QUEENS NORTH HAWAII COMMUNITY HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- QUEENS NORTH HAWAII COMMUNITY HOSPITAL (EIN 99-0260423)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201103199349309990
- Schema version
- 2010v3.2
- 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 C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-15T16:11:58-08:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TCA Partners LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 East Herndon Avenue Suite 211 | AddressLine1 |
| City | Fresno | City |
| State | CA | State |
| ZIP Code | 93720 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990260423 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | North Hawaii Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 8088814400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 Mamalahoa Highway | AddressLine1 |
| City | Kamuela | City |
| State | HI | State |
| ZIP Code | 96743 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jason Paret | Name |
| Title | CFO | Title |
| Date Signed | 2011-11-15 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Inger Sullenger CPA | Name |
| Phone | 5412056565 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Jason Paret | NameOfPrincipalOfficerPerson |
| Gross Receipts | 50403484 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | northhawaiicommunityhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1989 | YearFormation |
| State Legal Domicile | HI | StateLegalDomicile |
| Activity Or Mission Description | Acute Care Hospital | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 410 | TotalNbrEmployees |
| Total Nbr Volunteers | 70 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 3085661 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4780141 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 41047683 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 39483674 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 181897 | InvestmentIncomePriorYear |
| Investment Income Current Year | 627025 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1588322 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1518617 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 45903563 | TotalRevenuePriorYear |
| Total Revenue Current Year | 46409457 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 23285309 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 22929689 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 78000 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 200000 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 399962 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 23933120 | OtherExpensePriorYear |
| Other Expenses Current Year | 21974477 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 47296429 | TotalExpensesPriorYear |
| Total Expenses Current Year | 45104166 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1392866 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1305291 | RevenuesLessExpensesCY |
| Total Assets BOY | 51765613 | TotalAssetsBOY |
| Total Assets EOY | 46463891 | TotalAssetsEOY |
| Total Liabilities BOY | 20520062 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14079094 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 31245551 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 32384797 | NetAssetsOrFundBalancesEOY |
| Mission Description | Acute Care Hospital | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 30221101 | Expense |
| Revenue | 40439024 | Revenue |
| Description | North Hawaii Community Hospital (the Hospital), located in Kamuela, Hawaii on the island of Hawaii, is a not-for-profit, acute-care hospital that provides inpatient, outpatient, and emergency care services for the residents and visitors of North Hawaii. The Hospital was chartered in November 1987 and commenced operations in May 1996. The Hospital is currently licensed for 39 beds. Admitting physicians are practitioners in the local area. In January 2008, the Hospital retained Quorum Health Resources LLC (QHR) to manage the Hospital. Effective March 2010, the Hospital terminated its agreement with QHR to manage the Hospital.Total outpatient visits for 2010 were: 56,773. Total admissions for 2010 were: 1,893. | Description |
| Total Program Service Expense | 30221101 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | 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 | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| 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 | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 67 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 410 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | 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 | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| 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 |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Michael Kendall Controller | NamePerson |
| Telephone Number | 8088814675 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 Mamalahoa Hwy | AddressLine1 |
| City | Kamuela | City |
| State | HI | State |
| ZIP Code | 967438496 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | OfficerOfficer |
|---|---|---|---|---|---|---|---|
| William Hutchinson | |||||||
| Treasurer | 3.00 | X | 0 | 0 | 0 | ||
| Wayne Higaki | |||||||
| Administrator | 0.00 | 150771 | 0 | 3262 | X | ||
| Wayne Allen | |||||||
| CFO | 50.00 | 270168 | 0 | 9889 | X | ||
| Robert Momsen | |||||||
| Chair | 6.00 | X | 0 | 0 | 0 | ||
| Robert Hastings | |||||||
| Secretary | 3.00 | X | 0 | 0 | 0 | ||
| Patricia Gunter | |||||||
| Physician | 40.00 | 178846 | 0 | 10973 | X | ||
| Mike Luce | |||||||
| Board Member | 3.00 | X | 0 | 0 | 0 | ||
| Michael Rossi | |||||||
| Treasurer | 3.00 | X | 0 | 0 | 0 | ||
| Linda Clifford | |||||||
| Board Member | 3.00 | X | 0 | 0 | 0 | ||
| Kahu Billy Mitchell | |||||||
| Board Member | 3.00 | X | 0 | 0 | 0 | ||
| John White | |||||||
| CEO | 50.00 | 422491 | 0 | 9595 | X | ||
| Howard Wong | |||||||
| Physician | 40.00 | 350742 | 0 | 3782 | X | ||
| Dr William Park | |||||||
| Board Member | 43.00 | X | 437861 | 0 | 8683 | ||
| Dr Virginia Pressler | |||||||
| Board Member | 3.00 | X | 0 | 0 | 0 | ||
| Dr Sharon Vitousek | |||||||
| Vice Chair | 3.00 | X | 0 | 0 | 0 | ||
| Dr Dana Lee | |||||||
| Board Member | 3.00 | X | 0 | 0 | 0 | ||
| Diane Payne | |||||||
| Physician | 40.00 | 177852 | 0 | 12963 | X | ||
| Cliff Dias | |||||||
| Vice Chair | 3.00 | X | 0 | 0 | 0 | ||
| Carolyn Quick | |||||||
| Board Member | 3.00 | X | 0 | 0 | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1988731 | TotalReportableCompFromOrg |
| Total Other Compensation | 59147 | TotalOtherCompensation |
| Number Individuals GT100 K | 22 | NumberIndividualsGT100K |
| Formers Listed | false | 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 |
|---|---|---|---|---|---|
| Phoenix Health Systems | |||||
| 910 Clopper Road Ste 165 | Gaithersburg | MD | 20878 | IS Management | 733983 |
| Kristin Buehler MD | |||||
| 64-726 Punakea Place | Kamuela | HI | 96743 | Anesthesia Physician | 446282 |
| Edward Hon MD | |||||
| PO Box 6629 | Kamuela | HI | 96743 | Anesthesia Physician | 446282 |
| Clinical Labs of Hawaii LLP | |||||
| Box 1300 | Honolulu | HI | 96807 | Clinical Laboratory | 798038 |
| Aramark CTS Inc | |||||
| 10510 Twin Lakes Parkway | Charlotte | NC | 28269 | Maintenance | 384321 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 20 | NumberOfContractorsGT100K |
| Fundraising Events | 3247398 | FundraisingEvents |
| All Other Contributions | 1532743 | AllOtherContributions |
| Noncash Contributions | 56000 | NoncashContributions |
| Total Contributions | 4780141 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net patient service | Description |
| Total Revenue Column | 39483674 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39483674 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 39483674 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 72081 | TotalRevenueColumn |
| Exclusion | $72,081 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 73219 | TotalRevenueColumn |
| Exclusion | $73,219 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 373190 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 373190 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 373190 | TotalRevenueColumn |
| Exclusion | $373,190 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3777577 | Securities |
| Other | 517048 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3300151 | Securities |
| Other | 512749 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 477426 | Securities |
| Other | 4299 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 481725 | TotalRevenueColumn |
| Exclusion | $481,725 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 371204 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 56000 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 181127 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 190077 | TotalRevenueColumn |
| Exclusion | $190,077 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Cafe & Other Member Svcs | Description |
| Total Revenue Column | 955350 | TotalRevenueColumn |
| Related Or Exempt Function Income | 955350 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 955350 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 46409457 | TotalRevenueColumn |
| Related Or Exempt Function Income | 40439024 | RelatedOrExemptFunctionIncome |
| Exclusion | $1,190,292 | 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 | 1158687 | Total |
| Program Services | 776354 | ProgramServices |
| Management And General | 382333 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17859199 | Total |
| Program Services | 11966182 | ProgramServices |
| Management And General | 5853351 | ManagementAndGeneral |
| Fundraising | 39666 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90000 | Total |
| Program Services | 60303 | ProgramServices |
| Management And General | 29697 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2495795 | Total |
| Program Services | 1672255 | ProgramServices |
| Management And General | 809215 | ManagementAndGeneral |
| Fundraising | 14325 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1326008 | Total |
| Program Services | 888464 | ProgramServices |
| Management And General | 437544 | 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 | 4319 | Total |
| Program Services | 2894 | ProgramServices |
| Management And General | 1425 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164553 | Total |
| Program Services | 110255 | ProgramServices |
| Management And General | 54298 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62749 | Total |
| Program Services | 42044 | ProgramServices |
| Management And General | 20705 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200000 | Total |
| Fundraising | 200000 | Fundraising |
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 | 3779824 | Total |
| Program Services | 2666598 | ProgramServices |
| Management And General | 1066356 | ManagementAndGeneral |
| Fundraising | 46870 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116892 | Total |
| Program Services | 78321 | ProgramServices |
| Management And General | 36238 | ManagementAndGeneral |
| Fundraising | 2333 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 924521 | Total |
| Program Services | 619456 | ProgramServices |
| Management And General | 305065 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2899711 | Total |
| Program Services | 1942891 | ProgramServices |
| Management And General | 954180 | ManagementAndGeneral |
| Fundraising | 2640 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 731016 | Total |
| Program Services | 489802 | ProgramServices |
| Management And General | 241214 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Utilities | 1531632 | 1026238 | 505394 | |
| Supplies | 5181676 | 3471873 | 1698576 | 11227 |
| Purchased Services | 4445460 | 2978587 | 1429829 | 37044 |
| Provision for bad debts | 1324084 | 887175 | 436909 | |
| Other | 638800 | 428013 | 170443 | 40344 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169240 | Total |
| Program Services | 113396 | ProgramServices |
| Management And General | 50331 | ManagementAndGeneral |
| Fundraising | 5513 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45104166 | Total |
| Program Services | 30221101 | ProgramServices |
| Management And General | 14483103 | ManagementAndGeneral |
| Fundraising | 399962 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2650 | BOY |
| EOY | 2850 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3137127 | BOY |
| EOY | 3871202 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3625873 | BOY |
| EOY | 2304831 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5991482 | BOY |
| EOY | 4877068 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 789385 | BOY |
| EOY | 815027 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 718756 | BOY |
| EOY | 1143756 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 586650 | BOY |
| EOY | 734747 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 62960760 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 34070706 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30734090 | BOY |
| EOY | 28890054 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6179600 | BOY |
| EOY | 3824356 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51765613 | BOY |
| EOY | 46463891 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3249445 | BOY |
| EOY | 3012007 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12740000 | BOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3804011 | BOY |
| EOY | 10816975 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 726606 | BOY |
| EOY | 250112 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20520062 | BOY |
| EOY | 14079094 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26647347 | BOY |
| EOY | 27840219 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4598204 | BOY |
| EOY | 4544578 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31245551 | BOY |
| EOY | 32384797 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51765613 | BOY |
| EOY | 46463891 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1305291 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -166045 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | true | MediaAdvertisements |
| Media Advertisements | $30,580 | MediaAdvertisementsAmount |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | true | DirectContactLegislators |
| Direct Contact Legislators | $32,169 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 62749 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i | Identifier |
| Return Reference | Part II-B, Line 1i - Other Activities Description | ReturnReference |
| Explanation | The Hospital pays professional organization dues, of which a portion is used for lobbying activities in the form of direct contact with legislators. The amount of dues paid for 2010 was $1,589 | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 7694551 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 3600000 | OtherCostOrOtherBasis |
| Book Value | 11294551 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20985072 | OtherCostOrOtherBasis |
| Depreciation | 11183824 | Depreciation |
| Book Value | 9801248 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4025826 | OtherCostOrOtherBasis |
| Depreciation | 4132752 | Depreciation |
| Book Value | -106926 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25861121 | OtherCostOrOtherBasis |
| Depreciation | 18754130 | Depreciation |
| Book Value | 7106991 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 794190 | OtherCostOrOtherBasis |
| Book Value | 794190 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 28890054 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Unamortized Financing Costs | 149530 |
| Estimated Third Party Payor Settlements | 755386 |
| Asssets limited as to use, bond trustee | 2877334 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3824356 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Implied Capital Lease | Description |
| Amount | $250,112 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 250112 | TotalOfAmounts |
| Total Revenue | 46409457 | TotalRevenue |
| Total Expenses | 45104166 | TotalExpenses |
| Excess Or Deficit For Year | 1305291 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 153151 | NetUnrealizedGLOnInvestments |
| Other | -$319,196 | OtherAmount |
| Total Adjustments | -166045 | TotalAdjustments |
| Excess Or Deficit Per FS | 1139246 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 46593584 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 184127 | OtherRevenues |
| Revenue Not Rptd F990 | 184127 | RevenueNotRptdF990 |
| Revenue Subtotal | 46409457 | RevenueSubtotal |
| Total Revenue Per Form990 | 46409457 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 45285293 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 181127 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 181127 | ExpensesNotRptdF990 |
| Expenses Subtotal | 45104166 | ExpensesSubtotal |
| Total Expenses Per Form990 | 45104166 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part XIII, Line 2d | Part XIII, Line 2d: Other expenses and losses per audited F/S | Special Events Reclassifications $181127 |
| Part XII, Line 2d | Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 | Assets released from restrictions $3000 Special Events Reclassifications $181127 |
| Part XI, Line 8 | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | Assets released from restriction $3000 Assets released from restriction-Capital $934740 Extraordinary Loss-Bond Defeasement $ -319196 Assets released from restriction-Capital $ -934740 Assets released from restriction $ -3000 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Phone Solicitations | X | PhoneSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | true | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
Name Of Organization NameOfOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1-2-1 Philanthr | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | Gen Fundraising | Activity |
| Fundraiser Control Of Funds | false | FundraiserControlOfFunds |
| Gross Receipts | 3191398 | GrossReceipts |
| Amount Retained By Contractor | 200000 | AmountRetainedByContractor |
| Net To Organization | 2991398 | NetToOrganization |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 3191398 | TotalGrossReceipts |
| Total Retained By Contractors | 200000 | TotalRetainedByContractors |
| Total Net To Organization | 2991398 | TotalNetToOrganization |
| Licensed States | HI | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Cheers | NameOfEvent1 |
| Gross Receipts Event1 | 427204 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 56000 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 371204 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 65756 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 115371 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 427204 | GrossReceiptsTotal |
| Charitable Contributions Total | 56000 | CharitableContributionsTotal |
| Gross Revenue Total Events | 371204 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 65756 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 115371 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 181127 | DirectExpenseSummaryEvents |
| Net Income Summary | 190077 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 125449 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 125449 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8168850 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2436259 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5732591 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12710 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8294299 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2436259 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5858040 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12990 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8294299 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2436259 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5858040 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12990 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $586,336 | BadDebtExpenseAmount |
| Amount Attributable To | 125449 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4796619 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5975813 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1179194 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 0 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | North Hawaii Community Hospita | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 Mamalahoa Highway | AddressLine1 |
| City | Kamuela | City |
| State | HI | State |
| ZIP Code | 96743 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | North Hawaii Community Hospita | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | false | EligibilityCriteriaExplained |
| Uses FPG Free | false | UsesFPGFree |
| Uses FPG Discounted | false | UsesFPGDiscounted |
| Explains Basis | false | ExplainsBasis |
| Explains Application Method | false | ExplainsApplicationMethod |
| Includes Publicity Measures | false | IncludesPublicityMeasures |
| Actions On Nonpayment | false | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part VI - Additional Information | N/A |
| Part V - Explanation of Number of Facility Type | The Hospital operates a general surgery clinic; a women's health clinic; and a home health facility. |
| Part VI - States Where Community Benefit Report Filed | HI |
| Part VI - Affilated Health Care System Roles and Promotion | N/A |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | The organization's Board is comprised of Community members from the Northern Hawaii area. The Hospital conducted approximately 42 different events including health fairs and education days in the local community, hotels, and schools of the area as well as taking a leading role in Breast Cancer Awareness month. Total community people reached was approximately 4,300. |
| Part VI - Community Building Activities | N/A |
| Part VI - Community Information | North Hawaii Community Hospital (Hospital) is located in Kamuela, HI, also known as Waimea, HI, in the Kohala District of the northeastern region of the Island of Hawaii. It is a not-for-profit, acute care hospital that provides inpatient, outpatient, and emergency care services for about 30,000 residents and visitors of North Hawaii. The Hospital's primary service area consists of approximately one-fourth, or 1,000 square miles, of the Big Island's 4,028 total square miles. There are currently no other general acute care hospitals in the primary service area. The Hospital was chartered in November 1987 and commenced operations in May 1996. The Hospital is currently licensed for 39 beds. Admitting physicians are practitioners in the local area. |
| Part VI - Patient Education of Eligibility for Assistance | Hospital admitting staff members advise and assist all self-pay patients of the options for available assistance. |
| Part VI - Needs Assessment | Admitting physicians are practitioners in the local area, and the Board is comprised of community members. This allows the Hospital to assess the needs of the community that it serves. In addition, many community health improvement services are offered in the forms of activities or programs that help to assess and improve community health. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | The entire shortfall is attributable to community benefit. |
| Part III, Line 4 - Bad Debt Expense | The Hospital provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its charity care policy. Since the Hospital does not pursue collection of amounts determined to qualify as charity care, such amounts are not reported as net patient revenue. The charges at established rates foregone for services and supplies provided by the Hospital in 2010 and 2009 for charity care totaled $283,293 and $643,551, respectively. |
| Part I, Line 7g - Costs Associated With Physicans Clinics | N/A |
| Part I, Line 7, Column F - Explanation of Bad Debt Expense | Bad debt expense is shown as a percentage of total expense of the hospital, and represents the portion of unreimbursed expense from the hospital's applicable charity care programs. |
| Part I, Line 7 - Explanation of Costing Methodology | Cost to charge ratio |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|
| Wayne Higaki | |||
| 150771 | 3262 | 154033 | 163246 |
| Wayne Allen | |||
| 270168 | 9889 | 280057 | 131038 |
| Patricia Gunter | |||
| 178846 | 10973 | 189819 | |
| John White | |||
| 422491 | 9595 | 432086 | 163449 |
| Howard Wong | |||
| 350742 | 3782 | 354524 | 368868 |
| Dr William Park | |||
| 437861 | 8683 | 446544 | 432793 |
| Diane Payne | |||
| 177852 | 12963 | 190815 | |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Dr Dana Lee | |||
| Brd Mem/Contractor | 66250 | Contracted Physician | false |
| Dr William Park | |||
| Brd Mem/Physician | 446544 | Compensation as Physician | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Dr. William Park is a Board member of the Hospital, whom also serves as a physician employee of the Hospital. Due to this relationship, he was considered a non-independent voting member of the Board and listed as such on Form 990, part I. Dr. Dana Lee is a Board member of the Hospital, who serves as a contracted physician of the Hospital. Due to this relationship, and contractor compensation in excess of $10,000, Dr. Lee was considered a non-independent voting member of the Board and listed as such on Form 990, part I. | Explanation |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 2 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 4000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV/Cost | MethodOfDeterminingRevenues |
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 52000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV/Cost | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Schedule H, Part V, Facility Info, pages 4-6 | The IRS instructions for Part V, state that the questions regarding community health needs assessments (lines 1-7) are optional for tax year 2010. Additionally, Section B, lines 8-21, are also optional for hospital orgainzations reporting a tax year beginning on or before March 23, 2010. North Hawaii Community Hospital (NHCH) qualified for this optional reporting, and did not choose to respond to lines 1-21. However, the tax software program that was utilized in preparing the Form 990 automatically generated responses to questions: 1;8-14; 16; 18; 20 and 21. These responses were the result of a software malfunction and were unable to be removed before the filing deadline. Please disregard those responses, and note that NHCH did not complete them due to the fact they were OPTIONAL. All lines 1-21, in part V Section B, should be blank. | |
| Form 990, Part I, Line 4 | Dr. William Park is a Board member of the Hospital, whom also serves as a physician employee of the Hospital. Due to this relationship, he was considered a non-independent voting member of the Board and listed as such on Form 990, part I. Dr. Dana Lee is a Board member of the Hospital, who serves as a contracted physician of the Hospital. Due to this relationship, and contractor compensation in excess of $10,000, Dr. Lee was considered a non-independent voting member of the Board and listed as such on Form 990, part I. | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Available upon request | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Obtained salary market studies from contracted management company. Also compared salaries of applicants and former CEO's of the organization. | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Reviewed each year by administration | Form 990, Part VI, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | Prepared by consultant, reviewed by Controller, CFO, Board Finance Committee, and Board of Directors | Form 990, Part VI, Line 11 |