2011-05-09T09:28:37-04:00 2010-06-30 ERNST & YOUNG US LLP 55 MERCHANT ST SUITE 1900 C-120 HONOLULU HI 96813 990 2009-07-01 990246364 KAPI'OLANI HEALTH FOUNDATION KAPI 8085357100 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 DAVID OKABE 2011-04-28 8085312037 2009 2016-02-24 21:20:13Z MICHAEL ROBINSON 55 MERCHANT ST 26TH FLOOR HONOLULU HI 96813 18756168 false X www.kapiolanigift.org X 1986 HI TO IMPROVE THE HEALTH OF HAWAII'S PEOPLE THROUGH FUNDING OF MEDICAL CARE, EQUIPMENT, HEALTH EDUCATION AND RESEARCH AT KAPI'OLANI MEDICAL CTR FOR WOMEN & CHILDREN AND KAPI'OLANI MEDICAL CENTER AT PALI MOMI. 27 25 0 22 0 2319745 10715146 0 0 -773356 1132203 0 0 1546389 11847349 1954107 1141024 0 0 0 0 100224 260266 2792276 3547116 4829229 5601447 6230519 -4055058 5616830 45392405 57304425 764704 790159 44627701 56514266 TO IMPROVE THE HEALTH OF HAWAII'S PEOPLE THROUGH FUNDING OF MEDICAL CARE, EQUIPMENT, HEALTH EDUCATION AND RESEARCH AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN AND KAPI'OLANI MEDICAL CENTER AT PALI MOMI. false false 2961679 1125024 0 SEE SCHEDULE o 2961679 true true false false false false false true true true false true false false false false false true false false false true true true false false false false false false false false true false false false false true true false false true 38 0 true 0 false false false false false false false false false 27 25 false false false false true true true true true false false true true true true true true true true false X X ANN HO 8085272520 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 X MICHAEL O'MALLEY ESQ 0.2 X X 0 0 0 JEFFREY A ARCE 0.2 X X 0 0 0 LYNN ARAKI-REGAN 0.2 X 0 0 0 MEREDITH CHING 0.2 X 0 0 0 KIMBERLY W DEY 0.2 X 0 0 0 SARA DUDGEON 0.2 X 0 0 0 ROBERT T FUJIOKA 0.2 X 0 0 0 CLINTON GOO 0.2 X 0 0 0 MICHELLE HO 0.2 X 0 0 0 DAVID HUDSON 0.2 X 0 0 0 GREGG T KOKAME MD 0.2 X 0 0 0 THOMAS KOSASA MD 0.2 X 0 0 0 LORI L MCCARNEY 0.2 X 0 0 0 BARBARA MATHEWS 0.2 X 0 0 0 FRED M NOA 0.2 X 0 0 0 ALANA K PAKKALA 0.2 X 0 0 0 KEAHI D PELAYO 0.2 X 0 0 0 VIRGINIA PRESSLER-FISHER MD 1.0 X X 0 587408 106744 ABELINA M SHAW 0.2 X 0 0 0 PATRICIA W SHEEHAN 0.2 X 0 0 0 HEIDI SNOW 0.2 X 0 0 0 CHARLES A STED 3.0 X 0 2010991 283726 ANNE TAKABUKI 0.2 X 0 0 0 JOHN C WALKER JR 0.2 X 0 0 0 ROBERT WO JR 0.2 X 0 0 0 GREGORY K YIM MD 0.2 X 0 0 0 BARRY ZLATOPER 0.2 X 0 0 0 MICHAEL ROBINSON 30.0 X 0 158768 8210 DAVID OKABE 1.0 X 0 828139 109283 CHARLES R CHING 0.5 X 0 545613 79218 TERRY LONG 0.5 X 0 250732 35957 EARL INOUYE 0.5 X 0 338063 33175 JESSICA LEWIS 0.2 X 0 98248 11015 0 4817962 667328 0 false true false 0 10715146 38981 10715146 0 1043284 1043284 0 0 6997738 6908819 88919 88919 88919 0 0 0 0 11847349 1132203 1125024 1125024 16000 16000 0 0 0 0 0 0 0 0 0 0 3723 3723 0 260266 260266 171250 171250 1657932 162863 1495069 649184 649184 128244 8355 119889 0 0 91840 91840 39988 39988 0 2708 2708 12582 12582 0 19149 13792 5357 15151 15151 OTHER PURCHASES 120928 120928 CORPORATE ALLOCATIONS 88848 88848 Other Expenses 7047 7047 PROGRAM SERVICE EXPENDITURES 1820655 1820655 6230519 2961679 476564 2792276 3752131 4151184 7453480 898298 379052 325916 275490 69575 50426 20406905 22259110 18158304 20646747 2107192 2107192 257234 45392405 57304425 172194 182705 123717 112248 468793 495206 764704 790159 X 39749947 42919606 2768262 11485168 2109492 2109492 44627701 56514266 45392405 57304425 X false true true X false X 3479977 1399649 2859782 2319745 10715146 20774299 3479977 1399649 2859782 2319745 10715146 20774299 3378301 17395998 1148968 1017639 1915921 1261588 875092 6219208 34803 0 0 34803 27028310 0.64362 0.80110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true 44154504 1000 4203721 148560 48210665 53317480 21041 -9163154 20863 44154504 0.95000 0.04000 0.01000 false false 0 56667 53964 2703 0 216972 171510 45462 0 52277 50016 2261 50426 Unrestricted Investments 568317 F Restricted Investments 48006457 F 48574774 0 DUE TO KAPI'OLANI MEDICAL CTR WOMEN/CHILDREN 267909 DUE TO HAWAI'I PACIFIC HEALTH 97727 DUE TO KAPI'OLANI MEDICAL SPECIALISTS 56485 DUE TO WILCOX MEMORIAL HOSPITAL 43212 DUE TO WILCOX HEALTH FOUNDATION 29873 495206 DESCRIPTION OF INTENDED USES OF ENDOWMENT FUNDS FORM 990, SCHEDULE D, PART V, LINE 2B ESCROW LIABILITES REPRESENT AMOUNTS DUE UNDER CHARITABLE GIFT ANNUITIES. FORM 990, SCHEDULE D, PART V, LINE 4 ENDOWMENTS CALVIN C.J. SIA, MD ENDOWMENT ESTABLISHED IN 2001 IN HONOR OF DR. CAL SIA, PEDIATRICIAN, EDUCATOR, ADMINISTRATOR AND ADVOCATE FOR HAWAII'S KEIKI. THE PURPOSE OF THIS FUND IS TO PROMOTE OPTIMAL HEALTH AND DEVELOPMENT OF ALL CHILDREN. CECIL MARSHALL ENDOWMENT ESTABLISHED IN 2001 TO SUPPORT THE MISSION OF THE KAPI'OLANI HEALTH FOUNDATION. CHAN FAMILY FUND ESTABLISHED IN 1999 TO PROVIDE ASSISTANCE TO FAMILIES OF CHILDREN WITH CANCER. DAVID & DORIS CROWELL ENDOWMENT ESTABLISHED IN 2000 TO PROVIDE MEDICAL CARE FOR ECONOMICALLY DISADVANTAGED CHILDREN AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN. FLANDERS ENDOWMENT FUND ESTABLISHED BY MURIEL MACFARLANE FLANDERS IN MEMORY OF HER TWO GRANDMOTHERS, EMELIE HEDEMANN MACFARLANE AND ABIGAIL KUAIHELANI CAMPBELL. THE HARRY & JEANETTE WEINBERG FOUNDATION ENDOWMENT ESTABLISHED TO PROVIDE ONGOING SUPPORT TO KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN'S EMERGENCY ROOM AND PEDIATRIC INTENSIVE CARE UNIT (PICU). MARJORIE BOOTH STEPHENS FUND ESTABLISHED TO PROVIDE MEDICAL CARE TO ALL WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. MAUDE NISHIMOTO SCHOLARSHIP FUND ESTABLISHED TO PROVIDE SCHOLARSHIPS FOR CONTINUING MEDICAL EDUCATION. RICHARD DAVI SCHOLARSHIP FUND ESTABLISHED TO PROVIDE SCHOLARSHIPS FOR CONTINUING MEDICAL EDUCATION. THE WILLIAM SAUNDERS ENDOWMENT ESTABLISHED IN HONOR OF CECIL A. SAUNDERS, MD, A PEDIATRICIAN WHO ESTABLISHED BABY CLINICS IN THE 1920S, THIS FUND SUPPORTS PEDIATRIC PROGRAMS AT KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN. FIN 48 FOOTNOTE 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. X X X X X true MARTS AND LUNDY CAMPAIGN COUNSEL false 260266 260266 HI true KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990177350 501(C)(3) 743061 INTERNAL SERVICES HAWAI'I PACIFIC HEALTH 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246363 11B TYPE II 261623 INTERNAL SERVICES KAPI'OLANI MEDICAL CENTER AT PALI MOMI 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990274035 501(C)(3) 91597 INTERNAL SERVICES WILCOX HEALTH FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990204242 501(C)(3) 28743 INTERNAL SERVICES 4 0 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants FOR THE GRANTS REPORTED ON LINE 1, THESE ARE SPECIFIC PURPOSE DISBURSEMENTS AND THE FUNDS ARE ALLOCATED BASED ON THE RESTRICTIONS SPECIFIED BY THE DONORS. FOR THE $16,000 REPORTED ON LINE 2, THESE ARE TUITION REIMBURSEMENTS AWARDED. A LETTER INFORMING THE RECIPIENT OF THE SCHOLARSHIP AWARDED IS MAILED TO INFORM AND INSTRUCT THE STUDENT THAT A CHECK WILL BE MADE OUT TO THEIR SCHOOL AND THAT RECIPIENT SHOULD SUBMIT RECEIPTS FOR TUITION, BOOKS, LABS, ETC. UP TO THE TOTAL AMOUNT OF THE SCHOLARSHIP AWARD. A NAME AND PHONE NUMBER IS PROVIDED FOR THE STUDENT TO CONTACT THE SCHOLARSHIP COMITTEE FOR QUESTIONS. false true false false false false false false false VIRGINIA PRESSLER-FISHER MD 0 322660 0 63901 0 200847 0 76480 0 30264 0 694152 0 145627 CHARLES A STED 0 753034 0 189314 0 1068643 0 271408 0 12318 0 2294717 0 927278 MICHAEL ROBINSON 0 148613 0 10155 0 0 0 2784 0 5426 0 166978 0 0 DAVID OKABE 0 410893 0 83331 0 333915 0 94274 0 15009 0 937422 0 263953 CHARLES R CHING 0 309809 0 61739 0 174065 0 68962 0 10256 0 624831 0 129699 TERRY LONG 0 162112 0 26010 0 62610 0 28137 0 7820 0 286689 0 46971 EARL INOUYE 0 229057 0 28589 0 80417 0 30185 0 2990 0 371238 0 52775 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, QUESTION 3 THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ("HPH"), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR 990 PART VI, LINE 15A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, QUESTION 4B AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: CHARLES R. CHING $129,699 EARL INOUYE $52,775 TERRY LONG $46,971 DAVID OKABE $263,953 VIRGINIA PRESSLER-FISHER, M.D. $145,627 CHARLES A. STED $927,278 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. X 4 38981 cost or selling pric false true true SALE OF NON-CASH CONTRIBUTIONS PART I FOR NON-CASH CONTRIBUTIONS, SUCH AS SECURITIES, THAT ARE NOT TO BE USED BY KAPI'OLANI HEALTH FOUNDATION IN THE CONDUCT OF ITS OPERATIONS, KAPI'OLANI HEALTH FOUNDATION ARRANGES FOR FINANCIAL INSTITUTIONS WITH EXPERTISE IN THE AREA TO ASSIST WITH THE SALE. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A THE KAPI'OLANI HEALTH FOUNDATION IS AFFILIATED WITH HAWAI'I PACIFIC HEALTH, THE STATE'S LARGEST HEALTHCARE NETWORK. KAPI'OLANI HEALTH FOUNDATION CONTINUES TO GENERATE THE NECESSARY RESOURCES FOR ITS AFFILIATED HOSPITALS. FOR EXAMPLE, FUNDS RAISED BY THE KAPI'OLANI HEALTH FOUNDATION OFFSET MEDICAL COSTS FOR INDIVIDUAL CHILDREN WHOSE FAMILIES CAN NOT COVER THESE EXPENSES ON THEIR OWN. THE SPECIAL MEDICAL NEEDS INCLUDE TRAVEL, EDUCATION AND SURGICAL PROCEDURES. THE KAPI'OLANI HEALTH FOUNDATION ALSO HELPS TO SUPPORT PEDIATRIC RESEARCH, PURCHASE MUCH NEEDED MEDICAL EQUIPMENT, AND MAKES POSSBILE COMMUNITY OUTREACH AND EDUCATIONAL PROGRAMS. MEMBERS AND RIGHTS FORM 990, PART VI, LINE 6 HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARD. DESCRIPTION OF CLASSES OF 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 EXCLUSIVE POWER TO TAKE AND DIRECT THE FOLLOWING ACTIONS OF THE CORPORATION: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR OF THE BOARD; (II) AFTER CONSULTATION WITH THE BOARD, REMOVE THE PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR; (III) REMOVE A DIRECTOR FROM THE BOARD; (IV) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER; (V) AMEND THESE BYLAWS; (VI) CAUSE THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR ONE MILLION DOLLARS ($1,000,000) OR MORE; (VII) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VIII) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (IX) DETERMINE AND EFFECT INTER-CORPORATE FUND TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (X) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S EXECUTIVE COMPENSATION AND BENEFIT PLANS; (XI) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (XII) DEVELOP AND PROMULGATE OVERALL CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION; AND (XIII) DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER APPROVAL: (I) ELECT ANY DIRECTOR TO THE BOARD; (II) AMEND THE ARTICLES; (III) MERGE THE CORPORATION WITH ANY ENTITY; (IV) DISSOLVE THE CORPORATION; (V) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS BY OR ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VI) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000) EXCEPT FOR THOSE ASSETS ACQUIRED BY GIFTS, GRANT, OR DONATION; (VII) ACQUIRE SHARES IN ANOTHER CORPORATION; (VIII) SELL, LEASE, EXCHANGE, ENCUMBER OR DISPOSE OF TWENTY-FIVE PERCENT (25%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (IX) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (X) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONSHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; AND (XI) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE. REVIEW OF THE 990S BY THE ORGANIZATION'S GOVERNING 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 OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPLETED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER/ EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER/ EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYSTEM REVIEWS THE 990S OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE 990S ARE THEN PROVIDED TO THE GOVERNANCE AND NOMINATING COMMITTEE OF THE HEALTH CARE SYSTEM'S BOARD OF DIRECTORS FOR THEIR REVIEW. THE GOVERNANCE AND NOMINATING COMMITTEE OF THE PARENT ENTITY'S (HAWAI'I PACIFIC HEALTH "HPH") BOARD PROVIDES OVERSIGHT FOR THE 990 REPORTING AND REVIEWS THE 990S FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE 990S FOR EACH ENTITY 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 FACILITIY'S SITE FOR THE BOARD MEMBER TO REVIEW PRIOR TO FILING. 990S WILL BE POSTED TO THE HPH'S WEBSITE 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: 1) RECEIVED A COPY OF THE CONFLIC OF INTEREST ("COI") POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION, AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE IN-HOUSE LEGAL DEPARTMENT DISTRIBUTES THE STATEMENT REQUEST AND REVIEWS THE COI STATEMENTS RETURNED. IDENTIFIED CONFLICTS OF INTEREST ARE PRESENTED TO THE BOARD FOR REVIEW, DELIBERATION AND CONFIRMATION / REFUTATION THAT A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST HAS BEEN FOUND, THE INDIVIDUAL MAY ADDRESS THE BOARD AND EXPLAIN THE TRANSACTION OR ARRANGEMENT CAUSING THE CONFLICT. AFTER THE PRESENTATION, THE INDIVIDUAL IS EXCUSED FROM THE MEETING AND SHALL NOT PARTICIPATE WITH ANY DISCUSSION OR VOTE ON MATTERS PERTAINING TO THE TRANSACTION OR ARRANGEMENT. IN MEETINGS WHERE APPLICATION OF THE COI POLICY OCCURS, THE MEETING MINUTES INCLUDE NATURE OF THE FINANCIAL INTEREST/CONFLICT, NAME(S) OF THE PERSON(S) WITH THE POTENTIAL OR ACTUAL CONFLICT, ANY ACTION TAKEN TO ASSIST IN THE DETERMINATION OF WHETHER A CONFLICT EXISTED, INCLUDING ANY DISCUSSION OF ALTERNATIVE ARRANGEMENTS, THE BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT. BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT. OFFICES AND POSITIONS FOR WHICH PROCESS WAS USED, AND YEAR PROCESS WAS LAST COMPLETED FORM 990, PART VI, LINE 15A & 15B COMPENSATION FOR HAWAI'I PACIFIC HEALTH ("HPH") EXECUTIVES (VICE PRESIDENT AND ABOVE) IS SET BY THE HPH COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT, COMMUNITY-BASED MEMBERS OF THE HPH BOARD OF DIRECTORS. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVES' COMPENSATION AND BENEFITS. THE CONSULTANT PROVIDES A WRITTEN REPORT TO THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING. INCLUDED IN THE REPORT IS MARKET BASED DATA FROM LIKE ORGANIZATIONS. THE COMPENSATION COMMITTEE MAKES FINAL DECISIONS REGARDING COMPENSATION AND BENEFITS AT THE MEETING AFTER REVIEW AND DISCUSSION OF THE CONSULTANT'S REPORT, AND SUCH DECISIONS ARE DOCUMENTED IN THE COMPENSATION COMMITTEE MEETING MINUTES. COMMUNITY BASED DIRECTORS OF THE ORGANIZATION ARE NOT COMPENSATED. CERTAIN EMPLOYED PHYSICIANS MAY BE OFFICERS OR AN IDENTIFIED KEY EMPLOYEE OF THE REPORTING OR RELATED ORGANIZATION. PHYSICIAN COMPENSATION IS ALSO HANDLED IN THE SAME MANNER AS EXECUTIVE COMPENSATION, WITH THE HPH COMPENSATION COMMITTEE RECEIVING A REPORT FROM A NEUTRAL CONSULTANT AND FOLLOWING THE SAME PROCESS AS DESCRIBED ABOVE ON AN ANNUAL BASIS. 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 INOUYE 25.0 LEWIS .3 LONG 32.0 OKABE 35.0 PRESSLER-FISHER 45.0 STED 32.0 KAUA'I MEDICAL CENTER C.R. CHING 4.0 INOUYE 4.0 LEWIS 2.4 LONG 4.0 OKABE 1.0 STED 6.0 KAPI'OLANI MEDICAL CENTER AT PALI MOMI C.R. CHING 1.0 INOUYE 1.0 LEWIS 6.0 OKABE 3.0 PRESSLER-FISHER 1.0 STED 2.0 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN C.R. CHING 4.0 INOUYE 5.0 LEWIS 10.8 OKABE 4.0 PRESSLER-FISHER 1.0 STED 2.0 KAPI'OLANI MEDICAL SPECIALISTS C.R. CHING 3.0 INOUYE 2.0 LEWIS 1.3 OKABE 1.0 STED 1.0 PROVIDERS INSURANCE CORPORATION C.R. CHING 2.0 OKABE 1.0 STED 1.0 STRAUB CLINIC & HOSPITAL C.R. CHING 3.0 INOUYE 6.0 LEWIS 15.0 OKABE 6.0 PRESSLER-FISHER 2.0 STED 3.0 STRAUB FOUNDATION C.R. CHING .5 LEWIS .5 OKABE .5 PRESSLER-FISHER 1.0 ROBINSON 4.0 STED 1.0 WILCOX HEALTH FOUNDATION C.R. CHING .5 INOUYE .5 LEWIS .5 OKABE .5 PRESSLER-FISHER 1.0 ROBINSON 6.0 STED 1.0 WILCOX MEMORIAL HOSPITAL C.R. CHING 5.0 INOUYE 12.0 LEWIS 3.9 LONG 4.0 OKABE 3.0 PRESSLER-FISHER 2.0 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 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 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 KAUA'I MEDICAL CLINIC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990326099 HOSPITAL HI 501(C)(3) 3 NA STRAUB CLINIC & HOSPITAL 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 912151670 HOSPITAL HI 501(C)(3) 3 NA STRAUB FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990109350 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 HAWAI'I PACIFIC HEALTH PARTNERS INC&SUB 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990318588 HOLDING COMPANY HI HPH C CORP 0 0 0.00000 false true true false false false false false false true false false false true true true true true KAPI'OLANI MEDICAL CENTER WOMEN & CHILDREN B 743061 KAPI'OLANI MEDICAL CENTER AT PALI MOMI B 91597 KAPI'OLANI MEDICAL SPECIALISTS B 101418 STRAUB CLINIC & HOSPITAL Q 55309 PROVIDERS INSURANCE CORPORATION 0 STRAUB FOUNDATION 0 HAWAI'I PACIFIC HEALTH PARTNERS INC & SUB 0 KAPI'OLANI HEALTH FOUNDATION 0 WILCOX HEALTH FOUNDATION 0 WILCOX MEMORIAL HOSPITAL 0 KAUA'I MEDICAL CLINIC 0