2014-05-13T16:57:25-05:00 2013-06-30 ERNST & YOUNG US LLP 4370 LA JOLLA VILLAGE DR STE 500 SAN DIEGO CA 92122 990 2012-07-01 990073524 THE QUEEN'S MEDICAL CENTER % CLINTON YEE QUEE 8085389011 1301 PUNCHBOWL STREET Suite HONOLULU HI 96813 Robert Nobriga 2014-05-13 8585357200 2012 2015-11-30 17:44:51Z ARTHUR A USHIMJIMA 1301 PUNCHBOWL STREET HONOLULU HI 96813 1308644500 false X WWW.QUEENSMEDICALCENTER.NET X 1859 HI THE MISSION OF QMC IS TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE IN PERPETUITY QUALITY HEALTHCARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HI. 19 14 4406 320 10377988 1112707 31438975 35766583 683616214 715307816 17069781 77910258 19044676 27586656 751169646 856571313 2480742 2003912 0 0 356361527 394716782 0 0 85685 343251022 350166394 702093291 746887088 49076355 109684225 1056520269 1188717644 687598602 689785894 368921667 498931750 X THE MISSION OF QMC IS TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE IN PERPETUITY QUALITY HEALTHCARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII. false false 722959391 2003912 735578290 THE QUEEN'S MEDICAL CENTER IS THE LARGEST PRIVATE, NONPROFIT, ACUTE CARE MEDICAL FACILITY IN HAWAII. ITS STAFF IS DEDICATED TO PROVIDING QUALITY HEALTH CARE TO THE PEOPLE OF HAWAII AND THE PACIFIC. SEE SCHEDULE O FOR MORE INFORMATION. 722959391 true true false true false false false false false true true true false true true true false true false false false false false false true false true true true false true true false false false false false false false false false true false false false false false true true true false false true 535 0 true 4406 true true true false false false false true true false false false false X 19 14 false false false false true true true true true false false true false false false false true true false X CLINTON YEE 8085389011 1301 PUNCHBOWL STREET HONOLULU HI 96813 Maenette Benham EdD 1.0 1.0 X 0 0 0 Diane Cecchettini RN 1.0 1.0 X 0 0 0 Ernest Fukeda Jr 1.0 2.0 X 0 0 0 Christine M Gayagas 1.0 1.0 X 0 0 0 Peter Halford MD 22.0 0.0 X 134922 0 0 Peter K Hanashiro 1.0 1.0 X 0 0 0 Neil J Hannahs 1.0 2.0 X 0 0 0 Lyle Harada 1.0 1.0 X 0 0 0 Robert Hong MD 50.0 0.0 X 496634 0 21064 Stanley Kuriyama 1.0 1.0 X 0 0 0 Noreen Mokuau DSW 1.0 1.0 X X 0 0 0 Robert K Nobriga 1.0 3.0 X 0 0 0 William G Obana MD 12.0 3.0 X X 113264 0 0 Caroline Ward Oda 1.0 1.0 X 0 0 0 Robb K Ohtani MD 13.0 2.0 X 54593 0 0 James Kimo Steinwascher 1.0 1.0 X 0 0 0 Arthur A Ushijima 32.0 33.0 X X 0 1184114 449263 Jenai S Wall 1.0 1.0 X 0 0 0 Barry M Weinman 1.0 3.0 X 0 0 0 Julia C Wo 1.0 2.0 X 0 0 0 Eric K Yeaman 1.0 6.0 X 0 0 0 Susan Haramoto 8.0 32.0 X 0 58882 0 Richard Keene 20.0 35.0 X 0 569831 70775 Sharlene Tsuda 2.0 53.0 X 0 266174 61866 Mark Yamakawa 41.0 14.0 X 0 649808 160979 Clinton Yee 40.0 15.0 X 183976 0 35449 Paula Yoshioka 54.0 1.0 X 0 483257 65620 Sung Bae Lee 50.0 0.0 X 678186 0 34677 David J Fergusson MD 50.0 0.0 X 543483 0 11183 Nicholas Dang MD 50.0 0.0 X 507691 0 954 Christopher Aoki MD 50.0 0.0 X 485705 0 40436 Christian Spies MD 50.0 0.0 X 481413 0 36142 3679867 3212066 988408 924 false true false Hawaii Residency Programs Inc 1356 Lusitana Street 510 HONOLULU HI 96813 MEDICAL SERVICES 8208247 Xerox Business Service LLC PO Box 201322 DALLAS TX 753201322 INFO/SYSTM OUTSOURCE 8201106 UCERA 677 Ala Moana Boulevard 1003 HONOLULU HI 96813 MEDICAL SERVICES 7847813 Affiliated Computer Services PO Box 201322 DALLAS TX 753201322 INFO/SYSTM OUTSOURCE 4953065 Sodexo Inc Affiliates 1301 Punchbowl Street HONOLULU HI 96813 MANAGEMENT SERVICE 3739171 132 430433 34125580 1210570 5592 35766583 NET PATIENT REVENUE 622110 706765629 706765629 INTERCO PURCHASED 561000 8542187 5726478 2815709 715307816 9313374 1121203 8192171 0 0 850401 850401 0 850401 850401 520582030 9100 450629427 1364819 69952603 -1355719 68596884 68596884 103646 430433 78941 24705 24705 0 0 OTHER SERVICES 621500 8769355 3765583 5003772 RESEARCH 621500 2656768 2656768 OTHER OPERATING REVENUE 621500 15285427 13848123 1437304 26711550 856571313 732762581 10377988 77664161 X 2003912 2003912 0 0 0 964512 755458 209054 0 304942957 297046971 7895986 31215199 30325423 889776 36796076 35498613 1297463 20798038 20202660 595378 0 1198712 558793 639919 325058 325058 95122 95122 0 0 87777168 85116644 2660524 867075 839240 27835 2533198 2477528 54979 691 421359 415340 6019 0 18328463 18101607 226856 1428189 1339983 88206 0 1730 1730 8402169 8402169 0 32771043 32434453 336590 6062984 1 6062983 MEDICAL SUPPLIES 117585961 117585961 INTERCOMPANY CHARGES 40118619 39480305 638314 TAXES 17722521 17721183 1338 EDUCATION 2733003 2717972 15031 11794020 9933445 1775581 84994 746887088 722959391 23842012 85685 31716 30023 20134272 7817721 0 0 82911301 112977803 0 0 0 0 0 0 9378099 9983534 12981849 12928112 725839368 439843333 234378725 285996035 478654707 248728391 84623132 364199187 5591825 6397864 0 0 127834643 139658974 1056520269 1188717644 280390717 258561108 0 0 0 0 261830000 248895000 0 0 0 0 0 17500000 1077953 121863 144299932 164707923 687598602 689785894 X 349513521 480717282 13457332 12263654 5950814 5950814 368921667 498931750 1056520269 1188717644 X 109684225 -28819248 49145106 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 95122 113796 95122 113796 722800631 790087903 722895753 790201699 1000000 1000000 250000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 31942 46088 55188 113796 247014 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 7221401 500 697700 19000 816329 7084272 7237856 1125 119980 5543 132017 7221401 7195561 40500 662352 48405 612152 7237856 6633812 852775 386481 32281 645226 7195561 6236306 710304 42671 80428 275041 6633812 0.84000 0.16000 false false 38030635 38030635 425516668 264714751 160801917 12071872 8565451 3506421 220707337 166563131 54144206 29512856 29512856 285996035 ALTERNATIVE INVESTMENTS 364199187 F 364199187 DUE FROM AFFILIATES 125231057 ASSETS LIMITED - 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ASC 740 FOOTNOTE SCHEDULE D, PART X, LINE 2 QMC REGULARLY ASSESSES ITS TAX POSITIONS AND DID NOT HAVE MATERIAL UNCERTAIN TAX BENEFITS FOR THE YEAR ENDED JUNE 30, 2013 AND 2012. Benefit Dinner 534079 430433 103646 11552 56709 6038 4642 0 534079 430433 103646 11552 56709 6038 4642 78941 24705 true true X true X true X true true true false true true 3189000 0 3189000 0.00430 58288205 28156021 30132184 0.04030 61477205 28156021 33321184 0.04460 3379000 3379000 0.00450 13788000 13788000 0.01850 37554000 16386000 21168000 0.02830 1397000 1397000 0.00190 1742541 1742541 0.00230 57860541 16386000 41474541 0.05550 119337746 44542021 74795725 0.10010 1111000 1111000 0.00150 1111000 1111000 0.00150 true 21431019 187295900 208611700 -21315800 X true true 1 1 The Queen's Medical Center

1301 Punchbowl Street Honolulu HI 96813

www.queens.org X X X X X The Queen's Medical Center 1 true X X X X X X X X X 12 true true true X X X X X X false false true true 150. true 250. true X X X X X true true X true false X X X X true X false false SCHEDULE H, PART I, LINE 6A COMMUNITY BENEFITS ARE REPORTED ANNUALLY AS PART OF THE FORM 990. THIS IS NOT SEPARATELY AVAILABLE TO THE PUBLIC. A FORMAL REPORT ISSUED BY THE PARENT COMPANY, THE QUEEN'S HEALTH SYSTEMS, INCLUDES THE COMMUNITY BENEFITS OF THE QUEEN'S MEDICAL CENTER. THIS REPORT IS PUBLISHED PERIODICALLY AND IS SEPARATELY AVAILABLE TO THE PUBLIC. SCHEDULE H, PART I, LINE 7G THE QUEEN EMMA CLINICS PROVIDE COMPREHENSIVE PATIENT CARE TO INDIGENT PATIENTS AND SERVE A LARGE HOMELESS POPULATION. THE NET COSTS ASSOCIATED WITH THESE CLINICS WAS $5,894,000. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY CONSIDERS ALL PATIENT SEGMENTS. AMOUNTS REPRESENT THE NET COSTS FOR THE VARIOUS PROGRAMS AND OPERATIONS, CONSIDERING ACTUAL AMOUNTS INCURRED AND CALCULATED BENEFITS BASED ON COST-TO-CHARGE RATIOS AND AVERAGE RATES (I.E. WAGE RATES). SCHEDULE H, PART II 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. QMC IS THE ONLY LEVEL II TRAUMA CENTER IN THE STATE OF HAWAII. QMC ALLOCATED RESOURCES TO PLAN AND TEST ITS READINESS FOR COMMUNITY EMERGENCIES, INCLUDING TRAUMA, TERRORIST ATTACKS AND CONDITIONS RESULTING FROM HAZARDOUS MATERIAL SPILLS. 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 THE CONSTRUCTION OF THE KINAU STREET OFF-RAMP. SCHEDULE H, PART III, LINE 4 QMC PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AUDITED FINANCIAL STATEMENTS DO NOT DESCRIBE BAD DEBT EXPENSE. THE AUDITED FINANCIAL STATEMENTS DO DESCRIBE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. "QMC PROVIDES FOR AN ALLOWANCE AGAINST ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE BY ESTABLISHING AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. QMC ESTIMATES THE ALLOWANCE BASED ON THE AGING OF THE ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS." SCHEDULE H, PART III, LINE 8 THE MEDICARE AMOUNTS ABOVE ARE CALCULATED WITH DATA FROM JUNE 30, 2013 MEDICARE COST REPORT, USING THE STEP DOWN METHOD. CONSISTENT WITH REPORTING REQUIREMENTS, THERE ARE AMOUNTS EXCLUDED FROM THE COSTS LISTED IN LINE 6. WHEN USING THE FULLY ALLOCATED COST CALCULATION, THE MEDICARE SHORTFALL WAS APPROXIMATELY $37,286,000. SCHEDULE H, PART III, LINE 9B EVERY ATTEMPT IS MADE BEFORE DISCHARGE TO SCREEN PATIENTS WHO HAVE NO DOCUMENTATION OF MEDICAL INSURANCE FOR POSSIBLE ELIGIBILITY FOR DISCOUNTED CARE. NON-ER OUTPATIENTS WITH NO MEDICAL INSURANCE ARE REFERRED TO THE PATIENT'S PHYSICIAN FOR A DETERMINATION OF URGENT OR EMERGENCY CARE STATUS. CHARITY CARE DISCOUNTS ARE BASED ON FINANCIAL NEED WHICH IS DETERMINED BY INCOME AND ASSET THRESHOLDS BASED ON FEDERAL POVERTY LEVELS AND IN COMPLIANCE WITH FEDERAL RULES AND REGULATIONS. PATIENTS ARE REQUESTED TO COMPLETE A DISCOUNTED CARE APPLICATION AND MUST SUBMIT INCOME AND ASSET VERIFICATION DOCUMENTS. PATIENTS MAY ALSO BE DEEMED ELIGIBLE FOR QMC DISCOUNTED CARE BASED ON PRIOR OR SUBSEQUENT MEDICAID ELIGIBILITY. ONCE ELIGIBILITY FOR QMC DISCOUNTED CARE IS CONFIRMED, A PAYMENT PLAN IS DISCUSSED WITH THE PATIENT. BILLING STATEMENTS ARE MAILED MONTHLY TO ALL PATIENTS WITH SELF PAY BALANCES, INCLUDING PATIENTS WITH BALANCES AFTER QMC DISCOUNTED CARE IS APPLIED. BILLING STATEMENTS FOR PATIENTS WITH NO INSURANCE INCLUDE A STATEMENT ADVISING TO CALL THE NUMBER ON THE STATEMENT TO DISCUSS OPTIONS FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 3 TWENTY TWO KEY INFORMANTS WERE INTERVIEWED FOR THEIR STATE WIDE KNOWLEDGE OF HEALTH NEEDS; WHEN CERTAIN TOPIC AREAS WERE LACKING AN INTERVIEW WITH A STATE WIDE PERSPECTIVE, RELEVANT FINDINGS FROM HONOLULU COUNTY INTERVIEWS WERE INCLUDED. THE INTERVIEWS WERE WITH JENNIFER DANG, DEPARTMENT OF EDUCATION; LYNN FALLIN, HAWAII DEPARTMENT OF HEALTH; DR. KENNY FINK, DEPARTMENT OF HUMAN SERVICES; LORETTA FUDDY, HAWAII STATE DEPARTMENT OF HEALTH; BETH GIESTING, OFFICE OF THE GOVERNOR; DR. JOSH GREEN, STATE SENATOR & HAWAII INDEPENDENT PHYSICIANS ASSOCIATION; ROBERT HIROKAWA, HAWAII PRIMARY CARE ASSOCIATION; LOLA IRVIN, HAWAII DEPARTMENT OF HEALTH; DR. BLISS KANESHIRO, UNIVERSITY OF HAWAII; LESLIE LAM, AMERICAN DIABETES ASSOCIATION HAWAII; DEE JAY MAILER, KAMEHAMEHA SCHOOLS; KATHY MATAYOSHI, HAWAII STATE DEPARTMENT OF EDUCATION; DEE DEE NELSON, MOUNTAIN-PACIFIC QUALITY HEALTH; MAY OKIHIRO, UNIVERSITY OF HAWAII; DR. BILL OSHEROFF, HAWAII MEDICAL SERVICE ASSOCIATION; DR. NEAL PALAFOX, UNIVERSITY OF HAWAII; DR. SARAH PARK, DEPARTMENT OF HEALTH; DR. LINDA ROSEN, HAWAII STATE DEPARTMENT OF HEALTH; DAVID SAKAMOTO, HAWAII STATE DEPARTMENT OF HEALTH; EMILIE SMITH, CARERESOURCE HAWAII; HARDY SPOEHR, PAPA OLA LOKAHI; LORI SUAN, AMERICAN HEART ASSOCIATION, HAWAII CHAPTER; DR. JACKIE YOUNG, AMERICAN CANCER SOCIETY HAWAII SITE; AND KEN ZERI, HOSPICE HAWAII. THE INFORMATION OBTAINED FROM THESE INTERVIEWS WAS INCORPORATED INTO THE REPORT IN THREE WAYS. A SUMMARY QUALITATIVE ANALYSIS TOOL CALLED A "WORD CLOUD" WAS PRODUCED USING TAGCROWD.COM TO IDENTIFY THE MOST COMMON THEMES AND TOPICS. WORDS OR PHRASES THAT WERE MENTIONED MOST OFTEN DISPLAY IN THE WORD CLOUD IN THE LARGEST AND DARKEST FONT. NEXT, INPUT FROM THE KEY INFORMANTS WAS INCLUDED IN EACH RELEVANT TOPIC AREA IN SECTION 3.2 OF THE CHNA. IF AVAILABLE, INFORMATION SPECIFIC TO THE HEALTH OF MOLOKAI RESIDENTS IS LISTED IN THE FIRST SECTION OF EACH INTERVIEW SUMMARY TABLE; INFORMATION GATHERED ON THE GENERAL POPULATION OF HAWAII FOR EACH TOPIC AREA IS ALSO PRESENTED IN THE TABLES. ANY RECOMMENDED COMMUNITY PROGRAMS OR RESOURCES ARE INCLUDED IN THE LAST COLUMN TITLED "OPPORTUNITIES/STRENGTHS." SCHEDULE H, PART V, SECTION B, LINE 4 TWENTY SIX OF 28 HAWAII HOSPITALS, LOCATED ON ALL ISLANDS, PARTICIPATED IN THE CHNA PROJECT: CASTLE MEDICAL CENTER HALE HO`OLA HAMAKUA HILO MEDICAL CENTER KAHI MOHALA BEHAVIORAL HEALTH KAHUKU MEDICAL CENTER KAISER PERMANENTE MEDICAL CENTER KAPI`OLANI MEDICAL CENTER FOR WOMEN & CHILDREN KA`U HOSPITAL KAUAI VETERANS MEMORIAL HOSPITAL KOHALA HOSPITAL KONA COMMUNITY HOSPITAL KUAKINI MEDICAL CENTER KULA HOSPITAL LANA`I COMMUNITY HOSPITAL LEAHI HOSPITAL MAUI MEMORIAL MEDICAL CENTER MOLOKAI GENERAL HOSPITAL NORTH HAWAII COMMUNITY HOSPITAL PALI MOMI MEDICAL CENTER REHABILITATION HOSPITAL OF THE PACIFIC SAMUEL MAHELONA MEMORIAL HOSPITAL SHRINERS HOSPITALS FOR CHILDREN HONOLULU STRAUB CLINIC & HOSPITAL WAHIAWA GENERAL HOSPITAL WILCOX MEMORIAL HOSPITAL SCHEDULE H, PART V, SECTION B, LINE 5A THE WEBSITE ADDRESS WHERE THE CHNA CAN BE ACCESSED IS: HTTP://QUEENSMEDICALCENTER.ORG/COMMUNITY-BENEFITS SCHEDULE H, PART V, SECTION B, LINE 7 THE CHNA IDENTIFIED 20 AREAS OF COMMUNITY HEALTH NEEDS. THE QUEEN'S MEDICAL CENTER (QMC) RECOGNIZES THE IMPORTANCE OF THESE NEEDS AND HAS SUPPORTED EFFORTS TO ADDRESS MANY OF THEM. IT IS ALSO RECOGNIZED THAT THERE ARE HEALTH NEEDS THAT QMC WILL NOT DIRECTLY BE ADDRESSING FOR VARIOUS REASONS. AS PART OF THE PROCESS TO SELECT QMC'S PRIORITY AREA, EACH OF THE 20 IDENTIFIED AREAS OF NEED WERE MAPPED TO THREE CORE NEEDS TO BE ADDRESSED TO IMPROVE COMMUNITY HEALTH: PRIMARY HEALTH CARE NEEDS, SECONDARY HEALTH CARE NEEDS AND SOCIETAL NEEDS. THIS MAPPING ALLOWED QMC TO FOCUS ON ADDRESSING NEEDS WITHIN THE SCOPE OF ITS CORE COMPETENCIES. AS AN ACUTE CARE TERTIARY/QUATERNARY HOSPITAL, QMC'S CORE COMPETENCIES ARE IN THE PRIMARY HEALTH CARE NEEDS CATEGORY. COMMUNITY HEALTH NEEDS IN THE SECONDARY HEALTH CARE NEEDS AND SOCIETAL NEEDS CATEGORIES ARE BEING ADDRESSED THROUGH THE LEADERSHIP OF OTHER ORGANIZATIONS WHOSE MISSIONS, CORE COMPETENCIES AND EXPERTISE MEET THOSE NEEDS. THOSE ARE: - DISABILITIES - ECONOMY - EDUCATION - ENVIRONMENT - EXERCISE, NUTRITION AND WEIGHT - FAMILY PLANNING - INJURY PREVENTION AND SAFETY - ORAL HEALTH - SOCIAL ENVIRONMENT - SUBSTANCE ABUSE AND LIFESTYLE - TRANSPORTATION ALTHOUGH QMC WILL NOT DIRECTLY BE ADDRESSING THESE AREAS OF NEED, WE HAVE SUPPORTED AND PARTNERED WITH OTHERS TO ADDRESS SEVERAL OF THEM AND WILL CONTINUE TO SUPPORT OPPORTUNITIES TO ADDRESS COMMUNITY HEALTH NEEDS IN COLLABORATION WITH OTHERS. OF THE AREAS MAPPED TO THE PRIMARY HEALTH CARE NEEDS CATEGORY, QMC SELECTED DIABETES AS ITS PRIORITY AREA. FOR THE OTHER AREAS, QMC CURRENTLY PROVIDES MANY SERVICES AND PROGRAMS TO ADDRESS THESE NEEDS. THESE SERVICES AND PROGRAMS ARE OFFERED IN/AT THE HOSPITAL, IN CONJUNCTION WITH PARTNERS, AND THROUGH OUTREACH TO THE COMMUNITY. SCHEDULE H, PART V, SECTION B, LINE 20D CHARGES BILLED TO UNINSURED PATIENTS ARE THE SAME AMOUNTS AS CHARGES TO INSURED PATIENTS. PER QMC'S DISCOUNTED CARE POLICY, UNINSURED PATIENTS ARE ELIGIBLE FOR A 30% DISCOUNT PROVIDED "PATIENT AGREES TO A PROMPT PAYMENT SCHEDULE ACCEPTABLE TO QMC". NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 QMC'S MISSION 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 OF THE PEOPLE OF HAWAII. USING PUBLICLY AVAILABLE REPORTS AND DATA, AND THROUGH DISCUSSIONS WITH STAKEHOLDERS, QMC ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY WE SERVE BY FOCUSING ON FIVE STRATEGIC DIMENSIONS INCLUDING SUPERIOR QUALITY AND PERFORMANCE, BEING THE PROVIDER OF CHOICE, EMPLOYER OF CHOICE, DISPLAYING RESPONSIBLE CITIZENSHIP AND FOCUSING ON FINANCIAL PERFORMANCE. CORE STRATEGIES INVOLVING RESPONSIBLE CITIZENSHIP TO THE COMMUNITY INCLUDE HARDWIRING OUR NATIVE HAWAIIAN HEALTH STRATEGIC PLAN THROUGHOUT QUEEN'S ENTITIES, CREATING A SUSTAINABLE INFRASTRUCTURE THAT ALLOWS QUEEN'S TO QUANTIFY AND ARTICULATE COMMUNITY BENEFIT, AND STRENGTHENING GOVERNMENT AND COMMUNITY PARTNERSHIPS TO SUPPORT ACCESS AND AVAILABILITY OF PROGRAMS AND SERVICES THAT HELP ADDRESS UNMET COMMUNITY HEALTH NEEDS. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 MEDICAID AND MEDICARE ELIGIBILITY REQUIREMENTS ARE DISCUSSED WITH INPATIENTS AND/OR INPATIENT'S FAMILY MEMBERS. QMC HAS A CONTRACTED VENDOR WHO PERFORMS MEDICAID ELIGIBILITY ASSESSMENTS AND WORKS WITH PATIENTS TO SUBMIT AN APPLICATION AND THE REQUIRED DOCUMENTS. PATIENTS WHO MAY QUALIFY FOR MEDICARE ARE PROVIDED CONTACT INFORMATION FOR THE SOCIAL SECURITY OFFICE. SIGNS ARE POSTED IN REGISTRATION AREAS THROUGHOUT THE HOSPITAL ADVISING THE QMC HAS A DISCOUNTED CARE POLICY. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 QMC IS THE LEADING MEDICAL REFERRAL CENTER IN THE PACIFIC BASIN. LOCATED IN DOWNTOWN HONOLULU, IT'S THE LARGEST PRIVATE HOSPITAL IN HAWAII. ACCORDING TO RECENT DEMOGRAPHIC CENSUS DATA, THE STATE OF HAWAII IS VERY DIVERSE AND INCLUDES A POPULATION THAT IS APPROXIMATELY 10% NATIVE HAWAIIAN, OTHER PACIFIC ISLANDER, NATIVE ALASKAN AND AMERICAN INDIAN. OTHER DEMOGRAPHIC INFORMATION REGARDING HAWAII IS AS FOLLOWS: - MEDIAN AGE: 38.5 YEARS OLD (1) - 38% ASIAN, 25% WHITE, 9% NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER, 24% TWO OR MORE RACES (1) - MEDIAN HOUSEHOLD INCOME: $66,420 (2006-2010) (1) - 9.6% OF HAWAII'S POPULATION LIVES IN POVERTY (1) - OTHER THAN OAHU, THE ENTIRETY OF EACH ISLAND IS CONSIDERED UNDERSERVED(1) - NUMBER OF HOSPITALS (BY COUNTY) HAWAII COUNTY: 6 MAUI COUNTY: 4 C&C HONOLULU: 9 KAUAI COUNTY: 3 - 35% OF HOSPITAL INPATIENT DISCHARGES COVERED BY MEDICARE, 25% BY MEDICAID/QUEST (DATA FROM JAN - NOV 2012) (2) (1) HEALTHCARE ASSOCIATION OF HAWAII: HAWAII STATE COMMUNITY HEALTH NEEDS ASSESSMENT (2) HAWAII HEALTH INFORMATION CORPORATION PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 THE AMOUNTS MENTIONED IN PART II OF SCHEDULE H REPRESENT COSTS INCURRED TO ENSURE CONTINUED OPERATIONS THAT BENEFIT THE COMMUNITY. TO SUPPORT THE QUEEN'S MISSION AND TO FULFILL THE TAX-EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, QUEEN'S PROVIDES A NUMBER OF COMMUNITY BENEFITS. THIS INCLUDES UNCOMPENSATED CARE, WHERE QMC PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED; CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). IN BEHAVIORAL HEALTH, QUEEN'S PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES THAT ARE NECESSARY AND, IN CERTAIN INSTANCES, NOT GENERALLY AVAILABLE IN THE STATE OF HAWAII. QUEEN'S ALSO IS HOME TO QUEEN EMMA CLINICS, WHERE QMC PROVIDES OUTPATIENT SERVICES TO INDIGENT PATIENTS. OTHER EXAMPLES INCLUDE EMERGENCY PREPAREDNESS COSTS AND AMOUNTS EXPENDED TO EXPAND AND TEST BACK-UP POWER THAT CAN SERVICE PATIENTS IN TIMES OF EMERGENCY. IN ADDITION, QMC PROVIDES MANY FREE INFORMATIONAL SEMINARS AND EDUCATIONAL OPPORTUNITIES TO THE PUBLIC TO PROMOTE THE HEALTH OF COMMUNITY. THESE PROGRAMS ARE SPECIFICALLY DIRECTED TO ADDRESS HEALTH ISSUES WITHIN THE COMMUNITY INCLUDING DIABETES, CANCER AND WOMEN'S HEALTH ISSUES. A MAJORITY OF QMC'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN QMC'S PRIMARY SERVICE AREA (OAHU) WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF QMC. QMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 IN ADDITION THE QUEEN'S MEDICAL CENTER, AFFILIATE ORGANIZATIONS OF THE QUEEN'S HEALTH SYSTEMS OPERATE THE ONLY HOSPITAL ON ISLAND OF MOLOKA'I, PROVIDE DIAGNOSTIC LABORATORY SERVICES, OPERATE PHARMACIES AND PROVIDE THE HOSPITALS WITH GENERAL AND PROFESSIONAL LIABILITY INSURANCE. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 N/A FACILITY REPORTING GROUP(S) SCHEDULE H, PART VI, LINE 8 N/A true Aloha Council Boy Scouts of America 42 Puiwa Road Honolulu HI 96817 221576300 501(c)(3) 7500 Distinguished Aloha Medical Mission 810 North Vineyard Blvd Honolulu HI 96817 990234811 501(c)(3) 25100 Sponsor "30th Anniversaryn Event" and Donation Aloha United Way 200 North Vineyard Blvd Suite 700 Honolulu HI 96817 990073494 501(c)(3) 6100 Contribution "10th Annual Charity Golf Tournament" and Donation American Cancer Society 2370 Nuuanu Avenue Suite 2610 Honolulu HI 96817 990073489 501(c)(3) 10000 Sponsor "Midnight in Paris, Inagural Hope Gala Honolulu" American Diabetes Association 875 Waimanu Street 601 Honolulu HI 96813 131623888 501(c)(3) 47500 Sponsor "Step Out Walk to Fight Diabetes" "Tour de Cure" American Heart Association 677 Ala Moana Boulevard Suite 600 Honolulu HI 96813 135613797 501(c)(3) 30000 Sponsor "Heart Ball 2013" and "2013 Oahu Heart Walk" American Red Cross 4155 Diamond Head Road Honolulu HI 96816 530196605 501(c)(3) 10100 2013 Red Cross Corporate Partner and Donation Arthritis Foundation 615 Piikoi Street 1109 Honolulu HI 96814 951885447 501(c)(3) 25000 Sponsor "2013 State of Hawaii Arthritis Walk" Bishop Museum 1525 Bernice Street Suite 1109 Honolulu HI 96817 990161980 501(c)(3) 10000 Sponsor "15th Annual Bernice Pauahi Bishop Awards Dinner" Blood Bank of Hawaii 2043 Dillingham Blvd Honolulu HI 96819 990073479 501(c)(3) 25000 Contribution for purchase of a Bloodmobile Center for American Values Inc 101 South Main Suite 100 Suite 901 Pueblo CO 81003 272779073 501(c)(3) 10000 Sponsorship "2012 Medal of Honor Convention" Child & Family Service 91-1841 Fort Weaver Rd Suite 2E1 Box 3 Ewa Beach HI 96706 990073483 501(c)(3) 5236 Sponsor "Boogie Wonderland" and WHC gift certificates donation Hawaii Academy of Science 1776 University Avenue UA4 Rm 4 Honolulu HI 96822 996006863 501(c)(3) 25000 Sponsor "56th Annual Hawaii State Science and Engineering Fair" Hawaii Children's Cancer Foundation 1814 Liliha Street UA4 Rm 4 Honolulu HI 96817 990299937 501(c)(3) 6000 Sponsor "Eye of the Tiger" Hawaii Community Foundation 827 Fort Street Honolulu HI 96813 990261283 501(c)(3) 100000 Support "Daniel K Inouye Legacy Fund" Hawaii Meals on Wheels Inc PO Box 61194 Honolulu HI 96839 990198132 501(c)(3) 6000 Contribution "Meals from the Heart 2012" Hawaii Mission Houses 553 South King Street Honolulu HI 96813 990073491 501(c)(3) 6000 Contribution "Huaka'i: A Musical Journey" and Donation Hina Mauka 45-845 Pookela Street Kaneohe HI 96744 990173356 501(c)(3) 13000 Sponsor "Giving Hope for Recovery" Hospice Hawaii Inc 860 Iwalei Road Honolulu HI 96817 990203930 501(c)(3) 7600 Sponsor "Na Hoa Malama" Iolani School 563 Kamoku Street Honolulu HI 96826 990073502 501(c)(3) 10000 Sponsor "At Thy Call We Gather" Juvenile Diabetes Research Foundation 1019 Waimanu Street Suite 214 Honolulu HI 96814 231907729 501(c)(3) 7500 Sponsor "An Evening of Hope" March of Dimes 1451 South King Street Suite 504 Honolulu HI 96814 131846366 501(c)(3) 7500 Sponsor "2012 March of Dimes Govenor's Ball" and "March for Babies" National Kidney Foundation of Hawaii 1314 South King St 1555 Honolulu HI 96814 990266733 501(c)(3) 7500 Sponsor "Peace on Earth Concert" Native Hawaiian Education Association 818 South King St 1704 Suite 405-2 Honolulu HI 96813 800198123 501(c)(3) 10000 Sponsor "Aha Wahine 2012 Kuhinapapa" Pacific Links Hawaii Foundation 770 Auloa Road Kailua HI 96734 455637328 501(c)(3) 14000 Sponsor "Pacific Links Hawaii Championship" Papa Ola Lokahi 894 Queen Street Honolulu HI 96813 990273765 501(c)(3) 18000 Support "HOSW" Public Schools of Hawaii Foundation PO Box 4148 Honolulu HI 96812 880243449 501(c)(3) 10000 Sponsor "Kulia I Ka Nu'u Awards Banquet" Rehab Foundation 226 North Kuakini Street Honolulu HI 96817 990241634 501(c)(3) 100000 Matching grant for capital campaign St Francis Healthcare System Fdn of HI 228 Liliha Street 205 Honolulu HI 96817 990240060 501(c)(3) 6100 Contibution "A Night of Magic and Miracles" St Francis Healthcare System of Hawaii PO Box 29700 Honolulu HI 96820 990240059 501(c)(3) 5100 Contribution "10th Biennial International Bioethics Conference" University of Hawaii Foundation 2444 Dole Street Bachman Hall 105 Honolulu HI 96822 990085260 501(c)(3) 112962 Funding of Naleen N Andrade Scholarship Fund Hawaii Cancer Consortium 55 Merchant Street Suite 2700 Honolulu HI 96813 452280259 501(c)(3) 750000 Donation Healthcare Association of Hawaii 707 Richards Street PH2 Honolulu HI 96813 990105817 501(c)(3) 7500 Sponsor 2013 Awards & Scholarship Dinner Hawaii Medical Association 1360 South Beretania St Suite 200 Honolulu HI 96814 990067306 501(c)(6) 6500 Sponsor "Ola Pono Ike Medical Gala" 2012 and 2013 The Queen's Healthcare Systems 1301 Punchbowl Street Honolulu HI 96813 990238120 501(c)(3) 354079 Donations The Queen's Healthcare Systems 1301 Punchbowl Street Honolulu HI 96813 990238120 501(c)(3) 57112 FMV Equipment transfer Donations 34 1 Description of Organization's Procedures for Monitoring the Use of Grants Schedule I, Part I, Line 2 THE QUEEN'S MEDICAL CENTER MAKES DONATIONS TO VARIOUS TAX-EXEMPT 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, QMC REQUESTS FINANCIAL REPORTS IN ORDER TO MONITOR SUCH USE. false true false false false false false true false Robert Hong MD 442538 0 51774 0 2322 0 20124 0 940 0 517698 0 0 0 Arthur A Ushijima 0 860163 0 264958 0 58993 0 436171 0 13092 0 1633377 0 0 Richard Keene 0 439218 0 98654 0 31959 0 64154 0 6621 0 640606 0 0 Sharlene Tsuda 0 198063 0 51143 0 16968 0 49262 0 12604 0 328040 0 0 Mark Yamakawa 0 468448 0 140060 0 41300 0 144705 0 16274 0 810787 0 0 Clinton Yee 162700 0 14300 0 6976 0 15284 0 20165 0 219425 0 0 0 Paula Yoshioka 0 370434 0 96681 0 16142 0 56435 0 9185 0 548877 0 0 Sung Bae Lee 639284 0 38416 0 486 0 15975 0 18702 0 712863 0 0 0 David J Fergusson MD 459546 0 83937 0 0 0 0 0 11183 0 554666 0 0 0 Nicholas Dang MD 507182 0 0 0 509 0 0 0 954 0 508645 0 0 0 Christopher Aoki MD 380325 0 104613 0 767 0 18485 0 21951 0 526141 0 0 0 Christian Spies MD 428896 0 51684 0 833 0 18616 0 17526 0 517555 0 0 0 COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON THE QUEEN'S HEALTH SYSTEM (QHS) TO DETERMINE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL. QHS USED A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. 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 DURING 2012. SCHEDULE J, PART I, LINE 7 RECOGNITION AWARDS WERE PAID TO ALL EMPLOYEES BASED ON ACCOMPLISHMENTS OF PREDETERMINED GOALS AND OBJECTIVES 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. ALSO, CERTAIN PHYSICIANS RECEIVE INCENTIVE COMPENSATION BASED ON PROFESSIONAL SERVICES COLLECTIONS BY QMC. A MAXIMUM ON SUCH INCENTIVE COMPENSATION IS CAPPED ACCORDING TO QMC POLICY. COMPENSATION FOR SERVICES SCHEDULE J, PART II & FORM 990, PART VII ARTHUR A USHIJIMA MR. USHIJIMA SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER, THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEENS' RELATED AFFILIATES (2 HOURS PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. MR. USHIJIMA ALSO SERVES AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE QUEEN'S HEALTH SYSTEMS (PARENT COMPANY) AND AS PRESIDENT OF QMC. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR HIS VARIOUS SERVICES. MARK YAMAKAWA MR. YAMAKAWA SERVES AS EVP AND COO OF THE QUEEN'S HEALTH SYSTEM (PARENT COMPANY), EVP AND COO OF QMC AND PRESIDENT OF QDC. HE IS NOT SEPARATELY COMPENSATED FOR THESE VARIOUS SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. RICHARD C KEENE MR. KEENE SERVES AS QMC TREASURER, SVP/CFO AND TREASURER FOR THE QUEEN'S HEALTH SYSTEMS (PARENT COMPANY), TREASURER OF QEL AND TREASURER OF MGH. 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 QMC AND VP/SECRETARY FOR THE QUEEN'S HEALTH SYSTEMS (PARENT COMPANY). SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. PAULA YOSHIOKA MS. YOSHIOKA SERVES AS SVP/CAO OF QMC AND A DIRECTOR OF QIE. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. CLINTON YEE MR. YEE SERVES AS ASSISTANT TREASURER AND CORPORATE CONTROLLER OF QMC AND ASSISTANT TREASURER OF QMC, QHS AND QDC. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. SUSAN HARAMOTO MS. HARAMOTO SERVES AS ASSISTANT SECRETARY OF QMC, QHS AND QDC AND COORDINATOR OF COMMUNITY DEVELOPMENT OF QHS. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. PETER HALFORD MD DR. HALFORD SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER (1 HOUR PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. DR. HALFORD'S COMPENSATION IS FOR HIS ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER. WILLIAM G OBANA MD DR. OBANA SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER (2 HOURS PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. DR. OBANA'S COMPENSATION IS FOR HIS ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER. ROBB K OHTANI MD DR. OHTANI SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER (1 HOUR PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. DR. OHTANI'S COMPENSATION IS FOR HIS ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER. ROBERT HONG MD DR. HONG SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER (1 HOUR PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. DR. HONG'S COMPENSATION IS FOR HIS ON-CALL SPECIALTY SERVICES AS WELL AS HIS SERVICES AS CHIEF OF STAFF AT THE QUEEN'S MEDICAL CENTER. A DEPARTMENT OF BUDGET & FINANCE STATE OF HAWAII 990266961 419800FB8 2003-12-11 114300000 SEE PART VI false false false B DEPARTMENT OF BUDGET & FINANCE STATE OF HAWAII 990266961 419800FR3 2006-03-16 114875000 SEE PART VI false false false C DEPARTMENT OF BUDGET & FINANCE STATE OF HAWAII 990266961 419800HT7 2009-05-06 78670000 SEE PART VI false false false A 8825000 0 114300000 0 0 0 1683785 3276390 292217 0 0 0 2003 false true true true B 25750000 0 149237584 0 1300000 0 1307753 2193032 5170428 80928891 0 90144 2012 true false false C 6440000 0 78670000 0 0 0 1332516 236880 0 0 0 0 2009 true false true true A 0 B false false false true true true 0 false false false true C 0 A false true true true BANK OF AMERICA ML 25.6 false false false 0 false false B false true true true BANK OF AMERICA ML 18.2 false false false 0 false false C false true true true Bank of America ML 22.2 false false false 0 false false A true B true C true DESCRIPTION OF PURPOSE SCHEDULE K, PART I, COLUMN (F) BOND A) ON DECEMBER 11, 2003, QMC ISSUED SPECIAL PURPOSE REVENUE BONDS (THE QUEEN'S HEALTH SYSTEM) 2003 SERIES A, 2003 SERIES B AND 2003 SERIES C ("THE 2003 ISSUE"). THE PURPOSE OF THE 2003 ISSUE WAS TO ADVANCE REFUND A PORTION OF THE 1996 BOND SERIES ISSUED ON JULY 18, 1996. BOND B) ON MARCH 16, 2006, QMC ISSUED SPECIAL PURPOSE REVENUE BONDS (THE QUEEN'S HEALTH SYSTEM) 2006 SERIES A, 2006 SERIES B AND 2006 SERIES C ("THE 2006 ISSUE"). THE PURPOSE OF THE 2006 ISSUE WAS TO REFUND A PORTION OF THE 1998 BOND SERIES ISSUED ON JULY 1, 1998 ON A CURRENT BASIS AND TO FINANCE APPROVED CAPITAL PROJECTS. BOND C) ON MAY 6, 2009, QMC ISSUED SPECIAL PURPOSE REVENUE BONDS (THE QUEEN'S HEALTH SYSTEM) 2009 SERIES A AND 2009 SERIES B ("THE 2009 ISSUE"). THE PURPOSE OF THE 2009 ISSUE WAS TO REFUND THE 2003C AND 2006C BOND SERIES ISSUED DECEMBER 11, 2003 AND MARCH 16, 2006, RESPECTIVELY, ON A CURRENT BASIS. THE CUSIP NUMBER FOR 2009 SERIES A IS 419800HT7 AND THE CUSIP NUMBER FOR 2009 SERIES B IS 419800HV2. TOTAL PROCEEDS OF ISSUE SCHEDULE K, PART II, LINE 3 BOND B) THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE TOTAL PROCEEDS IS BECAUSE OF EARNED INTEREST INCOME. FOR PURPOSES OF PART II, QMC ASSUMES THAT AMOUNTS SPENT TO RETIRE PRIOR DEBT ARE NEITHER WORKING CAPITAL NOR CAPITAL EXPENDITURES, AND ARE NOT REPORTED HEREIN. DATE REBATE COMPUTATION WAS PERFORMED SCHEDULE K, PART IV ARBITRAGE Date Rebate Computation was performed: 2003 - 12/11/2008 2006 - 12/31/2013 2009 - 07/01/2013 2009 HEDGING CONTRACT SCHEDULE K, PART IV, LINE 4 THERE IS MORE THAN ONE HEDGING CONTRACT RELATED TO THE 2009 ISSUE. THE TERM OF THE 2003 HEDGE IS 25.6 YEARS WHILE THE TERM OF THE 2006C HEDGE IS 22.2 YEARS. SCHEDULE K ADDITIONAL INFORMATION 0 QMC BELIEVES, AND HAS PREPARED FORM 990, SCHEDULE K IN A MANNER CONSISTENT WITH SUCH BELIEF, THAT THE PART III EXCLUSION PROVIDED IN THE INSTRUCTIONS FOR BONDS THAT REFUND A PRE-2003 BOND ISSUE APPLIES TO THE 2003 SERIES A BONDS, THOUGH NO ALLOCATIONS UNDER REGULATIONS SECTION 1.141-13(D) HAVE YET BEEN ELECTED; THIS SUBMISSION DOES NOT CONSTITUTE AN ALLOCATION ELECTION UNDER REGULATIONS SECTION 1.141-13(D). QMC BELIEVES, AND HAS PREPARED FORM 990, SCHEDULE K IN A MANNER CONSISTENT WITH SUCH BELIEF, THAT THE PART III EXCLUSION PROVIDED IN THE INSTRUCTIONS FOR BONDS THAT REFUND A PRE-2003 BOND ISSUE APPLIES TO THE 2003 SERIES B BONDS, THOUGH NO ALLOCATIONS UNDER REGULATIONS SECTION 1.141-13(D) HAVE YET BEEN ELECTED; THIS SUBMISSION DOES NOT CONSTITUTE AN ALLOCATION ELECTION UNDER REGULATIONS SECTION 1.141-13(D). QMC BELIEVES, AND HAS PREPARED FORM 990, SCHEDULE K IN A MANNER CONSISTENT WITH SUCH BELIEF, THAT THE PART III EXCLUSION PROVIDED IN THE INSTRUCTIONS FOR BONDS THAT REFUND A PRE-2003 BOND ISSUE APPLIES TO THE 2006 SERIES A BONDS, THOUGH NO ALLOCATIONS UNDER REGULATIONS SECTION 1.141-13(D) HAVE YET BEEN ELECTED; THIS SUBMISSION DOES NOT CONSTITUTE AN ALLOCATION ELECTION UNDER REGULATIONS SECTION 1.141-13(D). QMC BELIEVES, AND HAS PREPARED FORM 990, SCHEDULE K IN A MANNER CONSISTENT WITH SUCH BELIEF, THAT THE PART III EXCLUSION PROVIDED IN THE INSTRUCTIONS FOR BONDS THAT REFUND A PRE-2003 BOND ISSUE APPLIES TO THE 2009 SERIES A BONDS, THOUGH NO ALLOCATIONS UNDER REGULATIONS SECTION 1.141-13(D) HAVE YET BEEN ELECTED; THIS SUBMISSION DOES NOT CONSTITUTE AN ALLOCATION ELECTION UNDER REGULATIONS SECTION 1.141-13(D). QMC BELIEVES, AND HAS PREPARED FORM 990, SCHEDULE K IN A MANNER CONSISTENT WITH SUCH BELIEF, THAT THE PART III EXCLUSION PROVIDED IN THE INSTRUCTIONS FOR BONDS THAT REFUND A PRE-2003 BOND ISSUE APPLIES TO THE 2009 SERIES B BONDS, THOUGH NO ALLOCATIONS UNDER REGULATIONS SECTION 1.141-13(D) HAVE YET BEEN ELECTED; THIS SUBMISSION DOES NOT CONSTITUTE AN ALLOCATION ELECTION UNDER REGULATIONS SECTION 1.141-13(D). Hawaiian Telecom Eric Yeaman, Trustee-QMC 382863 See Part V false TRANSACTIONS WITH INTERESTED PERSON SCHEDULE L, PART IV ERIC YEAMAN IS AN OFFICER OF HAWAIIAN TELCOM, A TELECOMMUNICATIONS COMPANY, THAT PROVIDES SERVICES TO THE ORGANIZATION. DURING THE YEAR, THE ORGANIZATION PAID SERVICE FEES IN THE AMOUNT OF $382,863. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A ESTABLISHED IN 1859 BY KING KAMEHAMEHA IV AND QUEEN EMMA, QMC IS THE FIRST HOSPITAL IN THE UNITED STATES FOUNDED BY ROYALTY. TODAY, IT IS THE LARGEST PRIVATE HOSPITAL IN HAWAII AND THE PACIFIC BASIN. THE QUEEN'S MEDICAL CENTER HAS 505 ACUTE CARE BEDS AND 28 SUB-ACUTE CARE BEDS. WITH OVER 3,000 EMPLOYEES AND OVER 1,200 PHYSICIANS ON STAFF, IT IS ALSO ONE OF THE STATE OF HAWAII'S LARGEST EMPLOYERS. AS THE LEADING MEDICAL REFERRAL CENTER IN HAWAII AND THE PACIFIC BASIN, QMC IS WIDELY KNOWN FOR ITS PROGRAMS IN CANCER, CARDIOVASCULAR DISEASE, NEUROSCIENCE, ORTHOPEDICS, SURGERY, TRAUMA, BEHAVIORAL MEDICINE, AND WOMEN'S HEALTH. QMC OFFERS A COMPREHENSIVE RANGE OF SPECIALTIES, INCLUDING CARDIAC DIAGNOSTICS, GASTRONETEROLOGY, GENETICS, GERIATRICS, GYNECOLOGY, NEONATOLOGY, OBSTETRICS, AND PULMONOLOGY. QMC SERVES AS THE MAIN TRAUMA CENTER IN THE PACIFIC BASIN, ("TRAUMA" IS DEFINED AS A LIFE-THREATENING INJURY OR SHOCK) AND HAS BEEN VERIFIED AS A LEVEL II TRAUMA CENTER BY THE VERIFICATION REVIEW COMMITTEE (VRC), AN AD HOC COMMITTEE OF THE COMMITTEE ON TRAUMA (COT) OF THE AMERICAN COLLEGE OF SURGEONS. QMC IS HOME TO A NUMBER OF RESIDENCY PROGRAMS OFFERED IN CONJUNCTION WITH THE JOHN A. BURNS SCHOOL OF MEDICINE. QMC IS ACCREDITED BY THE JOINT COMMISSION (TJC). QMC IS ALSO APPROVED TO PARTICIPATE IN RESIDENCY TRAINING BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), AND IS A MEMBER OF VHA, A NATIONAL COOPERATIVE OF OVER 1,400 HOSPITALS. 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. THE QUEEN'S MEDICAL CENTER ("QMC") PROVIDED APPROXIMATELY $118.7 MILLION OF COMMUNITY BENEFITS, IN SUPPORT OF ITS MISSION AS A TAX-EXEMPT CHARITABLE HOSPITAL: 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, 2013, THE ESTIMATED COST OF PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $3,189,000 AND $21,431,000 RESPECTIVELY. 2. QUEEN'S TRANSPLANT CENTER - IN JANUARY 2013, 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, 2013, THE ESTIMATED COST OF OPERATIONS OF THE QUEEN'S TRANSPLANT CENTER WAS $1,514,000 AND CAPITAL INVESTMENTS MADE TOTALED $34,000. 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 $3,538,000 FOR THE YEAR ENDED JUNE 30, 2013. 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 $5,894,000 FOR THE YEAR ENDED JUNE 30, 2013. 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 $9,720,000 IN ON CALL PHYSICIAN COVERAGE DURING THE YEAR ENDED JUNE 30, 2013. 6. FELLOWSHIP, RESIDENT AND INTERN COSTS - QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $11,420,000 DURING THE YEAR ENDED JUNE 30, 2013 RELATED TO ITS CARDIAC FELLOWSHIP, RESIDENT AND INTERN PROGRAMS. AS A TEACHING FACILITY, THE MEDICAL CENTER 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, 2013 WAS $702,000. 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, 2013 WAS $1,429,000. 9. TRANSPORTATION SERVICES - QMC PROVIDES TRANSPORTATION TO AND FROM THE MEDICAL CENTER TO PATIENTS WHO REQUIRE ASSISTANCE. THE COST OF PROVIDING THESE SERVICES WAS $94,000 FOR THE YEAR ENDED JUNE 30, 2013. 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, 2013, THE COST OF PROVIDING HEALTH AND WELLNESS EDUCATION WAS $519,000. 11. RESEARCH LOSSES - QMC EMPLOYS STAFF AND INCURS UNFUNDED COSTS FOR MEDICAL RESEARCH. FOR THE YEAR ENDED JUNE 30, 2013, RESEARCH COSTS WERE $1,397,000. 12. CHARITABLE CONTRIBUTIONS - QMC MAKES CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2013, CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS WERE $1,452,000. OF THIS AMOUNT, $354,000 WAS FOR FUNDING TO THE DEPARTMENT OF NATIVE HAWAIIAN HEALTH UNDER THE JOHN A. BURNS SCHOOL OF MEDICINE OF THE UNIVERSITY OF HAWAII AND $750,000 WAS DONATED TO THE UNIVERSITY OF HAWAII CANCER CONSORTIUM. 13. EMERGENCY PREPAREDNESS - QMC IS THE ONLY LEVEL II TRAUMA CENTER IN THE STATE OF HAWAII. QMC ALLOCATED RESOURCES TO PLAN AND TEST ITS READINESS FOR COMMUNITY EMERGENCIES, INCLUDING TRAUMA, TERRORIST ATTACKS AND CONDITIONS RESULTING FROM HAZARDOUS MATERIAL SPILLS. FOR THE YEAR ENDED JUNE 30, 2013, THE COSTS OF EMERGENCY PREPAREDNESS WERE $507,000. 14. 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, 2013, COSTS INCURRED FOR THE ELECTRICAL GENERATOR PROJECT WERE $36,000. TOTAL PROJECT COSTS INCURRED AS OF JUNE 30, 2013 WERE APPROXIMATELY $34,174,000. 15. 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 $30,132,000 DURING THE YEAR ENDED JUNE 30, 2013. 16. 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 $21,316,000 DURING THE YEAR ENDED JUNE 30, 2013. CONSISTENT WITH COST REPORT REQUIREMENTS, THERE ARE AMOUNTS THAT ARE EXCLUDED FROM THE COSTS ABOVE. 17. 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, 2013, REVENUES FOREGONE FROM LEASE RATES THAT WERE BELOW FAIR MARKET VALUE WERE $63,000. 18. 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, 2013, THESE PROGRAM COSTS TOTALED $1,000,000. 19. 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, 2013, COSTS INCURRED FOR THE IMPROVEMENT PROJECT WERE $534,000. 20. 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 $502,000 FOR THE YEAR ENDED JUNE 30, 2013. 21. 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 THE QUEEN'S CONFERENCE CENTER. FOR THE YEAR ENDED JUNE 30, 2013, THE VALUE OF THE USE OF THE CENTER WAS $291,000. 22. JOB SHADOWING PROGRAM - QMC SPONSORS A JOB SHADOWING PROGRAM FOR STUDENTS IN THE STATE OF HAWAII. FOR THE YEAR ENDED JUNE 30, 2013, COSTS INCURRED FOR THE PROGRAM WERE $10,000. 23. QMC NURSING PROGRAM - QMC PROVIDES NURSING INTERNSHIPS AND NURSE TRAINING THAT HELP ADDRESS THE CONTINUED NEED FOR SKILLED NURSES IN THE ISLANDS. FOR THE YEAR ENDED JUNE 30, 2013, THESE COSTS TOTALED $1,656,000. 24. HOSPITAL MINISTRY - QMC PROVIDES NON-DENOMINATIONAL SPIRITUAL GUIDANCE AND SUPPORT TO ITS PATIENTS AND THEIR FAMILIES THROUGH ITS HOSPITAL MINISTRY PROGRAM. QUALIFIED, PROFESSIONAL CHAPLAINS ARE PRESENT TO PROVIDE MINISTRY SERVICES 24-HOURS A DAY, 7-DAYS A WEEK. FOR THE YEAR ENDED JUNE 30, 2013, THE COST OF THESE SERVICES TOTALED $337,000. 25. COMMUNITY OUTREACH - QMC EMPLOYEES VOLUNTEER THEIR TIME AND EXPERIENCE PROVIDING FREE LECTURES TO MEMBERS OF THE COMMUNITY INCLUDING PROFESSIONALS, STUDENTS AND MEMBERS OF THE PUBLIC. 26. VOLUNTEER EFFORTS - QMC EMPLOYEES PERIODICALLY VOLUNTEER FOR OTHER CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2013, THESE EVENTS INCLUDED THE AMERICAN HEART ASSOCIATION'S "HEART WALK", AMERICAN CANCER SOCIETY'S "RELAY FOR LIFE" AND "HOPE LODGE FUNDRAISER", SUSAN G. KOMEN FOUNDATION'S "RACE FOR THE CURE", WAIKIKI IMPROVEMENT ASSOCIATION'S "BEACH CLEAN UP" AND THE AMERICAN DIABETES ASSOCIATION'S "STEP OUT" FUNDRAISER. IN ADDITION, QMC OFFICERS DEDICATE MANY HOURS SERVING AS VOLUNTEER BOARD MEMBERS FOR OTHER HAWAII BASED CHARITABLE ORGANIZATIONS. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 QMC HAS A SOLE MEMBER, WHICH IS THE QUEEN'S HEALTH SYSTEMS, A HAWAII NONPROFIT CORPORATION ("QHS"). DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A QHS ELECTS ALL OF THE BOARD MEMBERS OF THE QMC BOARD OF TRUSTEES. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7B CERTAIN MAJOR DECISIONS APPROVED BY THE QMC BOARD OF TRUSTEES MUST ALSO BE APPROVED BY QHS. SUCH DECISIONS INCLUDE: 1. A CHANGE TO THE PURPOSE OF THE COMPANY; 2. A FINANCING TRANSACTION IN EXCESS OF $500,000; 3. A LEASE TRANSACTION THAT HAS A TERM THAT IS LONGER THAN 3 YEARS OR HAS A RENT OBLIGATION IN EXCESS OF $1,000,000 OVER THE LEASE TERM; 4. A TRANSACTION INVOLVING THE SALE, LEASE, DISPOSITION OR HYPOTHECATION OF REAL PROPERTY; 5. ANNUAL OPERATIONAL AND CAPITAL BUDGETS; 6. STRATEGIC PLANS; 7. MERGER OR MAJOR ACQUISITIONS; 8. CREATION OF A NEW ENTITY OF 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. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B THE FORM 990 FOR THE QUEEN'S HEALTH SYSTEM ("QHS") AND THE SEPARATE FORMS FOR EACH OF THE NOT-FOR-PROFIT SUBSIDIARIES OF QHS WERE REVIEWED BY THE GOVERNING BODY OF QHS PRIOR TO THE FILING OF THE RETURNS. THE QHS FINANCE 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 QHS COMPENSATION COMMITTEE PRIOR TO FILING THE RETURNS. ALSO, A COPY OF THE QMC RETURN WAS MADE AVAILABLE TO EACH OF THE MEMBERS OF THE QMC BOARD OF TRUSTEES PRIOR TO THE RETURNS BEING FILED WITH THE INTERNAL REVENUE SERVICE. APPROVED POLICIES FORM 990, PART VI, LINES 12, 13 & 14 THE CONFLICT OF INTEREST, WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES HAVE BEEN APPROVED BY QHS ON BEHALF OF THE QMC BOARD BUT HAVE NOT BEEN SEPARATELY APPROVED BY THE QMC BOARD. AS SUCH, LINES 12, 13 AND 14 HAVE BEEN CHECKED 'NO'. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C ALL QHS COMPANIES ARE SUBJECT TO A WRITTEN CONFLICT OF INTEREST POLICY. ALL TRUSTEES, OFFICERS, DESIGNATED EMPLOYEES AND CONTRACTORS ARE REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE FORM. THE DESIGNATED EMPLOYEES ARE THOSE SELECTED BY EXECUTIVES IN THE ORGANIZATION WHO IDENTIFY THOSE EMPLOYEES (TYPICALLY MANAGER LEVEL AND ABOVE) WHO MAY BE IN A POSITION TO SELECT OR INFLUENCE THE SELECTION OF A VENDOR. DISCLOSURES ARE SUMMARIZED AND MAINTAINED BY EACH COMPANY'S CORPORATE SECRETARY. THE CONTRACTS MANAGEMENT DEPARTMENT AND LEGAL DEPARTMENT HAVE THE CONFLICT 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 TRANSACTION 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. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINE 15A AND 15B ALTHOUGH NOT COMPENSATED BY THE QUEEN'S MEDICAL CENTER, A RELATED ORGANIZATION, THE QUEEN'S HEALTH SYSTEMS, GOES THROUGH THE FOLLOWING PROCESS FOR DETERMINING THE CEO'S COMPENSATION. A COMMITTEE OF THE BOARD OF TRUSTEES CALLED THE COMPENSATION COMMITTEE MEETS REGULARLY TO REVIEW COMPENSATION OF ALL EXECUTIVES OF ALL COMPANIES WITHIN QHS. QMC'S EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY FOR ITS EXECUTIVE VP/COO, VP MEDICAL AFFAIRS, VP CLINICAL INTEGRATION, VP NURSING AND VP PATIENT CARE. 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 PERFORMANCE REVIEWS AND COMPARISON TO COMPARABLE COMPENSATION DATA PREPARED BY A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. OUTSIDE COUNSEL ASSISTS WITH THE REVIEW PROCESS AND DOCUMENTS THE DECISIONS OF THE COMMITTEE. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 QMC'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AND THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS RETURN, AS REQUIRED. QMC DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. OTHER CHANGES TO NET ASSETS/FUND BALANCES FORM 990, PART XI, LINE 9 Pension FAS 87 Adjustments $36,939,530 Gain on interest rate swap 12,151,940 Change in interest in subsidiary 806,039 Unrealized gain on hedging transaction (566,403) Transfer reclassed (186,000) ------------- Total $49,145,106 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:60259759 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:24169167 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:1693021 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:OTHER SERVICES TOTAL FEES:1655221 The Queen's Health Systems 1301 Punchbowl Street Honolulu HI 96813 990238120 Admin Service HI 501(c)(3) 11 Type II NA false Queen Emma Land Company 1301 Punchbowl Street Honolulu HI 96813 990183769 Support Svcs HI 501(c)(3) 11 Type II QHS true Molokai General Hospital PO Box 408 Kaunakakai HI 96748 990251372 Health Care HI 501(c)(3) 3 QHS true HAMQueen's PET 993266916 PET Imaging HI QMC Related 955415 5326259 false false 0.70000 The Queen's Development Corporation 1301 Punchbowl Street Honolulu HI 96813 990240109 Development HI NA C corp true Queen's Insurance Exchange Inc 1301 Punchbowl Street Honolulu HI 96813 911913839 Insurance HI NA C corp true Diagnostic Laboratory Services Inc 99-859 Iwaiwa Street Aiea HI 96701 990240499 Medical Lab Svcs HI NA C corp true false false true false false false false false false true true true false false false true true false false Queen Emma Land Company C 34125580 FMV Diagnostic Laboratory Services Inc P 13647507 FMV The Queen's Development Corporation K 3374560 FMV The Queen's Development Corporation Q 2196954 FMV The Queen's Development Corporation J 2134992 FMV Diagnostic Laboratory Services Inc J 805340 FMV Queen Emma Land Company K 487307 FMV Molokai General Hospital L 289937 FMV IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP SCHEDULE R, PART III 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: $34,234,175 Share of excess Lobbying Expenditures: $0 Name: The Queen's Health Systems Address: 1301 Punchbowl Street Honolulu, HI 96813 EIN: 99-0238120 Expenses: $24,583,081 Share of excess Lobbying Expenditures: $0 Name: The Queen's Medical Center Address: 1301 Punchbowl Street Honolulu, HI 96813 EIN: 99-0073524 Expenses: $722,895,753 Share of excess Lobbying Expenditures: $0 Name: Molokai General Hospital Address: P.O. Box 408 Kaunakakai, HI 96748 EIN: 99-0251372 Expenses: $8,488,690 Share of excess Lobbying Expenditures: $0