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KAPIOLANI HEALTH FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
KAPIOLANI HEALTH FOUNDATION (EIN 99-0246364)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-08
IRS object ID
201441289349301324
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

FieldValueIRS element (for citing)
Timestamp2014-05-08T12:06:04-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14370 LA JOLLA VILLAGE DR STE 500AddressLine1
CitySAN DIEGOCity
StateCAState
ZIP Code92122ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN990246364EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KAPI'OLANI HEALTH FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% ANN HOInCareOfName
Name ControlKAPINameControl
Phone8085357100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 MERCHANT STREET 24TH FLOORAddressLine1
Address Line2SuiteAddressLine2
CityHONOLULUCity
StateHIState
ZIP Code96813ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameEARL INOUYEName
TitleVP & SYSTEM CONTROLLERTitle
Date Signed2014-05-07DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone8585357200Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHAEL ROBINSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line155 MERCHANT ST 26TH FLOORAddressLine1
CityHONOLULUCity
StateHIState
ZIP Code96813ZIPCode
FieldValueIRS element (for citing)
Gross Receipts44588233GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.kapiolanigift.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1986YearFormation
State Legal DomicileHIStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE HEALTH OF HAWAI'I'S PEOPLE THROUGH FUNDING OF MEDICAL CARE, EQUIPMENT, HEALTH EDUCATION AND RESEARCH AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN.ActivityOrMissionDescription
Nbr Voting Members Governing Body24NbrVotingMembersGoverningBody
Nbr Independent Voting Members22NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers19TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year8081042ContributionsGrantsPriorYear
Contributions Grants Current Year13104576ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year1737979InvestmentIncomePriorYear
Investment Income Current Year2480565InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year11412OtherRevenueCurrentYear
Total Revenue Prior Year9819021TotalRevenuePriorYear
Total Revenue Current Year15596553TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2286327GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1839647GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year330396TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY125520TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year2282858TotalFundrsngExpCurrentYear
Other Expense Prior Year3794777OtherExpensePriorYear
Other Expenses Current Year3604638OtherExpensesCurrentYear
Total Expenses Prior Year6411500TotalExpensesPriorYear
Total Expenses Current Year5569805TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3407521RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10026748RevenuesLessExpensesCY
Total Assets BOY66613636TotalAssetsBOY
Total Assets EOY79724192TotalAssetsEOY
Total Liabilities BOY1253341TotalLiabilitiesBOY
Total Liabilities EOY1130646TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY65360295NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY78593546NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO IMPROVE THE HEALTH OF HAWAI'I'S PEOPLE THROUGH FUNDING OF MEDICAL CARE, EQUIPMENT, HEALTH EDUCATION AND RESEARCH AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2497590Expense
Grants1839647Grants
DescriptionSEE SCHEDULE ODescription
Total Program Service Expense2497590TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingtrueProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109661NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members24NbrVotingGoverningBodyMembers
Number Independent Voting Members22NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledHIStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonANN HONamePerson
Telephone Number8085272520TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line155 MERCHANT STREET 24TH FLOORAddressLine1
CityHONOLULUCity
StateHIState
ZIP Code96813ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (30 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MICHAEL O'MALLEY ESQ
BOARD OF DIRECTOR, CHAIR0.20.0XX000
JEFFREY A ARCE
BOARD OF DIRECTOR, VICE CHAIR0.20.0XX000
MEREDITH CHING
BOARD OF DIRECTOR0.20.0X000
KIMBERLY W DEY
BOARD OF DIRECTOR0.20.0X000
SARA DUDGEON
BOARD OF DIRECTOR0.20.0X000
ROBERT T FUJIOKA
BOARD OF DIRECTOR0.20.0X000
MICHELLE HO
BOARD OF DIRECTOR0.20.0X000
DAVID HUDSON
BOARD OF DIRECTOR0.20.0X000
THOMAS KOSASA MD
BOARD OF DIRECTOR0.20.0X000
LORI L MCCARNEY
BOARD OF DIRECTOR0.20.0X000
MARCUS MERNER
BOARD OF DIRECTOR0.20.0X000
FRED M NOA
BOARD OF DIRECTOR0.20.0X000
ALANA PAKKALA
BOARD OF DIRECTOR0.20.0X000
ABELINA SHAW
BOARD OF DIRECTOR0.20.0X000
PATRICIA W SHEEHAN
BOARD OF DIRECTOR0.20.0X000
HEIDI SNOW
BOARD OF DIRECTOR0.20.0X000
BRAD TOTHEROW
BOARD OF DIRECTOR0.20.0X000
JOHN C WALKER JR
BOARD OF DIRECTOR0.20.0X000
GREGORY K YIM MD
BOARD OF DIRECTOR0.20.0X000
VIRGINIA PRESSLER-FISHER MD
BOARD OF DIRECTOR, VP2.057.0XX0594421149714
CHARLES A STED
BOARD OF DIRECTOR (PART YEAR)2.058.0X0173322945535
KIM HEHIR
BOARD OF DIRECTOR0.20.0X000
SACHI BRADEN
BOARD OF DIRECTOR0.20.0X000
EILEEN WACKER
BOARD OF DIRECTOR0.20.0X000
RAYMOND P VARA JR
BOARD OF DIRECTOR0.264.0X01183271318255
MICHAEL ROBINSON
PRESIDENT20.020.0X020290417638
CHARLES R CHING
SECRETARY0.259.0X0561651117352
DAVID OKABE
TREASURER1.053.0X0735788156303
JESSICA LEWIS
ASSISTANT SECRETARY0.240.0X011241715739
EARL INOUYE
ASSISTANT TREASURER0.254.0X030640875801
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5430089TotalReportableCompFrmRltdOrgs
Total Other Compensation896337TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events2355FundraisingEvents
All Other Contributions13102221AllOtherContributions
Noncash Contributions266824NoncashContributions
Total Contributions13104576TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column945661TotalRevenueColumn
Exclusion$945,661ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities30510710Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities28975806Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1534904Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1534904TotalRevenueColumn
Exclusion$1,534,904ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events26715GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events2355CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses15874FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column10841TotalRevenueColumn
Exclusion$10,841ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionALL OTHER REVENUEDescription
Total Revenue Column571TotalRevenueColumn
Exclusion$571ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue571TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15596553TotalRevenueColumn
Exclusion$2,491,977ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1839647Total
Program Services1839647ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6598Total
Management And General6598ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total125520Total
Fundraising125520Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total222235Total
Management And General222235ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1755209Total
Management And General231303ManagementAndGeneral
Fundraising1523906Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total302174Total
Management And General12942ManagementAndGeneral
Fundraising289232Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total105697Total
Management And General21222ManagementAndGeneral
Fundraising84475Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total30166Total
Fundraising30166Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total86046Total
Fundraising86046Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total40947Total
Management And General2077ManagementAndGeneral
Fundraising38870Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6145Total
Management And General230ManagementAndGeneral
Fundraising5915Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11696Total
Management And General281ManagementAndGeneral
Fundraising11415Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total13983Total
Management And General13983ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PROGRAM SERVICE EXPENDITURE657943657943
CORPORATE ALLOCATION277656277656
OTHER PURCHASES6688763466253
OTHER EXPENSES2125619621060

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5569805Total
Program Services2497590ProgramServices
Management And General789357ManagementAndGeneral
Fundraising2282858Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4141992BOY
EOY5015363EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY7673384BOY
EOY14836234EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY622878BOY
EOY786252EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis361563LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec307692LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY49371BOY
EOY53871EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY31247173BOY
EOY36161648EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY20761646BOY
EOY20753632EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2117192BOY
EOY2117192EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY66613636BOY
EOY79724192EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY49603BOY
EOY123424EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY163183BOY
EOY159380EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1040555BOY
EOY847842EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1253341BOY
EOY1130646EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY44885111BOY
EOY47289945EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY18355692BOY
EOY29147736EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2119492BOY
EOY2155865EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY65360295BOY
EOY78593546EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY66613636BOY
EOY79724192EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10026748ReconcilationRevenueExpenses
Reconciliation Unrealized Invest3536304ReconciliationUnrealizedInvest
Reconcilation Other Changes-329801ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2319745CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10715146CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5992481CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8081042CurrentTaxYearMinus1Year
Current Tax Year13104576CurrentTaxYear
Total40212990Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2319745CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10715146CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5992481CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8081042CurrentTaxYearMinus1Year
Current Tax Year13104576CurrentTaxYear
Total40212990Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total8396117AmountsSubstContributorsTotal
Public Support Total17031816873PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1261588CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1043284CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1161238CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year896809CurrentTaxYearMinus1Year
Current Tax Year945661CurrentTaxYear
Total5308580Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year571CurrentTaxYear
Total571Total
FieldValueIRS element (for citing)
Total Support45522141TotalSupport
Public Support Pertcentage1700.69893PublicSupportPertcentage170
Public Support Pertcent Prior Year0.69600PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance55489203BeginningOfYearBalance
Contributions34773Contributions
Investment Earnings Or Losses5973274InvestmentEarningsOrLosses
Administrative Expenses99417AdministrativeExpenses
End Of Year Balance61397833EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance56726543BeginningOfYearBalance
Contributions15932Contributions
Investment Earnings Or Losses-1160109InvestmentEarningsOrLosses
Administrative Expenses93163AdministrativeExpenses
End Of Year Balance55489203EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance48210664BeginningOfYearBalance
Contributions3000Contributions
Investment Earnings Or Losses8530795InvestmentEarningsOrLosses
Administrative Expenses17916AdministrativeExpenses
End Of Year Balance56726543EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance44154504BeginningOfYearBalance
Contributions1000Contributions
Investment Earnings Or Losses4203721InvestmentEarningsOrLosses
Administrative Expenses148560AdministrativeExpenses
End Of Year Balance48210665EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance53317480BeginningOfYearBalance
Contributions21041Contributions
Investment Earnings Or Losses-9163154InvestmentEarningsOrLosses
Administrative Expenses20863AdministrativeExpenses
End Of Year Balance44154504EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.95760BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.03510PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00730TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
LandLand
BuildingsBuildings

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis56667OtherCostOrOtherBasis
Depreciation56667Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis252619OtherCostOrOtherBasis
Depreciation201110Depreciation
Book Value51509BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis52277OtherCostOrOtherBasis
Depreciation49915Depreciation
Book Value2362BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings53871TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
UNRESTRICTED INVESTMENTS282335F
RESTRICTED INVESTMENTS22588489F
FieldValueIRS element (for citing)
Total Of Book Value Securities22870824TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$847,842Amount
FieldValueIRS element (for citing)
Total Of Amounts847842TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
TRUST, ESCROW, AND CUSTODIAL ARRANGEMENTSFORM 990, SCHEDULE D, PART IVESCROW LIABILITIES REPRESENT AMOUNTS DUE TO INDIVIDUALS UNDER CHARITABLE REMAINDER TRUST AGREEMENTS.
DESCRIPTION OF INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDSFORM 990, SCHEDULE D, PART V, LINE 4ENDOWMENTS CALVIN C.J. SIA, MD ENDOWMENT ESTABLISHED IN 2001 IN HONOR OF DR. CAL SIA, PEDIATRICIAN, EDUCATOR, ADMINISTRATOR AND ADVOCATE FOR HAWAII'S KEIKI. THE PURPOSE OF THIS FUND IS TO PROMOTE OPTIMAL HEALTH AND DEVELOPMENT OF ALL CHILDREN. CECIL MARSHALL ENDOWMENT ESTABLISHED IN 2001 TO SUPPORT THE MISSION OF THE KAPI'OLANI HEALTH FOUNDATION. CHAN FAMILY FUND ESTABLISHED IN 1999 TO PROVIDE ASSISTANCE TO FAMILIES OF CHILDREN WITH CANCER. DAVID & DORIS CROWELL ENDOWMENT ESTABLISHED IN 2000 TO PROVIDE MEDICAL CARE FOR ECONOMICALLY DISADVANTAGED CHILDREN AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN. FLANDERS ENDOWMENT FUND ESTABLISHED BY MURIEL MACFARLANE FLANDERS IN MEMORY OF HER TWO GRANDMOTHERS, EMELIE HEDEMANN MACFARLANE AND ABIGAIL KUAIHELANI CAMPBELL. THE HARRY & JEANETTE WEINBERG FOUNDATION ENDOWMENT ESTABLISHED TO PROVIDE ONGOING SUPPORT TO KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN'S EMERGENCY ROOM AND PEDIATRIC INTENSIVE CARE UNIT (PICU). MARJORIE BOOTH STEPHENS FUND ESTABLISHED TO PROVIDE MEDICAL CARE TO ALL WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. RICHARD DAVI SCHOLARSHIP FUND ESTABLISHED TO PROVIDE SCHOLARSHIPS FOR CONTINUING MEDICAL EDUCATION. THE WILLIAM SAUNDERS ENDOWMENT ESTABLISHED IN HONOR OF CECIL A. SAUNDERS, MD, A PEDIATRICIAN WHO ESTABLISHED BABY CLINICS IN THE 1920S, THIS FUND SUPPORTS PEDIATRIC PROGRAMS AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN. SASHA FRANZEL LIFE PERMANENT ENDOWMENT ESTABLISHED IN 2011 FOR THE PURPOSE OF PROVIDING SUPPORT TO THE KAPIOLANI CLEFT & CRANIOFACIAL CENTER (KCCC). MILLARD HENLEIN AND FRANKIE HENLEIN CHILDREN'S FUND ESTABLISHED IN 1992 FOR THE PURPOSE OF PROVIDING DIRECT MEDICAL SERVICES TO NEEDY CHILDREN AT THE KMCWC.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingtrueAgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation (2 entries)

Name Of IndividualNameOfIndividualActivityActivityFundraiser Control Of FundsFundraiserControlOfFundsGross ReceiptsGrossReceiptsAmount Retained By ContractorAmountRetainedByContractorNet To OrganizationNetToOrganization
MARTS AND LUNDYCAMPAIGN COUNSELfalse0103520-103520
AUBREY HAWK PUBLIC RELATIONSPUBLIC RELATIONSfalse022000-22000
FieldValueIRS element (for citing)
Total Gross Receipts0TotalGrossReceipts
Total Retained By Contractors125520TotalRetainedByContractors
Total Net To Organization-125520TotalNetToOrganization
Licensed StatesHILicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event129070GrossReceiptsEvent1
Charitable Contributions Event12355CharitableContributionsEvent1
Gross Revenue Event126715GrossRevenueEvent1
Other Direct Expenses Event115874OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total29070GrossReceiptsTotal
Charitable Contributions Total2355CharitableContributionsTotal
Gross Revenue Total Events26715GrossRevenueTotalEvents
Other Direct Expenses Total Events15874OtherDirectExpensesTotalEvents
Direct Expense Summary Events15874DirectExpenseSummaryEvents
Net Income Summary10841NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN
55 Merchant St 24th FlHonoluluHI96813990177350501 (C)(3)1447589145043FMVGIFTS IN KINDGENERAL SUPPORT
KAPI'OLANI MEDICAL SPECIALISTS
55 Merchant St 24th FlHonoluluHI96813990322406501 (C)(3)141415GENERAL SUPPORT
HAWAI'I PACIFIC HEALTH
55 MERCHANT ST 24TH FLOORHONOLULUHI96813990246363501(C)(3)105600GENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTSIdentifier
Return ReferenceFORM 990, SCHEDULE IReturnReference
ExplanationTEMPORARILY RESTRICTED FUNDS RELEASED (& GRANTED) TO THE AFFILIATED ORGANIZATIONS ARE RELEASED AFTER THE SPECIFIC PURPOSE OF THE FUND HAS BEEN MET. ONCE THE AFFILIATED ORGANIZATION COMMUNICATES THE EXPENSE AND SATISFIES THE SUBSTANTIATION OF THE EXPENSE FOR THE PURPOSE THAT THE FUNDS WERE CONTRIBUTED FOR, THE FOUNDATION RELEASES THE RESTRICTION AND RECORDS THE GRANT TO THE AFFILIATED ORGANIZATION. NO FURTHER MONITORING OF THE FUNDS AFTER DISTRIBUTION IS NECESSARY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
VIRGINIA PRESSLER-FISHER MD
BOARD OF DIRECTOR, VP034035401327390121328012841202130207441350121235
CHARLES A STED
BOARD OF DIRECTOR (PART YEAR)076605904510500516120028913016622017787640552685
MICHAEL ROBINSON
PRESIDENT01886040109250337501059407044022054200
CHARLES R CHING
SECRETARY032625201448620905370115097022550679003094292
DAVID OKABE
TREASURER043199701836500120141014339101291208920910121653
EARL INOUYE
ASSISTANT TREASURER02319000363740381340540680217330382209028392
RAYMOND P VARA JR
BOARD OF DIRECTOR0645920032581602115350296596021659015015260220993

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL COMPENSATION INFORMATIONSCHEDULE J, PART I, QUESTION 3THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR 990 PART VI, LINE 15B FOR THE PROCESS USED BY HAWAI'I PACIFIC HEALTH TO DETERMINE COMPENSATION.
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANSCHEDULE J, PART I, LINE 4BTHE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. THE CAPITAL ACCUMULATION ACCOUNT (CAA) IS A SECTION 457(f) PROGRAM THAT WAS PREVIOUSLY AFFORDED TO EXECUTIVE OFFICERS OF THE ORGANIZATION TO PROVIDE BENEFITS ON A TAX DEFERRED BASIS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: $ 70,464 - VIRGINIA PRESSLER-FISHER $ 41,295 - CHARLES CHING $ 50,005 - DAVID OKABE $364,357 - CHARLES A. STED $ 89,128 - RAYMOND P. VARA, JR. $ 10,333 - EARL INOUYE LONG TERM INCENTIVE PLAN THE LONG TERM INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL AND LONG TERM SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: $132,739 - VIRGINIA PRESSLER-FISHER $131,362 - CHARLES CHING $171,650 - DAVID OKABE $451,050 - CHARLES A. STED $305,816 - RAYMOND P. VARA, JR. $ 36,374 - EARL INOUYE

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F990121781NoncashContribsRptdF990
Method Of Determining RevenuesCOST/SELLING PRICEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionMISCELLANEOUS DONATIONSDescription
Number Of Contributions0NumberOfContributions
Noncash Contribs Rptd F990145043NoncashContribsRptdF990
Method Of Determining RevenuesCOST/SELLING PRICEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierSCHEDULE M, PART I, COLUMN BIdentifier
ExplanationTHE NUMBER OF ITEMS DONATED IS NOT AVAILABLE FOR ALL CONTRIBUTIONSExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICES ACCOMPLISHMENTSFORM 990, PART III, LINE 4THE MISSION OF THE KAPI'OLANI HEALTH FOUNDATION (KHF) IS TO IMPROVE THE HEALTH OF HAWAI'I'S PEOPLE THROUGH FUNDING OF MEDICAL CARE, EQUIPMENT, HEALTH EDUCATION AND RESEARCH AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (KAPI'OLANI). AS A NONPROFIT HOSPITAL, KAPI'OLANI RELIES ON COMMUNITY SUPPORT TO FULFILL ITS MISSION. OUR GENEROUS DONORS, THROUGH CONTRIBUTIONS TO KHF, HELP THE HOSPITAL PROVIDE EXCEPTIONAL MEDICAL CARE FOR HAWAI'I'S WOMEN AND CHILDREN, INCLUDING THE CRITICALLY ILL. KAPI'OLANI IS HAWAI'I'S ONLY MATERNITY, NEWBORN AND PEDIATRIC SPECIALTY HOSPITAL. SERVICES INCLUDE INTENSIVE CARE FOR INFANTS AND CHILDREN, 24-HOUR EMERGENCY PEDIATRIC CARE, AIR TRANSPORT, MATERNAL FETAL MEDICINE, HIGH-RISK PERINATAL CARE, AND THE STATE'S FIRST BREAST HEALTH AND GYNECOLOGICAL CANCER CENTERS. SUPPORT FOR KAPI'OLANI, BOTH UNRESTRICTED AND FOR SPECIFIC PROGRAMS, MAKES THE HOSPITAL A TRULY FAMILY-FRIENDLY ENVIRONMENT. IN 2010, THE HOSPITAL WAS ALSO DESIGNATED A PEDIATRIC TRAUMA RESOURCE CENTER BY THE STATE OF HAWAI'I. IN FISCAL YEAR 2013, KHF FOCUSED MUCH OF ITS EFFORTS ON A CAPITAL CAMPAIGN TO REBUILD KAPI'OLANI, CALLED THE CAMPAIGN FOR HAWAI'I'S CHILDREN (THE CAMPAIGN). RAPIDLY EMERGING TECHNOLOGIES HAVE FUNDAMENTALLY CHANGED THE CARE DELIVERY PROCESS AND A REBUILD OF THE HOSPITAL IS VITAL TO PROVIDE THE LEVEL OF COMFORT AND CARE THAT HAWAI'I'S FAMILIES DESERVE. THE PHASE 1 RENOVATION AND REBUILD WILL HELP KAPI'OLANI REACH THE FOLLOWING GOALS: 1) CREATE FAMILY-CENTERED SPACE TO DELIVER FAMILY-CENTERED CARE, A CONCEPT AT THE CENTER OF HOSPITAL REBUILDS NATIONWIDE; 2) MEET THE CRITICAL CARE NEEDS OF HAWAI'I'S KEIKI, AS THE PACIFIC REGION'S SOLE TERTIARY REFERRAL CENTER FOR PEDIATRICS AND LEVEL III-B NEONATAL INTENSIVE CARE UNIT; AND 3) ENSURE ADEQUATE EDUCATIONAL CONFERENCE ROOMS AND SPACES ARE AVAILABLE AS HAWAI'I'S PEDIATRIC TEACHING HOSPITAL. WITH THE HELP OF DONATED FUNDS, KAPI'OLANI IS ABLE TO ACCESS CUTTING-EDGE CLINICAL RESEARCH TRIALS, ALLOWING THE HOSPITAL TO OFFER THE MOST UP-TO-DATE THERAPEUTIC OPTIONS TO THEIR PATIENTS. KAPI'OLANI HAS ALSO BEEN ABLE TO CONTINUE ITS LONGSTANDING PARTNERSHIP WITH THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE TRAINING FUTURE DOCTORS WITH RESIDENCY PROGRAMS IN OBSTETRICS, GYNECOLOGY AND PEDIATRICS. DONOR SUPPORT HELPS SUBSIDIZE PEDIATRIC HEART WEEK, WHICH HAS HAPPENED FIVE TIMES A YEAR SINCE 1995 WITH COLLABORATION BETWEEN KAPI'OLANI'S PEDIATRIC SPECIALISTS AND LEADING SPECIALISTS FROM RADY CHILDREN'S HOSPITAL IN SAN DIEGO AND LUCILE PACKARD CHILDREN'S HOSPITAL IN SAN FRANCISCO. THIS PROGRAM ALLOWS INFANTS, CHILDREN AND TEENS TO UNDERGO CARDIAC PROCEDURES WITHOUT THE STRESS, ANXIETY AND ADDED COST OF BEING AWAY FROM HOME. DONATIONS ALSO ENSURE THAT KAPI'OLANI FUNDS A TEAM OF EXPERTS WHO SUPPORT THE FAMILY GRIEVING PROCESS. THEY CREATE MEMORY BOXES WITH PERSONAL ITEMS THAT FAMILIES CAN KEEP AS MEMENTOS OF LOVED ONES THEY'VE LOST. THE KAPI'OLANI PLAYROOM OFFERS ANOTHER KIND OF RELIEF - IT IS A PLACE WHERE HOSPITALIZED CHILDREN HAVE A CHANCE FOR THERAPEUTIC AND RECREATIONAL PLAY AND SOCIALIZATION DURING THEIR LONG STAYS AT THE HOSPITAL. DONOR CONTRIBUTIONS HAVE ALSO HELPED THE HOSPITAL CONTINUE ITS POPULAR ANIMAL ASSISTED THERAPY WITH TUCKER, THE RESIDENT THERAPY DOG. IN ADDITION, THE KAPI'OLANI HEALTH FOUNDATION CONTINUED TO RAISE FUNDS TO OFFSET MEDICAL COSTS FOR INDIVIDUAL CHILDREN WHOSE FAMILIES CAN'T COVER THESE EXPENSES ON THEIR OWN. THESE SPECIAL MEDICAL NEEDS INCLUDE TRAVEL, EDUCATION AND SURGICAL PROCEDURES.
DESCRIPTION OF BUSINESS RELATIONSHIPSFORM 990, PART VI, LINE 2ALANA KOBAYASHI PAKKALA & JEFFREY ARCE HAVE A BUSINESS RELATIONSHIP. KOBAYASHI GROUP PROVIDES CERTAIN CONLSULTING SERVICES TO RAY VARA, WARREN CHAIKO, AND MARTHA SMITH. RAY VARA IS A BOARD MEMBER AT BANK OF HAWAI'I. BANK OF HAWAI'I PLEDGED $100,000 TO KHF. 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 BOARD.
DESCRIPTION OF CLASSES OF PERSON AND THE NATURE OF THEIR RIGHTSFORM 990, PART VI, LINE 7AHAWAI'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.
DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OFVOTING RIGHTSFORM 990, PART VI, LINE 7B HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS EXCLUSIVE POWER TO TAKE AND DIRECT THE FOLLOWING ACTIONS OF THE CORPORATION: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR OF THE BOARD; (II) AFTER CONSULTATION WITH THE BOARD, REMOVE THE PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR; (III) REMOVE A DIRECTOR FROM THE BOARD; (IV) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER; (V) AMEND THESE BYLAWS; (VI) CAUSE THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR ONE MILLION DOLLARS ($1,000,000) OR MORE; (VII) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VIII) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (IX) DETERMINE AND EFFECT INTER-CORPORATE FUND TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (X) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S EXECUTIVE COMPENSATION AND BENEFIT PLANS; (XI) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (XII) DEVELOP AND PROMULGATE OVERALL CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION; AND (XIII) DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER APPROVAL: (I) ELECT ANY DIRECTOR TO THE BOARD; (II) AMEND THE ARTICLES; (III) MERGE THE CORPORATION WITH ANY ENTITY; (IV) DISSOLVE THE CORPORATION; (V) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS BY OR ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VI) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000) EXCEPT FOR THOSE ASSETS ACQUIRED BY GIFTS, GRANT, OR DONATION; (VII) ACQUIRE SHARES IN ANOTHER CORPORATION; (VIII) SELL, LEASE, EXCHANGE, ENCUMBER OR DISPOSE OF TWENTY-FIVE PERCENT (25%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (IX) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (X) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONSHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; AND (XI) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE.
REVIEW OF THE 990S BY THE ORGANIZATION'S GOVERNING BODYFORM 990, PART VI, LINE 11BVARIOUS 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 OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPLETED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH 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 WEBSITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURN WITH THE IRS.
MONITORING & ENFORCING OF CONFLICT OF INTEREST POLICYFORM 990, PART VI, LINE 12CANNUALLY, EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) RECEIVED A COPY OF THE CONFLICT OF INTEREST ("COI") POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 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. BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT.
OFFICES AND POSITIONS FOR WHICH PROCESS WAS USED, AND YEAR PROCESS WASLAST COMPLETEDFORM 990, PART VI, LINES 15A & 15B THE CEO, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER THE TAX-EXEMPT PARENT, HPH. FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE CEO, OFFICERS AND KEY EMPLOYEES' COMPENSATION. COMPENSATION FOR HAWAI'I PACIFIC HEALTH ("HPH") EXECUTIVES (VICE PRESIDENT AND ABOVE) IS SET BY THE HPH COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT, COMMUNITY-BASED MEMBERS OF THE HPH BOARD OF DIRECTORS. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVES' COMPENSATION AND BENEFITS. THE CONSULTANT PROVIDES A WRITTEN REPORT TO THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING. INCLUDED IN THE REPORT IS MARKET BASED DATA FROM LIKE ORGANIZATIONS. THE COMPENSATION COMMITTEE MAKES FINAL DECISIONS REGARDING COMPENSATION AND BENEFITS AT THE MEETING AFTER REVIEW AND DISCUSSION OF THE CONSULTANT'S REPORT, AND SUCH DECISIONS ARE DOCUMENTED IN THE COMPENSATION COMMITTEE MEETING MINUTES. COMMUNITY BASED DIRECTORS OF THE ORGANIZATION ARE NOT COMPENSATED. CERTAIN EMPLOYED PHYSICIANS MAY BE OFFICERS OR AN IDENTIFIED KEY EMPLOYEE OF THE REPORTING OR RELATED ORGANIZATION. PHYSICIAN COMPENSATION IS ALSO HANDLED IN THE SAME MANNER AS EXECUTIVE COMPENSATION, WITH THE HPH COMPENSATION COMMITTEE RECEIVING A REPORT FROM A NEUTRAL CONSULTANT AND FOLLOWING THE SAME PROCESS AS DESCRIBED ABOVE ON AN ANNUAL BASIS. THIS PROCESS WAS LAST COMPLETED ON MARCH 5, 2013 TO REVIEW PHYSICIAN COMPENSATION AND ON AUGUST 7, 2013 TO REVIEW EXECUTIVE COMPENSATION.
DISCLOSURE OF GOV DOCS, CONFLICT OF INTEREST POLICY & FINANCIAL STMTSFORM 990, PART VI, LINE 19THE 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.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 9$(211,982) - EQUITY TRANSFERS WITH HPH $(129,720) - TEMP RESTRICTED DONATIONS TRANSFERRED TO OTHER FOUNDATIONS $ 11,901 - OTHER CHANGES IN NET ASSETS ---------- $(329,801) - TOTAL ==========
FEES FOR SERVICES (NON-EMPLOYEES) - OTHERPART IX FUNCTIONAL EXPENSES, LINE 11G$ 247,401 - CONSULTING EXPENSE $ 455,578 - FUNDRAISING EXPENSE $ 957,270 - INTERNAL SERVICES PROVIDED EXPENSE $ 11,862 - TEMP LABOR $ 12,524 - SERVICE CONTRACTS $ 72,809 - SERVICE OTHER $ (2,235) - REPAIR AND MAINTENANCE ------------ $ 1,755,209 TOTAL ============

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HAWAI'I PACIFIC HEALTH
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990246363HOLDING CO.HI501(C)(3)11B TYPE IINAfalse
WILCOX HEALTH FOUNDATION
3-3420 Kuhio HighwayLihueHI96766990204242FUNDRAISINGHI501(C)(3)7NAtrue
PALI MOMI FOUNDATION
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813383840327FUNDRAISINGHI501(C)(3)7NAtrue
PROVIDERS INSURANCE CORPORATION
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813710893000NFP INSURANCEHI501(C)(3)11B TYPE IINAtrue
KAPI'OLANI MEDICAL CTR WOMEN & CHILDREN
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990177350HOSPITALHI501(C)(3)3NAtrue
KAPI'OLANI MEDICAL SPECIALISTS
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990322406HEALTHCAREHI501(C)(3)9NAtrue
PALI MOMI MEDICAL CENTER
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990274038HOSPITALHI501(C)(3)3NAtrue
WILCOX MEMORIAL HOSPITAL
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990074365HOSPITALHI501(C)(3)3NAtrue
KAUA'I MEDICAL CLINIC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990326099HOSPITALHI501(C)(3)3NAtrue
STRAUB CLINIC & HOSPITAL
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813912151670HOSPITALHI501(C)(3)3NAtrue
STRAUB FOUNDATION
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990109350RESEARCH/EDUHI501(C)(3)7NAtrue

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1ASC PACIFIC VENTURES LLCBusinessNameLine1
FieldValueIRS element (for citing)
Primary ActivityAMBU. SURG. CNTRPrimaryActivity
Legal Domicile StateALLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
HAWAI'I PACIFIC HEALTH PARTNERS INC &SUB
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990318588HOLDING COMPANYHINAC CORP
STRAUB PHARMACY INC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990145107INACTIVEHINAC CORP
HICORD INC
55 MERCHANT STREET 24TH FLOORHONOLULUHI96813990251496INVESTMENTHINAC CORP
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
KAP'IOLANI MEDICAL SPECIALISTS
B128330FMV
KAPI'OLANI MEDICAL CNTR FOR WOMEN & CHILDREN
B1317771FMV
PALI MOMI FOUNDATION
R78154FMV
WILCOX HEALTH FOUNDATION
R58490FMV

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierRELATED ORG. TAXABLE AS PARTNERSHIPIdentifier
Return ReferenceSCHEDULE R, PART IIIReturnReference
ExplanationASC PACIFIC VENTURES, LLC EIN: 27-0540034 ADDRESS: 3000 RIVERCHASE GALLERIA, STE 500 BIRMINGHAM, AL 35244Explanation