STRATEGY STUDIO / PUBLIC DATA EXPLORER

OVERLAKE MEDICAL CENTER & CLINICS: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
OVERLAKE MEDICAL CENTER & CLINICS (EIN 91-0652651)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-10
IRS object ID
201341309349303229
Schema version
2011v1.5
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-10T15:49:17-07:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Clark Nuber PSBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4th St Ste 1700AddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN910652651EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OVERLAKE HOSPITAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOVERNameControl
Phone4256885000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11035 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGary McLaughlinName
TitleCFOTitle
Date Signed2013-05-03DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSara Elizabeth J HyreName
Phone4254544919Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCraig HendricksonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11035 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Gross Receipts450660938GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.overlakehospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionThe 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 medical excellence every day.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees2978TotalNbrEmployees
Total Nbr Volunteers635TotalNbrVolunteers
Total Gross UBI1246074TotalGrossUBI
Net Unrelated Business Txbl Income45190NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2201257ContributionsGrantsPriorYear
Contributions Grants Current Year5068085ContributionsGrantsCurrentYear
Program Service Revenue Prior Year409517574ProgramServiceRevenuePriorYear
Program Service Revenue CY420550975ProgramServiceRevenueCY
Investment Income Prior Year9626153InvestmentIncomePriorYear
Investment Income Current Year11280104InvestmentIncomeCurrentYear
Other Revenue Prior Year4678150OtherRevenuePriorYear
Other Revenue Current Year4333025OtherRevenueCurrentYear
Total Revenue Prior Year426023134TotalRevenuePriorYear
Total Revenue Current Year441232189TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1390016GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1552361GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year196249568SalariesEtcPriorYear
Salaries Etc Current Year209581189SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year192929432OtherExpensePriorYear
Other Expenses Current Year197410439OtherExpensesCurrentYear
Total Expenses Prior Year390569016TotalExpensesPriorYear
Total Expenses Current Year408543989TotalExpensesCurrentYear
Revenues Less Expenses Prior Year35454118RevenuesLessExpensesPriorYear
Revenues Less Expenses CY32688200RevenuesLessExpensesCY
Total Assets BOY544703202TotalAssetsBOY
Total Assets EOY576465313TotalAssetsEOY
Total Liabilities BOY248435151TotalLiabilitiesBOY
Total Liabilities EOY261358736TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY296268051NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY315106577NetAssetsOrFundBalancesEOY
Mission DescriptionThe 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 medical excellence every day.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense337026233Expense
Revenue420316639Revenue
DescriptionHospital 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 Mercer Island. 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 19,937 patients admitted for inpatient medical care for a total of 68,297 patient days. There were 253,100 outpatient visits out of which 45,286 were for emergency care visits. The Hospital delivered 3,982 babies. Overlake Medical Clinics provided 164,863 patient visits. Overlake Hospital demonstrated a commitment to improving the health of the community by supporting many health-related events, programs, clinical research and made 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 7,234 patients who are uninsured or under insured in the amount of $20,212,000 (estimated cost of $7,032,000). The Hospital provided care to Medicaid patients at rates below the cost of providing services. The payments were less than cost by $9,711,000. In keeping with the Hospital's spirit of giving back to the community it served, a total of $4,924,000 of community benefit service activities were also provided. Overlake Staff spent 2,785 hours in the community by participating in, organizing and managing health programs and activities. Overlake sponsors community health events and screenings for the general public. In January 2012, Overlake held its fourth annual Eastside Vitality Health Fair, performing 2,804 free health screenings to 952 people. Screenings included blood pressure checks, blood glucose testing, cholesterol tests, stroke assessments, peripheral artery disease screenings, bone density screenings and skin cancer checks. Overlake has been home to the most comprehensive program for cardiovascular and peripheral vascular care on the Eastside for more than 20 years. Today, the Hospital's heart care team includes a network of specialists whose collective expertise and training has helped Overlake earn its reputation as an award winning cardiac center. The Cancer Center at Overlake is noted for its enhanced services and technology, as well as for its exceptional patient experience. The Breast Center at Overlake was the first in the Seattle Metropolitan area to receive a three year full accreditation by the National Accreditation Program for Breast Center. Overlake's Women and Infants' Center provides a full continuum of care designed for women in their childbearing years and beyond. Overlake offers exceptional care for elderly patients by educating our nurses in effective geriatric care. For more than 30 years, Overlake has been the leader in providing quality adult and adolescent psychiatric care to the Puget Sound community. Our Specialty School is recognized by the school districts as a leader in helping students who need specialized behavioral services by providing academic, social, emotional and behavioral support. The Palliative Care Program completed its first full year helping patients and families face serious illness and navigate their care with kindness and respect. Overlake is expanding its network of Medical Clinics throughout the Eastside. Overlake understands how busy people's day to day lives can be, that's why the Hospital provides patients with convenient, accessible medical care located close to where they live and work. Overlake is proud to be recognized as foremost in the region for our focus on our patients and we have been rewarded for it by patients, families who prefer us for their comprehensive healthcare and through many national awards. We were recognized by Healthgrades as one of the top 5% of hospitals in the nation for patient safety for the fifth year in a row. We are the only hospital in Greater Seattle named a Top Performer on Key Quality Measures by the Joint Commission and noted as having the Most Advanced Neurointerventional care on the Eastside.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2043641Expense
Revenue234336Revenue
DescriptionEducation Services - In addition to the excellent care we provide our patients, the Hospital firmly believes education is critical to overall wellness so the organization 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 preventive care. The Education Program provided 42,507 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 health lifestyles. The Hospital provided 17,458 nursing education hours on a wide range of topics to internal and external staff and nursing residents.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1552361Expense
Grants1552361Grants
DescriptionOther Grants and Allocations - Grants to Overlake Hospital Foundation and Overlake Hospital Auxiliaries to cover their expenses.Description
FieldValueIRS element (for citing)
Total Program Service Expense340622235TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccounttrueEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096304NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2978NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonEric TeshimaNamePerson
Telephone Number4256885149TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11120 112th Ave Ste 202AddressLine1
CityBellevueCity
StateWAState
ZIP Code980044687ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Russell Stockdale
Trustee0.50X000
Walter Smith MD
Trustee3.00X6250000
Nolan Newman
Trustee1.50X000
Tom Miller MD
Trustee1.00X3000000
Douglas Martin
Trustee1.00X000
Linda Mahaffey
Trustee0.50X000
Ken Johnsen
Trustee1.00X000
John Hayhurst
Trustee1.50X000
Kathleen Gibson MD
Trustee1.00X000
Kemper Freeman Jr
Trustee1.00X000
Janine Florence
Trustee1.00X000
Patty Edwards
Trustee1.00X000
Gregory Collins
Trustee1.00X000
Tom Cleveland
Trustee2.00X000
Robert Campbell
Trustee2.00X000
Larry Hebner
Past Chair3.00X000X
Bertrand Valdman
Imm Past Chair1.00X000X
Patricia Bedient
Treasurer1.50X000X
John Murphy
Past Secretary2.00X000X
Jim Doud
Secretary3.00X000X
Cecily Hall
Chairman1.00X000X
Gary McLaughlin
Vice Pres & CFO40.005698660147448X
David Schultz
Vice Pres & COO50.00419212091491X
Craig Hendrickson
President & CEO50.0016234900204362X
Alan Ertle
Vice President55.00433065074880X
Catherine Whitaker-Klick
Vice President55.00310616053053X
T D Sam Baxter
Vice President55.002365510103419X
Richard Bryan
Vice President60.00232579077046X
William Reece MD
Rad Oncologists45.00735559020396X
Vu Hoang MD
Cardiac Surgeon45.00587250045138X
James Pelton MD
Rad Oncologists45.00496502025164X
Richard Clarfeld MD
Breast Surgeon45.00464797052443X
Robert Binford MD
Cardiothoracic45.00430490015684X
Jody Albright
Vice President & CIO55.00311904046981X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6944381TotalReportableCompFromOrg
Total Other Compensation957505TotalOtherCompensation
Number Individuals GT100 K298NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Puget Sound Blood Center
921 Terry AveSeattleWA981041256Blood Services2926523
Hospital Central Services Assoc
1300 E Columbia StSeattleWA98122Linen Services1384715
Gall Landau Young Construction Co
PO Box 6728BellevueWA980080728Construction2291462
Denali Advanced Integration
17735 NE 65th StRedmondWA98052Software Dev & Maint2024801
Aldrich & Associates Inc
810 240th St SEBothellWA980219397Construction2337583
FieldValueIRS element (for citing)
Number Of Contractors GT100 K90NumberOfContractorsGT100K
Related Organizations5068085RelatedOrganizations
Noncash Contributions1746NoncashContributions
Total Contributions5068085TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Program Related Invstmnts90000413256861325686
Other Program Services90000419040461904046
Non Government Payments900004276785648276785648
Medicare/Medicaid Payment900004140301259140301259
Education Services611710234336234336
FieldValueIRS element (for citing)
Total Program Service Revenue420550975TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7265605TotalRevenueColumn
Exclusion$7,265,605ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real492179Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real492179Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column492179TotalRevenueColumn
Exclusion$492,179ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities13390802Securities
Other52446Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9322196Securities
Other106553Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4068606Securities
Other-54107Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4014499TotalRevenueColumn
Exclusion$4,014,499ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Women's Clinic446199383390$383,390
Laboratory621500707795$65,023642772
Catering/Cafeteria7222102372247$1,768,945603302

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column377414TotalRevenueColumn
Exclusion$377,414ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3840846TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column441232189TotalRevenueColumn
Related Or Exempt Function Income420550975RelatedOrExemptFunctionIncome
Unrelated Business Revenue1246074UnrelatedBusinessRevenue
Exclusion$14,367,055ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1552361Total
Program Services1552361ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3641923Total
Program Services1123045ProgramServices
Management And General2518878ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total164734930Total
Program Services142456993ProgramServices
Management And General22277937ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9972856Total
Program Services8634018ProgramServices
Management And General1338838ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total19439541Total
Program Services15917417ProgramServices
Management And General3522124ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total11791939Total
Program Services9968957ProgramServices
Management And General1822982ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1126961Total
Program Services71071ProgramServices
Management And General1055890ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total250012Total
Program Services17354ProgramServices
Management And General232658ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total97095Total
Management And General97095ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total42782Total
Management And General42782ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total36071432Total
Program Services26477950ProgramServices
Management And General9593482ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1254745Total
Program Services7751ProgramServices
Management And General1246994ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total7853454Total
Program Services4508805ProgramServices
Management And General3344649ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total6369984Total
Management And General6369984ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total12136479Total
Program Services8941760ProgramServices
Management And General3194719ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total557967Total
Program Services259777ProgramServices
Management And General298190ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total348715Total
Program Services330585ProgramServices
Management And General18130ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total10048071Total
Program Services10048071ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total29771700Total
Program Services21791590ProgramServices
Management And General7980110ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3426445Total
Program Services2490512ProgramServices
Management And General935933ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
B & O Tax47159354715752183
Medicaid Prov Assessmnt88281468828146
Bad Debt1401033714010337
Medical Supplies572875175724812639391

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3212662Total
Program Services1221857ProgramServices
Management And General1990805ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total408543989Total
Program Services340622235ProgramServices
Management And General67921754ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY14259230BOY
EOY20314439EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY25402285BOY
EOY23941319EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY51117294BOY
EOY53490543EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY277253BOY
EOY56645EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5583830BOY
EOY5968141EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY9416155BOY
EOY9884735EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis382172452LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec188563010LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY188076766BOY
EOY193609442EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY236235728BOY
EOY249587217EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4045441BOY
EOY2910532EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY269640BOY
EOY6265994EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10019580BOY
EOY10436306EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY544703202BOY
EOY576465313EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY53377078BOY
EOY59224594EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY187627242BOY
EOY182618048EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
EOY761679EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7430831BOY
EOY18754415EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY248435151BOY
EOY261358736EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY296268051BOY
EOY313510498EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY1596079EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY296268051BOY
EOY315106577EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY544703202BOY
EOY576465313EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses32688200ReconcilationRevenueExpenses
Reconcilation Other Changes-13849674ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade

Sec527 Pol Orgs Sec527PolOrgs (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeAmt Pd From Internal FundsAmtPdFromInternalFundsEINEIN
American Hospital Association
P O Box 34936SeattleWA981248885
Millennia Public Affairs Inc
21127 47th Dr SEBothellWA9802146638911809445
Washington State Hospital Assoc
Dept5028 P O Box 34936SeattleWA9812448218
FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$52,457DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$44,638OtherActivitiesAmount
Total Lobbying Expenditures IIB97095TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationPart of the membership dues that are paid to the Washington State Hospital Association and American Hospital Association are used by them for lobbying purposes.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2151141OtherCostOrOtherBasis
Book Value2151141BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis193362108OtherCostOrOtherBasis
Depreciation72982553Depreciation
Book Value120379555BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4930800OtherCostOrOtherBasis
Depreciation3986505Depreciation
Book Value944295BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis180035761OtherCostOrOtherBasis
Depreciation111593952Depreciation
Book Value68441809BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1692642OtherCostOrOtherBasis
Book Value1692642BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings193609442TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Workers' Comp Reserve$1,806,709
Prof Liability Insurance Reserve$5,671,116
Pension Liability$11,193,924
Other Long Term Liaibilities$82,666
FieldValueIRS element (for citing)
Total Of Amounts18754415TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
Return ReferencePart XI, Line 8: Other Changes in Net Assets or Fund BalancesReturnReference
ExplanationAdjustment in Pension Liability $0 Consolidation of Joint Venture $2791605 Changes in Pension Liability $ -8765374 Change net unrealized gains/losses $ -7875905Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7033388TotalCommunityBenefitExpense
Net Community Benefit Expense7033388NetCommunityBenefitExpense
Percent Of Total Expense0.01720PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense23180175TotalCommunityBenefitExpense
Direct Offsetting Revenue13468781DirectOffsettingRevenue
Net Community Benefit Expense9711394NetCommunityBenefitExpense
Percent Of Total Expense0.02380PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense30213563TotalCommunityBenefitExpense
Direct Offsetting Revenue13468781DirectOffsettingRevenue
Net Community Benefit Expense16744782NetCommunityBenefitExpense
Percent Of Total Expense0.04100PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1412907TotalCommunityBenefitExpense
Direct Offsetting Revenue172500DirectOffsettingRevenue
Net Community Benefit Expense1240407NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2170727TotalCommunityBenefitExpense
Net Community Benefit Expense2170727NetCommunityBenefitExpense
Percent Of Total Expense0.00530PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2688447TotalCommunityBenefitExpense
Direct Offsetting Revenue1366345DirectOffsettingRevenue
Net Community Benefit Expense1322102NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense269080TotalCommunityBenefitExpense
Direct Offsetting Revenue184450DirectOffsettingRevenue
Net Community Benefit Expense84630NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense253544TotalCommunityBenefitExpense
Direct Offsetting Revenue62413DirectOffsettingRevenue
Net Community Benefit Expense191131NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6794705TotalCommunityBenefitExpense
Direct Offsetting Revenue1785708DirectOffsettingRevenue
Net Community Benefit Expense5008997NetCommunityBenefitExpense
Percent Of Total Expense0.01220PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense37008268TotalCommunityBenefitExpense
Direct Offsetting Revenue15254489DirectOffsettingRevenue
Net Community Benefit Expense21753779NetCommunityBenefitExpense
Percent Of Total Expense0.05320PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$4,874,196BadDebtExpenseAmount
Amount Attributable To4815175AmountAttributableTo
Amount Reimbursed By Medicare60341840AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare82524253CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-22182413MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1Overlake Surgery Center LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityAmbulatory Surgical SvcsDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.43000OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.57000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Overlake Hospital Medical CtrBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11035 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Overlake Hospital Medical CtrBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.0000FPGDiscountPercent
Explains BasisfalseExplainsBasis
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities16NumberOfOtherFacilities

Other Facilities OtherFacilities (16 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
OMC-Mercer Island Senior Health Center
7707 SE 27th St Ste 110Mercer IslandWA98040Geriatric Care
OMC-Redmond Primary Care
16315 NE 74th StRedmondWA98052Internal Medicine
OMC-Kirkland
290 Central WayKirklandWA98033Primary Care Clinic
OMC-Specialty Clinic Bariatric SurgeryWLS
1120 112th Ave NE Ste 101BellevueWA98004Bariatric Surgery/Weight Loss
OMC-Medical Oncology
1135 116th Ave NE Ste 230BellevueWA98004Oncology
OMC-Gilman Primary Care
450 NW Gilman Blvd Ste 201IssaquahWA98027Primary Care Clinic
OMC-Breast Surgery
1135 116th Ave NE Ste 180BellevueWA98004Breast Surgery
OMC-Issaquah Family Practice
5708 E Lk Sammamish Pkwy SE Ste 102IssaquahWA98029Primary Care Clinic
OMC-Bellevue Senior Health Center
1750 112th Ave NE Ste A101BellevueWA98004Geriatrics
OMC-Redmond Urgent Care
17209 Redmond WayRedmondWA98052Urgent Care
OMC-Cardiothoracic Surgery
1135 116th Ave NE Ste 605BellevueWA98004Cardiac Surgery
OMC-Downtown Bellevue Primary Care
400 108th Ave Ste 100BellevueWA98004Internal Medicine
OMC-Radiation Oncology
1135 116th Ave NE Ste 160BellevueWA98004Radiation Oncology
OMC-Medical Tower Primary Care
1135 116th Ave NE Ste 110BellevueWA98004Internal Medicine
OMC-Issaquah Urgent Care
5708 E Lk Sammamish Pkwy SE Ste 101IssaquahWA98029Urgent Care
OMC-Cardiology MOT
1135 116th Ave NE Ste 600BellevueWA98004Cardiology

Form990 Schedule H Part VI Form990ScheduleHPartVI (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Additional InformationPart I, Line 7The 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 8The costing methodology for Medicare allowable cost is derived from the 2011 Medicare Cost Report. The Hospital believes that all of 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 9bThe 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 2The Hospital conducted a community needs assessment in April 2011 and is using this as the primary basis for assessing the community health needs in the future. In addition, the Hospital distributes feedback forms in all our classes and at our major events, such as our annual community health fair. These forms ask attendees a range of questions, including what other classes or services people would like us to offer. We also include an item in every issue of Healthy Outlook asking people to contact us if they have requests for particular health classes or lectures. Finally, we maintain relationships with other area non-profits and work with them when they identify specific community health needs (e.g. stroke screenings at Hopelink). Part VI, Line 3Information 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 will discuss the financial assistance program. The Financial counselors will also assist patients in completing the Hospital's charity care application if the patients 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 4The Hospital's primary service area is East King County which is bounded by Lake Washington to the west and by the Cascade Mountains to the east and extends north to the King County line, near the City of Bothell, and south to the City of Renton. It has a population base of approximately 696,000 residents with an ethnic makeup of 68% white, 18% Asian, 7% Hispanic, and 7% other. 10% of the residents are 65 or older and another 28% in the 45 to 64 age bracket.Part VI, Line 5The 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 2,804 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.
Part V, Line 13g - Other Means Hospital Facility Publicized the PolicyWhile the written policy does not specifically mention the website and the patient statements, the hospital does do them in practice.Number of Hospital Faciltiy - 0
Part III, Line 4 - Bad Debt ExpenseThe Hospital and the Clinics provide an allowance for potential uncollectible patient accounts receivable whereby such receivables are reduced to their estimated net realizable value. The Hospital estimates this allowance based on the aging of accounts receivable, historical collection experience by payor, and other relevant factors. The Clinics estimates this allowance based on the historical collection experience by clinic and other relevant factors. There are various factors that can impact the collection trends, such as changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients, the increased burden of co-insurance, and deductibles to be made by patients with insurance and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process. The bad debt expense on Schedule H, Part III, lines 2 and 3 are estimated based on the cost to charge ratio. The Hospital believes that approximately 98% 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.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Overlake Hospital Foundation
1035 116th Ave NeBellevueWA98004911050325501 (c) (3)12368110Support Operations
Overlake Hospital Auxiliaries
1035 116th Ave NEBellevueWA98004237297831501 (c) (3)3155500Support Operations
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationOverlake 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
William Reece MD
29788641614521528980010596755955
Vu Hoang MD
387489142952568093390411234632388
T D Sam Baxter
1884532171726381935319888339970
Robert Binford MD
427187330314700984446174
Richard Clarfeld MD
3747556875831673736415079517240
Richard Bryan
205929208165834709966050309625
Jody Albright
2592132895423737409096072358885
James Pelton MD
29703419235271161470010464521666
Gary McLaughlin
431466629487545213272414724717314
David Schultz
34372652422230647676714724510703
Craig Hendrickson
637890112882872718191637127251827852637296
Catherine Whitaker-Klick
25669628774251463832914724363669
Alan Ertle
3759604229414811687126168507945

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationPart II Line 1 Column FCraig Henrickson received constructive receipt of $637,296 for his life insurance coverage under the Executive Flexible Benefit Plan upon vesting on his 65th birthday. This amount was included in taxable income in 2011.
Sch J, Part I, Line 7Part I, Line 7: Non-Fixed payments not listed aboveManagement incentive for the CEO, COO and Vice Presidents are contingent on Overlake Hospital Association's consolidated net operating income for the fiscal year being at least 80% of the net operating income budget. The incentive payment is then based on a combination of meeting organization and individual goals.Incentives were paid to William Reece, Vu Hoang and James Pelton on productivity and meeting certain individual quality goals. Incentives were paid to Richard Clarfeld based on meeting certain individual quality goals.
Sch J, Part I, Line 1aPart I, Line 1a: Relevant information in regards to selections on 1a.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
WA Health Care Facilities
91110892993978E7P12010-04-1499229494See Part VIfalsefalsefalse
WA Health Care Facilities Authority
91110892993978EYZ92005-06-08162497935Construction of Facilitytruefalsefalse
WA Health Care Facilities Authority
91110892993978EWQ12003-06-1922708358Refund Prior Issue 12/13/89falsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount RetiredAmountRetiredCapitalized InterestCapitalizedInterestCredit EnhancementCreditEnhancement
992298628293020166001021077020000000750000002010truefalsetruetrue
169310100651694021363811456945242008falsefalsetruetrue832600008527508175568
22708445371287213711591990truefalsetruetrue16425000966000

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUse
falsefalsefalsefalsetrue
falsetruefalsefalsetrue0.001100.009200.01030

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied
(no name)
falsefalsefalsefalsefalsetrue
IXIS Funding Corp
falsetruefalsetruefalsefalse3.1000true
(no name)
falsefalsefalsefalsefalsetrue

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Kathryn Crossland
See Part V30105Employed Physicianfalse
Puget Sound Physicians PLLC
See Part V937910UC Phys/M.Director Feesfalse
Washington Federal Savings
See Part V224419Leasing Clinical Spacefalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationPart IV Line 1 Column (c)Entity in which Jim Doud, Trustee, is a Board Member.Part IV Line 2 Column (c)Entity in which Tom Miller, MD, Trustee is a Partner with 5.5% ownership.Part IV Line 3 Column (c)Family relationship with Walter Smith, MD, Trustee.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VII, Section A, Line 1Cecily Hall devoted 1 hour to a related organization.Jim Doud devoted 3 hours to a related organization. John Murphy devoted 2 hours to a related organization. Patricia Bedient devoted .50 hour to a related organization. Bertrand Valdman devoted 1 hour to a related organization. Larry Hebner devoted 1 hour to a related organization. Robert Campbell devoted .50 hour to a related organization. Tom Cleveland devoted 2 hours to a related organization. Gregory Collins devoted 1 hour to a related organization. Patty Edwards devoted 3 hours to related organizations. Janine Florence devoted .50 hour to a related organization. Kemper Freeman, Jr.devoted 1 hour to a related organization. Kathleen Gibson, MD, devoted 1 hour to a related organization. John Hayhurst devoted .50 hour to a related organization. Ken Johnsen devoted 1 hour to a related organization. Linda Mahaffey devoted 3.5 hours to related organizations. Douglas Martin devoted 1 hour to a related organization. Tom Miller, MD devoted 1 hour to a related organization. Nolan Newman devoted .50 hour to a related organization. Walter Smith devoted 1 hour to a related organization. Russell Stockdale devoted .50 hour to a related organization. Craig Hendrickson devoted 20 hours to related organizations. Gary McLaughlin devoted 20 hours to related organizations.
Form 990, Part V Line 7g & 7hOverlake Hospital Medical Center did not receive any contributions of intellectual property, cars, boats, airplanes, or other vehicles.
Form 990, Part IV Line 12 - Fin. StmtsThe financial statements of Overlake Hospital Medical Center are audited on a consolidated basis. This IRS Form 990 for Overlake Hospital Medical Center only contains the activities of the Hospital while the activities of the related organizations are reported on separate IRS Form 990s.
Form 990, Part I Line 6 - VolunteersVolunteers provided 167,116 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 21 board members that volunteered their time as board members during the year.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableOverlake 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 Medical Center consolidated financial statements are also available on the Overlake Medical Center's website.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesOverlake's policy and process for Executive Compensation is fully documented in the "Executive Compensation Administration and Compliance Manual" which was last updated on 4/1/12. 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 a review of comparable data from external sources. All compensation related decisions for the CEO, COO and Vice Presidents are discussed, deliberated and voted on by the Compensation Committee and documented in the minutes of the meeting.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsBoard members and management annually signs a statement which affirms that such person: 1) has received a copy of the Conflict of Interest Policy2) has read and understands the policy3) has agreed to comply with the policy, and4) understands that the corporation is a charitable organization 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 lists of all financial interests or other relationships with any organization 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, Overlake Hospital Medical Center VP Human Resources and General Counsel. This information is also shared with the Chair-Elect, Committee Chairs, and the 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, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessThe 990 is prepared internally and reviewed by an independent accounting firm. The 990 is then reviewed by the President & CEO, CFO, VP Human Resources, VP of Risk Management/Safety, and Overlake Hospital Medical Center Finance Committee. The 990 is sent to the Overlake Hospital Medical Center Board members prior to submission to the IRS.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersOverlake Hospital Association, as sole member, 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, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyOverlake Hospital Association has the right to appoint and remove Overlake Hospital Medical Center's Trustees.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderOverlake Hospital Association is the sole member of Overlake Hospital Medical Center.Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeBusiness Name Line1DirectControllingEntityName/BusinessNameLine1EOY AssetsEOYAssets
Washington Imaging ServicesLLC
1035 116th Ave NEBellevueWA98004911730052Medical ImagingWA3956546Overlake Hospital Medical Center
Overlake Medical Clinics LLC
1035 116th Ave NEBellevueWA98004911932954Medical ClinicsWA23346385Overlake Hospital Medical Center15465461

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Overlake Hospital Association
1035 116th Ave NEBellevueWA98004911274134Provide SupportWA501(c)(3)11-Type IIN/Atrue
Overlake Hospital Auxiliaries
1035 116th Ave NEBellevueWA98004237297831Fund RaisingWA501(c)(3)9trueOverlake Hospital Medical Center
Overlake Hospital Foundation
1035 116th Ave NEBellevueWA98004911050325Fund RaisingWA501(c)(3)7trueOverlake Hospital Medical Center
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Overlake Hospital Association
p876533Cash
Overlake Hospital Association
n250113Other
Overlake Hospital Association
j4502162Cash
Overlake Hospital Association
d8430269Other
Overlake Hospital Auxiliaries
n190337Cash
Overlake Hospital Auxiliaries
c1013320Cash
Overlake Hospital Auxiliaries
b315550Cash
Overlake Hospital Foundation
n320898Cash
Overlake Hospital Foundation
m97015Cash
Overlake Hospital Foundation
c4054765Cash
Overlake Hospital Foundation
b1236811Cash