2022-05-13T08:05:46-05:00 2021-06-30 ERNST & YOUNG US LLP 4365 EXECUTIVE DR STE 1600 SAN DIEGO CA 92121 990 2020-07-01 990246363 Hawai'i Pacific Health % Chenwei Li HAWA 8085357401 55 Merchant Street 24th Floor Honolulu HI 96813 CARRIE ANN TSUTSUI VP & Controller 8085357355 2022-05-10 true CARRIE ANN TSUTSUI 999009999 JOCELYNE C MILLER P00634378 8585357200 2022-05-05 2 2020 2022-09-23 18:48:47Z RAYMOND P VARA Jr 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 276889486 false X HAWAIIPACIFICHEALTH.ORG X 1986 HI SEE SCHEDULE O 17 11 1192 11 1243935 634940 10906068 11104658 180305375 183848861 -4662069 3175780 0 0 186549374 198129299 525850 640995 0 0 121534317 122742159 0 0 2146057 72285870 70244262 194346037 193627416 -7796663 4501883 964668065 966967056 707763003 507367993 256905062 459599063 X HAWAI'I PACIFIC HEALTH IS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, AND ONE OF THE STATE'S LARGEST HEALTH CARE PROVIDERS AND PRIVATE EMPLOYERS. HAWAI'I PACIFIC HEALTH'S MISSION IS TO CREATE A HEALTHIER HAWAI'I. false false 100178695 640995 182396983 SEE SCHEDULE O. 100178695 true true false true false false false true false true true true false true true true false true false false true false false false false false false true false true true false false false false false false false false false false false false false false true true true true false false true 652 0 true 1192 true true true false false false false false false false false false true false X 17 11 false false false false false false false true true false false true true true true true true true true false CA HI X X Chenwei Li 8085357434 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 X RAYMOND P VARA JR Board of Dir, President & CEO 50.3 11.8 X X 2201810 0 2584503 DAVID OKABE EVP, CFO & Treasurer 35.0 15.0 X 946332 0 377896 MARTHA SMITH VP (Part Year) 5.0 55.0 X 876739 0 308071 ARTHUR GLADSTONE EVP & CSO 14.0 41.8 X 816310 0 309387 CHARLES R CHING EVP, Gen. Counsel & Secretary 26.1 13.9 X 770901 0 282179 GAIL LERCH Former Officer 38.5 12.5 X 742339 0 304514 STEVEN ROBERTSON EVP & CIO 40.0 13.0 X 746792 0 292161 MELINDA ASHTON MD EVP & CQO 43.0 6.3 X 720839 0 248689 JENNIE CHAHANOVICH EVP 1.5 55.0 X 660280 0 228096 LESLIE CHUN MD EVP 6.0 54.0 X 664477 0 114056 RODNEY WILLIAMS MD CMO - SCH 4.0 36.0 X 579383 0 96657 GERARD LIVAUDAIS MD EVP 49.8 0.2 X 523145 0 123914 DOUGLAS KWOCK MD VP 2.0 38.0 X 492064 0 95971 KENNETH B ROBBINS MD Former Officer 20.5 34.5 X 346070 0 180365 TRAVIS CLEGG COOO - SCH 0.0 50.0 X 406311 0 96095 GIDGET RUSCETTA RN COO - KMCWC 10.0 46.0 X 404309 0 94693 DAWN DUNBAR SVP 9.5 35.5 X 393438 0 104947 WARREN CHAIKO SVP 4.0 36.0 X 375732 0 110606 MAVIS NIKAIDO System CNE 1.0 55.0 X 371061 0 77433 SUSAN MASUMOTO-NONAKA VP 7.9 32.1 X 364629 0 81441 BRANDT FARIAS SVP (PART YEAR) 40.9 22.1 X 327384 0 85944 ANDY LEE MD MEDICAL DIRECTOR - HHP 1.0 48.0 X 358849 0 45247 MICHAEL ROBINSON VP 49.1 0.9 X 327479 0 74190 BRIGITTE MCKALE VP/CNE - PMMC 0.0 55.0 X 314717 0 75342 JAMES LIN MD VP 45.1 2.5 X 285691 27533 66003 BEAU NAKAMOTO MD Board of Director 0.4 40.0 X 0 343709 11550 EARL INOUYE Former Officer 16.5 31.5 X 285145 0 69530 DAVID STUMBAUGH VP 5.0 35.0 X 266339 0 79416 LORRIE-ANN LUKE VP 32.5 9.0 X 259855 0 82911 WILLIAM BURKE VP 22.0 32.0 X 277031 0 60631 SUNSHINE TOPPING SVP 37.5 12.5 X 289279 0 21615 MONICA PRICE MD Board of Director 0.4 40.0 X 0 251956 34427 CARRIE ANN TSUTSUI VP & Controller 18.3 29.7 X 230878 0 53413 KATIE SHIGEMITSU Compliance Officer 15.5 24.5 X 224686 0 38125 ALAN ITO Information Security Officer 36.8 3.2 X 200273 0 35376 MARK MAGELSSEN MD Board of Director 0.4 40.0 X 0 196136 20171 JESSICA LEWIS Assistant Corporate Secretary 17.0 23.0 X 170876 0 40404 DAVID FOX Privacy Officer (Part Year) 21.6 18.4 X 163615 0 32106 FRANCE GRAVES Privacy Officer 21.6 18.4 X 108993 0 33530 STEPHEN LIN MD Board of Director 0.4 1.3 X 81033 0 0 CHRISTOPHER JORDAN MD Board of Director 0.4 2.75 X 0 14452 578 STEVEN AI Board of Director 0.4 0.0 X 0 0 0 ELISIA FLORES Board of Director 0.4 0.0 X 0 0 0 MICHAEL GIBSON ESQ Board of Director 0.4 0.1 X 0 0 0 JAMES HINTON Board of Director 0.4 0.0 X 0 0 0 KATHRYN INOUYE Board of Director 0.4 0.0 X 0 0 0 TRINETTE KAUI Board of Director 0.4 0.2 X 0 0 0 KEITH MATSUMOTO MD Board of Director, Chair 0.4 0.0 X X 0 0 0 ELLIOT MILLS Board of Director 0.4 0.0 X 0 0 0 RICHARD WACKER Board of Director, Vice Chair 0.4 0.0 X X 0 0 0 MARK YAMAKAWA Board of Director 0.4 0.0 X 0 0 0 MICHAEL YAMANE Board of Director 0.4 0.2 X 0 0 0 15017081 27533 6458400 270 true true false EPIC SYSTEMS CORP PO BOX 88314 MILWAUKEE WI 532880314 MEDICAL RECORD SYST. 4924186 PACXA PO BOX 3347 HONOLULU HI 96801 HW/SW MAINTENANCE 2561258 HEALTH CATALYST INC 3165 MILLROCK DR STE 400 SALT LAKE CITY UT 84121 PROFESSIONAL SVCS. 1884203 ANTHOLOGY MARKETING GROUP 1003 BISHOP ST 9TH FLOOR HONOLULU HI 96813 MARKETING SERVICES 1729350 Microsoft Services One Microsoft Way REDMOND WA 980526399 COMPUTER SERVICES 1533126 72 3860 10596153 504645 11104658 ADMIN./MGMT. SERVICE TO TAX 561000 178969832 178335364 634468 0 HAWAI'I HEALTH PARTNERS 561000 3340877 2523467 817410 0 GRANT AND CLINICAL TRIALS 900099 733651 733651 0 0 NET PATIENT REVENUE 624190 357447 357447 0 0 CLINICAL TRIALS 624190 447054 447054 0 0 183848861 2269581 -207943 2477524 0 0 0 0 0 79666386 78760187 906199 906199 906199 0 0 0 0 0 0 0 0 0 0 198129299 182396983 1243935 3383723 640995 640995 0 0 0 0 0 0 13529526 9470668 4058858 0 989030 0 989030 0 84414746 34561080 48316505 1537161 7457467 4256076 3141242 60149 9990089 5500618 4207904 281567 6361301 3339286 2900211 121804 0 0 0 0 2661876 0 2661876 0 187871 0 187871 0 57600 0 57600 0 0 0 1018156 0 1018156 0 13215020 4139362 9069023 6635 3253400 252 3253148 0 180947 126018 54929 0 18004155 12313868 5690287 0 0 0 0 0 4329935 3017594 1312341 0 83952 56252 27700 0 0 0 0 0 93569 58720 34849 0 1572834 1553064 19770 0 0 0 0 0 9287874 9139373 0 148501 87021 0 87021 0 PROGRAM SERVICE EXPENDITURES 10097727 10097727 0 0 OTHER PURCHASES 1095425 295934 799491 0 DUES 994740 455442 539298 0 RECRUITMENT 260882 14539 246343 3761278 1141827 2629211 -9760 193627416 100178695 91302664 2146057 0 0 0 394857057 248491961 2836205 2019523 130071 152649 0 0 0 0 0 0 763105 0 4246849 4377473 139246558 91357913 51037278 47888645 145129746 174045174 250132006 307444193 0 0 0 0 115535748 182547438 964668065 966967056 38298310 41677674 0 0 0 0 583837045 427585625 0 0 0 0 0 0 0 0 85627648 38104694 707763003 507367993 X 243065759 443397646 13839303 16201417 256905062 459599063 964668065 966967056 X 4501883 83177672 0 0 0 115014446 X X false true X true true true X X 5 KAUA'I MEDICAL CLINIC 990326099 3 true 2000000 0 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN 990177350 3 true 0 0 WILCOX MEMORIAL HOSPITAL 990074365 3 true 0 0 PALI MOMI MEDICAL CENTER 990274038 3 true 0 0 STRAUB CLINIC & HOSPITAL 912151670 3 true 0 0 5 2000000 0 true false false false false true false false false false false false false false false true true true X true true SCHEDULE A, PART I, LINE 12G, COLUMN (VI) SUPPORTED ORGANIZATIONS HAWAI'I PACIFIC HEALTH ('HPH') IS THE SOLE MEMBER OF THE SUPPORTED ORGANIZATIONS AND HAS THE RIGHT TO PARTICIPATE IN THE SUPPORTED ORGANIZATIONS' GOVERANCE WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE SUPPORTED ORGANIZATIONS' GOVERNING BOARD. SCHEDULE A, PART IV, SECTION A, LINE 6 additional supported organizations HAWAI'I PACIFIC HEALTH'S DONATIONS COMMITTEE REVIEWS AND APPROVES DONATIONS TO 501(C)(3) ORGANIZATIONS ON BEHALF OF ITS SUPPORTED ORGANIZATIONS. SCHEDULE A, PART IV, SECTION D, LINE 3 Role of the supported organizations Five BOARD MEMBERS OF HAWAI'I PACIFIC HEALTH ('HPH') ALSO SERVE AS DIRECTORS FOR THE SUPPORTED ORGANIZATIONS. THEREFORE HPH'S SUPPORTED ORGANIZATIONS HAD A SIGNIFICANT VOICE IN THE INVESTMENT POLICIES AND IN DIRECTING THE USE OF THE ORGANIZATION'S INCOME OR ASSETS AT ALL TIMES DURING THE YEAR. SCHEDULE A, PART IV, SECTION E, LINE 3A power of appointment HAWAI'I PACIFIC HEALTH ('HPH') IS THE SOLE MEMBER WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARD FOR EACH OF ITS SUPPORTED ORGANIZATIONS. SCHEDULE A, PART IV, SECTION E, LINE 3B degree of direction over the policies, programs, and activities of support organizations HAWAI'I PACIFIC HEALTH ('HPH') IS THE SOLE MEMBER OF THE SUPPORTED ORGANIZATIONS AND HAS THE RIGHT TO PARTICIPATE IN THE SUPPORTED ORGANIZATIONS' GOVERNANCE WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE SUPPORTED ORGANIZATIONS' GOVERNING BOARD. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false 0 false 0 false 0 false 0 false 0 true 57600 57600 false false Schedule C, Part II-B, Line 1I LOBBYING ACTIVITY A REGISTERED LOBBYIST (CYNTHIA NAKAMURA) PROVIDES GENERAL ADVICE ON LEGISLATIVE ACTIVITIES INCLUDING INFORMATION AND INSIGHT ON LEGISLATIVE ACTIONS THAT MAY BE OF INTEREST TO HAWAI'I PACIFIC HEALTH ('HPH'). THE INDIVIDUAL ALSO PROVIDES GUIDANCE AND INSIGHT ON HOW TO NEGOTIATE THROUGH THE LEGISLATIVE PROCESS WHEN TRYING TO PASS LEGISLATION AS WELL AS INFORMATION AND INSIGHT ON THE GENERAL ACTIVITIES OF WHAT'S HAPPENING AT THE LEGISLATURE. THE INDIVIDUAL DOES SPEAK TO LEGISLATORS, SOMETIMES ON BEHALF OF LEGISLATION OR ISSUES IN WHICH HPH HAS AN INTEREST. THE INDIVIDUAL ALSO HAS AN INPUT ON HPH'S OVERALL LEGISLATIVE/COMMUNITY COMMUNICATION PLAN BUT DOES NOT SEND MAILINGS OUT TO LEGISLATORS OR THE PUBLIC ON HPH'S BEHALF. PUBLIC POLICY HAWAI'I PACIFIC HEALTH HAS A RESPONSIBILITY TO OFFER THOUGHTFUL AND INNOVATIVE INPUT TO LAWMAKERS REGARDING HEALTH CARE POLICY AND LEGISLATION. HAWAI'I PACIFIC HEALTH LEADERS ADVOCATE FOR LEGISLATIVE REFORM AND REGULATORY ENHANCEMENTS FOR VARIOUS HEALTH CARE INDUSTRY ISSUES RANGING FROM RETAINING PHYSICIANS IN THE STATE TO PROVIDING STABILITY FOR HEALTH CARE PROVIDERS. 24569 X false 12631036 254216 12376820 12942804 311768 12631036 13215382 272578 12942804 13167545 -47837 13215382 12993890 -173655 13167545 1.00000 false false 14981997 14981997 3067147 1681886 1385261 9921815 8594545 1327270 107940185 81081482 26858703 3335414 3335414 47888645 47090942 F LIMITED PARTNERSHIP 251088058 F HPH BOARD DESIGNATED 7265193 F INVESTMENT IN TRUVETA 2000000 F 307444193 BENEFICIAL INETREST- FDN ASSET 91799961 NOTE RECEIVABLE HPHPI 26938000 DUE FROM HPHMG 14269187 PREPAID PENSION 11375832 OTHER RECEIVABLES 10144325 RIGHT OF USE ASSETS OPERATING 9944922 DEFFERED CHARGES - TK57 8346177 DEFFERED CHARGES - RETIREMENT 2018171 PROVIDER'S INSURANCE CORP. 1826221 INVESTMENT LIFE INSURANCE CSV 1605206 RIGHT OF USE ASSETS FINANCE 1383946 COST OF INSURANCE 1348090 DUE FROM KAUA'I MEDICAL CENTER 615573 DUE FROM KAPI'OLANI HLTH. FDN. 214886 DUE FROM HPHPI 190924 DUE FROM STRAUB FOUNDATION 158678 DUE FROM WILCOX FOUNDATION 136197 DUE FROM HONOLULU SURGERY CTR. 73821 DUE FROM PALI MOMI FDN. 71154 DEFFERED CHARGES - LEASE/DEP 42811 ARTWORK 24569 DUE FROM KEAHONUIOKALANI 10674 DUE FROM HICORD, INC. 5145 ESCHEAT 2968 182547438 0 LT LEASE LIABILTIY-OPERATING 10306073 OTHER LONG TERM LIABILITIES 9589133 DUE TO KAPI'OLANI MED. SPECIALISTS 7748270 CURRENT PORTION OF CAPITAL LEASE 1775930 DEFFERED PAYROLL TAXES 1452357 DUE TO HPHMG 1441183 LT LEASE LIABILTIY-FINANCE 1099427 DUE TO WILCOX 869962 DUE TO PALI MOMI MED. CTR. 787211 DUE TO KAUA'I MEDICAL CLINIC 659463 DUE TO STRAUB CLINIC & HOSPITAL 579133 UH JOBSOM SCHOLARSHIP PLEDGE 549937 ST LEASE LIABILTIY-FINANCE 442505 LT FEDERAL EXCISE TAX 306250 STALE DATED AP CHECKS 285646 DEFFERED RENT LIABILITY 175863 DUE TO KAUA'I MEDICAL CLINIC 36352 ROUNDING -1 38104694 X SCHEDULE D, PART III, LINE 4 ORGANIZATION'S ART COLLECTION HAWAI'I PACIFIC HEALTH'S ('HPH') COLLECTION OF ARTWORK INCLUDES PAINTINGS AND SIMILAR WORKS THAT ARE DISPLAYED IN PUBLIC WAITING AREAS TO FURTHER ITS MISSION OF CREATING A HEALTHIER HAWAI'I. SCHEDULE D, PART X, LINE 2 Uncertain Tax Positions Audited Financial Statement Footnote The Company has not recorded any expense or accrued for any related expense for any uncertain tax positions. The company's 2017 through 2020 tax years remain subject to examination for federal income tax purposes, whereas the 2016 through 2020 tax years remain subject to examination for state taxing jurisdictions in which the Company operates. Central America and the Caribbean Investments 104994306 Europe (Including Iceland and Greenland) Investments 7000000 111994306 111994306 true false true false true false SCHEDULE F, PART IV FOREIGN INVESTMENTS THE INVESTMENT COMMITTEE OF HAWAI'I PACIFIC HEALTH HAS CHOSEN TO DIVERSIFY ITS INVESTMENT PORTFOLIO, INCLUDING CERTAIN ALTERNATIVE INVESTMENTS THAT ARE ESTABLISHED AS PARTNERSHIPS. THESE PARTNERSHIPS ARE NOT-OPERATING ENTITIES. HAWAI'I PACIFIC HEALTH'S DIRECT INVESTMENT IS MADE IN PARTNERSHIPS, AND THESE ENTITIES MAY MAKE UNDERLYING INVESTMENTS IN OTHER CERTAIN FOREIGN PARTNERSHIPS AND/OR CORPORATIONS. true GREAT ALOHA RUN 418 KUWILI STREET STE 102 HONOLULU HI 96817 990314751 501(c)(3) 150000 0 GENERAL SUPPORT HAWAI'I COMMUNITY FOUNDATION 827 FORT STREET MALL HONOLULU HI 96813 990261283 501(c)(3) 150000 0 GENERAL SUPPORT BIKESHARE HAWAI'I 914 ALA MOANA BLVD HONOLULU HI 96814 464561541 501(c)(3) 90000 0 GENERAL SUPPORT AMERICAN HEART ASSN 677 ALA MOANA BLVD HONOLULU HI 96813 135613797 501(c)(3) 72000 0 GENERAL SUPPORT HEALTHCARE ASSOCIATION OF HAWAI'I 707 RICHARDS ST PH2 HONOLULU HI 96813 990105817 501(c)(3) 26250 0 GENERAL SUPPORT UH FOUNDATION 2444 DOLE ST 105 HONOLULU HI 96822 990085260 501(c)(3) 23667 0 GENERAL SUPPORT AMERICAN RED CROSS 4155 DIAMOND HEAD ROAD HONOLULU HI 96816 530196605 501(c)(3) 18000 0 GENERAL SUPPORT HAWAI'I PUBLIC HEALTH INSTITUTE 850 RICHARDS STREET STE 201 HONOLULU HI 96813 680637054 501(c)(3) 18000 0 GENERAL SUPPORT HONOLULU MUSEUM OF ART 900 SOUTH BERETANIA ST HONOLULU HI 96814 990079713 501(c)(3) 10500 0 GENERAL SUPPORT AFTER SCHOOL ALL STAR 4747 KILAUEA AVE STE 210 HONOLULU HI 96816 274604870 501(c)(3) 10000 0 GENERAL SUPPORT GIFT FOUNDATION OF HAWAI'I 1288 ALA MOANA BLVD STE 201 HONOLULU HI 96814 300266316 501(c)(3) 10000 0 GENERAL SUPPORT MARCH OF DIMES 1580 MAKALOA STREET STE 1200 HONOLULU HI 96814 131846366 501(c)(3) 8000 0 GENERAL SUPPORT HAWAI'I APPLESEED CENTER 733 BISHOP STREET HONOLULU HI 96813 760748976 501(c)(3) 8000 0 GENERAL SUPPORT BOYS AND GIRLS CLUB OF HAWAI'I 1000 BISHOP ST STE 505 HONOLULU HI 96813 996005407 501(c)(3) 7000 0 GENERAL SUPPORT 14 0 FORM 990, SCHEDULE I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS THE HAWAI'I PACIFIC HEALTH ('HPH') DONATIONS COMMITTEE REVIEWS AND APPROVES DONATIONS TO 501(C)(3) & 501(C)(6) ORGANIZATIONS ON AN ANNUAL BASIS. NO FURTHER MONITORING IS NECESSARY FOR DONATIONS MADE TO 501(C)(3) ORGANIZATIONS. X X true true X X X X false true false false false false false false false RAYMOND P VARA JR Board of Dir, President & CEO 1110173 0 372487 0 719150 0 2558309 0 26194 0 4786313 0 593274 0 DAVID OKABE EVP, CFO & Treasurer 553990 0 132543 0 259799 0 362800 0 15096 0 1324228 0 224487 0 MARTHA SMITH VP (Part Year) 564852 0 138435 0 173452 0 292175 0 15896 0 1184810 0 182195 0 ARTHUR GLADSTONE EVP & CSO 516857 0 128098 0 171355 0 285469 0 23918 0 1125697 0 195252 0 CHARLES R CHING EVP, Gen. Counsel & Secretary 436925 0 104835 0 229141 0 262171 0 20008 0 1053080 0 164297 0 GAIL LERCH Former Officer 448776 0 107316 0 186247 0 294796 0 9718 0 1046853 0 176006 0 STEVEN ROBERTSON EVP & CIO 450338 0 108006 0 188448 0 276365 0 15796 0 1038953 0 172460 0 MELINDA ASHTON MD EVP & CQO 467643 0 111972 0 141224 0 233089 0 15600 0 969528 0 169135 0 JENNIE CHAHANOVICH EVP 381818 0 99404 0 179058 0 215398 0 12698 0 888376 0 133412 0 LESLIE CHUN MD EVP 532633 0 83827 0 48017 0 90427 0 23629 0 778533 0 0 0 RODNEY WILLIAMS MD CMO - SCH 245576 0 51984 0 281823 0 83641 0 13016 0 676040 0 47219 0 GERARD LIVAUDAIS MD EVP 410238 0 78825 0 34082 0 108525 0 15389 0 647059 0 71310 0 DOUGLAS KWOCK MD VP 407043 0 48037 0 36984 0 73862 0 22109 0 588035 0 45958 0 KENNETH B ROBBINS MD Former Officer 255484 0 0 0 90586 0 165414 0 14951 0 526435 0 219481 0 TRAVIS CLEGG COOO - SCH 336184 0 49405 0 20722 0 71416 0 24679 0 502406 0 0 0 GIDGET RUSCETTA RN COO - KMCWC 317467 0 51840 0 35002 0 80642 0 14051 0 499002 0 48845 0 DAWN DUNBAR SVP 299741 0 57822 0 35875 0 81124 0 23823 0 498385 0 65358 0 WARREN CHAIKO SVP 268426 0 52369 0 54937 0 84038 0 26568 0 486338 0 59768 0 MAVIS NIKAIDO System CNE 298793 0 38843 0 33425 0 70062 0 7371 0 448494 0 40312 0 SUSAN MASUMOTO-NONAKA VP 278475 0 39915 0 46239 0 71170 0 10271 0 446070 0 45567 0 BRANDT FARIAS SVP (PART YEAR) 249279 0 47553 0 30552 0 76212 0 9732 0 413328 0 50819 0 ANDY LEE MD MEDICAL DIRECTOR - HHP 302715 0 31200 0 24934 0 21375 0 23872 0 404096 0 0 0 MICHAEL ROBINSON VP 266844 0 38177 0 22458 0 64458 0 9732 0 401669 0 44010 0 BRIGITTE MCKALE VP/CNE - PMMC 258755 0 30524 0 25438 0 61466 0 13876 0 390059 0 28920 0 BEAU NAKAMOTO MD Board of Director 0 161849 0 5738 0 176122 0 11400 0 150 0 355259 0 0 EARL INOUYE Former Officer 201366 0 40705 0 43074 0 67586 0 1944 0 354675 0 46925 0 JAMES LIN MD VP 235544 26603 18953 0 31194 930 39945 2275 21768 2015 347404 31823 0 0 DAVID STUMBAUGH VP 217152 0 31699 0 17488 0 56827 0 22589 0 345755 0 34835 0 LORRIE-ANN LUKE VP 211025 0 30832 0 17998 0 57735 0 25176 0 342766 0 34527 0 WILLIAM BURKE VP 237450 0 16427 0 23154 0 43960 0 16671 0 337662 0 0 0 SUNSHINE TOPPING SVP 261580 0 0 0 27699 0 0 0 21615 0 310894 0 0 0 MONICA PRICE MD Board of Director 0 178273 0 12158 0 61525 0 9800 0 24627 0 286383 0 0 CARRIE ANN TSUTSUI VP & Controller 195857 0 17756 0 17265 0 41055 0 12358 0 284291 0 0 0 KATIE SHIGEMITSU Compliance Officer 221265 0 0 0 3421 0 23435 0 14690 0 262811 0 0 0 ALAN ITO Information Security Officer 185591 0 13070 0 1612 0 21083 0 14293 0 235649 0 0 0 MARK MAGELSSEN MD Board of Director 0 177463 0 279 0 18394 0 7195 0 12976 0 216307 0 0 JESSICA LEWIS Assistant Corporate Secretary 170876 0 0 0 0 0 15118 0 25286 0 211280 0 0 0 DAVID FOX Privacy Officer (Part Year) 160526 0 0 0 3089 0 16325 0 15781 0 195721 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 1A HEALTH AND SOCIAL CLUB DUES HEALTH/SOCIAL CLUB DUES WERE PAID FOR SIX OFFICERS OF THE ORGANIZATION. ALL AMOUNTS HAVE BEEN INCLUDED IN THE INDIVIDUAL'S FORM W-2 AS TAXABLE INCOME. HOUSING ALLOWANCE/RESIDENCE FOR PERSONAL USE HOUSING ALLOWANCES WERE PAID FOR ONE OFFICER OF THE ORGANIZATION. ALL AMOUNTS HAVE BEEN INCLUDED IN THE INDIVIDUALS FORM W-2 AS TAXABLE INCOME. FORM 990, SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 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. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $443,030 DAVID OKABE - $156,411 GAIL LERCH - $113,397 STEVEN ROBERTSON - $100,707 KENNETH B. ROBBINS, M.D. - $91,556 CHARLES R. CHING - $84,461 ARTHUR GLADSTONE - $77,843 MARTHA SMITH - $74,608 MELINDA ASHTON, M.D. - $61,798 JENNIE CHAHANOVICH - $47,714 ANNUAL INCENTIVE PLAN THE ANNUAL INCENTIVE PLAN is AFFORDED TO EXECUTIVES BASED ON ANNUAL SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $372,488 DAVID OKABE - $132,543 GAIL LERCH - $107,316 STEVEN ROBERTSON - $108,006 CHARLES R. CHING - $104,835 ARTHUR GLADSTONE - $128,098 MARTHA SMITH - $138,435 MELINDA ASHTON, M.D. - $111,972 JENNIE CHAHANOVICH - $99,404 LESLIE CHUN, M.D. - $83,827 GERARD LIVAUDAIS, M.D. - $78,824 DAWN DUNBAR - $57,822 WARREN CHAIKO - $52,368 RODNEY WILLIAMS, M.D. - $51,984 GIDGET RUSCETTA, R.N. - $51,840 TRAVIS CLEGG - $49,405 DOUGLAS KWOCK, M.D. - $48,037 BRANDT FARIAS - $47,553 EARL INOUYE - $40,705 SUSAN NONAKA - $39,915 MAVIS NIKAIDO - $38,843 MICHAEL ROBINSON - $38,177 DAVID STUMBAUGH - $31,700 LORRIE-ANN LUKE - $30,832 BRIGITTE MCKALE - $30,524 JAMES LIN, M.D. - $18,581 CARRIE ANN TSUTSUI - $17,756 WILLIAM BURKE - $16,427 RETENTION INCENTIVE PLAN THE RETENTION INCENTIVE PLAN WAS DESIGNED TO ENCOURAGE CONTINUED INTEREST IN THE SUCCESS OF THE ORGANIZATION AND PROVIDE COMPETITIVE RETIREMENT BENEFITS. THE SOLE PLAN PARTICIPANT IS HAWAI'I PACIFIC HEALTH'S CHIEF EXECUTIVE OFFICER, RAYMOND P. VARA JR. THE PLAN DOES NOT REPLACE THE ANNUAL AND LONG-TERM INCENTIVE PLAN NOR THE SERP RESTORATION PLAN. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR - $1,015,000 A STATE OF HAWAI'I - DEPARTMENT OF BUDGET & FINANCE 990266961 419800JX6 2013-10-03 159059332 SEE PART VI false false false B STATE OF HAWAI'I - DEPARTMENT OF BUDGET & FINANCE 990266961 2019-05-15 48079910 SEE PART VI false false false A 14475000 0 159068477 0 14284839 0 1995112 0 0 106439766 36348760 0 2016 true false true true B 3241590 0 48079910 0 0 0 493599 0 0 0 47586311 0 2019 true false true true A false true true true true true 0.00160 0.00000 0.00160 false true 0.01540 true B false true true true true true 0.00430 0.00430 false true 0.27000 true A false false false true false false 0 false 0 false true B false false false true false false 0 false 0 false true A true B true SCHEDULE K, PART I, COLUMN F DESCRIPTION OF PURPOSE OF TAX EXEMPT BONDS LINE A SERIES 2013-A IS NEW MONEY TO FUND THE Kapi'olani EXPANSION OF NEONATAL AND PEDIATRIC INTENSIVE CARE UNITS AND OTHER CLINICAL SERVICES. SERIES 2013-B IS REFUNDING SERIES 1998 BONDS ISSUED ON 04/08/1998 AND SERIES 2004-A BONDS ISSUED ON 01/14/2004. LINE B TO REFUND SERIES 2013-C BOND ISSUED 10/03/2013. SCHEDULE K, PART II, LINE 3 DIFFERENCE BETWEEN ISSUE PRICE AND TOTAL PROCEEDS THE DIFFERENCE IN ISSUE PRICE AND TOTAL PROCEEDS OF ISSUE IS DUE TO INVESTMENT EARNINGS. DATE OF REBATE COMPUTATION SCHEDULE K, PART IV, LINE 2C COLUMN A - 2013-AB - 01/10/2017 COLUMN B - 2019 - 07/10/2020 FORM 990, PART I, LINE 1 DESCRIPTION OF ORGANIZATION'S MISSION HAWAI'I PACIFIC HEALTH IS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, AND ONE OF THE STATE'S LARGEST HEALTH CARE PROVIDERS AND PRIVATE EMPLOYERS. HAWAI'I PACIFIC HEALTH'S MISSION IS TO CREATE A HEALTHIER HAWAI'I. FORM 990, PART III, LINE 4 PROGRAM SERVICE ACCOMPLISHMENTS OUTPATIENT OPERATING ROOMS IN FISCAL YEAR 2021, HAWAI'I PACIFIC HEALTH SPENT $62,130,342 IN DIRECT EXPENSES FOR OUTPATIENT OPERATING ROOMS AND SURGICAL PROCEDURES, AS PART OF OUR COMMITMENT TO PROVIDE CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. HAWAI'I PACIFIC HEALTH HOSPITALS PERFORMED A TOTAL OF 13,449 OUTPATIENT SURGERIES. KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN (KAPI'OLANI) IS THE ONLY HOSPITAL IN THE STATE PROVIDING DA VINCI ROBOT-AIDED PEDIATRIC SURGERY. THE ROBOT ALSO IS USED FOR GYNECOLOGICAL SURGICAL SERVICES. IN FISCAL YEAR 2021, KAPI'OLANI PERFORMED 4,341 PEDIATRIC AND ADULT OUTPATIENT SURGERIES. PALI MOMI MEDICAL CENTER'S (PALI MOMI) OPERATING ROOM FEATURES A FULLY INTEGRATED, MINIMALLY INVASIVE SURGICAL SUITE EQUIPPED WITH THE DA VINCI ROBOT-AIDED SURGICAL SYSTEM, AND PERFORMED 3,657 OUTPATIENT SURGERIES. STRAUB CLINIC AND HOSPITAL (STRAUB) HAS INTEGRATED OUTPATIENT SURGERY AND PERFORMED 3,872 OUTPATIENT SURGERIES. WILCOX MEMORIAL HOSPITAL (WILCOX) HAS A STATE-OF-THE-ART SURGICAL CENTER AND PERFORMED 3,369 OUTPATIENT SURGERIES. OUTPATIENT EMERGENCY ROOMS IN FISCAL YEAR 2021, HAWAI'I PACIFIC HEALTH HOSPITALS HAD 91,513 OUTPATIENT ER VISITS AND SPENT $53,537,856 IN DIRECT EXPENSES FOR OUTPATIENT ER SERVICES, AS PART OF OUR MISSION TO PROVIDE CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. THE KAPI'OLANI ER HAD 24,333 OUTPATIENT ER VISITS, THE PALI MOMI ER HAD 33,857 OUTPATIENT ER VISITS, THE STRAUB ER HAD 25,894 OUTPATIENT ER VISITS, AND THE WILCOX ER HAD 17,591 OUTPATIENT ER VISITS. PEDIATRIC-NEONATAL SERVICES IN FISCAL YEAR 2021, HAWAI'I PACIFIC HEALTH SPENT $50,376,770 IN DIRECT EXPENSES FOR PEDIATRIC-NEONATAL SERVICES, AS PART OF OUR COMMITMENT TO PROVIDE CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. THESE SERVICES WERE PROVIDED PRIMARILY AT KAPI'OLANI AND WILCOX FOR A TOTAL OF 3,774 PATIENTS. KAPI'OLANI IS RECOGNIZED AS HAWAI'I'S ONLY FULL-SERVICE SPECIALTY HOSPITAL FOR CHILDREN, AND ALSO PROVIDES CARE FOR PEDIATRIC PATIENTS THROUGHOUT THE PACIFIC REGION. IT HAS THE ONLY OPEN INTENSIVE CARE UNITS IN HAWAI'I TO TREAT CRITICALLY-ILL CHILDREN AND INFANTS. IN FISCAL YEAR 2021, KAPI'OLANI PROVIDED SPECIALIZED CARE FOR 3,628 PEDIATRIC-NEONATAL PATIENTS. WILCOX PROVIDES PREVENTIVE CARE AND TREATMENT SERVICES TO MEET THE HEALTH NEEDS OF KAUA'I'S CHILDREN. IN FISCAL YEAR 2021, WILCOX PROVIDED SPECIALIZED CARE FOR 146 PEDIATRIC-NEONATAL PATIENTS. OTHER PROGRAM SERVICES HAWAI'I RESIDENTS AND VISITORS RELY ON HAWAI'I PACIFIC HEALTH FOR ITS FULL RANGE OF PRIMARY, SECONDARY AND SELECT TERTIARY CARE SERVICES. IT IS ONE OF THE STATE'S LARGEST HEALTH CARE SYSTEMS WITH FOUR MEDICAL CENTERS, MORE THAN 70 LOCATIONS, 1,500+ AFFILIATED PHYSICIANS AND MORE THAN 7,000 FULL AND PART-TIME EMPLOYEES, AS WELL AS HUNDREDS OF COMMUNITY VOLUNTEERS. IN FISCAL YEAR 2021, THE MEDICAL CENTERS ADMITTED 28,355 PATIENTS. IN ADDITION, PALI MOMI CLINICS HAD 63,168 PATIENT CLINIC ENCOUNTERS, STRAUB CLINICS HAD 998,249 PATIENT CLINIC ENCOUNTERS, KAUA'I MEDICAL CLINIC HAD 261,667 PATIENT CLINIC ENCOUNTERS AND KAPI'OLANI MEDICAL SPECIALISTS HAD 125,093 PATIENT CLINIC ENCOUNTERS. AFFILIATES AND SUBSIDIARIES HAWAI'I HEALTH PARTNERS IS A PHYSICIAN-LED ACCOUNTABLE CARE ORGANIZATION WITH THE GOAL OF PROVIDING HIGH-QUALITY CARE, INCREASED EFFICIENCY AND OPTIMAL PATIENT HEALTH. KAPI'OLANI MEDICAL SPECIALISTS IS A SPECIALTY PHYSICIANS GROUP ORGANIZED TO SUPPORT KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN. THE FOUNDATIONS OF HAWAI'I PACIFIC HEALTH CONSIST OF KAPI'OLANI HEALTH FOUNDATION, PALI MOMI FOUNDATION, STRAUB FOUNDATION AND WILCOX HEALTH FOUNDATION. THESE CHARITABLE ENTITIES SUPPORT HEALTH RESEARCH, FACILITY ENHANCEMENTS, TECHNOLOGY INVESTMENTS, EDUCATIONAL PROGRAMS AND OTHER RESOURCES FOR THEIR RESPECTIVE MEDICAL CENTERS. HAWAI'I HEALTH PARTNERS, INC. IS A FOR-PROFIT SUBSIDIARY THAT SERVES AS THE JOINT VENTURE PARTNER WHEN HAWAI'I PACIFIC HEALTH WORKS WITH OTHER PROVIDERS. PROVIDERS INSURANCE CORPORATION IS A CAPTIVE INSURANCE COMPANY THAT PROVIDES PROFESSIONAL LIABILITY INSURANCE FOR HAWAI'I PACIFIC HEALTH-AFFILIATED EMPLOYED PHYSICIANS. PATIENT CARE HAWAI'I PACIFIC HEALTH HAS STRATEGIC INITIATIVES IN WOMEN'S HEALTH, PEDIATRIC CARE, CARDIOVASCULAR SERVICES, BONE & JOINT SERVICES, AND CANCER CARE. IT IS RECOGNIZED NATIONALLY FOR ITS EXCELLENCE IN HEALTH INFORMATION TECHNOLOGY, SPECIFICALLY THE USE OF ELECTRONIC HEALTH RECORDS TO IMPROVE QUALITY OF CARE AND PATIENT SAFETY. THE HAWAI'I PACIFIC HEALTH SYSTEM INCLUDES THE PACIFIC REGION'S ONLY FULL-SERVICE WOMEN'S AND CHILDREN'S MEDICAL CENTER AND ONLY DEDICATED BURNUNIT, STATE-OF-THE-ART IMAGING CENTER ON KAUA'I, WEST O'AHU'S ONLY CARDIAC CATHETERIZATION LABS AND COMPREHENSIVE CANCER CENTER, MINIMALLY INVASIVE BONE & JOINT CENTERS, THE STATE'S FIRST WOMEN'S CENTER, THE STATE'S ONLY BREAST AND WOMEN'S CANCER CENTERS, AND OTHER SPECIALIZED SERVICES CONSIDERED CRITICAL TO THE REMOTE HAWAIIAN ARCHIPELAGO. COMMUNITY ROLE/ACTIVITY AS ONE OF THE STATE'S LARGEST HEALTH CARE SYSTEMS, HAWAI'I PACIFIC HEALTH HAS A RESPONSIBILITY TO IMPROVE THE HEALTH OF HAWAI'I RESIDENTS AND, THROUGH ITS MISSION, IS COMMITTED TO CREATING A HEALTHIER HAWAI'I. EACH YEAR, HAWAI'I PACIFIC HEALTH SPONSORS HEALTH EDUCATION, TEACHING AND RESEARCH, AND SUPPORTS LIKE-MINDED ORGANIZATIONS. IN FISCAL YEAR 2021, HAWAI'I PACIFIC HEALTH SERVED AS A STATEWIDE RESOURCE TO THE COMMUNITY IN RESPONSE TO EVER-CHANGING HEALTH NEEDS BASED ON THE PANDEMIC. COVID-19 INITIATIVES BY THE SYSTEM INCLUDED FREE COMMUNITY VACCINE CLINICS, COMMUNITY TESTING SITES AT ITS MEDICAL FACILITIES AND DIRECTLY IN NEIGHBORHOODS THROUGH MOBILE OUTREACH EVENTS, RESPIRATORY CLINICS AND TELEHEALTH OPTIONS. OTHER COMMUNITY RESOURCES THAT HAWAI'I PACIFIC HEALTH PROVIDED WERE PUBLIC HEALTH EDUCATION, A FREE EMPLOYER COVID HOTLINE TO HELP NAVIGATE SAFE WORK ENVIRONMENTS AND A COHESIVE PUBLIC HEALTH RESPONSE IN COLLABORATING WITH THE DEPARTMENT OF HEALTH AND OTHER HEALTH CARE PROVIDERS. HAWAI'I PACIFIC HEALTH ALSO CONTINUED TO SUPPORT VARIOUS COMMUNITY BENEFIT PROGRAMS, INCLUDING THE KAPI'OLANI SEX ABUSE TREATMENT CENTER, KAPI'OLANI CHILD ADVOCACY AND PROTECTION CENTER, HEART DISEASE PREVENTION, BREAST AND CERVICAL CANCER SCREENING FOR UNINSURED PERSONS, WOMEN AND INFANT HEALTH AND NUTRITION, REHABILITATION SERVICES, SUPPORT GROUPS THAT MET VIRTUALLY, HEMOPHILIA PROGRAMS, AND OTHER EDUCATION AND SCREENINGS FOR HAWAI'I RESIDENTS ON HEALTH, WELLNESS AND DISEASE-PREVENTION STRATEGIES. IN FISCAL YEAR 2021, HAWAI'I PACIFIC HEALTH SPONSORED OR SUPPORTED NUMEROUS HEALTH EVENTS, INCLUDING "AHA HEARTWALK," "SUSAN G. KOMEN RACE FOR THE CURE," "ARTHRITIS FOUNDATION'S ARTHRITIS WALK," - ALL HELD VIRTUALLY THIS YEAR - AND MORE. HAWAI'I PACIFIC HEALTH ALSO SERVED AS THE PRESENTING SPONSOR FOR THE VIRTUAL GREAT ALOHA RUN AND VIRTUAL KEIKI GREAT ALOHA RUN. PROCEEDS FROM THE EVENT BENEFIT MORE THAN 150 NONPROFIT ORGANIZATIONS IN HAWAI'I. HAWAI'I PACIFIC HEALTH ALSO PARTICIPATED IN SYMPOSIA AND MEETINGS FOR HEALTH CARE PROFESSIONALS, HIRED STUDENTS AS SUMMER INTERNS, FACILITATED CLINICAL TRAINING PROGRAMS FOR PUBLIC HIGH SCHOOL STUDENTS TO EARN NATIONAL CERTIFICATION IN MEDICAL FIELDS AND SPONSORED WORKSHOPS FOR VOLUNTEERS. TO TRAIN HEALTH CARE PROVIDERS, HAWAI'I PACIFIC HEALTH HAS ALLIANCES WITH THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE AND HAWAI'I PACIFIC UNIVERSITY. HAWAI'I PACIFIC HEALTH INVESTS EACH YEAR IN TEACHING AND RESEARCH AS A PEDIATRIC AND OB-GYN TRAINING FACILITY FOR THE UNIVERSITY OF HAWAI'I. HAWAI'I PACIFIC HEALTH IS ALSO ACTIVELY INVOLVED IN CLINICAL TRIALS AND RESEARCH THROUGH ITS VARIOUS FACILITIES IN PEDIATRICS, ONCOLOGY, OPHTHALMOLOGY AND CARDIOLOGY. PUBLIC POLICY HAWAI'I PACIFIC HEALTH HAS A RESPONSIBILITY TO OFFER THOUGHTFUL AND INNOVATIVE INPUT TO LAWMAKERS REGARDING HEALTH CARE POLICY AND LEGISLATION. HAWAI'I PACIFIC HEALTH LEADERS ADVOCATE FOR LEGISLATIVE REFORM AND REGULATORY ENHANCEMENTS FOR VARIOUS HEALTH CARE INDUSTRY ISSUES RANGING FROM RETAINING PHYSICIANS IN THE STATE TO PROVIDING STABILITY FOR HEALTH CARE PROVIDERS. OTHER HAWAI'I PACIFIC HEALTH MEDICAL CENTERS TREAT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS A SAFETY NET PROVIDER OF HEALTH CARE FOR THE COMMUNITY. AN ESTABLISHED CHARITY CARE POLICY SETS GUIDELINES BY WHICH IT IS DETERMINED IF PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. HAWAI'I PACIFIC HEALTH CONTRIBUTES MORE THAN $1 BILLION TO THE STATE ECONOMY EACH YEAR, SUPPORTING ITS MORE THAN 7,000 EMPLOYEES, THEIR FAMILIES, AND MANY BUSINESSES THROUGH PURCHASES MADE BY ITS MEDICAL CENTERS AND CLINICS. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF THE FORM 990 BY THE ORGANIZATION'S GOVERNING BODY VARIOUS SCHEDULES OF THE FORM 990 ARE PREPARED BY STAFF WITHIN THE ACCOUNTING AREA OF THE ORGANIZATION WORKING WITH VARIOUS OTHER AREAS OF THE ORGANIZATION SUCH AS MANAGEMENT OF THE OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPILED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYSTEM REVIEWS THE FORM 990 OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGMENT HAS COMPLETED ITS REVIEW, THE FORMS 990 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 FORM 990 REPORTING AND REVIEWS THE FORM 990 FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE FORM 990 FOR EACH ENTITY IS MADE AVAILABLE TO THE BOARD MEMBERS OF EACH SUBSIDIARY UNIT OF HPH AND THE HPH BOARD OF DIRECTORS THROUGH A BOARD MEMBER PORTAL FOR REVIEW PRIOR TO THE FILING OF THE FORM 990. THE FORMS 990 WILL BE POSTED TO HPH'S WEBSITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURNS WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MONITORING & ENFORCEMENT OF CONFLICT OF INTEREST POLICY 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 COI POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) HAS DISCLOSED ANY CONFLICTS OR POTENTIAL CONFLICTS OR ECONOMIC INTERESTS AS REQUIRED; AND 5) 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. FORM 990, PART VI, SECTION B, LINES 15A & 15B PROCESS OF DETERMINING COMPENSATION COMPENSATION FOR HPH EXECUTIVES IS SET BY THE INDEPENDENT BOARD MEMBERS OF THE HAWAI'I PACIFIC BOARD'S COMPENSATION COMMITTEE. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE'S COMPENSATION AND BENEFITS. THE CONSULTANT PROVIDES A WRITTEN REPORT TO THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING. INCLUDED IN THE REPORT IS MARKET BASED DATA FROM LIKE ORGANIZATIONS. THE COMPENSATION COMMTTIEE MAKES A FINAL DECISIONS REGARDING COMPENSATION AND BENEFITS AT THE MEETING AFTER REVIEW AND DISCUSSION OF THE CONSULTANT'S REPORT. COMMUNITY BASED DIRECTORS OF THE ORGANIZATION ARE NOT COMPENSATED. CERTAIN EMPLOYED PHYSICIANS MAY BE OFFICERS OR AN IDENTIFIED KEY EMPLOYEE OF THE REPORTING OR RELATED ORGANIZATION. PHYSICIAN COMPENSATION IS ALSO HANDLED IN THE SAME MANNER AS EXECUTIVE COMPENSATION, WITH THE HPH COMPENSATION COMMITTEE RECEIVING A REPORT FROM A NEUTRAL CONSULTANT AND FOLLOWING THE SAME PROCESS AS DESCRIBED ABOVE ON AN ANNUAL BASIS. THIS PROCESS WAS MOST RECENTLY COMPLETED ON MARCH 09, 2021 TO REVIEW PHYSICIAN COMPENSATION AND ON JULY 28, 2021 TO REVIEW EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DISCLOSURE OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS DISCLOSURE OF GOVERNING DOCUMENTS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND STANDARDS OF CONDUCT ARE AVAILABLE ON THE HAWAI'I PACIFIC HEALTH WEBSITE. THE CONSOLIDATED AUDITED FINANCIAL STATAEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE HAWAI'I PACIFIC HEALTH WEBSITE. FORM 990, PART XI, LINE 9 other changes in net assets OBLIGATED GROUP INTERCOMPANY TRANFERS $128,115,327 PENSION AND POST RETIREMENT ADJUSTMENTS $56,910,554 CHANGE IN INTEREST IN KHF AND WHF $18,634,536 EQUITY OF UNCONSOLIDATED SUBS $4,926,357 CHANGE IN SWAP $904,260 NON CONTROLLING INTEREST $(119,565) EQUITY TRANSFERS WITH AFFILIATES $(94,357,023) --------------- TOTAL $115,014,446 Hawai'i Health Partners 55 Merchant Street 24th Floor Honolulu HI 96813 352480297 HEALTHCARE HI 5197558 11014851 HPH KAPI'OLANI MED CTR FOR WOMEN & CHILDREN 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990274038 HOSPITAL HI 501(c)(3) 3 HPH true STRAUB CLINIC & HOSPITAL 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 912151670 HOSPITAL HI 501(c)(3) 3 hph true PALI MOMI FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 383840327 FUNDRAISING HI 501(c)(3) 7 HPH true STRAUB FOUNDATION 55 MERCHANT STREET 26TH FLOOR HONOLULU HI 96813 990109350 FUNDRAISING HI 501(c)(3) 7 HPH true PALI MOMI MEDICAL CENTER 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990274038 HOSPITAL HI 501(c)(3) 3 HPH true WILCOX HEALTH FOUNDATION 3-3420 KUHIO HIGHWAY LIHUE HI 96766 990204242 FUNDRAISING HI 501(c)(3) 7 HPH true WILCOX MEMORIAL HOSPITAL 3-3420 KUHIO HIGHWAY LIHUE HI 96766 990074365 HOSPITAL HI 501(c)(3) 3 HPH true KAUA'I MEDICAL CLINIC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990326099 HOSPITAL HI 501(c)(3) 3 HPH true PROVIDERS INSURANCE CORPORATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 710893000 INSURANCE HI 501(c)(3) 12B, II HPH true KAPI'OLANI HEALTH FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246364 FUNDRAISING HI 501(c)(3) 7 HPH true KAPI'OLANI MEDICAL SPECIALISTS 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990322406 HEALTHCARE HI 501(c)(3) 3 HPH true ASC PACIFIC VENTURES LLC 3000 riverchase galleria ste 500 birmingham AL 35244 270540034 AMBU. SURG. CTR. AL NA N/A INVISION LLC MRI CENTER HI NA N/A MAUI CANCER CENTER PETCT LLC INACTIVE HI NA N/A MAUI CANCER CTR PROPERTY CO LLC INACTIVE HI NA N/A HAWAI'I PACIFIC HEALTH PARTNERS INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990318588 HOLDING COMPANY HI NA C Corp 5009754 72213363 1.00000 true STRAUB PHARMACY INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990145107 INACTIVE HI SCH C Corp 0 0 true HICORD INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990251496 INVESTMENT HI HPHPI C Corp 0 0 true false true true false false false false false false false false false false false true true true true true KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN b 178206 FMV KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN s 267858015 FMV KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN q 4679269 FMV KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN o 12562012 FMV KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN p 187623459 FMV KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN r 7011096 FMV PROVIDER'S INSURANCE CORPORATION q 65720 FMV PROVIDER'S INSURANCE CORPORATION c 1098254 FMV PROVIDER'S INSURANCE CORPORATION o 389399 FMV PROVIDER'S INSURANCE CORPORATION p 10126284 FMV KAPI'OLANI HEALTH FOUNDATION b 54717 FMV KAPI'OLANI HEALTH FOUNDATION o 539114 FMV KAPI'OLANI HEALTH FOUNDATION p 1745257 FMV KAPI'OLANI HEALTH FOUNDATION r 161219 FMV KAPI'OLANI MEDICAL SPECIALISTS b 92776012 FMV KAPI'OLANI MEDICAL SPECIALISTS s 3155092 FMV KAPI'OLANI MEDICAL SPECIALISTS q 1706040 FMV KAPI'OLANI MEDICAL SPECIALISTS o 225903913 FMV KAPI'OLANI MEDICAL SPECIALISTS p 46546108 FMV PALI MOMI MEDICAL CENTER b 106997 FMV PALI MOMI MEDICAL CENTER q 6637435 FMV PALI MOMI MEDICAL CENTER s 208126868 FMV PALI MOMI MEDICAL CENTER o 10993197 FMV PALI MOMI MEDICAL CENTER p 167333370 FMV PALI MOMI MEDICAL CENTER r 2011308 FMV STRAUB CLINIC & HOSPITAL b 94712 FMV STRAUB CLINIC & HOSPITAL q 18820285 FMV STRAUB CLINIC & HOSPITAL s 314600793 FMV STRAUB CLINIC & HOSPITAL o 16197265 FMV STRAUB CLINIC & HOSPITAL r 3281529 FMV STRAUB CLINIC & HOSPITAL p 277525065 FMV STRAUB FOUNDATION b 233787 FMV STRAUB FOUNDATION c 276213 FMV STRAUB FOUNDATION p 677380 FMV STRAUB FOUNDATION r 174033 FMV STRAUB FOUNDATION o 575153 FMV WILCOX MEMORIAL HOSPITAL b 52655 FMV WILCOX MEMORIAL HOSPITAL s 91628929 FMV WILCOX MEMORIAL HOSPITAL q 2988053 FMV WILCOX MEMORIAL HOSPITAL o 8330537 FMV WILCOX MEMORIAL HOSPITAL r 169562 FMV WILCOX MEMORIAL HOSPITAL p 89787347 FMV WILCOX HEALTH FOUNDATION b 106587 FMV WILCOX HEALTH FOUNDATION p 222333 FMV WILCOX HEALTH FOUNDATION o 491715 FMV KAUA'I MEDICAL CLINIC b 13723816 FMV KAUA'I MEDICAL CLINIC s 3360552 FMV KAUA'I MEDICAL CLINIC c 2000000 FMV KAUA'I MEDICAL CLINIC o 306239 FMV KAUA'I MEDICAL CLINIC p 9035885 FMV HAWAI'I PACIFIC HEALTH PARTNERS INC o 199220 FMV HAWAI'I PACIFIC HEALTH PARTNERS INC p 138987 FMV PALI MOMI FOUNDATION b 184540 FMV PALI MOMI FOUNDATION o 468231 FMV PALI MOMI FOUNDATION p 254290 FMV HONOLULU SURGERY CENTER p 660292 FMV SCHEDULE R, PART III RELATED ORGANIZATIONS TAXABLE AS PARTNERSHIP: ASC PACIFIC VENTURES, LLC EIN: 27-0540034 ADDRESS: 55 MERCHANT ST., 27TH FLOOR, HONOLULU, HI 96813 INVISION, LLC EIN: 20-8565615 ADDRESS: 1010 SOUTH KING STREET HONOLULU, HI 96813 MAUI CANCER CENTER PET/CT, LLC EIN: 26-0163883 ADDRESS: 227 MAHALANI ST., STE. 107 WAILUKU, HI 96793 MAUI CANCER CENTER PROPERTY COMPANY, LLC EIN: 26-0146602 ADDRESS: 227 MAHALANI ST., STE. 107 WAILUKU, HI 96793