2016-05-04T21:11:19-05:00 2015-06-30 ERNST & YOUNG US LLP 370 17TH STREET 3300 DENVER CO 80202 990 2014-07-01 990238120 The Queen's Health Systems % Clinton Yee QUEE 8085389011 1301 PUNCHBOWL STREET HONOLULU HI 96813 ROBERT NOBRIGA TREASURER 8085389011 2016-05-04 true KELLEY SIMON P00791436 7209314000 2014 2016-08-17 19:52:53Z ARTHUR A USHIJIMA 1301 PUNCHBOWL STREET HONOLULU HI 96813 164197565 false X WWW.QUEENSHEALTHSYSTEMS.COM X 1985 HI TO SUPPORT, PROMOTE AND MAINTAIN THE AFFILIATE CORPORATIONS OF QUEEN'S HEALTH SYSTEMS AND TO PROMOTE, SUPERVISE AND CONTRIBUTE TO HEALTHCARE RELATED ACTIVITIES. 25 22 118 837 -4830 82358 537204 32862946 111136410 7406871 7133028 0 0 40352175 118806642 82358 537204 0 0 21099554 59603735 0 0 0 12404661 51565961 33586573 111706900 6765602 7099742 118190351 215771397 42619345 153805712 75571006 61965685 X TO SUPPORT, PROMOTE AND MAINTAIN THE SUBSIDIARY AND AFFILIATE CORPORATIONS OF THE QUEEN'S HEALTH SYSTEMS AND TO PROMOTE, SUPERVISE AND OTHERWISE CONTRIBUTE TO HEALTHCARE RELATED ACTIVITIES. false false 93948987 537204 111136410 THE QUEEN'S HEALTH SYSTEMS ("QHS") IS THE PARENT COMPANY OF THE QUEEN'S MEDICAL CENTER ("QMC"), QUEEN EMMA LAND COMPANY ("QEL"), QUEEN'S DEVELOPMENT CORPORATION, MOLOKAI GENERAL HOSPITAL ("MGH"), NORTH HAWAII COMMUNITY HOSPITAL ("NHCH") AND VARIOUS OTHER HEALTHCARE RELATED ENTITIES (COLLECTIVELY REFERRED TO AS "QUEEN'S"). SEE SCHEDULE O. 93948987 true true false true false false false false false false true true false true true true false true false false false false false false false false false true false true true false false false false false false false false false false false false false false false true true true false false true 162 0 true 118 true true true false false false false false false false false false X 25 22 false false false false false false false true true false false true true true true true true true true false X Clinton Yee 8085389011 1301 PUNCHBOWL STREET HONOLULU HI 96813 GARY CAULFIELD TRUSTEE 1.0 1.0 X 0 0 0 DIANE CECCHITTINI RN Trustee 1.0 1.0 X 0 0 0 NORMAN CHONG TRUSTEE - PART YEAR 1.0 0.0 X 0 0 0 LANCE DUNBAR TRUSTEE 2.0 1.0 X 0 0 0 ERNEST FUKEDA JR TRUSTEE 2.0 2.0 X 0 0 0 CHRISTINE GAYAGAS TRUSTEE 2.0 1.0 X 0 0 0 PETER HALFORD MD TRUSTEE 1.0 38.0 X 0 215745 0 PETER HANASHIRO TRUSTEE 2.0 1.0 X 0 0 0 NEIL HANNAHS TRUSTEE - PART YEAR 1.0 2.0 X 0 0 0 LYLE HARADA TRUSTEE 1.0 2.0 X 0 0 0 DAVID HULIHEE TRUSTEE 2.0 0.0 X 0 0 0 KEAWE KAHOLOKULA PHD TRUSTEE 1.0 1.0 X 0 0 0 STANLEY KURIYAMA TRUSTEE 1.0 1.0 X 0 0 0 SHERRY MENOR-MCNAMARA TRUSTEE 1.0 1.0 X 0 0 0 ROBERT MOMSEN TRUSTEE 1.0 2.0 X 0 0 0 STEVEN NISHIDA MD TRUSTEE 1.0 1.0 X 0 0 0 ANDREW SCHWARTZ MD TRUSTEE 2.0 0.0 X 0 0 0 JAMES STEINWASCHER TRUSTEE 1.0 2.0 X 0 0 0 R BRIAN TSUJIMURA TRUSTEE 2.0 1.0 X 0 0 0 ARTHUR A USHIJIMA PRESIDENT/CEO 32.0 33.0 X X 1608484 0 186028 ALLEN UYEDA TRUSTEE 1.0 1.0 X 0 0 0 JENAI WALL TRUSTEE 2.0 1.0 X 0 0 0 JD WATAMULL TRUSTEE - PART YEAR 1.0 0.0 X 0 0 0 BARRY WEINMAN TRUSTEE 2.0 2.0 X 0 0 0 LESLIE WILCOX TRUSTEE 1.0 1.0 X 0 0 0 C SCOTT WO PHD TRUSTEE 2.0 1.0 X 0 0 0 ERIC YEAMAN CHAIR/TRUSTEE 4.0 3.0 X X 0 0 0 MAENETTE BENHAM EDD TRUSTEE 1.0 2.0 X 0 0 0 MARK YAMAKAWA EVP/COO - PART YEAR 8.0 47.0 X 761843 0 182296 WHITNEY LIMM MD VP CLINICAL INTEGRATION 48.0 12.0 X 633972 0 124152 JOHN NITAO VP/GENERAL COUNSEL 51.0 4.0 X 439196 0 71114 ERIC MARTINSON VICE PRESIDENT/CIO 22.0 33.0 X 456300 0 76648 JANICE KALANIHUIA VICE PRESIDENT 1.0 54.0 X 258175 0 61350 KENNETH GRAHAM VICE PRESIDENT 1.0 54.0 X 237524 0 0 SHARLENE TSUDA VP COMMUNITY DEVELOPMENT 52.0 3.0 X 281766 0 67474 LORI-ANN NOELANI HARRIS ASSISTANT SECRETARY 40.0 0.0 X 58356 0 5683 ROBERT NOBRIGA TREASURER/CFO 45.0 15.0 X 462437 0 78779 CLINTON YEE ASSISTANT TREASURER 10.0 45.0 X 0 192016 39782 GERARD AKAKA VP NAT HWN AFFAIRS/CLIN SUPPRT 50.0 0.0 X 478969 0 82670 PAULA YOSHIOKA SVP CORP DEVELOPMENT 49.0 1.0 X 487256 0 74797 HUNTER PRAYWELL VP IT/CIO 50.0 0.0 X 375734 0 59981 KATHLEEN MORIMOTO VP STRATEGIC PLANNING 50.0 0.0 X 248209 0 49315 JONATHAN KAUFFMAN CHIEF MED INFO OFFICER 50.0 0.0 X 196263 0 28179 RICHARD KEENE FORMER TREASURER/CFO 0.0 0.0 X 752882 0 22529 7737366 407761 1210777 37 true true false ERNST YOUNG LLP 55 MERCHANT STREET HONOLULU HI 96813 CONSULTING SERVICES 696008 BDC ADVISORS LLC 1221 BRICKELL AVENUE STE 1470 MIAMI FL 33131 CONSULTING SERVICES 620959 KPMG LLP 1001 BISHOP STREET HONOLULU HI 96813 ACCOUNTING SERVICES 306503 KENNETH D GRAHAM FACHE 2344 OLD PAGE MILL ROAD PALO ALTO CA 94304 CONSULTING SERVICES 237524 JEFFREY N YU LLC 1011 HOA STREET HONOLULU HI 96825 IT CONSULTING SRVCS 220309 6 0 537204 0 537204 Support Services 561000 111136410 111136410 0 0 111136410 6442409 837 6441572 0 0 0 0 0 46081542 45390923 690619 690619 690619 0 0 0 0 118806642 111136410 837 7132191 X 537204 537204 0 0 0 0 0 0 6770274 5754733 1015541 0 358578 0 358578 0 39366775 33766550 5600225 0 2013331 1711331 302000 0 7894699 6710494 1184205 0 3200078 2720066 480012 0 0 0 0 406620 0 406620 0 866859 0 866859 0 0 0 0 0 0 0 0 0 0 0 5031526 4276797 754729 238084 202371 35713 0 1078346 916594 161752 0 1811072 1539411 271661 0 0 0 0 0 1273372 1082366 191006 0 1084421 921758 162663 0 0 0 0 0 229835 195360 34475 0 276606 235115 41491 0 30402485 25842112 4560373 0 4373974 3717878 656096 0 322395 274036 48359 0 EQUIP RENTAL & MAINTENANCE 747245 635158 112087 0 BOOKS, DUES & SUBSCRIPTION 415081 352819 62262 0 PARKING 13024 11071 1953 0 TAXES 93117 79149 13968 0 2901899 2466614 435285 111706900 93948987 17757913 0 0 0 0 9908374 4347979 0 0 339024 454928 0 0 0 0 0 0 0 0 142914 27990 91448907 63313424 3227980 28135483 26854728 21834992 37413148 42836050 0 0 0 0 40304183 118133975 118190351 215771397 23701357 23929758 0 0 0 0 0 93796170 0 0 0 0 8941355 2811355 0 0 9976633 33268429 42619345 153805712 X 75571006 61965685 0 0 0 0 75571006 61965685 118190351 215771397 X 7099742 -795283 -19909780 X X false true X true true true X X X 3 THE QUEEN'S MEDICAL CENTER 990073524 3 true 0 0 MOLOKAI GENERAL HOSPITAL 990251372 3 true 0 0 NORTH HAWAII COMMUNITY HOSPITAL 990260423 3 false 0 0 3 false false false false false true false false false false false false false false false false true true X true true SCHEDULE A, PART I, LINE 11H, COLUMN (VII) DESCRIPTION OF NON-MONETARY SUPPORT QHS PROVIDES LEGAL, ACCOUNTING, HUMAN RESOURCES AND ADMINISTRATIVE SERVICES TO QMC, MGH AND NHCH. SCHEDULE A, PART IV, SECTION A, LINE 1 IN ITS ARTICLES OF INCORPORATION, THE QUEEN'S HEALTH SYSTEMS (QHS) LISTS THE FOLLOWING SUPPORTED ORGANIZATIONS: THE QUEEN'S MEDICAL CENTER (QMC), MOLOKAI GENERAL HOSPITAL (MGH), AND A CLASS DEFINED AS ALL SECTION 509(A)(1) ORGANIZATIONS IN WHICH QHS IS A MEMBER. NORTH HAWAII COMMUNITY HOSPITAL (NHCH) BELONGS TO THIS SUPPORTED CLASS. AS THE SOLE MEMBER OF QMC, MGH, AND NHCH, QHS HAS A HISTORIC AND CONTINUING RELATIONSHIP WITH EACH ENTITY. NHCH IS THE NEWEST MEMBER OF THE AFFILIATED GROUP. QHS HAS MAINTAINED A CLINICAL AFFILIATION WITH NHCH SINCE 2005 AND A FORMAL AFFILIATION SINCE 2014. SCHEDULE A, PART IV, SECTION A, LINE 6 QHS CONTRIBUTED $437,204 TO UNIVERSITY OF HAWAII OFFICE OF RESEARCH SERVICES AND $100,000 TO FIVE MOUNTAINS HAWAII INC ON BEHALF OF QMC, ITS SUPPORTED ORGANIZATION. SCHEDULE A, PART IV, SECTION D, LINE 1 THE WRITTEN NOTIFICATION WAS NOT SENT BY NOVEMBER 30, 2015; HOWEVER, THE NOTIFICATION WAS SENT IN FEBRUARY, 2016 PRIOR TO THE FILING OF THE FORM 990. THE ORGANIZATION HAS PUT PROCEDURES IN PLACE TO ENSURE THE NOTIFICATION IS SENT TIMELY IN THE FUTURE. SCHEDULE A, PART IV, SECTION D, LINE 3 EIGHTEEN TRUSTEES FOR THE QUEEN'S HEALTH SYSTEMS (QHS) ALSO SERVE AS TRUSTEES FOR THE QUEEN'S MEDICAL CENTER (QMC), INCLUDING THE PRESIDENT OF QMC. FIVE TRUSTEES FOR QHS ALSO SERVE AS TRUSTEES FOR NORTH HAWAII COMMUNITY HOSPITAL AND 6 TRUSTEES FOR QHS ALSO SERVE AS TRUSTEES FOR MOLOKAI GENERAL HOSPITAL. THEREFORE, QHS'S SUPPORTED ORGANIZATIONS HAD A SIGNIFICANT VOICE IN THE INVESTMENT POLICY AND DIRECTING THE USE OF THE ORGANIZATION'S INCOME AND ASSETS AT ALL TIMES DURING THE YEAR. SCHEDULE A, PART IV, SECTION E, LINE 3A THE QUEEN'S HEALTH SYSTEMS (QHS) IS THE SOLE MEMBER WITH THE SOLE POWER TO ELECT BOARD MEMBERS FOR EACH OF ITS SUPPORTED ORGANIZATIONS, THE QUEEN'S MEDICAL CENTER, MOLOKAI GENERAL HOSPITAL (MGH), AND NORTH HAWAII COMMUNITY HOSPITAL (NHCH). IN ADDITION, QHS' PRESIDENT SERVES AS THE CHAIR OF THE BOARD FOR MGH AND NHCH. SCHEDULE A, PART IV, SECTION E, LINE 3B QHS IS THE SOLE MEMBER OF QMC, NHCH AND MGH AND SETS OVERARCHING ADMINISTRATIVE POLICIES FOR ITS SUPPORTED ORGANIZATIONS SUCH AS PRIVACY AND CORPORATE COMPLIANCE. IN ADDITION, CERTAIN MAJOR DECISIONS APPROVED BY THE BOARD OF TRUSTEES OF THE SUPPORTED ORGANIZATIONS 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 WHERE THE SUPPORTED ORGANIZATION IS THE TENANT WITH 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 OF REAL PROPERTY FOR A TERM OF 35 YEARS OR MORE, 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 $2,000,000 FOR QMC, NHCH AND MGH. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 0 52172 0 52172 93948987 1043999273 93948987 1044051445 1000000 1000000 250000 250000 1000000 1000000 1000000 1000000 4000000 6000000 55188 113796 116026 52172 337182 250000 250000 250000 250000 1000000 1500000 0 0 12002 12002 73781901 63313424 10468477 17655004 17655004 28135483 POOLED INVESTMENTS-NON PUBLIC 42836050 F 42836050 DUE FROM AFFILIATES 21648030 FIRST TRUST ASSETS 1807968 TRUSTEE HELD ASSETS 89548014 DEFERRED BOND COSTS 5129963 118133975 0 DUE TO AFFILIATES 10013885 INTEREST PAYABLE 23254544 33268429 X SCHEDULE D, PART X, LINE 2 FIN 48(ASC740) Footnote THE QUEEN'S HEALTH SYSTEM EVALUATES ITS UNCERTAIN TAX POSITIONS AND HAS NO MATERIAL UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2015. true UNIV OF HAWAII OFFICE OF RESEARCH SERVICES 2440 CAMPUS ROAD BOX 368 HONOLULU HI 96822 996000354 GOVT. 437204 0 FMV General Support FIVE MOUNTAINS HAWAII INC 65-1158 Mamalahoa Hwy Suite 2D KAMUELA HI 96743 990330168 501(c)(3) 100000 0 FMV 2 SCHEDULE I, PART I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS: THE QUEEN'S HEALTH SYSTEMS MAKES DONATIONS TO VARIOUS TAX-EXEMPT ORGANIZATIONS ON BEHALF OF ITS SUPPORTED ORGANIZATIONS WITH THE PURPOSE OF PROVIDING OPPORTUNITIES FOR BETTER HEALTH AND WELLNESS TO ALL THE PEOPLE OF HAWAII. THERE ARE GENERALLY NO RESTRICTIONS PLACED ON THE USE OF THOSE DONATIONS AND THE RECEIVING ORGANIZATIONS MAY USE THE DONATIONS AT THEIR DISCRETION IN ORDER TO FURTHER THEIR EXEMPT PURPOSE. WHERE RESTRICTIONS ARE PLACED ON THE USE OF THOSE DONATIONS, QHS REQUESTS FINANCIAL REPORTS IN ORDER TO MONITOR SUCH USE. X X X X X true true false false false false false true false PETER HALFORD MD TRUSTEE 0 215745 0 0 0 0 0 0 0 0 0 215745 0 0 ARTHUR A USHIJIMA PRESIDENT/CEO 811198 0 303171 0 494115 0 172690 0 13338 0 1794512 0 0 0 MARK YAMAKAWA EVP/COO - PART YEAR 431351 0 137306 0 193186 0 169881 0 12415 0 944139 0 0 0 WHITNEY LIMM MD VP CLINICAL INTEGRATION 470976 0 121015 0 41981 0 96473 0 27679 0 758124 0 0 0 JOHN NITAO VP/GENERAL COUNSEL 330236 0 90500 0 18460 0 52212 0 18902 0 510310 0 0 0 ERIC MARTINSON VICE PRESIDENT/CIO 344218 0 55436 0 56646 0 50291 0 26357 0 532948 0 0 0 JANICE KALANIHUIA VICE PRESIDENT 182909 0 53455 0 21811 0 48248 0 13102 0 319525 0 0 0 KENNETH GRAHAM VICE PRESIDENT 237524 0 0 0 0 0 0 0 0 0 237524 0 0 0 SHARLENE TSUDA VP COMMUNITY DEVELOPMENT 210401 0 50138 0 21227 0 54359 0 13115 0 349240 0 0 0 ROBERT NOBRIGA TREASURER/CFO 391677 0 54031 0 16729 0 57000 0 21779 0 541216 0 0 0 CLINTON YEE ASSISTANT TREASURER 0 170191 0 14200 0 7625 0 17380 0 22402 0 231798 0 0 GERARD AKAKA VP NAT HWN AFFAIRS/CLIN SUPPRT 367214 0 73811 0 37944 0 62114 0 20556 0 561639 0 0 0 PAULA YOSHIOKA SVP CORP DEVELOPMENT 364781 0 93403 0 29072 0 65098 0 9699 0 562053 0 0 0 HUNTER PRAYWELL VP IT/CIO 292515 0 59021 0 24198 0 41153 0 18828 0 435715 0 0 0 KATHLEEN MORIMOTO VP STRATEGIC PLANNING 197657 0 43173 0 7379 0 30653 0 18662 0 297524 0 0 0 JONATHAN KAUFFMAN CHIEF MED INFO OFFICER 195901 0 0 0 362 0 12554 0 15625 0 224442 0 0 0 RICHARD KEENE FORMER TREASURER/CFO 84703 0 0 0 668179 0 19385 0 3144 0 775411 0 0 0 SCHEDULE J, PART I, LINE 3 COMPENSATION COMMITTEE REFERS TO A COMMITTEE OF THE ORGANIZATION'S GOVERNING BODY RESPONSIBLE FOR DETERMINING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION PACKAGE, WHETHER OR NOT THE COMMITTEE HAS BEEN DELEGATED THE AUTHORITY TO MAKE AN EMPLOYMENT AGREEMENT WITH THE TOP MANAGEMENT OFFICIAL ON BEHALF OF THE ORGANIZATION. THE COMPENSATION COMMITTEE MAY ALSO HAVE OTHER DUTIES. SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT FROM QHS DURING THE YEAR: RICHARD KEENE - $775,411 SCHEDULE J, PART I, LINE 4B THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) PROVIDES FOR AN UMBRELLA BENEFIT EQUAL TO A LIFE ANNUITY OF 60% OF FINAL AVERAGE SALARY AT NORMAL RETIREMENT AGE (WHICH BENEFIT IS OFFSET HOWEVER BY THE BENEFIT PROVIDED TO THE CEO UNDER THE QHS PENSION PLAN, THE QHS 401(K) PLAN FOR MATCHING CONTRIBUTIONS ONLY, THE QHS PENSION RESTORATION PLAN, AND 50% OF ESTIMATED SOCIAL SECURITY RETIREMENT BENEFITS). NORMAL RETIREMENT AGE IS DEFINED AS AGE 65 AND THE BENEFIT VESTS AND IS PAID OUT AS A LUMP SUM AT THAT POINT REGARDLESS IF EMPLOYMENT IS CONTINUED PAST AGE 65. THERE WERE NO PAYOUTS MADE IN 2014. 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 COMPENSATION PAID FOR SERVICES ARTHUR A. USHIJIMA MR. USHIJIMA SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEEN'S RELATED AFFILIATES. HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. HIS HOURS SERVED AS A TRUSTEE OF QHS ARE 2 HOURS PER WEEK. MR. USHIJIMA ALSO SERVES 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"). THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR HIS VARIOUS SERVICES. MARK YAMAKAWA MR. YAMAKAWA SERVES AS EVP AND COO OF QHS AND EVP AND COO OF QMC. HE IS NOT SEPARATELY COMPENSATED FOR THESE VARIOUS SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. JANICE KALANIHUIA MS. KALANIHUIA SERVES AS VP FOR QHS AND PRESIDENT OF MOLOKAI GENERAL HOSPITAL ("MGH"). SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. ROBERT NOBRIGA MR. NOBRIGA SERVES AS TREASURER OF QUEEN EMMA LAND COMPANY ("QEL"), QMC AND THE TREASURER/CHIEF FINANCIAL OFFICER OF QHS. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. SHARLENE TSUDA MS. TSUDA SERVES AS SECRETARY FOR QHS, QMC AND NORTH HAWAII COMMUNITY HOSPITAL ("NHCH") AND VP OF COMMUNITY DEVELOPMENT OF QHS. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. ERIC MARTINSON MR. MARTINSON SERVES AS PRESIDENT OF QEL, VICE PRESIDENT/CHIEF INVESTMENT OFFICER OF QHS AND PRESIDENT OF THE QUEEN'S DEVELOPMENT CORPORATION ("QDC"). HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. JOHN NITAO MR. NITAO SERVES AS VP/GENERAL COUNSEL FOR QHS AND SECRETARY OF QEL. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. WHITNEY LIMM, MD DR. LIMM SERVES AS SENIOR VP OF CLINICAL INTEGRATION AND CHIEF PHYSICIAN EXECUTIVE OF QHS AND QMC. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. KENNETH GRAHAM MR. GRAHAM SERVES AS VP OF QHS AND IS PRESIDENT OF NHCH. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. MR. GRAHAM IS COMPENSATED FOR THESE SERVICES THROUGH HIS SOLE PROPRIETORSHIP, KENNETH GRAHAM, FACHE. CLINTON YEE MR. YEE SERVES AS CORPORATE CONTROLLER OF QHS, 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. A DEPT OF BUDGET & FINANCE STATE OF HI SERIES ABC 990266961 419800LM7 2015-01-29 350356476 SEE PART VI false false false A 0 0 350362507 0 0 0 4726000 0 0 114000000 8116086 89541979 true false false true A false false false true true 0.00000 0.00000 0.00000 false 0.00000 false true A false true false false true true ML CAPITAL SERVICES 6.5 false false false 0 false true A true SCHEDULE K THE QUEEN'S HEALTH SYSTEM (QHS) BORROWED ON BEHALF OF ITSELF AND AND ITS AFFILIATES, THE QUEEN'S MEDICAL CENTER (QMC) AND NORTH HAWAII COMMUNITY HOSPITAL (NHCH). INFORMATION REPORTED ON SCHEDULE K, IS FOR THE ENTIRE BOND ISSUE. THE OUTSTANDING BOND LIABILITY IS ALLOCATED BETWEEN THE PART I, LINE A, COLUMN (F) DESCRIPTION OF PURPOSE THE BONDS ARE ISSUED FOR THE BENEFIT OF THE BORROWER (THE QUEEN'S HEALTH SYSTEMS) AND THE FOLLOWING ORGANIZATIONS, EACH OF WHICH IS CONTROLLED BY THE BORROWER AND WHICH IS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE: THE QUEEN'S MEDICAL CENTER, MOLOKA'I GENERAL HOSPITAL AND NORTH HAWAII COMMUNITY HOSPITAL (TOGETHER WITH THE BORROWER, THE "OBLIGATED GROUP MEMBERS"). ON JANUARY 23, 2015, QHS ISSUED SPECIAL PURPOSE REVENUE BONDS 2015 SERIES A, 2015 SERIES B AND 2015 SERIES C. THE PURPOSE OF THIS ISSUE WAS TO REFUND ALL DEBT OBLIGATIONS PREVIOUSLY ISSUED UNDER THE MASTER TRUST INDENTURE DATED JULY 1, 1996, AS AMENDED AMONG THE BORROWER, THE QUEEN'S MEDICAL CENTER, AND OTHER AFFILIATED CORPORATIONS, AND THE MASTER TRUSTEE NAMED THEREIN, FINANCE, REFINANCE OR REIMBURSE THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING FACILITIES BENEFITING THE OBLIGATED GROUP MEMBERS AND PAY COSTS OF ISSUANCE OF THE BONDS. THE ISSUE DATES FOR THE REFUNDED BONDS WERE: 12/11/2003 5/6/2009 3/16/2006 FORM 990, PART III, LINE 4A THE MISSION OF THE QUEEN'S HEALTH SYSTEM ("QHS") IS TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE IN PERPETUITY QUALITY HEALTH CARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII. QHS FULFILLS ITS EXEMPT PURPOSE BY SUPPORTING THE QUEEN'S MEDICAL CENTER ("QMC"), MOLOKAI GENERAL HOSPITAL AND NORTH HAWAII COMMUNITY HOSPITAL. IN ADDITION, QHS SUPPORTS ITS SUBSIDIARIES BY PROVIDING ADMINISTRATIVE AND SUPPORT SERVICES (INCLUDING LEGAL, ACCOUNTING, AND HUMAN RESOURCES). QMC SUPPORTS NATIVE HAWAIIAN HEALTH INITIATIVES THROUGH MANY OF ITS PROGRAMS AND SERVICES, PARTICULARLY ITS NATIVE HAWAIIAN HEALTH PROGRAM (NHHP). THE FOCUS AREAS OF NHHP INCLUDE IMPROVEMENTS IN CLINICAL OUTCOMES, HEALTHCARE TRAINING, RESEARCH, AND ACCESS AND OUTREACH. NHHP CONDUCTS ONGOING ASSESSMENT AND DEVELOPMENT OF QMC PROGRAMS AND SERVICES FOCUSED ON NATIVE HAWAIIANS, INCLUDING SPECIFIC CLINICAL PROGRAMS IN AREAS SUCH AS CARDIOLOGY, ONCOLOGY, COMPREHENSIVE WEIGHT MANAGEMENT, MEDICINE, NEUROSCIENCE, AND DIABETES. QMC COLLABORATES AND PARTNERS TO PROVIDE HEALTHCARE TRAINING AND EDUCATION OPPORTUNITIES TO NATIVE HAWAIIAN STUDENTS AND THOSE COMMITTED TO SERVING NATIVE HAWAIIAN COMMUNITIES FROM ADOLESCENCE TO GRADUATE STUDIES, SUCH AS, THE ULU KUKUI PROJECT, WHICH IS A PRE-COLLEGE SCIENCE EDUCATION PROGRAM AT STEVENSON MIDDLE SCHOOL TO PROMOTE EXCELLENCE IN SCIENCE EDUCATION AND THE PURSUIT OF BIOMEDICAL CAREERS BY NATIVE HAWAIIANS AND PACIFIC ISLANDERS. IN ADDITION, NHHP PROGRAMS FOCUS ON QUALITY IMPROVEMENT AND INCREASED ACCESS FOR NATIVE HAWAIIANS TO QMC AND COLLABORATE WITH THE NATIVE HAWAIIAN COMMUNITY IN EDUCATION, RESEARCH, AND COMMUNITY OUTREACH. THROUGH EACH OF THESE AREAS OF FOCUS, NHHP WORKS TO PROVIDE A FRAMEWORK FOR THE DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF CLINICAL INITIATIVES THAT AIM TO ENHANCE THE OLA PONO (WELL BEING) OF NATIVE HAWAIIANS. IN ADDITION TO NHHP, MANY OF QMC'S PROGRAM SERVICES DESCRIBED BELOW PROVIDE BENEFITS TO NATIVE HAWAIIANS, INCLUDING COMPONENTS OF CHARITY CARE AND UNCOMPENSATED CARE PROVIDED TO OUR PATIENTS. IN MAY 2012, QHS AND ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII ANNOUNCED A SIGNED LETTER-OF-INTENT TO ENABLE QHS TO EXPLORE THE FEASIBILITY OF ACQUIRING AND REOPENING THE FORMED HAWAII MEDICAL CENTER (HMC) WEST CAMPUS, WHICH WAS IN THE PROCESS OF BEING RETURNED TO ST. FRANCIS HEALTHCARE SYSTEM FOLLOWING A LENGTHY BANKRUPTCY PROCESS. IN DECEMBER 2012, QHS ANNOUNCED THAT IT OFFICIALLY ACQUIRED HMC FROM ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII. THE QUEEN'S MEDICAL CENTER - WEST OAHU WAS OPENED IN MAY 2014. TO SUPPORT QHS'S MISSION AND TO FULFILL ITS TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, QHS PROVIDED THE FOLLOWING COMMUNITY BENEFITS, TOTALING APPROXIMATELY $161,742,000 ON A SYSTEM-WIDE BASIS, FOR THE YEAR ENDED JUNE 30, 2015. 1. UNCOMPENSATED CARE - QMC PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). FOR THE YEAR ENDED JUNE 30, 2015, THE ESTIMATED COST OF PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $2,395,000 AND $31,717,000, RESPECTIVELY. 2. QUEEN'S TRANSPLANT CENTER - IN JANUARY 2012, QMC OPENED THE ONLY ORGAN TRANSPLANT CENTER IN HAWAII AND THE PACIFIC BASIN. THIS NEW CENTER IS HOME TO PHYSICIANS AND STAFF WITH OVER 20 YEARS OF EXPERIENCE IN TRANSPLANTATION. FOR THE YEAR ENDED JUNE 30, 2015, THE ESTIMATED COST OF OPERATIONS OF THE QUEEN'S TRANSPLANT CENTER WAS $5,181,000. 3. BEHAVIORAL HEALTH - QMC PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES THAT ARE NECESSARY AND, IN CERTAIN INSTANCES, NOT GENERALLY AVAILABLE IN THE STATE OF HAWAII. THE ESTIMATED COST OF OPERATIONS RESULTING FROM BEHAVIORAL HEALTH SERVICES WAS $1,256,000 FOR THE YEAR ENDED JUNE 30, 2015. 4. QUEEN EMMA CLINICS - QMC PROVIDES OUTPATIENT SERVICES TO INDIGENT PATIENTS AND OTHERS THROUGH THE QUEEN EMMA CLINICS. THE ESTIMATED COST OF OPERATION OF THE QUEEN EMMA CLINICS WAS APPROXIMATELY $5,858,000 FOR THE YEAR ENDED JUNE 30, 2015. 5. ON CALL PHYSICIAN COMPENSATION - QMC MAINTAINS THE ONLY LEVEL II TRAUMA CENTER IN THE STATE OF HAWAII. IN ORDER TO PROVIDE LEVEL II TRAUMA COVERAGE, THE MEDICAL CENTER INCURRED APPROXIMATELY $9,629,000 IN ON CALL PHYSICIAN COVERAGE DURING THE YEAR ENDED JUNE 30, 2015. 6. FELLOWSHIP, RESIDENT AND INTERN COSTS - QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $13,542,000 DURING THE YEAR ENDED JUNE 30, 2015 RELATED TO ITS CARDIAC FELLOWSHIP, RESIDENT AND INTERN PROGRAMS. AS A TEACHING FACILITY, QMC PARTICIPATES IN AND SHARES THE COSTS OF THE HAWAII RESIDENCY PROGRAM. 7. HAWAII MEDICAL LIBRARY - QMC MAINTAINS A MEDICAL LIBRARY THAT BENEFITS HEALTHCARE PROFESSIONALS IN THE STATE OF HAWAII. THE ESTIMATED COST OF OPERATING THE HAWAII MEDICAL LIBRARY FOR THE YEAR ENDED JUNE 30, 2015 WAS $887,000. 8. TRANSFER HOTLINE - QMC MAINTAINS A CARDIAC TRANSFER HOTLINE AND A REFERRAL HOTLINE TO ASSIST PATIENTS AND OTHER HEALTHCARE PROVIDERS WITH THE TRANSFER AND/OR REFERRAL OF PATIENTS TO APPROPRIATE HEALTHCARE SERVICES. THE ESTIMATED COST OF PROVIDING THESE SERVICES FOR THE YEAR ENDED JUNE 30, 2015 WAS $1,839,000. 9. TRANSPORTATION SERVICES - QMC PROVIDES TRANSPORTATION TO AND FROM QMC TO PATIENTS WHO REQUIRE ASSISTANCE. THE COST OF PROVIDING THESE SERVICES WAS $95,000 FOR THE YEAR ENDED JUNE 30, 2015. 10. HEALTH AND WELLNESS EDUCATION - QMC PROVIDES HEALTH AND WELLNESS EDUCATION TO THE COMMUNITY IN AN EFFORT TO PROMOTE HEALTHY LIFESTYLES. FOR THE YEAR ENDED JUNE 30, 2015, THE COST OF PROVIDING HEALTH AND WELLNESS EDUCATION WAS $424,000. 11. RESEARCH LOSSES - QMC EMPLOYS STAFF AND INCURS UNFUNDED COSTS FOR MEDICAL RESEARCH. FOR THE YEAR ENDED JUNE 30, 2015, RESEARCH COSTS WERE $799,000. 12. CHARITABLE CONTRIBUTIONS - QMC MAKES CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2015, CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS WERE $2,198,000. OF THIS AMOUNT, $437,000 WAS FOR FUNDING TO THE DEPARTMENT OF NATIVE HAWAIIAN HEALTH UNDER THE JOHN A. BURNS SCHOOL OF MEDICINE OF THE UNIVERSITY OF HAWAII AND $1,000,000 WAS DONATED TO THE UNIVERSITY OF HAWAII CANCER CONSORTIUM. 13. ELECTRICAL GENERATOR PROJECT - IN ORDER TO MAINTAIN NECESSARY LIFE SUPPORT, DIAGNOSTIC AND OPERATING SYSTEMS, IN THE EVENT OF AN EMERGENCY, QMC SIGNIFICANTLY UPGRADED ITS POWER PLANT BY ADDING TWO NEW GENERATORS THAT ARE CAPABLE OF PROVIDING ELECTRICAL POWER FOR THE MEDICAL CENTER. FOR THE YEAR ENDED JUNE 30, 2015, COSTS INCURRED FOR THE ELECTRICAL GENERATOR PROJECT WERE $43,000. TOTAL PROJECT COSTS INCURRED AS OF JUNE 30, 2015 WERE APPROXIMATELY $34,260,000. 14. MEDICAID SHORTFALL IN PAYMENTS - QMC PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICAID PATIENTS IN THE STATE OF HAWAII. QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $50,147,000 DURING THE YEAR ENDED JUNE 30, 2015. 15. MEDICARE SHORTFALL IN PAYMENTS - QMC PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICARE PATIENTS IN THE STATE OF HAWAII. QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT BASED ON MEDICARE COST REPORTS OF APPROXIMATELY $24,669,000 DURING THE YEAR ENDED JUNE 30, 2015. CONSISTENT WITH COST REPORT REQUIREMENTS, THERE ARE AMOUNTS THAT ARE EXCLUDED FROM THE COSTS ABOVE. 16. LEASE PRICING BELOW FAIR MARKET VALUE - QMC EXTENDED LEASE RATES TO THE UNIVERSITY OF HAWAII THAT ARE BELOW FAIR MARKET VALUE. FOR THE YEAR ENDED JUNE 30, 2015, REVENUES FOREGONE FROM LEASE RATES THAT WERE BELOW FAIR MARKET VALUE WERE $75,000. 17. PROGRAMS THAT IMPROVE ACCESS TO HEALTHCARE - QMC IMPROVES THE COMMUNITY'S ACCESS TO HEALTHCARE BY HELPING PATIENTS QUALIFY FOR MEDICAID AND OTHER TYPES OF INSURANCE. FOR THE YEAR ENDED JUNE 30, 2015, THESE PROGRAM COSTS TOTALED $1,051,000. 18. MOLOKAI GENERAL HOSPITAL ("MGH") - QHS SUPPORTS MGH IN PROVIDING HEALTHCARE SERVICES TO THE ISLAND OF MOLOKAI. FOR THE YEAR ENDED JUNE 30, 2015, MGH PROVIDED COMMUNITY BENEFITS TOTALING $1,099,000. 19. NATIVE HAWAIIAN HEALTH AT QMC - QHS SUPPORTS A NATIVE HAWAIIAN HEALTH PROGRAM AT QMC. FOR THE YEAR ENDED JUNE 30, 2015, EXPENSES TOTALED $991,000. 20. KINAU STREET OFF-RAMP IMPROVEMENT PROJECT - IN ORDER TO IMPROVE ACCESS TO ITS EMERGENCY DEPARTMENT AND HOSPITAL, QMC, IN CONJUNCTION WITH THE STATE DEPARTMENT OF TRANSPORTATION AND CITY DEPARTMENT OF TRANSPORTATION SERVICES, SUPPORTED CONSTRUCTION OF THE KINAU STREET OFF-RAMP. FOR THE YEAR ENDED JUNE 30, 2015, COSTS INCURRED FOR THE IMPROVEMENT PROJECT WERE $42,000. 21. DENTAL CLINIC - QMC PROVIDES DENTAL SERVICES TO INDIGENT PATIENTS AND OTHERS THROUGH ITS DENTAL CLINIC. THE COST OF OPERATIONS FROM THE DENTAL CLINIC WAS APPROXIMATELY $554,000 FOR THE YEAR ENDED JUNE 30, 2015. 22. DONATED USE OF CONFERENCE ROOMS - QMC ALLOWS PHYSICIANS AND TEACHERS FROM THE JOHN A. BURNS SCHOOL OF MEDICINE OF THE UNIVERSITY OF HAWAII, VARIOUS GOVERNMENTAL ENTITIES INCLUDING THE HAWAII DEPARTMENT OF HEALTH, AND OTHER NONPROFIT ORGANIZATIONS THE FREE USE OF ITS FACILITIES AT QHS' 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 QHS RETURNS WAS MADE AVAILABLE TO EACH OF THE MEMBERS OF THE QHS BOARD OF TRUSTEES PRIOR TO THE RETURNS BEING FILED WITH THE INTERNAL REVENUE SERVICE. 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 MANAGER DEPARTMENT AND THE 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, LINE 15 PROCESS 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. QHS' EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY FOR ITS PRESIDENT/CEO, EXECUTIVE VP/COO, EXECUTIVE VP/CFO, QHS SENIOR VP ENDOWMENT, QHS SENIOR VP CORPORATE DEVELOPMENT, QHS VP GENERAL COUNSEL, QHS VP HUMAN RESOURCES, QHS VP INFORMATION TECHNOLOGY/CIO, QHS VP COMMUNITY DEVELOPMENT, QHS VP MEDICAL AFFAIRS, AND QHS VP CLINICAL INTEGRATION. 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 SEPTEMBER 2015. OUTSIDE COUNSEL ASSISTS WITH THE REVIEW PROCESS AND DOCUMENTS THE DECISIONS OF THE COMMITTEE. FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC QHS' GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND THE QHS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE QUEEN'S MEDICAL CENTER, MOLOKAI GENERAL HOSPITAL, AND NORTH HAWAII COMMUNITY HOSPITAL TAX RETURNS, AS REQUIRED. QHS DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS PENSION FAS 87 ADJUSTMENT 80,382 CHANGE IN OTHER COMPREHENSIVE INCOME 33,905 SHARED SERVICES TRANSFER FROM AFFILIATE 19,795,490 ROUNDING 3 --------------- TOTAL 19,909,780 FORM 990, PART XII, LINE 3B AUDITS WERE COMPLETED AS REQUIRED. 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) 11c QHS true MOLOKAI GENERAL HOSPITAL PO BOX 408 KAUNAKAKAI MOLOKAI HI 96748 990251372 MEDICAL SVCS HI 501(c)(3) 3 QHS true NORTH HAWAII COMMUNITY HOSPITAL 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 96743 990260423 MEDICAL SVCS HI 501(c)(3) 3 QHS true HAMQUEEN'S PET 1301 PUNCHBOWL STREET HONOLULU HI 96813 943266916 PET IMAGING HI NA N/A THE QUEEN'S DEVELOPMENT CORPORATION 1301 PUNCHBOWL STREET HONOLULU HI 96813 990240109 DEVELOPMENT HI QHS C Corp 1.00000 true DIAGNOSTIC LABORATORY SERVICES 99-859 IWAIWA STREET AIEA HI 96701 990240499 MEDICAL LAB SVCS HI QDC C Corp true QUEEN'S INSURANCE EXCHANGE 1301 PUNCHBOWL STREET HONOLULU HI 96813 911913839 INSURANCE HI QHS C Corp 1.00000 true false false true false false false false false false false false false false false false true true false false QUEEN'S MEDICAL CENTER c 537204 FMV QUEEN'S MEDICAL CENTER p 4197727 FMV MOLOKAI GENERAL HOSPITAL q 1251566 FMV QUEEN EMMA LAND COMPANY q 2340616 FMV QUEEN'S MEDICAL CENTER q 100637701 FMV THE QUEEN'S DEVELOPMENT CORPORATION q 1997399 FMV QUEEN'S INSURANCE EXCHANGE q 289997 FMV NORTH HAWAII COMMUNITY HOSPITAL q 2433204 FMV THE QUEEN'S DEVELOPMENT CORPORATION p 112643 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 Name: Queen Emma Land Company Address: 1301 Punchbowl Street Honolulu, HI 96813 EIN: 99-0183769 Expenses: $32,712,087 501(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: $93,948,987 501(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: $907,476,665 501(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: $9,861,534 501(H) Election: YES Share of excess Lobbying Expenditures: $0 Name: NORTH HAWAII COMMUNITY HOSPITAL Address: 67-1125 MAMALAHOA HIGHWAY KAMUELA, HI 96743-8496 EIN: 99-0260423 Expenses: $39,869,046 501(H) Election: NO Share of excess Lobbying Expenditures: $0