2021-05-12T15:28:45-05:00 2020-06-30 ERNST & YOUNG US LLP 4365 EXECUTIVE DR STE 1600 SAN DIEGO CA 92121 990 2019-07-01 990251372 MOLOKAI GENERAL HOSPITAL % ZESSICA APIKI MOLO 8085533125 PO BOX 408 KAUNAKAKAI MOLOKAI HI 96748 CLINTON YEE TREASURER 8085533125 2021-05-06 true JOCELYNE MILLER P00634378 8585357200 2021-05-04 2019 2022-09-23 18:48:47Z JANICE KALANIHUIA PO BOX 408 KAUNAKAKAI HI 96748 21589778 false X www.molokaigeneralhospital.com X 1987 HI TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE ISLAND OF MOLOKAI. 5 3 106 0 3507 0 2093913 2484103 11458539 15132684 239831 233189 505492 553289 14297775 18403265 0 1005 0 0 6987001 7416078 0 0 0 7677561 8588937 14664562 16006020 -366787 2397245 18049891 24900485 3902559 8650966 14147332 16249519 X TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE ISLAND OF MOLOKAI. false false 12511469 0 15501499 MOLOKAI GENERAL HOSPITAL (MGH) IS A RURAL HEALTH CARE FACILITY WITH A CRITICAL ACCESS HOSPITAL DESIGNATION. IT PROVIDES THE ONLY EMERGENCY ROOM SERVICES FOR RESIDENTS AND VISITORS ON THE ISLAND OF MOLOKAI, AND PROVIDES ACUTE CARE, INPATIENT HOSPICE, SKILLED NURSING, AND LOW-RISK OBSTETRICAL SERVICES. MGH ALSO OFFERS CHEMOTHERAPY, LIMITED SPECIAL PROCEDURES, DIABETES MANAGEMENT, MIDWIFERY, FAMILY PLANNING, AND PRIMARY CARE IN ITS RURAL HEALTH CLINIC(LOCATED ON HOSPITAL GROUNDS). SEE SCHEDULE O FOR MORE INFORMATION. 12511469 true true false true false false false false false false true true false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 2 0 true 106 true false false false false false false false false false false false false X 5 3 false false false false true true true true true false false true false false false false false false X ZESSICA APIKI 8085533125 PO BOX 408 KAUNAKAKAI HI 96748 ARTHUR USHIJIMA TRUSTEE/CHAIR - PART YEAR 1.0 64.0 X X 0 1475521 75855 JILL HOGGARD GREEN TRUSTEE/CHAIR - EFF. 10/2019 1.0 64.0 X X 0 549163 3837 JANICE KALANIHUIA PRESIDENT 54.0 1.0 X X 0 286852 58087 WILLIAM THOMAS JR MD PHYSICIAN 40.0 0.0 X 293886 0 46294 CLINTON YEE TREASURER 2.0 53.0 X 0 221175 50579 MICHAEL MULLEN DIR OF NURSING 40.0 0.0 X 149737 0 35979 PUNAHELE ALCON VICE PRESIDENT 50.0 0.0 X 143106 0 32462 BRIANNA MULLEN NURSE PRACTITIONER 40.0 0.0 X 128851 0 6026 NORIKO NAKANO NURSE 40.0 0.0 X 120836 0 13073 TONIA STEVENSON MIDWIFE 40.0 0.0 X 125772 0 7927 MARINA LAFAELE SECRETARY 40.0 0.0 X 24165 0 12434 DONNA HAYTKO-PAOA TRUSTEE 1.0 0.0 X 0 0 0 JENAI WALL TRUSTEE 1.0 6.0 X 0 0 0 LANCE DUNBAR VICE CHAIR/TRUSTEE 1.0 0.0 X X 0 0 0 986353 2532711 342553 11 false true false HAWAII EMERGENCY PHYSICIANS ASSOCIA PO BOX 1266 KAILUA HI 96734 MEDICAL SERVICES 1013896 KANOPY HEALTHCARE PARTNERS INC PO BOX 1460 MAGEE MS 39111 CONSULTING SERVICES 515303 AUREUS RADIOLOGY LLC 13609 CALIFORNIA STREET OMAHA NE 68154 MEDICAL SERVICES 230904 VISTA STAFFING SOLUTIONS INC FILE 50834 LOS ANGELES CA 900740834 MEDICAL SERVICES 211105 THERMAL ENGINEERING CORP 512 KALIHI STREET HONOLULU HI 968193267 CONSULTING SERVICES 150953 8 2448603 35500 0 2484103 NET PATIENT SERVICE REVENUE 623000 13815473 13815473 0 0 SUSTAINABILITY FEE 623000 1312639 1312639 0 0 INTERCOMPANY REVENUE 900099 4572 4572 0 0 15132684 111969 3507 108462 0 0 184474 184474 0 184474 184474 3306193 1540 3186513 119680 1540 121220 121220 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 624200 300186 300186 0 0 QUALITY PAYMENT 900099 47997 47997 0 0 GET REFUNDS 900099 7020 7020 0 0 13612 13612 0 0 368815 18403265 15501499 3507 414156 X 1005 1005 0 0 0 0 0 0 188556 0 188556 0 0 0 0 0 5668556 4070356 1598200 0 321888 214690 107198 0 837805 474807 362998 0 399273 270188 129085 0 0 0 0 0 81 0 81 0 49012 0 49012 0 807 0 807 0 0 0 3868 0 3868 0 1986150 1930203 55947 0 2302 2225 77 0 416029 125462 290567 0 92226 12756 79470 0 0 0 0 0 464993 41971 423022 0 91369 66198 25171 0 0 0 0 0 17546 9099 8447 0 0 0 0 0 0 0 0 0 845908 728469 117439 0 153184 152603 581 0 INTERCOMPANY CHARGES 2556278 2556278 0 0 MEDICAL SUPPLIES 1316113 1316113 0 0 REPAIRS & MAINTENANCE 222513 203698 18815 0 PROVIDER TAX 223986 223986 0 0 146572 111362 35210 16006020 12511469 3494551 0 0 700 700 4371440 10981466 0 0 909964 1311277 0 0 0 0 0 0 77799 94159 77878 76626 26419934 19187619 7546888 7232315 2184860 3032324 2875028 2171596 0 0 0 0 5334 22 18049891 24900485 1071815 1541824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2830744 7109142 3902559 8650966 X 14147332 16249519 0 0 14147332 16249519 18049891 24900485 X 2397245 -18218 0 0 0 -276840 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 807 141608 807 141608 12510662 1363873323 12511469 1364014931 775573 1000000 193893 250000 672915 688315 1000000 775614 3136844 4705266 103797 122347 160095 141608 527847 250000 250000 250000 250000 1000000 1500000 0 0 0 0 19071103 12903623 6167480 6892364 6283996 608368 456467 0 456467 7232315 POOLED INVESTMENTS - NONPUBLIC 2171596 F 2171596 0 DUE TO AFFILIATES 270701 GEN & PROFESSIONAL TAIL LIABILITY 84174 DUE TO GOVT REIMBURSEMENT PROGRAM 6130782 LONG TERM PENSION LIABILITY 623485 7109142 X SCHEDULE D, PART X, LINE 2 FIN 48(ASC 740) FOOTNOTE QHS EVALUATES ITS UNCERTAIN TAX POSITIONS AND HAS NO MATERIAL UNRECOGNIZED TAX POSITIONS AS OF JUNE 30, 2020. true true X true X true X true true true false true true 173985 0 173985 0.01090 4036676 4400566 0 4210661 4400566 173985 0.01090 11414 11414 0.00070 491346 343942 147404 0.00920 1005 1005 503765 343942 159823 0.00990 4714426 4744508 333808 0.02080 true 405597 405597 6029409 4341174 1688235 X true true 1 1 MOLOKAI GENERAL HOSPITAL 280 HOME OLU PLACE KAUNAKAKAI MOLOKAI HI 96748 www.molokaigeneralhospital.org 18-H X X X X MOLOKAI GENERAL HOSPITAL 1 false false true X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 150. 250. X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM COMMUNITY REPRESENTATIVES OUR CONSULTANT, ISLANDER INSTITUTE CREATED AN INITIAL LIST OF PEOPLE WHO COULD SHED LIGHT ON QUESTIONS OF HEALTH, SOCIAL DETERMINANTS, AND THE CIRCUMSTANCES IN VARIOUS COMMUNITIES. THE INITIAL LIST INCLUDED EXPERTS AND AUTHORITIES WITH WHOM ISLANDER INSTITUTE HAD EXISTING RELATIONSHIPS BASED ON ITS MANY YEARS OF WORKING IN HAWAII. THROUGHOUT THE MONTHS OF CONVERSATIONS, PEOPLE SUGGESTED OTHERS TO TALK TO AND HELPED MAKE CONNECTIONS. IN TOTAL, ISLANDER INSTITUTE SPOKE WITH ROUGHLY 200 PEOPLE FROM SIX ISLANDS IN PERSON OR OVER THE PHONE, IN A ONE-ON-ONE FORMAT OR IN SMALL GROUPS, AND IN FORMAL OR INFORMAL SETTINGS. A FULL LIST OF KEY INFORMANTS WHOSE VIEWS INFLUENCED THIS REPORT CAN BE FOUND IN APPENDIX E OF THE CHNA. THE CONVERSATIONS BEGAN WITH A FEW GENERAL QUESTIONS, AND KEY INFORMANTS WERE ENCOURAGED TO DELVE INTO WHATEVER THEY FELT WAS MOST IMPORTANT TO SHARE. WHEN APPROPRIATE, THEY SHARED ABOUT THEIR OWN PERSONAL EXPERIENCES AND/OR PROFESSIONAL CONNECTION TO HEALTH. AMONG THE KEY INFORMANTS, ISLANDER INSTITUTE ALSO MET WITH REPRESENTATIVES OF EACH OF THE 19 PARTICIPATING HOSPITAL FACILITIES TO BEST UNDERSTAND THEIR ENGAGEMENT WITH THE CHNA AND THE COMMUNITIES THEY SERVE. THESE CONVERSATIONS HELPED ILLUMINATE INTERESTS, CAPACITIES, AND MISSIONS OF EACH FACILITY AND SHED LIGHT ON LIMITATIONS AND USES OF PREVIOUS CHNAS AND THE POTENTIAL FOR THIS CHNA. AS PART OF THE 2013 AND 2015 CHNAS, KEY INFORMANTS WERE ALSO INTERVIEWED. A FEW OF THE SAME PERSONS PARTICIPATED IN THE 2018 CHNA PROCESS, WHILE OTHERS FELT THEY HAD ALREADY SHARED WHAT THEY HAD TO SAY IN THE PREVIOUS PROCESS(ES). RATHER THAN RE-INTERVIEW MANY OF THE SAME PEOPLE IN THE SAME POSITIONS, ISLANDER INSTITUTE OBTAINED THE INFORMANT INTERVIEW NOTES FROM THE PAST TWO CHNAS, REVIEWED THEM, AND INCORPORATED THOSE VIEWS THAT WERE STILL TIMELY INTO THIS PROCESS. A FULL LIST OF THE REVIEWED PAST INTERVIEWS CAN BE FOUND IN APPENDIX F OF THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 6A CHNA HOSPITAL FACILITIES NINETEEN HEALTHCARE ASSOCIATION OF HAWAII (HAH) MEMBER HOSPITALS CONTRIBUTED TO THE PRODUCTION OF THIS CHNA: ADVENTIST HEALTH CASTLE KAHI MOHALA KAHUKU MEDICAL CENTER KAISER FOUNDATION HOSPITAL - HONOLULU KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN KUAKINI MEDICAL CENTER KULA HOSPITAL LANA'I COMMUNITY HOSPITAL MAUI MEMORIAL MEDICAL CENTER MOLOKAI GENERAL HOSPITAL QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL PALI MOMI MEDICAL CENTER THE QUEEN'S MEDICAL CENTER THE QUEEN'S MEDICAL CENTER - WEST O'AHU REHABILITATION HOSPITAL OF THE PACIFIC SHRINERS HOSPITALS FOR CHILDREN - HONOLULU STRAUB MEDICAL CENTER WAHIAWA GENERAL HOSPITAL WILCOX MEDICAL CENTER SCHEDULE H, PART V, SECTION B, LINE 6B CHNA OTHER THAN HOSPITAL FACILITIES THE HEALTHCARE ASSOCIATION OF HAWAII PARTNERED WITH ISLANDER INSTITUTE TO CONDUCT A CHNA FOR MAUI COUNTY. AS A SUBSET OF THE LARGER PROJECT, DATA RELEVANT TO MOLOKAI WAS ASSESSED SEPARATELY, IN ORDER TO BETTER UNDERSTAND THE UNIQUE NEEDS AND CONCERNS OF THE ISLAND. SCHEDULE H, PART V, SECTION B, LINE 7A & 10A WEBSITE WHERE THE MOLOKAI GENERAL HOSPITAL FACILITY'S CHNA AND MOST RECENTLY ADOPTED IMPLEMENTATION STARTEGY CAN BE ACCESSED: https://www.queens.org/about-us/community-benefit-mgh SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS NOT ASSESSED TOGETHER, THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) MEMBER HOSPITALS PRIORITIZED THE AREAS OF NEED FOR THE STATE. THE TOP RANKED GOALS WERE: 1. SECURE THE BASIC FOUNDATIONS SO THAT PEOPLE CAN HAVE MORE CONTROL OVER THEIR OWN HEALTH; 1.1 ADDRESS FINANCIAL INSECURITY 1.2 WORK TOGETHER FOR EQUALITY AND JUSTICE 1.3 STRENGTHEN FAMILIES 1.4 PREPARE FOR EMERGENCIES 1.5 BUILD GOOD FOOD SYSTEMS 2. PRESERVE, NURTURE, EXPAND, AND EMPLOY THE HEALING PROPERTIES OF COMMUNITY; 2.1 RESTORE ENVIRONMENT AND SENSE OF PLACE 2.2 NURTURE COMMUNITY IDENTITY AND COHESIVENESS 2.3 INVEST IN TEENAGERS AND HEALTHY STARTS 2.4 SHIFT KUPUNA AWAY FROM "SICK CARE" 3. IMPROVE THE RELATIONSHIP BETWEEN PEOPLE AND THE HEALTHCARE SYSTEM 3.1 STRENGTHEN TRUST IN HEALTHCARE 3.2 PROVIDE ACCESSIBLE, PROACTIVE SUPPORT FOR THOSE WITH HIGH NEEDS SENIOR MANAGEMENT OF THE QUEEN'S HEALTH SYSTEMS (QUEEN'S), THE NONPROFIT PARENT COMPANY OF A FAMILY OF HEALTH CARE-RELATED COMPANIES THAT INCLUDES THE QUEEN'S MEDICAL CENTER (QMC), QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH) AND MOLOKAI GENERAL HOSPITAL (MGH), DISCUSSED THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THIS ASSESSMENT AND SELECTED GOAL 3.2 AS THE GOAL FOR THE SYSTEM. (QUEEN'S SENIOR MANAGEMENT TEAM INCLUDES THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, OPERATING ENTITY HEADS, CLINICAL LEADERS [PHYSICIANS AND SERVICE LINES], AND THOSE RESPONSIBLE FOR SYSTEM-WIDE FUNCTIONS SUCH AS HUMAN RESOURCES, FINANCE, ENDOWMENT, LEGAL, CORPORATE DEVELOPMENT, INFORMATION TECHNOLOGY, AND COMMUNITY DEVELOPMENT.) MANAGEMENT'S RECOMMENDATION WAS PRESENTED TO THE JOINT BOARDS OF TRUSTEES, AND THE BOARDS SUPPORTED THE SELECTION OF "PROVIDING ACCESSIBLE, PROACTIVE SUPPORT FOR THOSE WITH HIGH NEEDS" AS THE GOAL FOR THE SYSTEM. AS A RESULT, THE MOLOKAI GENERAL HOSPITAL EXECUTIVE TEAM, THE DIRECTOR OF STRATEGIC AND BUSINESS PLANNING AND THE QHS V.P. OF COMMUNITY DEVELOPMENT DEVELOPED THE FOLLOWING PRIORITIES TO ADDRESS ACCESSIBILITY AND PROACTIVE SUPPORT: PRIORITIES: 1. SUPPORT WOUND CARE CLINIC ON MOLOKAI TO MINIMIZE TRAVEL FOR THOSE WITH LIFE-ALTERING WOUNDS. YEAR ONE: EVALUATE CURRENT CLINIC MODEL AND PROVIDE FINANCIAL SUPPORT. YEAR TWO: CONTINUE SUPPORT AND EVALUATE IMPACT OF FINANCIAL SUPPORT. YEAR THREE: ADJUST SUPPORT BASED ON YEAR-TWO EVALUATION. 2. SUPPORT NAVIGATION OF ALL PATIENTS AS A WAY TO PROACTIVELY ENSURE ACCESS TO CLINICAL CARE, TRAVEL SUPPORT, FINANCIAL INFORMATION. YEAR ONE: EVALUATE CURRENT NAVIGATION PROGRAM AT MOLOKAI GENERAL HOSPITAL AND INCREASE SUPPORT AS NEEDED. YEAR TWO: ADJUST SUPPORT FOR NAVIGATION PROGRAM BASED ON EVALUATION. YEAR THREE: CONTINUE TO EVALUATE AND SUPPORT NAVIGATION IN THE MOLOKAI COMMUNITY. FOR OTHER AREAS NOT DIRECTLY ADDRESSED, MOLOKAI GENERAL HOSPITAL RECOGNIZES THE IMPORTANCE OF THESE NEEDS AND HAS SUPPORTED EFFORTS TO ADDRESS MANY OF THEM. ALTHOUGH MGH WILL NOT DIRECTLY BE ADDRESSING ALL AREAS OF NEED, WE HAVE SUPPORTED AND PARTNERED WITH OTHERS TO ADDRESS SEVERAL OF THEM AND WILL CONTINUE TO SUPPORT OPPORTUNITIES TO ADDRESS COMMUNITY HEALTH NEEDS IN COLLABORATION WITH OTHERS. SCHEDULE H, PART V, SECTION B, LINE 13H MEDICARE OR MEDICAID/QUEST ELIGIBILITY SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY IS WIDELY AVAILABLE ON THE MOLOKAI GENERAL HOSPITAL WEBSITE AT: https://www.queens.org/molokai/patients-and-visitors/pay-your-bill-mgh SCHEDULE H, PART V, SECTION B, LINE 16J OTHER METHOD FOR PUBLICIZING POLICIES A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WAS ATTACHED TO BILLING INVOICES, PROVIDED IN WRITING TO PATIENTS ON ADMISSION TO THE HOSPITAL AND AVAILABLE UPON REQUEST. THE FULL POLICY IS PROVIDED TO MGH CLINIC PATIENTS DURING THE ADMISSION PROCESS. SCHEDULE H, PART I, LINE 6A COMMUNITY BENEFIT REPORT - RELATED ORGANIZATION COMMUNITY BENEFITS ARE REPORTED ANNUALLY AS PART OF THE FORM 990. THIS IS NOT SEPARATELY AVAILABLE TO THE PUBLIC. A FORMAL REPORT ISSUED BY THE PARENT COMPANY, THE QUEEN'S HEALTH SYSTEMS, INCLUDES THE COMMUNITY BENEFITS OF THE MOLOKAI GENERAL HOSPITAL. THIS REPORT IS PUBLISHED PERIODICALLY AND IS SEPARATELY AVAILABLE TO THE PUBLIC. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY CONSIDERS ALL PATIENT SEGMENTS. AMOUNTS REPRESENT THE NET COSTS FOR THE VARIOUS PROGRAMS AND OPERATIONS, CONSIDERING ACTUAL AMOUNTS INCURRED AND CALCULATED BENEFITS BASED ON COST-TO-CHARGE RATIOS AND AVERAGE RATES (I.E. WAGE RATES). SCHEDULE H, PART III, LINE 2 MGH PROVIDES AN ALLOWANCE AGAINST ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE BY ESTABLISHING AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. MGH ESTIMATES THE ALLOWANCE BASED ON THE AGING OF THE ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR AND OTHER RELEVANT FACTORS. MGH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER MGH'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED ON THE COST-TO-CHARGE RATIO. THE HOSPITAL ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ACCOUNTING STANDARDS UPDATE 2014-09 TOPIC 606 (ASU 606) EFFECTIVE JULY 1, 2018. ASU 606 AND THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) DIFFERENTIATE BAD DEBT FROM IMPLICIT PRICE CONCESSIONS. THE HOSPITAL MAKES A DETERMINATION REGARDING A PRICE CONCESSION TO STANDARD PRICING ON A PORTFOLIO BASIS PRIOR TO ASSESSING THE CREDIT RISK OF INDIVIDUALS WITHIN THE PORTFOLIO. PATIENT SERVICE REVENUE IS RECORDED NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, INCLUDING AN ESTIMATE FOR IMPLICIT PRICE CONCESSIONS. BAD DEBT IS RECORDED AS AN OPERATING EXPENSE AND RESULTS WHEN A PATIENT, DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES, IS UNWILLING TO DO SO. THE AMOUNT SHOWN ON PART III, LINE 2 IS THE PRICE CONCESSION AMOUNT FOR THE TAX YEAR ENDED JUNE 30, 2020. SCHEDULE H, PART III, LINE 3 BAD DEBT AS COMMUNITY BENEFIT THE PORTION OF THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING THE COST TO CHARGE RATIO TO THE TOTAL BAD DEBT EXPENSE. BAD DEBT PERTAINING TO PATIENT CARE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE, CONSISTENT WITH MGH'S MISSION, PATIENTS RECEIVE CARE REGARDLESS OF WHETHER MGH COLLECTS PAYMENT FOR SERVICES PERFORMED. FOR FY2020, MGH REPORTED BAD DEBT EXPENSE OF $405,597. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE FOOTNOTE THE AUDITED FINANCIAL STATEMENTS DO NOT DESCRIBE BAD DEBT EXPENSE. THE AUDITED FINANCIAL STATEMENTS DO DESCRIBE THE RECEIVEABLES FOR PATIENT SERVICES. "ACCOUNTS RECEIVABLE PRIMARILY COMPRISE AMOUNTS DUE FOR HEALTHCARE SERVICES FROM PATIENTS AND THIRD-PARTY PAYORS AND ARE RECORDED NET OF AMOUNTS FOR CONTRACTUAL ADJUSTMENTS, IMPLICIT PRICE CONCESSIONS AND BAD DEBTS." SCHEDULE H, PART III, LINE 8 TREATMENT OF MEDICARE SHORTFALL COMMUNITY BENEFIT FOR THE FISCAL YEAR ENDED JUNE 30, 2020, MOLOKAI GENERAL HOSPITAL HAD A MEDICARE SURPLUS. AS SUCH, MEDICARE SHORTFALL WAS NOT REPORTED AS A COMMUNITY BENEFIT. MEDICARE COSTING METHODOLOGY THE MEDICARE AMOUNTS ABOVE ARE CALCULATED WITH DATA FROM THE JUNE 30, 2020 COST REPORT, BASED ON A RATIO OF TOTAL PATIENT REVENUES TO TOTAL PATIENT COSTS CALCULATED BY COST CENTERS. MGH IS THE ISLAND OF MOLOKAI'S ONLY HOSPITAL, PROVIDING 24 HOUR SERVICE TO ALL MEMBERS OF THE PUBLIC. SCHEDULE H, PART III, LINE 9B APPLICATION OF THE COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE MGH PROVIDES FULL OR PARTIAL DISCOUNTS FOR ELIGIBLE PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. ELIGIBILITY CONTINUES FOR SIX MONTHS OR UPON CHANGE IN PATIENT'S INCOME AND ASSETS PER GUIDELINES. PATIENTS MAY RECERTIFY EVERY SIX MONTHS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT EVALUATION AND SURVEYS ARE COMPLETED AS NEEDED BY COST CENTERS OR DEPARTMENTS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE MGH HAS AN ON-STAFF SOCIAL WORKER WHO ASSISTS PATIENTS AND THEIR FAMILIES BY PROVIDING EDUCATION AND ASSISTANCE IN APPLYING FOR ASSISTANCE UNDER FEDERAL, STATE AND LOCAL PROGRAMS, INCLUDING MGH'S CHARITY CARE POLICY. ADDITIONALLY, THE REGISTRATION STAFF AND BUSINESS OFFICE STAFF PROVIDE WRITTEN AND VERBAL INFORMATION REGARDING THE HOSPITAL'S CHARITY CARE POLICIES DURING INTAKE AND DISCHARGE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION MGH, PART OF THE QUEEN'S HEALTH SYSTEMS, IS THE ONLY HOSPITAL ON THE ISLAND OF MOLOKA'I, PROVIDING 24-HOUR CARE SERVICES FOR A POPULATION OF 7,300. MOLOKA'I IS DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA IN PRIMARY CARE, DENTAL AND MENTAL HEALTH SERVICES. ADDITIONALLY, THE ISLAND IS LISTED AS A FEDERAL MEDICALLY UNDERSERVED AREA (MUA). THE AVERAGE HOUSEHOLD INCOME IS $46,000 WITH 63% OF THE POPULATION REPORTING THEY ARE OF NATIVE HAWAIIAN ANCESTRY (MULTIPLE RACE) IN 2010. ON AVERAGE, THIRTY PERCENT OF FAMILY HOUSEHOLDS REPORT RECEIVING SOME FORM OF GOVERNMENT ASSISTANCE. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH THE AMOUNTS MENTIONED IN PART I OF SCHEDULE H REPRESENT COSTS INCURRED TO ENSURE CONTINUED OPERATIONS THAT BENEFIT THE COMMUNITY. TO SUPPORT MGH'S MISSION AND TO FULFILL THE TAX-EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, MGH PROVIDES A NUMBER OF COMMUNITY BENEFITS. THIS INCLUDES UNCOMPENSATED CARE, WHERE MGH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBT). MGH ALSO IS HOME TO AN OUTPATIENT CLINIC, WHERE MGH PROVIDES OUTPATIENT SERVICES TO INDIGENT PATIENTS. IN ADDITION, MGH PROVIDES MANY FREE INFORMATIONAL SEMINARS AND EDUCATIONAL OPPORTUNITIES TO THE PUBLIC TO PROMOTE THE HEALTH OF THE COMMUNITY. THESE PROGRAMS ARE SPECIFICALLY DIRECTED TO ADDRESS HEALTH ISSUES WITHIN THE COMMUNITY INCLUDING DIABESTES, CANCER AND WOMEN'S HEALTH ISSUES. MGH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS AND IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND PROVIDES FREE FLU CLINICS IN AREAS OUTSIDE THE MAIN TOWN. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM MGH IS A MEMBER OF THE QUEEN'S HEALTH SYSTEMS (QHS) AFFILIATED GROUP. THE GROUP INCLUDES QUEEN'S MEDICAL CENTER (QMC), QUEEN EMMA LAND COMPANY (QEL), QUEEN'S INSURANCE EXCHANGE (QIE), QUEEN'S DEVELOPMENT CORPORATION (QDC) AND QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH). QHS PROVIDED LEGAL, ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO MGH AND QIE PROVIDED MEDICAL MALPRACTICE INSURANCE TO MGH. IN RETURN, MGH ASSISTED QMC IN FULFILLING ITS MISSION TO PROVIDE IN PERPETUITY QUALITY HEALTH CARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT N/A false false false false false false false true false ARTHUR USHIJIMA TRUSTEE/CHAIR - PART YEAR 0 956872 0 362479 0 156170 0 60842 0 15013 0 1551376 0 0 JILL HOGGARD GREEN TRUSTEE/CHAIR - EFF. 10/2019 0 243592 0 304680 0 891 0 0 0 3837 0 553000 0 0 JANICE KALANIHUIA PRESIDENT 0 214493 0 53592 0 18767 0 42852 0 15235 0 344939 0 0 WILLIAM THOMAS JR MD PHYSICIAN 232187 0 54048 0 7651 0 38075 0 8219 0 340180 0 0 0 CLINTON YEE TREASURER 0 189835 0 22040 0 9300 0 27131 0 23448 0 271754 0 0 MICHAEL MULLEN DIR OF NURSING 137377 0 12360 0 0 0 13908 0 22071 0 185716 0 0 0 PUNAHELE ALCON VICE PRESIDENT 122548 0 15540 0 5018 0 17180 0 15282 0 175568 0 0 0 SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON THE QUEEN'S HEALTH SYSTEMS ("QHS", PARENT COMPANY) TO DETERMINE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL. QHS USED A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY AND STUDY, FORM 990 OF OTHER ORGANIZATIONS AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SCHEDULE J, PART I, LINE 7 OTHER NON-FIXED PAYMENTS RECOGNITION AWARDS WERE PAID TO ALL EMPLOYEES BASED ON ACCOMPLISHMENTS OF PREDETERMINED GOALS SET FORTH IN THE INCENTIVE AND STRATEGIC PLANS AND DEFINED ELIGIBILITY OF THE EMPLOYEE. RECOGNITION AWARDS ARE DISCRETIONARY AND CONSIDER QUALITY THRESHOLDS WHICH INCLUDE ANNUAL ACCREDITATION AND MINIMUM OPERATING INCOME LEVEL CRITERIA. IN ADDITION, EXECUTIVE AWARDS ARE WEIGHTED BASED ON INDIVIDUAL GOALS ESTABLISHED FOR EACH EXECUTIVE. SCHEDULE J, PART II & FORM 990, PART VII COMPENSATION PAID FOR SERVICES ARTHUR A. USHIJIMA MR. USHIJIMA SERVED AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEEN'S RELATED AFFILIATES THROUGH SEPTEMBER 2019. MR. USHIJIMA ALSO SERVED AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE QUEEN'S HEALTH SYSTEMS ("QHS", PARENT COMPANY) AND AS PRESIDENT OF THE QUEEN'S MEDICAL CENTER ("QMC"). HIS HOURS SERVED AS A TRUSTEE OF MGH IS 1 HOUR PER WEEK. HE IS A VOLUNTEER TRUSTEE AND WAS NOT COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED WAS HIS TOTAL COMPENSATION FOR HIS VARIOUS SERVICES. JILL HOGGARD GREEN MS. HOGGARD GREEN SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEEN'S RELATED AFFILIATES. MS. HOGGARD GREEN ALSO SERVES AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE QUEEN'S HEALTH SYSTEMS ("QHS", PARENT COMPANY). HER HOURS SERVED AS A TRUSTEE OF MGH IS 1 HOUR PER WEEK. SHE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR HER VARIOUS SERVICES. JANICE KALANIHUIA MS. KALANIHUIA SERVES AS VICE PRESIDENT FOR THE QUEEN'S HEALTH SYSTEMS AND PRESIDENT OF MGH. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. PUNAHELE ALCON MS. ALCON SERVES AS VICE PRESIDENT AND DIRECTOR OF OUTPATIENT AND BUSINESS SERVICES OF MGH. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. CLINTON YEE MR. YEE SERVES AS CORPORATE CONTROLLER OF QUEEN'S HEALTH SYSTEMS, ASSISTANT TREASURER OF QMC, QHS, QEL AND TREASURER OF MGH. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. FORM 990, PART III, LINE 4A TO SUPPORT THE MGH'S MISSION AND TO FULFILL THE TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, MGH PROVIDED THE FOLLOWING COMMUNITY BENEFITS, TOTALING $739,000 FOR THE YEAR ENDED JUNE 30, 2020. 1. UNCOMPENSATED CARE - MGH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY/ARE ELIGIBLE FOR FINANCIAL ASSISTANCE (BAD DEBTS). FOR THE YEAR ENDED JUNE 30, 2020, THE ESTIMATED COST OF PROVIDING CHARITY CARE WAS $174,000 AND THE ESTIMATED COST OF BAD DEBT WAS $406,000. 2. HEALTH AND WELLNESS EDUCATION - MGH PROVIDES HEALTH AND WELLNESS EDUCATION TO THE COMMUNITY IN AN EFFORT TO PROMOTE HEALTHY LIFESTYLES. FOR THE YEAR ENDED JUNE 30, 2020, THE COST OF PROVIDING HEALTH AND WELLNESS EDUCATION WAS $11,000. 3. SUBSIDIZED HEALTH SERVICES - MGH IS THE ONLY FACILITY ON THE ISLAND OF MOLOKAI TO PROVIDE CHEMOTHERAPY TO CANCER PATIENTS. MGH INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $147,000 DURING THE YEAR ENDED JUNE 30, 2020. 4. CHARITABLE CONTRIBUTIONS - MGH MAKES CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2020, CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS CONSISTENT WITH MGH'S EXEMPT PURPOSE WERE $1,000. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS MGH HAS A SOLE MEMBER, WHICH IS THE QUEEN'S HEALTH SYSTEMS (QHS), A HAWAII NONPROFIT CORPORATION. FORM 990, PART VI, LINE 7A POWER TO ELECT OR APPOINT BOARD MEMBERS QHS ELECTS ALL OF THE BOARD MEMBERS OF THE MGH BOARD OF TRUSTEES. FORM 990, PART VI, LINE 7B DESCRIPTION OF CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS CERTAIN MAJOR DECISIONS APPROVED BY THE MGH BOARD OF TRUSTEES MUST ALSO BE APPROVED BY QHS. SUCH DECISIONS INCLUDE: 1. A CHANGE TO THE PURPOSE OF THE COMPANY; 2. A FINANCING TRANSACTION IN EXCESS OF $500,000; 3. A LEASE TRANSACTION THAT HAS A TERM THAT IS LONGER THAN 3 YEARS OR HAS A RENT OBLIGATION IN EXCESS OF $1,000,000 OVER THE LEASE TERM; 4. A TRANSACTION INVOLVING THE SALE, LEASE, DISPOSITION OR HYPOTHECATION OF REAL PROPERTY; 5. ANNUAL OPERATIONAL AND CAPITAL BUDGETS; 6. STRATEGIC PLANS; 7. MERGER OR MAJOR ACQUISITIONS; 8. CREATION OF A NEW ENTITY OR JOINT VENTURE; 9. SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; 10. DISSOLUTION; 11. AMENDMENT OF BYLAWS; 12. ADOPTION, AMENDMENT OR RESCISSION OF A BOARD POLICY; 13. CAPITAL EXPENDITURES IN EXCESS OF $1,000,000 FOR MGH. FORM 990, PART VI, SECTION B, LINE 11B PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 FOR THE QUEEN'S HEALTH SYSTEMS (QHS) AND THE SEPARATE FORMS FOR EACH OF THE NOT-FOR-PROFIT SUBSIDIARIES OF QHS WERE REVIEWED BY THE GOVERNING BODY PRIOR TO THE FILING OF THE TAX RETURN. THE QHS AUDIT COMMITTEE, WHICH IS COMPRISED OF MEMBERS OF THE QHS BOARD OF TRUSTEES, WAS DELEGATED THE RESPONSIBILITY TO REVIEW THE RETURNS PRIOR TO THEIR FILING. THE RETURNS WERE PRESENTED TO THE COMMITTEE BY MANAGEMENT AND BY THE INDEPENDENT PUBLIC ACCOUNTING FIRM THAT PREPARED THE RETURNS. IN ADDITION, COMPENSATION RELATED DISCLOSURES IN THE RETURNS WERE REVIEWED BY THE CHAIRPERSON OF THE COMPENSATION COMMITTEE PRIOR TO FILING THE RETURNS. ALSO, A COPY OF THE MOLOKAI GENERAL HOSPITAL (MGH) RETURN WAS MADE AVAILABLE TO EACH OF THE MEMBERS OF THE MGH BOARD OF TRUSTEES PRIOR TO THE RETURNS BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12, 13 AND 14 APPROVED POLICIES THE CONFLICT OF INTEREST, WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES HAVE BEEN APPROVED BY QHS ON BEHALF OF THE MGH BOARD OF TRUSTEES BUT HAVE NOT BEEN SEPARATELY APPROVED BY THE MGH BOARD. AS SUCH, LINES 12, 13 AND 14 HAVE BEEN CHECKED 'NO'. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY ALL QHS COMPANIES ARE SUBJECT TO A WRITTEN CONFLICT OF INTEREST POLICY. ALL TRUSTEES, OFFICERS, DESIGNATED EMPLOYEES AND CONTRACTORS ARE REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE FORM. THE DESIGNATED EMPLOYEES ARE THOSE SELECTED BY EXECUTIVES IN THE ORGANIZATION WHO IDENTIFY THOSE EMPLOYEES (TYPICALLY MANAGER LEVEL AND ABOVE) WHO MAY BE IN A POSITION TO SELECT OR INFLUENCE THE SELECTION OF A VENDOR. DISCLOSURES ARE SUMMARIZED AND MAINTAINED BY EACH COMPANY'S CORPORATE SECRETARY. THE CONTRACTS MANAGEMENT DEPARTMENT AND LEGAL DEPARTMENT HAVE THE CONFLICT OF INTEREST SUMMARIES AND CHECK FOR CONFLICTS OF INTEREST AT THE BEGINNING OF THE CONTRACT PROCESS. ANY CONFLICT OF INTEREST INVOLVING A TRUSTEE IS PRESENTED TO THE BOARD OF TRUSTEES. ANY CONFLICT OF INTEREST INVOLVING A DISQUALIFIED PERSON IS SUBJECT TO THE PROCESS OF ESTABLISHING A REBUTTABLE PRESUMPTION OF REASONABLENESS. ANY TRUSTEE WITH A CONFLICT OF INTEREST IS EXCUSED FOR THE PORTION OF THE MEETING WHERE THE SUBJECT MATTER IS DISCUSSED AND VOTED ON. FORM 990, PART VI, SECTION B, LINES 15A AND 15B PROCESS USED FOR DETERMINING COMPENSATION A COMMITTEE OF THE BOARD OF TRUSTEES CALLED THE COMPENSATION COMMITTEE MEETS REGULARLY TO REVIEW THE COMPENSATION OF ALL EXECUTIVES OF ALL COMPANIES WITHIN QHS. MGH'S EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY FOR ITS PRESIDENT. ALL DECISIONS REGARDING EXECUTIVE COMPENSATION ARE MADE IN CONFORMITY WITH THE PROCEDURES REQUIRED TO ESTABLISH A REBUTTABLE PRESUMPTION OF REASONABLENESS. ANY ADJUSTMENT TO COMPENSATION IS SUBJECT TO THE PROCESS OF ANNUAL PERFORMANCE REVIEWS AND COMPARISON TO COMPARABLE COMPENSATION DATA PREPARED BY A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. THE MOST RECENT REVIEW TOOK PLACE IN OCTOBER 2020. OUTSIDE COUNSEL ASSISTS WITH THE REVIEW PROCESS AND DOCUMENTS THE DECISIONS OF THE COMMITTEE. FORM 990, PART VI, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC MGH'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND THE QHS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS TAX RETURN, AS REQUIRED. MGH DOES NOT MAKE THE CONFLICT OF INTEREST POLICY THAT IT FOLLOWS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS MINIMUM PENSION LIABILITY $ (286,038) FUND TRANSFER $ 9,197 ROUNDING $ 1 ----------- TOTAL $ (276,840) FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:1294610 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION SERVICES TOTAL FEES:609787 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:11501 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER SERVICES TOTAL FEES:70252 THE QUEEN'S HEALTH SYSTEMS 1301 PUNCHBOWL STREET HONOLULU HI 96813 990238120 ADMIN SERVICE HI 501(c)(3) 12c NA false THE QUEEN'S MEDICAL CENTER 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 MEDICAL SVCS HI 501(c)(3) 3 QHS true QUEEN EMMA LAND COMPANY 1301 PUNCHBOWL STREET HONOLULU HI 96813 990183769 SUPPORT SVCS HI 501(c)(3) 12a QHS true QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 96743 990260423 MEDICAL SVCS HI 501(c)(3) 3 QHS true HAMAMATSUQUEEN'S PET IMAGING 1301 PUNCHBOWL STREET HONOLULU HI 96813 943266916 PET IMAGING HI NA N/A PRIMARY CARE PHYSICIAN ENTERPRISE LLC 1301 PUNCHBOWL STREET HONOLULU HI 96813 834591861 MEDICAL SERVICES HI NA N/A QUEEN'S DEVELOPMENT CORPORATION 1301 PUNCHBOWL STREET HONOLULU HI 96813 990240109 DEVELOPMENT HI NA C Corp true QUEEN'S INSURANCE EXCHANGE 1301 PUNCHBOWL STREET HONOLULU HI 96813 911913839 INSURANCE HI NA C Corp true DIAGNOSTIC LABORATORY SERVICES INC 99-859 IWAIWA STREET AIEA HI 96701 990240499 MEDICAL LAB SVCS HI NA C Corp true false false false false false false false false false false false true true false false true true false false THE QUEEN'S MEDICAL CENTER m 124163 FMV DIAGNOSTIC LABORATORY SERVICES p 908210 FMV SCHEDULE R, PART III IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP HAMAMATSU/QUEEN'S PET IMAGING CENTER, LLC EIN: 94-3266916 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 PRIMARY CARE PHYSICIAN ENTERPRISE LLC EIN: 83-4591861 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 NAME: QUEEN EMMA LAND COMPANY ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 EIN: 99-0183769 EXPENSES: $34,587,534 501(H) ELECTION: YES SHARE OF EXCESS LOBBYING EXPENDITURES: $0 NAME: THE QUEEN'S HEALTH SYSTEMS ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 EIN: 99-0238120 EXPENSES: $122,782,942 501(H) ELECTION: YES SHARE OF EXCESS LOBBYING EXPENDITURES: $0 NAME: THE QUEEN'S MEDICAL CENTER ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 EIN: 99-0073524 EXPENSES: $1,130,224,861 501(H) ELECTION: YES SHARE OF EXCESS LOBBYING EXPENDITURES: $0 NAME: MOLOKAI GENERAL HOSPITAL ADDRESS: P.O. BOX 408 KAUNAKAKAI MOLOKAI, HI 96748 EIN: 99-0251372 EXPENSES: $12,511,469 501(H) ELECTION: YES SHARE OF EXCESS LOBBYING EXPENDITURES: $0 NAME: QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL ADDRESS: 67-1125 MAMALAHOA HIGHWAY KAMUELA, HI 96743 EIN: 99-0260423 EXPENSES: $58,908,125 501(H) ELECTION: NO SHARE OF EXCESS LOBBYING EXPENDITURES: $0