2015-05-05T15:46:09-07:00 2014-06-30 Clark Nuber PS 10900 NE 4th St Ste 1700 Bellevue WA 98004 990 2013-07-01 910652651 OVERLAKE HOSPITAL MEDICAL CENTER OVER 4256885000 1035 116th Ave NE Bellevue WA 98004 Gary McLaughlin CFO 2015-05-05 true Sara Elizabeth J Hyre P00235495 4254544919 2013 2016-03-07 17:11:31Z J Michael Marsh 1035 116th Ave NE Bellevue WA 98004 471798477 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. 17 17 2995 545 1322307 -114428 3427381 3909161 416612006 425617699 26564756 16764851 4152115 5192030 450756258 451483741 1337853 1259976 0 221074739 223320993 0 0 194173446 193334099 416586038 417915068 34170220 33568673 610805572 691544890 256501985 279296499 354303587 412248391 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 332599935 425433888 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 17,207 patients admitted for inpatient medical care for a total of 62,005 patient days. There were 225,242 outpatient visits out of which 43,844 were for emergency care visits. The Hospital delivered 3,551 babies. Overlake Medical Clinics provided 198,288 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 6,683 patients who are uninsured or under insured in the amount of $20,230,000 (estimated cost of $6,741,000). The Hospital provided care to Medicaid patients at rates below the cost of providing services. The payments were less than cost by $9,541,000. In keeping with the Hospital's spirit of giving back to the community, it provided a total of $5,041,000 of community benefit service activities. Overlake Staff spent 3,708 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, 2013 at the Kirkland, Issaquah and Redmond clinics and at the main campus. There were 180 volunters, physicians and staff who helped provide free screenings, tours and overall community goodwill. More than 1,000 participants received 3,662 services and screenings. 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 solidified its place as the leader and provider of the most comprehensive array of cardiac services available to Eastside patients by opening the state-of-the-art David and Shelley Hovind Heart & Vascular Center in August 2013. Overlake Hospital's Cardiac services can be accessed in one convenient location. The new Heart & Vascular Center brings all our people and services in interventional cardiology together, including electrophysiology, cardiac catheterization, interventional radiology and a 15-bed patient care unit. 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. Overlake has been a nationally recognized leader in the cancer center since 1974. 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, families who prefer us for their comprehensive healthcare and through many national awards. Two leading national organizations focused on improving safety and quality in America's hospitals have recognized Overlake Medical Center's efforts to improve care for patients. Overlake was honored with an "A" Hospital Safety Score by The Leapfrog Group, an independent nonprofit organization and advocate for patient safety nationwide. Overlake was the only Eastside hospital to receive Leapfrog's "A" Grade. In addition, Overlake Medical Center earned "Top Performer on Key Quality Measures" recognition from The Joint Commission, the leading accreditor of healthcare organizations in America, for its exemplary performance in using evidence-based clinical processes to improve patient care for heart attack, heart failure, pneumonia and surgical patients. 1660785 183811 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 38,317 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. The Hospital provided 14,720 nursing education hours on a wide range of topics to internal and external staff and nursing residents. 1259976 1259976 Other Grants and Allocations - Grants to Overlake Hospital Foundation and Overlake Hospital Auxiliaries to cover expenses and Grants to others for Community events. 335520696 true true false true false false false false false false true false false true true false false true false false false false false false false false true true true false true true false true false false false false false false false false false false false false true true true true false false true 247 0 true 2995 true true false false false false false false 0 false false false false false false false false false false X 17 17 false false false false true true true true true false false true true true true true true true true true true X Eric Teshima 4256885149 1231 116th Ave Ste 600 Bellevue WA 980044687 X John Hayhurst Chairman 10.00 0.50 X X 0 0 0 Jim Doud Secretary 3.00 3.00 X X 0 0 0 Patricia Bedient Treasurer 2.00 1.00 X X 0 0 0 Cecily Hall Imm Past Chair 5.00 5.00 X X 0 0 0 Bertrand Valdman Imm Past Chair 2.00 2.00 X X 0 0 0 Robert Campbell Trustee 2.50 2.50 X 0 0 0 Jorge Cerda Trustee 2.00 2.00 X 0 0 0 Gregory Collins Trustee 1.00 1.00 X 0 0 0 Janine Florence Trustee 2.00 0.50 X 0 0 0 Kemper Freeman Jr Trustee 1.00 0.50 X 0 0 0 David Hovind Trustee 3.00 3.00 X 0 0 0 Linda Mahaffey Trustee 2.00 2.50 X 0 0 0 Douglas Martin Trustee 1.00 1.00 X 0 0 0 Lani Mobius Trustee 2.00 4.00 X 0 0 0 Nolan Newman Trustee 1.50 1.50 X 0 0 0 Russell Stockdale Trustee 2.00 0.50 X 0 0 0 Thomas Stoll MD Trustee 1.50 1.50 X 0 0 0 Tim Wan Trustee 2.00 0.50 X 0 0 0 J Michael Marsh President & CEO 50.00 20.00 X 0 0 0 Craig Hendrickson President & CEO 50.00 20.00 X 947014 0 221693 David Schultz Vice Pres & COO 50.00 0.00 X 451453 0 102817 Gary McLaughlin Vice Pres & CFO 40.00 20.00 X 559660 0 145531 Richard Bryan Vice President 60.00 0.00 X 322363 0 81599 T D Sam Baxter Vice President 55.00 0.00 X 242913 0 91918 Caitlin Hillary-Moulding Vice President 55.00 0.00 X 341838 0 78400 Julie Clayton Vice President 55.00 0.00 X 276116 0 63448 Kathryn Crossland MD Medical Oncologist 40.00 0.00 X 902257 0 22109 John Walter Smith MD Medical Oncologist 40.00 0.00 X 717945 0 22109 Abhineet Chowdhary MD Neurosurgeon 40.00 0.00 X 696344 0 22205 John Heywood MD Cardiologist 40.00 0.00 X 690743 0 31775 David Nelson MD Cardio-Thoracic 40.00 0.00 X 684402 0 30917 Jody Albright Vice President & CIO 48.00 0.00 X 487224 0 49362 7320272 963883 368 true true false Gall Landau Young Construction Co P O Box 6728 Bellevue WA 98008 Construction 13037689 Epic Systems Corporation P O Box 88314 Milwaukee WI 532880314 Software Developer 7966754 Denali Advanced Integration 17735 NE 65th St Redmond WA 98052 IT Support Services 3100903 Puget Sound Blood Center 921 Terry Avenue Seattle WA 981041256 Blood Services 2901967 Aldrich & Associates Inc 810 240th St SE Bothell WA 980219397 Construction 2646108 81 3909161 3909161 Education Services 611710 183811 183811 Medicare/Medicaid Payment 900004 152300049 152300049 Non Government Payments 900004 267456969 267456969 Other Program Services 900004 4401594 4401594 Program Related Invstmnts 900004 1275276 1275276 425617699 5974947 5974947 0 0 351469 351469 351469 351469 30874649 4866 20008198 81413 10866451 -76547 10789904 10789904 0 0 276739 225125 51614 51614 Cafeteria/Catering 722210 2423598 553647 1869951 Laboratory 621500 1750223 768660 981563 Parking Revenue 812930 317488 317488 297638 297638 4788947 451483741 425617699 1322307 20634574 1259976 1259976 0 0 0 3811610 1008734 2802876 0 176346012 145774448 30571564 10628326 8874584 1753742 19778935 15471176 4307759 12756110 10539665 2216445 0 702029 46770 655259 329259 329259 120309 120309 0 170823 170823 36678155 27547584 9130571 1521121 26446 1494675 7188682 4224294 2964388 8313110 8313110 0 14752375 10673438 4078937 490740 230094 260646 0 406973 371027 35946 9873389 9873389 0 33931020 23148300 10782720 5738109 4635219 1102890 Medical Supplies 64648151 64573069 75082 B & O Tax 4595569 4595569 Licenses & Membership Dues 2050009 1363826 686183 Medicaid Prov Assessmnt 1102403 1102403 721873 180685 541188 417915068 335520696 82394372 0 14388882 24592527 24834303 25942620 0 52498332 51076404 0 0 285000 275003 6417354 7284247 11054208 21020773 446203865 225284872 224915153 220918993 261934346 295984802 0 2841694 2905768 5366330 4466666 6269970 37077087 610805572 691544890 67318096 79823606 9807498 178539468 173117249 140650 10503771 16548146 256501985 279296499 X 353990502 410595788 313085 1652603 354303587 412248391 610805572 691544890 X 33568673 21296887 3079244 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 46852 Millennia Public Affairs Inc 21127 47th Dr SE Bothell WA 98021 911809445 63336 American Hospital Association P O Box 34936 Seattle WA 98124 10121 false false false false false false true 56973 false true 63336 120309 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 211466334 84668892 126797442 4618177 3792249 825928 226277712 136823731 89453981 1690501 1690501 220918993 Prof Liability Insurance Receivable 34917959 Receivable from Affiliates 1232097 Remaining Other Assets 927031 37077087 Other Long Term Liabilities 78699 Prof Liability Insurance Reserve 14658968 Workers' Comp Reserve 1810479 16548146 true true X true X true X true true false false true true 6740709 6740709 0.01610 21089031 11547712 9541319 0.02280 27829740 11547712 16282028 0.03890 1174886 133194 1041692 0.00250 2234254 166517 2067737 0.00490 2872978 1259402 1613576 0.00390 426765 327498 99267 0.00020 283567 65245 218322 0.00050 6992450 1951856 5040594 0.01200 34822190 13499568 21322622 0.05090 false 4251405 3231068 61634328 75686248 -14051920 X true true Overlake Surgery Center LLC Ambulatory Surgical Svcs 0.33000 0.67000 1 1 Overlake Hospital Medical Ctr 1035 116th Ave NE Bellevue WA 98004 overlakehospital.org X X X X X Overlake Hospital Medical Ctr 1 true X X X X X X X X 14 true false true X overlakehospital.org/about-us/ X X X X X X false false false true true 200.0000 true 400.0000 true X X X true true X X X true false true X false false Part V, Line 3 - Account Input from Person 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 7 - 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 12h - Other Factors Used in Determing Amounts Charged Patients The percentage discount used to determine the amount patient is responsible for increases based on the amount of the charges before the discount. Part V, Line 14g - Other Means Hospital Facility Publicized the Policy A clear, concise summary of the financial assistance application process and the contact information of the office that can assist with the application process is posted at the emergency room, admitting office, and other admitting points of entry. The summary is provided to patients on admission to the hospital. The contact information of the office that can assist with the application process is included on the bill. The website address for the policy will be added to the bill in fiscal 2015. 19 OMC-CardiologyPulmonology 1135 116th Ave NE Ste 600 Bellevue WA 98004 Cardiology/Pulmonology OMC-Urgent Care Issaquah 5708 E Lk Sammamish Pkwy Ste 100 Issaquah WA 98029 Urgent Care OMC-Urgent CarePulmonology Redmond 17209 Redmond Way Redmond WA 98052 Urgent Care/Pulmonology OMC-Medical Tower Primary Care 1135 116th Ave NE Ste 110 Bellevue WA 98004 Primary Care OMC-Cardiology Bellevue 1414 1414 116th Ave NE Ste E Bellevue WA 98004 Cardiology OMC-Downtown Bellevue Primary Care 400 108th Ave NE Ste 100 Bellevue WA 98004 Primary Care OMC-Medical Oncology 1135 116th Ave NE Ste 230 Bellevue WA 98004 Oncology OMC-Primary Care & Specialty Clinic Issaquah 5708 E Lk Sammamish Pkwy Ste 105 Issaquah WA 98027 Primary Care/Bariatric Surgery/Weight Loss OMC-Radiation Oncology 1135 116th Ave NE Ste 160 Bellevue WA 98004 Oncology OMC-Cardiac Surgery 1135 116th Ave NE Ste 605 Bellevue WA 98004 Cardiac Surgery OMC-Bariatric Surgery 1231 116th Ave Ne Ste 515 Bellevue WA 98004 Bariatric Surgery/Weight Loss OMC-Breast Surgery 1135 116th Ave NE Ste 180 Bellevue WA 98004 Breast Surgery OMC-Primary CareCardiology Redmond 16315 Ne 74th St Redmond WA 98052 Primary Care/Cardiology OMC-Gilman Primary Care 450 NW Gilman Blvd Ste 201 Issaquah WA 98027 Primary Care OMC-PulmonologyCardiology Issaquah 1740 NW Maple Ste 207 Issaquah WA 98027 Pulmonology/Cardiology OMC-Primary CareCardiology Kirkland 290 Central Ave Kirkland WA 98033 Primary Care/Cardiology OMC-Outpatient PTOccupational Therapy & Speech 1417 116th Ave NE Ste 110 Bellevue WA 98004 Physical Therapy/Occupational Therapy/Speech OMC-Nutrition Services & Senior Health Center 1750 112th Ave NE Ste A101 Bellevue WA 98004 Nutrition/Geriatric OMC-Neurosurgery 1231 116th Ave NE Ste 535 Bellevue WA 98004 Neurosurgery Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The Hospital and the Clinics provide an allowance for potential uncollectible patient accounts receivable whereby such receivables are reduced to their estimated net realizable value. The Hospital estimates this allowance based on the aging of accounts receivable, historical collection experience by payor, and other relevant factors. The Clinics estimates this allowance based on the historical collection experience by clinic and other relevant factors. There are various factors that can impact the collection trends, such as changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients, the increased burden of co-insurance, and deductibles to be made by patients with insurance and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process. The bad debt expense on Schedule H, Part III, lines 2 and 3 are estimated based on the cost to charge ratio. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The Hospital believes that approximately 76% 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 14-15,section 6. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The costing methodology for Medicare allowable cost is derived from FY 2014 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 The Hospital conducted a community needs assessment in June 2014 and is using this as the primary basis for assessing the community health needs in the future. In addition, the Hospital distributes feedback forms in all our classes and at our major events, such as our annual community health fair. These forms ask attendees a range of questions, including what other classes or services people would like us to offer. We also include an item in every issue of Healthy Outlook asking people to contact us if they have requests for particular health classes or lectures. Finally, we maintain relationships with other area non-profits and work with them when they identify specific community health needs (e.g. stroke screenings at Hopelink). Part VI - 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 patients brings in information and needs help completing the application. The Hospital engages an outside company to assist patients with applying for Medicaid. General information about the assistance programs is then included as part of each patient statement that is sent to a patient and includes the phone number of the Patient Financial Services department to call for assistance. In addition, as part of the account follow up, Patient Financial Service Representatives will call patients after their second statement and will discuss patient financial assistance as part of the call. Overlake's charity care policy is posted on the Washington State Department of Health's website and on the Hospital's website. Part VI - 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 the City of Renton. It has a population base of approximately 872,339 residents with an ethnic makeup of 67% white, 18% Asian, 8% Hispanic, 7% other. 12% of the residents are 65 or older and another 28% in the 45 to 64 age bracket. 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 3,662 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 - States Where Community Benefit Report Filed WA Part VI - Additional Information 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 Amercian Cancer Society 2120 1st Ave N Seattle WA 98109 131788491 501 (c) (3) 10000 0 Sponsor American Heart Association P O Box 4002030 Des Moines IA 50340 135613797 501 (c) (3) 10000 0 Sponsor American Red Cross P O Box 3097 Seattle WA 98114 530196605 501 (c) (3) 10000 0 Sponsor Bellevue Arts Museum 510 Bellevue Way NE Bellevue WA 98004 916028261 501 (c) (3) 15000 0 Sponsor Bellevue Chamber of Commerce 302 Bellevue Square Bellevue WA 98004 910533602 501 (c) (3) 7500 0 Sponsor Group Health Foundation P O Box 34015 Seattle WA 98124 910511770 501 (c) (3) 10000 0 Sponsor Issaquah Schools Foundation P O Box 835 Issaquah WA 98027 943050254 501 (c) (3) 10000 0 Sponsor Kirkland UncorkedBold Hat Pr 3503 Phinney Ave N Seattle WA 98103 912152615 501 (c) (3) 8273 0 Sponsor March of Dimes 1904 3rd Ave Ste 230 Seattle WA 31193 131846366 501 (c) (3) 10000 0 Sponsor Overlake Hospital Auxiliaries 1035 116th Ave NE Bellevue WA 98004 237297831 501 (c) (3) 95711 0 Support Operations Overlake Hospital Foundation 1035 116th Ave Ne Bellevue WA 98004 911050325 501 (c) (3) 1026918 0 Support Operations 11 0 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. X true true X X X X X true true false false false false false true false false Abhineet Chowdhary MD Neurosurgeon 634795 40250 21299 15300 6905 718549 Caitlin Hillary-Moulding Vice President 278656 28949 34233 72004 6396 420238 29205 Craig Hendrickson President & CEO 656547 101990 188477 208246 13447 1168707 159091 David Nelson MD Cardio-Thoracic 632032 47857 4513 15300 15617 715319 David Schultz Vice Pres & COO 362988 47357 41108 87205 15612 554270 16549 Gary McLaughlin Vice Pres & CFO 427922 54277 77461 129919 15612 705191 52808 Jody Albright Vice President & CIO 222502 28525 236197 44032 5330 536586 127905 John Heywood MD Cardiologist 661277 24000 5466 15300 16475 722518 John Walter Smith MD Medical Oncologist 474869 233919 9157 15300 6809 740054 Julie Clayton Vice President 246266 19688 10162 52972 10476 339564 Kathryn Crossland MD Medical Oncologist 679876 198835 23546 15300 6809 924366 Richard Bryan Vice President 261632 31500 29231 71399 10200 403962 22427 T D Sam Baxter Vice President 194506 19743 28664 81445 10473 334831 18085 Part I, Line 1a: Relevant information in regards to selections on 1a. 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 100% 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 Kathryn Crossland and John Walter Smith, based on productivity and meeting certain individual quality goals. Incentive were paid to Abhineet Chowdhary, John Heywood and David Nelson based on meeting certain individual quality goals. A WA Health Care Facilities Authority 911108929 93978EWQ1 2003-06-19 22708358 Refund Prior Issue 12/13/89 false false false B WA Health Care Facilities Authority 911108929 93978EYZ9 2005-06-08 162497935 Construction of Facility true false false C WA Health Care Facilities 911108929 93978E7P1 2010-04-14 99229494 See Part VI false false false A 17545000 22708445 371287 966000 21371159 1990 true false true true B 89465000 169310007 6516846 852750 2136381 8175568 145694524 2008 false false true true C 1305000 99229743 8292901 1660010 210770 20000000 75000000 2010 true false true true B false true false false 0.00110 0.00110 false false true C false false false false false false true A false false true true false false false true B false false false true false true IXIS Funding Corp 3.1000 true false true C false true true false false false false true A true B true C true Part VI Schedule K, Part IV, Arbitrage, Line 2c:(a) Issuer Name: Washington Health Care Facilities Authority Date the Rebate Computation was Performed: 12/19/2003.(b) Issuer Name: Washington Health Care Facilities Authority Date the Rebate Computation was Performed: 05/31/2010.Note regarding the rebate computation on 12/19/2003: Since the bond proceeds have been spent, a spending exception was met, and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary.Part I, Line A, Column (c) - cusip - 93978E WQ1/WR9Part I, Line B, Column (c) - cusip - 93978E YZ9 / YL0 / YF3 / YG1Part I, Line C, Column (f) - Construction of facilities & partially refund prior issue (6/8/05)Part II, Line 3 - The total proceeds do not agree to the issue price in Part I, Column (e) due to investment earnings.Part II, Line 3 - The total proceeds do not equal the summation of Lines 4-12 due to transferred or replacement proceeds in line 4.Part IV, Line 2c, Column A - The date is 7/15/08Part IV, Line 2c, Column B - The date is 7/15/10 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Overlake Hospital Association is the sole member of Overlake Hospital Medical Center. 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, as sole member, must approve: (a) any sale or lease of all or substantially all of the assets of the corporation;(b) any increased indebtedness exceeding five percent of the gross patient service revenue during a fiscal year of the corporation;(c) the annual budget of the corporation and any material amendments thereto;(d) the auditors of the corporation; and(e) any amendments to the articles of incorporation and bylaws of the corporation. Form 990, Part VI, Line 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, VP System Change Management & CCO, VP Human Resources, 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 signs a statement which affirms that such person: 1) has received a copy of the Conflict of Interest Policy2) has read and understands the policy3) has agreed to comply with the policy, and4) understands that the corporation is a charitable organization and that in order to maintain their federal tax exemption they must avoid conflicts of interest and engage primarily in activities which accomplish one or more of their tax-exempt functions.A 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, Overlake Hospital Medical Center VP Human Resources and General Counsel. This information is also shared with the Chair, Chair-Elect, Committee Chairs, and the CFO. At Board Meetings, members are expected to recuse themselves from voting on issues when there is a conflict of interest. Form 990, Part VI, Line 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". This manual details the charter of the Compensation Committee of the Board, the compensation philosophy and how salary increases, incentives and benefits and perquisites are administered. Compensation Committee members are independent board members as required by the Charter and By-laws. The process includes an independent consultant who works directly for the Compensation Committee and a review of comparable data from external sources. All compensation related decisions for the CEO, COO and Vice Presidents are discussed, deliberated and voted on by the Compensation Committee and documented in the minutes of the meeting. The last compensation review was completed in December, 2013. 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 Medical Center 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 = $3079244 Form 990, Part I Line 6 - Volunteers Volunteers provided 43,328 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 18 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 while the activities of the 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 Line 1a (19) & (20) Compensation of Officers Craig Hendrickson was President & CEO through April 2014. J. Michael Marsh was President & CEO effective April 2014. Overlake Medical Clinics LLC 1035 116th Ave NE Bellevue WA 98004 911932954 Medical Clinics WA 31820915 18079015 Overlake Hospital Medical Center Overlake Hospital Foundation 1035 116th Ave NE Bellevue WA 98004 911050325 Fund Raising WA 501(c)(3) 7 Overlake Hospital Medical Center true Overlake Hospital Auxiliaries 1035 116th Ave NE Bellevue WA 98004 237297831 Fund Raising WA 501(c)(3) 7 Overlake Hospital Medical Center true Overlake Hospital Association 1035 116th Ave NE Bellevue WA 98004 911274134 Provide Support WA 501(c)(3) 11-Type II N/A true false true true false false false false false false false true false false true true false true false false Overlake Hospital Foundation b 1026918 Cash Overlake Hospital Foundation c 3165440 Cash Overlake Hospital Foundation n 72451 Cash Overlake Hospital Foundation o 225087 Cash Overlake Hospital Auxiliaries b 95711 Cash Overlake Hospital Auxiliaries c 743721 Cash Overlake Hospital Auxiliaries n 23056 Cash Overlake Hospital Auxiliaries o 139651 Cash Overlake Hospital Association k 5658073 FMV Overlake Hospital Association o 193865 Cash Overlake Hospital Association q 368850 Cash