KAUAI MEDICAL CLINIC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- KAUAI MEDICAL CLINIC (EIN 99-0326099)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-08
- IRS object ID
- 201401289349301600
- Schema version
- 2012v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-08T12:06:05-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4370 LA JOLLA VILLAGE DR STE 500 | AddressLine1 |
| City | SAN DIEGO | City |
| State | CA | State |
| ZIP Code | 92122 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990326099 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAUA'I MEDICAL CLINIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % DEBRA TUQUERO | InCareOfName |
| Name Control | KAUA | NameControl |
| Phone | 8082451500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT STREET 24TH FLOOR | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EARL INOUYE | Name |
| Title | VP & SYSTEM CONTROLLER | Title |
| Date Signed | 2014-05-07 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8585357200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RAYMOND VARA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT STREET 24TH FLOOR | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 33884826 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WILCOXHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | HI | StateLegalDomicile |
| Activity Or Mission Description | KAUA'I MEDICAL CLINIC IS AN AFFILIATE OF HAWAI'I PACIFIC HEALTH. IT IS A FOUR-LOCATION, MULTI-SPECIALTY CLINIC WHOSE NOT-FOR-PROFIT MISSION IS TO SERVE THE KAUA'I COMMUNITY WITH ACCESSIBLE, QUALITY HEALTH CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 268 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 34714831 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 33877496 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 12377 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2194 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 87700 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5136 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 34814908 | TotalRevenuePriorYear |
| Total Revenue Current Year | 33884826 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 32809610 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 33344377 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14818116 | OtherExpensePriorYear |
| Other Expenses Current Year | 15566061 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 47627726 | TotalExpensesPriorYear |
| Total Expenses Current Year | 48910438 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -12812818 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -15025612 | RevenuesLessExpensesCY |
| Total Assets BOY | 6928697 | TotalAssetsBOY |
| Total Assets EOY | 7346338 | TotalAssetsEOY |
| Total Liabilities BOY | 4627877 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5770578 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2300820 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1575760 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE KAUA'I MEDICAL CLINIC IS A NOT-FOR-PROFIT MULTI-SPECIALTY CLINIC WHOSE MISSION IS TO SERVE THE KAUA'I COMMUNITY WITH ACCESSIBLE, QUALITY HEALTH CARE THAT SURPASSES EXPECTATIONS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 42677324 | Expense |
| Grants | 0 | Grants |
| Revenue | 33882632 | Revenue |
| Description | SEE SCHEDULE O. | Description |
| Total Program Service Expense | 42677324 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 24 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 268 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | HI | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DEBRA TUQUERO | NamePerson |
| Telephone Number | 8085357284 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT STREET 24TH FLOOR | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| MARK MAGELSSEN MD | |||||||||
| BOARD OF DIRECTOR, CHAIR | 40.0 | 0.0 | X | X | 315603 | 0 | 45455 | ||
| MALVIN DOHRMAN | |||||||||
| BOARD OF DIRECTOR (PART-YEAR) | 0.2 | 0.0 | X | X | 0 | 0 | 0 | ||
| SAM CHEN MD | |||||||||
| BOARD OF DIRECTOR | 40.0 | 0.0 | X | 351551 | 0 | 45569 | |||
| SANDI KATO-KLUTKE | |||||||||
| BOARD OF DIRECTOR | 0.2 | 0.0 | X | 0 | 0 | 0 | |||
| MIKE MURAKOSHI | |||||||||
| BOARD OF DIRECTOR | 0.2 | 0.0 | X | 0 | 0 | 0 | |||
| CHARLES A STED | |||||||||
| BOARD OF DIRECTOR (PART-YEAR) | 2.0 | 58.0 | X | 0 | 1733229 | 45535 | |||
| DAVID ROVINSKY MD | |||||||||
| BOARD OF DIRECTOR (PART-YEAR) | 40.0 | 0.0 | X | 226244 | 0 | 42505 | |||
| RAYMOND P VARA JR | |||||||||
| BOARD OF DIRECTOR, PRESIDENT | 5.0 | 60.0 | X | X | 0 | 1183271 | 318255 | ||
| SUSAN TAI | |||||||||
| BOARD OF DIRECTOR | 0.2 | 0.0 | X | 0 | 0 | 0 | |||
| ROBERT WOTRING II MD | |||||||||
| BOARD OF DIRECTOR | 40.0 | 0.0 | X | 256411 | 0 | 26107 | |||
| GERI YOUNG MD | |||||||||
| CMO | 40.0 | 21.0 | X | 0 | 428148 | 56653 | |||
| MELINDA ASHTON MD | |||||||||
| VP | 1.0 | 48.0 | X | 0 | 401315 | 70584 | |||
| WARREN CHAIKO | |||||||||
| VP | 1.0 | 51.0 | X | 0 | 282181 | 53128 | |||
| CHARLES R CHING | |||||||||
| SVP, GEN. CNSL & SECRETARY | 4.0 | 56.0 | X | 0 | 561651 | 157352 | |||
| ARTHUR GLADSTONE | |||||||||
| VP & CNE | 0.2 | 54.0 | X | 0 | 399942 | 75634 | |||
| EARL INOUYE | |||||||||
| VP & SYSTEM CONTROLLER | 4.0 | 51.0 | X | 0 | 306408 | 75801 | |||
| GAIL LERCH | |||||||||
| EVP | 0.2 | 59.0 | X | 0 | 604506 | 143372 | |||
| SUSAN MASUMOTO-NONAKA | |||||||||
| VP | 1.0 | 59.0 | X | 0 | 257284 | 44923 | |||
| DAVID OKABE | |||||||||
| EVP, CFO & TREASURER | 1.0 | 54.0 | X | 0 | 735788 | 156303 | |||
| VIRGINIA PRESSLER-FISHER MD | |||||||||
| EVP | 0.2 | 58.0 | X | 0 | 594421 | 149714 | |||
| KENNETH B ROBBINS MD | |||||||||
| EVP | 10.0 | 50.0 | X | 0 | 737654 | 190882 | |||
| STEVEN ROBERTSON | |||||||||
| EVP & CIO | 1.0 | 59.0 | X | 0 | 601432 | 148329 | |||
| KEKA SANBORN | |||||||||
| VP | 0.2 | 57.0 | X | 0 | 276522 | 2032 | |||
| DAVID FOX | |||||||||
| PRIVACY/INFO SECURITY OFFICER | 4.8 | 35.0 | X | 0 | 118230 | 40863 | |||
| JESSICA LEWIS | |||||||||
| ASSISTANT CORPORATE SECRETARY | 2.4 | 38.0 | X | 0 | 112417 | 15739 | |||
| THERESA RAMEY | |||||||||
| COMPLIANCE OFFICER | 16.0 | 24.0 | X | 0 | 120896 | 34381 | |||
| ANN PETERS | |||||||||
| VP | 1.0 | 54.0 | X | 0 | 215560 | 47705 | |||
| KATHLEEN CLARK | |||||||||
| CEO | 20.0 | 41.0 | X | 0 | 291712 | 45173 | |||
| JOHN J CULLINEY MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 455107 | 0 | 49951 | X | |||
| MICHAEL LEE MAY MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 436627 | 0 | 21111 | X | |||
| JOSEPH M MURRAY MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 548752 | 0 | 48922 | X | |||
| SURENDRA D RAO MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 787256 | 0 | 43422 | X | |||
| THOMAS J HEMINGWAY MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | 433567 | 0 | 46699 | X | |||
| KEOKI CLEMENTE | |||||||||
| FORMER OFFICER | 0.0 | 0.0 | 0 | 144405 | 19464 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3811118 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 10106972 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2261563 | TotalOtherCompensation |
| Number Individuals GT100 K | 79 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SHIOI CONSTRUCTION INC | |||||
| 98-724 KUAHAO PLACE | PEARL CITY | HI | 96782 | CONSTRUCTION | 561344 |
| LAWRENCE CARPET SERVICE | |||||
| 1970 HANALIMA ST UNIT F-105 | LIHUE | HI | 96766 | CARPET SERVICE | 151259 |
| VRP OF CA PA | |||||
| 25983 NETWORK PLACE | CHICAGO | IL | 606731259 | PATIENT CARE | 135861 |
| MICHAEL LADNER INC | |||||
| PO BOX 223728 | PRINCEVILLE | HI | 96722 | GENERAL CONTRACTING | 150756 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | 28933014 | 28933014 |
| PREMIUM REVENUE | 622110 | 4357263 | 4357263 |
| RENTAL INCOME | 900099 | 92791 | 92791 |
| OTHER HEALTH CARE REVENUE | 622110 | 416211 | 416211 |
| MEDICAL RECORDS AND DEPOSITIONS | 900099 | 78217 | 78217 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 33877496 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2194 | TotalRevenueColumn |
| Exclusion | $2,194 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ALL OTHER REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 5136 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5136 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5136 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 33884826 | TotalRevenueColumn |
| Related Or Exempt Function Income | 33882632 | RelatedOrExemptFunctionIncome |
| Exclusion | $2,194 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1323803 | Total |
| Program Services | 1323803 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 270489 | Total |
| Program Services | 270489 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27346974 | Total |
| Program Services | 26618498 | ProgramServices |
| Management And General | 728476 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 782336 | Total |
| Program Services | 741080 | ProgramServices |
| Management And General | 41256 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2240783 | Total |
| Program Services | 2126095 | ProgramServices |
| Management And General | 114688 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1379992 | Total |
| Program Services | 1330062 | ProgramServices |
| Management And General | 49930 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 195711 | Total |
| Management And General | 195711 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4927932 | Total |
| Program Services | 3643702 | ProgramServices |
| Management And General | 1284230 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83231 | Total |
| Management And General | 83231 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2252005 | Total |
| Program Services | 2176623 | ProgramServices |
| Management And General | 75382 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 865384 | Total |
| Management And General | 865384 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2081153 | Total |
| Program Services | 1996556 | ProgramServices |
| Management And General | 84597 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 156077 | Total |
| Program Services | 136552 | ProgramServices |
| Management And General | 19525 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 557645 | Total |
| Program Services | 546974 | ProgramServices |
| Management And General | 10671 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1764705 | Total |
| Program Services | 1673375 | ProgramServices |
| Management And General | 91330 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| CORPORATE ALLOCATION | 2444520 | 2444520 | |
| OTHER PURCHASES | 154155 | 61432 | 92723 |
| ALL OTHER EXPENSES | 83543 | 82751 | 792 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48910438 | Total |
| Program Services | 42677324 | ProgramServices |
| Management And General | 6233114 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -15728 | BOY |
| EOY | 17014 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22 | BOY |
| EOY | 17 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2182428 | BOY |
| EOY | 2424705 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9294930 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6048533 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3322325 | BOY |
| EOY | 3246397 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1439650 | BOY |
| EOY | 1658205 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6928697 | BOY |
| EOY | 7346338 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3642629 | BOY |
| EOY | 4098776 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 985248 | BOY |
| EOY | 1671802 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4627877 | BOY |
| EOY | 5770578 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2300820 | BOY |
| EOY | 1575760 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2300820 | BOY |
| EOY | 1575760 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6928697 | BOY |
| EOY | 7346338 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -15025612 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 14300552 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2866336 | OtherCostOrOtherBasis |
| Depreciation | 758025 | Depreciation |
| Book Value | 2108312 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6299848 | OtherCostOrOtherBasis |
| Depreciation | 5290508 | Depreciation |
| Book Value | 1009340 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 128745 | OtherCostOrOtherBasis |
| Book Value | 128745 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3246397 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DEPOSITS AND OTHER NON-CURRENT | 1195339 |
| DUE FROM GOVERNMENT AGENCIES | 343375 |
| OTHER RECEIVABLES | 56639 |
| HPH RESEARCH INSTITUTE | 24202 |
| KAPI'OLANI MEDICAL SPECIALISTS | 38650 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1658205 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (10 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| 457(B) LIABILITY | $1,144,210 |
| ESCHEAT LIABILITY | $5,017 |
| KAPI'OLANI WOMEN | $50,391 |
| KAPI'OLANI HEALTH FDN | $9,953 |
| STRAUB FOUNDATION | $188 |
| STAUB CLINIC | $51,842 |
| WILCOX HEALTH FDN | $8,346 |
| PALI MOMI MEDICAL CENTER | $7,701 |
| PALI MOMI FDN | $9 |
| PROVIDERS INSURANCE CORP | $394,145 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1671802 | TotalOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (29 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK MAGELSSEN MD | ||||||||||||||
| BOARD OF DIRECTOR, CHAIR | 80165 | 0 | 0 | 235438 | 0 | 32500 | 0 | 12955 | 0 | 361058 | 0 | 0 | 0 | |
| SAM CHEN MD | ||||||||||||||
| BOARD OF DIRECTOR | 347051 | 0 | 0 | 0 | 0 | 27000 | 0 | 18569 | 0 | 397120 | 0 | 0 | 0 | 4500 |
| CHARLES A STED | ||||||||||||||
| BOARD OF DIRECTOR (PART-YEAR) | 0 | 766059 | 451050 | 0 | 516120 | 0 | 28913 | 0 | 16622 | 0 | 1778764 | 0 | 552685 | 0 |
| DAVID ROVINSKY MD | ||||||||||||||
| BOARD OF DIRECTOR (PART-YEAR) | 224161 | 0 | 0 | 2083 | 0 | 26083 | 0 | 16422 | 0 | 268749 | 0 | 0 | 0 | 0 |
| RAYMOND P VARA JR | ||||||||||||||
| BOARD OF DIRECTOR, PRESIDENT | 0 | 645920 | 325816 | 0 | 211535 | 0 | 296596 | 0 | 21659 | 0 | 1501526 | 0 | 220993 | 0 |
| GERI YOUNG MD | ||||||||||||||
| CMO | 0 | 336507 | 33133 | 0 | 58508 | 0 | 43490 | 0 | 13163 | 0 | 484801 | 0 | 34834 | 0 |
| MELINDA ASHTON MD | ||||||||||||||
| VP | 0 | 307135 | 55871 | 0 | 38309 | 0 | 49992 | 0 | 20592 | 0 | 471899 | 0 | 36079 | 0 |
| WARREN CHAIKO | ||||||||||||||
| VP | 0 | 211391 | 34490 | 0 | 36300 | 0 | 30968 | 0 | 22160 | 0 | 335309 | 0 | 25928 | 0 |
| CHARLES R CHING | ||||||||||||||
| SVP, GEN. CNSL & SECRETARY | 0 | 326252 | 144862 | 0 | 90537 | 0 | 155097 | 0 | 2255 | 0 | 719003 | 0 | 94292 | 0 |
| ARTHUR GLADSTONE | ||||||||||||||
| VP & CNE | 0 | 291734 | 65399 | 0 | 42809 | 0 | 55333 | 0 | 20301 | 0 | 475576 | 0 | 45145 | 0 |
| EARL INOUYE | ||||||||||||||
| VP & SYSTEM CONTROLLER | 0 | 231900 | 36374 | 0 | 38134 | 0 | 54068 | 0 | 21733 | 0 | 382209 | 0 | 28392 | 0 |
| GAIL LERCH | ||||||||||||||
| EVP | 0 | 342097 | 148764 | 0 | 113645 | 0 | 127620 | 0 | 15752 | 0 | 747878 | 0 | 98482 | 0 |
| SUSAN MASUMOTO-NONAKA | ||||||||||||||
| VP | 0 | 203875 | 30942 | 0 | 22467 | 0 | 29691 | 0 | 15232 | 0 | 302207 | 0 | 14027 | 0 |
| DAVID OKABE | ||||||||||||||
| EVP, CFO & TREASURER | 0 | 431997 | 183650 | 0 | 120141 | 0 | 143391 | 0 | 12912 | 0 | 892091 | 0 | 121653 | 0 |
| VIRGINIA PRESSLER-FISHER MD | ||||||||||||||
| EVP | 0 | 340354 | 132739 | 0 | 121328 | 0 | 128412 | 0 | 21302 | 0 | 744135 | 0 | 121235 | 0 |
| KENNETH B ROBBINS MD | ||||||||||||||
| EVP | 0 | 413181 | 165485 | 0 | 158988 | 0 | 170943 | 0 | 19939 | 0 | 928536 | 0 | 154812 | 0 |
| STEVEN ROBERTSON | ||||||||||||||
| EVP & CIO | 0 | 349025 | 149873 | 0 | 102534 | 0 | 126027 | 0 | 22302 | 0 | 749761 | 0 | 108848 | 0 |
| KEKA SANBORN | ||||||||||||||
| VP | 0 | 209817 | 41503 | 0 | 25202 | 0 | 0 | 0 | 2032 | 0 | 278554 | 0 | 12469 | 0 |
| DAVID FOX | ||||||||||||||
| PRIVACY/INFO SECURITY OFFICER | 0 | 118230 | 0 | 0 | 0 | 0 | 22066 | 0 | 18797 | 0 | 159093 | 0 | 0 | 0 |
| THERESA RAMEY | ||||||||||||||
| COMPLIANCE OFFICER | 0 | 114067 | 6829 | 0 | 0 | 0 | 22760 | 0 | 11621 | 0 | 155277 | 0 | 0 | 0 |
| JOHN J CULLINEY MD | ||||||||||||||
| PHYSICIAN | 428107 | 0 | 0 | 0 | 0 | 32500 | 0 | 17451 | 0 | 505058 | 0 | 0 | 0 | 27000 |
| MICHAEL LEE MAY MD | ||||||||||||||
| PHYSICIAN | 436127 | 0 | 0 | 0 | 0 | 15004 | 0 | 6107 | 0 | 457738 | 0 | 0 | 0 | 500 |
| JOSEPH M MURRAY MD | ||||||||||||||
| PHYSICIAN | 521208 | 0 | 0 | 26140 | 0 | 32500 | 0 | 16422 | 0 | 597674 | 0 | 0 | 0 | 1404 |
| SURENDRA D RAO MD | ||||||||||||||
| PHYSICIAN | 787256 | 0 | 0 | 0 | 0 | 27000 | 0 | 16422 | 0 | 830678 | 0 | 0 | 0 | 0 |
| KEOKI CLEMENTE | ||||||||||||||
| FORMER OFFICER | 0 | 133601 | 10804 | 0 | 0 | 0 | 2565 | 0 | 16899 | 0 | 163869 | 0 | 0 | 0 |
| ROBERT WOTRING II MD | ||||||||||||||
| BOARD OF DIRECTOR | 248290 | 0 | 0 | 0 | 0 | 20000 | 0 | 6107 | 0 | 282518 | 0 | 0 | 0 | 8121 |
| ANN PETERS | ||||||||||||||
| VP | 0 | 168985 | 25875 | 0 | 20700 | 0 | 24722 | 0 | 22983 | 0 | 263265 | 0 | 13931 | 0 |
| KATHLEEN CLARK | ||||||||||||||
| CEO | 0 | 208738 | 53844 | 0 | 29130 | 0 | 38692 | 0 | 6481 | 0 | 336885 | 0 | 24637 | 0 |
| THOMAS J HEMINGWAY MD | ||||||||||||||
| PHYSICIAN | 99111 | 0 | 0 | 239758 | 0 | 27000 | 0 | 19699 | 0 | 480266 | 0 | 0 | 0 | 94698 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| SCHEDULE J, PART I, LINE 3 | THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ("HPH"), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FORM 990 PART VI, LINE 15A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION. |
| SCHEDULE J, PART I, LINE 4B | 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 DERERRED BASIS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: MELINDA ASHTON $14,409 CHARLES CHING $41,295 DAVID OKABE $50,005 CHARLES A. STED $364,357 RAYMOND P. VARA, JR. $89,128 EARL INOUYE $10,333 VIRGINIA PRESSLER-FISHER $70,464 KATHLEEN CLARK $4,772 GAIL LERCH $43,101 STEVEN ROBERTSON $50,529 KENNETH B. ROBBINS $86,050 WARREN CHAIKO $6,665 SUSAN MASUMOTO-NONAKA $96 ART GLADSTONE $17,455 GERI YOUNG $20,903 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 ORGANIZATION: MELINDA ASHTON $45,871 CHARLES CHING $131,362 DAVID OKABE $171,650 CHARLES A. STED $451,050 RAYMOND P. VARA, JR. $305,816 EARL INOUYE $36,374 VIRGINIA PRESSLER-FISHER $132,739 KATHLEEN CLARK $43,844 GAIL LERCH $135,764 STEVEN ROBERTSON $139,873 KENNETH B. ROBBINS $165,485 WARREN CHAIKO $34,490 SUSAN MASUMOTO-NONAKA $30,942 ART GLADSTONE $55,399 GERI YOUNG $20,903 KEALA PETERS $25,875 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| AMY HUTSON | |||
| FAMILY MEMBER OF DIRECTOR | 121000 | COMPENSATION | false |
| JOSEPH MURRAY | |||
| SEE PART V | 101814 | PAYMENTS TO VMM LLC FOR KOLOA | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL BUSINESS TRANSACTION INFORMATION | Identifier |
| Return Reference | SCHEDULE L, PART IV, LINE 2 | ReturnReference |
| Explanation | JOSEPH MURRAY IS AN OFFICER OF KAUA'I MEDICAL CLINIC AND OWNER OF VMM, LLC. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4A | ESTABLISHED IN 1967, KAUA'I MEDICAL CLINIC HAS PROVIDED THE RESIDENTS AND VISITORS OF KAUA'I WITH PRIMARY AND SPECIALTY CARE FOR MORE THAN 40 YEARS. KAUA'I MEDICAL CLINIC PARTNERS WITH WILCOX MEMORIAL HOSPITAL AS PART OF WILCOX HEALTH. KAUA'I MEDICAL CLINIC OFFERS MORE THAN 20 SPECIALTIES AT FOUR LOCATIONS: THE MAIN CLINIC IN LIHUE AND THREE SATELLITE CLINICS IN KAPA'A, KOLOA AND ELE'ELE. KAUA'I MEDICAL CLINIC EMPLOYS 88 PHYSICIANS AND 150 DIRECT SUPPORT STAFF. IN FISCAL YEAR 2013, CLINIC VISITS WERE 217,025 AND TOTAL PATIENT ENCOUNTERS WERE 300,381. SPECIALTY UNITS: KAUA'I MEDICAL CLINIC IS KAUAI'S ONLY MULTI-SPECIALTY GROUP. IT PROVIDES CARE IN CARDIOLOGY, FAMILY MEDICINE, GASTROENTEROLOGY, GENERAL MEDICINE, GENERAL SURGERY, HEMATOLOGY, INFECTIOUS DISEASES, INTERNAL MEDICINE, NEUROLOGY, OBSTETRICS AND GYNECOLOGY, ONCOLOGY, ORTHOPEDIC SURGERY, OTOLARYNGOLOGY, PEDIATRICS, PHYSIATRY, PODIATRY, RHEUMATOLOGY AND UROLOGY. THIS RANGE OF SPECIALTIES, MULTIPLE LOCATIONS, AND AFFILIATION WITH HAWAI'I PACIFIC HEALTH SIGNIFICANTLY INCREASES ACCESS TO CARE FOR KAUA'I RESIDENTS AND VISITORS. KAUA'I MEDICAL CLINIC PATIENTS ENJOY EASY APPOINTMENT SCHEDULING, URGENT CARE SERVICES, CHRONIC DISEASE MANAGEMENT, DIABETES CONSULTATION AND EDUCATION, DIAGNOSTIC IMAGING, FINANCIAL COUNSELING, AND A PHARMACY. COMMUNITY: KAUA'I MEDICAL CLINIC IS AN ACTIVE COMMUNITY PARTNER. IN FISCAL 2013, ITS HEALTH EDUCATION, PREVENTION PROGRAMS AND SUPPORT GROUPS FOCUSED ON DIABETES, SPORTS MEDICINE, WATER SAFETY, INJURY PREVENTION, AND HEALTH FAIRS. TOGETHER WITH WILCOX MEMORIAL HOSPITAL, THE CLINIC HOSTED OR SPONSORED A VARIETY OF COMMUNITY HEALTH EDUCATION EVENTS, AND STAFF SUPPORTED THEIR COMMUNITY BY PARTICIPATING IN ANNUAL CHARITABLE ENDEAVORS. THESE INCLUDED "KIDS' SUMMER FEST", "THE WOMEN'S 10K RACE", SEVERAL PHYSICIAN-LED COMMUNITY WALKS, "THE OLD KOLOA SUGAR MILL RUN", "PARADE OF LIGHTS", "RELAY FOR LIFE", "HOEDOWN FOR HOPE", "KAUA'I KEIKI BIKE AND SAFETY DAY", KAUA'I LIFE GUARD ASSOCIATION'S "FIRST WAVE", KAUA'I DIABETES TODAY'S "SUMMER BASH" AND MALAMA PONO HEALTH SERVICES' "PARADISE RIDE". KAUA'I MEDICAL CLINIC ALSO PROVIDED PHYSICIAN SUPPORT FOR LOCAL HIGH SCHOOL FOOTBALL TEAMS. KAUA'I MEDICAL CLINIC TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING (WITH WILCOX MEMORIAL HOSPITAL) AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. IN FISCAL YEAR 2013, KAUA'I MEDICAL CLINIC PROVIDED $4,353,712 WORTH OF CARE TO PATIENTS WHO WERE UNINSURED OR UNABLE TO PAY FOR THEIR CARE, AS WELL AS OTHER COMMUNITY BENEFITS. |
| MEMBERS AND RIGHTS | FORM 990, PART VI, LINE 6 | HAWAI'I PACIFIC 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 BODY. |
| ORGANIZATION ELECTS ONE OR MORE MEMBERS OF THE GOVERNING BODY | FORM 990, PART VI, LINE 7A | 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. |
| DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS | FORM 990, PART VI, LINE 7B | THE MEMBER SHALL HAVE THE EXCLUSIVE POWER TO TAKE AND DIRECT THE FOLLOWING ACTIONS OF THE CORPORATION: (1) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS, AS SUCH TERM IS DEFINED IN THE BYLAWS; (2) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (3) AMEND THE BYLAWS; (4) DETERMINE AND EFFECT THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1)YEAR AND/OR FOR ONE MILLION DOLLAR ($1,000,000) OR MORE; (5) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (6) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (7) EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (8) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (9) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, OR PARTNERSHIP OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (10) EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAW OF THE STATE OF HAWAI`I, SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY WILCOX MEMORIAL HOSPITAL, KAUA'I MEDICAL CLINIC AND WILCOX HEALTH FOUNDATION (THE "WILCOX AFFILIATES"); (11) EXCEPT AS PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAI`I, SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (12) CLOSE THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORPORATION; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (13) CONVERT THE CLINIC OWNED AND OPERATED BY THE CORPORATION INTO A FACILITY NO LONGER OFFERING MEDICAL SERVICES; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (14) AFTER CONSULTING WITH THE BOARD, REMOVE THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, TREASURER, SECRETARY, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS; PROVIDED, HOWEVER, THAT TO REMOVE OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER WILL REQUIRE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE MEMBER TO FULLY COLLABORATE AND CONSULT WITH THE BOARD AND SEEK THE BOARD'S ADVANCE CONSENT FOR SUCH REMOVAL OR TERMINATION. IF THE BOARD DOES NOT CONCUR WITH THE PROPOSED REMOVAL OR TERMINATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SUCH REMOVAL OR TERMINATION WILL REQUIRE THE APPROVAL OF A MAJORITY OF THE MEMBERS ON THE MEMBER BOARD; (15) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG RANGE AND STRATEGIC PLANS OF THE CORPORATION; AND (16) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER BOARD APPROVAL: (1) ADD ANY DIRECTOR TO THE BOARD; (2) REMOVE ANY DIRECTOR FROM THE BOARD; (3) AMEND THE ARTICLES; (4) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (5) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000); (6) ACQUIRE SHARES IN ANOTHER CORPORATION; (7) SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE WILCOX AFFILIATES; (8) SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (9) SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (10) MERGE THE CORPORATION WITH ANY ENTITY; (11) DISSOLVE OR LIQUIDATE THE CORPORATION; (12) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (13) 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 (14) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE. |
| REVIEW OF THE 990S BY THE ORGANIZATION'S GOVERNING BODY | FORM 990, PART VI, LINE 11B | VARIOUS SCHEDULES OF THE 990S ARE PREPARED PRIMARILY BY STAFF WITHIN THE ACCOUNTING AREA OF THE ORGANIZATION WORKING WITH VARIOUS OTHER AREAS OF THE ORGANIZATION SUCH AS MANAGEMENT OF THE OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPILED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE 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 990S WILL BE POSTED TO HPH'S WEB SITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURN WITH THE IRS. |
| DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICT OF INTEREST | FORM 990, PART VI, LINE 12C | ANNUALLY, EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) RECEIVED A COPY OF THE CONFLICT OF INTEREST ("COI") POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; AND 4) 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. |
| OFFICES & POSITIONS FOR WHICH PROCESS WAS USED AND YEAR PROCESS WAS LAST | COMPLETED | FORM 990, PART VI, LINE 15A/15B THE CEO OF THE ORGANIZATION IS NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER BY THE TAX EXEMPT PARENT HAWAI'I PACIFIC HEALTH ("HPH"). FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE CEO'S 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 COMPLETED ON MARCH 5,2013 TO REVIEW PHYSICIAN COMPENSATION, AND ON AUGUST 7, 2013 TO REVIEW EXECUTIVE COMPENSATION. |
| DISCLOSURE GOV DOCS, CONFLICT OF INTEREST POLICY, & FINANCIAL STMTS | FORM 990, PART VI, LINE 19 | 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. STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE HAWAI'I PACIFIC HEALTH WEBSITE. |
| OTHER CHANGES IN NET ASSETS OR FUND BALANCES | FORM 990, PART XI, LINE 9 | $14,300,552 - EQUITY TRANSFERS WITH HPH |
| DESCRIPTION OF OTHER ON STMT OF FUNCTIONAL EXPENSES | FORM 990, PART IX, LINE 11G | 173,488 - SERVICES PHYSICIAN 2,084 - SERVICES MEDICAL 42,675 - CONSULTING 96,962 - LAUNDRY 16,321 - SERVICES CONTRACT RECURRING 26,660 - COLLECTION FEES 255 - BUS PASS 207,772 - COURIER SERVICES, STERILE CLEANING SUPPLIES & INSPECT/PACKAGE SUPPLIES, TECH AND CLERK HOURS FOR RECEIVING, STOCKING, ISSUING/DELIVERY OF SUPPLIES 253,462 - SERVICES (RECEPTIONIST, AIDE, TECH) PROVIDED BY WMH STAFF FOR IMAGING DEPT 452,556 - SERVICES PROVIDED BY WMH STAFF FOR ENVIRONMENTAL SERVICES; JANITORIAL, DISPOSAL SHREDDING, PEST CONTROL AND CLEANING SERVICES 809,696 - SERVICES PROVIDED BY WMH STAFF FOR HEALTH INFO MGMT 182,886 - SERVICES PROVIDED BY WMH STAFF FOR PLANT/GROUNDS MAINTENANCE, SECURITY SERVICES 247,217 - VARIOUS SERVICES 443,813 - REPAIRS MAINTENANCE 3,250,320 - INTERNAL SERVICES PROVIDED (1,278,235)- EXPENSE RECOVERY - PHYSICIAN COVERAGE SERVICES PROVIDED TO WMH ------------- 4,927,932 TOTAL ============= |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HAWAI'I PACIFIC HEALTH | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990246363 | HOLDING CO. | HI | 501(C)(3) | 11B TYPE II | NA | false |
| STRAUB CLINIC & HOSPITAL | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 912151670 | HOSPITAL | HI | 501(C)(3) | 3 | NA | true |
| STRAUB FOUNDATION | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990109350 | RESEARCH/EDU | HI | 501(C)(3) | 7 | NA | true |
| PROVIDERS INSURANCE CORPORATION | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 710893000 | NFP INSURANCE | HI | 501(C)(3) | 11B TYPE II | NA | true |
| PALI MOMI FOUNDATION | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 383840327 | FUNDRAISING | HI | 501(C)(3) | 7 | NA | true |
| KAPI'OLANI MEDICAL CTR WOMEN & CHILDREN | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990177350 | HOSPITAL | HI | 501(C)(3) | 3 | NA | true |
| KAPI'OLANI HEALTH FOUNDATION | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990246364 | FUNDRAISING | HI | 501(C)(3) | 7 | NA | true |
| KAPI'OLANI MEDICAL SPECIALIST | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990322406 | HEALTH CARE | HI | 501(C)(3) | 9 | NA | true |
| PALI MOMI MEDICAL CENTER | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990274038 | HOSPITAL | HI | 501(C)(3) | 3 | NA | true |
| WILCOX MEMORIAL HOSPITAL | ||||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990074365 | HOSPITAL | HI | 501(C)(3) | 3 | NA | true |
| WILCOX HEALTH FOUNDATION | ||||||||||
| 990204242 | FUNDRAISING | HI | 501(C)(3) | 7 | NA | true | ||||
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASC PACIFIC VENTURES LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 RIVERCHASE GALLERIA STE 500 | AddressLine1 |
| City | BIRMINGHAM | City |
| State | AL | State |
| ZIP Code | 35244 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270540034 | EIN |
| Primary Activity | AMBU. SURG. CNTR | PrimaryActivity |
| Legal Domicile State | AL | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeType |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| HAWAI'I PACIFIC HEALTH PARTNERS INC & SU | ||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990318588 | HOLDING COMPA | HI | NA | C CORP |
| STRAUB PHARMACY INC | ||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990145107 | INACTIVE | HI | NA | C CORP |
| HICORD INC | ||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990251496 | INVESTMENT | HI | NA | C CORP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| STRAUB CLINIC & HOSPITAL | ||
| S | 94166 | FMV |
| WILCOX MEMORIAL HOSPITAL | ||
| Q | 2690659 | FMV |
| WILCOX MEMORIAL HOSPITAL | ||
| R | 53857 | FMV |
| PROVIDERS INSURANCE CORPORATION | ||
| R | 1497848 | FMV |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | RELATED ORG. TAXABLE AS PARTNERSHIP | Identifier |
| Return Reference | SCHEDULE R, PART III | ReturnReference |
| Explanation | ASC PACIFIC VENTURES, LLC EIN: 27-0540034 ADDRESS: 3000 RIVERCHASE GALLERIA, STE 500 BIRMINGHAM, AL 35244 | Explanation |