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KAPIOLANI HEALTH FOUNDATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
KAPIOLANI HEALTH FOUNDATION (EIN 99-0246364)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-04-28
IRS object ID
201711189349300961
Schema version
2015v3.0
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)
Return2017-04-28T17:15:36-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

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 Line1370 17TH ST 3300AddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN990246364EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kapi'olani Health FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Donna Masuda-KamInCareOfNm
Business Name ControlKAPIBusinessNameControlTxt
Phone8085357100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 Merchant Street 24th FloorAddressLine1Txt
CityHonoluluCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96813ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEARL INOUYEPersonNm
Person TitleVICE PRESIDENTPersonTitleTxt
Phone8085357100PhoneNum
Signature2017-04-28SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKELLEY SIMONPreparerPersonNm
PTINP00791436PTIN
Phone7209314000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerThomas MundellPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 Merchant Street 26th FloorAddressLine1Txt
CityHonoluluCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96813ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$38,244,861GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.kapiolanigift.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateHILegalDomicileStateCd
Activity Or MissionTHE MISSION OF KAPI'OLANI HEALTH FOUNDATION IS TO CREATE A HEALTHIER HAWAI'I.ActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers21TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$3,483,583PYContributionsGrantsAmt
CY Contributions Grants$5,044,427CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$2,229,277PYInvestmentIncomeAmt
CY Investment Income-$1,274,674CYInvestmentIncomeAmt
PY Other Revenue$9,483PYOtherRevenueAmt
CY Other Revenue$367,923CYOtherRevenueAmt
PY Total Revenue$5,722,343PYTotalRevenueAmt
CY Total Revenue$4,137,676CYTotalRevenueAmt
PY Grants And Similar Paid$2,020,966PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,444,616CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$114,348PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$59,606CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,258,699CYTotalFundraisingExpenseAmt
PY Other Expenses$2,780,232PYOtherExpensesAmt
CY Other Expenses$2,512,683CYOtherExpensesAmt
PY Total Expenses$4,915,546PYTotalExpensesAmt
CY Total Expenses$5,016,905CYTotalExpensesAmt
PY Revenues Less Expenses$806,797PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$879,229CYRevenuesLessExpensesAmt
Total Assets BOY$88,652,469TotalAssetsBOYAmt
Total Assets EOY$87,743,680TotalAssetsEOYAmt
Total Liabilities BOY$1,686,782TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,981,119TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$86,965,687NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$85,762,561NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF KAPI'OLANI HEALTH FOUNDATION IS TO CREATE A HEALTHIER HAWAI'I.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$3,143,945ExpenseAmt
Grant$2,444,616GrantAmt
Revenue$0RevenueAmt
DescSEE SCHEDULE ODesc
Total Program Service Expenses$3,143,945TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
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 FundraisingYes (true)ProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
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 MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
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
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members20GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
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 OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
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)
PersonDonna Masuda-KamPersonNm
Phone8085272520PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 Merchant Street 24th FloorAddressLine1Txt
CityHonoluluCityNm
State AbbreviationHIStateAbbreviationCd
ZIP96813ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JEFFREY A ARCE
Board of Director, Chair0.20.0Yes (X)Yes (X)$0$0$0
MEREDITH CHING
Board of Director0.20.0Yes (X)$0$0$0
KIMBERLY W DEY
Board of Director, Vice Chair0.20.0Yes (X)Yes (X)$0$0$0
SARA DUDGEON
Board of Director0.20.0Yes (X)$0$0$0
STEPHANIE GAMBETTA
Board of Director0.20.0Yes (X)$0$0$0
KIM HEHIR
Board of Director0.20.0Yes (X)$0$0$0
MICHELLE HO
Board of Director0.20.0Yes (X)$0$0$0
DAVID HUDSON
Board of Director0.20.0Yes (X)$0$0$0
THOMAS KOSASA MD
Board of Director0.20.0Yes (X)$0$0$0
LORI L MCCARNEY
Board of Director0.20.0Yes (X)$0$0$0
PAUL MARX
Board of Director0.20.0Yes (X)$0$0$0
MARCUS MERNER
Board of Director0.20.0Yes (X)$0$0$0
RALPH MESICK
Board of Director0.20.0Yes (X)$0$0$0
ALANA PAKKALA
Board of Director0.20.0Yes (X)$0$0$0
ANGELA PRATT
Board of Director0.20.0Yes (X)$0$0$0
ABELINA SHAW
Board of Director0.20.0Yes (X)$0$0$0
PATRICIA W SHEEHAN
Board of Director0.20.0Yes (X)$0$0$0
RAYMOND P VARA JR
Board of Director0.261.9Yes (X)$0$1,619,202$657,628
EILEEN WACKER
Board of Director0.20.0Yes (X)$0$0$0
GREGORY K YIM MD
Board of Director0.20.0Yes (X)$0$0$0
SACHI BRADEN
Board of Director (part year)0.20.0Yes (X)$0$0$0
FRED M NOA
Board of Director (part year)0.20.0Yes (X)$0$0$0
THOMAS MUNDELL
PRESIDENT6.056.0Yes (X)$0$319,598$78,217
DAVID OKABE
Treasurer0.155.3Yes (X)$0$727,747$271,732
EARL INOUYE
Assistant Treasurer0.250.8Yes (X)$0$323,923$66,330
CHARLES R CHING
Secretary0.157.4Yes (X)$0$613,655$218,402
JESSICA LEWIS
Assistant Treasurer1.039.0Yes (X)$0$128,274$25,615
MICHAEL ROBINSON
Former Officer0.053.0$0$216,195$39,408Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,948,594TotReportableCompRltdOrgAmt
Total Other Compensation$1,357,332TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$20,000FundraisingAmt
All Other Contributions$5,024,427AllOtherContributionsAmt
Noncash Contributions$572,787NoncashContributionsAmt
Total Contributions$5,044,427TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$773,404TotalRevenueColumnAmt
Exclusion$773,404ExclusionAmt

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$31,919,527SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$33,967,605SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$2,048,078SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,048,078TotalRevenueColumnAmt
Exclusion-$2,048,078ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$506,855FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$20,000ContriRptFundraisingEventAmt
Fundraising Direct Expenses$139,580FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$367,275TotalRevenueColumnAmt
Exclusion$367,275ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescALL OTHER REVENUEDesc
Total Revenue Column$648TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$648ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$648OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,137,676TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$906,751ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,444,616TotalAmt
Program Services$2,444,616ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$4,208TotalAmt
Program Services$0ProgramServicesAmt
Management And General$4,208ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$59,606TotalAmt
Fundraising$59,606FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$192,976TotalAmt
Management And General$192,976ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$901,370TotalAmt
Management And General$310,568ManagementAndGeneralAmt
Fundraising$590,802FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$131,238TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$131,238FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$94,246TotalAmt
Program Services$0ProgramServicesAmt
Management And General$33,640ManagementAndGeneralAmt
Fundraising$60,606FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$64,914TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$64,914FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$35,967TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$35,967FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$42,490TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$42,490FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,976TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$5,976FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,244TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$10,244FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$13,321TotalAmt
Program Services$0ProgramServicesAmt
Management And General$13,321ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Program Expenditures$699,329$699,329$0$0
OTHER PURCHASES$256,078$256,078
CORPORATE ALLOCATION$59,548$59,548
ALL OTHER EXPENSES$778$778

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,016,905TotalAmt
Program Services$3,143,945ProgramServicesAmt
Management And General$614,261ManagementAndGeneralAmt
Fundraising$1,258,699FundraisingAmt

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$10,618,497BOYAmt
EOY$17,198,585EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,786,857BOYAmt
EOY$8,776,320EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$851,515BOYAmt
EOY$654,029EOYAmt

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$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$327,970LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$304,831LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$33,383BOYAmt
EOY$23,139EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$35,089,843BOYAmt
EOY$35,517,752EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$27,895,498BOYAmt
EOY$23,206,980EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,218,318BOYAmt
EOY$2,218,319EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$158,558BOYAmt
EOY$148,556EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$88,652,469BOYAmt
EOY$87,743,680EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$120,068BOYAmt
EOY$108,017EOYAmt

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$160,722BOYAmt
EOY$153,221EOYAmt

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$1,405,992BOYAmt
EOY$1,719,881EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,686,782BOYAmt
EOY$1,981,119EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$46,687,688BOYAmt
EOY$43,449,003EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$37,989,063BOYAmt
EOY$39,898,867EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,288,936BOYAmt
EOY$2,414,691EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$86,965,687BOYAmt
EOY$85,762,561EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$88,652,469BOYAmt
EOY$87,743,680EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$879,229ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$117,619NetUnrlzdGainsLossesInvstAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$206,278OtherChangesInNetAssetsAmt
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)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,081,042CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,104,576CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,440,469CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,483,583CurrentTaxYearMinus1YearAmt
Current Tax Year$5,044,427CurrentTaxYearAmt
Total$40,154,097TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,081,042CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,104,576CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,440,469CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,483,583CurrentTaxYearMinus1YearAmt
Current Tax Year$5,044,427CurrentTaxYearAmt
Total$40,154,097TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$7,747,593SubstantialContributorsTotAmt
Public Support Total170$32,406,504PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$896,809CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$945,661CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,007,105CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,072,788CurrentTaxYearMinus1YearAmt
Current Tax Year$773,404CurrentTaxYearAmt
Total$4,695,767TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$571CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$691CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$488CurrentTaxYearMinus1YearAmt
Current Tax Year$648CurrentTaxYearAmt
Total$2,398TotalAmt
FieldValueIRS element (for citing)
Total Support$44,852,262TotalSupportAmt
Public Support CY1700.72252PublicSupportCY170Pct
Public Support PY1700.70803PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$66,720,120BeginningYearBalanceAmt
Contributions$125,755ContributionsAmt
Investment Earnings Or Losses-$1,382,870InvestmentEarningsOrLossesAmt
Administrative Expenses$84,637AdministrativeExpensesAmt
End Year Balance$65,378,368EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$68,635,843BeginningYearBalanceAmt
Contributions$102,429ContributionsAmt
Investment Earnings Or Losses-$1,899,330InvestmentEarningsOrLossesAmt
Administrative Expenses$118,822AdministrativeExpensesAmt
End Year Balance$66,720,120EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$61,397,833BeginningYearBalanceAmt
Contributions$15,361ContributionsAmt
Investment Earnings Or Losses$7,313,112InvestmentEarningsOrLossesAmt
Administrative Expenses$90,463AdministrativeExpensesAmt
End Year Balance$68,635,843EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$55,489,203BeginningYearBalanceAmt
Contributions$34,773ContributionsAmt
Investment Earnings Or Losses$5,973,274InvestmentEarningsOrLossesAmt
Administrative Expenses$99,417AdministrativeExpensesAmt
End Year Balance$61,397,833EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,726,543BeginningYearBalanceAmt
Contributions$15,932ContributionsAmt
Investment Earnings Or Losses-$1,160,109InvestmentEarningsOrLossesAmt
Administrative Expenses$93,163AdministrativeExpensesAmt
End Year Balance$55,489,203EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.96000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.01000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.03000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Book Value$0BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Depreciation$0DepreciationAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$56,667OtherCostOrOtherBasisAmt
Depreciation$56,667DepreciationAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$268,942OtherCostOrOtherBasisAmt
Depreciation$248,164DepreciationAmt
Book Value$20,778BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,361OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$2,361BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$23,139TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescCOMBINED INVESTMENT POOLDesc
Book Value$23,206,980BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$23,206,980TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to AflliatesDesc
Amt$1,719,881Amt
FieldValueIRS element (for citing)
Total Liability$1,719,881TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Schedule d, Part iv, line 2bTrust, Escrow and custodial arrrengements Escrow liabilities represent amounts due to individuals under charitable remainder trust agreements.
FORM 990, SCHEDULE D, PART V, LINE 4DESCRIPTION OF INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS CALVIN C.J. SIA, MD ENDOWMNET. ESTABLISHED IN 2001 IN HONOR OF DR. CAL SIA, PEDIATRICIAN, EDUCATOR, ADMINISTRATOR AND ADVOCATE FOR HAWAI'I'S KEIKI. THE PURPOSE OF THIS FUND IS TO PROMOTE OPTIMAL HEALTH AND DEVELOPMENT OF ALL CHILDREN. CECIL MARSHALL ENDOWMENT ESTABLISHED IN 2001 TO SUPPORT THE MISSION OF THE KAPI'OLANI HEALTH FOUNDATION. DAVID & DORIS CROWELL ENDOWMENT ESTABLISHED IN 2000 TO PROVIDE MEDICAL CARE FOR ECONOMICALLY DISADVANTAGED CHILDREN AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN. FLANDERS ENDOWMENT FUND ESTABLISHED BY MURIEL MACFARLANE FLANDERS IN MEMORY OF HER TWO GRANDMOTHERS, EMELIE HEDEMANN MACFARLANE AND ABIGAIL KUAIHELANI CAMPBELL. THE HARRY & JEANETTE WEINBERG FOUNDATION ENDOWMENT ESTABLISHED TO PROVIDE ONGOING SUPPORT TO KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN'S EMERGENCY ROOM AND PEDIATRIC INTENSIVE CARE UNIT (PICU). MARJORIE BOOTH STEPHENS FUND ESTABLISHED TO PROVIDE MEDICAL CARE TO ALL WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THE WILIAM SAUNDERS ENDOWMENT ESTABLISHED IN HONOR OF CECIL A. SAUNDERS, MD, A PEDIATRICIAN WHO ESTABLISHED BABY CLINICS IN THE 1920S, THIS FUND SUPPORTS PEDIATRIC PROGRAMS AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN. SASHA FRANZEL LIFE PERMANENT ENDOWMENT ESTABLISHED IN 2011 FOR THE PURPOSE OF PROVIDING SUPPORT TO THE KAPI'OLANI CLEFT & CRANIOFACIAL CENTER (KCCC). MILLARD HENLEIN AND FRANKIE HENLEIN CHILDREN'S FUND ESTABLISHED IN 1992 FOR THE PURPOSE OF PROVIDING DIRECT MEDICAL SERVICES TO NEEDY CHILDREN AT THE KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN. PAMELA ANN SHIGEZAWA MEDICAL LIBRARY ESTABLISHED FOR THE USE AND BENEFIT OF THE KAPI'OLANI HOSPITAL MEDICAL LIBRARY. KAPI'OLANI PEDIATRIC ENDOWMENT FUND THE FUND SHALL BE USED TO SUPPORT THE PEDIATRIC PROGRAM AT KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN. ABBIE VARA ENDOWMENT THE FUND SHALL SUPPORT THE KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN PEDIATRIC REHABILITATION SERVICES PROGRAM AND/OR OTHER PROGRAMS OR SERVICES OF KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (true)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

FieldValueIRS element (for citing)
PersonMARTS LUNDYPersonNm
ActivityPUBLIC RelationsActivityTxt
Fundraiser Control Of FundsfalseFundraiserControlOfFundsInd
Retained By Contractor$59,606RetainedByContractorAmt
Net To Organization-$59,606NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Retained By Contractors$59,606TotalRetainedByContractorsAmt
Total Net To Organization-$59,606TotalNetToOrganizationAmt

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMENTEvent1Nm
Gross Receipts Event1$526,855GrossReceiptsEvent1Amt
Charitable Contri Event1$20,000CharitableContriEvent1Amt
Gross Revenue Event1$506,855GrossRevenueEvent1Amt
Rent Facility Costs Event1$14,981RentFacilityCostsEvent1Amt
Food And Beverage Event1$11,725FoodAndBeverageEvent1Amt
Entertainment Event1$885EntertainmentEvent1Amt
Other Direct Expenses Event1$111,989OtherDirectExpensesEvent1Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$526,855GrossReceiptsTotalAmt
Charitable Contributions Tot$20,000CharitableContributionsTotAmt
Gross Revenue Total Events$506,855GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$14,981RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$11,725FoodAndBeverageTotalEventsAmt
Entertainment Total Events$885EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$111,989OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$139,580DirectExpenseSummaryEventsAmt
Net Income Summary$367,275NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
Kapi'olani Med Center for Women & Children
55 MERCHANT ST 24TH FLHonoluluHI96813990177350501(c)(3)$2,251,288$64,355FMVGIFTS-IN-KINDGENERAL SUPPORT
Kapi'olani Medical Specialists
55 Merchant St 24th FlHonoluluHI96813990322406501(c)(3)$94,962$0GENERAL SUPPORT
Hawai'i Pacific Health
55 Merchant St 24th FlHonoluluHI96813990246363501(c)(3)$13,355$0GENERAL SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE I, part IIFormAndLineReferenceDesc
ExplanationDESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS TEMPORARILY RESTRICTED FUNDS RELEASED (& GRANTED) TO THE AFFILIATED ORGANIZATIONS ARE RELEASED AFTER THE SPECIFIC PURPOSE OF THE FUND HAS BEEN MET. ONCE THE AFFILIATED ORGANIZATION COMMUNICATES THE EXPENSE AND SATISFIES THE SUBSTANTIATION OF THE EXPENSE FOR THE PURPOSE THAT THE FUNDS WERE CONTRIBUTED FOR, THE FOUNDATION RELEASES THE RESTRICTION AND RECORDS THE GRANT TO THE AFFILIATED ORGANIZATION. NO FURTHER MONITORING OF THE FUNDS AFTER DISTRIBUTION IS NECESSARY.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 (7 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
THOMAS MUNDELL
PRESIDENT$0$225,815$0$45,416$0$48,367$0$64,643$0$13,574$0$397,815$0$0
RAYMOND P VARA JR
Board of Director$0$893,498$0$388,324$0$337,380$0$634,530$0$23,098$0$2,276,830$0$296,712
DAVID OKABE
Treasurer$0$450,780$0$152,265$0$124,702$0$257,404$0$14,328$0$999,479$0$94,882
EARL INOUYE
Assistant Treasurer$0$246,127$0$38,502$0$39,294$0$51,458$0$14,872$0$390,253$0$19,251
CHARLES R CHING
Secretary$0$338,812$0$123,416$0$151,427$0$198,040$0$20,362$0$832,057$0$89,031
JESSICA LEWIS
Assistant Treasurer$0$127,774$0$500$0$0$0$6,349$0$19,266$0$153,889$0$0
MICHAEL ROBINSON
Former Officer$0$193,143$0$19,823$0$3,229$0$35,572$0$3,836$0$255,603$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 PRESIDENT 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, 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. THE CAPITAL ACCUMULATION ACCOUNT (CAA) IS A SECTION 457(F) PROGRAM THAT WAS PREVIOUSLY AFFORDED TO EXECUTIVE OFFICERS OF THE ORGANIZATION TO PROVIDE BENEFITS ON A TAX DEFERRED BASIS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: $132,595 - RAYMOND P. VARA JR. $36249 - DAVID OKABE $44,823 - CHARLES R. CHING LONG TERM INCENTIVE PLAN THE LONG TERM INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL AND LONG TERM SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: $328,234 - RAYMOND P. VARA JR. $117,265 - DAVID OKABE $38,502 - EARL INOUYE $88,416 - CHARLES R. CHING

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution7ContributionCnt
Noncash Contributions Rpt F990$422,062NoncashContributionsRptF990Amt
Method Of Determining Revenuescost/selling priceMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp
Drugs And Medical SuppliesDrugsAndMedicalSuppliesGrp
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Descgifts in kindDesc
Contribution45ContributionCnt
Noncash Contributions Rpt F990$150,725NoncashContributionsRptF990Amt
Method Of Determining Revenuescost/selling priceMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule M, Part I, COLUMN BFormAndLineReferenceDesc
ExplanationCOLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4PROGRAM SERVICE ACCOMPLISHMENTS The mission of kapi'olani health foundation The mission of kapi'olani health foundation (the foundation) is to create a healthier Hawai'i. Kapi'olani Medical Center for Women & Children (Kapi'olani) is a not for profit medical center located in Honolulu and dedicated to the health and well being of all Hawai'i residents. Kapi'olani is Hawai'i's only maternity, newborn and pediatric specialty hospital. Kapi'olani is part of the Hawai'i Pacific Health System, one of the state's largest health care providers. Services include: - intensive care for infants and children - 24-hour emergency pediatric and adult care - critical care transport - maternal-fetal medicine - the state's first breast health and gynecological cancer centers - the sex abuse treatment center - obstetrics & gynecology - pediatric care - children's specialty clinics As a not-for-profit medical center, kapi'olani relies on philanthropic support from the community to fulfill its mission of serving its patients, regardless of their ability to pay. Contributions, both unrestricted and designated, help the medical center provide exceptional medical care for hawai'i's women and children, particularly the most critically ill. Our generous donors help the medical center in four key areas: patient care, capital improvements, education and research, community health and uncompensated care. Capital improvements Research shows that patients heal better and faster when families are involved with their care. As Kapi'olani continues to expand and renovate the facility, the intent is to build around the concept of family-centered care by providing ample space to accommodate new technology and to allow parents and caregivers to stay overnight. Rapidly emerging technologies have fundamentally changed the care delivery process for patients. To continue to deliver the level and comfort that hawai'i's families deserve, kapi'olani has embarked on a long term plan to rebuild the medical center. Phase 1 has been completed with the opening of the diamond head tower. The new structure offers: 1. Family-centered space to deliver family-centered care, a concept at the center of hospital rebuilds nationwide; 2. Services that meet the critical care needs of hawai'i's children, as the pacific region's sole tertiary referral center for pediatric, neonatal and maternal care; and 3. Adequate educational conference rooms and spaces that are available foster Hawai'i's pediatric teaching hospital. Specialized pediatric care Gifts to the foundation enable kapi'olani to provide a full breadth of specialized pediatric care, from general pediatrics to multi specialty care. not typically available to populations the size of hawai'i's, which is 1.4 million. Children with cancer, blood disorders, autoimmune deficiencies and other diseases need follow-up care beyond their inpatient stay. The road to recovery can include years of outpatient treatment. For kids in hawai'i, this means regular trips to kapi'olani's pediatric ambulatory unit, the only facility of its kind in the pacific region. Neonatal-pediatric critical care transport team The kapi'olani neonatal-pediatric critical care transport team is the only one like it in the state and donor-supported. Specially trained staff provide 24/7 lifesaving care to the state's most critically ill newborns and children, regardless of where they are located throughout the islands. Kapi'olani transported more than 572 patients on o'ahu, from neighbor islands and to the mainland in fiscal year 2015. Many of them would not have survived without the immediate medical attention they received from the team. Heart week Since many children in hawai'i with serious heart conditions are not well enough to fly to the mainland for open-heart surgery, donor support allows kapi'olani to bring the surgeons to them for heart week. For one week, multiple times per year, some of the nation's finest specialists from hospitals, such as rady children's hospital san diego, work alongside the pediatric cardiologists and surgeons from kapi'olani. They perform a wide range of surgeries and procedures on patients who are unlikely to survive if their condition is left untreated. Kapi'olani cleft and craniofacial center Donors also support kapi'olani's pediatric specialty clinics, including the kapi'olani cleft and craniofacial center. Cleft lip and cleft palate are complex conditions. They require multidisciplinary therapies from birth through young adulthood by a coordinated team of medical specialists. The center is the only one of its kind in the state, and gathers the essential mix of dedicated specialists in pediatrics, audiology, ear/nose/throat, occupational therapy, dentistry, orthodontics, oral and maxillofacial surgery, plastic surgery, ophthalmology and genetics in one place to serve patients and their families.
FORM 990, PART V, LINE 1AHAWAI'I PACIFIC HEALTH (HPH), THE ORGANIZATION'S TAX EXEMPT PARENT, PAYS ALL VENDORS. THEREFORE, HPH ISSUES FORM 1099S UNDER ITS TAX ID.
FORM 990, PART VI, LINE 2DESCRIPTION OF BUSINESS RELATIONSHIPS ALANA PAKKALA, MARTHA SMITH AND RAYMOND VARA HAVE A BUSINESS RELATIONSHIP. JEFFREY ARCE, RAYMOND VARA, WARREN CHAIKO AND MARTHA SMITH HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, LINE 6MEMBERS AND RIGHTS HAWAI'I PACTIFIC HEALTH IS THE SOLE MEMBER WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARD.
FORM 990, PART VI, LINE 7ADESCRIPTION CLASSES OF PERSON AND THE NATURE OF THEIR RIGHTS HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER, AND HAS THE POWER TO APPROVE THE ELECTION OF 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, LINE 7B DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS EXCLUSIVE POWER TO TAKE AND DIRECT THE FOLLOWING ACTIONS OF THE CORPORATION: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR OF THE BOARD; (II) AFTER CONSULTATION WITH THE BOARD, REMOVE THE PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR; (III) REMOVE A DIRECTOR FROM THE BOARD; (IV) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER; (V) AMEND THESE BYLAWS; (VI) CAUSE THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR ONE MILLION DOLLARS ($1,000,000) OR MORE; (VII) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VIII) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (IX) DETERMINE AND EFFECT INTER-CORPORATE FUND TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (X) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S EXECUTIVE COMPENSATION AND BENEFIT PLANS; (XI) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (XII) DEVELOP AND PROMULGATE OVERALL CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION; AND (XIII) DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER APPROVAL: (I) ELECT ANY DIRECTOR TO THE BOARD; (II) AMEND THE ARTICLES; (III) MERGE THE CORPORATION WITH ANY ENTITY; (IV) DISSOLVE THE CORPORATION; (V) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS BY OR ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VI) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000) EXCEPT FOR THOSE ASSETS ACQUIRED BY GIFTS, GRANT, OR DONATION; (VII) ACQUIRE SHARES IN ANOTHER CORPORATION; (VIII) SELL, LEASE, EXCHANGE, ENCUMBER OR DISPOSE OF TWENTY-FIVE PERCENT (25%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (IX) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (X) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONSHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; AND (XI) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE.
FORM 990, PART VI, LINE 11BREVIEW OF THE 990 BY THE ORGANIZATION'S GOVERNING BODY VARIOUS SCHEDULES OF THE 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 OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPLETED 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 DESCRIBE THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYSTEM REVIEWS THE 990S OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE 990S 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 ENTITY'S (HAWAI'I PACIFIC HEALTH "HPH") BOARD PROVIDES OVERSIGHT FOR THE 990 REPORTING AND REVIEWS THE 990S FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE 990S FOR EACH ENTITY ARE MADE AVAILABLE TO THE BOARD MEMBERS OF EACH SUBSIDIARY UNIT OF HPH AND THE HPH BOARD OF DIRECTORS THROUGH A BOARD MEMBER PORTAL FOR REVIEW PRIOR TO THE FILING OF THE 990. THE 990 WILL BE POSTED TO HPH'S WEBSITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURN WITH THE IRS.
FORM 990, PART VI, LINE 12CANNUALLY, 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 UNDERSTANDS 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 ACTIVITIES 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. 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, LINES 15A & 15BPROCESS FOR DETERMINING COMPENSATION THE PRESIDENT, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER THE TAX-EXEMPT PARENT, HPH. FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE PRESIDENT, OFFICERS AND KEY EMPLOYEES' COMPENSATION. COMPENSATION FOR HAWAI'I PACIFIC HEALTH ("HPH") EXECUTIVES (VICE PRESIDENT AND ABOVE) IS SET BY THE HPH COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT, COMMUNITY-BASED MEMBERS OF THE HPH BOARD OF DIRECTORS. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVES' 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, AND SUCH DECISIONS ARE DOCUMENTED IN THE COMPENSATION COMMITTEE MEETING MINUTES. 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 11, 2016 TO REVIEW PHYSICIAN COMPENSATION AND ON AUGUST 24, 2016 TO REVIEW EXECUTIVE COMPENSATION.
FORM 990, PART VI, LINE 19DISCLOSURE OF GOV DOCS, CONFLICT OF INTEREST POLICY & FINANCIAL STMTS THE CONFLICT OF INTEREST POLICY 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 OR FUND BALANCES $(101,026) - EQUITY TRANSFERS WITH HPH $ (10,614) - CHANGES IN SPLIT INTEREST AGREEMENTS $ (5,118) - OTHER CHANGES IN TR NET ASSETS $ (89,552) - TRANSFERS $ 2 - ROUNDING ------------ $ (120,645) - TOTAL
FORM 990 PART IX LINE 11GDESCRIPTION:INTERNAL SVC PROVIDER EXPENSE TOTAL FEES:901370

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
Pali Momi Medical Center
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990274038hospitalHI501(c)(3)3NAYes (true)
STRAUB CLINIC & HOSPITAL
55 MERCHANT STREET 24TH FLOORHonoluluHI96813912151670hospitalHI501(c)(3)3NAYes (true)
Kapi'OLANI MEDICAL CTR WOMEN & CHILDREN
55 MERCHANT STREET 24TH FLOORHonoluluHI96813990177350hospitalHI501(c)(3)3NAYes (true)
Kapi'olani Medical Specialists
55 Merchant Street 24th FloorHonoluluHI96813990322406healthcareHI501(c)(3)9NAYes (true)
Hawai'i Pacific Health
55 MERCHANT STREET 24TH FLOORHonoluluHI96813990246363HOLDING CO.HI501(c)(3)11B, III-FINAfalse
Wilcox Health Foundation
3-3420 KUHIO HIGHWAYLihueHI96766990204242fundraisingHI501(c)(3)7NAYes (true)
Pali Momi Foundation
55 Merchant Street 24TH FLOORHonoluluHI96813383840327fundraisingHI501(c)(3)7NAYes (true)
Straub Foundation
55 MERCHANT STREET 26TH FLOORHonoluluHI96813990109350FUNDRAISINGHI501(c)(3)7NAYes (true)
Wilcox Memorial HOSPITAL
3-3420 Kuhio HIGHWAYLihueHI96766990074365hospitalHI501(c)(3)3NAYes (true)
PROVIDERS INSURANCE CORPORATION
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813710893000INSURANCEHI501(C)(3)11B, IINAYes (true)
KAUA'I MEDICAL CLINIC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990326099HOSPITALHI501(C)(3)3NAYes (true)

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Business Name Line1ASC Pacific Ventures LLCBusinessNameLine1Txt
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EIN270540034EIN
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Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxt
Straub Pharmacy INC
55 Merchant Street 24th FloorHonoluluHI96813990145107INACTIVEHINAC Corp
Hicord Inc
55 Merchant Street 24th FloorHonoluluHI96813990251496INVESTMENTHINAC Corp
Hawai'i Pacific Health Partners INC &SUB
55 Merchant Street 24th FloorHonoluluHI96813990318588Holding COMPAHINAC Corp
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Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
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Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Kapi'olani Medical Specialists
b$75,000FMV
Kapi'olani Medical Ctr for Women & Children
b$2,054,424FMV
Kapi'olani Medical Ctr for Women & Children
s$209,232FMV
Kapi'olani Medical Ctr for Women & Children
r$209,172FMV
Straub Foundation
p$93,364FMV
Pali Momi Foundation
p$65,421FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceRELATED ORG. TAXABLE AS PARTNERSHIPFormAndLineReferenceDesc
ExplanationSCHEDULE R, PART III ASC PACIFIC VENTURES, LLC EIN: 27-0540034 ADDRESS: 3000 RIVERCHASE GALLERIA, STE 500 BIRMINGHAM, AL 35244ExplanationTxt