KAUAI MEDICAL CLINIC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- KAUAI MEDICAL CLINIC (EIN 99-0326099)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-09
- IRS object ID
- 201101299349300130
- Schema version
- 2009v1.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-09T10:21:31-04:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT ST SUITE 1900 C-120 | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990326099 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAUA'I MEDICAL CLINIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KAUA | NameControl |
| Phone | 8082451500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT STREET 24TH FLOOR | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EARL INOUYE | Name |
| Title | VP & SYSTEM CONTROLLER | Title |
| Date Signed | 2011-05-09 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8085312037 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RAYMOND VARA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT STREET 24TH FLOOR | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 33662486 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.WILCOXHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | HI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE MEDICAL CARE OF THE HIGHEST STANDARDS TO THE PEOPLE OF KAUA'I AT A REASONABLE COST. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 229 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 8065 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 254974 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 33743272 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 33230285 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -9391 | InvestmentIncomePriorYear |
| Investment Income Current Year | 227 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 131701 | OtherRevenuePriorYear |
| Other Revenue Current Year | 177000 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 33873647 | TotalRevenuePriorYear |
| Total Revenue Current Year | 33662486 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 27574250 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 30470192 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 15257740 | OtherExpensePriorYear |
| Other Expenses Current Year | 15251612 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 42831990 | TotalExpensesPriorYear |
| Total Expenses Current Year | 45721804 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -8958343 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -12059318 | RevenuesLessExpensesCY |
| Total Assets BOY | 7842334 | TotalAssetsBOY |
| Total Assets EOY | 6671191 | TotalAssetsEOY |
| Total Liabilities BOY | 4558643 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5067656 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3283691 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1603535 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE KAUA'I MEDICAL CLINIC IS A NONPROFIT MULTI-SPECIALTY CLINIC WHOSE MISSION IS TO SERVE THE KAUA'I COMMUNITY WITH ACCESSIBLE, QUALITY HEALTH CARE THAT SURPASSES EXPECTATIONS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 39707212 | Expense |
| Revenue | 33407286 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Total Program Service Expense | 39707212 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | true | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 27 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 229 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DEBRA TUQUERO | NamePerson |
| Telephone Number | 8085357284 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT STREET 24TH FLOOR | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (32 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| THOMAS WILLIAMSON MD | |||||||||
| CHAIR, BOARD OF DIRECTOR | 40.0 | X | X | 222356 | 0 | 14041 | |||
| MALVIN DOHRMAN | |||||||||
| VICE CHAIR, BOARD OF DIRECTOR | 0.2 | X | X | 0 | 0 | 0 | |||
| TOM CANUTE | |||||||||
| BOARD OF DIRECTOR | 0.2 | X | 0 | 0 | 0 | ||||
| TRINETTE KAUI | |||||||||
| BOARD OF DIRECTOR | 0.2 | X | 0 | 0 | 0 | ||||
| MARK MAGELSSEN MD | |||||||||
| BOARD OF DIRECTOR | 40.0 | X | 304985 | 0 | 24672 | ||||
| DAVID ROVINSKY MD | |||||||||
| BOARD OF DIRECTOR | 40.0 | X | 565663 | 0 | 23600 | ||||
| CHARLES A STED | |||||||||
| BOARD OF DIRECTOR | 6.0 | X | 0 | 2010991 | 283726 | ||||
| RAYMOND P VARA JR | |||||||||
| PRESIDENT & CEO | 5.0 | X | 0 | 1389883 | 182347 | ||||
| DAVID OKABE | |||||||||
| EVP, CFO & TREASURER | 1.0 | X | 0 | 828139 | 109283 | ||||
| KENNETH B ROBBINS MD | |||||||||
| EVP & CMO | 10.0 | X | 0 | 861367 | 126959 | ||||
| GAIL LERCH | |||||||||
| EVP | 0.1 | X | 0 | 623021 | 100175 | ||||
| VIRGINIA PRESSLER-FISHER MD | |||||||||
| EVP | 0.1 | X | 0 | 587408 | 106744 | ||||
| CHARLES R CHING | |||||||||
| SVP, GENERAL COUNSEL & SECRETA | 4.0 | X | 0 | 545613 | 79218 | ||||
| STEVEN ROBERTSON | |||||||||
| SVP & CIO | 1.0 | X | 0 | 447932 | 93805 | ||||
| EARL INOUYE | |||||||||
| VP & SYSTEM CONTROLLER | 4.0 | X | 0 | 338063 | 33175 | ||||
| ARTHUR GLADSTONE | |||||||||
| VP & CNE | 0.1 | X | 0 | 397128 | 43542 | ||||
| TERRY LONG | |||||||||
| VP | 4.0 | X | 0 | 250732 | 35958 | ||||
| HILTON RAETHEL | |||||||||
| VP | 5.0 | X | 0 | 304447 | 14688 | ||||
| SUSAN MASUMOTO-NONAKA | |||||||||
| VP | 1.0 | X | 0 | 260504 | 40021 | ||||
| WARREN CHAIKO | |||||||||
| VP | 1.0 | X | 0 | 287396 | 30756 | ||||
| THERESA RAMEY | |||||||||
| COMPLIANCE OFFICER | 20.0 | X | 0 | 113223 | 16116 | ||||
| JESSICA LEWIS | |||||||||
| ASSISTANT CORPORATE SECRETARY | 2.4 | X | 0 | 98248 | 11015 | ||||
| LYNNE JOHNSON-JOSEPH | |||||||||
| COO | 5.0 | 0 | 207562 | 33183 | X | ||||
| STEPHEN KEITH MD | |||||||||
| PHYSICIAN | 40.0 | 723156 | 0 | 23360 | X | ||||
| SURENDRA RAO MD | |||||||||
| PHYSICIAN | 40.0 | 714288 | 0 | 23600 | X | ||||
| JOHN CULLINEY MD | |||||||||
| PHYSICIAN | 40.0 | 564442 | 0 | 24183 | X | ||||
| MICHAEL L MAY MD | |||||||||
| PHYSICIAN | 40.0 | 546132 | 0 | 14962 | X | ||||
| ALLEN JOHNSON | |||||||||
| PHYSICIAN | 40.0 | 542928 | 0 | 20173 | X | ||||
| PAULA DIAS | |||||||||
| FORMER OFFICER | 0.0 | 0 | 270249 | 25517 | X | ||||
| JOHN HARLACHER | |||||||||
| FORMER OFFICER | 0.0 | 0 | 108201 | 19650 | X | ||||
| KENNETH PIERCE MD | |||||||||
| FORMER OFFICER | 0.0 | 0 | 174532 | 0 | X | ||||
| KEOKI CLEMENTE | |||||||||
| FORMER OFFICER | 0.0 | 0 | 103335 | 15916 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4183950 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 10207974 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1570385 | TotalOtherCompensation |
| Number Individuals GT100 K | 68 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MEDICAL DOCTOR ASSOCIATES | |||||
| PO BOX 277185 | ATLANTA | GA | 303847185 | HEALTHCARE STAFFING | 424530 |
| COMPHEALTH INC | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | HEALTHCARE STAFFING | 348381 |
| RUEL ANESTHESIA ASSOCIATES INC | |||||
| 1600 S BAYSHORE LANE 9B | MIAMI | FL | 33133 | HEALTHCARE STAFFING | 150685 |
| VRP OF CA PA | |||||
| PO BOX 1521 DEPT 1140 | MINNEAPOLIS | MN | 554801521 | PATIENT CARE | 136449 |
| LEO A DALY COMPANY | |||||
| 1357 KAPIOLANI BLVD SUITE 1230 | HONOLULU | HI | 968144537 | CONSTRUCTION | 106691 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Related Organizations | 254974 | RelatedOrganizations |
| Total Contributions | 254974 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | 20876461 | 20876461 |
| CAPITATION REVENUE | 622110 | 4046447 | 4046447 |
| MEDICARE / MEDICAID REVENUE | 622110 | 8216036 | 8216036 |
| RENTAL INCOME | 622110 | 91341 | 91341 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 33230285 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 227 | TotalRevenueColumn |
| Exclusion | $227 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICAL RECORDS | 622110 | 74196 | 74196 |
| INTEREST ON LATE PAYMENTS | 900099 | 2813 | 2813 |
| LEGAL SETTLEMENT | 900099 | 80433 | 80433 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19558 | TotalRevenueColumn |
| Related Or Exempt Function Income | 19558 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 177000 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 33662486 | TotalRevenueColumn |
| Related Or Exempt Function Income | 33407285 | RelatedOrExemptFunctionIncome |
| Exclusion | $227 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1035411 | Total |
| Program Services | 1035411 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91000 | Total |
| Program Services | 91000 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25725392 | Total |
| Program Services | 25158379 | ProgramServices |
| Management And General | 567013 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 673871 | Total |
| Program Services | 645366 | ProgramServices |
| Management And General | 28505 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1692008 | Total |
| Program Services | 1581380 | ProgramServices |
| Management And General | 110628 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1252510 | Total |
| Program Services | 1213931 | ProgramServices |
| Management And General | 38579 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 190084 | Total |
| Management And General | 190084 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4555451 | Total |
| Program Services | 3361544 | ProgramServices |
| Management And General | 1193907 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34084 | Total |
| Program Services | 4270 | ProgramServices |
| Management And General | 29814 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2013382 | Total |
| Program Services | 1940929 | ProgramServices |
| Management And General | 72453 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 689158 | Total |
| Management And General | 689158 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1359142 | Total |
| Program Services | 1271457 | ProgramServices |
| Management And General | 87685 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135077 | Total |
| Program Services | 115942 | ProgramServices |
| Management And General | 19135 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80 | Total |
| Program Services | 80 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 765917 | Total |
| Program Services | 731397 | ProgramServices |
| Management And General | 34520 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1168630 | Total |
| Program Services | 1136079 | ProgramServices |
| Management And General | 32551 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| CORPORATE ALLOCATION | 2762796 | 2762796 | |
| BAD DEBT | 1326538 | 1326538 | |
| OTHER PURCHASES | 116109 | 25382 | 90727 |
| All other expenses | 135164 | 132382 | 2782 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45721804 | Total |
| Program Services | 39707212 | ProgramServices |
| Management And General | 6014592 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -138915 | BOY |
| EOY | -114441 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1533882 | BOY |
| EOY | 454140 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1779599 | BOY |
| EOY | 2067072 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1824 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22641 | BOY |
| EOY | 10580 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7318585 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4242321 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3300695 | BOY |
| EOY | 3076264 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1342608 | BOY |
| EOY | 1177576 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7842334 | BOY |
| EOY | 6671191 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4014472 | BOY |
| EOY | 4339381 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 544171 | BOY |
| EOY | 728275 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4558643 | BOY |
| EOY | 5067656 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3283691 | BOY |
| EOY | 1603535 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3283691 | BOY |
| EOY | 1603535 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7842334 | BOY |
| EOY | 6671191 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1228800 | OtherCostOrOtherBasis |
| Depreciation | 422519 | Depreciation |
| Book Value | 806281 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5579850 | OtherCostOrOtherBasis |
| Depreciation | 3819802 | Depreciation |
| Book Value | 1760048 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 509935 | OtherCostOrOtherBasis |
| Book Value | 509935 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3076264 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DEPOSITS AND OTHER NON-CURRENT | 635511 |
| DUE FROM GOVERNMENT AGENCIES | 523334 |
| OTHER RECEIVABLES | 17023 |
| DUE FROM STRAUB CLINIC & HOSP | 475 |
| DUE FROM HPHRI | 1233 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1177576 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (9 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| 457(B) LIABILITY | $584,381 |
| ESCHEAT LIABILITY | $18,981 |
| DUE TO PROVIDERS INSURANCE | $76,424 |
| DUE TO KAPI'OLANI MEDICAL AT PALI MOMI | $26,858 |
| DUE TO WILCOX HEALTH FDTN | $10,864 |
| DUE TO KAPI'OLANI HEALTH FDTN | $6,533 |
| DUE TO KAPI'OLANI MEDICAL SPECIALISTS | $3,211 |
| DUE TO KAPI'OLANI MEDICAL CTR WOMEN/CHILDREN | $982 |
| DUE TO STRAUB FOUNDATION | $40 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 728275 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE D - FIN 48 FOOTNOTE | Identifier |
| Return Reference | PART X, LINE 2 | ReturnReference |
| Explanation | FOLLOWING IS THE FIN 48 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 EXACTED 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. | Explanation |
Schedule G IRS990ScheduleG
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (27 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS WILLIAMSON MD | |||||||||||||
| 222356 | 0 | 0 | 0 | 0 | 0 | 8879 | 0 | 5162 | 0 | 236397 | 0 | 0 | 0 |
| MARK MAGELSSEN MD | |||||||||||||
| 269035 | 0 | 0 | 0 | 35950 | 0 | 9800 | 0 | 14872 | 0 | 329657 | 0 | 0 | 0 |
| DAVID ROVINSKY MD | |||||||||||||
| 555663 | 0 | 2500 | 0 | 7500 | 0 | 9800 | 0 | 13800 | 0 | 589263 | 0 | 0 | 0 |
| CHARLES A STED | |||||||||||||
| 0 | 753034 | 0 | 189314 | 0 | 1068643 | 0 | 271408 | 0 | 12318 | 0 | 2294717 | 0 | 927278 |
| RAYMOND P VARA JR | |||||||||||||
| 0 | 601040 | 0 | 130473 | 0 | 658370 | 0 | 166024 | 0 | 16323 | 0 | 1572230 | 0 | 558878 |
| DAVID OKABE | |||||||||||||
| 0 | 410893 | 0 | 83331 | 0 | 333915 | 0 | 94274 | 0 | 15009 | 0 | 937422 | 0 | 263953 |
| KENNETH B ROBBINS MD | |||||||||||||
| 0 | 407086 | 0 | 83109 | 0 | 371172 | 0 | 109190 | 0 | 17769 | 0 | 988326 | 0 | 301378 |
| GAIL LERCH | |||||||||||||
| 0 | 320190 | 0 | 69507 | 0 | 233324 | 0 | 82010 | 0 | 18165 | 0 | 723196 | 0 | 185756 |
| VIRGINIA PRESSLER-FISHER MD | |||||||||||||
| 0 | 322660 | 0 | 63901 | 0 | 200847 | 0 | 76480 | 0 | 30264 | 0 | 694152 | 0 | 145627 |
| CHARLES R CHING | |||||||||||||
| 0 | 309809 | 0 | 61739 | 0 | 174065 | 0 | 68962 | 0 | 10256 | 0 | 624831 | 0 | 129699 |
| STEVEN ROBERTSON | |||||||||||||
| 0 | 306299 | 0 | 66491 | 0 | 75142 | 0 | 66642 | 0 | 27163 | 0 | 541737 | 0 | 25048 |
| EARL INOUYE | |||||||||||||
| 0 | 229057 | 0 | 28589 | 0 | 80417 | 0 | 30185 | 0 | 2990 | 0 | 371238 | 0 | 52775 |
| ARTHUR GLADSTONE | |||||||||||||
| 0 | 279978 | 0 | 43298 | 0 | 73852 | 0 | 21015 | 0 | 22527 | 0 | 440670 | 0 | 46593 |
| TERRY LONG | |||||||||||||
| 0 | 162112 | 0 | 26010 | 0 | 62610 | 0 | 28138 | 0 | 7820 | 0 | 286690 | 0 | 46971 |
| HILTON RAETHEL | |||||||||||||
| 0 | 203431 | 0 | 24396 | 0 | 76620 | 0 | 11637 | 0 | 3051 | 0 | 319135 | 0 | 75187 |
| SUSAN MASUMOTO-NONAKA | |||||||||||||
| 0 | 197875 | 0 | 24444 | 0 | 38185 | 0 | 11637 | 0 | 28384 | 0 | 300525 | 0 | 23460 |
| WARREN CHAIKO | |||||||||||||
| 0 | 210889 | 0 | 26472 | 0 | 50035 | 0 | 11653 | 0 | 19103 | 0 | 318152 | 0 | 26874 |
| LYNNE JOHNSON-JOSEPH | |||||||||||||
| 0 | 163920 | 0 | 25974 | 0 | 17668 | 0 | 13564 | 0 | 19619 | 0 | 240745 | 0 | 0 |
| STEPHEN KEITH MD | |||||||||||||
| 723156 | 0 | 0 | 0 | 0 | 0 | 9800 | 0 | 13560 | 0 | 746516 | 0 | 0 | 0 |
| SURENDRA RAO MD | |||||||||||||
| 714288 | 0 | 0 | 0 | 0 | 0 | 9800 | 0 | 13800 | 0 | 737888 | 0 | 0 | 0 |
| JOHN CULLINEY MD | |||||||||||||
| 541042 | 0 | 23400 | 0 | 0 | 0 | 9800 | 0 | 14383 | 0 | 588625 | 0 | 0 | 0 |
| MICHAEL L MAY MD | |||||||||||||
| 546132 | 0 | 0 | 0 | 0 | 0 | 9800 | 0 | 5162 | 0 | 561094 | 0 | 0 | 0 |
| ALLEN JOHNSON | |||||||||||||
| 542928 | 0 | 0 | 0 | 0 | 0 | 9800 | 0 | 10373 | 0 | 563101 | 0 | 0 | 0 |
| PAULA DIAS | |||||||||||||
| 0 | 191240 | 0 | 24224 | 0 | 54785 | 0 | 11638 | 0 | 13879 | 0 | 295766 | 0 | 35942 |
| JOHN HARLACHER | |||||||||||||
| 0 | 105163 | 0 | 3038 | 0 | 0 | 0 | 6276 | 0 | 13374 | 0 | 127851 | 0 | 0 |
| KENNETH PIERCE MD | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 174532 | 0 | 0 | 0 | 0 | 0 | 174532 | 0 | 0 |
| KEOKI CLEMENTE | |||||||||||||
| 0 | 102087 | 0 | 1248 | 0 | 0 | 0 | 1848 | 0 | 14068 | 0 | 119251 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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. SEVERANCE PAYMENT SCHEDULE J, PART I, LINE 4A PAID TO KENNETH PIERCE, M.D. BY HAWAI'I PACIFIC HEALTH, FILING ORGANIZATION'S PARENT. |
| SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN | SCHEDULE J, PART I, LINE 4B | AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: WARREN CHAIKO $26,874 CHARLES R. CHING $129,699 ARTHUR GLADSTONE $46,593 EARL INOUYE $52,775 GAIL LERCH $185,756 TERRY LONG $46,971 SUSAN MASUMOTO-NONAKA $23,460 DAVID OKABE $263,953 VIRGINIA PRESSLER-FISHER, M.D. $145,627 STEVEN ROBERTSON $25,048 HILTON RAETHEL $75,187 KENNETH B. ROBBINS, M.D. $301,378 CHARLES A. STED $927,278 RAYMOND P. VARA, JR. $558,878 PAULA DIAS $35,942 RAYMOND P. VARA, JR. $558,878 PAULA DIAS $35,942 IN RESPONSE TO NEW REGULATORY REQUIREMENTS ASSOCIATED WITH INTERNAL REVENUE CODE SECTIONS 409A AND 457(F). HPH PROVIDED AN OPTION TO ITS OFFICERS ON PAYING OUT ACCUMULATED BALANCES ON ITS VARIOUS NON-QUALIFIED DEFERRED COMPENSATION ARRANGEMENTS IN 2009 OR TO DEFER ITS DISTRIBUTION SUBJECT TO CLIFF VESTING IN ACCORDANCE WITH THE IRS APPROVED ONE TIME 409A TRANSITION RULE. CERTAIN OFFICERS SELECTED THE PAY OUT OPTION ON THE ACCUMULATED BALANCE ASSOCIATED WITH THE CAPITAL ACCUMULATION PLAN AND ITS RESTORATION PLAN DURING 2009. THE AMOUNTS PAID OUT HAVE BEEN INCLUDED IN THE W-2 OF THOSE PARTICIPANTS ELECTING THE PAYOUT OPTION. 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 DEFERRED BASIS. |
| NON-FIXED PAYMENTS TO PERSON LISTED ON PART VII, SECTION A, LINE 1A | SCHEDULE K, PART I, LINE 7 | NON-FIXED PAYMENTS ARE MADE TO EXECUTIVES 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. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | AMY HUTSON | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FAMILY MEMBER OF DIRECTOR | Relationship |
| Amount Of Transaction | 91000 | AmountOfTransaction |
| Description Of Transaction | COMPENSATION | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4A | ESTABLISHED IN 1967, KAUA'I MEDICAL CLINIC HAS PROVIDED THE RESIDENTS AND VISITORS OF KAUA'I WITH AFFORDABLE AND ACCESSIBLE PRIMARY AND SPECIALTY CARE FOR MORE THAN 40 YEARS. AN AFFILIATE OF HAWAI'I PACIFIC HEALTH, THE STATE'S LARGEST HEALTH CARE PROVIDER, KAUA'I MEDICAL CLINIC WORKS IN PARTNERSHIP WITH WILCOX MEMORIAL HOSPITAL AS PART OF WILCOX HEALTH. TOGETHER, THEY PROVIDE PRIMARY AND SECONDARY CARE, OFFERING MORE THAN 20 MEDICAL SPECIALTIES AT FOUR LOCATIONS ON KAUA'I. THE MAIN CLINIC IS IN LIHUE, WITH THREE SATELLITE LOCATIONS IN KAPAA, KOLOA AND ELEELE. KAUA'I MEDICAL CLINIC EMPLOYS 88 PROVIDERS AND 113 DIRECT SUPPORT STAFF. TOTAL PATIENT ENCOUNTERS AT THE CLINICS WERE 322,161 IN FISCAL YEAR 2010. KAUA'I MEDICAL CLINIC IS KAUAI'S ONLY MULTI-SPECIALTY MEDICAL GROUP AND ONE OF HAWAII'S LARGEST AND MOST COMPREHENSIVE MEDICAL PRACTICES. IT PROVIDES CARE IN CARDIOLOGY, DERMATOLOGY, FAMILY MEDICINE, GASTROENTEROLOGY, GENERAL MEDICINE, GENERAL SURGERY, HEMATOLOGY, INFECTIOUS DISEASES, INTERNAL MEDICINE, NEUROLOGY, OBSTETRICS AND GYNECOLOGY, ONCOLOGY, ORTHOPEDIC SURGERY, OTOLARYNGOLOGY, PEDIATRICS, PSYCHIATRY, PODIATRY, RHEUMATOLOGY AND UROLOGY. THIS RANGE OF SERVICES, TOGETHER WITH MULTIPLE LOCATIONS, MAKE TOP-QUALITY CARE AND THE LATEST MEDICAL TECHNOLOGY MORE ACCESSIBLE FOR KAUA'I RESIDENTS. IN ADDITION, THE CLINICS OFFER PATIENTS ACCESS TO APPOINTMENT SCHEDULING, URGENT CARE SERVICES, CHRONIC DISEASE HEALTH MANAGEMENT PROGRAMS, DIABETES CONSULTATION AND EDUCATION, DIAGNOSTIC IMAGING, FINANCIAL COUNSELING, AND AN ON-SITE PHARMACY. KAUA'I MEDICAL CLINIC PLAYS AN ACTIVE ROLE AS A COMMUNITY PARTNER BY EXTENDING CARE OUTSIDE ITS WALLS THROUGH HEALTH EDUCATION, PREVENTION PROGRAMS AND SUPPORT GROUPS. IN FISCAL 2010, THESE INCLUDED DIABETES EDUCATION AND SUPPORT GROUPS FOR INSULIN PUMP USERS, A SPEAKER'S SERIES ON SPORTS MEDICINE, ACTIVE PARTICIPATION IN WATER SAFETY AND INJURY PREVENTION, AND PARTICIPATION IN ANNUAL HEALTH FAIRS. THE CLINIC HELPED SPONSOR THE ARTHRITIS WALK AND OLD KOLOA SUGAR MILL WALK/RUN, ITS BONE AND JOINT CENTER SPONSORED KIDS SUMMER FEST TO RAISE AWARENESS OF THE IMPORTANCE OF PHYSICAL ACTIVITY, AND ITS CARDIOLOGY DEPARTMENT, TOGETHER WITH WILCOX MEMORIAL HOSPITAL, SPONSORED A "HEART HEALTHY" COMMUNITY EVENT. IN ADDITION, STAFF SUPPORTED THEIR COMMUNITY BY PARTICIPATING IN ANNUAL CHARITABLE ENDEAVORS, INCLUDING THE PARADE OF LIGHTS, THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, TOYS FOR TOTS, THE ALOHA UNITED WAY WALK, THE MARCH OF DIMES WALKAMERICA, BLUE JEANS FOR BABIES, KAUA'I FOODBANK, AND BY PROVIDING PHYSICIAN SUPPORT TO LOCAL HIGH SCHOOL FOOTBALL TEAMS. KAUA'I MEDICAL CLINIC TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING TOGETHER WITH WILCOX MEMORIAL HOSPITAL AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. AN ESTABLISHED CHARITY CARE POLICY SETS GUIDELINES ON WHICH PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. IN FISCAL YEAR 2010, KAUA'I MEDICAL CLINIC PROVIDED $811,048 WORTH OF UNCOMPENSATED CARE TO PATIENTS. |
| MEMBERS AND RIGHTS | FORM 990, PART VI, LINE 6 HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER AND HAS THE POWER TO APPROVE THE ELECTION OF MEMBERS OF THE GOVERNING BODY. HAWAI'I PACIFIC HEALTH, AS MEMBER, ALSO HAS THE POWER TO ELECT ONE OR MORE EX-OFFICIO VOTING MEMBERS OF THE GOVERNING BODY. DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7B HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS THE EXCLUSIVE POWER TO TAKE AND DIRECT THE FOLLOWING ACTIONS OF THE CORPORATION: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS, AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THE BYLAWS; (IV) PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1)YEAR AND/OR FOR ONE MILLION DOLLARS ($1,000,000) OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (VII) EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, OR PARTNERSHIP OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (X) EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAW OF THE STATE OF HAWAI`I, SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY WILCOX MEMORIAL HOSPITAL, KAUA'I MEDICAL CLINIC, AND WILCOX HEALTH FOUNDATION (THE "WILCOX AFFILIATES"); (XI) EXCEPT AS PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAI`I, SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (XII) CLOSE THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORPORATION; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (XIII) CONVERT THE CLINIC OWNED AND OPERATED BY THE CORPORATION INTO A FACILITY NO LONGER OFFERING MEDICAL SERVICES; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (XIV) AFTER CONSULTING WITH THE BOARD, REMOVE THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, TREASURER, SECRETARY, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS; PROVIDED, HOWEVER, THAT TO REMOVE OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER WILL REQUIRE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE MEMBER TO FULLY COLLABORATE AND CONSULT WITH THE BOARD AND SEEK THE BOARD'S ADVANCE CONSENT FOR SUCH REMOVAL OR TERMINATION. IF THE BOARD DOES NOT CONCUR WITH THE PROPOSED REMOVAL OR TERMINATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SUCH REMOVAL OR TERMINATION WILL REQUIRE THE APPROVAL OF A MAJORITY OF THE MEMBERS ON THE MEMBER BOARD; (XV) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG RANGE AND STRATEGIC PLANS OF THE CORPORATION; AND (XVI) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER BOARD APPROVAL: (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 CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (V) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000); (VI) ACQUIRE SHARES IN ANOTHER CORPORATION; (VII) SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE WILCOX AFFILIATES; (VIII) SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (IX) SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (X) MERGE THE CORPORATION WITH ANY ENTITY; (XI) DISSOLVE OR LIQUIDATE THE CORPORATION; (XII) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (XIII) 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 (XIV) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE. | |
| REVIEW OF THE 990S BY THE ORGANIZATION'S GOVERNING BODY | FORM 990, PART VI, LINE 11A | VARIOUS SCHEDULES OF THE 990S ARE PREPARED PRIMARILY BY STAFF WITHIN THE ACCOUNTING AREA OF THE ORGANIZATION WORKING WITH VARIOUS OTHER AREAS OF THE ORGANIZATION SUCH AS MANAGEMENT OF THE OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPILED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYSTEM REVIEWS THE 990S OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE 990S ARE THEN PROVIDED TO THE GOVERNANCE AND NOMINATING COMMITTEE OF THE HEALTH CARE SYSTEM'S BOARD OF DIRECTORS FOR THEIR REVIEW. THE GOVERNANCE AND NOMINATING COMMITTE 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 IS MADE AVAILABLE TO THE HPH BOARD OF DIRECTORS THROUGH A BOARD MEMBER 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 IS PHYSICALLY LOCATED AT EACH FACILITY'S SITE FOR THE BOARD MEMBER TO REVIEW PRIOR TO FILING. 990S WILL BE POSTED TO HPH'S WEB SITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURN WITH THE IRS. MONITORING & ENFORCING OF CONFLICT OF INTEREST POLICY 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: - RECEIVED A COPY OF THE CONFLICT OF INTEREST ("COI") POLICY; - HAS READ AND UNDERSTANDS THE POLICY; - AGREES TO COMPLY WITH THE POLICY; AND - UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE IN-HOUSE LEGAL DEPARTMENT DISTRIBUTES THE STATEMENT REQUEST AND REVIEWS THE COI STATEMENTS RETURNED. IDENTIFIED CONFLICTS OF INTEREST ARE PRESENTED TO THE BOARD FOR REVIEW, DELIBERATION AND CONFIRMATION/REFUTATION THAT A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST HAS BEEN FOUND, THE INDIVIDUAL MAY ADDRESS THE BOARD AND EXPLAIN THE TRANSACTION OR ARRANGEMENT CAUSING THE CONFLICT. AFTER THE PRESENTATION, THE INDIVIDUAL IS EXCUSED FROM THE MEETING AND SHALL NOT PARTICIPATE WITH ANY DISCUSSION OR VOTE ON MATTERS PERTAINING TO THE TRANSACTION OR ARRANGEMENT. IN MEETINGS WHERE APPLICATION OF THE COI POLICY OCCURS, THE MEETING MINUTES INCLUDE NATURE OF THE FINANCIAL INTEREST/CONFLICT, NAME(S) OF THE PERSON(S) WITH THE POTENTIAL OR ACTUAL CONFLICT, ANY ACTION TAKEN TO ASSIST IN THE DETERMINATION OF WHETHER A CONFLICT EXISTED, INCLUDING ANY DISCUSSION OF ALTERNATIVE ARRANGEMENTS, THE BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT. |
| OFFICES AND POSITIONS FOR WHICH PROCESS WAS USED, AND YEAR PROCESS WAS | LAST COMPLETED | FORM 990, PART VI, LINE 15A & 15B COMPENSATION FOR HPH EXECUTIVES (VICE PRESIDENT AND ABOVE) IS SET BY THE HAWAI'I PACIFIC HEALTH ("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. |
| 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 WILL BE MADE AVAILABLE TO THE PUBLIC VIA THE HAWAI'I PACIFIC HEALTH WEBSITE. |
| SCHEDULE J-2, COLUMN B | INDIVIDUALS LISTED ON SCHEDULE J-2 ALSO DEVOTE TIME TO RELATED ORGANIZATION AS LISTED BELOW: HAWAI'I PACIFIC HEALTH C.R. CHING 30.0 CHAIKO 15.0 GLADSTONE 5.0 INOUYE 25.0 LERCH 40.0 LEWIS .3 LONG 32.0 MASUMOTO-NONAKA 20.0 OKABE 35.0 PRESSLER-FISHER 45.0 RAETHEL 15.0 ROBBINS 10.0 ROBERTSON 15.0 STED 32.0 VARA 5.0 KAPI'OLANI HEALTH FOUNDATION C.R CHING .5 INOUYE .5 LEWIS .2 LONG .5 OKABE 1.0 PRESSLER-FISHER 1.0 STED 3.0 KAPI'OLANI MEDICAL CENTER AT PALI MOMI C.R. CHING 1.0 CHAIKO 10.0 GLADSTONE .5 INOUYE 1.0 LERCH 6.0 LEWIS 6.0 MASUMOTO-NONAKA 8.0 OKABE 3.0 PRESSLER-FISHER 1.0 RAETHEL 5.0 ROBERTSON 8.0 STED 2.0 VARA 10.0 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN C.R. CHING 4.0 CHAIKO 15.0 DIAS 30.0 GLADSTONE .5 INOUYE 5.0 LERCH 6.0 LEWIS 10.8 MASUMOTO-NONAKA 10.0 OKABE 4.0 PRESSLER-FISHER 1.0 RAETHEL 10.0 ROBERTSON 12.0 STED 2.0 VARA 10.0 KAPI'OLANI MEDICAL SPECIALISTS C.R. CHING 3.0 CHAIKO 1.0 INOUYE 2.0 LERCH 1.0 LEWIS 1.3 OKABE 1.0 RAETHEL 5.0 ROBBINS .2 ROBERTSON 1.0 STED 1.0 PROVIDERS INSURANCE CORPORATION C.R. CHING 2.0 OKABE 1.0 STED 1.0 VARA 5.0 STRAUB CLINIC & HOSPITAL C.R. CHING 3.0 CHAIKO 5.0 DIAS 2.0 GLADSTONE 50.0 INOUYE 6.0 LERCH 6.0 LEWIS 15.0 MASUMOTO-NONAKA 12.0 OKABE 6.0 PRESSLER-FISHER 2.0 RAETHEL 10.0 ROBBINS 40.0 ROBERTSON 15.0 STED 3.0 VARA 15.0 STRAUB FOUNDATION C.R. CHING .5 LEWIS .5 OKABE .5 ROBBINS .1 STED 1.0 VARA .1 WILCOX HEALTH FOUNDATION C.R. CHING .5 INOUYE .5 LEWIS .5 OKABE .5 PRESSLER-FISHER 1.0 STED 1.0 WILCOX MEMORIAL HOSPITAL C.R. CHING 5.0 CHAIKO 5.0 CULLINEY .2 GLADSTONE .5 INOUYE 12.0 LERCH 1.0 LEWIS 3.9 LONG 4.0 MASUMOTO-NONAKA 9.0 OKABE 3.0 PRESSLER-FISHER 2.0 RAETHEL 5.0 RAMEY 20.0 ROBERTSON 8.0 STED 8.0 | |
| SCHEDULE R, PART V, LINE 2 | IN GENERAL, AMOUNTS REPORTED WITH RELATED ORGANIZATIONS ARE DETERMINED BASED ON MARKET VALUES FOR SIMILAR ITEMS OR SERVICES |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| 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 CTR 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 |
| KAPI'OLANI MEDICAL SPECIALIST | |||||||||
| 55 MERCHANT STREET 24TH FLOOR | HONOLULU | HI | 96813 | 990322406 | HEALTHCARE | HI | 501(c)(3) | 9 | NA |
| KAPI'OLANI MEDICAL CENTER AT PALI MOMI | |||||||||
| 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 |
| 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 | RESEARCH/EDU | 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 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAI'I PACIFIC HEALTH PARTNERS INC&SUB | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 MERCHANT STREET 24TH FLOOR | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990318588 | EIN |
| Primary Activity | HOLDING COMPANY | PrimaryActivity |
| Legal Domicile State | HI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Share Of Total Income | 0 | ShareOfTotalIncome |
| Share Of EOY Assets | 0 | ShareOfEOYAssets |
| Percentage Ownership | 0.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| PROVIDERS INSURANCE CORPORATION | |
| Q | 1073446 |
| WILCOX MEMORIAL HOSPITAL | |
| P | 1725780 |
| WILCOX MEMORIAL HOSPITAL | |
| Q | 108944 |
| KAPI'OLANI MEDICAL CENTER FOR WOMEN& CHILDREN | |
| 0 | |
| KAPI'OLANI HEALTH FOUNDATION | |
| 0 | |
| KAPI'OLANI MEDICAL SPECIALISTS | |
| 0 | |
| KAPI'OLANI MEDICAL CENTER AT PALI MOMI | |
| 0 | |
| WILCOX HEALTH FOUNDATION | |
| 0 | |
| STRAUB CLINIC & HOSPITAL | |
| 0 | |
| STRAUB FOUNDATION | |
| 0 | |
| HAWAI'I PACIFIC HEALTH PARTNERS INC & SUB | |
| 0 | |