OVERLAKE HOSPITAL FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- OVERLAKE HOSPITAL FOUNDATION (EIN 91-1050325)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-09
- IRS object ID
- 201841299349302869
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-09T13:12:14-07:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
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 | 2016-07-01 | 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 |
| Signature | 2018-04-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Sara Elizabeth J Hyre | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | 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 Ave NE | AddressLine1Txt |
| City | Bellevue | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,409,318 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| 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 | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 13 | TotalEmployeeCnt |
| Total Volunteers | 99 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $5,472,579 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,984,556 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $425,958 | PYInvestmentIncomeAmt |
| CY Investment Income | $434,622 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$291,647 | PYOtherRevenueAmt |
| CY Other Revenue | -$288,191 | CYOtherRevenueAmt |
| PY Total Revenue | $5,606,890 | PYTotalRevenueAmt |
| CY Total Revenue | $13,130,987 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,388,820 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,535,710 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $980,090 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,036,404 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $932,734 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $466,117 | PYOtherExpensesAmt |
| CY Other Expenses | $514,297 | CYOtherExpensesAmt |
| PY Total Expenses | $4,835,027 | PYTotalExpensesAmt |
| CY Total Expenses | $11,086,411 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $771,863 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,044,576 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,766,827 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,703,950 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $155,182 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $62,984 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,611,645 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,640,966 | 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 | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,535,710 | ExpenseAmt |
| Grant | $9,535,710 | GrantAmt |
| Desc | Overlake Hospital Foundation raised $11,102,473 in contributions / pledges from donors. The Foundation provided $9,535,710 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 | $9,535,710 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | Yes (true) | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 13 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Eric Teshima | PersonNm |
| Phone | 4256885149 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 |
|---|---|---|---|---|---|---|---|---|
| Tiffany Koenig | ||||||||
| Chairman | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jason Thompson | ||||||||
| Chairman | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Lauren Bennett | ||||||||
| Secretary | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jeff Wilcox | ||||||||
| Treasurer | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| David Goldstein | ||||||||
| Treasurer | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ted Herb | ||||||||
| Past Chair | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Lynnette Anderson | ||||||||
| Trustee | 0.25 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| Pauline Bach | ||||||||
| Trustee | 0.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Brittany Barker | ||||||||
| Trustee | 0.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Merrill Behnke | ||||||||
| Trustee | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Rachele Bouchand | ||||||||
| Trustee | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sarah Doud | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Patty Edwards | ||||||||
| Trustee | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| York Harris | ||||||||
| Trustee | 0.75 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Dan Kwon | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Warren Michelsen | ||||||||
| Trustee | 0.25 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Steve Nicholes | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Tara Reimers MD | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Cecille Schuman | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Julie Sun | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Anthony Welcher | ||||||||
| Trustee | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TJ Woosley | ||||||||
| Trustee | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Mary Beth Stearns | ||||||||
| Chf Dev Officer | 49.00 | 1.00 | Yes (X) | $281,127 | $5,738 | $62,138 | ||
| J Michael Marsh | ||||||||
| President & CEO | 10.00 | 50.00 | Yes (X) | $0 | $917,855 | $164,927 | ||
| Andrew Tokar | ||||||||
| Interim CFO | 1.00 | 54.00 | Yes (X) | $0 | $185,253 | $14,031 | ||
| Gary McLaughlin | ||||||||
| CFO | 1.00 | 49.00 | Yes (X) | $0 | $667,713 | $140,347 | ||
| Stephanie Stewart | ||||||||
| Dept. Director | 40.00 | 0.00 | $147,880 | $0 | $21,198 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $429,007 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,776,559 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $402,641 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $1,068,209 | FundraisingAmt |
| Related Organizations | $2,063,203 | RelatedOrganizationsAmt |
| All Other Contributions | $9,853,144 | AllOtherContributionsAmt |
| Noncash Contributions | $2,692,715 | NoncashContributionsAmt |
| Total Contributions | $12,984,556 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $388,459 | TotalRevenueColumnAmt |
| Exclusion | $388,459 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,799,976 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,753,813 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $46,163 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,163 | TotalRevenueColumnAmt |
| Exclusion | $46,163 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $202,227 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $1,068,209 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $518,718 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$316,491 | TotalRevenueColumnAmt |
| Exclusion | -$316,491 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $34,100 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $5,800 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,300 | TotalRevenueColumnAmt |
| Exclusion | $28,300 | ExclusionAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,130,987 | TotalRevenueColumnAmt |
| Exclusion | $146,431 | 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 | $9,535,710 | TotalAmt |
| Program Services | $9,535,710 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,172 | TotalAmt |
| Management And General | $116,069 | ManagementAndGeneralAmt |
| Fundraising | $174,103 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $579,064 | TotalAmt |
| Management And General | $195,670 | ManagementAndGeneralAmt |
| Fundraising | $383,394 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,851 | TotalAmt |
| Management And General | $37,457 | ManagementAndGeneralAmt |
| Fundraising | $73,394 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,317 | TotalAmt |
| Management And General | $19,030 | ManagementAndGeneralAmt |
| Fundraising | $37,287 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,757 | TotalAmt |
| Management And General | $48,757 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,730 | TotalAmt |
| Management And General | $44,835 | ManagementAndGeneralAmt |
| Fundraising | $219,895 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1 | TotalAmt |
| Fundraising | $1 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,699 | TotalAmt |
| Management And General | $13,358 | ManagementAndGeneralAmt |
| Fundraising | $44,341 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,366 | TotalAmt |
| Management And General | $1,103 | ManagementAndGeneralAmt |
| Fundraising | $263 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,240 | TotalAmt |
| Management And General | $100,240 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,766 | TotalAmt |
| Management And General | $1,721 | ManagementAndGeneralAmt |
| Fundraising | $45 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,402 | TotalAmt |
| Management And General | $4,402 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,454 | TotalAmt |
| Management And General | $13,454 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| Membership Dues | $21,668 | $21,668 | |
| Other Expenses | $214 | $203 | $11 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,086,411 | TotalAmt |
| Program Services | $9,535,710 | ProgramServicesAmt |
| Management And General | $617,967 | ManagementAndGeneralAmt |
| Fundraising | $932,734 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $983,868 | BOYAmt |
| EOY | $2,261,384 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,627 | BOYAmt |
| EOY | $24,461 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,414,275 | BOYAmt |
| EOY | $3,958,059 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $33,654 | BOYAmt |
| EOY | $35,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $430,868 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $430,868 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,454 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,280,751 | BOYAmt |
| EOY | $12,424,190 | 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) |
|---|---|---|
| BOY | $198 | BOYAmt |
| EOY | $187 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,766,827 | BOYAmt |
| EOY | $18,703,950 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,078 | BOYAmt |
| EOY | $8,874 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,104 | BOYAmt |
| EOY | $54,110 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,182 | BOYAmt |
| EOY | $62,984 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,882,368 | BOYAmt |
| EOY | $4,121,530 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,153,273 | BOYAmt |
| EOY | $8,789,861 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,576,004 | BOYAmt |
| EOY | $5,729,575 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,611,645 | BOYAmt |
| EOY | $18,640,966 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,766,827 | BOYAmt |
| EOY | $18,703,950 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,044,576 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $984,745 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | $4,075,063 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,879,176 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,855,340 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,472,579 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,984,556 | CurrentTaxYearAmt |
| Total | $35,266,714 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,075,063 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,879,176 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,855,340 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,472,579 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,984,556 | CurrentTaxYearAmt |
| Total | $35,266,714 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $10,596,728 | SubstantialContributorsTotAmt |
| Public Support Total170 | $24,669,986 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $221,391 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $410,511 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $501,345 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $376,417 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $388,459 | CurrentTaxYearAmt |
| Total | $1,898,123 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $37,164,837 | TotalSupportAmt |
| Public Support CY170 | 0.66380 | PublicSupportCY170Pct |
| Public Support PY170 | 0.75180 | 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 | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,965,973 | BeginningYearBalanceAmt |
| Contributions | $163,571 | ContributionsAmt |
| Investment Earnings Or Losses | $1,354,368 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$407,207 | OtherExpendituresAmt |
| End Year Balance | $12,076,705 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,134,453 | BeginningYearBalanceAmt |
| Contributions | $103,582 | ContributionsAmt |
| Investment Earnings Or Losses | $126,822 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$398,884 | OtherExpendituresAmt |
| End Year Balance | $10,965,973 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,133,164 | BeginningYearBalanceAmt |
| Contributions | $104,663 | ContributionsAmt |
| Investment Earnings Or Losses | $219,356 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$322,730 | OtherExpendituresAmt |
| End Year Balance | $11,134,453 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,681,908 | BeginningYearBalanceAmt |
| Contributions | $286,639 | ContributionsAmt |
| Investment Earnings Or Losses | $1,491,986 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$327,369 | OtherExpendituresAmt |
| End Year Balance | $11,133,164 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,373,334 | BeginningYearBalanceAmt |
| Contributions | $569,145 | ContributionsAmt |
| Investment Earnings Or Losses | $852,025 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$112,596 | OtherExpendituresAmt |
| End Year Balance | $9,681,908 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.29000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.47000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.24000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $154,803 | OtherCostOrOtherBasisAmt |
| Depreciation | $154,803 | DepreciationAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $276,065 | OtherCostOrOtherBasisAmt |
| Depreciation | $276,065 | DepreciationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Rev Etc Audited Fincl Stmt | $14,536,286 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $984,745 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$48,757 | OtherRevenueAmt |
| Revenue Not Reported | $935,988 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,600,298 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$469,311 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$469,311 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,130,987 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,506,965 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $469,311 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $469,311 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,037,654 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $48,757 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $48,757 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,086,411 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: Explanation of escrow account liability | Annuities are held in a custodial account (BNY Mellon). The assets and liability are reported on the balance sheet. |
| Part V, Line 4: Intended uses of the endowment fund. | Endowment distributions are used to support capital and operational needs of Overlake Hospital Medical Center as directed by the individual Endowment purpose. |
| Part XII, Line 2d: Other expenses and losses per audited F/S | Fundraising Expenses $469311 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Bandage Ball | Event1Nm |
| Gross Receipts Event1 | $971,796 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $796,839 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $174,957 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $190,629 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $127,002 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $87,749 | OtherDirectExpensesEvent1Amt |
| Event2 | Corp Lunch | Event2Nm |
| Gross Receipts Event2 | $298,640 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $271,370 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $27,270 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $78,747 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $27,852 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $6,739 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $1,270,436 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $1,068,209 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $202,227 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $269,376 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $154,854 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $94,488 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $518,718 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$316,491 | NetIncomeSummaryAmt |
Gaming Information GamingInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteer Labor Bingo | false | VolunteerLaborBingoInd |
| Volunteer Labor Pull Tabs | false | VolunteerLaborPullTabsInd |
| Gross Revenue Other Gaming | $34,100 | GrossRevenueOtherGamingAmt |
| Non Cash Prizes Other Gaming | $5,800 | NonCashPrizesOtherGamingAmt |
| Volunteer Labor Other Gaming | Yes (true) | VolunteerLaborOtherGamingInd |
| Volunteer Labor Other Gaming | 1.00000 | VolunteerLaborOtherGamingPct |
| Gross Revenue Total Gaming | $34,100 | GrossRevenueTotalGamingAmt |
| Non Cash Prizes Total Gaming | $5,800 | NonCashPrizesTotalGamingAmt |
| Direct Expense Summary Gaming | $5,800 | DirectExpenseSummaryGamingAmt |
| Net Gaming Income Summary | $28,300 | NetGamingIncomeSummaryAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | WA | StatesWhereGamingConductedCd |
| Licensed | Yes (true) | LicensedInd |
| License Suspended Etc | false | LicenseSuspendedEtcInd |
| Gaming With Nonmembers | Yes (true) | GamingWithNonmembersInd |
| Member Of Other Entity | false | MemberOfOtherEntityInd |
| Gaming Other Facility | 1.00000 | GamingOtherFacilityPct |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eric Teshima | BusinessNameLine1Txt |
Persons With Books US Address PersonsWithBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 - 116th Ave NE | AddressLine1Txt |
| City | Bellevue | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct With3rd Prty For Game Rev | false | CntrctWith3rdPrtyForGameRevInd |
| Gaming Manager Person | Mary Beth Stearns | GamingManagerPersonNm |
| Gaming Manager Services Prov | General oversight | GamingManagerServicesProvTxt |
| Gaming Manager Is Director Ofcr | Yes (X) | GamingManagerIsDirectorOfcrInd |
| Charitable Distribution Rqr | false | CharitableDistributionRqrInd |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | 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 Ave 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 | $9,535,710 | 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 | Grantmaker's Description of How Grants are Used | 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 | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Andrew Tokar | |||||||||||||
| Interim CFO | $171,442 | $12,932 | $879 | $6,586 | $7,445 | $199,284 | |||||||
| Gary McLaughlin | |||||||||||||
| CFO | $467,970 | $108,430 | $91,313 | $126,455 | $13,892 | $808,060 | $61,411 | ||||||
| J Michael Marsh | |||||||||||||
| President & CEO | $703,664 | $193,068 | $21,123 | $147,126 | $17,801 | $1,082,782 | |||||||
| Mary Beth Stearns | |||||||||||||
| Chf Dev Officer | $4,597 | $867 | $274 | $1,060 | $183 | $6,981 | $225,239 | $42,481 | $13,407 | $51,929 | $8,966 | $342,022 | |
| Stephanie Stewart | |||||||||||||
| Dept. Director | $137,417 | $10,298 | $165 | $9,108 | $12,090 | $169,078 | |||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7: Non-Fixed payments not listed above | FormAndLineReferenceDesc |
| Explanation | Management incentive for the Chief Development Officer is 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. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Julie Michelsen | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | See note below | RelationshipDescriptionTxt |
| Transaction | $43,390 | TransactionAmt |
| Transaction | Wages | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part V Supplemental Information | FormAndLineReferenceDesc |
| Explanation | (b) Relationship between interested person and the organization.Employee of organization and Family member of Warren Michelsen, a trustee. | ExplanationTxt |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 15 | ContributionCnt |
| Noncash Contributions Rpt F990 | $2,637,508 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | Auction Items | 86 | $49,407 | FMV |
| Yes (X) | Raffle Items | 2 | $5,800 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Overlake Hospital Medical Center is the sole member of Overlake Hospital Foundation. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Overlake Hospital Medical Center has the right to appoint and remove Overlake Hospital Foundation's Trustees. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Overlake Hospital Medical Center, as sole member, 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, 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 Chief Development Officer, President & CEO, CFO, Overlake Hospital Medical Center Chief Human Resources and Compliance Officer, and the Overlake Hospital Medical Center Finance Committee. A public disclosure copy is distributed to the Foundation 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 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, 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". 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, Gary McLaughlin and Andrew Tokar are paid by related affiliate Overlake Hospital Medical Center. The most recent compensation review was at the November 2016 Compensation Committee meeting. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Overlake's policy and process for Executive Compensation is fully documented in the "Executive Compensation Administration and Compliance Manual" which was last updated April 2012. This manual details the charter of the Compensation Committee of the Board, the compensation philosophy and how salary increases, incentives, benefits and prerequisites are administered. Compensation Committee members are independent board members as required by the Charter and By-laws. The process includes an independent consultant who works directly for the Compensation Committee and a review of comparable data from external sources. All compensation related decisions for the CEO, COO and Vice Presidents and Foundation Chief Development Officer are discussed, deliberated and voted on by the Compensation Committee and documented in the minutes of the meeting. Officers Craig Hendrickson and Gary McLaughlin are paid by related affiliate Overlake Hospital Medical Center. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | 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 I, Line 6 | Overlake Hospital Foundation had 22 board members that volunteered their time as board members during the year. Another 77 volunteers assisted with special events. |
| Form 990, Part V, Line 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 V, Line 7g and 7h | Overlake Hospital Foundation did not receive any contributions of intellectual property, cars, boats, airplanes, or other vehicles. |
| 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 VII, Section A, Line 1a | Jason Thompson was Board Chair from July 1, 2016 to November 3, 2016. Tiffany Koenig was Board Chair from January 11, 2017 to June 30, 2017. David Goldstein was Board Treasurer from July 1, 2016 to December 31, 2016. Jeff Wilcox was Board Treasurer from January 11, 2017 to June 30, 2017. Gary McLaughlin was Chief Financial Officer from July 1, 2016 to June 23, 2017. Andrew Tokar was Interim Chief Financial Officer from June 26, 2017 to June 30, 2017. |
| From 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Overlake Hospital Medical Center | ||||||||||
| 1035 - 116th Ave NE | Bellevue | WA | 98004 | 910652651 | Hospital | WA | 501(c)(3) | 3 | Overlake Hospital Association | false |
| Overlake Hospital Auxiliaries | ||||||||||
| 1035 - 116th Ave NE | Bellevue | WA | 98004 | 237297831 | Fund Raising | WA | 501(c)(3) | 7 | Overlake Hospital Medical Center | false |
| Overlake Hospital Association | ||||||||||
| 1035 - 116th Ave NE | Bellevue | WA | 98004 | 911274134 | Rent Medical and office space to Hospital | WA | 501(c)(3) | 11-Type II | NA | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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