2021-05-14T13:58:06-05:00 2020-06-30 ERNST & YOUNG US LLP 4365 EXECUTIVE DR 1600 SAN DIEGO CA 92121 990 2019-07-01 990073524 THE QUEEN'S MEDICAL CENTER % CLINTON YEE QUEE 8085389011 1301 PUNCHBOWL STREET HONOLULU HI 96813 PAUL MCDOWELL TREASURER 2021-05-11 true JOCELYNE MILLER P00634378 8585357200 2021-05-04 2019 2022-09-23 18:48:47Z JASON CHANG 1301 PUNCHBOWL STREET HONOLULU HI 96813 1858567647 false X WWW.QUEENS.ORG X 1859 HI TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE QUALITY HEALTHCARE TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII. 21 17 5771 330 11764599 0 58025207 68788935 1118237520 1154187066 32483732 29878302 20967773 21122277 1229714232 1273976580 3320519 3688193 0 0 544192128 596025841 0 0 199026 561402203 580929258 1108914850 1180643292 120799382 93333288 2117525376 2563409000 1137700085 1535779079 979825291 1027629921 X THE MISSION OF QMC IS TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE, IN PERPETUITY, QUALITY HEALTHCARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII. false false 1130224861 3688193 1164893686 THE QUEEN'S MEDICAL CENTER IS THE LARGEST PRIVATE, NONPROFIT ACUTE CARE MEDICAL FACILITY IN HAWAII. ITS STAFF IS DEDICATED TO PROVIDING QUALITY HEALTH CARE TO THE PEOPLE OF HAWAII AND THE PACIFIC. SEE SCHEDULE O FOR MORE INFORMATION. 1130224861 true true false true false false false false false true true true false true true true false true false false true false false false true false true true true false true true false false false false false false false false false false true false false false true true true true false false true 0 0 5771 true true true false false false false true true false false false false false false X 21 17 false false false false true true true true true false false true false false false false false true true X CLINTON YEE 8085389011 1301 PUNCHBOWL STREET HONOLULU HI 96813 ARTHUR USHIJIMA TRUSTEE/PRESIDENT - PART YEAR 25.0 40.0 X X 0 1475521 75855 JEFFREY LOH MD PHYSICIAN 50.0 0.0 X 1215517 0 48157 WHITNEY LIMM MD SENIOR VICE PRESIDENT 12.0 48.0 X 0 765436 184838 PETER TSAI MD PHYSICIAN 50.0 0.0 X 900879 0 31075 TODD SETO MD PHYSICIAN 50.0 0.0 X 844069 0 51095 JASON CHANG PRESIDENT 25.0 30.0 X 740671 0 129924 MICHEL RICCIONI TREASURER 20.0 45.0 X 0 748504 120576 SUNG BAE LEE MD PHYSICIAN 50.0 0.0 X 809077 0 54389 ERIC MARTINSON FORMER TREASURER 0.0 60.0 X 0 669115 136516 OMAR ABDUL GHANI PHYSICIAN 50.0 0.0 X 688878 0 35381 JOHN NITAO VP/GENERAL COUNSEL 2.0 53.0 X 0 541209 105736 SUSAN MURRAY VP/COO - 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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, 2020. 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X X X X X X true true X X X X true X SEE PART V, SECTION C X SEE SECTION C X SEE SECTION C X X X X X X X true X false 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 OUR CONSULTANT, ISLANDER INSTITUTE CREATED AN INITIAL LIST OF PEOPLE WHO COULD SHED LIGHT ON QUESTIONS OF HEALTH, SOCIAL DETERMINANTS, AND THE CIRCUMSTANCES IN VARIOUS COMMUNITIES. THE INITIAL LIST INCLUDED EXPERTS AND AUTHORITIES WITH WHOM ISLANDER INSTITUTE HAD EXISTING RELATIONSHIPS BASED ON ITS MANY YEARS OF WORKING IN HAWAII. THROUGHOUT THE MONTHS OF CONVERSATIONS, PEOPLE SUGGESTED OTHERS TO TALK TO AND HELPED MAKE CONNECTIONS. IN TOTAL, ISLANDER INSTITUTE SPOKE WITH ROUGHLY 200 PEOPLE FROM SIX ISLANDS IN PERSON OR OVER THE PHONE, IN A ONE-ON-ONE FORMAT OR IN SMALL GROUPS, AND IN FORMAL OR INFORMAL SETTINGS. A FULL LIST OF KEY INFORMANTS WHOSE VIEWS INFLUENCED THIS REPORT CAN BE FOUND IN APPENDIX E OF THE CHNA. THE CONVERSATIONS BEGAN WITH A FEW GENERAL QUESTIONS, AND KEY INFORMANTS WERE ENCOURAGED TO DELVE INTO WHATEVER THEY FELT WAS MOST IMPORTANT TO SHARE. WHEN APPROPRIATE, THEY SHARED ABOUT THEIR OWN PERSONAL EXPERIENCES AND/OR PROFESSIONAL CONNECTION TO HEALTH. AMONG THE KEY INFORMANTS, ISLANDER INSTITUTE ALSO MET WITH REPRESENTATIVES OF EACH OF THE 19 PARTICIPATING HOSPITAL FACILITIES TO BEST UNDERSTAND THEIR ENGAGEMENT WITH THE CHNA AND THE COMMUNITIES THEY SERVE. THESE CONVERSATIONS HELPED ILLUMINATE INTERESTS, CAPACITIES, AND MISSIONS OF EACH FACILITY AND SHED LIGHT ON LIMITATIONS AND USES OF PREVIOUS CHNAS AND THE POTENTIAL FOR THIS CHNA. AS PART OF THE 2013 AND 2015 CHNAS, KEY INFORMANTS WERE ALSO INTERVIEWED. A FEW OF THE SAME PERSONS PARTICIPATED IN THE 2018 CHNA PROCESS, WHILE OTHERS FELT THEY HAD ALREADY SHARED WHAT THEY HAD TO SAY IN THE PREVIOUS PROCESS(ES). RATHER THAN RE-INTERVIEW MANY OF THE SAME PEOPLE IN THE SAME POSITIONS, ISLANDER INSTITUTE OBTAINED THE INFORMANT INTERVIEW NOTES FROM THE PAST TWO CHNAS, REVIEWED THEM, AND INCORPORATED THOSE VIEWS THAT WERE STILL TIMELY INTO THIS PROCESS. A FULL LIST OF THE REVIEWED PAST INTERVIEWS CAN BE FOUND IN APPENDIX F OF THE CHNA. 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 KAHI MOHALA 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 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 ISLANDER INSTITUTE TO CONDUCT A CHNA FOR HAWAII COUNTY. SCHEDULE H, PART V, SECTION B, LINE 7A & 10A WEBSITE WHERE THE QUEEN'S MEDICAL CENTER FACILITY'S CHNA CAN BE ACCESSED: https://www.queens.org/about-us/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: 1. SECURE THE BASIC FOUNDATIONS SO THAT PEOPLE CAN HAVE MORE CONTROL OVER THEIR OWN HEALTH; 1.1 ADDRESS FINANCIAL INSECURITY 1.2 WORK TOGETHER FOR EQUALITY AND JUSTICE 1.3 STRENGTHEN FAMILIES 1.4 PREPARE FOR EMERGENCIES 1.5 BUILD GOOD FOOD SYSTEMS 2. PRESERVE, NURTURE, EXPAND, AND EMPLOY THE HEALING PROPERTIES OF COMMUNITY; 2.1 RESTORE ENVIRONMENT AND SENSE OF PLACE 2.2 NURTURE COMMUNITY IDENTITY AND COHESIVENESS 2.3 INVEST IN TEENAGERS AND HEALTHY STARTS 2.4 SHIFT KUPUNA AWAY FROM "SICK CARE" 3. IMPROVE THE RELATIONSHIP BETWEEN PEOPLE AND THE HEALTHCARE SYSTEM 3.1 STRENGTHEN TRUST IN HEALTHCARE 3.2 PROVIDE ACCESSIBLE, PROACTIVE SUPPORT FOR THOSE WITH HIGH NEEDS 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 IDENTIFIED IN THIS ASSESSMENT AND SELECTED GOAL 3.2 AS THE GOAL FOR THE SYSTEM. (QUEEN'S SENIOR MANAGEMENT TEAM INCLUDES THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, OPERATING ENTITY HEADS, CLINICAL LEADERS [PHYSICIANS AND SERVICE LINES], AND THOSE RESPONSIBLE FOR SYSTEM-WIDE FUNCTIONS SUCH AS HUMAN RESOURCES, FINANCE, ENDOWMENT, LEGAL, CORPORATE DEVELOPMENT, INFORMATION TECHNOLOGY, AND COMMUNITY DEVELOPMENT). STATEWIDE PRIORITY 3.2 WAS IDENTIFIED AS A HIGHEST NEED AREA ON THE ISLANDS OF HAWAII, MAUI, MOLOKAI, AND OAHU. AS QHS HAS HOSPITALS ON THREE OF THESE ISLANDS, ALL OF THE HOSPITALS, INCLUDING QMC, SELECTED THIS PRIORITY AS THEIR PRIORITY AREA. THE REASONS CONSIDERED IN SELECTING THIS PRIORITY INCLUDE: 1. QUEEN'S MISSION AND THE FOCUS ON NATIVE HAWAIIANS... "TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE IN PERPETUITY QUALITY HEALTH CARE SERVICES TO IMPROVE THE WELLBEING OF NATIVE HAWAIIANS AND ALL OF THE PEOPLE OF HAWAII." 2. NATIVE HAWAIIANS HAVE POORER HEALTH STATUS AND HIGHER CHRONIC DISEASE RISK IN COMPARISON TO OTHER ETHNIC GROUPS. 2.1 THEY HAVE A LOWER LIFE EXPECTANCY (6.2 YEARS LOWER THAN OVERALL RESIDENTS OF HAWAII) AND HIGHER MORTALITY RATES THAN ALL OTHER ETHNICITIES. 2.2 NATIVE HAWAIIANS' HIGHER RISK FOR CHRONIC DISEASE RESULTS FROM HIGHER PREVALENCE OF OBESITY, SMOKING, AND CHRONIC ALCOHOL USE. 2.3 LEADING CAUSES OF DEATH IN WHICH NATIVE HAWAIIANS ARE DISPROPORTIONATELY REPRESENTED INCLUDE DIABETES, HEART DISEASE, AND CANCER. 3. AS PART OF QHS' SYSTEM-WIDE GOAL "MALAMA COMMUNITY ... SIGNIFICANTLY IMPACT UNMET COMMUNITY HEALTH CARE NEEDS IN OUR COMMUNITY," WE ARE UPDATING OUR NATIVE HAWAIIAN HEALTH STRATEGIC PLAN, CALLED KAHUA OLA. UNDERTAKING INITIATIVES TO ADDRESS THIS STATEWIDE PRIORITY WOULD ALIGN WELL WITH KAHUA OLA. STRATEGIES: 1. IMPROVE ACCESS TO HEALTH CARE SERVICES (FY2020 - FY2022) 1.1 REDUCE BARRIERS TO ACCESSING PRIMARY CARE AND SPECIALTY CARE IN THE WEST O'AHU COMMUNITY (E.G., INCREASING ACCESS TO TRANSPORTATION, SUPPORTING NAVIGATION OF PATIENTS THROUGHOUT CONTINUUM OF CARE). 1.2 WORK WITH COMMUNITY ORGANIZATIONS TO IMPROVE ACCESSIBILITY TO QUEEN EMMA CLINICS SERVICES FOR AT-RISK YOUTH. 2. PROMOTE QUALITY PATIENT CARE AND PATIENT ENGAGEMENT BY INCREASING CULTURAL AWARENESS, KNOWLEDGE, AND PRACTICES (FY2020 - FY2022) 2.1 EXPAND SERVICES AND SUPPORT FOR PROVIDERS, STAFF, AND COMMUNITY TO ENHANCE CULTURAL AWARENESS AND PRACTICE AT QMC-WO. 2.2 COLLABORATE WITH KAPI'OLANI COMMUNITY COLLEGE TO REDESIGN THE COURSE CURRICULUM FOR THE COMMUNITY HEALTH WORKER PROGRAM TO INCLUDE CULTURALLY-RESPONSIVE APPROACHES. FOR OTHER AREAS NOT DIRECTLY ADDRESSED, THE QUEEN'S MEDICAL CENTER RECOGNIZES THE IMPORTANCE OF THESE NEEDS AND HAS SUPPORTED EFFORTS TO ADDRESS MANY OF THEM. ALTHOUGH QMC WILL NOT DIRECTLY BE ADDRESSING ALL AREAS OF NEED, 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, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY IS WIDELY AVAILABLE ON THE QUEEN'S MEDICAL CENTER WEBSITE AT: https://www.queens.org/the-queens-medical-center/patients-and-visitors/pay -your-bill/pay-your-bill-qmc. 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. 28 QMC West Oahu Specialty Clinics 91-2135 Fort Weaver Road Ste 401 EWA BEACH HI 96706 Outpatient Specialty Clinics Queen's HeartGeriatrics 550 S Beretania Street Ste 601 HONOLULU HI 96813 Cardiac Care Center QMC - Endoscopy 550 S Beretania Street Ste 701 HONOLULU HI 96813 Endoscopy Services Queen's Imaging 91-2139 Fort Weaver Road Ste 108 EWA BEACH HI 96706 Imaging Services QMC - Pain & Spine 550 S Beretania Street Ste 703/704 HONOLULU HI 96813 Pain and Spine Clinic QMC - Radiology 550 S Beretania Street Ste B-1 HONOLULU HI 96813 Radiology Services QMC - Gastroenterology 550 S Beretania Street Ste 501 HONOLULU HI 96813 Gastroenterology Services QMC - Radiology 1329 Lusitana Street Ste B-1 HONOLULU HI 96813 Radiology Services Queen's Imaging 91-2135 Fort Weaver Road Ste 103 EWA BEACH HI 96706 Imaging Services QMC - Transplant Center 550 S Beretania Street Ste 404/406 HONOLULU HI 96813 Organ Transplant Center IUC - Pearl Kai 98-199 Kamehameha Highway Ste F-01 AIEA HI 96701 Urgent Care Clinic IUC - Kakaako 400 Keawe Street Ste 101/102 HONOLULU HI 96813 Urgent Care Clinic QMC - Valve & Structural Heart 550 S Beretania Street Ste 702 HONOLULU HI 96813 Cardiac Care Center QMC Neuroscience Institute 550 S Beretania Street Ste 400/405 HONOLULU HI 96813 Neuroscience Services QMC West Patient Care Services 91-2127 Fort Weaver Road EWA BEACH HI 96706 Infusion Clinic, Wound Care, Diabetes Ed IUC - Waikiki 449 Kapahulu Ave Ste 104 HONOLULU HI 96815 Urgent Care Clinic QMC - OncologyHematology 1380 Lusitana Street Ste 608 HONOLULU HI 96813 Oncology/Hematology Queen's Heart 551 S Beretania Street Ste 610 HONOLULU HI 96813 Cardiac Care Center IUC - Hawaii Kai 377 Keahole Street Ste D-1 HONOLULU HI 96825 Urgent Care Clinic Queen's Heart Physician Practice 98-1247 Kaahumanu Street Ste 206 AIEA HI 96701 Cardiac Care Center QMC - CWMP 1380 Lusitana Street Ste 300 HONOLULU HI 96813 Comprehensive Weight Management Physician Center 91-2139 Fort Weaver Road Ste 101 EWA BEACH HI 96706 Physician Center QMC - Pulmonology 1331 Lusitana Street Ste 704 HONOLULU HI 96813 Pulmonology/Sleep Clinic QMC - Acute Care Surgical Center 550 S Beretania Street Ste 509 HONOLULU HI 96813 Acute Care Services QMC - Pulmonology 1330 Lusitana Street Ste 107 HONOLULU HI 96813 Pulmonology QMC - Head and Neck 1380 Lusitana Street Ste 615 HONOLULU HI 96813 Head and Neck Institute Queen's Heart 1380 Lusitana Street Ste 913 HONOLULU HI 96813 Cardiac Care Center QMC West Oahu Specialty Clinincs 91-2139 Fort Weaver Road Ste 203 EWA BEACH HI 96706 Specialty Clinics 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 MEDICAL CENTER. THIS REPORT IS PUBLISHED PERIODICALLY AND IS SEPARATELY AVAILABLE TO THE PUBLIC. SCHEDULE H, PART I, LINE 7 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 THE QUEEN EMMA CLINICS PROVIDE COMPREHENSIVE PATIENT CARE TO INDIGENT PATIENTS AND SERVE A LARGE HOMELESS POPULATION. SCHEDULE H, PART II, LINE 10 COMMUNITY BUILDING ACTIVITIES IN ORDER TO MAINTAIN NECESSARY LIFE SUPPORT, DIAGNOSTIC AND OPERATING SYSTEMS, IN THE EVENT OF AN EMERGENCY, QMC SIGNIFICANTLY UPGRADED ITS POWER PLANT BY ADDING TWO NEW GENERATORS THAT ARE CAPABLE OF PROVIDING ELECTRICAL POWER FOR THE MEDICAL CENTER. QMC IS THE ONLY LEVEL I TRAUMA CENTER IN THE STATE OF HAWAII. IN ORDER TO PROVIDE ACCESS TO ITS EMERGENCY DEPARTMENT AND HOSPITAL, QMC, IN CONJUNCTION WITH THE STATE DEPARTMENT OF TRANSPORTATION AND CITY DEPARTMENT OF TRANSPORTATION SERVICES, SUPPORTED THE CONSTRUCTION OF THE KINAU OFF-RAMP. SCHEDULE H, PART III, LINE 2 QMC 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. QMC ESTIMATES THE ALLOWANCE BASED ON THE AGING OF THE ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR AND OTHER RELEVANT FACTORS. QMC 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 QMC'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, 2020. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE FOOTNOTE QMC 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 RECEIVEABLES 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 MEDICARE COSTING METHODOLOGY THE MEDICARE AMOUNTS ABOVE ARE CALCULATED WITH DATA FROM THE JUNE 30, 2020 COST REPORT, USING THE STEP DOWN METHOD. CONSISTENT WITH REPORTING REQUIREMENTS, THERE ARE AMOUNTS EXCLUDED FROM THE COSTS LISTED IN LINE 6. WHEN USING THE FULLY ALLOCATED COST CALCULATION, THE MEDICARE SHORTFALL WAS APPROXIMATELY $102,747,000. 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 QMC'S MISSION AND IS A BENEFIT TO THE COMMUNITY. SCHEDULE H, PART III, LINE 9B APPLICATION OF THE COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE EVERY ATTEMPT IS MADE BEFORE DISCHARGE TO SCREEN PATIENTS WHO HAVE NO DOCUMENTATION OF MEDICAL INSURANCE FOR POSSIBLE ELIGIBILITY FOR DISCOUNTED CARE. NON-ER OUTPATIENTS WITH NO MEDICAL INSURANCE ARE REFERRED TO THE PATIENT'S PHYSICIAN FOR A DETERMINATION OF URGENT OR EMERGENCY CARE STATUS. CHARITY CARE DISCOUNTS ARE BASED ON FINANCIAL NEED WHICH IS DETERMINED BY INCOME AND ASSET THRESHOLDS BASED ON FEDERAL POVERTY LEVELS AND IN COMPLIANCE WITH FEDERAL RULES AND REGULATIONS. PATIENTS ARE REQUESTED TO COMPLETE A DISCOUNTED CARE APPLICATION AND MUST SUBMIT INCOME AND ASSET VERIFICATION DOCUMENTS. PATIENTS MAY ALSO BE DEEMED ELIGIBLE FOR QMC DISCOUNTED CARE BASED ON PRIOR OR SUBSEQUENT MEDICAID ELIGIBILITY. ONCE ELIGIBILITY FOR QMC DISCOUNTED CARE IS CONFIRMED, A PAYMENT PLAN IS DISCUSSED WITH THE PATIENT. BILLING STATEMENTS FOR PATIENTS ARE MAILED MONTHLY TO ALL PATIENTS WITH SELF PAY BALANCES; INCLUDING PATIENTS WITH BALANCES AFTER QMC DISCOUNTED CARE IS APPLIED. BILLING STATEMENTS FOR PATIENTS WITH NO INSURANCE INCLUDE A STATEMENT ADVISING THEM TO CALL THE NUMBER ON THE STATEMENT TO DISCUSS OPTIONS FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT QMC'S MISSION IS TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE IN PERPETUITY QUALITY HEALTH CARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII. USING PUBLICLY AVAILABLE REPORTS AND DATA, AND THROUGH DISCUSSION WITH STAKEHOLDERS, QMC ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY WE SERVE BY FOCUSING ON FIVE STRATEGIC DIMENSIONS INCLUDING SUPERIOR QUALITY AND PERFORMANCE, BEING THE PROVIDER OF CHOICE, EMPLOYER OF CHOICE, DISPLAYING RESPONSIBLE CITIZENSHIP AND FOCUSING ON FINANCIAL PERFORMANCE. CORE STRATEGIES INVOLVING RESPONSIBLE CITIZENSHIP TO THE COMMUNITY INCLUDE HARDWIRING OUR NATIVE HAWAIIAN HEALTH STRATEGIC PLAN THROUGHOUT QUEEN'S ENTITIES, CREATING A SUSTAINABLE INFRASTRUCTURE THAT ALLOWS QUEEN'S TO QUANTIFY AND ARTICULATE COMMUNITY BENEFIT, AND STRENGTHENING GOVERNMENT AND COMMUNITY PARTNERSHIPS TO SUPPORT ACCESS AND AVAILABILITY OF PROGRAMS AND SERVICES THAT HELP ADDRESS UNMET COMMUNITY HEALTH NEEDS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE MEDICAID AND MEDICARE ELIGIBILITY REQUIREMENTS ARE DISCUSSED WITH INPATIENTS AND/OR INPATIENT'S FAMILY MEMBERS. QMC HAS A CONTRACTED VENDOR WHO PERFORMS MEDICAID ELIGIBILITY ASSESSMENTS AND WORKS WITH PATIENTS TO SUBMIT AN APPLICATION AND THE REQUIRED DOCUMENTS. PATIENTS WHO MAY QUALIFY FOR MEDICARE ARE PROVIDED CONTACT INFORMATION FOR THE SOCIAL SECURITY OFFICE. SIGNS ARE POSTED IN REGISTRATION AREAS THROUGHOUT THE HOSPITAL ADVISING THAT QMC HAS A DISCOUNTED CARE POLICY. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION QMC IS THE LEADING MEDICAL REFERRAL CENTER IN THE PACIFIC BASIN. LOCATED IN DOWNTOWN HONOLULU, IT'S THE LARGEST PRIVATE HOSPITAL IN HAWAII. ACCORDING TO RECENT DEMOGRAPHIC CENSUS DATA, THE STATE OF HAWAII IS VERY DIVERSE AND INCLUDES A POPULATION THAT IS APPROXIMATELY 10% NATIVE HAWAIIAN, OTHER PACIFIC ISLANDER, NATIVE ALASKAN AND AMERICAN INDIAN. OTHER DEMOGRAPHIC INFORMATION REGARDING HAWAII IS AS FOLLOWS: - MEDIAN AGE: 38.1 YEARS OLD (1) - 37.8% ASIAN, 25.6% WHITE, 9.8% NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER, 23.5% TWO OR MORE RACES (1) - MEDIAN HOUSEHOLD INCOME: $67,402 (2009 - 2013) (1) - 11.2% OF HAWAII'S POPULATION LIVES IN POVERTY (1) - OTHER THAN OAHU, THE ENTIRETY OF EACH ISLAND IS CONSIDERED UNDERSERVED (1) - NUMBER OF HOSPITALS (BY COUNTY) HAWAII COUNTY: 6 MAUI COUNTY: 4 C&C HONOLULU: 9 KAUAI COUNTY: 3 (1) HEALTHCARE ASSOCIATION OF HAWAII: HAWAII STATE COMMUNITY HEALTH NEEDS ASSESSMENT HAWAII HEALTH INFORMATION CORPORATION. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH THE AMOUNTS MENTIONED IN PART II OF SCHEDULE H REPRESENT COSTS INCURRED TO ENSURE CONTINUED OPERATIONS THAT BENEFIT THE COMMUNITY. TO SUPPORT THE QUEEN'S MISSION AND TO FULFILL THE TAX-EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, QUEEN'S PROVIDES A NUMBER OF COMMUNITY BENEFITS. THIS INCLUDES UNCOMPENSATED CARE, WHERE QMC 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 DEBT). QUEEN'S IS ALSO HOME TO THE QUEEN EMMA CLINICS, WHERE QMC PROVIDES OUTPATIENT SERVICES TO INDIGENT PATIENTS. OTHER EXAMPLES INCLUDE EMERGENCY PREPAREDNESS COSTS AND AMOUNTS EXPENDED TO EXPAND AND TEST BACK-UP POWER THAT CAN SERVICE PATIENTS IN TIMES OF EMERGENCY. IN ADDITION, QMC PROVIDES MANY FREE INFORMATIONAL SEMINARS AND EDUCATIONAL OPPORTUNITIES TO THE PUBLIC TO PROMOTE THE HEALTH OF THE COMMUNITY. THESE PROGRAMS ARE SPECIFICALLY DIRECTED TO ADDRESS HEALTH ISSUES WITHIN THE COMMUNITY INCLUDING DIABETES, CANCER AND WOMEN'S HEALTH ISSUES. A MAJORITY OF QMC'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN QMC'S PRIMARY SERVICE AREA (OAHU) WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF QMC. QMC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM QMC IS A MEMBER OF THE QUEEN'S HEALTH SYSTEMS (QHS) AFFILIATED GROUP. THE GROUP ALSO INCLUDES QUEEN EMMA LAND COMPANY (QEL), QUEEN'S INSURANCE EXCHANGE (QIE), QUEEN'S DEVELOPMENT CORPORATION (QDC), MOLOKAI GENERAL HOSPITAL (MGH) AND QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH). QHS PROVIDED LEGAL, ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO QMC AND QIE PROVIDED MEDICAL MALPRACTICE INSURANCE TO QMC. AFFILIATE ORGANIZATIONS OF THE QUEEN'S HEALTH SYSTEMS OPERATE THE ONLY HOSPITAL ON THE ISLAND OF MOLOKA'I, OPERATE THE QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL ON THE BIG ISLAND, PROVIDE DIAGNOSTIC LABORATORY SERVICES, OPERATE PHARMACIES AND PROVIDE THE HOSPITALS WITH GENERAL AND PROFESSIONAL LIABILITY INSURANCE. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT N/A true Aloha Medical Mission 810 North Vineyard Blvd Honolulu HI 96817 990234811 501c(3) 10000 Sponsorship 2019 Benefit Concert American Cancer Society 2370 Nuuanu Avenue Honolulu HI 96817 131788491 501c(3) 17500 General Support American Diabetes Association 875 Waimanu Street Ste 601 Honolulu HI 96813 131623888 501c(3) 60000 Sponsorship "2020 ADA Hawaii Year Round Sponsorship" American Heart Association 677 Ala Moana Boulevard Ste 600 Honolulu HI 96813 135613797 501c(3) 30000 General Support American Red Cross 4155 Diamond Head Road Honolulu HI 96816 530196605 501c(3) 15000 Sponsorship "2020 Red Cross Corporate Partner Program" Arthritis Foundation 1355 Peachtree Street NE Ste 600 Atlanta GA 30309 581341679 501c(3) 10000 Sponsorship "2019 Taste of the Town" Assistance Dogs of Hawaii 675 Kealaloa Avenue Makawao HI 96768 990353694 501c(3) 30000 General Support Boy Scouts of America Aloha Council 42 Puiwa Rd Honolulu HI 96817 990073482 501c(3) 7500 Sponsorship "2019 Hawaii's Distinguished Citizen" Boys and Girls Club of Hawaii 1000 Bishop Street Ste 550 Honolulu HI 96813 996005407 501c(3) 6000 Sponsorship "23rd Annual Walk in the Country, Build Great Futures" Child and Family Service 91-1841 Fort Weaver Rd Ewa Beach HI 96706 990073483 501c(3) 15000 Sponsorship "A Night on Broadway" Council for Native Hawaiian Advancement 91-1270 Kinoiki Street Building 1 Kapolei HI 96707 910313383 501c(3) 13000 General Support Farrington High School Health Academy 1564 N King St Honolulu HI 96817 990266482 501c(3) 62000 Contribution "Supplies and Equipment for Medical Assistant Program" Friends of Iolani Palace The PO Box 2259 1001 Bishop Street Honolulu HI 96804 990115665 501c(3) 15000 Sponsorship "Fundraising Gala" Hawaii Academy of Science 1776 University Avenue UA4 Rm 4 Honolulu HI 96822 996006863 501c(3) 10000 Sponsorship "2020 support for the Hawaii State Science & Engineering Fair" Hawaii Cancer Consortium 55 Merchant Street Honolulu HI 96813 452280259 501c(3) 500000 General Support Hawaii Community Foundation 827 Fort Street Mall Honolulu HI 96813 990261283 501c(3) 5500 General Support Hawaii Executive Conference 1000 Bishop Street Ste 202 Honolulu HI 96813 943278794 501c(3) 7500 Contribution "2019 Hawaii Executive Conference" Hawaii Food & Wine Festival PO Box 235480 850 Richards Stree Honolulu HI 96823 460618609 501c(3) 17500 General Support Hawaii Homeless Healthcare Hui 1301 Punchbowl Street Clark Apt 40 Honolulu HI 96813 823190718 501c(3) 500000 General Support HI Share 3571 Manoa Rd Honolulu HI 96822 832046210 501c(3) 25000 Contribution "Support for 3-part documentary series on Climate Change Crisis Facing Hawaii" Hina Mauka 45-845 Pookela Street Kaneohe HI 96744 990173356 501c(3) 10000 Contribution "2019 50th Anniversary Benefit Luau, Kokua Na Haumana" Hospice Hawaii Inc 860 Iwilei Road Honolulu HI 96817 990203930 501c(3) 10000 Sponsorship "40th Anniversary Gala, The Voyage Together" Island Pacific Academy 909 Haumea St Kapolei HI 96707 680534162 501c(3) 20000 Sponsorship "2019 Annual Grand Expedition: Oh the Places We'll Go" Kawaiahao Church Corporation 957 Punchbowl St Honolulu HI 96813 990075241 501c(3) 50000 Sponsorship "2020 Bicentennial Commemorative Celebration" Kokua Kalihi Valley 2239 North School Street Honolulu HI 96819 990149797 501c(3) 10000 Contribution "Support expanding access to traditional medicine" Kokua Mau PO Box 62155 Honolulu HI 96839 990339201 501c(3) 20000 General Support Kupu 677 Ala Moana Blvd Ste 1200 Honolulu HI 96813 510652665 501c(3) 50000 Contribution "Grant to provide free, consistent and nutritious meals for individuals and families affected by COVID-19" Legacy of Life Hawaii 405 N Kuakini Street Ste 810 Honolulu HI 96817 990257883 501c(3) 27500 General Support Lunalilo Home 501 Kekauluohi Street Honolulu HI 96825 990075244 501c(3) 9000 General Support Ma'O Organic Farms PO Box 441 Waianae HI 96792 990350803 501c(3) 54983 Contribution "Alumni Survey Project" March of Dimes Foundation 1451 South King Street Ste 504 Honolulu HI 96814 131846366 501c(3) 20000 General Support Navian Hawaii 860 Iwilei Road Honolulu HI 96817 990203930 501c(3) 12500 General Support Pacific Buddhist Academy 1754 Lusitana Street Honolulu HI 96813 043660909 501c(3) 6000 General Support Polynesian Football Hall of Fame PO Box 11266 Honolulu HI 96828 463158865 501c(3) 25000 Sponsorship "2020 Polynesian Bowl" Public Schools of Hawaii Foundation PO Box 4148 Honolulu HI 96812 880243449 501c(3) 15000 Sponsorship "29th Annual Kulia I Ka Nu'u Awards Banquet" Rehab Foundation 226 North Kuakini Street Honolulu HI 96817 990241634 501c(3) 6750 General Support St Andrews Schools 224 Queen Emma Square Honolulu HI 96813 990073525 501c(3) 125000 General Support St Francis Healthcare Foundation of HI 2228 Liliha Street Ste 205 Honolulu HI 96817 990240060 501c(3) 10000 General Support Susan G Komen Hawaii 3555 Harding Ave Ste 2D Honolulu HI 96816 751835298 501c(3) 20000 General Support University of Hawaii Foundation 2444 Dole Street Bachman Hall 105 Honolulu HI 96822 990085260 501c(3) 1048858 General Support University of Hawaii JABSON PO Box 11270 Honolulu HI 968280270 996000354 GOVT 559634 Project Hooulu Kukui Waimanalo Health Center 41-1295 Kalanianaole Hwy Waimanalo HI 96795 990273205 501c(3) 40000 Contribution "Support for Facility expansion" Young Womens Christian Association 1040 Richard Street Honolulu HI 96813 990073534 501c(3) 5250 General Support 43 SCHEDULE I, PART I, LINE 2 DESRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS THE QUEEN'S MEDICAL CENTER MAKES DONATIONS TO VARIOUS TAX-EXEMPT ORGANIZATIONS WITH THE PURPOSE OF PROVIDING OPPORTUNITIES FOR BETTER HEALTH AND WELLNESS TO ALL THE PROPLE OF HAWAII. THERE ARE GENERALLY NO RESTRICTIONS PLACED ON THE USE OF THOSE DONATIONS AND THE RECEIVING ORGANIZATION MAY USE THE DONATIONS AT THEIR DISCRETION IN ORDER TO FURTHER THEIR EXEMPT PURPOSE. WHERE RESTRICTIONS ARE PLACED ON THE USE OF THOSE DONATIONS, QMC REQUESTS FINANCIAL REPORTS IN ORDER TO MAINTAIN SUCH USE. false false false false false false false true false ARTHUR USHIJIMA TRUSTEE/PRESIDENT - PART YEAR 0 956872 0 362479 0 156170 0 60842 0 15013 0 1551376 0 0 JEFFREY LOH MD PHYSICIAN 451170 0 745856 0 18491 0 25227 0 22930 0 1263674 0 0 0 WHITNEY LIMM MD SENIOR VICE PRESIDENT 0 552277 0 184170 0 28989 0 169085 0 15753 0 950274 0 0 PETER TSAI MD PHYSICIAN 848710 0 50927 0 1242 0 5769 0 25306 0 931954 0 0 0 TODD SETO MD PHYSICIAN 393521 0 449306 0 1242 0 43045 0 8050 0 895164 0 0 0 JASON CHANG PRESIDENT 554643 0 185488 0 540 0 107318 0 22606 0 870595 0 0 0 MICHEL RICCIONI TREASURER 0 542658 0 181167 0 24679 0 103558 0 17018 0 869080 0 0 SUNG BAE LEE MD PHYSICIAN 657376 0 124398 0 27303 0 28680 0 25709 0 863466 0 0 0 ERIC MARTINSON FORMER TREASURER 0 484498 0 163266 0 21351 0 111211 0 25305 0 805631 0 0 OMAR ABDUL GHANI PHYSICIAN 370207 0 317915 0 756 0 12600 0 22781 0 724259 0 0 0 JOHN NITAO VP/GENERAL COUNSEL 0 423699 0 106961 0 10549 0 81654 0 24082 0 646945 0 0 SUSAN MURRAY VP/COO - QMC WEST OAHU 378517 0 110578 0 55209 0 30219 0 15296 0 589819 0 0 0 JILL HOGGARD GREEN TRUSTEE - EFF. 10/2019 0 243592 0 304680 0 891 0 0 0 3837 0 553000 0 0 SHARLENE TSUDA SECRETARY 0 274642 0 69262 0 14785 0 72551 0 15428 0 446668 0 0 CLINTON YEE ASSISTANT TREASURER 0 189835 0 22040 0 9300 0 27131 0 23448 0 271754 0 0 ROBB OHTANI MD TRUSTEE 0 234960 0 0 0 0 0 0 0 0 0 234960 0 0 JOELLE TANABE ASSISTANT SECRETARY 0 106237 0 12600 0 5207 0 15659 0 22756 0 162459 0 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 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. ALSO, CERTAIN PHYSICIANS RECEIVE INCENTIVE COMPENSATION BASED ON PROFESSIONAL SERVICES COLLECTIONS BY QMC. A MAXIMUM OF SUCH INCENTIVE COMPENSATION IS CAPPED ACCORDING TO QMC POLICY. SCHEDULE J, PART II & FORM 990, PART VII COMPENSATION PAID FOR SERVICES ARTHUR A. USHIJIMA MR. USHIJIMA SERVED AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEEN'S RELATED AFFILIATES THROUGH SEPTEMBER 2019. MR. USHIJIMA ALSO SERVED AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE QUEEN'S HEALTH SYSTEMS (QHS, PARENT COMPANY) AND AS PRESIDENT OF THE QUEEN'S MEDICAL CENTER (QMC). HIS HOURS SERVED AS A TRUSTEE OF QMC WAS 1 HOUR PER WEEK. HE WAS A VOLUNTEER TRUSTEE AND WAS NOT COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED WAS HIS TOTAL COMPENSATION FOR HIS VARIOUS SERVICES. JILL HOGGARD GREEN MS. HOGGARD GREEN SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEENS RELATED AFFILEATES. MS HOGGARD GREEN ALSO SERVES AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE QUEEN'S HEALTH SYSTEMS ("QHS", PARENT COMPANY). HER HOURS SERVED AS A TRUSTEE OF QMC ARE 25 HOURS PER WEEK. SHE IS A VOLUNTEER AND IS NOT COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR HER VARIOUS SERVICES. JASON CHANG MR. CHANG SERVES AS EVP AND COO OF QHS AND PRESIDENT OF QMC. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. SHARLENE TSUDA MS. TSUDA SERVES AS CORPORATE SECRETARY FOR QHS, QMC AND NHCH AND VP OF COMMUNITY DEVELOPMENT OF QHS. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. MICHEL RICCIONI MR. RICCIONI SERVED AS TREASURER OF QMC AND THE TREASURER/CHIEF FINANCIAL OFFICER OF QHS. HE WAS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. ERIC MARTINSON MR. MARTINSON SERVED AS PRESIDENT OF QEL AND VICE PRESIDENT/CHIEF INVESTMENT OFFICER OF QHS. HE WAS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES WHITNEY LIMM, MD DR. LIMM SERVES AS SENIOR VP OF CLINICAL INTEGRATION AND CHIEF PHYSICIAN EXECUTIVE OF QHS AND QMC. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. JOHN NITAO MR. NITAO SERVES AS VP/GENERAL COUNSEL FOR THE QUEEN'S HEALTH SYSTEMS AND QMC AND CORPORATE SECRETARY OF QEL. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. SUSAN MURRAY MS. MURRAY SERVES AS SENIOR VP OF QHS-WEST OAHU REGION AND COO OF QMC-WEST OAHU. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. CLINTON YEE MR. YEE SERVES AS CORPORATE CONTROLLER OF QUEEN'S HEALTH SYSTEMS, ASSISTANT TREASURER OF QMC, QHS QEL AND TREASURER OF MGH. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES. JOELLE TANABE MS. TANABE SERVED AS ASSISTANT SECRETARY OF QMC AND QHS AND THE DIRECTOR OF CORPORATE GOVERNANCE OF QHS. SHE WAS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. ROBB OHTANI MD DR. OHTANI SERVES AS A TRUSTEE FOR QMC. HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR HIS ON-CALL SPECIALTY SERVICES. A DEPARTMENT OF BUDGET AND FINANCE STATE OF HI 990266961 419800LM7 2015-01-29 350356476 SEE PART VI false false false A 0 0 350362507 0 0 0 4726000 0 0 185627500 160009007 0 2019 true false false 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 Description of Arrangement Related Organization Reporting SCHEDULE K QUEEN'S MEDICAL CENTER (QMC) SOLE CORPORATE MEMBER, THE QUEEN'S HEALTH SYSTEMS (QHS) BORROWED ON BEHALF OF ITSELF AND ITS AFFILIATES, 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. QMC'S SHARE OF THE OUTSTANDING LIABILITY IS $338,093,690. 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 OF THE 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 142715 FMV X 4 27232 FMV X 11 111739 FMV X TABLE FAVORS 1 5750 FMV 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 4A PROGRAM SERVICE ACCOMPLISHMENTS ESTABLISHED IN 1859 BY KING KAMEHAMEHA IV AND QUEEN EMMA, THE QUEEN'S MEDICAL CENTER (QMC) IS THE FIRST HOSPITAL IN THE UNITED STATES FOUNDED BY ROYALTY. TODAY, IT IS THE LARGEST PRIVATE HOSPITAL IN HAWAII AND THE PACIFIC BASIN. THE QUEEN'S MEDICAL CENTER HAS 505 ACUTE CARE BEDS AND 28 SUB-ACUTE CARE BEDS. WITH OVER 3,000 EMPLOYEES AND OVER 1,200 PHYSICIANS ON STAFF, IT IS ALSO ONE OF THE STATE OF HAWAII'S LARGEST EMPLOYERS. AS THE LEADING MEDICAL REFERRAL CENTER IN HAWAII AND THE PACIFIC BASIN, QMC IS WIDELY KNOWN FOR ITS PROGRAMS IN CANCER, CARDIOVASCULAR DISEASE, NEUROSCIENCE, ORTHOPEDICS, SURGERY, TRAUMA, BEHAVIORAL MEDICINE AND WOMEN'S HEALTH. QMC OFFERS A COMPREHENSIVE RANGE OF SPECIALTIES, INCLUDING CARDIAC DIAGNOSTICS, GASTROENTEROLOGY, GENETICS, GERIATRICS, GYNECOLOGY, NEONATOLOGY, OBSTETRICS AND PULMONOLOGY. QMC SERVES AS THE MAIN TRAUMA CENTER IN THE PACIFIC BASIN, ("TRAUMA" IS DEFINED AS A LIFE-THREATENING INJURY OR SHOCK) AND HAS BEEN VERIFIED AS A LEVEL I TRAUMA CENTER BY THE VERIFICATION REVIEW COMMITTEE (VRC), AN AD HOC COMMITTEE ON TRAUMA (COT) OF THE AMERICAN COLLEGE OF SURGEONS. QMC IS HOME TO A NUMBER OF RESIDENCY PROGRAMS OFFERED IN CONJUNCTION WITH THE JOHN A BURNS SCHOOL OF MEDICINE. QMC IS ACCREDITED BY THE JOINT COMMISION (TJC). QMC IS ALSO APPROVED TO PARTICIPATE IN RESIDENCY TRAINING BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (QCGME), AND IS A MEMBER OF VHA, A NATIONAL COOPERATIVE OF OVER 1,400 HOSPITALS. QMC SUPPORTS NATIVE HAWAIIAN HEALTH INITIATIVES THROUGH MANY OF ITS PROGRAMS AND SERVICES, PARTICULARLY ITS NATIVE HAWAIIAN HEALTH PROGRAM (NHHP). THE FOCUS AREAS OF NHHP INCLUDE IMPROVEMENTS IN CLINICAL OUTCOMES, HEALTHCARE TRAINING, RESEARCH, AND ACCESS AND OUTREACH. NHHP CONDUCTS ONGOING ASSESSMENT AND DEVELOPMENT OF QMC PROGRAMS AND SERVICES FOCUSED ON NATIVE HAWAIIANS, INCLUDING SPECIFIC CLINICAL PROGRAMS IN AREAS SUCH AS CARDIOLOGY, ONCOLOGY, COMPREHENSIVE WEIGHT MANAGEMENT, MEDICINE, NEUROSCIENCE, AND DIABETES. QMC COLLABORATES AND PARTNERS TO PROVIDE HEALTHCARE TRAINING AND EDUCATION OPPORTUNITIES TO NATIVE HAWAIIAN STUDENTS AND THOSE COMMITTED TO SERVING NATIVE HAWAIIAN COMMUNITIES FROM ADOLESCENCE TO GRADUATE STUDIES, SUCH AS, THE ULU KUKUI PROJECT, WHICH IS A PRE-COLLEGE SCIENCE EDUCATION PROGRAM AT STEVENSON MIDDLE SCHOOL TO PROMOTE EXCELLENCE IN SCIENCE EDUCATION AND THE PURSUIT OF BIOMEDICAL CAREERS BY NATIVE HAWAIIANS AND PACIFIC ISLANDERS. IN ADDITION, NHHP PROGRAMS FOCUS ON QUALITY IMPROVEMENT AND INCREASED ACCESS FOR NATIVE HAWAIIANS TO QMC AND COLLABORATE WITH THE NATIVE HAWAIIAN COMMUNITY IN EDUCATION, RESEARCH, AND COMMUNITY OUTREACH. THROUGH EACH OF THESE AREAS OF FOCUS, NHHP WORKS TO PROVIDE A FRAMEWORK FOR THE DEVELOPMENT, IMPLEMENTATION AND EVALUATION OF CLINICAL INITIATIVES THAT AIM TO ENHANCE THE OLA PONO (WELL BEING) OF NATIVE HAWAIIANS. IN ADDITION TO NHHP, MANY OF QMC'S PROGRAM SERVICES DESCRIBED BELOW PROVIDE BENEFITS TO NATIVE HAWAIIANS, INCLUDING COMPONENTS OF CHARITY CARE AND UNCOMPENSATED CARE PROVIDED TO OUR PATIENTS. TO SUPPORT THE QUEEN'S MISSION AND TO FULFILL THE TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, QUEEN'S PROVIDED THE FOLLOWING COMMUNITY BENEFITS, TOTALING APPROXIMATELY $164.4M ON A SYSTEM-WIDE BASIS, FOR THE YEAR ENDED JUNE 30, 2020. 1. UNCOMPENSATED CARE - QMC 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, 2020, THE ESTIMATED COST OF PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $4,418,000 AND $61,614,000 RESPECTIVELY. 2. BEHAVIORAL HEALTH - QMC PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES THAT ARE NECESSARY AND IN CERTAIN INSTANCES, NOT GENERALLY AVAILABLE IN THE STATE OF HAWAII. THE ESTIMATED COST OF OPERATIONS RESULTING FROM BEHAVIORAL HEALTH SERVICES WAS $257,000 FOR THE YEAR ENDED JUNE 30, 2020. 3. QUEEN EMMA CLINICS - QMC PROVIDES OUTPATIENT SERVICES TO INDIGENT PATIENTS AND OTHERS THROUGH THE QUEEN EMMA CLINICS. THE ESTIMATED COST OF OPERATION OF THE QUEEN EMMA CLINICS WAS APPROXIMATELY $989,000 FOR THE YEAR ENDED JUNE 30, 2020. 4. ON CALL PHYSICIAN COMPENSATION - QMC MAINTAINS THE ONLY LEVEL I TRAUMA CENTER IN THE STATE OF HAWAII. IN ORDER TO PROVIDE LEVEL I TRAUMA COVERAGE, THE MEDICAL CENTER INCURRED APPROXIMATELY $11,370,000 IN ON CALL PHYSICIAN COVERAGE DURING THE YEAR ENDED JUNE 30, 2020. 5. FELLOWSHIP, RESIDENT AND INTERN COSTS - QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $14,924,000 DURING THE YEAR ENDED JUNE 30, 2020 RELATED TO ITS CARDIAC FELLOWSHIP, RESIDENT AND INTERN PROGRAMS. AS A TEACHING FACILITY, THE MEDICAL CENTER PARTICIPATES IN AND SHARES THE COSTS OF THE HAWAII RESIDENCY PROGRAM. 6. HAWAII MEDICAL LIBRARY - QMC MAINTAINS A MEDICAL LIBRARY THAT BENEFITS HEALTHCARE PROFESSIONALS IN THE STATE OF HAWAII. THE ESTIMATED COST OF OPERATING THE HAWAII MEDICAL LIBRARY FOR THE YEAR ENDED JUNE 30, 2020 WAS $381,000. 7. TRANSFER HOTLINE - QMC MAINTAINS A CARDIAC TRANSFER HOTLINE AND A REFERRAL HOTLINE TO ASSIST PATIENTS AND OTHER HEALTHCARE PROVIDERS WITH THE TRANSFER AND/OR REFERRAL OF PATIENTS TO APPROPRIATE HEALTHCARE SERVICES. THE ESTIMATED COST OF PROVIDING THESE SERVICES FOR THE YEAR ENDED JUNE 30, 2020 WAS $1,341,000. 8. RESEARCH LOSSES - QMC EMPLOYS STAFF AND INCURS UNFUNDED COSTS FOR MEDICAL RESEARCH. FOR THE YEAR ENDED JUNE 30, 2020, RESEARCH COSTS WERE $867,000. 9. CHARITABLE CONTRIBUTIONS - QMC MAKES CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2020, CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS CONSISTENT WITH QMC'S EXEMPT PURPOSE WERE $3,189,000. OF THIS AMOUNT, $560,000 WAS FOR FUNDING TO THE DEPARTMENT OF NATIVE HAWAIIAN HEALTH UNDER THE JOHN A. BURNS SCHOOL OF MEDICINE OF THE UNIVERSITY OF HAWAII, $500,000 WAS DONATED TO THE UNIVERSITY OF HAWAII CANCER CONSORTIUM AND $500,000 WAS DONATED TO HAWAII HOMELESS HEALTHCARE HUI. FORM 990, PART III, LINE 4A - CONTINUED 10. MEDICAID SHORTFALL IN PAYMENTS - QMC PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICAID PATIENTS IN THE STATE OF HAWAII. QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $19,673,000 DURING THE YEAR ENDED JUNE 30, 2020. 11. MEDICARE SHORTFALL IN PAYMENTS - QMC PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICARE PATIENTS IN THE STATE OF HAWAII. QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT BASED ON MEDICARE COST REPORTS OF APPROXIMATELY $38,807,000 DURING THE YEAR ENDED JUNE 30, 2020. CONSISTENT WITH COST REPORT REQUIREMENTS, THERE ARE AMOUNTS THAT ARE EXCLUDED FROM THE COSTS ABOVE. 12. LEASE PRICING BELOW FAIR MARKET VALUE - QMC EXTENDED LEASE RATES TO THE UNIVERSITY OF HAWAII THAT ARE BELOW FAIR MARKET VALUE. FOR THE YEAR ENDED JUNE 30, 2020, REVENUES FOREGONE FROM LEASE RATES THAT WERE BELOW FAIR MARKET VALUE WERE $55,000. 13. DENTAL CLINIC - QMC PROVIDES DENTAL SERVICES TO INDIGENT PATIENTS AND OTHERS THROUGH ITS DENTAL CLINIC. THE COST OF OPERATIONS FROM THE DENTAL CLINIC WAS APPROXIMATELY $1,189,000 FOR THE YEAR ENDED JUNE 30, 2020. 14. DONATED USE OF CONFERENCE ROOMS - QMC ALLOWS PHYSICIANS AND TEACHERS FROM THE JOHN A. BURNS SCHOOL OF MEDICINE OF THE UNIVERSITY OF HAWAII, VARIOUS GOVERNMENTAL ENTITIES INCLUDING THE HAWAII DEPARTMENT OF HEALTH AND OTHER NONPROFIT ORGANIZATIONS THE FREE USE OF ITS FACILITIES AT THE QUEEN'S CONFERENCE CENTER. FOR THE YEAR ENDED JUNE 30, 2020, THE VALUE OF THE USE OF THE CENTER WAS $260,000. 15. TUTU BERT'S HOUSE - TUTU BERT'S HOUSE IS AN 8-BED PRIVATE MEDICAL RESPITE HOUSE IN PARTNERSHIP WITH THE QUEEN'S MEDICAL CENTER AND HOMEAID HAWAII. TUTU BERT'S HOUSE OFFERS MEDICALLY FRAIL HOMELESS DISCHARGED FROM THE QUEEN'S MEDICAL CENTER WHO NO LONGER IN NEED OF IN-PATIENT HOSPITALIZATION, BUT WHO ARE STILL TOO FRAIL TO RECUPERATE ON THE STREETS OR IN AN URBAN SHELTER, WITH A SAFETY NET RESOURCE. THE HOUSE FACILITATES SHORT-TERM STABILIZATION AND SUPPORTIVE CASE MANAGEMENT THAT ACCELERATES THEIR TRANSITION OUT OF HOMELESSNESS, AND INTO AVAILABLE HOUSING OPTIONS. FOR THE YEAR ENDED JUNE 30, 2020 COSTS INCURRED FOR THE PROGRAM WERE $1,243,000. 16. OHANA HOUSE - OHANA HOUSE IS A 14-BED PRIVATE MEDICAL RESPITE HOUSE IN PARTNERSHIP WITH THE QUEEN'S MEDICAL CENTER AND KALIHI PALAMA HEALTH CENTER. THIS PROGRAM PROVIDES CASE MANAGEMENT AND SHORT-TERM RESIDENTIAL CARE THAT ALLOWS HOMELESS DISCHARGED FROM THE HOSPITAL THE OPPORTUNITY TO REST IN A SAFE ENVIRONMENT WHILE ACCESSING MEDICAL CARE AND OTHER SUPPORTIVE SERVICES. THE SERVICES PROVIDED TO CLIENTS INCLUDE CASE MANAGEMENT, TRANSPORTATION, SHELTER, MEALS, EMERGENCY CLOTHING AND HYGIENE SERVICES. FOR THE YEAR ENDED JUNE 30, 2020 COSTS INCURRED FOR THE PROGRAM WERE $406,000. 17. QUEEN'S CARE COALITION (KE KU'UNA NA'AU) - THE QUEEN'S CARE COALITION PAIRS PATIENTS WHO HAVE PSYCHOSOCIAL ISSUES WITH NAVIGATORS WHO BUILD TRUSTING RELATIONSHIPS, IDENTIFY AND BRIDGE BARRIERS TO CARE AND CONNECT PATIENTS WITH EXISTING SUPPORT IN THE COMMUNITY. THE NAVIGATOR ACCOMPANIES PATIENTS ON VISITS TO THEIR PRIMARY CARE AND SPECIALTY DOCTORS; MAKES SURE HOME HEALTH SUPPLIES ARE DELIVERED; ADVOCATES FOR FINANCIAL BENEFITS; CONNECTS PATIENTS TO COMMUNITY SUPPORT AND EVEN HELPS FIND HOMELESS PATIENTS HOUSING. KE KU`UNA NA`AU NAVIGATORS SERVE NATIVE HAWAIIAN PATIENTS ADMITTED TO HOSPITAL WITH CHRONIC MEDICAL CONDITIONS, BEHAVIORAL HEALTH PROBLEMS, AND/OR PSYCHOSOCIAL STRESSORS. FOR THE YEAR ENDED JUNE 30, 2020 COSTS INCURRED FOR THE PROGRAM WERE $680,000. 18. SAMOA MEDICAL MISSION - IN DECEMBER 2019, QMC SPONSORED A PROGRAM TO FLY A TEAM OF PHYSICIANS, NURSES AND SUPPORT STAFF TO RESPOND TO A MEASLES EPIDEMIC IN WESTERN SAMOA. IN ALL, 76 PERSONNEL WENT TO SAMOA TO HELP VACCINATE AND TREAT PATIENTS IN APIA. FOR THE YEAR ENDED JUNE 30, 2020, THE COST OF SPONSORING THE PROGRAM WAS $307,000. 19. HEALTH AND WELLNESS EDUCATION - QMC PROVIDES HEALTH AND WELLNESS EDUCATION TO THE COMMUNITY IN AN EFFORT TO PROMOTE HEALTHY LIFESTYLES. FOR THE YEAR ENDED JUNE 30, 2020, THE COST OF PROVIDING HEALTH AND WELLNESS EDUCATION WAS $190,000. 20. NATIVE HAWAIIAN HEALTH STRATEGIC PLAN (KAHULA OLA) - QMC IS IN THE PROCESS OF IMPLEMENTING MISSION-RELATED PROGRAMS FOR THE NATIVE HAWAIIAN POPULATION SERVED BY QMC AND AFFILIATES. EXPECTED OUTCOMES INCLUDE IMPROVEMENTS IN NEGATIVE HEALTH BEHAVIORS OR RISK FACTORS FOR NATIVE HAWAIIAN PATIENTS, INCREASE USE OF OUTPATIENT SERVICES, ESPECIALLY PRIMARY CARE, INCREASE THE NUMBER OF HAWAIIANS WITH DEDICATED PRIMARY CARE PROVIDER/HOME, IMPROVE PATIENT SATISFACTION, INCREASE THE NUMBER OF ENGAGED ORGANIZATIONS SERVING NATIVE HAWAIIANS, ESTABLISH SUPPORT NETWORK OF MULTIDISCIPLINARY ORGANIZATIONS WITH SHARED GOALS, IMPROVE TIMELY ACCESS TO SERVICES, INCREASE PARTICIPATION IN CULTURALLY RESPONSIVE LEARNING, INCREASE EMPLOYEE ENGAGEMENT AND PROVIDER SATISFACTION AND IMPROVE RECRUITMENT OF PROVIDERS. FOR THE YEAR ENDED JUNE 30, 2020, THE COST RELATED TO KAHULA OLA WAS $50,000. 21. PROGRAMS THAT IMPROVE ACCESS TO HEALTHCARE - QMC IMPROVES THE COMMUNITY'S ACCESS TO HEALTHCARE BY HELPING PATIENTS QUALIFY FOR MEDICAID AND OTHER TYPES OF INSURANCE. FOR THE YEAR ENDED JUNE 30, 2020, THESE PROGRAM COSTS TOTALED $2,170,000. 22. COMMUNITY OUTREACH - QMC EMPLOYEES VOLUNTEER THEIR TIME AND EXPERIENCE PROVIDING FREE LECTURES TO MEMBERS OF THE COMMUNITY INCLUDING PROFESSIONALS, STUDENTS AND MEMBERS OF THE PUBLIC. 23. VOLUNTEER EFFORTS - QMC EMPLOYEES PERIODICALLY VOLUNTEER FOR OTHER CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2020, THESE EVENTS INCLUDED THE AMERICAN HEART ASSOCIATION'S "HEART WALK", AMERICAN CANCER SOCIETY'S "RELAY FOR LIFE"HOPE LODGE FUNDRAISER", SUSAN G. KOMEN FOUNDATION'S "RACE FOR THE CURE", WAIKIKI IMPROVEMENT ASSOCIATION'S "BEACH CLEAN UPTHE AMERICAN DIABETES ASSOCIATION'S "STEP OUT" FUNDRAISER. IN ADDITION, QMC OFFICERS DEDICATE MANY HOURS SERVING AS VOLUNTEER BOARD MEMBERS FOR OTHER HAWAII BASED CHARITABLE ORGANIZATIONS. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS QMC HAS A SOLE MEMBER, WHICH IS THE QUEEN'S HEALTH SYSTEMS, A HAWAII NONPROFIT CORPORATION ("QHS"). FORM 990, PART VI, LINE 7A POWER TO ELECT OR APPOINT MEMBERS QHS ELECTS ALL OF THE BOARD MEMBERS OF THE QMC 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 QMC 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 $2,000,000 FOR QMC. FORM 990, PART VI, LINE 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 AUDIT 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 PREPARED 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 QMC RETURN WAS MADE AVAILABLE TO EACH OF THE MEMBERS OF THE QMC BOARD OF TRUSTEES PRIOR TO THE RETURNS BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12, 13 AND 14 APPROVED POLICIES QMC ABIDES BY THE CONFLICT OF INTEREST, WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES THAT HAVE BEEN APPROVED BY QHS ON BEHALF OF THE QMC BOARD OF TRUSTEES, BUT HAVE NOT BEEN SEPARATELY APPROVED BY THE QMC BOARD. AS SUCH, LINES 12, 13 AND 14 HAVE BEEN CHECKED 'NO'. FORM 990, PART VI, LINE 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 SELECTED 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, LINES 15A & 15B PROCESS USED FOR DETERMINING COMPENSATION ALTHOUGH NOT COMPENSATED BY THE QUEEN'S MEDICAL CENTER, 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. QMC'S EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY FOR ITS EXECUTIVE VP/COO, VP MEDICAL AFFAIRS, VP CLINICAL INTEGRATION, VP NURSING AND VP PATIENT CARE. 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 2020. 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 PUBLIC QMC'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND THE QHS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS TAX RETURN, AS REQUIRED. QMC DOES NOT MAKE THE CONFLICT OF INTEREST POLICY THAT IT FOLLOWS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 OTHER CHANGES TO NET ASSETS PENSION FAS 87 ADJUSTMENTS ($39,486,745) CHANGE IN INTEREST IN SUBSIDIARY ($2,455,588) NET ASSETS RELEASED FROM RESTRICTION ($258,174) OTHER $10,000 ------------- TOTAL ($42,190,507) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICE TOTAL FEES:80224857 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICE TOTAL FEES:51483958 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICE TOTAL FEES:1549362 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER SERVICE TOTAL FEES:2754536 QUEENS MSSP ACO LLC 1301 PUNCHBOWL STREET HONOLULU HI 96813 830771278 ACC. 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BOX 408 KAUNAKAKAI MOLOKAI, HI 96748 EIN: 99-0251372 EXPENSES: $12,511,469 501(H) ELECTION: YES SHARE OF EXCESS LOBBYING EXPENDITURES: $0 NAME: QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL ADDRESS: 67-1125 MAMALAHOA HIGHWAY KAMUELA, HI 96743 EIN: 99-0260423 EXPENSES: $58,908,125 501(H) ELECTION: NO SHARE OF EXCESS LOBBYING EXPENDITURES: $0