2024-05-10T13:32:31-05:00 2023-06-30 911194016 CLARK NUBER PS 10900 NE 4TH ST STE 1400 BELLEVUE WA 98004 990 2022-07-01 911050325 OVERLAKE HOSPITAL FOUNDATION OVER 4256885000 1035 116TH AVENUE NE BELLEVUE WA 98004 PAUL ISHIZUKA INTERIM CFO 4256885331 2024-05-04 1 PAUL ISHIZUKA 999009999 0 MEGAN R RYAN P00737884 4254544919 2024-05-04 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARY BETH STEARNS 1035 116TH AVENUE NE BELLEVUE WA 98004 20120628 0 X WWW.OVERLAKEHOSPITAL.ORG/WAYS-TO-GIVE X 1978 WA THE PURPOSE OF OVERLAKE HOSPITAL FOUNDATION IS TO ADVANCE AND IMPROVE MEDICAL AND HEALTH CARE EXCELLENCE BY PROVIDING FUNDRAISING AND OTHER SUPPORT TO OVERLAKE HOSPITAL MEDICAL CENTER FOR NEW FACILITIES, MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. 14 14 14 32 0 0 10648760 18222629 0 0 1242399 1214546 -224445 -251344 11666714 19185831 9141355 18300709 0 0 1533937 1659089 0 0 1221295 385767 266567 11061059 20226365 605655 -1040534 23723897 22492373 557219 315694 23166678 22176679 THE PURPOSE OF OVERLAKE HOSPITAL FOUNDATION IS TO ADVANCE AND IMPROVE MEDICAL AND HEALTH CARE EXCELLENCE BY PROVIDING FUNDRAISING AND OTHER SUPPORT TO OVERLAKE HOSPITAL MEDICAL CENTER FOR NEW FACILITIES, MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. 0 0 18300709 18300709 OVERLAKE HOSPITAL FOUNDATION RAISED $15,581,731 IN CONTRIBUTIONS AND PLEDGES FROM DONORS. THE FOUNDATION PROVIDED $18,300,709 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. 18300709 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 14 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 WA X LINDSEY SOBOLOSKI 4256885552 1035 116TH AVENUE NE BELLEVUE WA 98004 X JULIE SUN CHAIR 3.00 4.00 X X 0 0 0 WHITNEY NAKAJIMA SECRETARY 2.00 0.00 X X 0 0 0 BENJAMIN LIU SECRETARY 2.00 0.00 X X 0 0 0 PAULINE BACH PAST CHAIR 0.50 4.00 X 0 0 0 MERRILL BEHNKE TRUSTEE 2.00 0.00 X 0 0 0 RACHELE BOUCHAND TRUSTEE 2.00 0.00 X 0 0 0 JAMES GREGSON TRUSTEE 2.00 0.00 X 0 0 0 SHERYL GUDAITIS TRUSTEE 2.00 0.00 X 0 0 0 YORK HARRIS TRUSTEE 5.00 0.00 X 0 0 0 TAYLOR MILLER TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL RIDGEWAY TRUSTEE 1.00 0.00 X 0 0 0 YUKA SHIMIZU TRUSTEE 1.00 0.00 X 0 0 0 CLAIRE SUMADIRWIRYA TRUSTEE 2.00 0.00 X 0 0 0 TYLER TONKIN TRUSTEE 1.00 0.00 X 0 0 0 J MICHAEL MARSH PRESIDENT & CEO 10.00 49.00 X 0 1462825 144346 ANDREW TOKAR CFO 2.00 55.00 X 0 591433 72826 MARY BETH STEARNS CHIEF DEVELOPMENT OFFICER 50.00 0.00 X 433551 0 70050 STEPHANIE STEWART DEVELOPMENT DIRECTOR 40.00 0.00 X 196821 0 27578 630372 2054258 314800 2 0 1 0 0 1144008 2430893 14647728 802157 18222629 1216487 1216487 446046 447987 -1941 -1941 -1941 235466 1144008 486810 -251344 -251344 19185831 0 0 963202 18300709 18300709 478581 147469 331112 880699 260146 620553 213221 62982 150239 86588 25577 61011 48 48 10098 10098 28482 28482 32747 32747 23849 11221 12628 72 72 152323 152323 73 68 5 925 590 335 844 844 FOOD 14356 1691 12665 MEMBERSHIP DUES 2750 2750 20226365 18300709 704361 1221295 4259708 3154862 139479 614678 4510090 3843112 24936 24789 347411 343404 4850 4007 14525093 14672528 259741 178397 23723897 22492373 173626 38961 68837 56526 314756 220207 557219 315694 X 4138972 5023466 19027706 17153213 23166678 22176679 23723897 22492373 X -1040534 141835 -91300 X 0 0 0 X 12467666 9381198 13227580 10648760 18222629 63947833 12467666 9381198 13227580 10648760 18222629 63947833 11718907 52228926 642294 600693 509441 1239711 1216487 4208626 68156459 0.76630 0.81640 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 14493472 139866 1345654 862779 15116213 16891583 239515 -1957644 679982 14493472 13741651 160083 3492449 502600 16891583 13480020 270372 316445 325186 13741651 13003120 110825 739360 373285 13480020 0.30490 0.42660 0.26850 0 0 154803 154803 0 192608 188601 4007 4007 CAPITAL LEASE OBLIGATION 220207 220207 PART IV, LINE 2B: ANNUITIES ARE HELD IN A CUSTODIAL ACCOUNT (BNY MELLON). THE ASSETS AND LIABLILITY ARE REPORTED ON THE BALANCE SHEET. PART V, LINE 4: ENDOWMENT DISTRIBUTIONS ARE USED TO SUPPORT CAPITAL AND OPERATIONAL NEEDS OF OVERLAKE HOSPITAL MEDICAL CENTER AS DIRECTED BY THE INDIVIDUAL ENDOWMENT PURPOSE. BANDAGE BALL 2023 1379474 1144008 235466 1328 99495 205778 180209 1379474 1144008 235466 1328 99495 205778 180209 486810 -251344 1 OVERLAKE HOSPITAL MEDICAL CENTER 1035 116TH AVENUE NE BELLEVUE WA 98004 910652651 501(C)(3) 18042274 258435 FAIR MARKET VALUE MEDICAL SUPPLIES, EQUIPMENT SUPPORT OVERLAKE HOSPITAL 1 0 PART I, LINE 2: OVERLAKE HOSPITAL FOUNDATION STAFF NOTIFIES THE OVERLAKE HOSPITAL MEDICAL CENTER ACCOUNTING STAFF WHEN THERE IS A SPECIFIC GRANT. IF THE GRANT IS FOR OPERATIONAL EXPENSES THAT THE HOSPITAL DOES NOT INCUR IN THE NORMAL COURSE OF BUSINESS, THE APPROPRIATE DEPARTMENT IN THE HOSPITAL IS CONTACTED TO DEVELOP PLANS AND TIMING FOR USING THE FUNDS AS DESIGNATED. IF THE GRANT IS FOR CAPITAL, THE ACCOUNTING STAFF WILL MONITOR WHEN THE CAPITAL HAS BEEN PURCHASED AND RELEASE THE GRANT FROM RESTRICTION. WHEN THE DEPARTMENT MAKES THE EXPENDITURE, ACCOUNTING IS NOTIFIED, AND THE RESTRICTION OF THE GRANT IS RELEASED. X X X X X 0 1 0 0 0 0 0 0 0 J MICHAEL MARSH PRESIDENT & CEO 0 926784 0 429961 0 106080 0 123611 0 20735 0 1607171 0 0 ANDREW TOKAR CFO 0 443482 0 144978 0 2973 0 60094 0 12732 0 664259 0 0 MARY BETH STEARNS CHIEF DEVELOPMENT OFFICER 286599 0 110207 0 36745 0 53463 0 16587 0 503601 0 0 0 STEPHANIE STEWART DEVELOPMENT DIRECTOR 171146 0 23525 0 2150 0 14094 0 13484 0 224399 0 0 0 PART I, LINE 4B J. MICHAEL MARSH, MARY BETH STEARNS, AND ANDREW TOKAR PARTICIPATED IN A BENEFIT WITHIN THE EXECUTIVE BENEFIT PLAN CALLED THE CAPITAL ACCUMULATION ACCOUNT. THE CAPITAL ACCUMULATION ACCOUNT IS CLASSIFIED AS A 457 (F) PLAN BY THE IRS. NO PAYMENTS WERE SENT TO J. MICHAEL MARSH, MARY BETH STEARNS, OR ANDREW TOKAR IN 2022. X 13 447986 FAIR MARKET VALUE X MEDICAL SUPPLY 42838 256885 FAIR MARKET VALUE X AUCTION ITEMS 42 95736 FAIR MARKET VALUE X EQUIPMENT 3 1550 FAIR MARKET VALUE 0 0 1 0 PART I, COLUMN (B): THE NUMBER IN PART I COLUMN (B) IS THE BASED ON THE NUMBER OF CONTRIBUTIONS RECEIVED FOR DONATED SECURITIES AND THE NUMBER OF ITEMS RECEIVED FOR AUCTION ITEMS, EQUIPMENT AND MEDICAL SUPPLY. FORM 990, PART I, LINE 6: DURING FY23, 14 VOLUNTEERS SERVED ON THE BOARD OF DIRECTORS AND 17 VOLUNTEERS ASSISTED WITH VARIOUS TASKS AT THE ANNUAL BANDAGE BALL EVENT. FORM 990, PART V, LINES 2A AND 2B: EMPLOYEES ARE PAID THROUGH THE USE OF A COMMON PAYMASTER AND REPORTED ON THE FORM W-3 AND OTHER REQUIRED FILINGS OF OVERLAKE HOSPITAL MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 6 ALTHOUGH THE GOVERNING DOCUMENTS DO NOT STATE THAT THERE ARE ANY MEMBERS OF OVERLAKE HOSPITAL FOUNDATION, OVERLAKE HOSPITAL MEDICAL CENTER DOES HAVE THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. FORM 990, PART VI, SECTION A, LINE 7A OVERLAKE HOSPITAL MEDICAL CENTER HAS THE RIGHT TO APPOINT AND REMOVE OVERLAKE HOSPITAL FOUNDATION'S TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B OVERLAKE HOSPITAL MEDICAL CENTER 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) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN REVIEWED BY THE CHIEF DEVELOPMENT OFFICER, PRESIDENT & CEO, OVERLAKE HOSPITAL MEDICAL CENTER CHIEF COMPLIANCE OFFICER, AND THE OVERLAKE HOSPITAL MEDICAL CENTER AUDIT & COMPLIANCE COMMITTEE. A PUBLIC DISCLOSURE COPY IS DISTRIBUTED TO THE FOUNDATION BOARD MEMBERS PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND MANAGEMENT ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, 2) HAS READ AND UNDERSTANDS THE POLICY, 3) HAS AGREED TO COMPLY WITH THE POLICY, AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN THEIR FEDERAL TAX EXEMPTION THEY MUST AVOID CONFLICTS OF INTEREST AND ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF THEIR TAX-EXEMPT FUNCTIONS. A LIST OF ALL FINANCIAL INTERESTS OR OTHER RELATIONSHIPS WITH ANY ORGANIZATION THAT HAS, OR CAN BE REASONABLY EXPECTED TO HAVE, A TRANSACTION WITH THE CORPORATION, COMPETES AGAINST THE CORPORATION, OR WHOSE INTEREST MATERIALLY CONFLICTS WITH THE INTEREST OF THE CORPORATION IS SUBMITTED ANNUALLY TO THE OVERLAKE HOSPITAL MEDICAL CENTER COMPLIANCE OFFICER FOR REVIEW. THE COMPLIANCE OFFICER SUMMARIZES ANY CONFLICTS OF INTEREST AND DISCUSSES THESE RESULTS WITH THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE, CEO, AND GENERAL COUNSEL. THIS INFORMATION IS ALSO SHARED WITH THE BOARD CHAIRMAN, COMMITTEE CHAIRS, AND THE CFO. AT BOARD MEETINGS, MEMBERS ARE EXPECTED TO RECUSE THEMSELVES FROM VOTING ON ISSUES WHEN THERE IS A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A OVERLAKE'S POLICY AND PROCESS FOR EXECUTIVE COMPENSATION IS FULLY DOCUMENTED IN THE "EXECUTIVE COMPENSATION ADMINISTRATION AND COMPLIANCE MANUAL". THIS MANUAL DETAILS THE CHARTER OF THE COMPENSATION COMMITTEE OF THE BOARD, THE COMPENSATION PHILOSOPHY AND HOW SALARY INCREASES, INCENTIVES, BENEFITS AND PERQUISITES ARE ADMINISTERED. COMPENSATION COMMITTEE MEMBERS ARE INDEPENDENT BOARD MEMBERS AS REQUIRED BY THE CHARTER AND BY-LAWS. THE PROCESS INCLUDES AN INDEPENDENT CONSULTANT WHO WORKS DIRECTLY FOR THE COMPENSATION COMMITTEE AND REVIEW OF COMPARABLE DATA FROM EXTERNAL SOURCES. ALL COMPENSATION RELATED DECISIONS FOR THE FOUNDATION'S CHIEF DEVELOPMENT OFFICER MARY BETH STEARNS ARE DELIBERATED AND VOTED ON BY THE OVERLAKE HOSPITAL MEDICAL CENTER/OVERLAKE HOSPITAL ASSOCIATION/OVERLAKE HOSPITAL FOUNDATION COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES OF THE MEETING. OFFICERS J. MICHAEL MARSH AND ANDREW TOKAR ARE PAID BY RELATED AFFILIATE OVERLAKE HOSPITAL MEDICAL CENTER. THE MOST RECENT COMPENSATION REVIEW WAS AT THE DECEMBER 2023 COMPENSATION COMMITTEE MEETING. FORM 990, PART VI, SECTION C, LINE 19 OVERLAKE HOSPITAL FOUNDATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE THROUGH THE HOSPITAL'S ADMINISTRATION OFFICE. FORM 990, PART VII: OVERLAKE HOSPITAL FOUNDATION STAFF ARE PAID BY ITS RELATED ORGANIZATION (OVERLAKE HOSPITAL MEDICAL CENTER) THROUGH A COMMON PAYMASTER. THESE PAYROLL EXPENSES ARE CHARGED TO OVERLAKE HOSPITAL FOUNDATION. FORM 990, PART XI, LINE 9: WRITE-OFF OF PRIOR YEAR PLEDGES -91,300. OVERLAKE HOSPITAL MEDICAL CENTER 1035 116TH AVENUE NE BELLEVUE WA 98004 910652651 HOSPITAL WA 501(C)(3) LINE 3 OVERLAKE HOSPITAL ASSOCIATION 0 OVERLAKE HOSPITAL ASSOCIATION 1035 116TH AVENUE NE BELLEVUE WA 98004 911274134 RENT MEDICAL & OFFICE SPACE TO HOSPITAL WA 501(C)(3) LINE 12B, II N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0