2025-05-06T12:07:12-05:00 2024-06-30 911194016 CLARK NUBER PS 10900 NE 4TH ST STE 1400 BELLEVUE WA 98004 990 2023-07-01 911050325 OVERLAKE HOSPITAL FOUNDATION OVER 4256885000 1035 116TH AVENUE NE BELLEVUE WA 98004 CHRISSY YAMADA INTERIM CFO 4256885331 2025-04-22 1 0 MEGAN R RYAN P00737884 4254544919 2025-04-22 2023 2025-03-06 01:10:19Z JON DUARTE 1035 116TH AVENUE NE BELLEVUE WA 98004 14566425 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 MEDICAL CENTER & CLINICS FOR NEW FACILITIES, MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. 15 15 11 76 0 0 18222629 11928907 0 0 1214546 1626873 -251344 -292219 19185831 13263561 18300709 11083493 0 0 1659089 1864432 0 0 1406938 266567 264728 20226365 13212653 -1040534 50908 22492373 22698949 315694 339285 22176679 22359664 THE PURPOSE OF OVERLAKE HOSPITAL FOUNDATION IS TO ADVANCE AND IMPROVE MEDICAL AND HEALTH CARE EXCELLENCE BY PROVIDING FUNDRAISING AND OTHER SUPPORT TO OVERLAKE MEDICAL CENTER & CLINICS FOR NEW FACILITIES, MODERN EQUIPMENT AND COMPREHENSIVE SERVICES AND PROGRAMS. 0 0 11083493 11083493 OVERLAKE HOSPITAL FOUNDATION RAISED $9,657,599 IN CONTRIBUTIONS AND PLEDGES FROM DONORS. THE FOUNDATION PROVIDED $11,083,493 OF FINANCIAL SUPPORT TO OVERLAKE MEDICAL CENTER & CLINICS 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. 11083493 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 11 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 WA X SHARON PHELPS 4256885471 1035 116TH AVENUE NE BELLEVUE WA 98004 X JULIE SUN CHAIR 3.00 2.00 X X 0 0 0 BENJAMIN LIU TREASURER, CHAIR ELECT 2.00 0.00 X X 0 0 0 WHITNEY NAKAJIMA SECRETARY 1.00 0.00 X X 0 0 0 PAULINE BACH PAST CHAIR 2.00 3.00 X X 0 0 0 MERRILL BEHNKE TRUSTEE THRU 12/23 1.00 0.00 X 0 0 0 RACHELE BOUCHAND TRUSTEE 1.00 0.00 X 0 0 0 JEFFREY EULBERG TRUSTEE 1.00 0.00 X 0 0 0 JAMES GREGSON TRUSTEE 0.50 0.00 X 0 0 0 LEIGHA GRIMALDI TRUSTEE 1.00 0.00 X 0 0 0 SHERYL GUDAITIS TRUSTEE 1.00 0.00 X 0 0 0 YORK HARRIS TRUSTEE 1.00 0.00 X 0 0 0 ROHAN KUMAR 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 3.00 0.00 X 0 0 0 TYLER TONKIN TRUSTEE 0.50 0.00 X 0 0 0 J MICHAEL MARSH PRESIDENT & CEO 4.00 49.00 X 0 1155989 149860 ANDREW TOKAR CFO THRU 04/24 2.00 55.00 X 0 490217 36310 MARY BETH STEARNS CHIEF DEVELOPMENT OFFICER 50.00 0.00 X 362934 0 74377 PAUL ISHIZUKA INTERIM CFO FROM 03/24 0.50 49.50 X 0 0 0 STEPHANIE STEWART DEVELOPMENT DIRECTOR 40.00 0.00 X 184058 0 27506 MEREDITH GROSECLOSE MAJOR GIFTS OFFICER 40.00 0.00 X 106022 0 22776 LAURIE RAMACCI-NOEGEL INDIVIDUAL GIVING OFFICER 40.00 0.00 X 105293 0 13794 JODI FORSCHMIEDT GRANT WRITING OFFICER 40.00 0.00 X 104248 0 16866 JENNIFER FISCHER SPECIAL EVENTS OFFICER 40.00 0.00 X 102622 0 22964 965177 1646206 364453 7 0 1 0 0 1218790 2390208 8319909 436440 11928907 1623812 1623812 830724 827663 3061 3061 3061 156375 1218790 470201 -313826 -313826 26600 5000 21600 21600 PURCHASE DISCOUNT 900099 7 7 7 13263561 0 0 1334654 11083493 11083493 463393 139018 324375 1123073 304105 818968 58838 15516 43322 142443 41845 100598 76685 21417 55268 26 26 15310 15310 27760 27760 2485 2485 42253 9564 32689 170048 170048 76 68 8 899 403 496 844 844 MEMBERSHIP DUES 4089 3960 129 938 98 840 13212653 11083493 722222 1406938 3154862 1357967 614678 464370 3843112 4651701 24789 22810 347411 344247 4007 3164 14672528 16104605 178397 94332 22492373 22698949 38961 163160 56526 56198 220207 119927 315694 339285 X 5023466 5381955 17153213 16977709 22176679 22359664 22492373 22698949 50908 132077 0 X 0 1 X 1 0 X 9381198 13227580 10648760 18222629 11928907 63409074 9381198 13227580 10648760 18222629 11928907 63409074 10311045 53098029 600693 509441 1239711 1216487 1623812 5190144 7 7 68599225 0.77400 0.76630 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: PURCHASE DISCOUNT - 2023 AMOUNT: $ 7. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 15116213 261125 1737034 715103 16399269 14493472 139866 1345654 862779 15116213 16891583 239515 -1957644 679982 14493472 13741651 160083 3492449 502600 16891583 13480020 270372 316445 325186 13741651 0.30003 0.40916 0.29081 0 0 154803 154803 0 192608 189444 3164 3164 CAPITAL LEASE OBLIGATION 119927 119927 PART IV, LINE 2B: ANNUITIES ARE HELD IN A CUSTODIAL ACCOUNT (PRINCIPAL BANK). 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 MEDICAL CENTER & CLINICS AS DIRECTED BY THE INDIVIDUAL ENDOWMENT PURPOSE. BANDAGE BALL 2024 1375165 1218790 156375 1359 107700 238990 122152 1375165 1218790 156375 1359 107700 238990 122152 470201 -313826 26600 5000 0 26600 5000 5000 21600 WA 1 0 1 0 0.00000 1.00000 OVERLAKE MEDICAL CENTER & CLINICS 1035 116TH AVE NE BELLEVUE WA 98004 0 MARY BETH STEARNS 0 GENERAL OVERSIGHT X 0 1 OVERLAKE MEDICAL CENTER & CLINICS 1035 116TH AVENUE NE BELLEVUE WA 98004 910652651 501(C)(3) 11036331 47162 FAIR MARKET VALUE MEDICAL SUPPLIES, EQUIPMENT SUPPORT OVERLAKE MEDICAL CENTER & CLINICS 1 0 PART I, LINE 2: OVERLAKE HOSPITAL FOUNDATION STAFF NOTIFIES THE OVERLAKE MEDICAL CENTER & CLINICS 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 FOR USING THE FUNDS AS DESIGNATED. ACCOUNTING WORKS WITH THE FOUNDATION TO MONITOR WHEN THE EXPENDITURES HAVE BEEN MADE AND RELEASE THE GRANT. IF THE GRANT IS FOR CAPITAL, THE ACCOUNTING STAFF WILL MONITOR WHEN THE CAPITAL HAS BEEN PURCHASED AND RELEASE THE GRANT. X X X X X 0 1 0 0 0 0 0 0 0 J MICHAEL MARSH PRESIDENT & CEO 0 979055 0 65067 0 111867 0 130474 0 19386 0 1305849 0 102261 ANDREW TOKAR CFO THRU 04/24 0 456772 0 30400 0 3045 0 23100 0 13210 0 526527 0 0 MARY BETH STEARNS CHIEF DEVELOPMENT OFFICER 300892 0 20467 0 41575 0 56819 0 17558 0 437311 0 28505 0 STEPHANIE STEWART DEVELOPMENT DIRECTOR 182907 0 0 0 1151 0 13214 0 14292 0 211564 0 0 0 PART I, LINE 4B J. MICHAEL MARSH AND MARY BETH STEARNS 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. THE FOLLOWING AMOUNTS REFLECT 2023 DEFERRALS: J. MICHAEL MARSH ($107,374), MARY BETH STEARNS ($33,719). IN 2023, THE FOLLOWING VESTED BENEFITS WERE PAID: J. MICHAEL MARSH ($102,261), MARY BETH STEARNS ($28,505). ANDREW TOKAR PARTIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN BENEFIT. THIS IS A NONQUALIFIED PLAN SPONSORED BY OVERLAKE MEDICAL CENTER & CLINICS. NO AMOUNTS WERE DEFERRED OR PAID IN 2023. X 8 325203 FAIR MARKET VALUE X 1 44000 FAIR MARKET VALUE X AUCTION ITEMS 61 64075 FAIR MARKET VALUE X SUPPLIES 2 3162 FAIR MARKET VALUE 1 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, ARCHEOLOGICAL ARTIFACTS, AND SUPPLIES. FORM 990, PART I, LINE 6: DURING FY24, 16 VOLUNTEERS SERVED ON THE BOARD OF TRUSTEES AND 60 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 MEDICAL CENTER & CLINICS. 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 MEDICAL CENTER & CLINICS DOES HAVE THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. FORM 990, PART VI, SECTION A, LINE 7A OVERLAKE MEDICAL CENTER & CLINICS HAS THE RIGHT TO ELECT AND REMOVE OVERLAKE HOSPITAL FOUNDATION'S TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B OVERLAKE MEDICAL CENTER & CLINICS 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 REVIEWED BY THE ASSISTANT CONTROLLER AND/OR CONTROLLER, THEN REVIEWED ON A HIGH LEVEL BY THE CHIEF DEVELOPMENT OFFICER, PRESIDENT & CEO, OVERLAKE MEDICAL CENTER & CLINICS CHIEF COMPLIANCE & RISK OFFICER. THE 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. BOARD MEMBERS AND MANAGEMENT ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICT OF INTEREST SITUATIONS ON THEIR ANNUAL DISCLOSURE FORM AND ON A SITUATIONAL BASIS FOR ANY SITUATION OCCURING DURING THE YEAR. DISCLOSURES ARE REVIEWED BY THE OVERLAKE MEDICAL CENTER & CLINICS OFFICE OF COMPLIANCE AND RISK MANAGEMENT (OCRM). DISCLOSURES REQUIRING MITIGATION WILL BE HANDLED BY A MEMBER OF THE OCRM. IF THERE IS A VIOLATION OF THIS POLICY OR THERE IS A PERCEIVED OR ACTUAL CONFLICT THAT NEEDS TO BE MANAGED, THE OCRM WILL TAKE APPROPRIATE CORRECTIVE ACTION, WHICH MAY INCLUDE A CONFLICT MANAGEMENT PLAN. 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. THE COMPENSATION COMMITTEE IS A JOINT COMMITTEE OF OVERLAKE MEDICAL CENTER & CLINICS, OVERLAKE HOSPITAL ASSOCIATION, AND OVERLAKE HOSPITAL FOUNDATION BOARDS AND THE 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 COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES OF THE MEETING. OFFICERS J. MICHAEL MARSH, ANDREW TOKAR, AND PAUL ISHIZUKA ARE PAID BY RELATED AFFILIATE OVERLAKE MEDICAL CENTER & CLINICS. 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 MEDICAL CENTER & CLINICS) THROUGH A COMMON PAYMASTER. THESE PAYROLL EXPENSES ARE CHARGED TO OVERLAKE HOSPITAL FOUNDATION. OVERLAKE MEDICAL CENTER & CLINICS 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