FURP.ORG / PUBLIC DATA EXPLORER

QUEENS NORTH HAWAII COMMUNITY HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
QUEENS NORTH HAWAII COMMUNITY HOSPITAL (EIN 99-0260423)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-12
IRS object ID
202141329349303754
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-12T15:28:45-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14365 EXECUTIVE DRIVE 1600AddressLine1Txt
CitySAN DIEGOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92121ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN990260423EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1QUEEN'S NORTH HAWAII COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% SHANNON OLSENInCareOfNm
Business Name ControlQUEEBusinessNameControlTxt
Phone8088814400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line167-1125 MAMALAHOA HIGHWAYAddressLine1Txt
CityKAMUELACityNm
State AbbreviationHIStateAbbreviationCd
ZIP967438496ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMONEY ATWALPersonNm
Person TitleTREASURERPersonTitleTxt
Signature2021-05-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOCELYNE MILLERPreparerPersonNm
PTINP00634378PTIN
Phone8585357200PhoneNum
Preparation2021-05-04PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCYNTHIA KAMIKAWAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line167-1125 MAMALAHOA HIGHWAYAddressLine1Txt
CityKAMUELACityNm
State AbbreviationHIStateAbbreviationCd
ZIP967438496ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$85,648,634GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NHCH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1989FormationYr
Legal Domicile StateHILegalDomicileStateCd
Activity Or MissionACUTE CARE HOSPITAL WITH THE MISSION TO TO IMPROVE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee441TotalEmployeeCnt
Total Volunteers47TotalVolunteersCnt
Total Gross UBI$38,979TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$30,094NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$7,477,845PYContributionsGrantsAmt
CY Contributions Grants$11,593,977CYContributionsGrantsAmt
PY Program Service Revenue$69,578,309PYProgramServiceRevenueAmt
CY Program Service Revenue$73,038,864CYProgramServiceRevenueAmt
PY Investment Income$181,066PYInvestmentIncomeAmt
CY Investment Income$219,791CYInvestmentIncomeAmt
PY Other Revenue$809,935PYOtherRevenueAmt
CY Other Revenue$749,394CYOtherRevenueAmt
PY Total Revenue$78,047,155PYTotalRevenueAmt
CY Total Revenue$85,602,026CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$32,713,660PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$35,455,778CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$4,595PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$337CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$77,641CYTotalFundraisingExpenseAmt
PY Other Expenses$39,512,308PYOtherExpensesAmt
CY Other Expenses$44,502,178CYOtherExpensesAmt
PY Total Expenses$72,230,563PYTotalExpensesAmt
CY Total Expenses$79,958,293CYTotalExpensesAmt
PY Revenues Less Expenses$5,816,592PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,643,733CYRevenuesLessExpensesAmt
Total Assets BOY$213,183,241TotalAssetsBOYAmt
Total Assets EOY$241,972,998TotalAssetsEOYAmt
Total Liabilities BOY$79,000,293TotalLiabilitiesBOYAmt
Total Liabilities EOY$83,639,987TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$134,182,948NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$158,333,011NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionACUTE CARE HOSPITAL WITH THE MISSION TO IMPROVE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$58,908,125ExpenseAmt
Grant$0GrantAmt
Revenue$73,273,004RevenueAmt
DescQUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (THE HOSPITAL), LOCATED IN KAMUELA, HAWAII ON THE ISLAND OF HAWAII, IS A NOT-FOR-PROFIT, ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR THE RESIDENTS AND VISITORS OF NORTH HAWAII. THE HOSPITAL WAS CHARTERED IN NOVEMBER 1987 AND COMMENCED OPERATIONS IN MAY 1996. THE HOSPITAL IS CURRENTLY LICENSED FOR 35 BEDS. ADMITTING PHYSICIANS ARE PRACTITIONERS IN THE LOCAL AREA. THE NUMBER OF PATIENTS SERVED FROM 7/1/2019 - 6/30/2020 THROUGH OUTPATIENT VISITS WAS 89,833 AND THE NUMBER OF ADMISSIONS WAS 1,589.Desc
Total Program Service Expenses$58,908,125TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee441EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSHANNON OLSENPersonNm
Phone8088814675PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line167-1125 MAMALAHOA HIGHWAYAddressLine1Txt
CityKAMUELACityNm
State AbbreviationHIStateAbbreviationCd
ZIP96743ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ARTHUR USHIJIMA
CHAIR/TRUSTEE - PART YEAR3.062.0Yes (X)Yes (X)$0$1,475,521$75,855
CYNTHIA KAMIKAWA
PRESIDENT/TRUSTEE54.01.0Yes (X)Yes (X)$0$472,903$86,918
DARRIN KUCZYNSKI MD
PHYSICIAN50.00.0$530,245$0$24,987Yes (X)
JILL HOGGARD GREEN
CHAIR/TRUSTEE - EFF. 10/20193.062.0Yes (X)Yes (X)$0$549,163$3,837
HOWARD WONG MD
PHYSICIAN50.00.0$449,026$0$16,475Yes (X)
TY CHUN MD
PHYSICIAN50.00.0$433,135$0$30,982Yes (X)
KARL MOON MD
PHYSICIAN50.00.0$426,460$0$30,626Yes (X)
SHARLENE TSUDA
SECRETARY1.054.0Yes (X)$0$358,689$87,979
WILLIAM RYAN MD
PHYSICIAN50.00.0$382,747$0$23,719Yes (X)
MONEY ATWAL
TREASURER45.010.0Yes (X)$0$217,990$34,368
LILINOE WATANABE
FORMER OFFICER0.055.0$0$205,634$43,278Yes (X)
SHARIANN GONSALVES
ASSISTANT SECRETARY40.00.0Yes (X)$63,792$0$15,467
ROBERT HASTINGS II
TRUSTEE1.00.0Yes (X)$0$0$0
NEIL KUYPER
TRUSTEE1.00.0Yes (X)$0$0$0
RICHARD LEVY PHD
TRUSTEE1.00.0Yes (X)$0$0$0
ROBERT LINDSAY
TRUSTEE1.00.0Yes (X)$0$0$0
KAHU BILLY MITCHELL
TRUSTEE1.00.0Yes (X)$0$0$0
ROBERT MOMSEN
TRUSTEE1.02.0Yes (X)$0$0$0
JENAI WALL
TRUSTEE1.06.0Yes (X)$0$0$0
MAENETTE BENHAM EDD
TRUSTEE1.02.0Yes (X)$0$0$0
KYLE CHOCK
TRUSTEE1.03.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,285,405TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,279,900TotReportableCompRltdOrgAmt
Total Other Compensation$474,491TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K60IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$5,755,899GovernmentGrantsAmt
All Other Contributions$5,838,078AllOtherContributionsAmt
Noncash Contributions$872,912NoncashContributionsAmt
Total Contributions$11,593,977TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE622110$68,593,240$68,593,240$0$0
STATE OF HI SUSTAINABILITY900099$4,288,698$4,288,698$0$0
INTERCOMPANY INCOME561000$156,926$156,926$0$0
FieldValueIRS element (for citing)
Total Program Service Revenue$73,038,864TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$260,651TotalRevenueColumnAmt
Unrelated Business Revenue$38,979UnrelatedBusinessRevenueAmt
Exclusion$221,672ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$285,527RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$285,527RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$285,527TotalRevenueColumnAmt
Exclusion$285,527ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,748SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$46,608OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,748SecuritiesAmt
Other-$46,608OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$40,860TotalRevenueColumnAmt
Exclusion-$40,860ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
VENDING MACHINE/CAFETERIA900099$229,727$0$0$229,727
GET REFUND900099$45,048$45,048$0$0
COMMON AREA MAINT. REIMBURSEMENTS900099$43,857$43,857$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$145,235TotalRevenueColumnAmt
Related Or Exempt Func Income$145,235RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$463,867OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$85,602,026TotalRevenueColumnAmt
Related Or Exempt Func Income$73,273,004RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$38,979UnrelatedBusinessRevenueAmt
Exclusion$696,066ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$65,158TotalAmt
Program Services$0ProgramServicesAmt
Management And General$65,158ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$29,529,102TotalAmt
Program Services$24,752,872ProgramServicesAmt
Management And General$4,722,366ManagementAndGeneralAmt
Fundraising$53,864FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$591,583TotalAmt
Program Services$525,327ProgramServicesAmt
Management And General$65,092ManagementAndGeneralAmt
Fundraising$1,164FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,420,480TotalAmt
Program Services$2,751,409ProgramServicesAmt
Management And General$658,418ManagementAndGeneralAmt
Fundraising$10,653FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,849,455TotalAmt
Program Services$1,467,168ProgramServicesAmt
Management And General$378,030ManagementAndGeneralAmt
Fundraising$4,257FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$56,607TotalAmt
Program Services$0ProgramServicesAmt
Management And General$56,607ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$51,330TotalAmt
Program Services$0ProgramServicesAmt
Management And General$51,330ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$60,219TotalAmt
Program Services$0ProgramServicesAmt
Management And General$60,219ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$2,773TotalAmt
Program Services$0ProgramServicesAmt
Management And General$2,773ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$337TotalAmt
Fundraising$337FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$3,897TotalAmt
Program Services$0ProgramServicesAmt
Management And General$3,897ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,426,831TotalAmt
Program Services$9,655,389ProgramServicesAmt
Management And General$1,771,442ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$114,785TotalAmt
Program Services$23,867ProgramServicesAmt
Management And General$90,918ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$260,566TotalAmt
Program Services$196,679ProgramServicesAmt
Management And General$59,220ManagementAndGeneralAmt
Fundraising$4,667FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$84,424TotalAmt
Program Services$42,814ProgramServicesAmt
Management And General$41,610ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,738,510TotalAmt
Program Services$437,843ProgramServicesAmt
Management And General$2,300,667ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$191,935TotalAmt
Program Services$145,306ProgramServicesAmt
Management And General$46,629ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$212,764TotalAmt
Program Services$177,628ProgramServicesAmt
Management And General$35,136ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$331,126TotalAmt
Program Services$33ProgramServicesAmt
Management And General$331,093ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,141,835TotalAmt
Program Services$3,942,039ProgramServicesAmt
Management And General$1,199,622ManagementAndGeneralAmt
Fundraising$174FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$585,046TotalAmt
Program Services$0ProgramServicesAmt
Management And General$585,046ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES$13,271,389$13,062,652$208,737$0
PROVIDER TAX$1,539,550$1,539,550$0$0
INTERCOMPANY PAYMENTS$8,003,215$0$8,003,215$0
DUES & SUBSCRIPTIONS$201,706$97,481$104,225$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$223,670TotalAmt
Program Services$90,068ProgramServicesAmt
Management And General$131,077ManagementAndGeneralAmt
Fundraising$2,525FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$79,958,293TotalAmt
Program Services$58,908,125ProgramServicesAmt
Management And General$20,972,527ManagementAndGeneralAmt
Fundraising$77,641FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,301,367BOYAmt
EOY$9,869,342EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,649,570BOYAmt
EOY$18,709,175EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,590,582BOYAmt
EOY$3,035,656EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,207,651BOYAmt
EOY$4,447,696EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,703,971BOYAmt
EOY$1,782,097EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$478,702BOYAmt
EOY$533,956EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$106,766,298LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$38,423,034LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$61,261,078BOYAmt
EOY$68,343,264EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,351,006BOYAmt
EOY$171,960EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$115,639,314BOYAmt
EOY$135,079,852EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$213,183,241BOYAmt
EOY$241,972,998EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,822,816BOYAmt
EOY$7,147,239EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,165,309BOYAmt
EOY$4,910,221EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$66,012,168BOYAmt
EOY$71,582,527EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$79,000,293BOYAmt
EOY$83,639,987EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,309,915BOYAmt
EOY$23,239,608EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$118,873,033BOYAmt
EOY$135,093,403EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$134,182,948BOYAmt
EOY$158,333,011EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$213,183,241BOYAmt
EOY$241,972,998EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,643,733ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$173NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$18,506,503OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Media Advertisements$0MediaAdvertisementsAmt
Mailings MembersfalseMailingsMembersInd
Mailings Members$0MailingsMembersAmt
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Publications Or Broadcast$0PublicationsOrBroadcastAmt
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Grants Other Organizations$0GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Direct Contact Legislators$0DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Rallies Demonstrations$0RalliesDemonstrationsAmt
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$2,773OtherActivitiesAmt
Total Lobbying Expenditures$2,773TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationLOBBYING EXPENSES ARE THE PORTION OF DUES PAID TO HEALTHCARE ASSOCIATIONS ALLOCATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,391,892BeginningYearBalanceAmt
Investment Earnings Or Losses-$44,257InvestmentEarningsOrLossesAmt
Other Expenditures$195,249OtherExpendituresAmt
Administrative Expenses$22,749AdministrativeExpensesAmt
End Year Balance$4,129,637EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,533,839BeginningYearBalanceAmt
Investment Earnings Or Losses$140,572InvestmentEarningsOrLossesAmt
Other Expenditures$272,942OtherExpendituresAmt
Administrative Expenses$9,577AdministrativeExpensesAmt
End Year Balance$4,391,892EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,661,526BeginningYearBalanceAmt
Investment Earnings Or Losses$314,819InvestmentEarningsOrLossesAmt
Other Expenditures$409,523OtherExpendituresAmt
Administrative Expenses$32,983AdministrativeExpensesAmt
End Year Balance$4,533,839EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,715,923BeginningYearBalanceAmt
Contributions$1,217ContributionsAmt
Investment Earnings Or Losses$385,499InvestmentEarningsOrLossesAmt
Other Expenditures$414,534OtherExpendituresAmt
Administrative Expenses$26,579AdministrativeExpensesAmt
End Year Balance$4,661,526EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,930,827BeginningYearBalanceAmt
Contributions$440,000ContributionsAmt
Investment Earnings Or Losses-$195,847InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$423,897OtherExpendituresAmt
Administrative Expenses$35,160AdministrativeExpensesAmt
End Year Balance$4,715,923EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,210,000OtherCostOrOtherBasisAmt
Book Value$12,210,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,182,611OtherCostOrOtherBasisAmt
Depreciation$16,120,520DepreciationAmt
Book Value$42,062,091BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,139,498OtherCostOrOtherBasisAmt
Depreciation$412,715DepreciationAmt
Book Value$726,783BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,950,450OtherCostOrOtherBasisAmt
Depreciation$21,889,799DepreciationAmt
Book Value$9,060,651BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,283,739OtherCostOrOtherBasisAmt
Book Value$4,283,739BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$68,343,264TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
EQUITY IN PARKER RANCH FDN TRU$123,237,000
INVESTMENT IN LIBERTY DIALYSIS$42,106
BENEFICIAL INTERESTS$4,129,637
CONTRIBUTED USE OF LAND$6,705,416
DUE FROM AFFILIATES$805,960
OTHER RECEIVABLES$159,733
FieldValueIRS element (for citing)
Total Book Value Other Assets$135,079,852TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DEFERRED RENT$107,982
GENERAL AND PROF TAIL LIABILITY$77,886
DUE TO GOVT PROGRAMS$7,493,666
DUE TO AFFILIATES$63,902,993
FieldValueIRS element (for citing)
Total Liability$71,582,527TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4INTENDED USE OF ENDOWMENT FUNDS THE ORGANIZATION HAS BENEFICIAL INTERESTS IN SEVERAL ENDOWMENTS, ALL WITH THE PURPOSE OF PROVIDING RESOURCES TO BE USED TO ENHANCE HEALTH CARE SERVICES IN NORTH HAWAII.
SCHEDULE D, PART X, LINE 2FIN 48 (ASC 740) FOOTNOTE QHS EVALUATES ITS UNCERTAIN TAX POSITIONS AND HAS NO MATERIAL UNRECOGNIZED TAX POSITIONS AS OF JUNE 30, 2020.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,450TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$41,450NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,147,014TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,000,207DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,146,807NetCommunityBenefitExpnsAmt
Total Expense0.07690TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,188,464TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,000,207DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,188,257NetCommunityBenefitExpnsAmt
Total Expense0.07740TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$365,883TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$910,831DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$365,883TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$910,831DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,554,347TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,911,038DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,188,257NetCommunityBenefitExpnsAmt
Total Expense0.07740TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$7,595,493BadDebtExpenseAmt
Bad Debt Expense Attributable$115,835BadDebtExpenseAttributableAmt
Reimbursed By Medicare$12,773,658ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,386,837CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,613,179MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1QUEEN'S NORTH HAWAII COMM HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line167-1125 MAMALAHOA HIGHWAYAddressLine1Txt
CityKAMUELACityNm
State AbbreviationHIStateAbbreviationCd
ZIP967438496ZIPCd
FieldValueIRS element (for citing)
Website AddressWWWW.NHCH.COMWebsiteAddressTxt
State License39-HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherNORTH HAWAII MEDICAL GROUP AND KOHALA HOME HEALTH AGENCYOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1QUEEN'S NORTH HAWAII COMM HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care250.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SECTION C, PART VFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SECTION C, PART VFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3ETHE 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 5INPUT 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 6ACHNA 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 6BCHNA 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 & 10AWEBSITE WHERE THE CHNA AND MOST RECENTLY ADOPTED IMPLEMENTATION STARTEGY CAN BE ACCESSED: https://www.queens.org/north-hawaii/about-us/community-benefit-nhch
SCHEDULE H, PART V, SECTION B, LINE 11NEEDS 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). WITH THE VASTNESS OF HAWAII ISLAND, IT IS EASY FOR PEOPLE AND PROBLEMS, LIKE HOUSELESSNESS, SEVERE MENTAL ILLNESS, AND SUBSTANCE ABUSE, TO REMAIN HIDDEN AND FORGOTTEN. SOME PREFER NOT TO GO TO THE DOCTOR BECAUSE THEY DO NOT TRUST THEM, THEY FEEL DISRESPECTED AND DISCRIMINATED AGAINST, AND THEY LACK THE MONEY NEEDED FOR PRESCRIPTIONS. MANY JUST WAIT UNTIL THE POINT WHERE THEY ARE SENT TO URGENT CARE OR THE EMERGENCY ROOM. A DIFFICULT AND COMMON BARRIER IS RETURNING TO THE DOCTOR FOR FOLLOW-UPS, WHICH OFTEN DOES NOT HAPPEN BECAUSE OF THE INCONVENIENCE AND LACK OF TRANSPORTATION. THERE ARE DISPARITIES WITHIN THE WAIMEA COMMUNITY, SUCH AS HIDDEN POVERTY THAT REVEALS ITSELF IN THE SCHOOLS. QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL DEVELOPED THE FOLLOWING STRATEGIES TO IMPROVE ACCESS TO CARE AND PROVIDE HIGH QUALITY SERVICES AT A REASONABLE COST: PRIORITIES: 1. IMPROVE HEALTH CARE BY FOCUSING ON AVAILABILITY OF CARE. 2019 - 2020: RECRUIT AND HIRE SPECIALTY PHYSICIANS AND STAFF. 2019 - 2020: DEVELOP WOUND CARE SERVICES. 2019 - 2020: EXPAND PULMONARY SERVICES. 2. SUPPORT NAVIGATION OF ALL PATIENTS AS A WAY TO PROACTIVELY ENSURE ACCESS TO CLINICAL CARE, TRAVEL SUPPORT, FINANCIAL INFORMATION. 2019 - 2020: EXPAND CHILD/ADOLESCENT PSYCHIATRIC SERVICES TO CARE FOR THIS POPULATION'S MENTAL HEALTH NEEDS. ALTHOUGH NHCH WILL NOT DIRECTLY BE ADDRESSING ALL OF THE AREAS OF NEED LISTED ON THE CHNA REPORT, WE HAVE SUPPORTED AND PARTNERED WITH OTHERS TO ADDRESS SEVERAL OF THEM AND WILL CONTINUE TO SUPPORT OPPORTUNITIES TO ADDRESS COMMUNITY HEALTH NEEDS IN COLLABORATION WITH OTHERS.
SCHEDULE H, PART V, SECTION B, LINE 13BINCOME 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, LINES 16A, 16B & 16CTHE FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL WEBSITE AT: https://www.queens.org/north-hawaii/patients-and-visitors/pay-your-bill-nh ch
SCHEDULE H, PART V, SECTION B, LINE 16JOTHER METHOD FOR PUBLICIZING POLICIES NOTICES THAT FINANCIAL ASSISTANCE IS AVAILABLE IS 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.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
HALE OLA PONO
65-1267 KAWAIHAE ROADWAIMEAHI96743PRIMARY CARE CLINIC
N HAWAII COM HOSP SPECIALTY CARE CLINIC
67-1185 MAMALAHOA HIGHWAYKAMUELAHI96743SPECIALTY CARE CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 6COMMUNITY BENEFIT REPORT - RELATED ORGANIZATION COMMUNITY BENEFITS ARE REPORTED ANNUALLY AS PART OF THE FORM 990. THIS IS NOT SEPARATELY AVAILABLE TO THE PUBLIC. A FORMAL REPORT ISSUED BY THE PARENT COMPANY, THE QUEEN'S HEALTH SYSTEMS, INCLUDES THE COMMUNITY BENEFITS OF THE QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL. THIS REPORT IS PUBLISHED PERIODICALLY AND IS SEPARATELY AVAILABLE TO THE PUBLIC.
SCHEDULE H, PART I, LINE 7COSTING METHODOLOGY THE COSTING METHODOLOGY CONSIDERS ALL PATIENT SEGMENTS. AMOUNTS REPRESENT THE NET COSTS FOR THE VARIOUS PROGRAMS AND OPERATIONS, CONSIDERING ACTUAL AMOUNTS INCURRED AND CALCULATED BENEFITS BASED ON COST-TO-CHARGE RATIOS AND AVERAGE RATES (I.E. WAGE RATES).
SCHEDULE H, PART III, LINE 2BAD DEBT METHODOLOGY NHCH PROVIDES AN ALLOWANCE AGAINST ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE BY ESTABLISHING AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. NHCH ESTIMATES THE ALLOWANCE BASED ON THE AGING OF THE ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR AND OTHER RELEVANT FACTORS. NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER NHCH'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED ON THE COST-TO-CHARGE RATIO. THE HOSPITAL ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ACCOUNTING STANDARDS UPDATE 2014-09 TOPIC 606 (ASU 606) EFFECTIVE JULY 1, 2018. ASU 606 AND THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) DIFFERENTIATE BAD DEBT FROM IMPLICIT PRICE CONCESSIONS. THE HOSPITAL MAKES A DETERMINATION REGARDING A PRICE CONCESSION TO STANDARD PRICING ON A PORTFOLIO BASIS PRIOR TO ASSESSING THE CREDIT RISK OF INDIVIDUALS WITHIN THE PORTFOLIO. PATIENT SERVICE REVENUE IS RECORDED NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, INCLUDING AN ESTIMATE FOR IMPLICIT PRICE CONCESSIONS. BAD DEBT IS RECORDED AS AN OPERATING EXPENSE AND RESULTS WHEN A PATIENT, DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES, IS UNWILLING TO DO SO. THE AMOUNT SHOWN ON PART III, LINE 2 IS THE PRICE CONCESSION AMOUNT FOR THE TAX YEAR ENDED JUNE 30, 2020.
SCHEDULE H, PART III, LINE 3BAD DEBT AS COMMUNITY BENEFIT THE PORTION OF THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING THE COST TO CHARGE RATIO TO THE TOTAL BAD DEBT EXPENSE. BAD DEBT PERTAINING TO PATIENT CARE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE, CONSISTENT WITH NHCH'S MISSION, PATIENTS RECEIVE CARE REGARDLESS OF WHETHER NHCH COLLECTS PAYMENT FOR SERVICES PERFORMED.
SCHEDULE H, PART III, LINE 4BAD DEBT EXPENSE FOOTNOTE NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AUDITED FINANCIAL STATEMENTS DO NOT DESCRIBE BAD DEBT EXPENSE. THE AUDITED FINANCIAL STATEMENTS DO DESCRIBE THE 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 8TREATMENT OF MEDICARE SHORTFALL COMMUNITY BENEFIT THE HOSPITAL MUST TREAT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE GOVERNMENT SETS NON-NEGOTIABLE MEDICARE RATES AND THE REIMBURSEMENT HAS NOT KEPT PACE WITH THE RISING COSTS OF PROVIDING THESE SERVICES. DUE TO THE REQUIREMENT TO PROVIDE CARE AND THE INABILITY OF THE MEDICARE REIMBURSEMENT TO KEEP PACE WITH THE COST OF PROVIDING SERVICES, WE FEEL THAT THE LOSS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES IS PART OF NHCH'S MISSION AND IS A BENEFIT TO THE COMMUNITY. MEDICARE COSTING METHODOLOGY THE MEDICARE AMOUNTS ABOVE ARE CALCULATED WITH DATA FROM THE JUNE 30, 2020 COST REPORT USING THE STEP DOWN METHOD.
SCHEDULE H, PART III, LINE 9BAPPLICATION OF THE COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE CHARITY CARE WILL BE GRANTED TO ALL UNDERINSURED AND UNINSURED PATIENTS. THE SCREENING PROCESS WILL OPTIMALLY OCCUR AT THE TIME OF SERVICE, BUT MAY OCCUR ANYTIME DURING THE COLLECTION PROCESS INCLUDING POST ASSIGNMENT TO AN OUTSIDE COLLECTION AGENCY. ACCOUNTS FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE IDENTIFIED FOR A YEAR AND ASSESSED ANNUALLY AND/OR DURING SUBSEQUENT VISITS TO THE HOSPITAL. PROMPT PAYMENT DISCOUNTS ARE AVAILABLE FOR PATIENTS WHO PAY FOR SERVICE AT THE TIME OF TREATMENT. THE CARE PAYMENT PROGRAM IS AVAILABLE FOR ELIGIBLE PATIENTS AND PROVIDES LOW MONTHLY PAYMENTS WITH 0% INTEREST.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT ADMITTING PHYSICIANS ARE PRACTITIONERS IN THE LOCAL AREA AND THE BOARD IS COMPRISED OF COMMUNITY MEMBERS. THIS ALLOWS THE HOSPITAL TO ASSESS THE NEEDS OF THE COMMUNITY THAT IT SERVES. IN ADDITION, MANY COMMUNITY HEALTH SERVICES ARE OFFERED IN THE FORMS OF ACTIVITIES OR PROGRAMS THAT HELP TO ASSESS AND IMPROVE COMMUNITY HEALTH. AS REPORTED IN SCHEDULE H, PART V, SECTION B, FOR THE 2018 TAX YEAR, QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL COMPLETED A CHNA WITH THE ASSISTANCE OF THE HEALTHCARE ASSOCIATION OF HAWAII.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE NOTICES ARE POSTED IN ALL PATIENT REGISTRATION, BILLING OFFICE AND EMERGENCY DEPARTMENT AREAS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME AND UNINSURED PATIENTS. THIS INFORMATION IS ALSO POSTED ON THE HOSPITAL WEBSITE AND ON PATIENT BILLING STATEMENTS. APPROPRIATE STAFF MEMBERS THAT COMMUNICATE WITH THE PUBLIC REGARDING THEIR BILLS ARE TRAINED AND KNOWLEDGEABLE ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL IS LOCATED IN KAMUELA, HAWAII, ALSO KNOWN AS WAIMEA, HAWAII, IN THE KOHALA DISTRICT OF THE NORTHEASTERN REGION OF THE ISLAND OF HAWAII. IT IS A NOT-FOR-PROFIT, ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR ABOUT 30,000 RESIDENTS AND VISITORS OF NORTH HAWAII. THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF APPROXIMATELY ONE-FOURTH, OR 1,000 SQUARE MILES, OF THE BIG ISLAND'S 4,028 TOTAL SQUARE MILES. THERE ARE CURRENTLY NO OTHER GENERAL ACUTE CARE HOSPITALS IN THE PRIMARY SERVICE AREA. THE HOSPITAL WAS CHARTERED IN NOVEMBER 1987 AND COMMENCED OPERATIONS IN MAY 1996. THE HOSPITAL IS CURRENTLY LICENSED FOR 35 BEDS. ADMITTING PHYSICIANS ARE PRACTITIONERS IN THE LOCAL AREA.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH THE MAJORITY OF THE ORGANIZATION'S BOARD IS COMPRISED OF COMMUNITY MEMBERS FROM THE NORTHERN HAWAII AREA AND HAS AN OPEN MEDICAL STAFF. THE HOSPITAL CONDUCTED DIFFERENT EVENTS INCLUDING HEALTH FAIRS AND EDUCATION DAYS IN THE LOCAL COMMUNITY, HOTELS AND SCHOOLS OF THE AREA AS WELL AS TAKING A LEAD ROLE IN BREAST CANCER AWARENESS MONTH.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM NHCH IS A MEMBER OF THE QUEEN'S HEALTH SYSTEMS (QHS) AFFILIATED GROUP. THE GROUP INCLUDES QUEEN'S MEDICAL CENTER (QMC), QUEEN EMMA LAND COMPANY (QEL), QUEEN'S INSURANCE EXCHANGE (QIE), QUEEN'S DEVELOPMENT CORPORATION (QDC) AND MOLOKAI GENERAL HOSPITAL (MGH). QHS PROVIDED LEGAL, ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO NHCH AND QIE PROVIDED MEDICAL MALPRACTICE INSURANCE TO NHCH. IN RETURN, NHCH ASSISTED QMC IN FULFILLING ITS MISSION TO PROVIDE IN PERPETUITY QUALITY HEALTH CARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL THE PEOPLE OF HAWAII.
SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORT N/A

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ARTHUR USHIJIMA
CHAIR/TRUSTEE - PART YEAR$0$956,872$0$362,479$0$156,170$0$60,842$0$15,013$0$1,551,376$0$0
CYNTHIA KAMIKAWA
PRESIDENT/TRUSTEE$0$359,136$0$86,124$0$27,643$0$72,312$0$14,606$0$559,821$0$0
DARRIN KUCZYNSKI MD
PHYSICIAN$470,870$0$59,375$0$0$0$8,400$0$16,587$0$555,232$0$0$0
JILL HOGGARD GREEN
CHAIR/TRUSTEE - EFF. 10/2019$0$243,592$0$304,680$0$891$0$0$0$3,837$0$553,000$0$0
HOWARD WONG MD
PHYSICIAN$408,364$0$38,340$0$2,322$0$8,400$0$8,075$0$465,501$0$0$0
TY CHUN MD
PHYSICIAN$376,724$0$38,279$0$18,132$0$8,400$0$22,582$0$464,117$0$0$0
KARL MOON MD
PHYSICIAN$404,585$0$21,875$0$0$0$8,400$0$22,226$0$457,086$0$0$0
SHARLENE TSUDA
SECRETARY$0$274,642$0$69,262$0$14,785$0$72,551$0$15,428$0$446,668$0$0
WILLIAM RYAN MD
PHYSICIAN$345,727$0$30,161$0$6,859$0$8,400$0$15,319$0$406,466$0$0$0
MONEY ATWAL
TREASURER$0$194,652$0$22,716$0$622$0$17,842$0$16,526$0$252,358$0$0
LILINOE WATANABE
FORMER OFFICER$0$175,753$0$21,454$0$8,427$0$35,188$0$8,090$0$248,912$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3THE 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 7OTHER NON-FIXED PAYMENTS RECOGNITION AWARDS WERE PAID TO EMPLOYEES BASED ON ACCOMPLISHMENTS OF PREDETERMINED GOALS SET FORTH IN THE INCENTIVE AND STRATEGIC PLANS AND DEFINED ELIGIBILITY OF THE EMPLOYEE. RECOGNITION AWARDS ARE DISCRETIONARY AND CONSIDER QUALITY THRESHOLDS WHICH INCLUDE ANNUAL ACCREDITATION AND MINIMUM OPERATING INCOME LEVEL CRITERIA. IN ADDITION, EXECUTIVE AWARDS ARE WEIGHTED BASED ON INDIVIDUAL GOALS ESTABLISHED FOR EACH EXECUTIVE.
SCHEDULE J, PART II & FORM 990, PART VIICOMPENSATION 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 NHCH IS 3 HOUR PER WEEK. HE IS 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 QUEEN'S RELATED AFFILIATES. 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 NHCH IS 1 HOUR PER WEEK. SHE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR HER VARIOUS SERVICES. CYNTHIA KAMIKAWA MS. KAMIKAWA SERVES AS VP OF QHS AND IS PRESIDENT OF QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. SHARLENE TSUDA MS. TSUDA SERVES AS 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. MONEY ATWAL MR. ATWAL SERVES DIRECTOR OF FINANCE AND INFORMATION TECHNOLOGY FOR MOLOKAI GENERAL HOSPITAL ("MGH") AND NHCH AND TREASURER OF NHCH. HE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR ALL SERVICES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DEPT OF BUDGET & FINANCE STATE OF HIBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN990266961BondIssuerEIN
CUSIP419800LM7CUSIPNum
Bond Issued2015-01-29BondIssuedDt
Issue Price$350,356,476IssuePriceAmt
PurposeSEE PART VIPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$0RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$350,362,507TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$4,726,000IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$185,627,500CapitalExpendituresAmt
Other Spent Proceeds$160,009,007OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2019SubstantialCompletionYr
Refunding Tax Exempt BondsYes (true)RefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadefalseFinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsYes (true)AnyResearchAgreementsInd
Engage Bond Counsel ResearchYes (true)EngageBondCounselResearchInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DueYes (true)NoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecYes (true)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1ML CAPITAL SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Term Of Hedge6.5TermOfHedgePct
Superintegrated HedgefalseSuperintegratedHedgeInd
Hedge TerminatedfalseHedgeTerminatedInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE KDESCRIPTION OF ARRANGEMENT RELATED ORGANIZATION REPORTING QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL'S (NHCH) SOLE CORPORATE MEMBER, THE QUEEN'S HEALTH SYSTEMS (QHS) BORROWED ON BEHALF OF ITSELF AND ITS AFFILIATES, THE QUEEN'S MEDICAL CENTER (QMC) AND QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH). INFORMATION REPORTED ON SCHEDULE K IS FOR THE ENTIRE BOND ISSUE. THE OUTSTANDING BOND LIABILITY IS ALLOCATED BETWEEN ENTITIES AND REPORTED SEPERATELY ON FORM 990, PART X. NHCH'S SHARE OF THE OUTSTANDING LIABILITY IS $4,910,221.
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 2CTHE REBATE CALCULATION WAS PERFORMED ON JANUARY 29, 2020.

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution6ContributionCnt
Noncash Contributions Rpt F990$854,934NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution2ContributionCnt
Noncash Contributions Rpt F990$17,978NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART I, COLUMN BFormAndLineReferenceDesc
ExplanationTHE AMOUNTS REPORTED IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS RECEIVED.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4ATO SUPPORT THE QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL'S (NHCH) MISSION AND TO FULFILL THE TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, NHCH PROVIDED THE FOLLOWING COMMUNITY BENEFITS, TOTALING APPROXIMATELY $8,917,271 FOR THE YEAR ENDED JUNE 30, 2020. 1. UNCOMPENSATED CARE - NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). FOR THE YEAR ENDED JUNE 30, 2020, THE ESTIMATED COST OF PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $41,450 AND $115,835 RESPECTIVELY. 2. MEDICAID SHORTFALL IN PAYMENTS - NHCH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICAID PATIENTS IN THE STATE OF HAWAII. NHCH INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $6,146,807 DURING THE YEAR ENDED JUNE 30, 2020. 3. MEDICARE SHORTFALL IN PAYMENTS - NHCH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICARE PATIENTS IN THE STATE OF HAWAII. NHCH INCURRED COSTS IN EXCESS OF REIMBURSEMENT BASED ON MEDICARE COST REPORTS OF APPROXIMATELY $2,613,179 DURING THE YEAR ENDED JUNE 30, 2020. CONSISTENT WITH COST REPORT REQUIREMENTS, THERE ARE AMOUNTS THAT ARE EXCLUDED FROM THE COSTS ABOVE. 4. COMMUNITY OUTREACH PROGRAMS - NHCH PROVIDES MEDICAL NUTRITION THERAPY FREE OF CHARGE TO ANYONE ON THE BIG ISLAND. IN ADDITION, NUTRITION CLASSES WERE TAUGHT AT AN ONCOLOGY SUPPORT GROUP, LOCAL SCHOOL AND SENIOR CENTER AND OTHER ACTIVITIES WERE PROVIDED TO COMMUNITY TO SUPPORT NUTRITION EDUCATION.
FORM 990, PART VI, LINE 6MEMBERS OR STOCKHOLDERS NHCH HAS A SOLE MEMBER, WHICH IS THE QUEEN'S HEALTH SYSTEMS (QHS), A HAWAII NONPROFIT CORPORATION.
FORM 990, PART VI, LINE 7APOWER TO ELECT OR APPOINT MEMBERS QHS ELECTS ALL OF THE BOARD MEMBERS OF THE NHCH BOARD OF TRUSTEES.
FORM 990, PART VI, LINE 7BDESCRIPTION OF CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS CERTAIN MAJOR DECISIONS APPROVED BY THE NHCH BOARD OF TRUSTEES MUST ALSO BE APPROVED BY QHS. SUCH DECISIONS INCLUDE: 1. A CHANGE TO THE PURPOSE OF THE COMPANY; 2. A FINANCING TRANSACTION IN EXCESS OF $500,000; 3. A LEASE TRANSACTION THAT HAS A TERM THAT IS LONGER THAN 3 YEARS OR HAS A RENT OBLIGATION IN EXCESS OF $1,000,000 OVER THE LEASE TERM; 4. A TRANSACTION INVOLVING THE SALE, LEASE, DISPOSITION OR HYPOTHECATION OF REAL PROPERTY; 5. ANNUAL OPERATIONAL AND CAPITAL BUDGETS; 6. STRATEGIC PLANS; 7. MERGER OR MAJOR ACQUISITIONS; 8. CREATION OF A NEW ENTITY OR JOINT VENTURE; 9. SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; 10. DISSOLUTION; 11. AMENDMENT OF BYLAWS; 12. ADOPTION, AMENDMENT OR RESCISSION OF A BOARD POLICY; 13. CAPITAL EXPENDITURES IN EXCESS OF $1,000,000 FOR NHCH.
FORM 990, PART VI, LINE 11BPROCESS 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 QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL (NHCH) RETURN WAS MADE AVAILABLE TO EACH OF THE MEMBERS OF THE NHCH BOARD OF TRUSTEES PRIOR TO THE RETURNS BEING FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, LINES 12, 13 & 14APPROVED POLICIES THE CONFLICT OF INTEREST, WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES HAVE BEEN APPROVED BY QHS ON BEHALF OF THE NHCH BOARD OF TRUSTEES BUT HAVE NOT BEEN SEPARATELY APPROVED BY THE NHCH BOARD. AS SUCH, LINES 12, 13 AND 14 HAVE BEEN CHECKED 'NO'.
FORM 990, PART VI, LINE 12CMONITORING 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 & 15BPROCESS FOR DETERMINING COMPENSATION A COMMITTEE OF THE BOARD OF TRUSTEES CALLED THE COMPENSATION COMMITTEE MEETS REGULARLY TO REVIEW THE COMPENSATION OF ALL EXECUTIVES OF ALL COMPANIES WITHIN QHS. NHCH'S EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY FOR ITS PRESIDENT. ALL DECISIONS REGARDING EXECUTIVE COMPENSATION ARE MADE IN CONFORMITY WITH THE PROCEDURES REQUIRED TO ESTABLISH A REBUTTABLE PRESUMPTION OF REASONABLENESS. ANY ADJUSTMENT TO COMPENSATION IS SUBJECT TO THE PROCESS OF ANNUAL PERFORMANCE REVIEWS AND COMPARISON TO COMPARABLE COMPENSATION DATA PREPARED BY A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. THE MOST RECENT REVIEW TOOK PLACE IN OCTOBER 2020. OUTSIDE COUNSEL ASSISTS WITH THE REVIEW PROCESS AND DOCUMENTS THE DECISIONS OF THE COMMITTEE.
FORM 990, PART VI, LINE 19AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE GENERAL PUBLIC NHCH'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND THE QHS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS TAX RETURN, AS REQUIRED. NHCH DOES NOT MAKE THE CONFLICT OF INTEREST POLICY THAT IT FOLLOWS AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS CHANGE IN BENEFICIAL INTEREST $ 18,506,507 ROUNDING $ (4) ------------ TOTAL $ 18,506,503
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED SERVICE TOTAL FEES:5804141
FORM 990 PART IX LINE 11GDESCRIPTION:MEDICAL SERVICE TOTAL FEES:5595156
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING SERVICE TOTAL FEES:27534

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
LUCY K HENRIQUES TRUST
1301 PUNCHBOWL STREETHONOLULUHI96813996002291SUPPORTHI501(c)(3)12cNAfalse
PARKER RANCH FOUNDATION TRUST
66-1304 MAMALAHOA HIGHWAYKAMUELAHI96743996064620PROPERTY MGMTHI501(c)(3)12aNAfalse
THE QUEEN'S HEALTH SYSTEMS
1301 PUNCHBOWL STREETHONOLULUHI96813990238120ADMIN SERVICEHI501(c)(3)12cNAfalse
QUEEN EMMA LAND COMPANY
1301 PUNCHBOWL STREETHONOLULUHI96813990183769SUPPORT SVCSHI501(c)(3)12aQHSYes (true)
THE QUEEN'S MEDICAL CENTER
1301 PUNCHBOWL STREETHONOLULUHI96813990073524MEDICAL SVCSHI501(c)(3)3QHSYes (true)
MOLOKAI GENERAL HOSPITAL
PO BOX 408KAUNAKAKAIHI96748990251372MEDICAL SVCSHI501(c)(3)3QHSYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
HAMAMATSUQUEEN'S PET IMAGING CENTER LL
1301 PUNCHBOWL STREETHONOLULUHI96813943266916PET IMAGINGHINAN/A
PRIMARY CARE PHYSICIAN ENTERPRISE LLC
1301 PUNCHBOWL STREETHONOLULUHI96813834591861MEDICAL SERVICESHINAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
THE QUEEN'S DEVELOPMENT CORPORATION
1301 PUNCHBOWL STREETHONOLULUHI96813990240109DEVELOPMENTHINAC CorpYes (true)
QUEEN'S INSURANCE EXCHANGE
1301 PUNCHBOWL STREETHONOLULUHI96813911913839INSURANCEHINAC CorpYes (true)
DIAGNOSTIC LABORATORY SERVICES INC
99-859 IWAIWA STREETAIEAHI96701990240499MEDICAL LAB SVCSHINAC CorpYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DIAGNOSTIC LABORATORY SERVICES INC
j$135,100FMV
THE QUEEN'S MEDICAL CENTER
m$310,148FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART IIIFormAndLineReferenceDesc
ExplanationIDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP HAMAMATSU/QUEEN'S PET IMAGING CENTER, LLC EIN: 94-3266916 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 PRIMARY CARE PHYSICIAN ENTERPRISE LLC EIN: 83-4591861 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813ExplanationTxt