2018-05-09T11:37:02-07:00 2017-06-30 Clark Nuber PS 10900 NE 4th Ste Ste 1400 Bellevue WA 98004 990 2016-07-01 910652651 OVERLAKE HOSPITAL MEDICAL CENTER OVER 4256885000 1035 116th Ave NE Bellevue WA 98004 Andrew Tokar CFO 2018-05-09 true Sara Elizabeth J Hyre P00235495 4254544919 2016 2022-09-23 18:48:47Z J Michael Marsh 593329233 false false X www.overlakehospital.org X 1953 WA The purpose is to operate a hospital for the care of persons,to participate in education,research and other activities designed to promote general health of the community. The Hospital's mission is to provide medical excellence every day. 11 11 3281 441 1311884 133412 3528820 17703478 499721165 500814854 9884081 22986148 6428019 6352662 519562085 547857142 2073761 2352078 0 258151469 272318855 0 0 235951538 238578880 496176768 513249813 23385317 34607329 677003032 733328963 245396431 243202505 431606601 490126458 The purpose is to operate a hospital for the care of persons,to participate in education,research and other activities designed to promote general health of the community. The Hospital's mission is to provide medical excellence every day. false false 412728807 500658327 Hospital Services - Overlake Hospital Medical Center is a nonprofit, independently operated regional center serving the eastern Puget Sound region with medical facilities in Bellevue, Issaquah, Kirkland, and Redmond. Founded in 1953, today Overlake Hospital is a regional leader in health care, providing advanced medical services in the areas of cardiac care, general and specialty surgery, women's services, cancer care and emergency services. The Hospital also has a network of neighborhood clinics in its primary service area. There were 18,232 patients admitted for inpatient medical care for a total of 67,333 patient days. There were 232,427 outpatient visits out of which 48,576 were for emergency care visits. The Hospital delivered 3,805 babies. Overlake Medical Clinics provided 277,772 patient visits. Overlake Hospital demonstrated a commitment to improving the health of the community by supporting many health-related events, programs, clinical research and made various contributions throughout the year that had a direct benefit to the community. The Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services. Overlake Hospital provided care to 5,447 patients who were uninsured or under insured at an estimated cost of $5,202,000. The Hospital provided care to Medicaid patients at rates below the cost of providing services. The payments were less than cost by $13,685,000. In keeping with the Hospital's spirit of giving back to the community, it provided a total of $6,136,000 of community benefit service activities. Overlake Staff spent 2,223 hours in the community by participating in, organizing and managing health programs and activities. Overlake sponsors community health events and screenings for the general public. Overlake held four successful Eastside Vitality Health Fair events in September 2017 at the Kirkland, Issaquah and Redmond clinics and at the main campus in October 2017. There were 233 volunteers, physicians and staff who helped provide more than 2,235 free screenings, tours and overall community goodwill. As the health care needs of our community increase and grow more complex, Overlake has strengthened its commitment to providing the most advanced treatment and technology alongside compassionate care every day. Overlake's Heart & Vascular Center provides electrophysiology, cardiac catheterization and interventional radiology services. Since December 2013, the heart valve team at Overlake Hospital Medical Center has been performing the minimally invasive transcatheter aortic valve replacement (TAVR) procedure for patients with severe aortic stenosis. Overlake is the only hospital on the Eastside and one of only four hospitals in the state to provide this procedure. The Cancer Center at Overlake is noted for its newest cancer treatments and most advanced technologies available, as well as for its exceptional patient experience. Overlake's Cancer Center holds three national accreditations: The American College of Surgeons Commission of Cancer, the National Accreditation Program for Breast Cancer (NAPBC), and Overlake is also the only site fully accredited by the American College of Radiation Oncology in Washington State. Overlake's Women and Infants' Center provides a full continuum of care designed for women in their childbearing years and beyond. Overlake offers exceptional care for elderly patients by educating our nurses in effective geriatric care. For more than 30 years, Overlake has been the leader in providing quality adult and adolescent psychiatric care to the Puget Sound community. Our Specialty School is recognized by the school districts as a leader in helping students who need specialized behavioral services by providing academic, social, emotional and behavioral support. Overlake is expanding its network of Medical Clinics throughout the Eastside. Overlake understands how busy people's day to day lives can be, that's why the Hospital provides patients with convenient, accessible medical care located close to where they live and work. Overlake is proud to be recognized as foremost in the region for our focus on our patients and we have been rewarded for it by patients and families who prefer us for their comprehensive healthcare and through many national awards. Overlake Hospital was the first Level III Trauma Center on the Eastside and we are known for providing award-winning, compassionate and patient-centered care. Overlake received many awards and recognitions both regionally and nationally. The Bob and Patty Edwards Arrhythmia Center at Overlake Medical Center is the first on the West Coast and only the 9th in the nation to receive national recognition of atrial fibrillation "AFib" accreditation by the Society of Cardiovascular Patient Care (SCPC), an Institute of the American College of Cardiology that accredits hospitals that have achieved best-in-class standards of care related to the treatment of cardiovascular disease. Overlake Hospital's Bariatric Surgical Center has been accredited as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MSAQIP), a joint program of the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery. Overlake received a Hospital Safety Score "A" letter grade from The Leapfrog Group. Overlake was one of only eight hospitals in the state, and the only one on the Eastside, to received an A. The Medical Center also received Blue Cross-Blue Shield Blue Distinction + for maternity and cardiac care, along with several honors from Healthgrades, a leading online resource for comprehensive information about physicians and hospitals. Overlake has been recognized by Healthgrades a Five-Star Recipient in Cardiac, Orthopedics, Neuroscience, Pulmonary, Gastrointestinal, Appendectomy, Labor and Delivery, Gynecology Surgery and Bariatric. Healthgrades also recognized Overlake Medical Center with awards of excellence. These recognize the top 10% of hospitals in the nation. Healthgrades Joint Replacement Excellence Award, Healthgrades Stroke Care Excellence Award and Healthgrades Gynecologic Surgery Excellence Award. 2373685 156527 Education Services - In addition to the excellent care we provide our patients, the Hospital firmly believes education is critical to overall wellness so the organization reaches out to the community to engage and empower its patients in becoming educated healthcare consumers by offering free and low-cost classes for all age groups. Health education is an important part of preventive care. The Education Program provided 51,798 family contact hours offering classes of a wide range of health related topics including women's health, prenatal care, coping skills, dealing with cancer, positive parenting, safety, asthma, heart disease, diabetes, living wills, incontinence, weight loss, maintaining balance, babysitting for teens, CPR and healthy lifestyles. 2352078 2352078 Other Grants and Allocations - Grants to Overlake Hospital Foundation and Overlake Hospital Auxiliaries to cover expenses and grants to support other community non profit organizations. 417454570 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true false false true X 267 0 true 3281 true true true false false false false false false 0 false false false false false false false false false false X 11 11 false false false false false true true true true false false true true true true true true true true true true WA X Eric Teshima 4256885149 1231 116th Ave Ste 600 Bellevue WA 980044687 X Patricia Bedient Chairman 5.00 2.00 X X 0 0 0 Robert Campbell Secretary 7.00 1.00 X X 0 0 0 Jason Thompson Treasurer 3.00 2.00 X X 0 0 0 Greg Collins Past Chair 2.00 0.50 X X 0 0 0 Jim Doud Secretary 3.00 3.00 X X 0 0 0 Jorge Cerda Trustee 4.00 4.00 X 0 0 0 Janine Florence Trustee 0.25 0.25 X 0 0 0 Kemper Freeman Jr Trustee 1.00 1.00 X 0 0 0 Ted Herb Trustee 1.50 1.50 X 0 0 0 David Hovind Trustee 3.00 2.00 X 0 0 0 Linda Mahaffey Trustee 2.00 1.00 X 0 0 0 N Elizabeth McCaw Trustee 1.00 0.25 X 0 0 0 Nolan Newman Trustee 2.00 2.00 X 0 0 0 Phyllis Stark Trustee 5.00 7.00 X 0 0 0 Russell Stockdale Trustee 1.50 0.50 X 0 0 0 Thomas Stoll MD Trustee 8.00 1.00 X 42000 0 0 J Michael Marsh President & CEO 45.00 15.00 X 917855 0 164927 Thomas Debord COO 55.00 10.00 X 529042 0 96000 Gary McLaughlin CFO thru6/23/17 40.00 10.00 X 667713 0 140347 Andrew Tokar Interim CFO 52.00 3.00 X 185253 0 14031 T D Sam Baxter Vice President 55.00 0.00 X 287175 0 89610 Richard Bryan Vice President 70.00 0.00 X 373264 0 78989 Valerie Chrusciel OMC COO 60.00 0.00 X 255379 0 48493 Julie Clayton Vice President 55.00 0.00 X 344888 0 64211 David Knoepfler Vice President 55.00 0.00 X 504634 0 96866 Dennis Rochier OMC CEO 55.00 0.00 X 246547 0 42117 Abhineet Chowdhary MD Neurosurgeon 40.00 0.00 X 1107954 0 24173 Derek Rodrigues MD Cardiologist 40.00 0.00 X 1005795 0 34529 Frank Bishop MD Neurosurgeon 40.00 0.00 X 771203 0 34529 Thien Nguyen MD Bariatric Surgeon 40.00 0.00 X 754242 0 39829 William Reece MD Rad. Oncologist 40.00 0.00 X 736885 0 34453 Caitlin H Moulding Former Key Employee 55.00 0.00 X 380371 0 75093 David Schultz Former Officer 0.00 0.00 X 203588 0 0 9313788 1078197 497 true true false Gall Landau Young Const Co P O Box 6728 Bellevue WA 980080728 Construction 11073559 Bloodworks Northwest 921 Terry Avenue Seattle WA 981041256 Blood Services 3358364 Epic Systems Corp P O Box 88314 Milwaukee WI 532880314 Software Developer 3340393 Quest Media & Supplies Inc P O Box 910 Roseville CA 95678 IT Management & Svcs 3002530 Perkins Coie LLP 1201 3rd Ave Ste 4900 Seattle WA 981013099 Legal Services 1667182 98 17703478 17703478 Education Services 611710 156527 156527 Medicare/Medicaid Payment 900004 185045049 185045049 Non Government Payments 900004 311158848 311158848 Other Program Services 900004 3029324 3029324 Program Related Invstmnts 900004 1425106 1425106 500814854 7868583 7868583 0 0 346698 346698 346698 346698 59973048 388891 44861033 383341 15112015 5550 15117565 15117565 0 0 433134 227717 205417 205417 Cafeteria/Catering 722210 2826584 2826584 Laboratory 621500 2583070 1311884 1271186 Parking Revenue 812930 390893 390893 5800547 547857142 500814854 1311884 28026926 2352078 2352078 0 0 0 3755378 1207149 2548229 0 214524698 179686451 34838247 13489882 11487353 2002529 25709027 20526535 5182492 14839870 12302801 2537069 0 2155979 47166 2108813 289892 289892 105986 105986 0 187953 187953 47795870 35558483 12237387 1211702 1211702 10125880 6537069 3588811 10487553 10487553 0 16344611 11587509 4757102 532780 331959 200821 0 585196 324656 260540 7189724 7189724 0 31459057 22389727 9069330 6563232 5278878 1284354 Medical Supplies 78211881 78105663 106218 Medicaid Prov Assessmnt 15184906 15184906 Business & Occupation Tax 5239632 4448316 791316 Licenses & Membership Dues 1826352 1122524 703828 3080694 1785623 1295071 513249813 417454570 95795243 0 21708448 20279720 8856801 9056864 0 54136176 54982913 0 0 328168 83790 8562598 9029188 11064615 9780082 497601312 288638136 203231372 208963176 349825106 406465719 0 2713621 3091331 2750984 2174952 13825143 9421228 677003032 733328963 82447361 75046537 14029371 149804180 143316404 13144890 10810193 245396431 243202505 X 431574176 485041919 32425 5084539 431606601 490126458 677003032 733328963 X 34607329 19774458 4138070 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false Washington State Hospital Assoc Dept5028 P O Box 34936 Seattle WA 98124 Millennia Public Affairs Inc 21127 47th Dr SE Bothell WA 98021 911809445 American Hospital Association P O Box 34936 Seattle WA 98124 false false false false false false true 57986 false true 48000 105986 false false Part II-B, Line 1i - Other Activities Description Part of the membership dues that are paid to the Washington State Hospital Association and American Hospital Association are used for lobbying purposes. 2151141 2151141 217598967 104254184 113344783 4841115 4053733 787382 254585271 180330219 74255052 18424818 18424818 208963176 Other Long Term Liabilities 89294 Prof Liability Insurance Reserve 9072599 Workers' Comp Reserve 1648300 10810193 true true X true X true X true true true false true true 5202140 5202140 0.01010 45818197 32132872 13685325 0.02670 51020337 32132872 18887465 0.03680 1330308 127525 1202783 0.00230 2455263 5967 2449296 0.00480 3679647 1630668 2048979 0.00400 535598 423733 111865 0.00020 322696 322696 0.00060 8323512 2187893 6135619 0.01190 59343849 34320765 25023084 0.04870 false 2891504 1737216 67128193 80847798 -13719605 X true true Overlake Surgery Center LLC Ambulatory Surgical Svcs 0.30160 0.69840 1 1 Overlake Hospital Medical Ctr 1035 116th Ave NE Bellevue WA 98004 overlakehospital.org/about- HAC.FS.00000131 X X X X X Overlake Hospital Medical Ctr 1 false false true X X X X X X X X 15 true true true true X overlakehospital.org/about-overlake X true 15 true overlakehospital.org/about-overlake false false true X 200.0000 400.0000 X false true X X X true X see 16 J X see 16J X see 16 J X X X X X X X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community The Community Health Needs Assessment incorporated existing demographic and health data for the communities served by the Hospital. It included collection and analysis of input from persons who represent the broad interests of the community served by the hospital, including those with special knowledge of public health. The health needs were identified from issues supported by primary and secondary data sources gathered for the Community Health Needs Assessment. The needs were indicated by stakeholder interviews, focus groups, and secondary data sources. The needs were confirmed by more than one indicator or data source. Community stakeholders, identified by the hospital, were contacted and asked to participate in the needs assessment. Interview participants included leaders and representatives of medically underserved, low-income, and minority populations, as well as the local health department that has "current data or information relevant to the health needs of the community served by the hospital facility," per IRS requirements. The interviews took into account input from a broad range of persons located in or serving its community including, health care consumers, nonprofit and community-based organizations, academic experts, local government officials, local school districts, health care providers and community health centers. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment Evergreen HealthCHI Franciscan HealthGroup Health CooperativeMultiCare Health SystemNavosSeattle Cancer Care AllianceSeattle Children's HospitalSnoqualmie Valley Hospital DistrictSwedish Medical CenterUW MedicineVirginia Mason Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why The Hospital has chosen not to actively address the remaining health need of dental care as identified in the Community Health Needs Assessment. Taking existing hospital and community resources into consideration, Overlake will concentrate on those health needs that we can most effectively address given our areas of focus and expertise. Part V, Line 16i - Other Means Hospital Facility Publicized the Policy Part V, Line 16a, 16b, 16c Website:http://www.overlakehospital.org/Financial-Arrangements OMC-Cardiology 1135 116th Ave NE Ste 600 Bellevue WA 98004 Cardiology OMC-Issaquah Urgent & Primary Care 5708 E Lk Sammamish Pkwy SE Ste 100 Issaquah WA 98029 Urgent Care / Primary Care / Specialty Clinic OMC-Primary Care Hosp Campus Pulmonology Endocrinology 1231 116th Ave NE Ste 400 Bellevue WA 98004 Primary Care / Pulmonology / Endocrinology OMC-Urgent Care Redmond 17209 Redmond Way Redmond WA 98052 Urgent Care OMC-Downtown Bellevue Urgent & Primary Care 400 108th Ave NE Ste 100 Bellevue WA 98004 Urgent Care / Primary Care OMC-Neurosciences 1135 116th Ave NE Ste 500 Bellevue WA 98004 Neurosurgery / Neurology OMC-Medical Oncology & Breast Surgery 1135 116th Ave NE Ste 200 Bellevue WA 98004 Oncology OMC-Redmond Primary Care Cardiology Pulmonology Psych 7345 164th Ave NE Ste I-105 Redmond WA 98052 Primary Care / Cardiology / Pulmonology / Psych OMC-Outpatient PT Occupational Therapy & Speech 1417 116th Ave NE Ste 110 Bellevue WA 98004 Physical Therapy / Occupational Therapy / Speech OMC-Cardiac Surgery 1135 116th Ave Ne Ste 605 Bellevue WA 98004 Cardiac Surgery OMC-Kirkland Primary Care Cardiology 290 Central Way Kirkland WA 98033 Primary Care / Cardiology OMC-Colorectal Surgery 1135 116th Ave NE Ste 550 Bellevue WA 98004 Colorectal Surgery OMC-Radiation Oncology 1135 116th Ave NE Ste 160 Bellevue WA 98004 Oncology OMC-Specialty Clinic Bellevue 1231 116th Ave NE Ste 515 Bellevue WA 98004 Bariatric & Nutrition Services OMC-Lake Hills Primary & Urgent Care 619 156th Ave SE Bellevue WA 98007 Primary & Urgent Care OMC-Infectious Diseases 1200 116th Ave NE Ste D Bellevue WA 98004 Infectious Disease OMC-Concierge Services 1231 116th Ave Ne Ste 525 Bellevue WA 98004 Primary Care OMC-Senior Health Center 1750 112th Ave NE Ste A101 Bellevue WA 98004 Geriatric OMC-Musculoskeletal Medicine 1740 NW Maple St Ste 111 Issaquah WA 98027 Musculoskeletal Medicine OMC-Cardiology Issaquah Pulmonology 1740 NW Maple Ste Ste 207 Issaquah WA 98027 Cardiology / Pulmonology OMC-Pelvic Health 1135 116th Ave NE Ste 420 Bellevue WA 98004 Pelvic Health OMC-Expedia Primary Care 333 108th Ave NE Ste M150 Bellevue WA 98004 Primary Care Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Patient bills are reduced by payments, contractual adjustments, charity adjustments, and other adjustments as applicable. Patients are then responsible for any remaining balance. If a patient does not pay the balance or make payment arrangements according to the collection policy, the balance is written off to bad debt. The bad debt expense on Schedule H, Part III, lines 2 and 3 are estimated based on the cost to charge ratio. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The Hospital believes that approximately 60% of the bad debt expense are related to patients that would be eligible under the Hospital's charity care guidelines had the patient provided the financial information necessary to make the determination. This percentage is based on running credit checks on a sample of accounts that were being sent to bad debts. Part III, Line 4 - Bad Debt Expense Provision for Bad Debt footnote on attached Audited Financial Statement page 16, section 6. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The costing methodology for Medicare allowable cost is derived from FY 2017 Medicare Cost Report. The Hospital believes that all of the Medicare shortfall should be treated as community benefit. The IRS community benefit standard includes the provision of care to Medicare patients and the Hospital continues providing care to the Medicare beneficiaries regardless of the shortfall. By absorbing the Medicare shortfall, the Hospital thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients The Hospital will place a patient's account on hold when a patient's account is being considered for charity. Once a determination has been made that a patient qualifies for charity care, the patient's account is reduced by the charity amount granted and a letter is sent to the patient noting the charity adjustment. The patient may appeal the decision if he/she believes there is additional information that should have been considered or the financial situation has changed. The patient is responsible for any balance remaining after the charity adjustment, if any, and the collection process will continue in the normal process. Part VI - Needs Assessment In 2015, the Hospital participated in a collaborative process for the Community Health Needs Assessment as part of the King County Hospitals for a Healthier Community (HHC). HHC is a collaborative of all 12 hospitals and health systems in King County and Public Health-Seattle & King County. The HHC members joined together to identify important health needs and assets in the communities they serve. This shared approach avoids duplication and focuses available resources on a community's most important health needs. Primary data sources took into account input from people who represent the broad interest of the communities served by HHC hospitals and health systems. Stakeholders included representatives of medically underserved, low-income and minority populations, populations with chronic disease needs, local health departments, human service providers, government staff, fire departments, law enforcement, advocacy organizations, hospital staff, groups focused on health disparities, faith communities, labor, and managed care organizations. A total of 11 coalitions and 99 individual organizations or key informants provided information.Secondary data was collected from a variety of local, county and state sources to present a community profile, birth indicators, leading causes of death, access to care, chronic disease, communicable disease, health behaviors, social issues and school and student characteristics. When available, these data sets were presented in the context of King County and Washington, framing the scope of an issue as it relates to the broader community.In addition, the Hospital conducted targeted interviews to gather information and opinions from persons who represent the broad interest of the community served by the hospital. The report includes benchmark comparison data, comparing the Hospital community data findings with Health People 2020 objectives. Part VI - Patient Education of Eligibility for Assistance Information about assistance programs starts at the point of registration. Placards describing the financial assistance programs are at all admitting registration desks. Financial assistance can take the form of assistance in qualifying for Medicaid, charity, or prompt pay discounts. Financial counselors are available to discuss the financial arrangements for all patients and they discuss the financial assistance program. The Financial counselors will also assist patients in completing the Hospital's charity care application if the patient brings in information and needs help completing the application. The Hospital engages an outside company to assist patients with applying for Medicaid. General information about the assistance programs is then included as part of each patient statement that is sent to a patient and includes the phone number of the Patient Financial Services department to call for assistance. In addition, as part of the account follow up, Patient Financial Service Representatives will call patients after their second statement and will discuss patient financial assistance as part of the call. Overlake's charity care policy is posted on the Washington State Department of Health's website and on the Hospital's website. Part VI - Community Information The Hospital's primary service area is East King County which is bounded by Lake Washington to the west and the Cascade Mountains to the east and extends north to the King County line, near the City of Bothell, and south to Black Diamond. It has a population base of approximately 901,064 residents with an ethnic makeup of 70% white, 19% Asian, 3% African American, 8% other. 12% of the residents are 65 or older and another 28% in the 45 to 64 age bracket.The median household income was $94,002. However, 6.4% of the population was living at or below 100% of the federal poverty level during the 5 year average period from 2008-2012. 15.1% were living at or below 200% of the federal poverty level. 8.6% of adults and 2.2% of children in the community are uninsured. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The Hospital staff participates in the county wide disaster preparedness group and is the back up to Harborview Medical Center. The Hospital has an open medical staff model. The Hospital operates an active screening program in which we offer free health screenings at least four times annually at community events. The largest one is the annual Overlake Eastside Vitality Community Health Fair in which we provide over 2,000 free screenings including cholesterol, stroke risk, diabetes, and skin cancer. Screening results and free counseling are provided at the events. Those who need to see a physician are given a list of providers, including community medical clinics. Part VI - Additional Information Part I, Line 3cIn addition to the FPL criteria, there is a residency requirement to either be a resident of the state of Washington or meet an exception for non residents. Non residents may be eligible for financial assistance while receiving services within the Emergency department or as a result of a direct admission from the Emergency Department. Exceptions to the Washington State residency requirement also include refugees, asylees, and those seeking asylum that possess and can present INS documentation.Part I, Line 7The costing methodology for charity care and unreimbursed Medicaid was the cost to charge method using the cost to charge ratio derived from worksheet 2. The community health improvement cost, health professional education, research and cash and in-kind contributions are direct cost and do not include any indirect cost. The cost for subsidized health services is derived from a cost accounting system that addresses all patient segments. true American Cancer Society 2120 1st Ave N Seattle WA 98109 131788491 501(c)3 13110 0 Sponsor American Heart Association P O Box 50085 Prescott AZ 86304 135613797 501(c)3 20000 0 Sponsor Bellevue Arts Museum 510 Bellevue Way Bellevue WA 98004 916028261 501(c)3 40000 0 Sponsor Bellevue Chamber of Commerce 330 112th Ave NE Ste 100 Bellevue WA 98004 910533602 501(c)6 23000 0 Sponsor Bellevue Schools Foundation P O Box 40644 Belleve WA 98015 911080997 501(c)3 10000 0 Sponsor Issaquah Schools Foundation P O Box 835 Issaquah WA 98027 943050254 501(c)3 10000 0 Sponsor Kirkland Downtown Association 440 Central Way Kirkland WA 98033 911943529 501(c)3 10000 0 Sponsor March of Dimes Foundation 1904 3rd Ave Ste 230 Seattle WA 98101 131846366 501(c)3 23000 0 Sponsor Northwest Healthcare Response 7100 Fort Dent Way Ste 210 Tukwila WA 98188 463002271 501(c)3 30000 0 Sponsor Overlake Hospital Auxiliaries 1035 116th Ave NE Bellevue WA 98004 237297831 501(c)3 74565 0 Support Operations Overlake Hospital Foundation 1035 116th Ave Ne Bellevue WA 98004 911050325 501(c)3 2063203 0 Support Operations 10 1 Grantmaker's Description of How Grants are Used Overlake Hospital Medical Center performs the record keeping for Overlake Hospital Foundation and Overlake Hospital Auxiliaries and monitors its operating expenses as part of the monthly financial review process. The grants are reimbursement for expenses already incurred.Grants to sponsor events of non profit organizations are not monitored beyond verifying that the event occurred. X X X X X false true false false false false false true false false Abhineet Chowdhary MD Neurosurgeon 932013 150000 25941 15900 8273 1132127 Andrew Tokar Interim CFO 171442 12932 879 6586 7445 199284 Caitlin H Moulding Former Key Employee 271908 50645 57818 65296 9797 455464 33614 David Knoepfler Vice President 406535 90415 7684 84429 12437 601500 David Schultz Former Officer 203588 203588 201508 Dennis Rochier OMC CEO 241228 5319 38047 4070 288664 Derek Rodrigues MD Cardiologist 761877 225977 17941 15900 18629 1040324 Frank Bishop MD Neurosurgeon 704764 61074 5365 15900 18629 805732 Gary McLaughlin CFO thru6/23/17 467970 108430 91313 126455 13892 808060 61411 J Michael Marsh President & CEO 703664 193068 21123 147126 17801 1082782 Julie Clayton Vice President 272717 56959 15212 52062 12149 409099 Richard Bryan Vice President 268992 51322 52950 66684 12305 452253 30093 T D Sam Baxter Vice President 215671 36656 34848 77461 12149 376785 20440 Thien Nguyen MD Bariatric Surgeon 598992 150760 4490 21200 18629 794071 Thomas Debord COO 410836 92310 25896 78199 17801 625042 Valerie Chrusciel OMC COO 203481 40832 11066 39517 8976 303872 William Reece MD Rad. Oncologist 586572 143216 7097 21200 13253 771338 Part I, Line 7: Non-Fixed payments not listed above Management incentive for the CEO, COO and Vice Presidents are contingent on Overlake Hospital Association's consolidated net operating income for the fiscal year being at least 80% of the net operating income budget. The incentive payment is then based on a combination of meeting organizational and individual goals. The incentive payments are approved by the Governance Committee of the Board.Incentives were paid to Derek Rodrigues, Thien Nguyen and William Reece based on productivity and meeting certain individual quality goals. Incentives were paid to Abhineet Chowdhary and Frank Bishop based on meeting certain individual quality goals. A WA Health Care Facilities Authority 911108929 93978E7P1 2010-04-14 99229484 See Part VI false false false B WA Health Care Facilities Authority 911108929 93978HKJ3 2014-08-06 58116440 Refund prior issue-6/8/05 false false false A 5220000 99230954 1660010 210770 20000000 77360174 2010 true false true true B 6260000 58151860 825678 60425 57265757 2008 false true true true A false true false false 0.00110 0.00110 false true 0.01210 false true B false true false false 0.00140 0.00140 false true 0.00550 false true A false false true true false false false true B false false false true false false false true A true B true Part VI Schedule K, Part IV, Arbitrage, Line 2c:(a) Issuer Name: Washington Health Care Facilities Authority Date the Rebate Computation was Performed: 08/06/2014.(a) Issuer Name: Washington Health Care Facilities Authority Date the Rebate Computation was performed: 07/01/2015.Note regarding the rebate computations: Since the bond proceeds have been spent, and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary.Part I, Line A, Column (f) - Construction of facilities & partially refund prior issue (06/08/05)Part II, Line 3, - The total proceeds do not agree to the issue price in Part I, Column (e) due to investment earnings. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Overlake Hospital Association has the right to appoint and remove Overlake Hospital Medical Center's Trustees. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Overlake Hospital Association, must approve: (a) any sale or lease of all or substantially all of the assets of the corporation;(b) any increased indebtedness exceeding five percent of the gross patient service revenue during a fiscal year of the corporation;(c) the annual budget of the corporation and any material amendments thereto;(d) the auditors of the corporation; and(e) any amendments to the articles of incorporation and bylaws of the corporation. Form 990, Part VI, Line 11b: Form 990 Review Process The 990 is prepared internally and reviewed by an independent accounting firm. The 990 is then reviewed by the President & CEO, CFO, Chief Human Resources and Compliance Officer, and Overlake Hospital Medical Center Finance Committee. The 990 is sent to the Overlake Hospital Medical Center Board members prior to submission to the IRS. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Board members and management annually sign a statement which affirms that such person: 1) has received a copy of the Conflict of Interest Policy2) has read and understands the policy3) has agreed to comply with the policy, and4) understands that the corporation is a charitable organization and that in order to maintain their federal tax exemption they must avoid conflicts of interest and engage primarily in activities which accomplish one or more of their tax-exempt functions.A list of all financial interests or other relationships with any organization that has, or can reasonably expected to have, a transaction with the corporation, competes against the corporation, or whose interest materially conflicts with the interest of the corporation is submitted annually to the Overlake Hospital Medical Center Compliance Officer for review. The Compliance Officer summarizes any conflicts of interest and discusses these results with the Chair of the Audit & Compliance Committee, CEO and General Counsel. This information is also shared with the Chair, Committee Chairs, and the CFO. At Board Meetings, members are expected to recuse themselves from voting on issues when there is a conflict of interest. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management Overlake's policy and process for Executive Compensation is fully documented in the "Executive Compensation Administration and Compliance Manual" which was last updated in November of 2016. This manual details the charter of the Compensation Committee of the Board, the compensation philosophy and how salary increases, incentives and benefits and perquisites are administered. Compensation Committee members are independent board members as required by the Charter and By-laws. The process includes an independent consultant who works directly for the Compensation Committee and review of comparable data from external sources. All compensation related decisions for the CEO, COO and other executives are discussed, deliberated and voted on by the Compensation Committee and documented in the minutes of the meeting. The compensation and incentive payment of the CEO is reviewed and approved by the full Board. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Overlake Hospital makes its disclosure of governing documents, conflict of interest policy, and audited financial statements available through the Hospital's administration office. The Overlake Hospital Association consolidated financial statements are also available on the Overlake Medical Center's website. Other Changes In Net Assets Or Fund Balances - Other Increases Adjustment in Pension Liability = $4138070 Form 990, Part I Line 6 - Volunteers Volunteers provided 37,221 hours of service to Overlake Hospital Medical Center during the year. Volunteers provide assistance for patients and guests at point of entry with information, way-finding, and transportation services. In the nursing units, volunteers help answer call lights and provide comfort to support and facilitate the physical, emotional, mental and spiritual health and self-healing of the patient. Included in the total volunteers are 15 board members that volunteered their time as board members during the year. Form 990, Part IV Line 12 - Fin. Stmts The financial statements of Overlake Hospital Medical Center are audited on a consolidated basis. This IRS Form 990 for Overlake Hospital Medical Center only contains the activities of the Hospital and Clinics while the activities of other related organizations are reported on separate IRS Form 990s. Form 990, Part V Line 7g & 7h Overlake Hospital Medical Center did not receive any contributions of intellectual property, cars, boats, airplanes, or other vehicles. Form 990, Part VII Section A, Line 1a Jim Doud was Secretary from July 2016 to December 2016 and Robert Campbell was Secretary from January 2017 to June 2017.Gary McLaughlin was Chief Financial Officer from July 01, 2016 to June 23, 2017. Andrew Tokar was Interim Chief Financial Officer from June 26, 2017 to June 30, 2017. 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