OVERLAKE HOSPITAL FOUNDATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- OVERLAKE HOSPITAL FOUNDATION (EIN 91-1050325)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202301329349307585
- Schema version
- 2021v4.2
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T14:53:49-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | 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 ST STE 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 | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911050325 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE HOSPITAL FOUNDATION | 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 | 2023-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ANDREW | PersonFirstNm |
| Person Last | TOKAR | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SARA ELIZABETH H JONES | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Preparation | 2023-05-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY BETH STEARNS | 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 | $14,378,627 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OVERLAKEHOSPITAL.ORG/WAYS-TO-GIVE | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | THE PURPOSE OF OVERLAKE HOSPITAL FOUNDATION IS TO ADVANCE AND IMPROVE MEDICAL AND HEALTH CARE EXCELLENCE BY PROVIDING FUNDRAISING AND OTHER SUPPORT TO OVERLAKE HOSPITAL MEDICAL CENTER FOR NEW FACILITIES, MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 13 | TotalEmployeeCnt |
| Total Volunteers | 18 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $13,227,580 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,648,760 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $533,798 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,242,399 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$90,102 | PYOtherRevenueAmt |
| CY Other Revenue | -$224,445 | CYOtherRevenueAmt |
| PY Total Revenue | $13,671,276 | PYTotalRevenueAmt |
| CY Total Revenue | $11,666,714 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $12,957,251 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,141,355 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,408,216 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,533,937 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,164,626 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $457,898 | PYOtherExpensesAmt |
| CY Other Expenses | $385,767 | CYOtherExpensesAmt |
| PY Total Expenses | $14,823,365 | PYTotalExpensesAmt |
| CY Total Expenses | $11,061,059 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,152,089 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $605,655 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,396,715 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,723,897 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $617,464 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $557,219 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,779,251 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,166,678 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE PURPOSE OF OVERLAKE HOSPITAL FOUNDATION IS TO ADVANCE AND IMPROVE MEDICAL AND HEALTH CARE EXCELLENCE BY PROVIDING FUNDRAISING AND OTHER SUPPORT TO OVERLAKE HOSPITAL MEDICAL CENTER FOR NEW FACILITIES, MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,141,355 | ExpenseAmt |
| Grant | $9,141,355 | GrantAmt |
| Desc | OVERLAKE HOSPITAL FOUNDATION RAISED $7,764,750 IN CONTRIBUTIONS AND PLEDGES FROM DONORS. THE FOUNDATION PROVIDED $9,141,355 OF FINANCIAL SUPPORT TO OVERLAKE HOSPITAL MEDICAL CENTER FOR NEW FACILITIES, MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. THE DIFFERENCE BETWEEN CONTRIBUTION REVENUE AND THE SUPPORT PROVIDED TO OVERLAKE HOSPITAL IS DUE TO THE TIMING OF PLEDGE PAYMENTS. | Desc |
| Total Program Service Expenses | $9,141,355 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 13 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | Yes (1) | 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 | 0 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| 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 | 1035 116TH AVENUE NE | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PAULINE BACH | ||||||||
| CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BENJAMIN LIU | ||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JULIE SUN | ||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MERRILL BEHNKE | ||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RACHELE BOUCHAND | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| HALEH CLAPP | ||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES GREGSON | ||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LEIGHA GRIMALDI | ||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| YORK HARRIS | ||||||||
| TRUSTEE | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TAYLOR MILLER | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LANI MOBIUS | ||||||||
| TRUSTEE | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| WHITNEY NAKAJIMA | ||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE NICHOLES | ||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TARA REIMERS MD | ||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL RIDGEWAY | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| YUKA SHIMIZU | ||||||||
| TRUSTEE | 4.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CLAIRE SUMADIRWIRYA | ||||||||
| TRUSTEE | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TYLER TONKIN | ||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| J MICHAEL MARSH | ||||||||
| PRESIDENT & CEO | 10.00 | 50.00 | Yes (X) | $0 | $1,314,369 | $140,806 | ||
| ANDREW TOKAR | ||||||||
| CFO | 2.00 | 55.00 | Yes (X) | $0 | $592,130 | $85,014 | ||
| MARY BETH STEARNS | ||||||||
| CHIEF DEVELOPMENT OFFICER | 50.00 | 0.00 | Yes (X) | $395,516 | $0 | $83,484 | ||
| STEPHANIE STEWART | ||||||||
| DEVELOPMENT DIRECTOR | 40.00 | 0.00 | $207,307 | $0 | $30,364 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $602,823 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,906,499 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $339,668 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOULCRAFT LLC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2301 VICTOR STREET | AddressLine1Txt |
| City | BELLINGHAM | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98225 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | DIGITAL PRODUCTION SERVICES | ServicesDesc |
| Compensation | $108,999 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $1,034,692 | FundraisingAmt |
| Related Organizations | $2,438,892 | RelatedOrganizationsAmt |
| All Other Contributions | $7,175,176 | AllOtherContributionsAmt |
| Noncash Contributions | $1,796,032 | NoncashContributionsAmt |
| Total Contributions | $10,648,760 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,239,711 | TotalRevenueColumnAmt |
| Exclusion | $1,239,711 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,415,726 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,413,038 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,688 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,688 | TotalRevenueColumnAmt |
| Exclusion | $2,688 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $74,430 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $1,034,692 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $298,875 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$224,445 | TotalRevenueColumnAmt |
| Exclusion | -$224,445 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,666,714 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,017,954 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,141,355 | TotalAmt |
| Program Services | $9,141,355 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,371 | TotalAmt |
| Management And General | $111,877 | ManagementAndGeneralAmt |
| Fundraising | $250,494 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $972,296 | TotalAmt |
| Management And General | $282,369 | ManagementAndGeneralAmt |
| Fundraising | $689,927 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,842 | TotalAmt |
| Management And General | $35,675 | ManagementAndGeneralAmt |
| Fundraising | $87,167 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,428 | TotalAmt |
| Management And General | $22,196 | ManagementAndGeneralAmt |
| Fundraising | $54,232 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,787 | TotalAmt |
| Management And General | $62,787 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,884 | TotalAmt |
| Management And General | $53,828 | ManagementAndGeneralAmt |
| Fundraising | $43,056 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,419 | TotalAmt |
| Management And General | $6,675 | ManagementAndGeneralAmt |
| Fundraising | $744 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,290 | TotalAmt |
| Management And General | $13,252 | ManagementAndGeneralAmt |
| Fundraising | $28,038 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,732 | TotalAmt |
| Management And General | $2,625 | ManagementAndGeneralAmt |
| Fundraising | $107 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,767 | TotalAmt |
| Management And General | $149,767 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578 | TotalAmt |
| Management And General | $30 | ManagementAndGeneralAmt |
| Fundraising | $548 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,791 | TotalAmt |
| Management And General | $1,598 | ManagementAndGeneralAmt |
| Fundraising | $193 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $844 | TotalAmt |
| Management And General | $844 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| FOOD | $16,413 | $6,403 | $10,010 |
| MEMBERSHIP DUES | $5,262 | $5,152 | $110 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,061,059 | TotalAmt |
| Program Services | $9,141,355 | ProgramServicesAmt |
| Management And General | $755,078 | ManagementAndGeneralAmt |
| Fundraising | $1,164,626 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $992,336 | BOYAmt |
| EOY | $4,259,708 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $288,430 | BOYAmt |
| EOY | $139,479 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,958,110 | BOYAmt |
| EOY | $4,510,090 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,159 | BOYAmt |
| EOY | $24,936 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $347,411 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $342,561 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,694 | BOYAmt |
| EOY | $4,850 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,806,460 | BOYAmt |
| EOY | $14,525,093 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,526 | BOYAmt |
| EOY | $259,741 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,396,715 | BOYAmt |
| EOY | $23,723,897 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,057 | BOYAmt |
| EOY | $173,626 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,859 | BOYAmt |
| EOY | $68,837 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $403,548 | BOYAmt |
| EOY | $314,756 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $617,464 | BOYAmt |
| EOY | $557,219 | 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 | $5,590,041 | BOYAmt |
| EOY | $4,138,972 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,189,210 | BOYAmt |
| EOY | $19,027,706 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,779,251 | BOYAmt |
| EOY | $23,166,678 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,396,715 | BOYAmt |
| EOY | $23,723,897 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $605,655 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$3,218,228 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,967,289 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,468,527 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,464,560 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,227,580 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,648,760 | CurrentTaxYearAmt |
| Total | $53,776,716 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,967,289 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,468,527 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,464,560 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,227,580 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,648,760 | CurrentTaxYearAmt |
| Total | $53,776,716 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $7,000,955 | SubstantialContributorsTotAmt |
| Public Support Total170 | $46,775,761 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $526,114 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $642,294 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $600,693 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $509,441 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,239,711 | CurrentTaxYearAmt |
| Total | $3,518,253 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $57,294,969 | TotalSupportAmt |
| Public Support CY170 | 0.81640 | PublicSupportCY170Pct |
| Public Support PY170 | 0.76900 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,891,583 | BeginningYearBalanceAmt |
| Contributions | $239,515 | ContributionsAmt |
| Investment Earnings Or Losses | -$1,957,644 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $679,982 | OtherExpendituresAmt |
| End Year Balance | $14,493,472 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,741,651 | BeginningYearBalanceAmt |
| Contributions | $160,083 | ContributionsAmt |
| Investment Earnings Or Losses | $3,492,449 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $502,600 | OtherExpendituresAmt |
| End Year Balance | $16,891,583 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,480,020 | BeginningYearBalanceAmt |
| Contributions | $270,372 | ContributionsAmt |
| Investment Earnings Or Losses | $316,445 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $325,186 | OtherExpendituresAmt |
| End Year Balance | $13,741,651 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,003,120 | BeginningYearBalanceAmt |
| Contributions | $110,825 | ContributionsAmt |
| Investment Earnings Or Losses | $739,360 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $373,285 | OtherExpendituresAmt |
| End Year Balance | $13,480,020 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,076,705 | BeginningYearBalanceAmt |
| Contributions | $514,507 | ContributionsAmt |
| Investment Earnings Or Losses | $907,218 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $495,310 | OtherExpendituresAmt |
| End Year Balance | $13,003,120 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.31000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.36000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.33000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $154,803 | OtherCostOrOtherBasisAmt |
| Depreciation | $154,803 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $192,608 | OtherCostOrOtherBasisAmt |
| Depreciation | $187,758 | DepreciationAmt |
| Book Value | $4,850 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,850 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAPITAL LEASE OBLIGATION | Desc |
| Amt | $314,756 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $314,756 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $8,624,751 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$3,218,228 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$3,218,228 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,842,979 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $62,787 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | -$239,052 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$176,265 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,666,714 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,237,324 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $239,052 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $239,052 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,998,272 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $62,787 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $62,787 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,061,059 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | ANNUITIES ARE HELD IN A CUSTODIAL ACCOUNT (BNY MELLON). THE ASSETS AND LIABLILITY ARE REPORTED ON THE BALANCE SHEET. |
| PART V, LINE 4: | ENDOWMENT DISTRIBUTIONS ARE USED TO SUPPORT CAPITAL AND OPERATIONAL NEEDS OF OVERLAKE HOSPITAL MEDICAL CENTER AS DIRECTED BY THE INDIVIDUAL ENDOWMENT PURPOSE. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | SPECIAL EVENT DEDUCTIONS ON PART VIII -239,052. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT DEDUCTIONS ON PART VIII 239,052. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | BANDAGE BALL 2022 | Event1Nm |
| Gross Receipts Event1 | $1,109,122 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $1,034,692 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $74,430 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $32,870 | RentFacilityCostsEvent1Amt |
| Entertainment Event1 | $183,073 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $82,932 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $1,109,122 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $1,034,692 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $74,430 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $32,870 | RentFcltyCostsTotalEventsAmt |
| Entertainment Total Events | $183,073 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $82,932 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $298,875 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$224,445 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| 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 AVENUE NE | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 910652651 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $9,141,355 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | SUPPORT OVERLAKE HOSPITAL | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | 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 FOUNDATION STAFF NOTIFIES THE OVERLAKE HOSPITAL MEDICAL CENTER ACCOUNTING STAFF WHEN THERE IS A SPECIFIC GRANT. IF THE GRANT IS FOR OPERATIONAL EXPENSES THAT THE HOSPITAL DOES NOT INCUR IN THE NORMAL COURSE OF BUSINESS, THE APPROPRIATE DEPARTMENT IN THE HOSPITAL IS CONTACTED TO DEVELOP PLANS AND TIMING FOR USING THE FUNDS AS DESIGNATED. IF THE GRANT IS FOR CAPITAL, THE ACCOUNTING STAFF WILL MONITOR WHEN THE CAPITAL HAS BEEN PURCHASED AND RELEASE THE GRANT FROM RESTRICTION. WHEN THE DEPARTMENT MAKES THE EXPENDITURE, ACCOUNTING IS NOTIFIED, AND THE RESTRICTION OF THE GRANT IS RELEASED. | 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 | 0 | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 | $0 | $856,487 | $0 | $340,548 | $0 | $117,334 | $0 | $122,561 | $0 | $18,245 | $0 | $1,455,175 | $0 | $97,060 |
| ANDREW TOKAR | ||||||||||||||
| CFO | $0 | $428,308 | $0 | $143,248 | $0 | $20,574 | $0 | $77,376 | $0 | $7,638 | $0 | $677,144 | $0 | $0 |
| MARY BETH STEARNS | ||||||||||||||
| CHIEF DEVELOPMENT OFFICER | $272,365 | $0 | $77,378 | $0 | $45,773 | $0 | $71,285 | $0 | $12,199 | $0 | $479,000 | $0 | $0 | $0 |
| STEPHANIE STEWART | ||||||||||||||
| DEVELOPMENT DIRECTOR | $178,208 | $0 | $28,754 | $0 | $345 | $0 | $18,139 | $0 | $12,225 | $0 | $237,671 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | J. MICHAEL MARSH, MARY BETH STEARNS, AND ANDREW TOKAR 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. NO PAYMENTS WERE SENT TO J. MICHAEL MARSH, MARY BETH STEARNS, OR ANDREW TOKAR IN 2021. | ExplanationTxt |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 17 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,736,209 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | AUCTION ITEMS | Desc |
| Contribution | 79 | ContributionCnt |
| Noncash Contributions Rpt F990 | $59,823 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBER IN PART I COLUMN (B) IS BASED ON THE NUMBER OF CONTRIBUTIONS RECEIVED FOR DONATED SECURITIES AND THE NUMBER OF ITEMS RECEIVED FOR AUCTION ITEMS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6: | OVERLAKE HOSPITAL FOUNDATION HAD 18 BOARD MEMBERS THAT VOLUNTEERED THEIR TIME AS BOARD MEMBERS DURING THE YEAR. DUE TO COVID-19 THE FOUNDATION DID NOT USE ANY VOLUNTEERS OUTSIDE OF THE BOARD MEMBERS. |
| FORM 990, PART V, LINES 2A AND 2B: | EMPLOYEES ARE PAID THROUGH THE USE OF A COMMON PAYMASTER AND REPORTED ON THE FORM W-3 AND OTHER REQUIRED FILINGS OF OVERLAKE HOSPITAL MEDICAL CENTER. |
| FORM 990, PART VI, SECTION A, LINE 6 | ALTHOUGH THE GOVERNING DOCUMENTS DO NOT STATE THAT THERE ARE ANY MEMBERS OF OVERLAKE HOSPITAL FOUNDATION, OVERLAKE HOSPITAL MEDICAL CENTER DOES HAVE THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. |
| FORM 990, PART VI, SECTION A, LINE 7A | OVERLAKE HOSPITAL MEDICAL CENTER HAS THE RIGHT TO APPOINT AND REMOVE OVERLAKE HOSPITAL FOUNDATION'S TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | OVERLAKE HOSPITAL MEDICAL CENTER MUST APPROVE: (A) ANY SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (B) ANY SINGLE TRANSACTION INCREASING LONG TERM INDEBTEDNESS BY AN AMOUNT EXCEEDING FIVE PERCENT OF THE TOTAL ASSETS OF THE CORPORATION 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 CHIEF DEVELOPMENT OFFICER, PRESIDENT & CEO, CFO, OVERLAKE HOSPITAL MEDICAL CENTER CHIEF COMPLIANCE OFFICER, AND THE OVERLAKE HOSPITAL MEDICAL CENTER AUDIT & COMPLIANCE COMMITTEE. A PUBLIC DISCLOSURE COPY IS DISTRIBUTED TO THE FOUNDATION 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 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 LIST OF ALL FINANCIAL INTERESTS OR OTHER RELATIONSHIPS WITH ANY ORGANIZATION THAT HAS, OR CAN BE 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 BOARD CHAIRMAN, 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, SECTION B, LINE 15A | OVERLAKE'S POLICY AND PROCESS FOR EXECUTIVE COMPENSATION IS FULLY DOCUMENTED IN THE "EXECUTIVE COMPENSATION ADMINISTRATION AND COMPLIANCE MANUAL". THIS MANUAL DETAILS THE CHARTER OF THE COMPENSATION COMMITTEE OF THE BOARD, THE COMPENSATION PHILOSOPHY AND HOW SALARY INCREASES, INCENTIVES, 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 FOUNDATION'S CHIEF DEVELOPMENT OFFICER MARY BETH STEARNS ARE DELIBERATED AND VOTED ON BY THE OVERLAKE HOSPITAL MEDICAL CENTER/OVERLAKE HOSPITAL ASSOCIATION/OVERLAKE HOSPITAL FOUNDATION COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES OF THE MEETING. OFFICERS J. MICHAEL MARSH AND ANDREW TOKAR ARE PAID BY RELATED AFFILIATE OVERLAKE HOSPITAL MEDICAL CENTER. THE MOST RECENT COMPENSATION REVIEW WAS AT THE DECEMBER 2022 COMPENSATION COMMITTEE MEETING. |
| FORM 990, PART VI, SECTION C, LINE 19 | OVERLAKE HOSPITAL FOUNDATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE THROUGH THE HOSPITAL'S ADMINISTRATION OFFICE. THE OVERLAKE HOSPITAL FOUNDATION FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII: | OVERLAKE HOSPITAL FOUNDATION STAFF ARE PAID BY ITS RELATED ORGANIZATION (OVERLAKE HOSPITAL MEDICAL CENTER) THROUGH A COMMON PAYMASTER. THESE PAYROLL EXPENSES ARE CHARGED TO OVERLAKE HOSPITAL FOUNDATION. |
| FORM 990, PART IX, LINE 8: | EMPLOYEES OF OVERLAKE HOSPITAL FOUNDATION RECEIVE PENSION BENEFITS ADMINISTERED THROUGH OVERLAKE HOSPITAL MEDICAL CENTER. THESE EXPENSES ARE INCLUDED IN THE OVERLAKE HOSPITAL MEDICAL CENTER IRS FORM 990, ARE NOT ALLOCATED TO THE OVERLAKE HOSPITAL FOUNDATION, AND ARE NOT REIMBURSED TO OVERLAKE HOSPITAL MEDICAL CENTER. |
Schedule R IRS990ScheduleR
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 MEDICAL CENTER | |||||||||||
| 1035 116TH AVENUE NE | BELLEVUE | WA | 98004 | 910652651 | HOSPITAL | WA | 501(C)(3) | LINE 3 | OVERLAKE HOSPITAL ASSOCIATION | 0 | |
| OVERLAKE HOSPITAL ASSOCIATION | |||||||||||
| 1035 116TH AVENUE NE | BELLEVUE | WA | 98004 | 911274134 | RENT MEDICAL & OFFICE SPACE TO HOSPITAL | WA | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| OVERLAKE HOSPITAL AUXILIARIES | |||||||||||
| 1035 116TH AVENUE NE | BELLEVUE | WA | 98004 | 237297831 | FUNDRAISING | WA | 501(C)(3) | LINE 7 | OVERLAKE HOSPITAL MEDICAL CENTER | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | 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 | Yes (1) | 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 | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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