILDREN AND YOUTH, AGES 0-17, MAKE UP ALMOST ONE-FOURTH (24%) OF THE POPULATION OF THE SERVICE AREA; 6.6% ARE 18-24 YEARS OF AGE, 30% ARE 25-44, 27.8% ARE 45-64, AND 11.7% OF THE POPULATION ARE SENIORS, 65 YEARS OF AGE AND OLDER. THE AREA HAS HIGHER RATES OF CHILDREN UNDER AGE 18 AND FEWER SENIORS WHEN COMPARED TO THE COUNTY AND THE STATE. THE MAJORITY RACE/ETHNICITY IN THE SERVICE AREA IS WHITE/CAUCASIANS (66.1%) WHILE ASIANS MAKE UP 19.3% OF THE POPULATION, AND HISPANICS OR LATINOS ARE 7%.POVERTY THRESHOLDS ARE USED FOR CALCULATING ALL OFFICIAL POVERTY POPULATION STATISTICS AND ARE UPDATED EVERY THREE YEARS BY THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. THE NEXT UPDATE WILL BE IN 2021. IN THE OVERLAKE SERVICE AREA, 6.5% OF THE POPULATION WAS LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 14.7% WERE CONSIDERED LOW-INCOME (LIVING AT OR BELOW 200% FPL). THESE RATES ARE BETTER THAN COUNTY AND STATE. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS $101,457. THIS IS HIGHER MEDIAN INCOME THAN IN THE COUNTY ($78,800) OR STATE ($62,848). |
| PART VI, LINE 5: | THE HOSPITAL STAFF PARTICIPATES IN THE COUNTY WIDE DISASTER PREPAREDNESS GROUP AND IS THE BACK UP TO HARBORVIEW MEDICAL CENTER. THE HOSPITAL HAS AN OPEN MEDICAL STAFF MODEL. THE HOSPITAL OPERATES AN ACTIVE SCREENING PROGRAM IN WHICH WE OFFER FREE HEALTH SCREENINGS AT LEAST FOUR TIMES ANNUALLY AT COMMUNITY EVENTS. THE LARGEST ONE IS THE ANNUAL OVERLAKE EASTSIDE VITALITY COMMUNITY HEALTH FAIR IN WHICH WE PROVIDE OVER 2,000 FREE SCREENINGS INCLUDING CHOLESTEROL, STROKE RISK, DIABETES AND SKIN CANCER. SCREENING RESULTS AND FREE COUNSELING ARE PROVIDED AT THE EVENTS. THOSE WHO NEED TO SEE A PHYSICIAN ARE GIVEN A LIST OF PROVIDERS, INCLUDING COMMUNITY MEDICAL CLINICS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| OVERLAKE HOSPITAL FOUNDATION | |||||||
| 1035 116TH AVE NE | BELLEVUE | WA | 98004 | 911050325 | 501(C)(3) | $1,938,431 | SUPPORT OPERATIONS |
| OVERLAKE HOSPITAL AUXILIARIES | |||||||
| 1035 116TH AVE NE | BELLEVUE | WA | 98004 | 237297831 | 501(C)(3) | $29,676 | SUPPORT OPERATIONS |
| AMERICAN HEART ASSOCIATION | |||||||
| PO BOX 4002030 | DES MOINES | IA | 50340 | 135613797 | 501(C)(3) | $10,000 | SPONSOR |
| AMERICAN CANCER SOCIETY | |||||||
| 2120 1ST AVE N | SEATTLE | WA | 98109 | 131788491 | 501(C)(3) | $15,000 | SPONSOR |
| ASIAN COUNSELING AND REFERRAL SERVICES | |||||||
| 3639 MARTIN LUTHER KING JR ST | SEATTLE | WA | 98144 | 910916176 | 501(C)(3) | $6,000 | SPONSOR |
| BELLEVUE SCHOOLS FOUNDATION | |||||||
| PO BOX 40644 | BELLEVUE | WA | 98015 | 911051671 | 501(C)(3) | $10,000 | SPONSOR |
| BLOODWORKS NW | |||||||
| 921 TERRY AVE | SEATTLE | WA | 98104 | 911019655 | 501(C)(3) | $10,000 | SPONSOR |
| LAKE WASHINGTON SCHOOLS | |||||||
| 16250 NE 74TH ST | REDMOND | WA | 98052 | 550891792 | 501(C)(3) | $10,000 | SPONSOR |
| NAMI EASTSIDE | |||||||
| 16225 NE 87TH ST SUITE A9 | REDMOND | WA | 98052 | 912106510 | 501(C)(3) | $7,500 | SPONSOR |
| THE SOPHIA WAY | |||||||
| 11061 NE 2ND ST SUITE 223 | BELLEVUE | WA | 98004 | 454084539 | 501(C)(3) | $10,000 | SPONSOR |
| WASHINGTON POISON CENTER | |||||||
| 155 NE 100TH ST SUITE 100 | SEATTLE | WA | 98125 | 943214597 | 501(C)(3) | $10,000 | SPONSOR |
| YOUTH EASTSIDE SERVICES | |||||||
| 999 164TH AVE NE | BELLEVUE | WA | 98008 | 910849093 | 501(C)(3) | $10,000 | SPONSOR |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 12 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | OVERLAKE HOSPITAL MEDICAL CENTER PERFORMS THE RECORD KEEPING FOR OVERLAKE HOSPITAL FOUNDATION AND OVERLAKE HOSPITAL AUXILIARIES AND MONITORS ITS OPERATING EXPENSES AS PART OF THE MONTHLY FINANCIAL REVIEW PROCESS. THE GRANTS ARE REIMBURSEMENT FOR EXPENSES ALREADY INCURRED. GRANTS TO SPONSOR EVENTS OF NON PROFIT ORGANIZATIONS ARE NOT MONITORED BEYOND VERIFYING THAT THE EVENT OCCURRED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J MICHAEL MARSH | ||||||||||||||
| PRESIDENT & CEO | $791,430 | $0 | $282,526 | $0 | $627,705 | $0 | $113,274 | $0 | $17,448 | $0 | $1,832,383 | $0 | $605,451 | $0 |
| ABHNEET CHOWDHARY MD | ||||||||||||||
| NEUROSURGEON | $902,929 | $0 | $225,000 | $0 | $30,313 | $0 | $22,400 | $0 | $8,621 | $0 | $1,189,263 | $0 | $0 | $0 |
| DEREK M RODRIGUES MD | ||||||||||||||
| CARDIOLOGIST | $833,934 | $0 | $163,771 | $0 | $50,589 | $0 | $22,400 | $0 | $19,003 | $0 | $1,089,697 | $0 | $0 | $0 |
| DAVID KNOEPFLER | ||||||||||||||
| VP/CHIEF MEDICAL OFFICER | $471,639 | $0 | $111,296 | $0 | $289,502 | $0 | $70,784 | $0 | $12,319 | $0 | $955,540 | $0 | $260,597 | $0 |
| DAVID W NELSON MD | ||||||||||||||
| CARDIOLOGIST | $548,738 | $0 | $159,402 | $0 | $123,819 | $0 | $22,400 | $0 | $19,003 | $0 | $873,362 | $0 | $0 | $0 |
| ROBERT WOOCHUL RHO MD | ||||||||||||||
| CARDIOLOGIST | $682,108 | $0 | $108,650 | $0 | $22,285 | $0 | $16,800 | $0 | $13,231 | $0 | $843,074 | $0 | $0 | $0 |
| THOMAS A DEBORD | ||||||||||||||
| COO | $472,368 | $0 | $111,841 | $0 | $30,360 | $0 | $56,664 | $0 | $15,501 | $0 | $686,734 | $0 | $0 | $0 |
| KELAN R KOENIG MD | ||||||||||||||
| OMC PHYSICIAN EXECUTIVE | $433,803 | $0 | $55,960 | $0 | $26,395 | $0 | $72,089 | $0 | $18,894 | $0 | $607,141 | $0 | $0 | $0 |
| ANDREW J TOKAR | ||||||||||||||
| CFO | $381,262 | $0 | $68,570 | $0 | $42,863 | $0 | $67,043 | $0 | $7,793 | $0 | $567,531 | $0 | $0 | $0 |
| CAITILN HILLARY MOULDING | ||||||||||||||
| FORMER KEY EMPLOYEE | $7,388 | $0 | $0 | $0 | $388,728 | $0 | $0 | $0 | $622 | $0 | $396,738 | $0 | $37,085 | $0 |
| VALERIE CHRUSCIEL | ||||||||||||||
| OMC COO | $253,616 | $0 | $47,658 | $0 | $1,074 | $0 | $51,046 | $0 | $12,569 | $0 | $365,963 | $0 | $0 | $0 |
| MICHELLE CURRY | ||||||||||||||
| VP/CHIEF NURSING OFFICER | $271,312 | $0 | $36,046 | $0 | $1,594 | $0 | $45,881 | $0 | $7,543 | $0 | $362,376 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 | INCENTIVES IN 2019 WERE PAID TO J. MICHAEL MARSH, THOMAS A. DEBORD, ANDREW J. TOKAR, KELAN R. KOENIG, VALERIE CHRUSCIEL, MICHELLE CURRY AND DAVID KNOEPFLER. THE INCENTIVES ARE AWARDED BASED ON PRODUCTIVITY AND MEETING CERTAIN INDIVIDUAL QUALITY GOALS. |
| PART I, LINE 4A | CAITLIN HILLARY MOULDING RECEIVED A SEVERANCE PAYMENT IN 2019 IN THE AMOUNT OF $308,780. |
| PART I, LINE 4B | J. MICHAEL MARSH, THOMAS A. DEBORD, DAVID KNOEPFLER, AND CAITLIN H. MOULDING PARTICIPATED IN A BENEFIT WITHIN THE EXECUTIVE BENEFIT PLAN CALLED THE CAPITAL ACCUMULATION ACCOUNT. THE CAPITAL ACCUMULATION ACCOUNT IS CLASSIFIED AS A 457(F) PLAN BY THE IRS. THE FOLLOWING AMOUNTS FROM THE CAPITAL ACCUMULATION ACCOUNT WERE PAID IN 2019. J MICHAEL MARSH $605,451 DAVID KNOEPFLER $260,597 CAITLIN H MOULDING $ 37,085 THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR FORMS 990. J. MICHAEL MARSH, DAVID KNOEPFLER AND CAITLIN H. MOULDING RECEIVED REDEMPTION OF CREDITS IN THE CAPITAL ACCUMULATION ACCOUNT THAT HAD BECOME VESTED. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| WA HEALTH CARE FACILITIES | ||||||||
| A | 911108929 | 93978HKJ3 | 2014-08-06 | $58,116,440 | REFUND PRIOR ISSUE-6/8/05 | 0 | 0 | 0 |
| WA HEALTH CARE FACILITIES | ||||||||
| B | 911108929 | 93978HUA1 | 2017-12-21 | $249,215,382 | CONSTRUCT, RENOVATE FACILITY, AND REFUND PRIOR ISSUE (4/14/10) | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capitalized InterestCapitalizedInterestAmt | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $10,135,000 | $58,151,860 | $825,678 | $60,425 | $57,265,757 | 2008 | 0 | Yes (1) | Yes (1) | Yes (1) | ||
| B | $256,198,001 | $1,653,471 | $101,826,728 | 2021 | 0 | Yes (1) | Yes (1) | Yes (1) | $19,810 | $152,697,992 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropPct | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0.00140 | 0.00000 | 0.00140 | 0 | Yes (1) | 0.01530 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0.00110 | 0.00000 | 0.00110 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DATE REBATE COMPUTATION PERFORMED | ISSUER NAME: WA HEALTH CARE FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2015 |
| SCHEDULE K, PART II, LINE 3: | THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO THE INVESTMENT EARNINGS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARSHANA SHANBHAG | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER OF TRUSTEE DILIP WAGLE | RelationshipDescriptionTxt |
| Transaction | $12,092 | TransactionAmt |
| Transaction | DARSHANA SHANBHAG IS EMPLOYED BY OVERLAKE HOSPITAL MEDICAL CENTER. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6: | VOLUNTEERS PROVIDED 19,845 HOURS OF SERVICE TO OVERLAKE HOSPITAL MEDICAL CENTER DURING THE YEAR. VOLUNTEERS PROVIDE ASSISTANCE FOR PATIENTS AND GUESTS AT POINT OF ENTRY WITH INFORMATION, WAY-FINDING, AND TRANSPORTATION SERVICES. IN THE NURSING UNITS, VOLUNTEERS HELP ANSWER CALL LIGHTS AND PROVIDE COMFORT TO SUPPORT AND FACILITATE THE PHYSICAL, EMOTIONAL, MENTAL AND SPIRITUAL HEALTH AND SELF-HEALING OF THE PATIENT. INCLUDED IN THE TOTAL VOLUNTEERS ARE 17 BOARD MEMBERS THAT VOLUNTEERED THEIR TIME AS BOARD MEMBERS DURING THE YEAR. |
| FORM 990, PART III, LINE 4A: | HOSPITAL SERVICES: OVERLAKE HOSPITAL MEDICAL CENTER IS A NONPROFIT, INDEPENDENTLY OPERATED REGIONAL CENTER SERVING THE EASTERN PUGET SOUND REGION WITH MEDICAL FACILITIES IN BELLEVUE, ISSAQUAH, KIRKLAND, REDMOND AND SAMMAMISH. FOUNDED IN 1953, TODAY OVERLAKE HOSPITAL IS A REGIONAL LEADER IN HEALTH CARE, PROVIDING ADVANCED MEDICAL SERVICES IN THE AREAS OF CARDIAC CARE, GENERAL AND SPECIALTY SURGERY, WOMEN'S SERVICES, CANCER CARE AND EMERGENCY SERVICES. THE HOSPITAL ALSO HAS A NETWORK OF NEIGHBORHOOD CLINICS IN ITS PRIMARY SERVICE AREA. THERE WERE 15,371 PATIENTS ADMITTED FOR INPATIENT MEDICAL CARE FOR A TOTAL OF 64,139 PATIENT DAYS. THERE WERE 225,814 OUTPATIENT VISITS OF WHICH 47,738 WERE FOR EMERGENCY CARE VISITS. THE HOSPITAL DELIVERED 3,553 BABIES. OVERLAKE MEDICAL CLINICS PROVIDED 314,169 PATIENT VISITS. OVERLAKE HOSPITAL DEMONSTRATED A COMMITMENT TO IMPROVING THE HEALTH OF THE COMMUNITY BY SUPPORTING MANY HEALTH-RELATED EVENTS, PROGRAMS, CLINICAL RESEARCH AND VARIOUS CONTRIBUTIONS THROUGHOUT THE YEAR THAT HAD A DIRECT BENEFIT TO THE COMMUNITY. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES. OVERLAKE HOSPITAL PROVIDED CARE TO 7,706 PATIENTS WHO WERE UNINSURED OR UNDER INSURED AT AN ESTIMATED COST OF $6,314,000. THE HOSPITAL PROVIDED CARE TO MEDICAID PATIENTS AT RATES BELOW THE COST OF PROVIDING SERVICES. THE PAYMENTS WERE LESS THAN COST BY $20,608,000. IN KEEPING WITH THE HOSPITAL'S SPIRIT OF GIVING BACK TO THE COMMUNITY, IT PROVIDED A TOTAL OF $5,942,000 OF COMMUNITY BENEFIT SERVICE ACTIVITIES. AS THE HEALTH CARE NEEDS OF OUR COMMUNITY INCREASE AND GROW MORE COMPLEX, OVERLAKE HAS STRENGTHENED ITS COMMITMENT TO PROVIDING THE MOST ADVANCED TREATMENT AND TECHNOLOGY ALONGSIDE COMPASSIONATE CARE EVERY DAY. WITH HEALTH CARE PROMINENT IN THE NATIONAL DEBATE, OVERLAKE MEDICAL CENTER IS GIVING EASTSIDE RESIDENTS AN OPPORTUNITY FOR A WIDE VARIETY OF FREE HEALTH SCREENINGS WHERE THE BARRIERS OF BOTH COST AND LANGUAGE ARE REMOVED. THE SCREENINGS ARE FREE AND DO NOT REQUIRE PATIENTS TO HAVE HEALTH INSURANCE. THE FREE SCREENINGS INCLUDE CHOLESTEROL, BLOOD PRESSURE, BODY MASS INDEX, CARDIAC AND DIABETES RISK ASSESSMENTS. CONSULTATIONS WITH A HEALTH CARE PROVIDER WILL ALLOW PATIENTS TO UNDERSTAND WHAT SCREENING RESULTS MEAN. FURTHERMORE, NOT WANTING LANGUAGE TO BE A BARRIER TO PATIENTS NOT FLUENT IN ENGLISH, OVERLAKE OFFERS INTERPRETERS IN MULTIPLE LANGUAGES INCLUDING MANDARIN, CANTONESE, HINDI, SPANISH AND RUSSIAN. IT IS PART OF OVERLAKE'S MISSION TO BRING HEALTH CARE OUT INTO THE COMMUNITY, TO MAKE IT ACCESSIBLE TO ALL PEOPLE AND THESE COMPLIMENTARY SCREENINGS HELP US FULFILL OUR MISSION IN A MEANINGFUL WAY. THE FUTURE IS NOW: PROJECT FUTURECARE, OUR $250 MILLION CAMPUS RENEWAL, SUPPORTED BY A $50 MILLION FUNDRAISING CAMPAIGN, IS WELL ON ITS WAY TO TRANSFORMING OVERLAKE. THE PROJECT REPLACES AN AGING BUILDING WITH A STATE-OF-THE-ART FACILITY THAT WILL EXTEND AND SUPPORT OUR WORLD-CLASS CARE. NEW OPERATING ROOMS WILL INCREASE THE NUMBER OF HEART PATIENTS WE CAN CARE FOR. THE CHILDBIRTH CENTER IN THE NEW BUILDING WILL INCLUDE BEAUTIFUL ROOMS WITH SPACE TO WELCOME FAMILY MEMBERS AND A HOST OF UPGRADED FEATURES. AN EXPANDED MENTAL HEALTH UNIT WILL MAKE CARE MORE ACCESSIBLE FOR PATIENTS WHO COME TO US WITH MENTAL HEALTH AS WELL AS MEDICAL CHALLENGES. IN 2018, SUPPORT FROM THE COMMUNITY HELPED THE OVERLAKE NEUROSCIENCE INSTITUTE OPEN THE FIRST AND ONLY EPILEPSY CLINIC ON THE EASTSIDE. PATIENTS WITH SEIZURE DISORDERS CAN NOW RECEIVE DIAGNOSTIC AND TREATMENT SERVICES CLOSE TO HOME. ACHIEVEMENT AWARDS RECEIVED IN 2020: 1. THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION HAS HONORED OVERLAKE MEDICAL CENTER& CLINICS WITH THE 2020 GET WITH THE GUIDELINES STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD. OVERLAKE EARNED THE AWARD BY MEETING SPECIFIC QUALITY ACHIEVEMENT MEASURES FOR THE DIAGNOSIS AND TREATMENT OF STROKE PATIENTS AT A SET LEVEL FOR A DESIGNATED PERIOD. 2. HEALTHGRADES HONORS OVERLAKE MEDICAL CENTER & CLINICS AS THE ONLY HOSPITAL IN WASHINGTON STATE TO ACHIEVE THE GYNECOLOGIC SURGERY EXCELLENCE AWARD FOR 3 YEARS IN A ROW. THE GYNECOLOGIC SURGERY EXCELLENCE AWARD PROVIDES HEALTHCARE CONSUMERS WITH MORE TRANSPARENCY ABOUT HOSPITALS THAT HAVE EXCEPTIONAL CLINICAL OUTCOMES IN PROCEDURES THAT TREAT DISEASES AND CONDITIONS OF THE FEMALE REPRODUCTIVE SYSTEM. 3. OVERLAKE MEDICAL CENTER NAMED AMONG 100 BEST HOSPITALS IN NATION FOR JOINT REPLACEMENT IN 2020 BY HEALTHGRADES FOR THE SECOND YEAR IN A ROW. ROUGHLY 1,400 PATIENTS UNDERGO TOTAL JOINT REPLACEMENT SURGERIES EACH YEAR AT OVERLAKE. ROBUST PRE-OPERATION EDUCATION INCLUDES INFORMATION ABOUT FALL RISK, INFECTION PREVENTION AND CUSTOMIZED REHABILITATION PROGRAMS. THESE PROGRAMS, ALONG WITH AVERAGE HOSPITAL STAYS OF 1.5 DAYS, HAVE RESULTED IN LOWER READMISSIONS AND IMPROVED OUTCOMES. 4. OVERLAKE MEDICAL CENTER & CLINICS BECOMES THE FIRST WESTERN WASHINGTON HOSPITAL HONORED FOR HEPATITIS B VACCINE BIRTH DOSE RATE. OVERLAKE MEDICAL CENTER HAS BEEN RECOGNIZED BY THE IMMUNIZATION ACTION COALITION (IAC) AND SEATTLE & KING COUNTY PUBLIC HEALTH FOR ACHIEVING ONE OF THE HIGHEST REPORTED VACCINATION RATES IN THE STATE FOR ITS WORK TO PROTECT NEWBORNS FROM HEPATITIS B. 5. HEALTHGRADES HAS RECOGNIZED OVERLAKE MEDICAL CENTER & CLINICS AS AMONG THE TOP 10% OF PATIENT SAFETY EXCELLENCE AWARD (PSEA) RECIPIENTS IN NATION FOR THE SECOND YEAR IN A ROW. OVERLAKE IS THE ONLY HOSPITAL IN THE SEATTLE-BELLEVUE-EVERETT AREA TO ACHIEVE THIS AWARD THE LAST TWO YEAR IN A ROW. |
| FORM 990, PART VI, SECTION A, LINE 7A | OVERLAKE HOSPITAL ASSOCIATION HAS THE RIGHT TO APPOINT AND REMOVE OVERLAKE HOSPITAL MEDICAL CENTER'S TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | OVERLAKE HOSPITAL ASSOCIATION MUST APPROVE: (A) ANY SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (B) ANY INCREASED INDEBTEDNESS EXCEEDING FIVE PERCENT OF THE GROSS PATIENT SERVICE REVENUE DURING A FISCAL YEAR OF THE CORPORATION; (C) THE ANNUAL BUDGET OF THE CORPORATION AND ANY MATERIAL AMENDMENTS THERETO; (D) THE AUDITORS OF THE CORPORATION; AND (E) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN REVIEWED BY THE PRESIDENT & CEO, CFO, CHIEF HUMAN RESOURCES AND COMPLIANCE OFFICER, AND THE OVERLAKE HOSPITAL MEDICAL CENTER AUDIT AND COMPLIANCE COMMITTEE. THE 990 IS SENT TO THE OVERLAKE HOSPITAL MEDICAL CENTER BOARD MEMBERS PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND MANAGEMENT ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY 2) HAS READ AND UNDERSTANDS THE POLICY 3) HAS AGREED TO COMPLY WITH THE POLICY, AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATIONS AND THAT IN ORDER TO MAINTAIN THEIR FEDERAL TAX EXEMPTION THEY MUST AVOID CONFLICTS OF INTEREST AND ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF THEIR TAX-EXEMPT FUNCTIONS. A LIST OF ALL FINANCIAL INTEREST OR OTHER RELATIONSHIPS WITH ANY ORGANIZATIONS THAT HAS, OR CAN REASONABLY EXPECTED TO HAVE, A TRANSACTION WITH THE CORPORATION, COMPETES AGAINST THE CORPORATION, OR WHOSE INTEREST MATERIALLY CONFLICTS WITH THE INTEREST OF THE CORPORATION IS SUBMITTED ANNUALLY TO THE OVERLAKE HOSPITAL MEDICAL CENTER COMPLIANCE OFFICER FOR REVIEW. THE COMPLIANCE OFFICER SUMMARIZES ANY CONFLICTS OF INTEREST AND DISCUSSES THESE RESULTS WITH THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE, CEO AND GENERAL COUNSEL. THIS INFORMATION IS ALSO SHARED WITH THE CHAIR, COMMITTEE CHAIRS, AND CFO. AT BOARD MEETINGS, MEMBERS ARE EXPECTED TO RECUSE THEMSELVES FROM VOTING ON ISSUES WHEN THERE IS A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | OVERLAKE'S POLICY AND PROCESS FOR EXECUTIVE COMPENSATION IS FULLY DOCUMENTED IN THE "EXECUTIVE COMPENSATION ADMINISTRATION AND COMPLIANCE MANUAL" WHICH WAS LAST UPDATED IN NOVEMBER OF 2016. THIS MANUAL DETAILS THE CHARTER OF THE COMPENSATION COMMITTEE OF THE BOARD, THE COMPENSATION PHILOSOPHY AND HOW SALARY INCREASES, INCENTIVES AND BENEFITS AND PERQUISITES ARE ADMINISTERED. COMPENSATION COMMITTEE MEMBERS ARE INDEPENDENT BOARD MEMBERS AS REQUIRED BY THE CHARTER AND BY-LAWS. THE PROCESS INCLUDES AN INDEPENDENT CONSULTANT WHO WORKS DIRECTLY FOR THE COMPENSATION COMMITTEE AND REVIEW OF COMPARABLE DATA FROM EXTERNAL SOURCES. ALL COMPENSATION RELATED DECISIONS FOR THE CEO, COO AND OTHER EXECUTIVES ARE DISCUSSED, DELIBERATED AND VOTED ON BY THE COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES OF THE MEETING. THE COMPENSATION AND INCENTIVE PAYMENT OF THE CEO IS REVIEWED AND APPROVED BY THE FULL BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | OVERLAKE HOSPITAL MAKES ITS DISCLOSURE OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE THROUGH THE HOSPITAL'S ADMINISTRATION OFFICE. THE OVERLAKE HOSPITAL ASSOCIATION CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE ON THE OVERLAKE MEDICAL CENTER'S WEBSITE. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| OVERLAKE MEDICAL CLINICS LLC | |||||||||
| 1035 116TH AVENUE NE | BELLEVUE | WA | 98004 | 911932954 | MEDICAL CLINICS | WA | $62,947,381 | $43,717,870 | OVERLAKE HOSPITAL MEDICAL CENTER |
| OVERLAKE PROVIDER NETWORK LLC | |||||||||
| 1035 116TH AVENUE NE | BELLEVUE | WA | 98004 | 474545130 | CLINICALLY INTEGRATED NETWORK | WA | OVERLAKE HOSPITAL MEDICAL CENTER | ||
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OVERLAKE HOSPITAL FOUNDATION | |||||||||||
| 1035 116TH AVE NE | BELLEVUE | WA | 98004 | 911050325 | FUNDRAISING | WA | 501(C)(3) | 7 - 509(A)(1) | OVERLAKE HOSPITAL MEDICAL CENTER | Yes (1) | |
| OVERLAKE HOSPITAL AUXILIARIES | |||||||||||
| 1035 116TH AVE NE | BELLEVUE | WA | 98004 | 237297831 | FUNDRAISING | WA | 501(C)(3) | 7 - 509(A)(1) | OVERLAKE HOSPITAL MEDICAL CENTER | Yes (1) | |
| OVERLAKE HOSPITAL ASSOCIATION | |||||||||||
| 1035 116TH AVE NE | BELLEVUE | WA | 98004 | 911274134 | PROVIDE SUPPORT | WA | 501(C)(3) | 12B - TYPE II SUPPOR | Yes (1) | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (12 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| OVERLAKE HOSPITAL FOUNDATION | ||
| B | $1,938,431 | CASH |
| OVERLAKE HOSPITAL FOUNDATION | ||
| C | $8,967,334 | CASH |
| OVERLAKE HOSPITAL FOUNDATION | ||
| N | $101,071 | CASH |
| OVERLAKE HOSPITAL FOUNDATION | ||
| O | $325,463 | CASH |
| OVERLAKE HOSPITAL AUXILIARIES | ||
| B | $29,676 | CASH |
| OVERLAKE HOSPITAL AUXILIARIES | ||
| N | $21,859 | CASH |
| OVERLAKE HOSPITAL AUXILIARIES | ||
| O | $41,397 | CASH |
| OVERLAKE HOSPITAL AUXILIARIES | ||
| Q | $7,937 | CASH |
| OVERLAKE HOSPITAL ASSOCIATION | ||
| A | $6,831,396 | FMV |
| OVERLAKE HOSPITAL ASSOCIATION | ||
| C | $2,800,000 | CASH |
| OVERLAKE HOSPITAL ASSOCIATION | ||
| O | $175,422 | CASH |
| OVERLAKE HOSPITAL ASSOCIATION | ||
| P | $511,624 | CASH |