2012-05-01T16:28:02-05:00 2011-06-30 ERNST & YOUNG US LLP 55 MERCHANT ST SUITE 1900 C-120 HONOLULU HI 96813 990 2010-07-01 990322406 KAPI'OLANI MEDICAL SPECIALISTS KAPI 8089838986 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 EARL INOUYE 2012-05-01 8085312037 2010 2016-02-24 21:20:13Z KENNETH NAKAMURA MD 1319 PUNAHOU STREET HONOLULU HI 96826 21891353 false X WWW.HAWAIIPACIFICHEALTH.ORG X 1995 HI KAPI'OLANI MEDICAL SPECIALISTS IS A SPECIALITY PHYSICIAN GROUP DEDICATED TO PROVIDING WORLD-CLASS CARE FOR HAWAI'I'S WOMEN AND CHILDREN THROUGH ACADEMICS, RESEARCH, AND CLINICAL CARE. 6 2 156 2 0 0 125521 112089 21244574 21775603 4893 3661 0 0 21374988 21891353 0 0 0 0 17677691 19826986 0 0 0 8388295 7556214 26065986 27383200 -4690998 -5491847 4090555 4643083 3221285 3751823 869270 891260 X SEE SCHEDULE O. false false 23605176 0 21775603 SEE SCHEDULE O. 23605176 true true false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 25 0 true 156 true false false false false false false false false false false X 6 2 false false false false true false true true true false false true false false false true true false X X DONNA MASUDA-KAM 8085357355 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 MARTHA SMITH 5.0 X X 0 498389 76327 ANTHONY GUERRERO MD 0.2 X 51758 0 906 RICHARD KASUYA MD 0.2 X 0 0 0 KEITH MATSUMOTO MD 0.2 X 0 0 0 KENNETH B ROBBINS MD 0.2 X 0 774200 131328 CHARLES A STED 1.0 X 0 1741906 370246 KENNETH T NAKAMURA MD 40.0 X 0 399059 35556 CHERYL HETRICK 40.0 X 141414 0 1544 DAVID OKABE 1.0 X 0 795218 94276 CHARLES R CHING 3.0 X 0 599319 75805 GAIL LERCH 1.0 X 0 604089 93486 STEVEN ROBERTSON 1.0 X 0 623242 90575 VIRGINIA PRESSLER-FISHER MD 0.2 X 0 615632 112590 SUSAN MASUMOTO-NONAKA 0.2 X 0 266449 37491 WARREN CHAIKO 1.0 X 0 296040 30527 EARL INOUYE 2.0 X 0 325704 51543 ANN MK PETERS 0.2 X 0 185386 21006 KATIE SHIGEMITSU 0.8 X 0 167726 17128 JESSICA LEWIS 1.3 X 0 108668 10465 KEKA SANBORN 0.2 X 0 103318 6758 MELINDA ASHTON MD 1.0 X 0 402336 44902 SIDNEY JOHNSON MD 40.0 X 632052 0 31306 DEVIN PUAPONG MD 40.0 X 520356 0 24113 ROBERT DURKIN MD 40.0 X 486199 0 32133 RUSSELL WOO MD 40.0 X 467996 0 29632 WILLIAM BURKHALTER MD 40.0 X 448701 0 34383 2748476 8506681 1454026 66 false true false UNIVERSITY OF HAWAI'I 2530 DOLE STREET HONOLULU HI 96822 Physician Services 1862728 1 112089 112089 NET PATIENT SERVICE REVENUE 900099 13408923 13408923 SERVICE CONTRACTS 900099 8366680 8366680 21775603 3661 3661 0 0 0 0 0 0 0 21891353 21775603 0 3661 0 0 0 0 212917 212917 0 16465549 16193582 271967 1335261 1275166 60095 924539 877944 46595 888720 862426 26294 0 53962 53962 137281 137281 0 0 0 2945797 1849532 1096265 6284 6284 141584 116015 25569 0 0 375576 354232 21344 108842 97564 11278 0 35 35 0 0 170164 168328 1836 1266688 1252506 14182 BAD DEBT 316307 316307 CORPORATE ALLOCATION 1842828 1842828 OTHER PURCHASES 41911 20674 21237 PROGRAM SERVICE EXPENDITURES 4121 4121 ALL OTHER EXPENSES 144834 3827 141007 27383200 23605176 3778024 0 170009 556683 1378104 1245415 43163 54388 2016803 1407437 275634 609366 2223645 2177231 4090555 4643083 2305645 2852272 915640 899551 3221285 3751823 X 832239 841264 37031 49996 869270 891260 4090555 4643083 X -5491847 5513837 X false true true X false X 55884 0 0 125521 112089 293494 14024534 16789539 20360418 21244574 21775603 94194668 14080418 16789539 20360418 21370095 21887692 94488162 915871 726199 1642070 915871 726199 1642070 92846092 11706 6139 13916 4893 3661 40315 11706 6139 13916 4893 3661 40315 14092124 16795678 20374334 21374988 21891353 94528477 0.98220 0.98187 0.00043 0.00056 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15705 1446 14259 722911 584559 138352 1278187 821432 456755 609366 VARIOUS DEFERRED CHARGES 146358 OTHER RECEIVABLES 417077 LIFE INSURANCE - CSV 850478 DUE FROM GOVERNMENT AGENCIES 125312 DUE FROM KAPI'OLANI WOMEN 506683 DUE FROM PROVIDERS INSURANCE 259 DUE FROM HPH RESEARCH INST 54792 DUE FROM KAPI'OLANI HEALTH FDN 35858 DUE FROM STRAUB FOUNDATION 40414 2177231 0 L/T LIAB - CAPITAL ACCUMULATION 97365 L/T LIAB - MCGF INS ADV 246011 L/T LIAB - ESCHEAT LIAB 2647 DUE TO HAWAI'I PACIFIC HEALTH 472057 DUE TO PALI MOMI 18854 DUE TO STRAUB CLINIC 59865 DUE TO WILCOX HEALTH FDN 12 DUE TO KAUA'I MEDICAL CLINIC 2740 899551 FIN 48 (ASC 70) FOOTNOTE SCHEDULE D, PART X, LINE 2 FOLLOWING IS THE FIN 48 (ASC 70) FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATION'S PARENT: THE TAXABLE AFFILIATES OF THE COMPANY UTILIZE THE LIABILITY METHOD OF ACCOUNTING FOR INCOME TAXES. UNDER THIS METHOD, DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON DIFFERENCES BETWEEN THE FINANCIAL REPORTING AND TAX BASIS OF ASSETS AND LIABILITIES, AND ARE MEASURED USING THE CURRENTLY ENACTED TAX RATES AND LAWS. VALUATION ALLOWANCES ARE USED TO REDUCE DEFERRED TAX ASSETS TO THEIR ESTIMATED NET REALIZABLE VALUES WHEN MANAGEMENT DETERMINES ULTIMATE RECOVERY OF THE DEFERRED TAX ASSETS IS NOT MORE LIKELY THAN NOT TO OCCUR. false true false false false false false true false MARTHA SMITH 0 327273 0 108301 0 62815 0 56218 0 20109 0 574716 0 33498 KENNETH T NAKAMURA MD 0 236235 0 63630 0 99194 0 23330 0 12226 0 434615 0 6624 KENNETH B ROBBINS MD 0 407784 0 266032 0 100384 0 115646 0 15682 0 905528 0 156082 CHARLES A STED 0 742711 0 734897 0 264298 0 359765 0 10481 0 2112152 0 448157 DAVID OKABE 0 408872 0 274875 0 111471 0 82840 0 11436 0 889494 0 157867 CHARLES R CHING 0 308285 0 205141 0 85893 0 68009 0 7796 0 675124 0 93424 GAIL LERCH 0 318615 0 215782 0 69692 0 79953 0 13533 0 697575 0 93486 STEVEN ROBERTSON 0 312546 0 202187 0 108509 0 66131 0 24444 0 713817 0 110115 VIRGINIA PRESSLER-FISHER MD 0 321073 0 215850 0 78709 0 85044 0 27546 0 728222 0 123927 SUSAN MASUMOTO-NONAKA 0 195503 0 56295 0 14651 0 12565 0 24926 0 303940 0 0 WARREN CHAIKO 0 209852 0 60427 0 25761 0 15901 0 14626 0 326567 0 16 EARL INOUYE 0 228359 0 64393 0 32952 0 35275 0 16268 0 377247 0 2048 ANN MK PETERS 0 138372 0 25032 0 21982 0 8373 0 12633 0 206392 0 0 KATIE SHIGEMITSU 0 165166 0 2560 0 0 0 8026 0 9102 0 184854 0 0 SIDNEY JOHNSON MD 550394 0 0 0 81658 0 11638 0 19668 0 663358 0 0 0 DEVIN PUAPONG MD 394493 0 0 0 125863 0 8854 0 15259 0 544469 0 0 0 ROBERT DURKIN MD 396779 0 10090 0 79330 0 11638 0 20495 0 518332 0 0 0 RUSSELL WOO MD 394493 0 0 0 73503 0 6907 0 22725 0 497628 0 0 0 WILLIAM BURKHALTER MD 389917 0 10090 0 48694 0 11638 0 22745 0 483084 0 0 0 MELINDA ASHTON MD 0 287982 0 79716 0 34638 0 26050 0 18852 0 447238 0 2514 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ("HPH"), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR 990 PART VI, LINE 15A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION. SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. THE CAPITAL ACCUMULATION ACCOUNT (CAA) IS A SECTION 457(F) PROGRAM THAT WAS PREVIOUSLY AFFORDED TO EXECUTIVE OFFICERS OF THE ORGANIZATION TO PROVIDE BENEFITS ON A TAX DERERRED BASIS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: MELINDA ASHTON, M.D. $2,514 WARREN CHAIKO $16 EARL INOUYE $2,048 GAIL LERCH $14,788 KENNETH T. NAKAMURA, M.D. $6,624 DAVID OKABE $32,476 VIRGINIA PRESSLER-FISHER, M.D. $25,459 KENNETH B. ROBBINS, M.D. $31,025 STEVEN ROBERTSON $18,273 MARTHA SMITH $33,498 CHARLES A. STED $106,674 NON FIXED PAYMENTS TO PERSONS LISTED ON PART VII, SECTION A, LINE 1A SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS ARE MADE TO EMPLOYEES BASED ON SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. NON-FIXED PAYMENTS MADE TO PHYSICIANS ARE BASED ON CLINICAL PERFORMANCE MEASURES. LONG TERM INCENTIVE PLAN THE LONG TERM INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL AND LONG TERM SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: DAVID OKABE $125,391 KENNETH B. ROBBINS, M.D. $125,057 GAIL LERCH $97,713 STEVEN ROBERTSON $91,842 CHARLES CHING $93,424 VIRGINIA PRESSLER-FISHER $98,468 CHARLES A. STED $341,483 DESCRIPTION OF ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 KAPI'OLANI MEDICAL SPECIALISTS (KMS) IS A SPECIALTY PHYSICIAN GROUP DEDICATED TO PROVIDING WORLD-CLASS CARE FOR HAWAII'S WOMEN AND CHILDREN THROUGH ACADEMICS, RESEARCH AND CLINICAL CARE. WORKING IN PARTNERSHIP WITH KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN, THE GROUP'S MISSION IS CARING FOR THE COMMUNITY THROUGH MEDICAL AND ACADEMIC EXCELLENCE. PROGRAM SERVICE ACTIVITY #1 FORM 990, PART III, LINE 4A AFFILIATE OF HAWAI'I PACIFIC HEALTH, KAPI'OLANI MEDICAL SPECIALISTS ("KMS") HAS ALMOST 100 PEDIATRIC SPECIALISTS AND SUB-SPECIALISTS IN PEDIATRIC INTENSIVE CARE, PEDIATRIC EMERGENCY MEDICINE, NEONATOLOGY, PEDIATRIC RHEUMATOLOGY, PSYCHIATRY/COUNSELING, BEHAVIORAL HEALTH SERVICES, MEDICAL GENETICS, GYNECOLOGY-ONCOLOGY, PEDIATRIC HEMATOLOGY-ONCOLOGY, RESEARCH, PEDIATRIC HOSPITALISTS, ADULT HOSPITALISTS (INTERNAL MEDICINE), PEDIATRIC SURGERY, PEDIATRIC UROLOGY, PEDIATRIC ORTHOPEDICS AND SPORTS MEDICINE, PEDIATRIC GASTROENTEROLOGY, PEDIATRIC SEDATION AND PALLIATIVE CARE. IN FISCAL YEAR 2011, KMS HAD 69,880 PATIENT VISITS AND 318,535 PATIENT ENCOUNTERS. KAPI'OLANI MEDICAL SPECIALISTS IS ALLIED WITH THE UNIVERSITY OF HAWAII'S JOHN A. BURNS SCHOOL OF MEDICINE, AS PART OF ADHERENCE TO ITS CORE VALUES OF WORLD-CLASS HEALTH CARE, PHYSICIAN TRAINING, AND MEDICAL RESEARCH. THIS PARTNERSHIP PROVIDES A UNIQUE ACADEMIC AFFILIATION WITHIN HAWAI'I PACIFIC HEALTH, ALLOWING THE NETWORK TO FURTHER ITS COMMITMENT TO EFFECTIVE HEALTH CARE THROUGH MEDICAL RESEARCH AND THE TRAINING OF TOMORROW'S HEALTH CARE PROVIDERS. KAPI'OLANI MEDICAL SPECIALISTS HAS DEVELOPED A VARIETY OF WAYS TO IDENTIFY AND MEET THE UNIQUE HEALTH CARE NEEDS OF HAWAII'S WOMEN AND CHILDREN. KMS RECRUITS PHYSICIANS FROM THROUGHOUT THE COUNTRY WHO DESIRE EMPLOYMENT IN A GROUP PRACTICE SETTING WITH HAWAII'S LEADING PEDIATRIC HOSPITAL, ESPECIALLY SUB-SPECIALISTS IN SHORT SUPPLY YET HIGH DEMAND. KMS DOCTORS PROVIDE PATIENT CARE AT OUTREACH CLINICS AND COMMUNITY HEALTH CENTERS THROUGHOUT HAWAII, PROMOTE LESSER-KNOWN SERVICES TO PATIENTS WITH SPECIAL NEEDS, PROVIDE HEALTH EDUCATION ON THE NEIGHBOR ISLANDS AND HEALTH CARE TRAINING TO THE COMMUNITY AND OTHER PROVIDERS, AND SERVE AS MEDICAL DIRECTORS ON VARIOUS COMMUNITY BOARDS. CARING FOR THE UNDERSERVED, A LONG-STANDING TRADITION OF ACADEMIC MEDICAL CENTERS THROUGHOUT THE NATION, CONTINUES TO BE A MAJOR FOCUS OF KAPI'OLANI MEDICAL SPECIALISTS. IN FISCAL YEAR 2011, THE GROUP PROVIDED $6,134,600 IN MEDICAL CARE TO PATIENTS WHO WERE UNINSURED OR UNABLE TO PAY FOR THEIR CARE. 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 APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY. DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7B HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS THE FOLLOWING RESERVED POWERS: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE CHIEF MEDICAL OFFICER, DIRECTOR OF OPERATIONS, TREASURER, SECRETARY, EXECUTIVE VICE PRESIDENT / CHIEF FINANCIAL OFFICER, OTHER EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, ASST. SECRETARIES, AND ALL VICE PRESIDENTS EXCEPT THE OPERATING UNIT VICE PRESIDENTS, AS SUCH TERMS ARE DEFINED IN THESE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION ("CORP") IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THESE BYLAWS; (IV) THE CORP'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF 1 YEAR AND/OR FOR $1,000,000 OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORP'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, THE ADVISORY SERVICE AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORP; (VII) EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORP AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORP'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORP, LIMITED LIABILITY COMPANY, OR PARTNERSHIP OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORP; (X) EXCEPT AS PROVIDED IN SECTION 3.2(C) OF THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAII, SELL, LEASE OR OTHERWISE TRANSFER 50% OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE CORP; (XI) EXCEPT AS PROVIDED IN SECTION 3.2(C) OF THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAII, SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE CORP WHICH GENERATE 50% OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE CORP DURING THE PRIOR FISCAL YEAR; (XII) CLOSE THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORP; PROVIDED THAT AFTER THE EFFECTIVE DATE OF THESE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORP MUST ALSO BE APPROVED BY THE BOARD; (XIII) CONVERT THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORP INTO A FACILITY NO LONGER OFFERING MEDICAL SERVICES; PROVIDED THAT AFTER THE EFFECTIVE DATE OF THESE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORP MUST ALSO BE APPROVED BY THE BOARD; (XIV) AFTER CONSULTING WITH THE BOARD, REMOVE THE CHIEF MEDICAL OFFICER, DIRECTOR OF OPERATIONS, EXECUTIVE VICE PRESIDENT / CHIEF FINANCIAL OFFICER, TREASURER, SECRETARY, OTHER EXECUTIVE VICE PRESIDENT, SENIOR VICE PRESIDENTS, ASST SECRETARIES, AND ALL VICE PRESIDENTS EXCEPT THE OPERATING UNIT VICE PRESIDENTS; PROVIDED, HOWEVER, THAT TO REMOVE OR TERMINATE THE CHIEF MEDICAL OFFICER WILL REQUIRE THE CHIEF MEDICAL OFFICER OF THE MEMBER TO FULLY COLLABORATE AND CONSULT WITH THE BOARD AND SEEK THE BOARD'S ADVANCE CONSENT FOR SUCH REMOVAL OR TERMINATION. IF THE BOARD DOES NOT CONCUR WITH THE PROPOSED REMOVAL OR TERMINATION OF THE CHIEF MEDICAL OFFICER, SUCH REMOVAL OR TERMINATION WILL REQUIRE THE APPROVAL OF A MAJORITY OF THE MEMBERS ON THE MEMBER BOARD; (XV) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORP GOALS AND THE LONG RANGE AND STRATEGIC PLANS OF THE CORP; AND (XVI) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. IN ADDITION, DECISIONS OF THE GOVERNING BODY REQUIRING THE APPROVAL OF HAWAI'I PACIFIC HEALTH, AS MEMBER, INCLUDE: (I) ADD ANY DIRECTOR TO THE BOARD; (II) REMOVE ANY DIRECTOR FROM THE BOARD; (III) AMEND THE ARTICLES; (IV) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS ON BEHALF OF THE CORP EXCEEDING $1,000,000 IN VALUE; (V) ACQUIRE ASSETS WORTH OVER $1,000,000; (VI) AQUIRE SHARES IN ANOTHER CORP; (VII) SELL, LEASE OR OTHERWISE TRANSFER 50% OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE CORP; (VIII) SELL, LEASE, EXCHANGE OR DISPOSE OF 50% OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION; (IX) SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE CORPORATION WHICH GENERATE 50% OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE CORPORATION DURING THE PRIOR FISCAL YEAR; (X) MERGE THE CORP WITH ANY ENTITY; (XI) DISSOLVE OR LIQUIDATE THE CORP; (XII) ISSUE THE CORP'S MEMBERSHIP TO ANY OTHER THAN THE MEMBER; (XIII) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONASHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORP AND ANY PERSON OR ENTITY; AND (XIV) DEVELOP A NEW LINE OF BUSINESS. PERSON OR ENTITY; AND (XIV) DEVELOP A NEW LINE OF BUSINESS. REVIEW OF THE 990S BY THE ORGANIZATION'S GOVERNING BODY FORM 990, PART VI, LINE 11B VARIOUS SCHEDULES OF THE 990S ARE PREPARED PRIMARILY BY STAFF WITHIN THE ACCOUNTING AREA OF THE ORGANIZATION WORKING WITH VARIOUS OTHER AREAS OF THE ORGANIZATION SUCH AS MANAGEMENT OF THE OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPILED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION / PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYTEM REVIEWS THE 990S OF EACH FILLING 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'S ENTITY (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 IS MADE AVAILABLE TO THE HPH BOARD OF DIRECTORS THROUGH A BOARD PORTAL FOR REVIEW PRIOR TO THE FILING OF THE 990. COPIES OF THE 990S ARE MADE AVAILABLE TO THE BOARD MEMBERS OF EACH SUBSIDIARY UNIT OF HPH AND ARE PHYSICALLY LOCATED AT EACH FACILITY'S SITE FOR THE BOARD MEMBER TO REVIEW PRIOR TO FILING. THE 990S WILL BE POSTED TO HPH'S WEB SITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURNS WITH THE IRS. ADOPTION OF POLICIES FORM 990, PART VI, LINES 12A, 13, 14 AND 16B THE POLICIES IDENTIFIED IN PART VI WERE FORMALLY ADOPTED BY THE BOARD OF HAWAI'I PACIFIC HEALTH ("HPH"), THE SOLE MEMBER OF THE ORGANIZATION. AS THE SOLE MEMBER, THE POLICIES ADOPTED BY HPH MUST BE FOLLOWED BY ALL HPH ORGANIZATIONS. THE POLICIES ARE CURRENTLY BEING ADOPTED BY THE ORGANIZATION'S BOARD. - LINE 12A - WRITTEN CONFLICT OF INTEREST POLICY WAS FORMALLY ADOPTED 12/3/07 BY HPH - LINE 13 - WRITTEN WHISTLEBLOWER POLICY WAS FORMALLY ADOPTED 5/26/11 BY HPH - LINE 14 - WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY WAS FORMALLY ADOPTED 5/26/11 BY HPH - LINE 16B - WRITTEN POLICY REGARDING PARTICIPATION IN JOINT VENTURE ARRANGEMENTS WAS FORMALLY ADOPTED 5/26/11 BY HPH DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C ANNUALLY, EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) RECEIVED A COPY OF THE CONFLICT OF INTEREST ("COI") POLICY; 2) HAS READ AND UNDERSTAND 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 ACTIVITES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE IN-HOUSE LEGAL DEPARTMENT DISTRIBUTES THE STATEMENT REQUEST AND REVIEWS THE COI STATEMENTS RETURNED. IDENTIFIED CONFLICTS OF INTEREST ARE PRESENTED TO THE BOARD FOR REVIEW, DELIBERATION AND CONFIRMATION / REFUTATION THAT A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST HAS BEEN FOUND, THE INDIVIDUAL MAY ADDRESS THE BOARD AND EXPLAIN THE TRANSACTION OR ARRANGEMENT CAUSING THE CONFLICT. AFTER THE PRESENTATION, THE INDIVIDUAL IS EXCUSED FROM THE MEETING AND SHALL NOT PARTICIPATE WITH ANY DISCUSSION OR VOTE ON MATTERS PERTAINING TO THE TRANSACTION OR ARRANGEMENT. IN MEETINGS WHERE APPLICATION OF THE COI POLICY OCCURS, THE MEETING MINUTES INCLUDE NATURE OF THE FINANCIAL INTEREST / CONFLICT, NAME(S) OF THE PERSON(S) WITH THE POTENTIAL OR ACTUAL CONFLICT, ANY ACTION TAKEN TO ASSIST IN THE DETERMINATION OF WHETHER A CONFLICT EXISTED, INCLUDING ANY DISCUSSION OF ALTERNATIVE ARRANGEMENTS, THE BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED AND YEAR PROCESS WAS LAST COMPLETED FORM 990, PART VI, LINE 15A & 15B COMPENSATION FOR HAWAI'I PACIFIC HEALTH ("HPH") EXECUTIVES (VP AND ABOVE) IS SET BY THE INDEPENDENT BOARD MEMBERS WHO ARE MEMBERS OF THE HPH COMPENSATION COMMITTEE. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE'S 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. 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 1, 2011 TO REVIEW PHYSICIAN COMPENSATION, AND ON JULY 12, 2011 AND AUGUST 9, 2011 TO REVIEW EXECUTIVE COMPENSATION. DISCLOSURE OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FINANCIAL STMTS FORM 990, PART VI, LINE 19 THE CONFLICT OF INTEREST POLICY AND STANDARDS OF CONDUCT ARE AVAILABLE ON THE HAWAI'I PACIFIC HEALTH WEBSITE. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE HAWAI'I PACIFIC HEALTH WEBSITE. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 5 FY10 PR ACCRUAL DIFFERENCE: ($1,491,384) - FY10 B/S - PAYROLL & RELATED LIAB BALANCE $1,465,466 - FY10 TB - ACCRUED PAYROLL BALANCE -------------------- ($25,918) - SUBTOTAL - FY10 PR ACC DIFFERENCE $5,539,755 - EQUITY TRANSFER WITH HPH ------------------- $5,513,837 - TOTAL OTHER CHANGES IN NET ASSETS HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, COLUMN B INDIVIDUALS LISTED ON PART VII ALSO DEOVTE TIME TO THE ORGANIZATIONS AS LISTED BELOW: WILCOX HEALTH FOUNDATION CHARLES CHING 0.5 CHARLES STED 1.0 DAVID FOX 0.4 DAVID OKABE 0.5 EARL INOUYE 0.5 JESSICA LEWIS 0.5 VIRGINIA PRESSLER-FISHER 1.0 KAPI'OLANI HEALTH FOUNDATION CHARLES CHING 0.5 CHARLES STED 3.0 DAVID FOX 0.4 DAVID OKABE 1.0 EARL INOUYE 0.5 JESSICA LEWIS 0.1 VIRGINIA PRESSLER-FISHER 1.0 STRAUB FOUNDATION CHARLES CHING 0.5 CHARLES STED 1.0 DAVID FOX 0.4 DAVID OKABE 0.5 EARL INOUYE 0.1 JESSICA LEWIS 0.5 KENNETH ROBBINS 0.1 VIRGINIA PRESSLER-FISHER 1.0 HAWAI'I PACIFIC HEALTH ANN PETERS 45.0 CHARLES CHING 30.0 CHARLES STED 32.0 DAVID FOX 2.4 DAVID OKABE 35.0 EARL INOUYE 25.0 GAIL LERCH 40.0 JESSICA LEWIS 0.5 KEKA SANBORN 50.0 KENNETH ROBBINS 10.0 MARTHA SMITH 0.5 MELINDA ASHTON 40.0 STEVEN ROBERTSON 15.0 SUSAN MASUMOTO-NONAKA 20.0 VIRGINIA PRESSLER-FISHER 45.0 WARREN CHAIKO 15.0 KAUA'I MEDICAL CLINIC ANN PETERS 1.0 CHARLES CHING 4.0 CHARLES STED 6.0 DAVID FOX 4.8 DAVID OKABE 1.0 EARL INOUYE 4.0 GAIL LERCH 0.1 JESSICA LEWIS 2.5 KATIE SHIGEMITSU 2.4 KEKA SANBORN 0.5 KENNETH ROBBINS 10.0 MELINDA ASHTON 1.0 STEVEN ROBERTSON 1.0 SUSAN MASUMOTO-NONAKA 1.0 VIRGINIA PRESSLER-FISHER 0.1 WARREN CHAIKO 1.0 PROVIDERS INSURANCE CHARLES CHING 2.0 CHARLES STED 1.0 DAVID FOX 0.4 DAVID OKABE 1.0 EARL INOUYE 0.5 MELINDA ASHTON 0.1 STRAUB CLINIC & HOSPITAL ANN PETERS 1.0 CHARLES CHING 3.0 CHARLES STED 3.0 DAVID FOX 10.0 DAVID OKABE 6.0 EARL INOUYE 6.0 GAIL LERCH 6.0 JESSICA LEWIS 15.0 KATIE SHIGEMITSU 20.0 KEKA SANBORN 2.0 KENNETH ROBBINS 38.5 MELINDA ASHTON 2.0 STEVEN ROBERTSON 15.0 SUSAN MASUMOTO-NONAKA 12.0 VIRGINIA PRESSLER-FISHER 2.0 WARREN CHAIKO 5.0 PALI MOMI MEDICAL CENTER ANN PETERS 1.0 CHARLES CHING 1.0 CHARLES STED 2.0 DAVID FOX 6.0 DAVID OKABE 3.0 EARL INOUYE 1.0 GAIL LERCH 6.0 JESSICA LEWIS 6.6 KATIE SHIGEMITSU 5.2 KEKA SANBORN 2.0 KENNETH ROBBINS 10.0 MELINDA ASHTON 2.0 STEVEN ROBERTSON 8.0 SUSAN MASUMOTO-NONAKA 3.0 VIRGINIA PRESSLER-FISHER 1.0 WARREN CHAIKO 10.0 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN ANN PETERS 1.0 CHARLES CHING 4.0 CHARLES STED 2.0 DAVID FOX 10.0 DAVID OKABE 4.0 EARL INOUYE 5.0 GAIL LERCH 6.0 JESSICA LEWIS 10.8 KATIE SHIGEMITSU 8.8 KEKA SANBORN 2.0 MARTHA SMITH 54.5 MELINDA ASHTON 2.0 STEVEN ROBERTSON 12.0 SUSAN MASUMOTO-NONAKA 8.0 VIRGINIA PRESSLER-FISHER 1.0 WARREN CHAIKO 15.0 WILCOX MEMORIAL HOSPITAL ANN PETERS 1.0 CHARLES CHING 5.0 CHARLES STED 8.0 DAVID FOX 4.8 DAVID OKABE 3.0 EARL INOUYE 12.0 GAIL LERCH 1.0 JESSICA LEWIS 4.1 KATIE SHIGEMITSU 2.8 KEKA SANBORN 2.0 KENNETH ROBBINS 0.5 MARTHA SMITH 0.5 MELINDA ASHTON 1.0 STEVEN ROBERTSON 8.0 SUSAN MASUMOTO-NONAKA 16.0 VIRGINIA PRESSLER-FISHER 2.0 WARREN CHAIKO 5.0 VIRGINIA PRESSLER-FISHER 2.0 WARREN CHAIKO 5.0 HAWAI'I PACIFIC HEALTH 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246363 HOLDING CO HI 501(C)(3) 11B TYPE II NA KAPI'OLANI MEDICAL CENTER WOMEN CHILDREN 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990177350 HOSPITAL HI 501(C)(3) 3 NA KAPI'OLANI HEALTH FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246364 FUNDRAISING HI 501(C)(3) 7 NA PALI MOMI MEDICAL CENTER 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990274038 HOSPITAL HI 501(C)(3) 3 NA WILCOX MEMORIAL HOSPITAL 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990074365 HOSPITAL HI 501(C)(3) 3 NA WILCOX HEALTH FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990204242 FUNDRAISING HI 501(C)(3) 7 NA KAUA'I MEDICAL CLINIC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990326099 HOSPITAL HI 501(C)(3) 3 NA STRAUB CLINIC & HOSPITAL 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 912151670 HOSPITAL HI 501(C)(3) 3 NA STRAUB FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990109350 FUNDRAISING HI 501(C)(3) 7 NA PROVIDERS INSURANCE CORPORATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 710893000 NFP INSURANCE HI 501(C)(3) 11B TYPE II NA PALI MOMI FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 383840327 FUNDRAISING HI 501(C)(3) 7 NA HAWAI'I PACIFIC HEALTH PARTNERS INC &SUB 55 MERCHANT ST 24TH FLOOR HONOLULU HI 96813 990318588 HOLDING CO HI NA C CORP 0 0 0.00000 false false true false false false false false false false false false false true true true true true KAPI'OLANI MEDICAL CNTR FOR WOMEN & CHILDREN n 61735 KAPI'OLANI MEDICAL CNTR FOR WOMEN & CHILDREN p 352772 KAPI'OLANI MEDICAL CNTR FOR WOMEN & CHILDREN r 96426 KAPI'OLANI MEDICAL CNTR FOR WOMEN & CHILDREN o 6291492 KAPI'OLANI MEDICAL CNTR FOR WOMEN & CHILDREN q 98555 PROVIDERS INSURANCE CORPORATION q 1195421 PALI MOMI MEDICAL CENTER r 70313 STRAUB CLINIC AND HOSPITAL r 60283 KAPI'OLANI HEALTH FOUNDATION c 95004