STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

KAPIOLANI MEDICAL SPECIALISTS: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
KAPIOLANI MEDICAL SPECIALISTS (EIN 99-0322406)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-12
IRS object ID
202201329349306585
Schema version
2020v4.1
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)
Return2022-05-12T15:30:16-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14365 EXECUTIVE DR STE 1600AddressLine1Txt
CitySAN DIEGOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92121ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN990322406EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kapi'olani Medical SpecialistsBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JESSICA LIInCareOfNm
Business Name ControlKAPIBusinessNameControlTxt
Phone8089838986PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 MERCHANT STREET 24TH FLOORAddressLine1Txt
CityHONOLULUCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96813ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCARRIE ANN TSUTSUIPersonNm
Person TitleVP AND CONTROLLERPersonTitleTxt
Phone8089838986PhoneNum
Signature2022-05-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstCARRIE ANNPersonFirstNm
Person LastTSUTSUIPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOCELYNE C MILLERPreparerPersonNm
PTINP00634378PTIN
Phone8585357200PhoneNum
Preparation2022-05-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HAWAI'I PACIFIC HEALTH MEDICAL GROUPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerLESLIE CHUN MD CEOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 WARD STREET STE 1130AddressLine1Txt
CityHONOLULUCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96814ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$297,683,089GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HAWAIIPACIFICHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateHILegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee853TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,593,511PYContributionsGrantsAmt
CY Contributions Grants$4,973,962CYContributionsGrantsAmt
PY Program Service Revenue$142,645,267PYProgramServiceRevenueAmt
CY Program Service Revenue$292,692,717CYProgramServiceRevenueAmt
PY Investment Income$6,979PYInvestmentIncomeAmt
CY Investment Income$16,410CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$146,245,757PYTotalRevenueAmt
CY Total Revenue$297,683,089CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$126,194,493PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$217,941,170CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$86,851,308PYOtherExpensesAmt
CY Other Expenses$169,734,772CYOtherExpensesAmt
PY Total Expenses$213,045,801PYTotalExpensesAmt
CY Total Expenses$387,676,942CYTotalExpensesAmt
PY Revenues Less Expenses-$66,800,044PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$89,993,853CYRevenuesLessExpensesAmt
Total Assets BOY$50,715,377TotalAssetsBOYAmt
Total Assets EOY$66,271,257TotalAssetsEOYAmt
Total Liabilities BOY$55,466,019TotalLiabilitiesBOYAmt
Total Liabilities EOY$69,591,766TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$4,750,642NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$3,320,509NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$371,667,466ExpenseAmt
Grant$1,000GrantAmt
Revenue$292,692,717RevenueAmt
DescSEE SCHEDULE ODesc
Total Program Service Expenses$371,667,466TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee853EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldHIStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJESSICA LIPersonNm
Phone8085357434PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 MERCHANT STREET 24TH FLOORAddressLine1Txt
CityHONOLULUCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96813ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (45 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
RAYMOND P VARA JR
BOARD OF DIRECTOR & PRESIDENT0.261.9Yes (X)Yes (X)$0$2,201,810$2,584,503
CASS NAKASONE MD
Physician40.00.0$1,586,527$0$32,931Yes (X)
DAVID OKABE
EVP, CFO & Treasurer3.047.0Yes (X)$0$946,332$377,896
MARTHA SMITH
Former Officer2.058.0$0$876,739$308,071Yes (X)
GREGORY CHOW MD
Physician40.00.0$1,105,058$0$32,045Yes (X)
ARTHUR GLADSTONE
EVP & CSO0.155.7Yes (X)$0$816,310$309,387
CHARLES R CHING
EVP, GEN. COUNSEL & SECRETARY0.539.5Yes (X)$0$770,901$282,179
GAIL LERCH
Former Officer38.512.5$0$742,339$304,514Yes (X)
STEVEN ROBERTSON
EVP & CIO10.043.0Yes (X)$0$746,792$292,161
DANIEL JUDD MD
Physician40.00.0$1,014,071$0$24,755Yes (X)
KENNETH LEE MD
Physician40.00.0$990,679$0$16,582Yes (X)
MELINDA ASHTON MD
EVP & CQO0.149.2Yes (X)$0$720,839$248,689
MARK GERBER MD
Physician40.00.0$941,071$0$18,715Yes (X)
LESLIE CHUN MD
CHIEF EXECUTIVE OFFICER45.015.0Yes (X)$0$664,477$114,056
PATRICK O'DONNELL MD
Board of Director40.10.0Yes (X)$647,645$0$36,969
DAVID CHO MD
Board of Director40.10.0Yes (X)$623,988$0$33,672
GERARD LIVAUDAIS MD
EVP0.050.0Yes (X)$0$523,145$123,914
DOUGLAS KWOCK MD
VP1.039.0Yes (X)$0$492,064$95,971
KENNETH B ROBBINS MD
Former Officer20.534.5$0$346,070$180,365Yes (X)
DAWN DUNBAR
SVP0.144.9Yes (X)$0$393,438$104,947
WARREN CHAIKO
SVP10.030.0Yes (X)$0$375,732$110,606
SUSAN MASUMOTO-NONAKA
VP0.139.9Yes (X)$0$364,629$81,441
BRANDT FARIAS
SVP/Chief Mktg. Offr. (pt yr)10.053.0Yes (X)$0$327,384$85,944
MICHAEL ROBINSON
VP0.149.9Yes (X)$0$327,479$74,190
JAMES LIN MD
VP2.045.6Yes (X)$27,533$285,691$66,003
ANNE DEMPSEY MD
Board of Director40.10.0Yes (X)$338,662$0$24,483
EARL INOUYE
Former Officer16.531.5$0$285,145$69,530Yes (X)
DAVID STUMBAUGH
VP1.538.5Yes (X)$0$266,339$79,416
LORRIE-ANN LUKE
VP1.540.0Yes (X)$0$259,855$82,911
WILLIAM BURKE
VP12.042.0Yes (X)$0$277,031$60,631
SUNSHINE TOPPING
SVP3.047.0Yes (X)$0$289,279$21,615
KENNETH T NAKAMURA MD
Former Officer28.02.5$147,639$123,801$25,940Yes (X)
CARRIE ANN TSUTSUI
VP & Controller12.135.9Yes (X)$0$230,878$53,413
TERENCE YOUNG
VP38.022.0Yes (X)$0$225,787$37,187
KATIE SHIGEMITSU
Compliance Officer5.035.0Yes (X)$0$224,686$38,125
JENNIFER JONES
VP60.00.0Yes (X)$73,441$116,065$53,896
ALAN ITO
Information Security Officer0.139.9Yes (X)$0$200,273$35,376
JESSICA LEWIS
Assistant Corporate Secretary2.537.5Yes (X)$0$170,876$40,404
DAVID FOX
Privacy Officer (part year)1.238.8Yes (X)$0$163,615$32,106
FRANCE GRAVES
Privacy Officer1.238.8Yes (X)$0$108,993$33,530
CHRIS ELDRIDGE
Board of Director0.20.0Yes (X)$0$0$0
GORDON HAMMOND
Board of Director, Chair0.20.0Yes (X)Yes (X)$0$0$0
WAYNE KATAYAMA
Board of Director0.20.0Yes (X)$0$0$0
ANDREW KAWANO
Board of Director0.20.0Yes (X)$0$0$0
WILLOW MORTON
Board of Director0.20.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$6,936,572TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$11,922,171TotReportableCompRltdOrgAmt
Total Other Compensation$5,940,506TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K612IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
UNIVERSITY OF HAWAI'I
2440 CAMPUS ROAD BOX 368HONOLULUHI96822PHYSICIAN SERVICES$1,272,048
COMPHEALTH INC
PO BOX 972651DALLASTX753972651PHYSICIAN SERVICES$417,831
MEDICAL DIRECTOR ASSOCIATES
5201 CONGRESS AVE STE 100BOCA RATONFL33487PHYSICIAN SERVICES$250,720
ERNST YOUNG US LLP
1003 BISHOP ST STE 2600HONOLULUHI96813ACCOUNTING SERVICES$133,325
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Related Organizations$70RelatedOrganizationsAmt
Government Grants$4,973,892GovernmentGrantsAmt
Total Contributions$4,973,962TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE900099$22,830,805$22,830,805
SERVICE CONTRACTS900099$5,805,749$5,805,749
INTER-ENTITY SERVICE REVENUE900099$264,056,163$264,056,163
FieldValueIRS element (for citing)
Total Program Service Revenue$292,692,717TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,410TotalRevenueColumnAmt
Exclusion$16,410ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$297,683,089TotalRevenueColumnAmt
Related Or Exempt Func Income$292,692,717RelatedOrExemptFuncIncomeAmt
Exclusion$16,410ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,000TotalAmt
Program Services$1,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,571,496TotalAmt
Program Services$1,565,670ProgramServicesAmt
Management And General$5,826ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$414,676TotalAmt
Program Services$206,039ProgramServicesAmt
Management And General$208,637ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$186,887,318TotalAmt
Program Services$183,482,350ProgramServicesAmt
Management And General$3,404,968ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,617,287TotalAmt
Program Services$5,475,029ProgramServicesAmt
Management And General$142,258ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$14,706,824TotalAmt
Program Services$9,055,579ProgramServicesAmt
Management And General$5,651,245ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,743,569TotalAmt
Program Services$8,536,060ProgramServicesAmt
Management And General$207,509ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$4,239TotalAmt
Management And General$4,239ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$493,524TotalAmt
Management And General$493,524ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$29,334,922TotalAmt
Program Services$24,468,194ProgramServicesAmt
Management And General$4,866,728ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$63TotalAmt
Program Services$63ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$139,534TotalAmt
Program Services$106,399ProgramServicesAmt
Management And General$33,135ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$336,793TotalAmt
Program Services$179,034ProgramServicesAmt
Management And General$157,759ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,498,573TotalAmt
Program Services$2,445,835ProgramServicesAmt
Management And General$52,738ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$641,403TotalAmt
Program Services$626,202ProgramServicesAmt
Management And General$15,201ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$202TotalAmt
Management And General$202ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$191,130TotalAmt
Program Services$191,130ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$640,551TotalAmt
Program Services$640,551ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$11,435,567TotalAmt
Program Services$11,362,481ProgramServicesAmt
Management And General$73,086ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACT SERVICE HPHMG$122,806,274$122,780,623$25,651
MOVING EXPENSE$474,328$474,328
OTHER PURCHASES$462,924$380,560$82,364
MEDICAL SUPPLIES$156,338$150,529$5,809

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$118,407TotalAmt
Program Services$14,138ProgramServicesAmt
Management And General$104,269ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$387,676,942TotalAmt
Program Services$371,667,466ProgramServicesAmt
Management And General$16,009,476ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,790,774BOYAmt
EOY$10,134,607EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,834,768BOYAmt
EOY$2,450,611EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,765,113BOYAmt
EOY$1,730,253EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,313,209LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,369,062LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,130,018BOYAmt
EOY$944,147EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$687,166BOYAmt
EOY$1,480,023EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$34,507,538BOYAmt
EOY$49,531,616EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$50,715,377BOYAmt
EOY$66,271,257EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$23,067,300BOYAmt
EOY$26,713,971EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$32,398,719BOYAmt
EOY$42,877,795EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$55,466,019BOYAmt
EOY$69,591,766EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$4,775,320BOYAmt
EOY-$3,345,187EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,678BOYAmt
EOY$24,678EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$4,750,642BOYAmt
EOY-$3,320,509EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$50,715,377BOYAmt
EOY$66,271,257EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$89,993,853ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$91,423,986OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd
Public Support CY5090.00000PublicSupportCY509Pct

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$291,010OtherCostOrOtherBasisAmt
Depreciation$151,718DepreciationAmt
Book Value$139,292BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,022,199OtherCostOrOtherBasisAmt
Depreciation$2,217,344DepreciationAmt
Book Value$804,855BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$944,147TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (12 entries)

DescDescBook ValueBookValueAmt
VARIOUS DEFERRED CHARGES$28,833,202
DUE FROM STRAUB CLINIC & HOSP.$7,768,571
OPERATING LEASE$5,793,415
DUE FROM KAUA'I MEDICAL CLINIC$2,692,994
DUE FROM HAWAI'I HLTH. PTNRS.$1,403,050
OTHER RECEIVABLES$1,279,706
DUE FROM KMCWC$706,042
DUE FROM PALI MOMI MED. CTR.$648,240
DUE FROM WILCOX MEMORIAL HOSP.$218,128
DUE FROM HPHRI$79,346
DUE FROM PROVIDERS INS. CORP.$68,508
DUE FROM STRAUB FOUNDATION$40,414
FieldValueIRS element (for citing)
Total Book Value Other Assets$49,531,616TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (13 entries)

DescDescAmtAmt
457B LIABILITY$28,787,221
DUE TO HAWAI'I PACIFIC HEALTH$6,562,129
LONG-TERM OPERATING LEASE LIABILITY$5,470,550
SHORT-TERM OPERATING LEASE$1,040,746
DEFERRED PAYROLL TAX LIABILITY$855,843
DUE TO CMS COVID PAYMENT$85,444
DUE TO KAPI'OLANI HEALTH FOUNDATION$35,336
DUE TO HONOLULU SURGERY CENTER$26,008
DEFERRED TENANT IMPROVE ALLOW LESSEE$8,855
CAPITAL ACCUMULATION LIABILITY$4,631
ESCHEAT LIABILTY$920
DUE TO PALI MOMI FOUNDATION$100
DUE TO WILCOX HEALTH FOUNDATION$12
FieldValueIRS element (for citing)
Total Liability$42,877,795TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2FormAndLineReferenceDesc
ExplanationUNCERTAIN TAX POSITIONS AUDITED FINANCIAL STATEMENT FOOTNOTE THE COMPANY HAS NOT RECORDED ANY EXPENSE OR ACCRUED FOR ANY RELATED EXPENSE FOR ANY UNCERTAIN TAX POSITIONS. THE COMPANY'S 2017 THROUGH 2020 TAX YEARS REMAIN SUBJECT TO EXAMINATION FOR FEDERAL INCOME TAX PURPOSES, WHEREAS THE 2016 THROUGH 2020 TAX YEARS REMAIN SUBJECT TO EXAMINATION FOR STATE TAXING JURISDICTIONS IN WHICH THE COMPANY OPERATES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (39 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RAYMOND P VARA JR
BOARD OF DIRECTOR & PRESIDENT$0$1,110,173$0$372,487$0$719,150$0$2,558,309$0$26,194$0$4,786,313$0$593,274
CASS NAKASONE MD
Physician$1,294,572$0$372$0$291,583$0$11,400$0$21,531$0$1,619,458$0$0$0
DAVID OKABE
EVP, CFO & Treasurer$0$553,990$0$132,543$0$259,799$0$362,800$0$15,096$0$1,324,228$0$224,487
MARTHA SMITH
Former Officer$0$564,852$0$138,435$0$173,452$0$292,175$0$15,896$0$1,184,810$0$182,195
GREGORY CHOW MD
Physician$1,018,091$0$1,488$0$85,479$0$11,400$0$20,645$0$1,137,103$0$0$0
ARTHUR GLADSTONE
EVP & CSO$0$516,857$0$128,098$0$171,355$0$285,469$0$23,918$0$1,125,697$0$195,252
CHARLES R CHING
EVP, GEN. COUNSEL & SECRETARY$0$436,925$0$104,835$0$229,141$0$262,171$0$20,008$0$1,053,080$0$164,297
GAIL LERCH
Former Officer$0$448,776$0$107,316$0$186,247$0$294,796$0$9,718$0$1,046,853$0$176,006
STEVEN ROBERTSON
EVP & CIO$0$450,338$0$108,006$0$188,448$0$276,365$0$15,796$0$1,038,953$0$172,460
DANIEL JUDD MD
Physician$959,294$0$372$0$54,405$0$2,850$0$21,905$0$1,038,826$0$0$0
KENNETH LEE MD
Physician$972,349$0$0$0$18,330$0$11,400$0$5,182$0$1,007,261$0$0$0
MELINDA ASHTON MD
EVP & CQO$0$467,643$0$111,972$0$141,224$0$233,089$0$15,600$0$969,528$0$169,135
MARK GERBER MD
Physician$890,092$0$744$0$50,235$0$11,400$0$7,315$0$959,786$0$0$0
LESLIE CHUN MD
CHIEF EXECUTIVE OFFICER$0$532,633$0$83,827$0$48,017$0$90,427$0$23,629$0$778,533$0$0
PATRICK O'DONNELL MD
Board of Director$628,175$0$744$0$18,726$0$11,400$0$25,569$0$684,614$0$0$0
DAVID CHO MD
Board of Director$595,629$0$7,474$0$20,885$0$11,400$0$22,272$0$657,660$0$0$0
GERARD LIVAUDAIS MD
EVP$0$410,238$0$78,825$0$34,082$0$108,525$0$15,389$0$647,059$0$71,310
DOUGLAS KWOCK MD
VP$0$407,043$0$48,037$0$36,984$0$73,862$0$22,109$0$588,035$0$45,958
KENNETH B ROBBINS MD
Former Officer$0$255,484$0$0$0$90,586$0$165,414$0$14,951$0$526,435$0$219,481
DAWN DUNBAR
SVP$0$299,741$0$57,822$0$35,875$0$81,124$0$23,823$0$498,385$0$65,358
WARREN CHAIKO
SVP$0$268,426$0$52,369$0$54,937$0$84,038$0$26,568$0$486,338$0$59,768
SUSAN MASUMOTO-NONAKA
VP$0$278,475$0$39,915$0$46,239$0$71,170$0$10,271$0$446,070$0$45,567
BRANDT FARIAS
SVP/Chief Mktg. Offr. (pt yr)$0$249,279$0$47,553$0$30,552$0$76,212$0$9,732$0$413,328$0$50,819
MICHAEL ROBINSON
VP$0$266,844$0$38,177$0$22,458$0$64,458$0$9,732$0$401,669$0$44,010
JAMES LIN MD
VP$26,603$235,544$0$18,953$930$31,194$2,275$39,945$2,015$21,768$31,823$347,404$0$0
ANNE DEMPSEY MD
Board of Director$311,420$0$952$0$26,290$0$11,400$0$13,083$0$363,145$0$0$0
EARL INOUYE
Former Officer$0$201,366$0$40,705$0$43,074$0$67,586$0$1,944$0$354,675$0$46,925
DAVID STUMBAUGH
VP$0$217,152$0$31,699$0$17,488$0$56,827$0$22,589$0$345,755$0$34,835
LORRIE-ANN LUKE
VP$0$211,025$0$30,832$0$17,998$0$57,735$0$25,176$0$342,766$0$34,527
WILLIAM BURKE
VP$0$237,450$0$16,427$0$23,154$0$43,960$0$16,671$0$337,662$0$0
SUNSHINE TOPPING
SVP$0$261,580$0$0$0$27,699$0$0$0$21,615$0$310,894$0$0
KENNETH T NAKAMURA MD
Former Officer$81,445$83,807$21,281$0$44,913$39,994$4,151$8,913$6,400$6,476$158,190$139,190$0$22,303
CARRIE ANN TSUTSUI
VP & Controller$0$195,857$0$17,756$0$17,265$0$41,055$0$12,358$0$284,291$0$0
TERENCE YOUNG
VP$0$183,457$0$11,901$0$30,429$0$28,055$0$9,132$0$262,974$0$0
KATIE SHIGEMITSU
Compliance Officer$0$221,265$0$0$0$3,421$0$23,435$0$14,690$0$262,811$0$0
JENNIFER JONES
VP$73,212$88,368$0$11,973$229$15,724$6,432$21,381$13,899$12,184$93,772$149,630$0$0
ALAN ITO
Information Security Officer$0$185,591$0$13,070$0$1,612$0$21,083$0$14,293$0$235,649$0$0
JESSICA LEWIS
Assistant Corporate Secretary$0$170,876$0$0$0$0$0$15,118$0$25,286$0$211,280$0$0
DAVID FOX
Privacy Officer (part year)$0$160,526$0$0$0$3,089$0$16,325$0$15,781$0$195,721$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE J, PART I, LINE 3SUPPLEMENTAL COMPENSATION INFORMATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ('HPH'), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, FORM 990 PART VI, SECTION B, LINE 15A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION.
FORM 990, SCHEDULE J, PART I, LINE 4BSUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $443,030 DAVID OKABE - $156,411 GAIL LERCH - $113,397 STEVEN ROBERTSON - $100,707 KENNETH B. ROBBINS, M.D. - $91,556 CHARLES R. CHING - $84,461 ARTHUR GLADSTONE - $77,843 MARTHA SMITH - $74,608 MELINDA ASHTON, M.D. - $61,798 ANNUAL INCENTIVE PLAN THE ANNUAL INCENTIVE PLANS ARE AFFORDED TO EXECUTIVES BASED ON ANNUAL SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $372,488 DAVID OKABE - $132,543 GAIL LERCH - $107,316 STEVEN ROBERTSON - $108,006 CHARLES R. CHING - $104,835 ARTHUR GLADSTONE - $128,098 MARTHA SMITH - $138,435 MELINDA ASHTON, M.D. - $111,972 LESLIE CHUN, M.D. - $83,827 GERARD LIVAUDAIS, M.D. - $78,824 DAWN DUNBAR - $57,822 WARREN CHAIKO - $52,368 DOUGLAS KWOCK, M.D. - $48,037 BRANDT FARIAS - $47,553 EARL INOUYE - $40,705 SUSAN NONAKA - $39,915 MICHAEL ROBINSON - $38,177 DAVID STUMBAUGH - $31,700 LORRIE-ANN LUKE - $30,832 JAMES LIN, M.D. - $18,581 CARRIE ANN TSUTSUI - $17,756 WILLIAM BURKE - $16,427 JENNIFER JONES - $11,973 TERENCE YOUNG - $11,901 Retention incentive plan The retention incentive plan was designed to encourage continued interest in the success of the organization and provide competitive retirement benefits. The sole plan participant is Hawai'i Pacific health's chief executive officer, Raymond P. Vara Jr. The plan does not replace the annual and long-term incentive plan nor the serp restoration plan. Amounts paid out during the year by a related organization: Raymond P. Vara JR - $1,015,000

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JANNY CHEN MD
SEE PART V$202,264PHYSICIAN COMPENSATIONfalse
Susan Lin MD
SEE PART V$259,318PHYSICIAN COMPENSATIONfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE L, PART IV, COLUMN BFormAndLineReferenceDesc
ExplanationJANNY CHEN, M.D. IS A FAMILY MEMBER OF DAVID CHO, M.D., A CURRENT MEMBER OF THE BOARD OF DIRECTORS. SUSAN LIN, M.D. IS A FAMILY MEMBER OF LESLIE CHUN, M.D., CHIEF EXECUTIVE OFFICER.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1MISSION STATEMENT KAPI'OLANI MEDICAL SPECIALISTS, AN AFFILIATE OF HAWAI'I PACIFIC HEALTH, IS A PROVIDER GROUP THAT SERVES HAWAII PACIFIC HEALTH THROUGH ACADEMICS, RESEARCH AND CLINICAL CARE, IN PARTNERSHIP WITH KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB MEDICAL CENTER, AND WILCOX HEALTH.
FORM 990, PART III, LINE 1MISSION STATEMENT KAPI'OLANI MEDICAL SPECIALISTS (DBA HAWAI'I PACIFIC HEALTH MEDICAL GROUP) IS A MULTI-SPECIALTY PROVIDER GROUP DEDICATED TO PROVIDING WORLD-CLASS CARE FOR HAWAI'I'S ADULTS AND CHILDREN THROUGH ACADEMICS, RESEARCH AND CLINICAL CARE. WORKING IN PARTNERSHIP WITH KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB MEDICAL CENTER, AND WILCOX HEALTH, THE GROUP'S MISSION IS TO CREATE A HEALTHIER HAWAI'I.
FORM 990, PART III, LINE 4APROGRAM SERVICE ACCOMPLISHMENTS KAPI'OLANI MEDICAL SPECIALISTS (DBA HAWAI'I PACIFIC HEALTH MEDICAL GROUP) HAS OVER 667 EMPLOYED FTE PROVIDERS AND IS ORGANIZED BY THE FOLLOWING SPECIALTIES: PRIMARY CARE, MEDICAL SUBSPECIALTIES, SURGERY, WOMEN'S HEALTH, HOSPITAL BASED MEDICINE, AND PEDIATRICS. IN FISCAL YEAR 2021, KAPI'OLANI MEDICAL SPECIALISTS (DBA HAWAI'I PACIFIC HEALTH MEDICAL GROUP) HAD 880,987 PATIENT ENCOUNTERS. KAPI'OLANI MEDICAL SPECIALISTS (DBA HAWAI'I PACIFIC HEALTH MEDICAL GROUP) ALLIES WITH THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE, IN ADHERENCE TO ITS CORE VALUES OF WORLD-CLASS HEALTH CARE, PHYSICIAN TRAINING, AND MEDICAL RESEARCH. THIS PARTNERSHIP PROVIDES A UNIQUE ACADEMIC AFFILIATION FOR HAWAI'I PACIFIC HEALTH AND FURTHERS ITS COMMITMENT TO EFFECTIVE HEALTH CARE THROUGH MEDICAL RESEARCH AND BY TRAINING TOMORROW'S HEALTH CARE PROVIDERS. KAPI'OLANI MEDICAL SPECIALISTS (DBA HAWAI'I PACIFIC HEALTH MEDICAL GROUP) HAS DEVELOPED A VARIETY OF WAYS TO IDENTIFY AND MEET THE UNIQUE HEALTH CARE NEEDS OF HAWAI'I. KAPI'OLANI MEDICAL SPECIALISTS RECRUITS PHYSICIANS FROM THROUGHOUT THE NATION WHO DESIRE EMPLOYMENT IN A GROUP PRACTICE SETTING WITH HAWAI'I'S LEADING HEALTH CARE SYSTEM, ESPECIALLY SUB-SPECIALISTS IN SHORT SUPPLY, YET HIGH DEMAND. KAPI'OLANI MEDICAL SPECIALISTS PHYSICIANS PROVIDE ESSENTIAL SERVICES AT OTHER HOSPITALS IN THE STATE OF HAWAI'I, I.E., NEONATAL SERVICES AT THE QUEEN'S MEDICAL CENTER, CLINICS AT TRIPLER ARMY MEDICAL CENTER, AND SPECIALTY SERVICES AT KAISER PEMANENTE LOCATIONS. ADDITIONALLY, THEY PROVIDE PATIENT CARE AT OUTREACH CLINICS AND COMMUNITY HEALTH CENTERS THROUGHOUT HAWAI'I, PROMOTE LESSER-KNOWN SERVICES TO PATIENTS WITH SPECIAL NEEDS, PROVIDE HEALTH EDUCATION ON THE NEIGHBOR ISLANDS AND HEALTH CARE TRAINING TO THE COMMUNITY AND OTHER PROVIDERS, AND SERVE AS MEDICAL DIRECTORS ON VARIOUS COMMUNITY BOARDS. CARING FOR THE UNDERSERVED, A LONG-STANDING TRADITION OF ACADEMIC MEDICAL CENTERS THROUGHOUT THE NATION, CONTINUES TO BE A MAJOR FOCUS OF KAPI'OLANI MEDICAL SPECIALISTS. IN FISCAL YEAR 2021, THE GROUP PROVIDED $293 MILLION IN MEDICAL CARE TO PATIENTS IN NEED OF MEDICAL SERVICES.
FORM 990,PART V, LINE 1AFORM 1096 REPORTING HAWAI'I PACIFIC HEALTH (HPH), THE ORGANIZATION'S TAX EXEMPT PARENT, PAYS ALL VENDORS. THEREFORE, HPH ISSUES FORMS 1099 UNDER ITS TAX ID.
FORM 990, PART VI, SECTION A, LINE 6MEMBERS AND RIGHTS HAWAI'I PACIFIC HEALTH (HPH) IS THE SOLE MEMBER WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE WITH THE RIGHT TO APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7ADESCRIPTION OF CLASSES OF PERSON AND THE NATURE OF THEIR RIGHTS HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER AND HAS THE POWER TO ELECT MEMBERS OF THE GOVERNING BODY. HAWAI'I PACIFIC HEALTH, AS MEMBER, ALSO HAS THE POWER TO ELECT ONE OR MORE EX-OFFICIO VOTING MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTIONA A, LINE 7BDESCRIPTION OF CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS THE FOLLOWING RESERVED POWERS: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE CHIEF MEDICAL OFFICER, DIRECTOR OF OPERATIONS, TREASURER, SECRETARY, EXECUTIVE VP/CFO, OTHER EXCUTIVE VP'S, SENIOR VP, ASSISTANT SECRETARIES, AND ALL VP'S EXCEPT THE OPERATING UNIT VP'S, AS SUCH TERMS ARE DEFINED IN THESE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THESE BYLAWS; (IV) THE CORPORATION's PARTICIPATION IN ALL LONG-TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF 1 YEAR AND/OR FOR $1,000,000 OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, THE ADVISORY SERVICE AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (VII) EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, OR PARTNERSHIP OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (X) EXCEPT AS PROVIDED IN SECTION 3.2(C) OF THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAI'I, SELL, LEASE OR OTHERWISE TRANSFER 50 OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE CORP; (XI) EXCEPT AS PROVIDED IN SECTION 3.2(C) OF THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAI'I, SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE CORPORATION WHICH GENERATE 50 OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE CORPORATION DURING THE PRIOR FISCAL YEAR; (XII) CLOSE THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORPORATION; PROVIDED THAT AFTER THE EFFECTIVE DATE OF THESE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORP MUST ALSO BE APPROVED BY THE BOARD; (XIII) CONVERT THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORPORATION INTO A FACILITY NO LONGER OFFERING MEDICAL SERVICES; PROVIDED THAT AFTER THE EFFECTIVE DATE OF THESE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (XIV) AFTER CONSULTING WITH THE BOARD, REMOVE THE CHIEF MEDICAL OFFICER, DIRECTOR OF OPERATIONS, EXECUTIVE VP/CFO, TREASURER, SECRETARY, OTHER EXECUTIVE VP'S, SENIOR VP'S, ASSISTANT SECRETARIES, AND ALL VP'S EXCEPT THE OPERATING UNIT VP'S; PROVIDED, HOWEVER, THAT TO REMOVE OR TERMINATE THE CHIEF MEDICAL OFFICER WILL REQUIRE THE CHIEF MEDICAL OFFICER OF THE MEMBER TO FULLY COLLABORATE AND CONSULT WITH THE BOARD AND SEEK THE BOARD'S ADVANCE CONSENT FOR SUCH REMOVAL OR TERMINATION. IF THE BOARD DOES NOT CONCUR WITH THE PROPOSED REMOVAL OR TERMINATION OF THE CHIEF MEDICAL OFFICER, SUCH REMOVAL OR TERMINATION WILL REQUIRE THE APPROVAL OF A MAJORITY OF THE MEMBERS ON THE MEMBER BOARD; (XV) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORPORATION GOALS AND THE LONG RANGE AND STRATEGIC PLANS OF THE CORPORATION; AND (XVI) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. IN ADDITION, DECISIONS OF THE GOVERNING BODY REQUIRING THE APPROVAL OF HAWAI'I PACIFIC HEALTH, AS MEMBER, INCLUDE: (I) ADD ANY DIRECTOR TO THE BOARD; (II) REMOVE ANY DIRECTOR FROM THE BOARD; (III) AMEND THE ARTICLES; (IV) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS ON BEHALF OF THE CORPORATION EXCEEDING $1,000,000 IN VALUE; (V) ACQUIRE ASSETS WORTH OVER $1,000,000; (VI) AQUIRE SHARES IN ANOTHER CORPORATION; (VII) SELL, LEASE OR OTHERWISE TRANSFER 50 OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE CORPORATION; (VIII) SELL, LEASE, EXCHANGE OR DISPOSE OF 50 OR MORE OF THE THEN PROPERTY AND ASSETS HELD BY THE CORPORATION; (IX) SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE CORPORATION WHICH GENERATE 50 OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE CORPORATION DURING THE PRIOR FISCAL YEAR; (X) MERGE THE CORPORATION WITH ANY ENTITY; (XI) DISSOLVE OR LIQUIDATE THE CORPORATION; (XII) ISSUE THE CORPORATION'S MEMBERSHIP TO ANY OTHER THAN THE MEMBER; (XIII) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONASHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; AND (XIV) DEVELOP A NEW LINE OF BUSINESS
FORM 990, PART VI, SECTION B, LINE 11BREVIEW OF THE FORM 990 BY THE ORGANIZATION'S GOVERNING BODY VARIOUS SCHEDULES OF THE FORM 990 ARE PREPARED PRIMARILY BY STAFF WITHIN THE ACCOUNTING AREA OF THE ORGANIZATION WORKING WITH VARIOUS OTHER AREAS OF THE ORGANIZATION SUCH AS MANAGEMENT OF THE OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPILED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYTEM REVIEWS THE FORM 990 OF EACH FILLING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE FORMS 990 ARE THEN PROVIDED TO THE GOVERNANCE AND NOMINATING COMMITTEE OF THE HEALTH CARE SYSTEM'S BOARD OF DIRECTORS FOR THEIR REVIEW. THE GOVERNANCE AND NOMINATING COMMITTEE OF THE PARENT'S ENTITY (HAWAI'I PACIFIC HEALTH "HPH") BOARD PROVIDES OVERSIGHT FOR THE FORM 990 REPORTING AND REVIEWS THE FORM 990 FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE FORM 990 FOR EACH ENTITY IS MADE AVAILABLE TO THE HPH BOARD OF DIRECTORS THROUGH A BOARD PORTAL FOR REVIEW PRIOR TO THE FILING OF THE FORM 990. COPIES OF THE FORMS 990 ARE MADE AVAILABLE TO THE BOARD MEMBERS OF EACH SUBSIDIARY UNIT OF HPH AND IS PHYSICALLY LOCATED AT EACH FACILITY'S SITE FOR THE BOARD MEMBER TO REVIEW PRIOR TO FILING. THE FORMS 990 WILL BE POSTED TO HPH'S WEBSITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURNS WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12Cmonitoring and enforcement of conflict of interest policy ANNUALLY, EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) RECEIVED A COPY OF THE CONFLICT OF INTEREST ('COI') POLICY; 2) HAS READ AND UNDERSTAND THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) HAS DISCLOSED ANY CONFLICTS OR POTENTIAL CONFLICTS OR ECONOMIC INTERESTS AS REQUIRED; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE IN-HOUSE LEGAL DEPARTMENT DISTRIBUTES THE STATEMENT REQUEST AND REVIEWS THE COI STATEMENTS RETURNED. IDENTIFIED CONFLICTS OF INTEREST ARE PRESENTED TO THE BOARD FOR REVIEW, DELIBERATION AND CONFIRMATION/REFUTATION THAT A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST HAS BEEN FOUND, THE INDIVIDUAL MAY ADDRESS THE BOARD AND EXPLAIN THE TRANSACTION OR ARRANGEMENT CAUSING THE CONFLICT. AFTER THE PRESENTATION, THE INDIVIDUAL IS EXCUSED FROM THE MEETING AND SHALL NOT PARTICIPATE WITH ANY DISCUSSION OR VOTE ON MATTERS PERTAINING TO THE TRANSACTION OR ARRANGEMENT. IN MEETINGS WHERE APPLICATION OF THE COI POLICY OCCURS, THE MEETING MINUTES INCLUDE NATURE OF THE FINANCIAL INTEREST/CONFLICT, NAME(S) OF THE PERSON(S) WITH THE POTENTIAL OR ACTUAL CONFLICT, ANY ACTION TAKEN TO ASSIST IN THE DETERMINATION OF WHETHER A CONFLICT EXISTED, INCLUDING ANY DISCUSSION OF ALTERNATIVE ARRANGEMENTS, THE BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT.
FORM 990, PART VI, SECTION B, LINES 15A & 15BPROCESS OF DETERMINING COMPENSATION THE TOP MANAGEMENT OFFICIALS OF THE ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER BY THE TAX-EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ("HPH"). FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. COMPENSATION FOR HPH EXECUTIVES (VP AND ABOVE) IS SET BY THE INDEPENDENT BOARD MEMBERS WHO ARE MEMBERS OF THE HPH COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE'S COMPENSATION AND BENEFITS. THE CONSULTANT PROVIDES A WRITTEN REPORT TO THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING. INCLUDED IN THE REPORT IS MARKET BASED DATA FROM LIKE ORGANIZATIONS. THE COMPENSATION COMMITTEE MAKES FINAL DECISIONS REGARDING COMPENSATION AND BENEFITS AT THE MEETING AFTER REVIEW AND DISCUSSION OF THE CONSULTANT'S REPORT. COMMUNITY BASED DIRECTORS OF THE ORGANIZATION ARE NOT COMPENSATED. CERTAIN EMPLOYED PHYSICIANS MAY BE OFFICERS OR AN IDENTIFIED KEY EMPLOYEE OF THE REPORTING OR RELATED ORGANIZATION. PHYSICIAN COMPENSATION IS ALSO HANDLED IN THE SAME MANNER AS EXECUTIVE COMPENSATION, WITH THE HPH COMPENSATION COMMITTEE RECEIVING A REPORT FROM A NEUTRAL CONSULTANT AND FOLLOWING THE SAME PROCESS AS DESCRIBED ABOVE ON AN ANNUAL BASIS. THIS PROCESS WAS LAST COMPLETED ON MARCH 09, 2021 TO REVIEW PHYSICIAN COMPENSATION AND ON JULY 28, 2021 TO REVIEW EXECUTIVE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19DISCLOSURE OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS DISCLOSURE OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND STANDARDS OF CONDUCT ARE AVAILABLE ON THE HAWAI'I PACIFIC HEALTH WEBSITE. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE HAWAI'I PACIFIC HEALTH WEBSITE.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS EQUITY TRANSFER WITH HPH $ 91,423,988 ROUNDING $ (2) -------------- TOTAL $ 91,423,986

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
HAWAI'I PACIFIC HEALTH
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990246363ADMIN. SVCS.HI501(c)(3)12C, III-FINAfalse
KAPI'OLANI HEALTH FOUNDATION
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990246364FUNDRAISINGHI501(c)(3)7HPHYes (true)
KAPI'OLANI MED CTR FOR WOMEN & CHILDREN
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990177350HOSPITALHI501(c)(3)3HPHYes (true)
KAUA'I MEDICAL CLINIC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990326099HOSPITALHI501(c)(3)3HPHYes (true)
PALI MOMI FOUNDATION
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813383840327FUNDRAISINGHI501(c)(3)7HPHYes (true)
PALI MOMI MEDICAL CENTER
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990274038HOSPITALHI501(c)(3)3HPHYes (true)
PROVIDERS INSURANCE COMPANY
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813710893000INSURANCEHI501(c)(3)12B, IIHPHYes (true)
STRAUB CLINIC & HOSPITAL
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813912151670HOSPITALHI501(c)(3)3HPHYes (true)
STRAUB FOUNDATION
55 MERCHANT STREET 26TH FLOORHONOLULUHI96813990109350FUNDRAISINGHI501(c)(3)7HPHYes (true)
WILCOX HEALTH FOUNDATION
3-3420 KUHIO HIGHWAYLIHUEHI96766990204242FUNDRAISINGHI501(c)(3)7HPHYes (true)
WILCOX MEMORIAL HOSPITAL
3-3420 KUHIO HIGHWAYLIHUEHI96766990074365HOSPITALHI501(c)(3)3HPHYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ASC PACIFIC VENTURES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 Merchant St 27th floorAddressLine1Txt
CityHonoluluCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96813ZIPCd
FieldValueIRS element (for citing)
EIN270540034EIN
Primary ActivitiesAMBU. SURG. CTR.PrimaryActivitiesTxt
Legal Domicile StateALLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeTypeTxt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxt
HAWAI'I PACIFIC HEALTH PARTNERS INC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990318588HOLDING COMPANYHINAC CORP
STRAUB PHARMACY INC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990145107INACTIVEHINAC CORP
HICORD INC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990251496INVESTMENTHINAC CORP
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
KAPI'OLANI MED CTR FOR WOMEN & CHILDREN
q$5,750,863FMV
KAPI'OLANI MED CTR FOR WOMEN & CHILDREN
p$14,873,068FMV
PALI MOMI MEDICAL CENTER
q$1,135,775FMV
PALI MOMI MEDICAL CENTER
o$68,423FMV
PALI MOMI MEDICAL CENTER
p$7,404,978FMV
STRAUB CLINIC & HOSPITAL
q$12,459,535FMV
STRAUB CLINIC & HOSPITAL
o$98,650FMV
STRAUB CLINIC & HOSPITAL
p$97,772,923FMV
STRAUB CLINIC & HOSPITAL
r$4,339,620FMV
WILCOX MEMORIAL HOSPITAL
q$4,303,162FMV
WILCOX MEMORIAL HOSPITAL
p$7,493,877FMV
KAUA'I MEDICAL CLINIC
p$28,525,227FMV
PROVIDERS INSURANCE CORPORATION
r$12,867,184FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART IIIFormAndLineReferenceDesc
ExplanationRELATED ORG. TAXABLE AS PARTNERSHIP: ASC PACIFIC VENTURES, LLC EIN: 27-0540034 ADDRESS: 55 MERCHANT ST., 27TH FLOOR HONOLULU, HI 96813ExplanationTxt