Form 990 for tax year 2022
Filed by OVERLAKE MEDICAL CENTER & CLINICS.
Totals
- Total revenue
- $722,143,602
- Total expenses
- $767,321,087
- Contributions and grants received
- $27,105,587
- Grants paid
- $2,678,500
- Program services expenses (Part IX)
- $641,477,833
- Management and general expenses
- $125,843,254
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $641,477,833
Program services were 83.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
JASON THOMPSON
CHAIR
- Total calculated
- $0
- Hours/week
- 6 + 0.5 related
-
TOM EVERT
SECRETARY & TREASURER
- Total calculated
- $0
- Hours/week
- 2 + 0.5 related
-
ROBERT CAMPBELL
IMMEDIATE PAST CHAIR
- Total calculated
- $0
- Hours/week
- 4 + 4 related
-
PAULINE BACH
TRUSTEE
- Total calculated
- $0
- Hours/week
- 3 + 1.5 related
-
KRISTINA BELFIORE
TRUSTEE
- Total calculated
- $0
- Hours/week
- 2 + 0.5 related
-
JORGE CERDA
TRUSTEE
- Total calculated
- $0
- Hours/week
- 3 + 3 related
-
ANNETTE CLARK
TRUSTEE
- Total calculated
- $0
- Hours/week
- 2 + 2 related
-
TED HERB
TRUSTEE
- Total calculated
- $0
- Hours/week
- 2 + 2 related
-
TIFFANY KOENIG
TRUSTEE
- Total calculated
- $0
- Hours/week
- 1.5 + 0.5 related
-
JIM LADD
TRUSTEE
- Total calculated
- $0
- Hours/week
- 3 + 0.5 related
-
MARTHA LEE
TRUSTEE
- Total calculated
- $0
- Hours/week
- 3 + 3 related
-
LINDA MAHAFFEY
TRUSTEE
- Total calculated
- $0
- Hours/week
- 1.5 + 1 related
-
UMA RAGHAVAN
TRUSTEE
- Total calculated
- $0
- Hours/week
- 4 + 0.5 related
-
LISA WISSNER-SLIVKA
TRUSTEE
- Total calculated
- $0
- Hours/week
- 5 + 1 related
-
JULIE SUN
FOUNDATION REP
- Total calculated
- $0
- Hours/week
- 2 + 5 related
-
DILIP WAGLE
TRUSTEE
- Total calculated
- $0
- Hours/week
- 2 + 1 related
-
JESSIE WOOLLEY-WILSON
TRUSTEE
- Total calculated
- $0
- Hours/week
- 2 + 2 related
-
J MICHAEL MARSH
PRESIDENT & CEO
- Total calculated
- $1,607,171
- From this org
- $1,462,825
- From related orgs
- $0
- Other
- $144,346
- Hours/week
- 45 + 14 related
Schedule J breakdown matched by us
- Base
- $926,784
- Bonus
- $429,961
- Other
- $106,080
- Deferred
- $123,611
- Nontaxable benefits
- $20,735
- Filer's total
- $1,607,171
-
THOMAS A DEBORD
COO THRU 11/22
- Total calculated
- $885,897
- From this org
- $797,792
- From related orgs
- $0
- Other
- $88,105
- Hours/week
- 50
Schedule J breakdown matched by us
- Base
- $501,717
- Bonus
- $208,248
- Other
- $87,827
- Deferred
- $71,590
- Nontaxable benefits
- $16,515
- Filer's total
- $885,897
-
ANDREW J TOKAR
CFO
- Total calculated
- $664,259
- From this org
- $591,433
- From related orgs
- $0
- Other
- $72,826
- Hours/week
- 50 + 7 related
Schedule J breakdown matched by us
- Base
- $443,482
- Bonus
- $144,978
- Other
- $2,973
- Deferred
- $60,094
- Nontaxable benefits
- $12,732
- Filer's total
- $664,259
-
JON DUARTE
CHIEF STRATEGY OFFICER
- Total calculated
- $484,641
- From this org
- $430,248
- From related orgs
- $0
- Other
- $54,393
- Hours/week
- 50
Schedule J breakdown matched by us
- Base
- $312,978
- Bonus
- $115,908
- Other
- $1,362
- Deferred
- $30,394
- Nontaxable benefits
- $23,999
- Filer's total
- $484,641
-
DAVID J WINOKUR
CHIEF ADMINISTRATIVE OFFICER
- Total calculated
- $289,493
- From this org
- $256,288
- From related orgs
- $0
- Other
- $33,205
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $226,362
- Bonus
- $25,785
- Other
- $4,141
- Deferred
- $13,044
- Nontaxable benefits
- $20,161
- Filer's total
- $289,493
-
KELAN R KOENIG MD
OMC PHYSICIAN EXECUTIVE
- Total calculated
- $800,952
- From this org
- $703,679
- From related orgs
- $0
- Other
- $97,273
- Hours/week
- 55
Schedule J breakdown matched by us
- Base
- $490,386
- Bonus
- $207,989
- Other
- $5,304
- Deferred
- $72,961
- Nontaxable benefits
- $24,312
- Filer's total
- $800,952
-
VALERIE CHRUSCIEL
OMC CHIEF OPERATING OFFICER
- Total calculated
- $475,856
- From this org
- $418,513
- From related orgs
- $0
- Other
- $57,343
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $281,333
- Bonus
- $101,112
- Other
- $36,068
- Deferred
- $40,803
- Nontaxable benefits
- $16,540
- Filer's total
- $475,856
-
MICHELLE CURRY
CHIEF NURSING OFFICER
- Total calculated
- $483,295
- From this org
- $427,843
- From related orgs
- $0
- Other
- $55,452
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $319,928
- Bonus
- $102,585
- Other
- $5,330
- Deferred
- $43,658
- Nontaxable benefits
- $11,794
- Filer's total
- $483,295
-
ASIF ALI KHAN MD
NEUROLOGIST
- Total calculated
- $1,069,048
- From this org
- $1,026,931
- From related orgs
- $0
- Other
- $42,117
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $602,824
- Bonus
- $417,248
- Other
- $6,859
- Deferred
- $15,250
- Nontaxable benefits
- $26,867
- Filer's total
- $1,069,048
-
DEREK RODRIGUES MD
CARDIOLOGIST
- Total calculated
- $1,026,492
- From this org
- $981,443
- From related orgs
- $0
- Other
- $45,049
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $839,431
- Bonus
- $125,945
- Other
- $16,067
- Deferred
- $21,350
- Nontaxable benefits
- $23,699
- Filer's total
- $1,026,492
-
ROBERT RHO MD
CARDIOLOGIST
- Total calculated
- $879,130
- From this org
- $843,825
- From related orgs
- $0
- Other
- $35,305
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $748,644
- Bonus
- $84,758
- Other
- $10,423
- Deferred
- $15,250
- Nontaxable benefits
- $20,055
- Filer's total
- $879,130
-
DAVID W NELSON MD
CARDIAC SURGEON
- Total calculated
- $974,431
- From this org
- $926,864
- From related orgs
- $0
- Other
- $47,567
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $865,444
- Bonus
- $46,728
- Other
- $14,692
- Deferred
- $21,350
- Nontaxable benefits
- $26,217
- Filer's total
- $974,431
-
ROBERT BINFORD MD
CARDIAC SURGEON
- Total calculated
- $883,936
- From this org
- $838,087
- From related orgs
- $0
- Other
- $45,849
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $777,792
- Bonus
- $46,728
- Other
- $13,567
- Deferred
- $20,132
- Nontaxable benefits
- $25,717
- Filer's total
- $883,936
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 3 · Compensation committee
- 3 · Independent compensation consultant
- 3 · Written employment contract
- 3 · Compensation survey or study
- 3 · Approval by the board or compensation committee
- 4b · Supplemental nonqualified retirement plan
- 7 · Other non-fixed payments
Answered no
- 4a · Severance or change-of-control payment
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 7
- INCENTIVES IN 2022 WERE PAID TO J. MICHAEL MARSH, THOMAS A. DEBORD, KELAN R. KOENIG, ANDREW J. TOKAR, JONATHAN T. DUARTE, MICHELLE CURRY, VALERIE CHRUSCIEL, AND DAVID J. WINOKUR. THE INCENTIVES ARE AWARDED BASED ON PRODUCTIVITY AND MEETING CERTAIN INDIVIDUAL QUALITY GOALS.
- PART I, LINE 4B:
- J. MICHAEL MARSH AND THOMAS A. DEBORD PARTICIPATE 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 2022 DEFERRALS: J. MICHAEL MARSH ($102,261) AND THOMAS A. DEBORD ($50,240). THE FOLLOWING AMOUNTS FROM THE CAPITAL ACCUMULATION ACCOUNT WERE PAID IN 2022: THOMAS A. DEBORD ($47,253) AND J. MICHAEL MARSH ($96,473). THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR FORMS 990. THOMAS A. DEBORD AND J. MICHAEL MARSH RECEIVED REDEMPTION OF CREDITS IN THE CAPITAL ACCUMULATION ACCOUNT THAT HAD BECOME VESTED. KELAN R. KOENIG, ANDREW J. TOKAR, JON DUARTE, MICHELLE CURRY AND VALERIE CHRUSCIEL ALL PARTIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN BENEFIT. THIS IS A NONQUALIFIED PLAN SPONSORED BY OVERLAKE HOSPITAL MEDICAL CENTER. THE FOLLOWING AMOUNTS REFLECT 2022 DEFERRALS: KELAN R. KOENIG ($51,611), ANDREW J. TOKAR ($38,744), JON DUARTE ($25,153), MICHELLE CURRY ($22,308) AND VALERIE CHRUSCIEL ($19,453). THE FOLLOWING AMOUNTS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WERE PAID IN 2022: VALERIE CHRUSCIEL ($29,975).
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
-
$2,430,893
SUPPORT OPERATIONS
-
$30,000
SPONSOR
-
$25,000
SPONSOR
-
SPONSOR
-
$15,000
SPONSOR
-
$15,000
SPONSOR
-
$12,500
SUPPORT OPERATIONS
-
SPONSOR
-
$10,000
SPONSOR
-
$10,000
SUPPORT OPERATIONS-CAR SEAT CHECK PROGRAM
The 10 largest by cash amount. The API serves every itemized grant.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
501(C)(3) · FUNDRAISING · WA · controlled entity
Directly controlled by OVERLAKE HOSPITAL MEDICAL CENTER
-
501(C)(3) · PROVIDE SUPPORT · WA · controlled entity
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 4 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202401319349303615
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
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