OVERLAKE HOSPITAL FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
OVERLAKE HOSPITAL FOUNDATION (EIN 91-1050325)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-13
IRS object ID
201431339349304063
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-13T12:25:00-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Clark Nuber PSBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4th St Ste 1700AddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN911050325EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Overlake Hospital FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOVERNameControl
Phone4256885149Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11035 - 116th Avenue NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGary McLaughlinName
TitleCFOTitle
Date Signed2014-05-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSara Elizabeth J HyreName
PTINP00235495PTIN
Phone4257096200Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1Mary Beth StearnsBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11035 - 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11251907GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.overlakehospital.org/supportWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionThe 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees11TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year5451059ContributionsGrantsPriorYear
Contributions Grants Current Year4075063ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year225351InvestmentIncomePriorYear
Investment Income Current Year1257952InvestmentIncomeCurrentYear
Other Revenue Prior Year-25292OtherRevenuePriorYear
Other Revenue Current Year-47338OtherRevenueCurrentYear
Total Revenue Prior Year5651118TotalRevenuePriorYear
Total Revenue Current Year5285677TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4054765GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2744495GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year828794SalariesEtcPriorYear
Salaries Etc Current Year786257SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year614370TotalFundrsngExpCurrentYear
Other Expense Prior Year404496OtherExpensePriorYear
Other Expenses Current Year345946OtherExpensesCurrentYear
Total Expenses Prior Year5288055TotalExpensesPriorYear
Total Expenses Current Year3876698TotalExpensesCurrentYear
Revenues Less Expenses Prior Year363063RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1408979RevenuesLessExpensesCY
Total Assets BOY10192160TotalAssetsBOY
Total Assets EOY11203660TotalAssetsEOY
Total Liabilities BOY183414TotalLiabilitiesBOY
Total Liabilities EOY151803TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10008746NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11051857NetAssetsOrFundBalancesEOY
Mission DescriptionThe 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2744495Expense
Grants2744495Grants
DescriptionOverlake Hospital Foundation raised $2,856,035 in contributions / pledges from donors. The Foundation provided $2,744,495 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.Description
Total Program Service Expense2744495TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees11NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonEric TeshimaNamePerson
Telephone Number4256885149TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11231 - 116th Ave NE Suite 600AddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
TJ Woosley
Trustee1.500.00X000
James Wigfall
Trustee1.000.00X000
Peggy Swistak
Trustee1.000.00X000
Roger Stark MD
Trustee1.500.00X000
Susan Smith
Trustee1.000.00X000
Vandana Slatter
Trustee0.500.00X000
Tara Reimers
Trustee1.000.00X000
Sue Raschella
Trustee1.000.00X000
Mark Quehrn
Trustee0.500.00X000
John O'Rourke
Trustee2.000.00X000
Stephen Nicholes
Trustee2.000.00X000
Mary Mott
Trustee1.000.10X000
Warren Michelsen
Trustee0.500.00X000
Tiffany Koenig
Trustee1.000.00X000
David Knoepfler MD
Trustee0.500.00X033237325031
Alice Harris
Trustee1.000.00X000
Sergei Dreizin
Trustee0.500.00X000
Jody Cunningham
Trustee1.000.00X000
Philip Corneil
Trustee2.000.00X000
Ned Clapp
Trustee1.000.00X000
Lauren Bennett
Trustee1.000.00X000
Linda Mahaffey
Past Chair2.001.00X000X
Jason Thompson
Treasurer3.000.00X000X
Shirley Schumacher
Secretary5.000.00X000X
Ted Herb
Chair Elect0.500.00X000X
Peter Glidden
Chairman1.000.00X000X
Gary McLaughlin
VicePres/CFO5.0055.000577280134666X
Craig Hendrickson
President & CEO10.0060.000945820219065X
Mary Beth Stearns
Executive Dir.46.004.001800646002255185X
FieldValueIRS element (for citing)
Total Reportable Comp From Org180064TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1915495TotalReportableCompFrmRltdOrgs
Total Other Compensation433947TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns289FederatedCampaigns
Fundraising Events328959FundraisingEvents
Related Organizations1245278RelatedOrganizations
All Other Contributions2500537AllOtherContributions
Noncash Contributions334551NoncashContributions
Total Contributions4075063TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column221391TotalRevenueColumn
Exclusion$221,391ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6929203Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5892642Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1036561Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1036561TotalRevenueColumn
Exclusion$1,036,561ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events26250GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events328959CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses73588FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-47338TotalRevenueColumn
Exclusion-$47,338ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5285677TotalRevenueColumn
Exclusion$1,210,614ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2744495Total
Program Services2744495ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total238312Total
Management And General83409ManagementAndGeneral
Fundraising154903Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total454777Total
Management And General144261ManagementAndGeneral
Fundraising310516Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total44639Total
Management And General14160ManagementAndGeneral
Fundraising30479Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total48529Total
Management And General15394ManagementAndGeneral
Fundraising33135Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3787Total
Management And General3787ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total37330Total
Management And General37330ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total73379Total
Management And General30961ManagementAndGeneral
Fundraising42418Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total48819Total
Management And General13804ManagementAndGeneral
Fundraising35015Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total21853Total
Management And General13725ManagementAndGeneral
Fundraising8128Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total102530Total
Management And General102530ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total5076Total
Management And General4812ManagementAndGeneral
Fundraising264Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1959Total
Management And General1959ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total33834Total
Management And General33834ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralFundraisingFundraising
Other Expenses817555262
Membership Dues1656217312-750

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3876698Total
Program Services2744495ProgramServices
Management And General517833ManagementAndGeneral
Fundraising614370Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY363167BOY
EOY262262EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY263447BOY
EOY164117EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY870554BOY
EOY706059EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY28338BOY
EOY31595EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis430868LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec323093LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY141609BOY
EOY107775EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8515713BOY
EOY9922626EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9332BOY
EOY9226EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY10192160BOY
EOY11203660EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY50974BOY
EOY40470EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY132440BOY
EOY111333EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY183414BOY
EOY151803EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3361605BOY
EOY3797049EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1765829BOY
EOY1902561EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4881312BOY
EOY5352247EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10008746BOY
EOY11051857EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10192160BOY
EOY11203660EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1408979ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-365868ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2891956CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2489157CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2972449CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5451059CurrentTaxYearMinus1Year
Current Tax Year4075063CurrentTaxYear
Total17879684Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2891956CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2489157CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2972449CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5451059CurrentTaxYearMinus1Year
Current Tax Year4075063CurrentTaxYear
Total17879684Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total1668300AmountsSubstContributorsTotal
Public Support Total17016211384PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years211367CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years162607CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years196831CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year218131CurrentTaxYearMinus1Year
Current Tax Year221391CurrentTaxYear
Total1010327Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Total Support18890011TotalSupport
Public Support Pertcentage1700.85820PublicSupportPertcentage170
Public Support Pertcent Prior Year0.82250PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance8373334BeginningOfYearBalance
Contributions569145Contributions
Investment Earnings Or Losses852025InvestmentEarningsOrLosses
Other Expenditures-112596OtherExpenditures
End Of Year Balance9681908EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance8219772BeginningOfYearBalance
Contributions198722Contributions
Investment Earnings Or Losses181153InvestmentEarningsOrLosses
Other Expenditures-226313OtherExpenditures
End Of Year Balance8373334EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7076049BeginningOfYearBalance
Contributions50150Contributions
Investment Earnings Or Losses1273817InvestmentEarningsOrLosses
Other Expenditures-180244OtherExpenditures
End Of Year Balance8219772EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance6354334BeginningOfYearBalance
Contributions149314Contributions
Investment Earnings Or Losses620157InvestmentEarningsOrLosses
Other Expenditures-47756OtherExpenditures
End Of Year Balance7076049EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7478956BeginningOfYearBalance
Contributions114720Contributions
Investment Earnings Or Losses-1007582InvestmentEarningsOrLosses
Other Expenditures-231760OtherExpenditures
End Of Year Balance6354334EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.28870BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.54760PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.16370TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis154802OtherCostOrOtherBasis
Depreciation129913Depreciation
Book Value24889BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis276066OtherCostOrOtherBasis
Depreciation193180Depreciation
Book Value82886BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings107775TotalOfBookValueLandBuildings
Tot Revenue Etc Audited Fincl Stmt5030726TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-365869NetUnrealizedGainsInvestments
Other Revenues37330OtherRevenues
Revenue Not Rptd F990-328539RevenueNotRptdF990
Revenue Subtotal5359265RevenueSubtotal
Other Revenues Not Included-73588OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-73588RevenueNotRptdOnFinStmt
Total Revenue Per Form9905285677TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3912956TotExpensesEtcAuditedFinclStmt
Other Expenses Included73588OtherExpensesIncluded
Expenses Not Rptd F99073588ExpensesNotRptdF990
Expenses Subtotal3839368ExpensesSubtotal
Investment Expenses Not Included237330InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt37330ExpensesNotRptdOnFinStmt
Total Expenses Per Form9903876698TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 2dPart XII, Line 2d: Other expenses and losses per audited F/SFundraising Expenses, Corp. Luncheon $73588
Part XI, Line 2dPart XI, Line 2d: Other revenue amounts included in F/S but not included on form 990Investment Management Fees $37330
Part V, Line 4Part 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 IV, Line 2bPart IV, Line 2b: Explanation of escrow account liabilityAnnuities are held in a custodial account (BNY Mellon). The assets and liability are reported on the balance sheet.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Corp Ptrs BkfstNameOfEvent1
Gross Receipts Event1355209GrossReceiptsEvent1
Charitable Contributions Event1328959CharitableContributionsEvent1
Gross Revenue Event126250GrossRevenueEvent1
Rent Facility Costs Event118117RentFacilityCostsEvent1
Food And Beverage Event128054FoodAndBeverageEvent1
Other Direct Expenses Event127417OtherDirectExpensesEvent1
Gross Receipts Total355209GrossReceiptsTotal
Charitable Contributions Total328959CharitableContributionsTotal
Gross Revenue Total Events26250GrossRevenueTotalEvents
Rent Facility Costs Total Events18117RentFacilityCostsTotalEvents
Food And Beverage Total Events28054FoodAndBeverageTotalEvents
Other Direct Expenses Total Events27417OtherDirectExpensesTotalEvents
Direct Expense Summary Events73588DirectExpenseSummaryEvents
Net Income Summary-47338NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Overlake Hospital Medical CenterBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11035 - 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient910652651EINOfRecipient
IRC Section501(c)3IRCSection
Amount Of Cash Grant2744495AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationFair Market ValueMethodOfValuation
Purpose Of GrantSupport Overlake HospitalPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationOverlake Hospital Foundation staff notifies the Overlake Hospital Medical Center Accounting staff when there is a specific grant. If the grant is for operational expenses, the appropriate department in the hospital is contacted. 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Mary Beth Stearns
Executive Dir.151222504082163072107212240433622112077767258922145373818
Gary McLaughlin
VicePres/CFO41589865445959371192821538471194652808
David Knoepfler MD
Trustee27784927768267561370511326357404
Craig Hendrickson
President & CEO639090123774182956205811132541164885154070

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 7Identifier
Return ReferencePart I, Line 7: Non-Fixed payments not listed aboveReturnReference
ExplanationManagement incentive for the Executive Director 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 organization and individual goals.Explanation

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions9NumberOfContributions
Noncash Contribs Rptd F990334551NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VIIOverlake 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 V, Line 7g and 7hOverlake Hospital Foundation did not receive any contributions of intellectual property, cars, boats, airplanes, or other vehicles.
Form 990, Part V, Line 2a and 2bEmployees 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 I, Line 6Overlake Hospital Foundation had 26 board members that volunteered their time as board members during the year. Another 14 volunteers assist with special events invitations and other donor mailings.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableOverlake Hospital Foundation makes its governing documents, conflict of interest policy, and audited financial statements available through the Hospital's administration office.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesOverlake'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 Executive Director 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 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsBoard members and management annually signs 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, Overlake Hospital Medical Center VP Human Resources and General Counsel. This information is also shared with the Board Chairman, 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 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe 990 is prepared internally and reviewed by an independent accounting firm. The 990 is then reviewed by Executive Director, President & CEO, CFO, VP System Change Management & CCO, VP Human Resources, and 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 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersOverlake 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 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyOverlake Hospital Medical Center has the right to appoint and remove Overlake Hospital Foundation's Trustees.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderOverlake Hospital Medical Center is the sole member of Overlake Hospital Foundation.Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Overlake Hospital Association
1035 - 116th Ave NEBellevueWA98004911274134Rent Medical and office space to HospitalWA501c311-Type IINAfalse
Overlake Hospital Auxiliaries
1035 - 116th Ave NEBellevueWA98004237297831Fund RaisingWA501c39Overlake Hospital Medical Centerfalse
Overlake Hospital Medical Center
1035 - 116th Ave NEBellevueWA98004910652651HospitalWA501c33Overlake Hospital Associationfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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