OVERLAKE HOSPITAL ASSOCIATION: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- OVERLAKE HOSPITAL ASSOCIATION (EIN 91-1274134)
- Tax period
- 2023-07-01 to 2024-06-16
- Filed
- 2025-05-06
- IRS object ID
- 202531269349301598
- Schema version
- 2023v6.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-06T12:07:12-05:00 | ReturnTs |
| Tax Period End | 2024-06-16 | 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 | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911274134 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE HOSPITAL ASSOCIATION | 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 | CHRISSY YAMADA | PersonNm |
| Person Title | INTERIM CFO | PersonTitleTxt |
| Phone | 4256885000 | PhoneNum |
| Signature | 2025-04-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN R RYAN | PreparerPersonNm |
| PTIN | P00737884 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Preparation | 2025-04-22 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Principal Officer | JON DUARTE | 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 | $11,413,597 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT OVERLAKE MEDICAL CENTER & CLINICS AND OVERLAKE HOSPITAL FOUNDATION. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 0 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,740,837 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,144,098 | CYProgramServiceRevenueAmt |
| PY Investment Income | $373 | PYInvestmentIncomeAmt |
| CY Investment Income | $947 | CYInvestmentIncomeAmt |
| PY Other Revenue | $166,560 | PYOtherRevenueAmt |
| CY Other Revenue | $159,994 | CYOtherRevenueAmt |
| PY Total Revenue | $11,907,770 | PYTotalRevenueAmt |
| CY Total Revenue | $11,305,039 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $7,600,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,000,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,725,218 | PYOtherExpensesAmt |
| CY Other Expenses | $5,051,910 | CYOtherExpensesAmt |
| PY Total Expenses | $12,325,218 | PYTotalExpensesAmt |
| CY Total Expenses | $13,051,910 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$417,448 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,746,871 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,473,309 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $405,116 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,068,193 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE PURPOSE OF OVERLAKE HOSPITAL ASSOCIATION IS TO PROVIDE SUPPORT TO OVERLAKE MEDICAL CENTER & CLINICS, OVERLAKE HOSPITAL FOUNDATION THEREBY IMPROVING THE HEALTH CARE OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $4,476,491 | ExpenseAmt |
| Revenue | $11,144,098 | RevenueAmt |
| Desc | THE ASSOCIATION RENTED 182,583 SQUARE FEET TO ITS EXEMPT AFFILIATES AND OTHER MEDICAL GROUPS DURING THE YEAR ENDED JUNE 16, 2024 ALLOWING ADDITIONAL HOSPITAL SERVICES AND PHYSICIAN SERVICES TO BE PROVIDED CLOSE TO THE HOSPITAL. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,000,000 | ExpenseAmt |
| Grant | $8,000,000 | GrantAmt |
| Desc | THE OVERLAKE HOSPITAL ASSOCIATION PROVIDED $8,000,000.00 OF FINANCIAL SUPPORT TO OVERLAKE MEDICAL CENTER & CLINICS FOR MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $12,476,491 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | Yes (1) | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 12 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 | 0 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHARON PHELPS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4256885471 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1231 116TH AVE NE SUITE 600 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|
| JASON THOMPSON | |||||||
| CHAIR | 2.00 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TOM EVERT | |||||||
| SECRETARY & TREASURER | 0.50 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PAULINE BACH | |||||||
| TRUSTEE | 1.50 | 3.50 | Yes (X) | $0 | $0 | $0 | |
| KRISTINA BELFIORE | |||||||
| TRUSTEE | 0.10 | 1.50 | Yes (X) | $0 | $0 | $0 | |
| ROBERT CAMPBELL | |||||||
| TRUSTEE | 3.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JORGE CERDA | |||||||
| TRUSTEE | 1.50 | 1.50 | Yes (X) | $0 | $0 | $0 | |
| ANNETTE CLARK | |||||||
| TRUSTEE | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| TED HERB | |||||||
| TRUSTEE | 0.10 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| TIFFANY KOENIG | |||||||
| TRUSTEE | 0.10 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES LADD | |||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| MARTHA LEE | |||||||
| TRUSTEE | 0.10 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LINDA MAHAFFEY | |||||||
| TRUSTEE | 0.50 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| UMA RAGHAVAN-THURMAN | |||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JULIE SUN | |||||||
| TRUSTEE | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |
| DILIP WAGLE | |||||||
| TRUSTEE | 0.10 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| LISA WISSNER-SLIVKA | |||||||
| TRUSTEE | 0.10 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JESSIE WOOLLEY-WILSON | |||||||
| TRUSTEE | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| J MICHAEL MARSH | |||||||
| PRESIDENT & CEO | 4.00 | 49.00 | Yes (X) | $0 | $1,155,989 | $149,860 | |
| ANDREW J TOKAR | |||||||
| CFO THRU 04/24 | 7.00 | 50.00 | Yes (X) | $0 | $490,217 | $36,310 | |
| PAUL ISHIZUKA | |||||||
| INTERIM CFO FROM 03/24 | 0.50 | 49.50 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,646,206 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $186,170 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| KAUFMAN HALL & ASSOCIATES LLC | |||||
| PO BOX 140909 | IRVING | TX | 75014 | CONSULTING | $198,850 |
| UNICO PROPERTY MANAGEMENT | |||||
| 1326 FIFTH AVENUE SUITE 800 | SEATTLE | WA | 98101 | PROPERTY MANAGEMENT | $177,039 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RENT FROM AFFILIATES | Desc |
| Business | 531120 | BusinessCd |
| Total Revenue Column | $11,144,098 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,144,098 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,144,098 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $947 | TotalRevenueColumnAmt |
| Exclusion | $947 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $268,552 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $108,558 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $159,994 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $159,994 | TotalRevenueColumnAmt |
| Exclusion | $159,994 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,305,039 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,144,098 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $160,941 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,000,000 | TotalAmt |
| Program Services | $8,000,000 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,697 | TotalAmt |
| Program Services | $133,697 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,948 | TotalAmt |
| Program Services | $53,879 | ProgramServicesAmt |
| Management And General | $178,069 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $764,637 | TotalAmt |
| Program Services | $367,287 | ProgramServicesAmt |
| Management And General | $397,350 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,638 | TotalAmt |
| Program Services | $121,638 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,305,134 | TotalAmt |
| Program Services | $1,305,134 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,351,393 | TotalAmt |
| Program Services | $1,351,393 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,527 | TotalAmt |
| Program Services | $133,527 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| REPAIRS & MAINTENANCE | $996,412 | $996,412 |
| B&O TAX | $13,524 | $13,524 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,051,910 | TotalAmt |
| Program Services | $12,476,491 | ProgramServicesAmt |
| Management And General | $575,419 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,735,512 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $633,808 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,114,886 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,610 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,895,493 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,473,309 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $364,475 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,641 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,116 | BOYAmt |
| EOY | $0 | 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 | $28,068,193 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,068,193 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,473,309 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,746,871 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$26,321,322 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| OVERLAKE MEDICAL CENTER & CLINICS | ||||
| 910652651 | 3 | Yes (1) | $8,000,000 | $0 |
| OVERLAKE HOSPITAL FOUNDATION | ||||
| 911050325 | 7 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $8,000,000 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | 0 | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, SECTION C, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE BOARD OF DIRECTORS OF OVERLAKE HOSPITAL ASSOCIATION AND THE BOARD OF TRUSTEES OF OVERLAKE MEDICAL CENTER & CLINICS ARE COMPRISED OF THE SAME MEMBERS. WHILE THE MAJORITY OF OVERLAKE HOSPITAL ASSOCIATION'S BOARD ARE NOT BOARD MEMBERS OF OVERLAKE HOSPITAL FOUNDATION, THE SAME INDIVIDUALS ARE PRESIDENT & CEO AND CFO OF OVERLAKE HOSPITAL ASSOCIATION, OVERLAKE MEDICAL CENTER & CLINICS, AND OVERLAKE HOSPITAL FOUNDATION. THEREFORE, MANAGEMENT CONTROL EXISTS BETWEEN THE SUPPORTING AND SUPPORTED ORGANIZATIONS. | ExplanationTxt |
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 MEDICAL CENTER & CLINICS | 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 | $8,000,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | SUPPORT OPERATIONS | 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 ASSOCIATION DOES NOT GIVE GRANTS OR RECEIVES GRANTS. THE GRANT IS A TRANSFER BETWEEN RELATED ENTITIES UNDER COMMON CONTROL. THE ACCOUNTING FOR BOTH ENTITIES ARE PERFORMED BY THE SAME STAFF AND THERE IS NO ONGOING MONITORING OF THE TRANSFER. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (2 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 | $979,055 | $0 | $65,067 | $0 | $111,867 | $0 | $130,474 | $0 | $19,386 | $0 | $1,305,849 | $0 | $102,261 |
| ANDREW J TOKAR | ||||||||||||||
| CFO THRU 04/24 | $0 | $456,772 | $0 | $30,400 | $0 | $3,045 | $0 | $23,100 | $0 | $13,210 | $0 | $526,527 | $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 PARTICIPATES IN A BENEFIT WITHIN THE EXECUTIVE BENEFIT PLAN CALLED THE CAPITAL ACCUMULATION ACCOUNT. THE CAPITAL ACCUMULATION ACCOUNT IS CLASSIFIED AS A 457(F) PLAN BY THE IRS. THE FOLLOWING AMOUNTS REFLECT 2023 DEFERRALS: J. MICHAEL MARSH ($107,374) THE FOLLOWING AMOUNTS FROM THE CAPITAL ACCUMULATION ACCOUNT WERE PAID IN 2023: J. MICHAEL MARSH ($102,261). THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR FORMS 990. J. MICHAEL MARSH RECEIVED REDEMPTION OF CREDITS IN THE CAPITAL ACCUMULATION ACCOUNT THAT HAD BECOME VESTED. ANDREW TOKAR PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN BENEFIT. THIS IS A NONQUALIFIED PLAN SPONSORED BY OVERLAKE MEDICAL CENTER & CLINICS. THERE WERE NO DEFERRALS OR PLAN PAYMENTS DURING 2023. | ExplanationTxt |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | ASSET NET OF LIABILITIES ON DISSOLUTION OF ENTITY | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2024-06-16 | DistributionDt |
| Fair Market Value Of Asset | $26,321,322 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | BOOK VALUE | MethodOfFMVDeterminationTxt |
| EIN | 910652651 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE MEDICAL CENTER & CLINICS | 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) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | 0 | DirectorOfSuccessorInd |
| Employee Of Successor | 0 | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | Yes (1) | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (1) | LiabilitiesPaidInd |
| Bonds Outstanding | 0 | BondsOutstandingInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART 1, LINE 6: | OVERLAKE HOSPITAL ASSOCIATION HAD 17 BOARD MEMBERS THAT VOLUNTEERED THEIR TIME AS BOARD MEMBERS DURING THE YEAR. |
| FORM 990, PART III, LINE 3 | OVERLAKE HOSPITAL ASSOCIATION WAS DISSOLVED AS A SEPARATE LEGAL ENTITY AND ALL REMAINING ASSETS WERE TRANSFERRED TO OVERLAKE MEDICAL CENTER & CLINICS, THE SUPPORTED ORGANIZATION OF THE ASSOCIATION. THE OVERLAKE MEDICAL TOWER, LLC BECAME A WHOLLY OWNED DISREGARDED ENTITY OF OVERLAKE MEDICAL CENTER & CLINICS AS A RESULT OF THIS MERGER. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION FILED ARTICLES OF MERGER TO OBTAIN CERTIFICATE OF MERGER FOR DISSOLUTION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINAL 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND WILL BE REVIEWED BY THE OVERLAKE MEDICAL CENTER & CLINICS BOARD OF DIRECTORS AS THEY REPRESENT THE INTERESTS OF OVERLAKE HOSPITAL ASSOCIATION THROUGH THE MERGER AGREEMENT. |
| 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. BOARD MEMBERS AND MANAGEMENT ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICT OF INTEREST SITUATIONS ON THEIR ANNUAL DISCLOSURE FORM AND ON A SITUATIONAL BASIS FOR ANY SITUATION OCCURING DURING THE YEAR. DISCLOSURES ARE REVIEWED BY THE OFFICE OF COMPLIANCE AND RISK MANAGEMENT (OCRM). DISCLOSURES REQUIRING MITIGATION WILL BE HANDLED BY A MEMBER OF THE OCRM. IF THERE IS A VIOLATION OF THIS POLICY OR THERE IS A PERCEIVED OR ACTUAL CONFLICT THAT NEEDS TO BE MANAGED, THE OCRM WILL TAKE APPRORIATE CORRECTIVE ACTION, WHICH MAY INCLUDE A CONFLICT MANAGEMENT PLAN. 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 C, LINE 19 | THE ORGANIZATION MAKES ITS DISCLOSURE OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE THROUGH THE HOSPITAL'S ADMINISTRATION OFFICE. THE OVERLAKE MEDICAL CENTER & CLINICS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATIONS WEBSITE. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER TO RELATED ORGANIZATION -26,321,322. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE MEDICAL TOWER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1135 116TH AVENUE NE | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911984117 | EIN |
| Primary Activities | MEDICAL OFFICE SPACE RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Total Income | $10,826,928 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OVERLAKE HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| OVERLAKE MEDICAL CENTER & CLINICS | ||||||||||
| 1035 116TH AVENUE NE | BELLEVUE | WA | 98004 | 910652651 | HOSPITAL | WA | 501(C)(3) | LINE 3 | OVERLAKE HOSPITAL ASSOCIATION | Yes (1) |
| OVERLAKE HOSPITAL FOUNDATION | ||||||||||
| 1035 116TH AVENUE NE | BELLEVUE | WA | 98004 | 911050325 | FUNDRAISING | WA | 501(C)(3) | LINE 7 | OVERLAKE MEDICAL CENTER & CLINICS | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| OVERLAKE MEDICAL CENTER & CLINICS | ||
| A | $7,240,704 | FAIR MARKET VALUE |
| OVERLAKE MEDICAL CENTER & CLINICS | ||
| B | $8,000,000 | CASH |
| OVERLAKE MEDICAL CENTER & CLINICS | ||
| O | $158,357 | CASH |
| OVERLAKE MEDICAL CENTER & CLINICS | ||
| P | $379,597 | CASH |
| OVERLAKE MEDICAL CENTER & CLINICS | ||
| R | $26,321,322 | CASH |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V, LINE 1O: | FormAndLineReferenceDesc |
| Explanation | SALARIES ARE PAID BY OVERLAKE MEDICAL CENTER & CLINICS AND ARE NOT ALLOCATED TO OVERLAKE HOSPITAL ASSOCIATION ON PART IX. THE SALARIES REPORTED ON LINE 1O REPRESENT AN ALLOCATION OF SALARIES AND BENEFITS FOR J. MICHAEL MARSH, ANDREW TOKAR, AND PAUL ISHIZUKA BASED ON HOURS REPORTED SPENT ON OVERLAKE HOSPITAL ASSOCIATION. | ExplanationTxt |
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