2024-05-09T17:41:20-05:00 2023-06-30 ERNST & YOUNG US LLP 370 17TH STREET SUITE 4800 DENVER CO 80202 990 2022-07-01 990260423 QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL % SHANNON OLSEN QUEE 8088814400 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 967438496 MONEY ATWAL TREASURER 8088814400 2024-05-06 true MONEY ATWAL 999009999 ANDREW JAMESON P01894820 7209314000 2024-05-03 2 2022 2023-04-26 12:10:37Z STEPHANY VAIOLETI 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 967438496 99519250 false X www.nhch.com X 1989 HI ACUTE CARE HOSPITAL WITH THE MISSION TO TO IMPROVE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII. 10 7 463 31 39539 28306 5629601 1886064 85274677 94282675 109373 526504 634380 2824007 91648031 99519250 49294022 0 0 0 38594691 44395959 395 0 105243 50474458 50501810 138363566 94897769 -46715535 4621481 242215242 229183587 127426012 116629927 114789230 112553660 X ACUTE CARE HOSPITAL WITH THE MISSION TO IMPROVE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII. false true 70624945 0 96522708 QUEEN'S 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 35 BEDS. ADMITTING PHYSICIANS ARE PRACTITIONERS IN THE LOCAL AREA. THE NUMBER OF PATIENTS SERVED FROM 7/1/2022 - 6/30/2023 THROUGH OUTPATIENT VISITS WAS 101,175 AND THE NUMBER OF ADMISSIONS WAS 1,903. SEE SCHEDULE O FOR MORE INFORMATION. 70624945 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false false false true true false false false true true true false false true 0 0 463 true true true false false false false false false false false false false false X 10 7 false false false false true true true true true false false true false false false false false true false X SHANNON OLSEN 8088814675 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 967438496 JILL HOGGARD GREEN TRUSTEE/CHAIR 3.0 62.0 X X 0 1709743 284902 JASON CHANG TRUSTEE 1.0 54.0 X 0 951232 131335 CYNTHIA KAMIKAWA PRESIDENT/TRUSTEE 54.0 1.0 X X 0 563181 48453 SHARLENE TSUDA FORMER OFFICER 0.0 0.0 X 0 285577 6974 MONEY ATWAL TREASURER 45.0 10.0 X 0 227419 31763 TONI KALAULI DIRECTOR OF NURSING 40.0 0.0 X 188173 0 13627 WAYNE HIGAKI ASST ADMIN, FUND DEV & SUP SVC 40.0 0.0 X 177315 0 13375 MARY OHIA DIRECTOR - QUALITY & RISK 40.0 0.0 X 165871 0 21807 YOWANDA GRAHAM-CORTEZ DIRECTOR - AMBULATORY 40.0 0.0 X 161166 0 21608 CARROL MARTIN NURSE 40.0 0.0 X 160206 0 13059 SHARIANN GONSALVES SECRETARY 40.0 0.0 X 70600 0 8443 ROBERT HASTINGS II TRUSTEE 1.0 0.0 X 0 0 0 NEIL KUYPER TRUSTEE 1.0 0.0 X 0 0 0 RICHARD LEVY PHD TRUSTEE 1.0 0.0 X 0 0 0 KAHU BILLY MITCHELL TRUSTEE 1.0 0.0 X 0 0 0 ROBERT MOMSEN TRUSTEE - PART YEAR 1.0 2.0 X 0 0 0 JENAI WALL TRUSTEE 1.0 8.0 X 0 0 0 KYLE CHOCK TRUSTEE 1.0 3.0 X 0 0 0 ROBERT DEAN TRUSTEE 1.0 2.0 X 0 0 0 923331 3737152 595346 70 true true false 0 837371 1048693 56058 1886064 PATIENT SERVICE REVENUE 622110 89778680 89778680 STATE OF HI SUSTAINABILITY 900099 4049268 4049268 COVID TESTING 622110 258376 258376 INTERCOMPANY INCOME 561000 196351 196351 94282675 524240 39539 484701 0 0 330974 330974 0 330974 330974 264 2000 264 2000 2264 2264 0 0 0 0 0 0 0 0 0 VENDING MACHINE/CAFETERIA 900099 253000 253000 HMSA PAYMENT - RELOCATION 900099 67500 67500 ASSETS RELEASED FROM RESTRICTION 900099 1923961 1923961 248572 248572 2493033 99519250 96522708 39539 1070939 X 0 0 0 0 72434 72434 0 37510065 31491794 5944732 73539 927062 823547 101174 2341 3792774 2587494 1192364 12916 2093624 1646474 441768 5382 0 238824 238824 44586 44586 8864 8864 0 755 755 11167266 9436816 1721023 9427 46388 1083 45305 1600937 1324212 275973 752 296778 27274 269475 29 0 3511783 613121 2898662 174608 140695 33913 0 126508 49601 76907 694389 694389 0 6300997 5541091 759906 1116533 1116533 SUPPLIES 14326255 14145571 180684 PROVIDER TAX 1520040 1520040 INTERCOMPANY PAYMENTS 7009797 7009797 UBI TAX 12291 12291 2304211 1263841 1039513 857 94897769 70624945 24167581 105243 X 13985370 8284869 7295491 3327339 2918160 1943824 9448056 13389281 0 0 0 0 0 0 1719536 2087665 518823 685026 126817715 56024638 70047768 70793077 710621 709164 0 0 0 0 0 0 135571417 127963342 242215242 229183587 10738307 8476152 0 0 0 0 4403294 4150399 0 0 0 0 51416440 51474840 0 0 60867971 52528536 127426012 116629927 X -18876069 -13310230 133665299 125863890 114789230 112553660 242215242 229183587 X 4621481 930 -6857981 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8864 8864 false SCHEDULE C, PART II-B, LINE 1I LOBBYING EXPENSES ARE THE PORTION OF DUES PAID TO HEALTHCARE ASSOCIATIONS ALLOCATED TO LOBBYING ACTIVITIES. 4812238 -141641 150716 31022 4488859 4790211 239949 192494 25428 4812238 4129637 860882 177845 22463 4790211 4391892 -44257 195249 22749 4129637 4533839 140572 272942 9577 4391892 1.00000 true true true 12210000 12210000 71580839 26459515 45121324 1136897 542579 594319 38527861 29022544 9505317 3362118 3362118 70793077 EQUITY IN PARKER RANCH FDN TRU 112837471 INVESTMENT IN LIBERTY DIALYSIS 42106 BENEFICIAL INTERESTS 4488857 CONTRIBUTED USE OF LAND 6389454 DUE FROM AFFILIATES 1046117 OTHER RECEIVABLES 208395 ROU ASSETS 1393442 NMTC FEE RESERVE 1557500 127963342 0 LEASE LIABILITY 1529284 GENERAL AND PROF TAIL LIABILITY 88009 DUE TO GOVT PROGRAMS 4320631 DUE TO AFFILIATES 46590612 52528536 X SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS THE ORGANIZATION HAS BENEFICIAL INTERESTS IN SEVERAL ENDOWMENTS, ALL WITH THE PURPOSE OF PROVIDING RESOURCES TO BE USED TO ENHANCE HEALTH CARE SERVICES IN NORTH HAWAII. SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE QHS EVALUATES ITS UNCERTAIN TAX POSITIONS AND HAS NO MATERIAL UNRECOGNIZED TAX POSITIONS AS OF JUNE 30, 2023. true true X true X 250. true X true true true false true true 17172 17172 0.00020 17611836 10050103 7561733 0.07970 17629008 10050103 7578905 0.07990 633134 2090290 633134 2090290 18262142 12140393 7578905 0.07990 true 6086917 58938 15253481 18040951 -2787470 X true true 1 1 QUEEN'S NORTH HAWAII COMM HOSPITAL 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 967438496 www.nhch.com 39-H X X X NORTH HAWAII MEDICAL GROUP AND KOHALA HOME HEALTH AGENCY QUEEN'S NORTH HAWAII COMM HOSPITAL 1 false false true X X X X X X X X X 21 true true true true X SEE PART V, SECTION C X true 21 true SEE PART V, SECTION C false true X 250. 400. X X X X X X true true X X X true X SEE SECTION C, PART V X SEE SECTION C, PART V X SEE SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 5 Input from Community Representatives Community Meetings - Organizations throughout the state, called "community connectors," helped to reach individuals from key communities for group talk story sessions. These organizations were invaluable partners, each trusted and recognized within their target communities, and willing both to provide input from their own work as well as create space and encourage their clients, partners, staff, and stakeholders to participate. Each meeting focused on both a geographic region and either an ethnic community or a vulnerable population. Key Informant Interviews - The Ward Team conducted 80 key informant interviews with individuals in key stakeholder positions able to provide input and insight on behalf of a target population. These tended to be organizational leaders serving stakeholder communities versus members of those actual populations that joined community meetings. Interviews were typically one on one between an interviewer and a key informant, lasting anywhere from 45 to 90 minutes. Small Groups - The Ward Team also held a series of private small group meetings with key leaders in three of these areas (food security, mental health, and housing). (Note that two of these necessitated additional one-on-one interviews, rather than small groups, given scheduling difficulties and the desire to speak with key individuals). These interviews followed the completion of most of the key informant interviews and community meetings and benefitted from that learning to date. The focus of discussion was around identifying COVID-19 adaptation strategies that worked and how that learning can be carried forward and built upon. Much of this discussion has augmented the Best Practice strategies highlighted in the report Community Advisory Committee - In 2021, the Community Advisory Committee (CAC) was composed of community leaders serving various target communities. CAC members were especially generous with their time, input, and expertise throughout the process. In addition to being key informants, they also participated in meetings during the last phase of the assessment and report and helped to make critical connections where there were gaps, ensure that things were ground-truthed with what they saw in their communities, and provided input as to how the priorities could be helpful both within the clinical and community-based contexts. SEE APPENDIX F OF THE CHNA FOR A LIST OF KEY INFORMANTS AND THEIR RESPECTIVE ORGANIZATIONS. SCHEDULE H, PART V, SECTION B, LINE 6A CHNA HOSPITAL FACILITIES NINETEEN HEALTHCARE ASSOCIATION OF HAWAII (HAH) MEMBER HOSPITALS CONTRIBUTED TO THE PRODUCTION OF THIS CHNA: ADVENTIST HEALTH CASTLE KAHUKU MEDICAL CENTER KAISER FOUNDATION HOSPITAL - HONOLULU KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN KUAKINI MEDICAL CENTER KULA HOSPITAL LANA'I COMMUNITY HOSPITAL MAUI MEMORIAL MEDICAL CENTER MOLOKAI GENERAL HOSPITAL QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL PALI MOMI MEDICAL CENTER THE QUEEN'S MEDICAL CENTER THE QUEEN'S MEDICAL CENTER - WEST O'AHU REHABILITATION HOSPITAL OF THE PACIFIC SHRINERS HOSPITALS FOR CHILDREN - HONOLULU STRAUB MEDICAL CENTER SUTTER HEALTH KAHI MOHALA WAHIAWA GENERAL HOSPITAL WILCOX MEDICAL CENTER SCHEDULE H, PART V, SECTION B, LINE 6B CHNA OTHER THAN HOSPITAL FACILITIES THE HEALTHCARE ASSOCIATION OF HAWAII PARTNERED WITH SOLUTIONS PACIFIC AND WARD RESEARCH TO CONDUCT A CHNA FOR THE STATE OF HAWAII. IN ADDITION, THE REPORT INVOLVED NUMEROUS OTHER HEALTH CARE FACILITIES AND RESOURCES WITHIN THE COMMUNITY THAT WERE ABLE TO RESPOND TO THE HEALTHCARE NEEDS IN THE COMMUNITY. THESE RESOURCES ARE LISTED ON PAGE 94 OF THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 7A and 10A WEBSITE WHERE THE CHNA AND IMPLEMENTATION PLAN CAN BE ACCESSED: https://www.queens.org/about/community-benefit-qhs/ SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS ASSESSED TOGETHER, THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) MEMBER HOSPITALS PRIORITIZED THE AREAS OF NEED FOR THE STATE. THE TOP RANKED GOALS WERE: . Financial Security . Food Security . Mental and Behavioral Health . Housing . Trust and Equitable Access IN ADDITION, THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED: . Work together for equity and justice . Strengthen safe families . Prepare for emergencies . Restore environment and sense of place . Shift kupuna care away from "sick care" . Nurture community identity and cohesiveness . Invest in teenagers and healthy starts SENIOR MANAGEMENT OF THE QUEEN'S HEALTH SYSTEMS (QUEEN'S), THE NONPROFIT PARENT COMPANY OF A FAMILY OF HEALTH CARE-RELATED COMPANIES THAT INCLUDES THE QUEEN'S MEDICAL CENTER (QMC), QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH) AND MOLOKAI GENERAL HOSPITAL (MGH), DISCUSSED THE COMMUNITY HEALTH NEEDS AND AGREED TO ADDRESS THE FOLLOWING PRIORITIES FOR THE SYSTEM: . Financial Security . Food Security . Mental and Behavioral Health . Housing . Trust and Equitable Access OBJECTIVES 1. Enhance equitable access to health care and wellness services by implementing the next phases of the QHS NHH Kahua Ola 2.0 Strategic Plan and DEIJ Road Map to develop and sustain relations and trust (i.e., pilina) between QHS and the communities it serves. ACTION PLAN - FY 2022/2023/2024 a. Recruit primary care physicians, pediatricians and specialists to provide access on island for these services (e.g., ENT and neurology). b. Integrate physician services/coverage with the Manamana campus to provide access to specialists (e.g., Maternal Fetal Medicine for OB/ GYN program). c. Continue to reduce barriers for accessing primary care through the culturally sensitive programs (Kahua Ola) for our Native Hawaiians, which includes social and navigation support. d. Continue to reduce barriers to accessing primary and specialty care at The Queen's North Hawai'i Community Hospital ambulatory services and incorporating Community Care Management on Hawai'i Island. e. Work with The Queen's Health System's departments of NHH and DEIJ & Caregiver Wellness to continue strengthening our working relationship with Native Hawaiian community leaders, and organizations from Hawai'i Island to review and set the CHNA priorities that these departments and Native Hawaiian organizations can collaborate and systematically acquire information and data on. Time Frame FY 2022, FY 2023, FY 2024 2. Promote quality patient care and sustain patient engagement with evidence-based interventions that are developmentally appropriate across the life span, culturally responsive, and upholds the QHS values of C.A.R.E. (Compassion, Aloha, Respect and Excellence) between providers and the persons, families, and communities. a. Continue to expand services and care after discharge to promote patient engagement in following health care instructions that are culturally appropriate. b. Workforce Development for students at the middle school, high school, college, and professional schools on Hawai'i Island: 1) Hire a QHS Human Resources and NHH/DEIJ-CW Coordinator who will oversee this workforce development program. 2) Develop relationships with middle and high schools to recruit volunteers and part-time employment and establish a pool of community health care workers, navigators, and a cadre of students entering the QHS NHH and JABSOM NH Center of Excellence and its health professionals program. 3) Continue to enhance the collaboration with University of Hawai'i campuses that includes a comprehensive student scholarship and recruitment program, along with training rotations for clinical learners in addition to the training programs for nurses, medical students, residents, and other health care professions. 3. Cultivate community partnerships that build a mutual respect and kuleana to transform the models and system of care from one that focuses on illness to a population health movement that leverages all local, state and federal resources to build the capacity for communities to address the SDoH drivers of positive change. a. QNHCH' s TJC Quality Management, Patient Safety and Reliability team is working with the Executive Vice President and Director of DEIJ-CW to ensure compliance with the new TJC health equities requirements and prepare for the upcoming TJC site visit. Time Frame FY 2022, FY 2023, FY 2024 b. Scale-up the Kahu a Ola Program with the needed clinical and non-clinical staff to increase the numbers of Native Hawaiians being served for primary care, mental and behavioral health counseling, and treatment interventions that are grounded in Native Hawaiian cultural traditions and allopathic medicine. c. Expand Clinical Program by increasing the numbers of Native Hawaiians who can access primary care, ambulatory care, and inpatient services. 1) Increase the numbers Native Hawaiians served by expanding the Kahu a Ola clinical and non-clinical staff. 2) Establish a Remote Patient Monitoring of patients to open access to health care within their homes. 3) Care Coordination and navigation that assesses and systematically addresses social and cultural determinants of health (e.g., transportation, housing, and family counseling) to strengthen support that enhance wellness and clinical care engagement. 4) Transitional Care . ED/Inpatient Discharges Follow-up 5) Home Visits & Outreach for Care Coordination + Primary Care Visits (High-Risk Patients) d. Extend Native Hawaiian culture awareness and education via a comprehensive Education and Training curriculum using virtual asynchronous learning, with face-to-face in person cultural immersion sessions that educate and train our clinical and non-clinical caregivers about our Ali'i Founders' Native Hawaiian traditions that enhance clinical and wellness perceptions and relationships with the patients and island communities we serve. e. Work to expand the QHS health and wellness services to include traditional Native Hawaiian Healing and the Medical Model by effective partnerships with the newly merged Hawai'i East and West Island FQHC and Hui Malama Ola Na Oiwi (the Hawai'i health center of Papa Ola Lokahi) and their Kupuna Council. f. Formally develop strategic relationships with Native Hawaiian community organizations, such as Hui Malama I ke Ala ?Ulili, to advance their vision of a 21st century Native Hawaiian 'ahupu'a'a that serves as a sacred gathering place for the North and West Hawai'i communities, enhances food stability via eco-agriculture and traditional Native Hawaiian la'au (herbal medicine), and promotes trust and equitable access that strengthens families and educates elementary, middle school, high school and college students. NEEDS NOT ADDRESSED ALTHOUGH NHCH WILL NOT DIRECTLY BE ADDRESSING ALL OF THE AREAS OF NEEDS LISTED ON THE CHNA REPORT, WE HAVE SUPPORTED AND PARTNERED WITH OTHERS TO ADDRESS SEVERAL OF THEM AND WILL CONTINUE TO SUPPORT OPPORTUNITIES TO ADDRESS COMMUNITY HEALTH NEEDS IN COLLABORATION WITH OTHERS. SCHEDULE H, PART V, SECTION B, LINE 13B INCOME LEVEL OTHER THAN FPG FOR CITIZENS OF FOREIGN COUNTRIES, THE INCOME QUALIFYING LEVEL IS BASED ON THE RESIDENT'S COUNTRY'S MINIMUM WAGE. SCHEDULE H, PART V, SECTION B, LINE 13H OTHER ELIGIBILITY CRITERIA MEDICARE OR MEDICAID/QUEST ELIGIBILITY SCHEDULE H, PART V, LINES 16A, 16B & 16C THE FINANCIAL ASSISTANCE POLICY AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL'S WEBSITE AT: https://www.queens.org/locations/hospitals/north-hawaii/pay-your-bill/ THE FINANCIAL ASSISTANCE POLICY'S APPLICATION FORM AND TRANSLATIONS ARE WIDELY AVAILABLE ON QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL'S WEBSITE AT: https://www.queens.org/locations/hospitals/north-hawaii/pay-your-bill/fina ncial-assistance/ SCHEDULE H, PART V, SECTION B, LINE 16J OTHER METHOD FOR PUBLICIZING POLICIES NOTICES THAT FINANCIAL ASSISTANCE IS AVAILABLE ARE POSTED IN ALL PATIENT REGISTRATION, BILLING OFFICE AND EMERGENCY DEPARTMENT AREAS. THESE NOTICES DO NOT CONTAIN THE FULL DETAILED TEXT OF THE POLICY. REGISTRATION PERSONNEL ARE KNOWLEDGEABLE TO ASSIST PATIENTS WITH QUESTIONS AND ARE ABLE TO GIVE THEM THE FINANCIAL ASSISTANCE APPLICATION. 2 HALE OLA PONO 65-1267 KAWAIHAE ROAD WAIMEA HI 96743 PRIMARY CARE CLINIC N HAWAII COM HOSP SPECIALTY CARE CLINIC 67-1185 MAMALAHOA HIGHWAY KAMUELA HI 96743 SPECIALTY CARE CLINIC SCHEDULE H, PART I, LINE 6 COMMUNITY BENEFIT REPORT - RELATED ORGANIZATION COMMUNITY BENEFITS ARE REPORTED ANNUALLY AS PART OF THE FORM 990. THIS IS NOT SEPARATELY AVAILABLE TO THE PUBLIC. A FORMAL REPORT ISSUED BY THE PARENT COMPANY, THE QUEEN'S HEALTH SYSTEMS, INCLUDES THE COMMUNITY BENEFITS OF THE QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL. THIS REPORT IS PUBLISHED PERIODICALLY AND IS SEPARATELY AVAILABLE TO THE PUBLIC. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY THE COSTING METHODOLOGY CONSIDERS ALL PATIENT SEGMENTS. AMOUNTS REPRESENT THE NET COSTS FOR THE VARIOUS PROGRAMS AND OPERATIONS, CONSIDERING ACTUAL AMOUNTS INCURRED AND CALCULATED BENEFITS BASED ON COST-TO-CHARGE RATIOS AND AVERAGE RATES (I.E. WAGE RATES). SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES Kohala Home Health Care provides quality care for homebound patients by offering services designed to meet the patient's medical needs. ITS SERVICE area includes Hilo, Hamakua, Kohala, Waimea, Kona and surrounding areas of Waikoloa. FOR THE YEAR ENDED JUNE 30, 2023, COSTS ATTRIBUTED TO KOHALA HOME HEALTH CARE TOTALLED $2,426,593. NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED ON SCHDULE H, PART I. SCHEDULE H, PART III, LINE 2 BAD DEBT METHODOLOGY NHCH PROVIDES AN ALLOWANCE AGAINST ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE BY ESTABLISHING AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. NHCH ESTIMATES THE ALLOWANCE BASED ON THE AGING OF THE ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR AND OTHER RELEVANT FACTORS. NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER NHCH'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED ON THE COST-TO-CHARGE RATIO. THE HOSPITAL ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ACCOUNTING STANDARDS UPDATE 2014-09 TOPIC 606 (ASU 606) EFFECTIVE JULY 1, 2018. ASU 606 AND THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) DIFFERENTIATE BAD DEBT FROM IMPLICIT PRICE CONCESSIONS. THE HOSPITAL MAKES A DETERMINATION REGARDING A PRICE CONCESSION TO STANDARD PRICING ON A PORTFOLIO BASIS PRIOR TO ASSESSING THE CREDIT RISK OF INDIVIDUALS WITHIN THE PORTFOLIO. PATIENT SERVICE REVENUE IS RECORDED NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, INCLUDING AN ESTIMATE FOR IMPLICIT PRICE CONCESSIONS. BAD DEBT IS RECORDED AS AN OPERATING EXPENSE AND RESULTS WHEN A PATIENT, DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES, IS UNWILLING TO DO SO. THE AMOUNT SHOWN ON PART III, LINE 2 IS THE PRICE CONCESSION AMOUNT FOR THE TAX YEAR ENDED JUNE 30, 2023. SCHEDULE H, PART III, LINE 3 BAD DEBT AS COMMUNITY BENEFIT THE PORTION OF THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING THE COST TO CHARGE RATIO TO THE TOTAL BAD DEBT EXPENSE. BAD DEBT PERTAINING TO PATIENT CARE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE, CONSISTENT WITH NHCH'S MISSION, PATIENTS RECEIVE CARE REGARDLESS OF WHETHER NHCH COLLECTS PAYMENT FOR SERVICES PERFORMED. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE FOOTNOTE NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AUDITED FINANCIAL STATEMENTS DO NOT DESCRIBE BAD DEBT EXPENSE. THE AUDITED FINANCIAL STATEMENTS DO DESCRIBE THE RECEIVABLES FOR PATIENT SERVICES. "ACCOUNTS RECEIVABLE PRIMARILY COMPRISE AMOUNTS DUE FOR HEALTHCARE SERVICES FROM PATIENTS AND THIRD-PARTY PAYORS AND ARE RECORDED NET OF AMOUNTS FOR CONTRACTUAL ADJUSTMENTS, IMPLICIT PRICE CONCESSIONS AND BAD DEBTS." SCHEDULE H, PART III, LINE 8 TREATMENT OF MEDICARE SHORTFALL COMMUNITY BENEFIT THE HOSPITAL MUST TREAT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE GOVERNMENT SETS NON-NEGOTIABLE MEDICARE RATES AND THE REIMBURSEMENT HAS NOT KEPT PACE WITH THE RISING COSTS OF PROVIDING THESE SERVICES. DUE TO THE REQUIREMENT TO PROVIDE CARE AND THE INABILITY OF THE MEDICARE REIMBURSEMENT TO KEEP PACE WITH THE COST OF PROVIDING SERVICES, WE FEEL THAT THE LOSS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES IS PART OF NHCH'S MISSION AND IS A BENEFIT TO THE COMMUNITY. MEDICARE COSTING METHODOLOGY THE MEDICARE AMOUNTS ABOVE ARE CALCULATED WITH DATA FROM THE JUNE 30, 2023 COST REPORT USING THE STEP DOWN METHOD. SCHEDULE H, PART III, LINE 9B APPLICATION OF THE COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE CHARITY CARE WILL BE GRANTED TO ALL UNDERINSURED AND UNINSURED PATIENTS. THE SCREENING PROCESS WILL OPTIMALLY OCCUR AT THE TIME OF SERVICE, BUT MAY OCCUR ANYTIME DURING THE COLLECTION PROCESS INCLUDING POST ASSIGNMENT TO AN OUTSIDE COLLECTION AGENCY. ACCOUNTS FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE IDENTIFIED FOR A YEAR AND ASSESSED ANNUALLY AND/OR DURING SUBSEQUENT VISITS TO THE HOSPITAL. PROMPT PAYMENT DISCOUNTS ARE AVAILABLE FOR PATIENTS WHO PAY FOR SERVICE AT THE TIME OF TREATMENT. THE CARE PAYMENT PROGRAM IS AVAILABLE FOR ELIGIBLE PATIENTS AND PROVIDES LOW MONTHLY PAYMENTS WITH 0% INTEREST. SCHEDULE H, PART VI, LINE 2 PROMOTION OF COMMUNITY HEALTH THE MAJORITY OF THE ORGANIZATION'S BOARD IS COMPRISED OF COMMUNITY MEMBERS FROM THE NORTHERN HAWAII AREA AND HAS AN OPEN MEDICAL STAFF. THE HOSPITAL CONDUCTED DIFFERENT EVENTS INCLUDING HEALTH FAIRS AND EDUCATION DAYS IN THE LOCAL COMMUNITY, HOTELS AND SCHOOLS OF THE AREA AS WELL AS TAKING A LEAD ROLE IN BREAST CANCER AWARENESS MONTH. QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL COMPLETED A CHNA WITH THE ASSISTANCE OF THE HEALTHCARE ASSOCIATION OF HAWAII. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE NOTICES ARE POSTED IN ALL PATIENT REGISTRATION, BILLING OFFICE AND EMERGENCY DEPARTMENT AREAS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME AND UNINSURED PATIENTS. THIS INFORMATION IS ALSO POSTED ON THE HOSPITAL WEBSITE AND ON PATIENT BILLING STATEMENTS. APPROPRIATE STAFF MEMBERS THAT COMMUNICATE WITH THE PUBLIC REGARDING THEIR BILLS ARE TRAINED AND KNOWLEDGEABLE ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. STAFF MEMBERS DISCUSS THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSIST PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL IS A RURAL ACUTE CARE HOSPITAL LOCATED IN KAMUELA, HAWAII, ALSO KNOWN AS WAIMEA, HAWAII, 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. QNHCH IS ONE OF SIX ACUTE CARE HOSPITALS ON THE ISLAND PROVIDING 24-HOUR CARE SERVICES TO A POPULATION OF 201,350. THE MEDIAN AGE ON THE ISLAND IS 42.8 YEARS OLD. THE AVERAGE HOUSEHOLD INCOME ON THE ISLAND IS $65,400 WITH 34% OF THE POPULATION REPORTING THEY ARE OF NATIVE HAWAIIAN ANCESTRY (MULTIPLE RACE) IN 2020. THE HOSPITAL WAS CHARTERED IN NOVEMBER 1987 AND COMMENCED OPERATIONS IN MAY 1996. THE HOSPITAL IS CURRENTLY LICENSED FOR 35 BEDS. ADMITTING PHYSICIANS ARE PRACTITIONERS IN THE LOCAL AREA. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH THE MAJORITY OF THE ORGANIZATION'S BOARD IS COMPRISED OF COMMUNITY MEMBERS FROM THE NORTHERN HAWAII AREA AND HAS AN OPEN MEDICAL STAFF. THE HOSPITAL CONDUCTED DIFFERENT EVENTS INCLUDING HEALTH FAIRS AND EDUCATION DAYS IN THE LOCAL COMMUNITY, HOTELS AND SCHOOLS OF THE AREA AS WELL AS TAKING A LEAD ROLE IN BREAST CANCER AWARENESS MONTH. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM NHCH IS A MEMBER OF THE QUEEN'S HEALTH SYSTEMS (QHS) AFFILIATED GROUP. THE GROUP INCLUDES QUEEN'S MEDICAL CENTER (QMC), QUEEN EMMA LAND COMPANY (QEL), QUEEN'S INSURANCE EXCHANGE (QIE), QUEEN'S DEVELOPMENT CORPORATION (QDC), MOLOKAI GENERAL HOSPITAL (MGH) AND QUEEN'S UNIVERSITY MEDICAL GROUP (QUMG). QHS PROVIDED LEGAL, ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO NHCH AND QIE PROVIDED MEDICAL MALPRACTICE INSURANCE TO NHCH. IN RETURN, NHCH ASSISTED QMC IN FULFILLING ITS MISSION TO PROVIDE IN PERPETUITY QUALITY HEALTH CARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT N/A true false false false false false false true false JILL HOGGARD GREEN TRUSTEE/CHAIR 0 1166644 0 535575 0 7524 0 267373 0 17529 0 1994645 JASON CHANG TRUSTEE 0 692791 0 257631 0 810 0 106493 0 24842 0 1082567 CYNTHIA KAMIKAWA PRESIDENT/TRUSTEE 0 449261 0 107062 0 6858 0 32025 0 16428 0 611634 SHARLENE TSUDA FORMER OFFICER 0 0 0 0 0 285577 0 6969 0 5 0 292551 MONEY ATWAL TREASURER 0 206531 0 19867 0 1021 0 13902 0 17861 0 259182 TONI KALAULI DIRECTOR OF NURSING 171056 0 16310 0 807 0 5063 0 8564 0 201800 0 WAYNE HIGAKI ASST ADMIN, FUND DEV & SUP SVC 166572 0 0 0 10743 0 4720 0 8655 0 190690 0 MARY OHIA DIRECTOR - QUALITY & RISK 149729 0 14110 0 2032 0 5368 0 16439 0 187678 0 YOWANDA GRAHAM-CORTEZ DIRECTOR - AMBULATORY 139337 0 21406 0 423 0 4921 0 16687 0 182774 0 CARROL MARTIN NURSE 154624 0 0 0 5582 0 4812 0 8247 173265 0 SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON THE QUEEN'S HEALTH SYSTEMS ("QHS", PARENT COMPANY) TO DETERMINE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL. QHS USED A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY AND STUDY, FORM 990 OF OTHER ORGANIZATIONS AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SCHEDULE J, PART I, LINE 4A THE TERMS OF THE SEVERANCE AGREEMENT ARE SUBJECT TO A NON-DISCLOSURE AGREEMENT. SCHEDULE J, PART I, LINE 7 OTHER NON-FIXED PAYMENTS RECOGNITION AWARDS WERE PAID TO EMPLOYEES BASED ON ACCOMPLISHMENTS OF PREDETERMINED GOALS SET FORTH IN THE INCENTIVE AND STRATEGIC PLANS AND DEFINED ELIGIBILITY OF THE EMPLOYEE. RECOGNITION AWARDS ARE DISCRETIONARY AND CONSIDER QUALITY THRESHOLDS WHICH INCLUDE ANNUAL ACCREDITATION AND MINIMUM OPERATING INCOME LEVEL CRITERIA. IN ADDITION, EXECUTIVE AWARDS ARE WEIGHTED BASED ON INDIVIDUAL GOALS ESTABLISHED FOR EACH EXECUTIVE. SCHEDULE J, PART II & FORM 990, PART VII COMPENSATION PAID FOR SERVICES JILL HOGGARD GREEN MS. HOGGARD GREEN SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEEN'S RELATED AFFILIATES. MS. HOGGARD GREEN ALSO SERVES AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE QUEEN'S HEALTH SYSTEMS ("QHS", PARENT COMPANY) AND CHAIR OF QUMG, MGH, QEL AND NHCH. SHE IS A VOLUNTEER TRUSTEE AND IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR HER VARIOUS SERVICES. CYNTHIA KAMIKAWA MS. KAMIKAWA SERVES AS VP OF QHS AND AS PRESIDENT AND TRUSTEE OF QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL ("NHCH"). SHE IS A VOLUNTEER TRUSTEE AND IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. JASON CHANG MR. CHANG SERVES AS EVP, INNOVATION & STRATEGY FOR THE QUEEN'S HEALTH SYSTEMS AND PRESIDENT OF QUEEN'S INNOVATION INSTITUTE, TRUSTEE OF QEL, MGH AND NHCH. HE ALSO SERVED AS COO OF QHS, PRESIDENT/TRUSTEE OF QMC AND QUMG THROUGH JANUARY 2023. HE IS A VOLUNTEER TRUSTEE AND IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. SHARLENE TSUDA MS. TSUDA SERVED AS SECRETARY FOR QHS, QMC AND NHCH AND VP OF COMMUNITY DEVELOPMENT OF QHS THROUGH NOVEMBER 2020. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. MONEY ATWAL MR. ATWAL SERVES DIRECTOR OF FINANCE AND INFORMATION TECHNOLOGY FOR MOLOKAI GENERAL HOSPITAL ("MGH") AND NHCH AND TREASURER OF NHCH. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. A DEPT OF BUDGET & FINANCE STATE OF HI 990266961 419800LM7 2015-01-29 350356476 SEE PART VI false false false A 31675000 0 350362507 0 0 0 4726000 0 0 185627500 160009007 0 2019 true false true true A false false false true true 0 false false true A false false false true true true ML CAPITAL SERVICES 6.5 false false false 0 false true A true Form 990, Schedule K, Part I-V-19, Line 1 DESCRIPTION OF ARRANGEMENT RELATED ORGANIZATION REPORTING QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL'S (NHCH) SOLE CORPORATE MEMBER, THE QUEEN'S HEALTH SYSTEMS (QHS) BORROWED ON BEHALF OF ITSELF AND ITS AFFILIATES, THE QUEEN'S MEDICAL CENTER (QMC) AND QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH). INFORMATION REPORTED ON SCHEDULE K IS FOR THE ENTIRE BOND ISSUE. THE OUTSTANDING BOND LIABILITY IS ALLOCATED BETWEEN ENTITIES AND REPORTED SEPERATELY ON FORM 990, PART X. NHCH'S SHARE OF THE OUTSTANDING LIABILITY IS $4,150,399. PART I, LINE A, COLUMN (F) DESCRIPTION OF PURPOSE THE BONDS ARE ISSUED FOR THE BENEFIT OF THE BORROWER (THE QUEEN'S HEALTH SYSTEMS) AND THE FOLLOWING ORGANIZATIONS, EACH OF WHICH IS CONTROLLED BY THE BORROWER AND WHICH IS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE: THE QUEEN'S MEDICAL CENTER AND QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (TOGETHER WITH THE BORROWER, THE "OBLIGATED GROUP MEMBERS"). ON JANUARY 23, 2015, QHS ISSUED SPECIAL PURPOSE REVENUE BONDS 2015 SERIES A, 2015 SERIES B AND 2015 SERIES C. THE PURPOSE OF THIS ISSUE WAS TO REFUND ALL DEBT OBLIGATIONS PREVIOUSLY ISSUED UNDER THE MASTER TRUST INDENTURE DATED JULY 1, 1996, AS AMENDED AMONG THE BORROWER, THE QUEEN'S MEDICAL CENTER, AND OTHER AFFILIATED CORPORATIONS, AND THE MASTER TRUSTEE NAMED THEREIN, FINANCE, REFINANCE OR REIMBURSE THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING FACILITIES BENEFITTING THE OBLIGATED GROUP MEMBERS AND PAY COSTS OF ISSUANCE OF THE BOND'S OBLIGATED GROUP MEMBERS AND PAY COSTS OF ISSUANCE ON BONDS. THE ISSUANCE DATES FOR THE BONDS WERE: 12/11/2003 05/06/2009 03/16/2006 PART IV, LINE 2C THE REBATE CALCULATION WAS PERFORMED ON JANUARY 29, 2020. X 2 55778 FMV X 1 60 FMV X PLANTS 1 220 FMV 0 false false false SCHEDULE M, PART I, COLUMN B THE AMOUNTS REPORTED IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART III, LINE 3 CHANGES TO HOW WE CONDUCT PROGRAM SERVICES On July 1, 2022, QNHCH transferred its physisicans to The Queen's University Medical Group (QUMG), the academic medical group practice of The Queen's Health System. QUMG is a separately incorporated, wholly owned subsidiary of QHS and provides health care services to the patients of QNHCH. FORM 990, PART VI, LINE 4A TO SUPPORT THE QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL'S (NHCH) MISSION AND TO FULFILL THE TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, NHCH PROVIDED THE FOLLOWING COMMUNITY BENEFITS, TOTALING APPROXIMATELY $10.4M FOR THE YEAR ENDED JUNE 30, 2023. 1. UNCOMPENSATED CARE - NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). FOR THE YEAR ENDED JUNE 30, 2023, THE ESTIMATED COST OF PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $17,172 AND $58,938 RESPECTIVELY. 2. MEDICAID SHORTFALL IN PAYMENTS - NHCH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICAID PATIENTS IN THE STATE OF HAWAII. NHCH INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $7,561,733 DURING THE YEAR ENDED JUNE 30, 2023. 3. MEDICARE SHORTFALL IN PAYMENTS - NHCH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICARE PATIENTS IN THE STATE OF HAWAII. NHCH INCURRED COSTS IN EXCESS OF REIMBURSEMENT BASED ON MEDICARE COST REPORTS OF APPROXIMATELY $2,787,470 DURING THE YEAR ENDED JUNE 30, 2023. CONSISTENT WITH COST REPORT REQUIREMENTS, THERE ARE AMOUNTS THAT ARE EXCLUDED FROM THE COSTS ABOVE. 4. COMMUNITY OUTREACH PROGRAMS - NHCH PROVIDES MEDICAL NUTRITION THERAPY FREE OF CHARGE TO ANYONE ON THE BIG ISLAND. IN ADDITION, NUTRITION CLASSES WERE TAUGHT AT AN ONCOLOGY SUPPORT GROUP, LOCAL SCHOOL AND SENIOR CENTER AND OTHER ACTIVITIES WERE PROVIDED TO COMMUNITY TO SUPPORT NUTRITION EDUCATION. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS NHCH HAS A SOLE MEMBER, WHICH IS THE QUEEN'S HEALTH SYSTEMS (QHS), A HAWAII NONPROFIT CORPORATION. FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS QHS ELECTS ALL OF THE BOARD MEMBERS OF THE NHCH BOARD OF TRUSTEES. FORM 990, PART VI, LINE 7B DESCRIPTION OF CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS CERTAIN MAJOR DECISIONS APPROVED BY THE NHCH BOARD OF TRUSTEES MUST ALSO BE APPROVED BY QHS. SUCH DECISIONS INCLUDE: 1. A CHANGE TO THE PURPOSE OF THE COMPANY; 2. A FINANCING TRANSACTION IN EXCESS OF $500,000; 3. A LEASE TRANSACTION THAT HAS A TERM THAT IS LONGER THAN 3 YEARS OR HAS A RENT OBLIGATION IN EXCESS OF $1,000,000 OVER THE LEASE TERM; 4. A TRANSACTION INVOLVING THE SALE, LEASE, DISPOSITION OR HYPOTHECATION OF REAL PROPERTY; 5. ANNUAL OPERATIONAL AND CAPITAL BUDGETS; 6. STRATEGIC PLANS; 7. MERGER OR MAJOR ACQUISITIONS; 8. CREATION OF A NEW ENTITY OR JOINT VENTURE; 9. SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; 10. DISSOLUTION; 11. AMENDMENT OF BYLAWS; 12. ADOPTION, AMENDMENT OR RESCISSION OF A BOARD POLICY; 13. CAPITAL EXPENDITURES IN EXCESS OF $1,000,000 FOR NHCH. FORM 990, PART VI, LINES 11B PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 FOR THE QUEEN'S HEALTH SYSTEMS (QHS) AND THE SEPARATE FORMS FOR EACH OF THE NOT-FOR-PROFIT SUBSIDIARIES OF QHS WERE REVIEWED BY THE GOVERNING BODY PRIOR TO THE FILING OF THE TAX RETURN. THE QHS RISK MANAGEMENT COMMITTEE, WHICH IS COMPRISED OF MEMBERS OF THE QHS BOARD OF TRUSTEES, WAS DELEGATED THE RESPONSIBILITY TO REVIEW THE RETURNS PRIOR TO THEIR FILING. THE RETURNS WERE PRESENTED TO THE COMMITTEE BY MANAGEMENT AND BY THE INDEPENDENT PUBLIC ACCOUNTING FIRM THAT REVIEWED THE RETURNS. IN ADDITION, COMPENSATION RELATED DISCLOSURES IN THE RETURNS WERE REVIEWED BY THE CHAIRPERSON OF THE COMPENSATION COMMITTEE PRIOR TO FILING THE RETURNS. ALSO, A COPY OF THE QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH) RETURN WAS MADE AVAILABLE TO EACH OF THE MEMBERS OF THE NHCH BOARD OF TRUSTEES PRIOR TO THE RETURNS BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12, 13 & 14 APPROVED POLICIES THE CONFLICT OF INTEREST, WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES HAVE BEEN APPROVED BY QHS ON BEHALF OF THE NHCH BOARD OF TRUSTEES BUT HAVE NOT BEEN SEPARATELY APPROVED BY THE NHCH BOARD. AS SUCH, LINES 12, 13 AND 14 HAVE BEEN CHECKED 'NO'. FORM 990, PART VI, LINES 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY ALL QHS COMPANIES ARE SUBJECT TO A WRITTEN CONFLICT OF INTEREST POLICY. ALL TRUSTEES, OFFICERS, DESIGNATED EMPLOYEES AND CONTRACTORS ARE REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE FORM. THE DESIGNATED EMPLOYEES ARE THOSE ELECTED BY EXECUTIVES IN THE ORGANIZATION WHO IDENTIFY THOSE EMPLOYEES (TYPICALLY MANAGER LEVEL AND ABOVE) WHO MAY BE IN A POSITION TO SELECT OR INFLUENCE THE SELECTION OF A VENDOR. DISCLOSURES ARE SUMMARIZED AND MAINTAINED BY EACH COMPANY'S CORPORATE SECRETARY. THE CONTRACTS MANAGEMENT DEPARTMENT AND LEGAL DEPARTMENT HAVE THE CONFLICT OF INTEREST SUMMARIES AND CHECK FOR CONFLICTS OF INTEREST AT THE BEGINNING OF THE CONTRACT PROCESS. ANY CONFLICT OF INTEREST INVOLVING A TRUSTEE IS PRESENTED TO THE BOARD OF TRUSTEES. ANY CONFLICT OF INTEREST INVOLVING A DISQUALIFIED PERSON IS SUBJECT TO THE PROCESS OF ESTABLISHING A REBUTTABLE PRESUMPTION OF REASONABLENESS. ANY TRUSTEE WITH A CONFLICT OF INTEREST IS EXCUSED FOR THE PORTION OF THE MEETING WHERE THE SUBJECT MATTER IS DISCUSSED AND VOTED ON. FORM 990, PART VI, LINE 15A AND 15B PROCESS USED FOR DETERMINING COMPENSATION ALTHOUGH NOT COMPENSATED BY QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL, A RELATED ORGANIZATION, THE QUEEN'S HEALTH SYSTEMS GOES THROUGH THE FOLLOWING PROCEDURES FOR DETERMINING THE CEO'S COMPENSATION. A COMMITTEE OF THE BOARD OF TRUSTEES CALLED THE COMPENSATION COMMITTEE MEETS REGULARLY TO REVIEW THE COMPENSATION OF ALL EXECUTIVES OF ALL COMPANIES WITHIN QHS. NHCH'S EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY FOR ITS PRESIDENT. ALL DECISIONS REGARDING EXECUTIVE COMPENSATION ARE MADE IN CONFORMITY WITH THE PROCEDURES REQUIRED TO ESTABLISH A REBUTTABLE PRESUMPTION OF REASONABLENESS. ANY ADJUSTMENT TO COMPENSATION IS SUBJECT TO THE PROCESS OF ANNUAL PERFORMANCE REVIEWS AND COMPARISON TO COMPARABLE COMPENSATION DATA PREPARED BY A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. THE MOST RECENT REVIEW TOOK PLACE IN OCTOBER 2023. OUTSIDE COUNSEL ASSISTS WITH THE REVIEW PROCESS AND DOCUMENTS THE DECISIONS OF THE COMMITTEE. FORM 990, PART VI, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE GENERAL PUBLIC NHCH'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND THE QHS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS TAX RETURN, AS REQUIRED. NHCH DOES NOT MAKE THE CONFLICT OF INTEREST POLICY THAT IT FOLLOWS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 CHANGE IN BENEFICIAL INTEREST ($ 6,857,978) ROUNDING ($3) ------------ TOTAL ($ 6,857,981) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:5909302 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:5152127 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:105837 LUCY K HENRIQUES TRUST 1301 PUNCHBOWL STREET HONOLULU HI 96813 996002291 SUPPORT HI 501(c)(3) 12c NA false PARKER RANCH FOUNDATION TRUST 66-1304 MAMALAHOA HIGHWAY KAMUELA HI 96743 996064620 PROPERTY MGMT HI 501(c)(3) 12a NA false THE QUEEN'S HEALTH SYSTEMS 1301 PUNCHBOWL STREET HONOLULU HI 96813 990238120 ADMIN SERVICE HI 501(c)(3) 12c NA false QUEEN EMMA LAND COMPANY 1301 PUNCHBOWL STREET HONOLULU HI 96813 990183769 SUPPORT SVCS HI 501(c)(3) 12a QHS true THE QUEEN'S MEDICAL CENTER 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 MEDICAL SVCS HI 501(c)(3) 3 QHS true MOLOKAI GENERAL HOSPITAL PO BOX 408 KAUNAKAKAI HI 96748 990251372 MEDICAL SVCS HI 501(c)(3) 3 QHS true QUEEN'S UNIVERSITY MEDICAL GROUP 1301 PUNCHBOWL STREET HONOLULU HI 96813 880820406 MEDICAL SVCS HI 501(C)(3) 10 QHS true HAMAMATSUQUEEN'S PET IMAGING CENTER LL 1301 PUNCHBOWL STREET HONOLULU HI 96813 943266916 PET IMAGING HI NA PRIMARY CARE PHYSICIAN ENTERPRISE LLC 1301 PUNCHBOWL STREET HONOLULU HI 96813 834591861 MEDICAL SERVICES HI NA THE QUEEN'S DEVELOPMENT CORPORATION 1301 PUNCHBOWL STREET HONOLULU HI 96813 990240109 DEVELOPMENT HI NA C Corp true QUEEN'S INSURANCE EXCHANGE 1301 PUNCHBOWL STREET HONOLULU HI 96813 911913839 INSURANCE HI NA C Corp true DIAGNOSTIC LABORATORY SERVICES INC 99-859 IWAIWA STREET AIEA HI 96701 990240499 MEDICAL LAB SVCS HI NA C Corp true false false false false false false false false false true false false true false false true false false false DIAGNOSTIC LABORATORY SERVICES INC j 184607 FMV THE QUEEN'S MEDICAL CENTER m 346307 FMV SCHEDULE R, PART III IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP HAMAMATSU/QUEEN'S PET IMAGING CENTER, LLC EIN: 94-3266916 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 PRIMARY CARE PHYSICIAN ENTERPRISE LLC EIN: 83-4591861 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813