FURP.ORG / PUBLIC DATA EXPLORER

OVERLAKE MEDICAL CENTER & CLINICS: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
OVERLAKE MEDICAL CENTER & CLINICS (EIN 91-0652651)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-08
IRS object ID
201241299349301029
Schema version
2010v3.2
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)
Timestamp2012-05-08T09:15:12-07:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

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 Street Ste 1700AddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN910652651EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OVERLAKE HOSPITAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOVERNameControl
Phone4256885000Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameGary McLaughlinName
TitleCFOTitle
Date Signed2012-05-03DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSara Elizabeth J HyreName
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCraig HendricksonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11035 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Gross Receipts426164107GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.overlakehospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionThe 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees2923TotalNbrEmployees
Total Nbr Volunteers955TotalNbrVolunteers
Total Gross UBI1482610TotalGrossUBI
Net Unrelated Business Txbl Income237354NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3215887ContributionsGrantsPriorYear
Contributions Grants Current Year2201257ContributionsGrantsCurrentYear
Program Service Revenue Prior Year386054483ProgramServiceRevenuePriorYear
Program Service Revenue CY409517574ProgramServiceRevenueCY
Investment Income Prior Year1204095InvestmentIncomePriorYear
Investment Income Current Year9626153InvestmentIncomeCurrentYear
Other Revenue Prior Year6863787OtherRevenuePriorYear
Other Revenue Current Year4678150OtherRevenueCurrentYear
Total Revenue Prior Year397338252TotalRevenuePriorYear
Total Revenue Current Year426023134TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year5216036GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1390016GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year184566220SalariesEtcPriorYear
Salaries Etc Current Year196249568SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year174243756OtherExpensePriorYear
Other Expenses Current Year192929432OtherExpensesCurrentYear
Total Expenses Prior Year364026012TotalExpensesPriorYear
Total Expenses Current Year390569016TotalExpensesCurrentYear
Revenues Less Expenses Prior Year33312240RevenuesLessExpensesPriorYear
Revenues Less Expenses CY35454118RevenuesLessExpensesCY
Total Assets BOY480719847TotalAssetsBOY
Total Assets EOY544703202TotalAssetsEOY
Total Liabilities BOY251374516TotalLiabilitiesBOY
Total Liabilities EOY248435151TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY229345331NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY296268051NetAssetsOrFundBalancesEOY
Mission DescriptionThe 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense323044268Expense
Revenue409303247Revenue
DescriptionHospital Services - Overlake Hospital Medical Center is a nonprofit, independently operated regional center serving the eastern Puget Sound region with medical centers in Bellevue, Issaquah and Mercer Island. Founded in 1953, today Overlake Hospital is a regional leader in health care, providing advance medical services and excelling in the areas of cardiac care, general and specialty surgery, women's services, cancer treatment and services for the seniors. There were 21,235 patients admitted for inpatient medical care for a total of 71,683 patient days. There were 235,098 outpatient visits including 50,409 for emergency care visits and 112,205 physician visits. The Hospital delivered 4,029 babies. 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 6,316 patients who are uninsured or under insured in the amount of $15,450,000 (estimated cost of $5,561,000). The Hospital provided care to Medicaid patients at rates below the cost of providing services. The payments were less than cost by $6,427,000. In keeping with the Hospital's spirit of giving back to the community it served, a total of $5,012,000 of community benefit service activities were also provided. Overlake Staff spent 2,518 hours in the community by participating in, organizing and managing health programs and activities. Overlake Hospital offers the most comprehensive services to the Eastside community. Overlake sponsors community health events and screenings for the general public. In October 2010, Overlake held its third annual Eastside Vitality Health Fair, performing free health screenings for more than 1,000 people. Screenings included blood pressure checks, blood glucose testing, cholesterol tests, stroke assessments, peripheral artery disease screenings, bone density screenings and skin cancer checks. Overlake has been home to the most comprehensive program for cardiovascular and peripheral vascular care on the Eastside for more than 20 years. Today, the hospital's heart care team includes a network of specialists whose collective expertise and training has helped Overlake earn its reputation as an award winning cardiac center. The Cancer Center at Overlake is noted for its enhanced services and technology, as well as for its exceptional patient experience. In 2011, the Cancer Center at Overlake received a prestigious commendation from the American College of Surgeons Commission on Cancer. 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.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2193421Expense
Revenue214327Revenue
DescriptionEducation 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. Overlake sponsors health and safety classes, with topics ranging from childbirth preparation and parenting to senior care. Health education is an important part of preventive care. The Education Program provided 45,818 contact hours offering classes in 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 health lifestyles. The Hospital also provided 22,875 contact hours of internal and external nursing education.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1390016Expense
Grants1390016Grants
DescriptionOther Grants and Allocations - Grants to Overlake Hospital Foundation and Overlake Hospital Auxiliaries to cover their expenses.Description
FieldValueIRS element (for citing)
Total Program Service Expense326627705TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccounttrueEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096276NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2923NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
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
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
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 Line11120 112th Ave Ste 202AddressLine1
CityBellevueCity
StateWAState
ZIP Code980044687ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekHighest Compensated EmployeeHighestCompensatedEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorKey EmployeeKeyEmployeeOfficerOfficer
Vu Hoang MD
Cardiac Surgeon45.00X1009475025039
Tom Miller MD
Trustee1.001500000X
Tom Cleveland
Trustee4.00000X
Thien Nguyen MD
Bariatric Surgeon45.00X298146021139
TD Sam Baxter
Vice President55.00227983068081X
Skip Rowley
Trustee1.00000X
Russell Stockdale
Trustee1.00000X
Robert Campbell
Trustee3.00000X
Rick Clarfeld MD
Breast Surgeon45.00X368991045239
Patty Edwards
Trustee0.25000X
Patricia Wangsness
Trustee0.50000X
Patricia Bedient
Treasurer3.00000XX
Lawrence Madewell MD
Urgent C Physician45.00X289175029169
Larry Hebner
Past Chair3.00000XX
Ken Johnsen
Trustee2.00000X
Kemper Freeman Jr
Trustee1.00000X
Kelan Koenig MD
Psychiatrist45.00X318353031265
Kathleen Gibson MD
Trustee1.008800000X
John Walter Smith MD
Trustee2.002000000X
John K Murphy
Secretary2.00000XX
Jody Albright
VP & CIO55.00313922024909X
Jim Doud
Trustee2.00000X
Jerome Mathews
Trustee1.00000X
Janine Florence
Trustee1.00000X
Gregory Engel MD
Trustee1.005050000X
Gregory Collins
Trustee1.00000X
Gary McLaughlin
VP & CFO35.005495540131259X
Douglas Martin
Trustee2.00000X
David Schultz
VP & COO55.00429451079398X
Craig Hendrickson
President & CEO40.008385080164919X
Cecily Hall
Chair Elect1.00000XX
Catherine Whitaker-Klick
Vice President55.00320718027358X
Bertrand Valdman
Chairman8.00000XX
Alan Ertle
Vice President55.00176663028063X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5314439TotalReportableCompFromOrg
Total Other Compensation675838TotalOtherCompensation
Number Individuals GT100 K255NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Puget Sound Blood Center
921 Terry AvenueSeattleWA981041256Blood Services1680450
Medical Information Technology Inc
P O Box 74569ChicagoIL60696Software Dev & Maint1671559
INX Inc
P O Box 4346 Dept 523HoustonTX772104346Computer Services2668379
Hospital Central Services Assoc
1300 E Columbia StSeattleWA98122Linen Services1425208
Gall Landau Young Construction Co
P O Box 6728BellevueWA980080728Construction1969365
FieldValueIRS element (for citing)
Number Of Contractors GT100 K80NumberOfContractorsGT100K
Related Organizations2201257RelatedOrganizations
Noncash Contributions1886NoncashContributions
Total Contributions2201257TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Program Related Invstmnts90000422187632218763
Other Program Services90000419971501997150
Non Government Payments900004261356710261356710
Medicare/Medicaid Payment900004143730624143730624
Education Services611710214327214327
FieldValueIRS element (for citing)
Total Program Service Revenue409517574TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5542928TotalRevenueColumn
Exclusion$5,542,928ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real303831Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real303831Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column303831TotalRevenueColumn
Exclusion$303,831ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2400973Securities
Other1823225Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other140973Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2400973Securities
Other1682252Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4083225TotalRevenueColumn
Exclusion$4,083,225ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Parking Revenue812930445814$445,814
Laboratory621500877625$74,578803047
Catering/Cafeteria7222102661996$1,986,969675027

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column388884TotalRevenueColumn
Unrelated Business Revenue4536UnrelatedBusinessRevenue
Exclusion$384,348ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4374319TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column426023134TotalRevenueColumn
Related Or Exempt Function Income409517574RelatedOrExemptFunctionIncome
Unrelated Business Revenue1482610UnrelatedBusinessRevenue
Exclusion$12,821,693ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1390016Total
Program Services1390016ProgramServices

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)
Total3353059Total
Program Services821140ProgramServices
Management And General2531919ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total153865739Total
Program Services130689535ProgramServices
Management And General23176204ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total10293971Total
Program Services8774866ProgramServices
Management And General1519105ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total17091958Total
Program Services13735362ProgramServices
Management And General3356596ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total11644841Total
Program Services9842558ProgramServices
Management And General1802283ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1003343Total
Program Services113397ProgramServices
Management And General889946ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total221668Total
Management And General221668ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total100936Total
Management And General100936ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total31190Total
Management And General31190ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total35427624Total
Program Services25998492ProgramServices
Management And General9429132ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1306341Total
Program Services1529ProgramServices
Management And General1304812ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total67820435Total
Program Services64066546ProgramServices
Management And General3753889ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5452598Total
Management And General5452598ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total9126130Total
Program Services6691443ProgramServices
Management And General2434687ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total662603Total
Program Services291040ProgramServices
Management And General371563ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total364631Total
Program Services311700ProgramServices
Management And General52931ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total10165831Total
Program Services10165831ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total22440809Total
Program Services17749056ProgramServices
Management And General4691753ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2938309Total
Program Services2188400ProgramServices
Management And General749909ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UBI Taxes1053310533
Other Expenses324749811773082070190
Medicaid Prov Assessment1022435810224358
Bad Debt1863890118638901
B & O Tax37456943745694

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total390569016Total
Program Services326627705ProgramServices
Management And General63941311ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12047336BOY
EOY14259230EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY31359813BOY
EOY25402285EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY49250772BOY
EOY51117294EOY

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)
BOY587241BOY
EOY277253EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4789159BOY
EOY5583830EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY9825971BOY
EOY9416155EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis351686906LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec163610140LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY184360207BOY
EOY188076766EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY179376288BOY
EOY236235728EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4098591BOY
EOY4045441EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY817567BOY
EOY269640EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4206902BOY
EOY10019580EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY480719847BOY
EOY544703202EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY45052701BOY
EOY53377078EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY193074775BOY
EOY187627242EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY13247040BOY
EOY7430831EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY251374516BOY
EOY248435151EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY229345331BOY
EOY296268051EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY229345331BOY
EOY296268051EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY480719847BOY
EOY544703202EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses35454118ReconcilationRevenueExpenses
Reconcilation Other Changes31468602ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade

Sec527 Pol Orgs Sec527PolOrgs (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeAmt Pd From Internal FundsAmtPdFromInternalFundsEINEIN
American Hospital Association
P O Box 34936SeattleWA981249896
Millennia Public Affairs Inc
21127 47th Dr SEBothellWA9802146488911809445
Washington State Hospital Assoc
Dept5028 P O Box 34936SeattleWA9812444552
FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$56,384DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$44,552OtherActivitiesAmount
Total Lobbying Expenditures IIB100936TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationPart of the membership dues that are paid to the Washington State Hospital Association and American Hospital Association are used by them for lobbying purposes.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2151142OtherCostOrOtherBasis
Book Value2151142BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis184782332OtherCostOrOtherBasis
Depreciation66824362Depreciation
Book Value117957970BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5459982OtherCostOrOtherBasis
Depreciation4459419Depreciation
Book Value1000563BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis157703868OtherCostOrOtherBasis
Depreciation92326359Depreciation
Book Value65377509BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1589582OtherCostOrOtherBasis
Book Value1589582BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings188076766TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Prof Liability Insurance Reserve$2,834,823
Pension Liability$4,516,750
Other Long Term Liabilities$79,258
FieldValueIRS element (for citing)
Total Of Amounts7430831TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
Return ReferencePart XI, Line 8: Other Changes in Net Assets or Fund BalancesReturnReference
ExplanationAdjustment in Pension Liability $4692068Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5561490TotalCommunityBenefitExpense
Net Community Benefit Expense5561490NetCommunityBenefitExpense
Percent Of Total Expense0.01420PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense24487916TotalCommunityBenefitExpense
Direct Offsetting Revenue18061371DirectOffsettingRevenue
Net Community Benefit Expense6426545NetCommunityBenefitExpense
Percent Of Total Expense0.01650PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense30049406TotalCommunityBenefitExpense
Direct Offsetting Revenue18061371DirectOffsettingRevenue
Net Community Benefit Expense11988035NetCommunityBenefitExpense
Percent Of Total Expense0.03070PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1618951TotalCommunityBenefitExpense
Direct Offsetting Revenue205808DirectOffsettingRevenue
Net Community Benefit Expense1413143NetCommunityBenefitExpense
Percent Of Total Expense0.00360PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1850179TotalCommunityBenefitExpense
Net Community Benefit Expense1850179NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense5082202TotalCommunityBenefitExpense
Direct Offsetting Revenue3549688DirectOffsettingRevenue
Net Community Benefit Expense1532514NetCommunityBenefitExpense
Percent Of Total Expense0.00390PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense316745TotalCommunityBenefitExpense
Direct Offsetting Revenue85144DirectOffsettingRevenue
Net Community Benefit Expense231601NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense279563TotalCommunityBenefitExpense
Direct Offsetting Revenue63453DirectOffsettingRevenue
Net Community Benefit Expense216110NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9147640TotalCommunityBenefitExpense
Direct Offsetting Revenue3904093DirectOffsettingRevenue
Net Community Benefit Expense5243547NetCommunityBenefitExpense
Percent Of Total Expense0.01340PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense39197046TotalCommunityBenefitExpense
Direct Offsetting Revenue21965464DirectOffsettingRevenue
Net Community Benefit Expense17231582NetCommunityBenefitExpense
Percent Of Total Expense0.04410PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$6,710,578BadDebtExpenseAmount
Amount Reimbursed By Medicare64162923AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare84844076CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-20681153MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership
Washington Imaging Svcs LLC
Diagnostic Imaging Services0.270000.72000
Overlake Surgery Center LLC
Ambulatory Surgical Svcs0.430000.540000.03000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Overlake Hospital Medical CtrBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11035 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Overlake Hospital Medical CtrBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
OMC-Downtown Bellevue
400 108th Ave NE Ste 605BellevueWA98004Primary Care Clinic
OMCSpecialty Clinic
1120 112th Ave NE Ste 101BellevueWA98004Specialty Clinic
OMC-Issaquah
5708 E Lk Sammamish Pkwy Ste 102IssaquahWA98029Primary Care Clinic
OMC-Cardiology
1135 116th Ave NE Ste 600BellevueWA98004Cardiology
OMC-Senior Care Center
1750 112th Ave NE Ste A101BellevueWA98004Geriatrics
OMC-Breast Surgery
1035 116th Ave NE Ste 180BellevueWA98004Breast Surgery
OMC-Cardiothoracic Surgery
1135 116th Ave NE Ste 605BellevueWA98004Cardiothoracic Surgery
OMC-Radiation Oncology
1135 116th Ave Ne Ste 160BellevueWA98004Radiation Oncology Physicians
OMC-Medical Tower
1135 116th Ave NE Ste 110BellevueWA98004Internal Medicine
OMC-Issaquah Urgent Care
5708 E Lk Sammamish Pkwy Ste 101IssaquahWA98029Urgent Care

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Return ReferencePart VI - Additional InformationReturnReference
ExplanationPart I, Line 7The costing methodology for charity care and un reimbursed Medicaid was the cost to charge method using the cost to charge ratio. The community health improvement cost, health professional education, and cash and in-kind contributions are direct costs and do not include any indirect costs. The cost for subsidized health services is derived from a cost accounting system that addresses all patient segments.Part III, Line 4The audited financial statements do not include a footnote discussing bad debt or the allowance for doubtful accounts. Bad debts are recorded on the Statement of Operations and Changes in Net Assets based on the patient charges written off to bad debt plus/minus changes to the allowance for uncollectable accounts. Any patient discount or payments reduce the amount of charges written off to bad debt. This is applied consistently to all patient balances. The bad debt expense on Schedule H, Part III, line 2 is estimated based on the cost to charge ratio. The Hospital believes that a portion of the bad debt expense is 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. The Hospital does not have a reasonable method to estimate this amount and is therefore not reporting an amount on Part III, Line 3.Part III, Line 8The costing methodology for Medicare allowable cost is derived from the 2010 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 9bThe 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, Line 2The Hospital completed a community needs assessment in April 2011 and will use this as the primary basis for assessing the community health needs. 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, Line 3Information 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 will discuss the financial assistance. 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. See Schedule O for continuation of Schedule H Part VI Line 3, and Part VI Line 4, 5,and 6.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Overlake Hospital Foundation
1035 116th Ave NeBellevueWA98004911050325501(c)(3)13560370Support Operations
Overlake Hospital Auxiliaries
1035 116th Ave NEBellevueWA98004237297831501(c)(3)339790Support Operations
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
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 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
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 (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Vu Hoang MD
47756629665123525810750142891034514
Thien Nguyen MD
2948883258147006439319285
TD Sam Baxter
1844093525083242854239539296064
Rick Clarfeld MD
3404652500035263114814091414230
Lawrence Madewell MD
2882119641488014289318344
Kelan Koenig MD
227611907421737913886349618
Jody Albright
24490346125228941470010209338831
Gary McLaughlin
4203441046042460622232109027680813
David Schultz
3435297951064121498464414508849
Craig Hendrickson
62675418142230332361991287201003427
Catherine Whitaker-Klick
24777248068248781470012658348076
Alan Ertle
172541412228063204726

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part I, Line 7Part I, Line 7: Non-Fixed payments not listed aboveManagement incentive for the CEO, COO and Vice Presidents are contingent on Overlake Hospital Association's consolidated net operating income for the fiscal year being at least 80% of the net operating income budget. The incentive payment is then based on a combination of meeting organization and individual goals.Incentives were paid to Vu Hoang on productivity and meeting certain individual quality goals. Incentives were paid to Richard Clarfeld based on meeting certain cost controls.
Sch J, Part I, Line 1aPart I, Line 1a: Relevant information in regards to selections on 1a.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
WA Health Care Facilities
91110892993978E7P12010-04-1499229494See Part Vfalsefalsefalse
WA Health Care Facilities Authority
91110892993978EYZ92005-06-08162497935Construction of Facilitytruefalsefalse
WA Health Care Facilities Authority
91110892993978EWQ12003-06-1922708358Refund Prior Issue 12/13/89falsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount RetiredAmountRetiredCapitalized InterestCapitalizedInterestCredit EnhancementCreditEnhancement
992294948292652166001021077020000000750000002010truefalsetruetrue
169309811651665121363811456945242008falsefalsetruetrue803800008527508175568
22708445371287213711591990truefalsetruetrue13890000966000

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalse0.000920.00092true
falsetruefalsefalsefalse0.000110.00011true

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied
(no name)
falsefalsefalsefalsefalsetrue
IXIS Funding Corp
falsetruefalsetruefalsefalse3.1000true
(no name)
falsefalsefalsefalsefalsetrue

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
ExplanationPart I, Column c, Line A-cusip- 93978E WQ1/WR9Part I, Column c, Line B-cusip-93978E YZ9/YL0/YF3/YG1Part I, Line C, Column f - Construction of facilities & partially refund prior issue (6/8/2005)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.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Puget Sound Physicians
See Part V793720See Part Vfalse
Washington Federal Savings
See Part V180280Leasing Clinical Spacefalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationPart IV Line 1 Column (b)Entity in which Jim Doud, Trustee, is a Director.Part IV Line 2 Column (b)Entity in which Tom Miller, MD, Trustee is a Partner.Part IV Line 2 Column (d)Urgent Care physician services and emergency room medical director services.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Schedule H, Part VI, Line 6The 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 700 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.
Schedule H, Part VI, Line 5The Hospital staff participate in the county wide disaster preparedness group and is the back up to Harborview.
Schedule H, Part VI, Line 4The Hospital's primary service area is East King County which is bounded by Lake Washington to the west and by 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 653,000 residents with an ethnic makeup of 74% white, 15% asian, 6% hispanic, and 5% other. 10% of the residents are 65 or older and another 27% in the 45 to 64 age bracket.
Schedule H Part VI, Line 3The Hospital engages an outside company to assist patients with applying for Medicaid. General information about the assistance programs are 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 website and on the Hospital's website.
Form 990, Part V Line 7g & 7hOverlake Hospital Medical Center did not receive any contributions of intellectual property, cars, boats, airplanes, or other vehicles.
Form 990, Part IV Line 12 - Fin. StmtsThe 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 I Line 6 - VolunteersVolunteers provided 281,129 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 22 board members that volunteered their time as board members during the year.
Form 990 Part VII Section A, Line 23 & 25 Column BCraig Hendrickson devoted 30 hours to related organizations.Gary McLaughlin devoted 20 hours to related organizations.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableOverlake Hospital makes its disclosure of 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." This manual details the charter of the Compensation Committee of the Board, the compensation philosophy and how salary increases, incentives and 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 are discussed, deliberated and voted on by the Compensation Committee and documented in the minutes of the meeting.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsEducation regarding conflicts of interest is provided at the annual meeting in January of each year to the full board. Conflict of interest statements are signed annually by Board members at the beginning of the calendar year and submitted to Overlake Hospital Medical Center's Chief Compliance Officer for review. The Chief Compliance Officer summarizes any conflicts of interest and discusses these results with the Chair of the Audit & Compliance Committee, CEO, and Legal Counsel. At Board meetings, members are reminded that they should recuse themselves from voting on issues when there is a conflict of interest.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessThe 990 is prepared internally and reviewed by an independent accounting firm. The 990 is then reviewed by the President & CEO, CFO, VP Human Resources, VP of Risk Management/Safety, and Overlake Hospital Medical Center Finance Committee. The 990 is sent to the Hospital Board members prior to submission to the IRS.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyOverlake Hospital Association has the right to appoint and remove Overlake Hospital Medical Center's Trustees.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderOverlake Hospital Association is the sole member of Overlake Hospital Medical Center.Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Overlake Medical Clinics LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11035 116th Ave NEAddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
EIN911932954EIN
Primary ActivitiesMedical ClinicsPrimaryActivities
Legal Domicile StateWALegalDomicileState
Total Income14668130TotalIncome
EOY Assets6142930EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Overlake Hospital Association
1035 116th Ave NEBellevueWA98004911274134Provide SupportWA501(c)(3)11-Type IIN/Atrue
Overlake Hospital Auxiliaries
1035 116th Ave NEBellevueWA98004237297831Fund RaisingWA501(c)(3)9trueOverlake Hospital Medical Center
Overlake Hospital Foundation
1035 116th Ave NEBellevueWA98004911050325Fund RaisingWA501(c)(3)7trueOverlake Hospital Medical Center
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 OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
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 OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Overlake Hospital Association
p1553883Cash
Overlake Hospital Association
n195457Other
Overlake Hospital Association
j3557096Cash
Overlake Hospital Association
d9058565Other
Overlake Hospital Auxiliaries
n133565Other
Overlake Hospital Auxiliaries
c747757Cash
Overlake Hospital Foundation
n205239Other
Overlake Hospital Foundation
m96547Cash
Overlake Hospital Foundation
c1407161Cash
Overlake Hospital Foundation
b1356037Cash