2020-05-15T13:40:12-05:00 2019-06-30 ERNST & YOUNG US LLP 4365 EXECUTIVE DR 1600 SAN DIEGO CA 92121 990 2018-07-01 990073524 THE QUEEN'S MEDICAL CENTER % CLINTON YEE QUEE 8085389011 1301 PUNCHBOWL STREET HONOLULU HI 96813 MICHEL RICCIONI TREASURER 2020-05-08 true JOCELYNE MILLER P00634378 8585357200 76.103.183.71 33577420201365000009 2020-05-15 P 337686BC7CC6EC2662FF9B863E3DABD55E8368B5 659BA02A141F0A93D56BC6460424A0B381644DBC 2018 2020-09-23 17:36:50Z JILL HOGGARD GREEN 1301 PUNCHBOWL STREET HONOLULU HI 96813 1645148163 false X WWW.QUEENSMEDICALCENTER.NET 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. 25 21 5849 448 8714667 0 71504792 58025207 1081549811 1118237520 16166041 32483732 20491658 20967773 1189712302 1229714232 3179151 3320519 0 0 530161399 544192128 0 0 283823 574790188 561402203 1108130738 1108914850 81581564 120799382 1820754936 2117525376 955667992 1137700085 865086944 979825291 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 1057055826 3320519 1131735916 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. 1057055826 true true false true false false false false false true true true false true true true false true false false false 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 5849 true true true false false false false true true false false false false false false X 25 21 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 MAENETTE BENHAM EDD TRUSTEE 1.0 3.0 X 0 0 0 GARY CAUFIELD TRUSTEE 1.0 2.0 X 0 0 0 DIANE CECCHETTINI RN TRUSTEE 1.0 2.0 X 0 0 0 PATRICK CHING TRUSTEE 1.0 2.0 X 0 0 0 KYLE CHOCK TRUSTEE 1.0 2.0 X 0 0 0 CHRISTINE GAYAGAS TRUSTEE 1.0 1.0 X 0 0 0 PETER HALFORD MD TRUSTEE 3.0 2.0 X 0 9798 0 PETER HANASHIRO TRUSTEE 1.0 2.0 X 0 0 0 ROBERT HONG MD TRUSTEE - PART YEAR 50.0 0.0 X 457873 0 19666 KEAWE KAHOLOKULA PHD TRUSTEE 1.0 2.0 X 0 0 0 KAMANI KUALA'AU TRUSTEE 1.0 2.0 X 0 0 0 STANLEY KURIYAMA TRUSTEE 1.0 2.0 X 0 0 0 KRISTI LEFFORGE TRUSTEE 1.0 1.0 X 0 0 0 SHERRY MENOR-MCNAMARA TRUSTEE 1.0 2.0 X 0 0 0 ROBERT MOMSEN TRUSTEE 1.0 3.0 X 0 0 0 CAMERON NEKOTA TRUSTEE 1.0 2.0 X 0 0 0 STEVEN NISHIDA MD TRUSTEE 1.0 2.0 X 0 0 0 ROBB OHTANI MD TRUSTEE 61.0 0.0 X 0 348108 0 JAMES STEINWASCHER TRUSTEE 1.0 1.0 X 0 0 0 NADINE TENN SALLE MD TRUSTEE/CHIEF OF PEDIATRICS 15.0 2.0 X 0 37842 0 ARTHUR USHIJIMA TRUSTEE/PRESIDENT 25.0 40.0 X X 0 1602592 91312 ALLEN UYEDA TRUSTEE 1.0 1.0 X 0 0 0 JENAI WALL TRUSTEE/CHAIR 1.0 3.0 X X 0 0 0 LESLIE WILCOX TRUSTEE 1.0 1.0 X 0 0 0 C SCOTT WO PHD TRUSTEE 1.0 2.0 X 0 0 0 JIM YATES TRUSTEE 1.0 2.0 X 0 0 0 JOELLE TANABE ASSISTANT SECRETARY 9.0 36.0 X 0 109767 36068 MICHEL RICCIONI TREASURER 20.0 45.0 X 0 769665 59031 SUSAN MURRAY VP/COO - QMC WEST OAHU 42.0 13.0 X 561795 0 75908 JASON CHANG EVP/COO 25.0 30.0 X 788330 0 55780 JOHN NITAO VP/GENERAL COUNSEL 2.0 53.0 X 0 570144 65816 SHARLENE TSUDA SECRETARY 2.0 53.0 X 0 354997 61435 CLINTON YEE ASSISTANT TREASURER 37.0 18.0 X 0 210786 45331 WHITNEY LIMM MD SENIOR VICE PRESIDENT 12.0 48.0 X 0 855609 113462 JEFFREY MING SHAN LAU MD PHYSICIAN 50.0 0.0 X 731508 0 26745 SUNG BAE LEE MD PHYSICIAN 50.0 0.0 X 1077064 0 63258 JEFFREY LOH MD PHYSICIAN 50.0 0.0 X 1235681 0 60681 TODD SETO MD PHYSICIAN 50.0 0.0 X 705899 0 57567 MAHDI VEILLET-CHOWDHURY MD PHYSICIAN 50.0 0.0 X 813698 0 31216 ERIC MARTINSON FORMER TREASURER 0.0 60.0 X 0 745842 82474 6371848 5615150 945750 1781 true true false 0 806039 51004948 3065362 3148858 37610 58025207 NET PATIENT REVENUE 622110 1099781812 1099781812 0 0 INTERCOMPANY PURCHASED SERVICES 561000 14743946 14743946 0 0 PATHOLOGY LABS 621500 3711762 0 3711762 0 1118237520 8574646 81449 8493197 0 0 2618157 2618157 0 2618157 2618157 438987615 148705 414289446 937788 24698169 -789083 23909086 23909086 136461 806039 206697 -70236 -70236 0 0 0 0 0 0 OTHER SERVICES 621500 6998038 5561720 1436318 0 RESEARCH 621500 2119639 2119639 0 0 CIPN INCOME 621500 3485138 0 3485138 0 5817037 5817037 0 18419852 1229714232 1128024154 8714667 34950204 X 3320519 3320519 0 0 0 0 0 0 1429762 0 1429762 0 0 0 0 0 430142010 423948374 6193636 0 29523706 29230727 292979 0 53849602 52390930 1458672 0 29247048 28844758 402290 0 0 0 0 0 553532 172592 380940 0 400591 0 400591 0 53877 0 53877 0 0 0 740394 0 740394 0 130430797 127452675 2978122 0 546876 523832 23044 0 4589070 4308725 280345 0 1481426 1481000 426 0 0 0 0 0 21867421 21557963 309458 0 1048419 1015191 33228 0 0 0 0 0 1241388 1218793 22595 0 13264513 0 13264513 0 0 0 0 0 41455413 41247408 208005 0 9207836 118467 9089369 0 MEDICAL SUPPLIES 177609773 177609773 0 0 INTERCOMPANY EXPENSES 122390652 111696019 10413313 281320 TAXES 28235883 27603028 632855 0 DUES AND SUBSCRIPTIONS 1766834 919160 847674 0 4517508 2395892 2119113 2503 1108914850 1057055826 51575201 283823 0 113733 17779 15214474 8315274 0 0 177165803 161153762 0 0 0 0 0 0 14988746 12993753 8972497 8913782 960235115 596301529 357086950 363933586 402305347 383510233 455196032 504656124 3165522 604012 0 0 386545832 673427071 1820754936 2117525376 253904398 206194393 0 0 0 0 355484190 334437505 0 0 0 0 22810757 23073065 0 0 323468647 573995122 955667992 1137700085 X 842114187 957010662 17021943 16863815 5950814 5950814 865086944 979825291 1820754936 2117525376 X 120799382 13599188 47217 0 0 -19707440 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 53877 160095 53877 160095 1057055826 1290451212 1057109703 1290611307 1000000 1000000 250000 250000 1000000 1000000 1000000 1000000 4000000 6000000 126289 103797 122347 160095 512528 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 7677396 1000 442455 89672 587658 7443521 8236719 2500 657875 82401 1137297 7677396 7336646 1000 905766 5948 745 8236719 7486419 1000 -135813 14000 960 7336646 8061260 1000 128985 19000 685826 7486419 0.80000 0.20000 false false 43323615 43323615 608953991 369898699 239055292 15840909 12119323 3721086 271334874 214283007 57051867 20781726 0 20781726 363933586 POOLED INVESTMENTS-NON PUBLIC 504656124 F 504656124 DUE FROM AFFILIATES 672365079 OTHER ASSETS-RESTRICTED FOR LT 952572 DEFERRED RENT 109420 673427071 0 DUE TO AFFILIATES 550571607 DUE TO GOVERNMENT 23423515 573995122 X SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS THE QUEEN'S MEDICAL CENTER USES THE EARNINGS ON PERMANENTLY ENDOWED INVESTMENTS FOR THE PURPOSES INTENDED BY THE DONORS OF THESE FUNDS. 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, 2019. BENEFIT DINNER 942500 806039 136461 1309 142457 6806 56125 0 942500 806039 136461 1309 142457 6806 56125 206697 -70236 true true X true X true X true true true false true true 2991000 2991000 0.00270 117429000 61048000 56381000 0.05080 120420000 61048000 59372000 0.05350 15975000 15975000 0.01440 17233000 17233000 0.01550 8617000 6571000 2046000 0.00180 692000 692000 0.00060 3246000 3246000 0.00290 45763000 6571000 39192000 0.03530 166183000 67619000 98564000 0.08890 9000 9000 0.00000 9000 9000 0.00000 true 53921000 53921000 281340100 314860092 -33519992 X true true 1 1 THE QUEEN'S MEDICAL CENTER 1301 PUNCHBOWL STREET HONOLULU HI 96813 WWW.QUEENS.ORG 29-H X X X X X The Queen's Medical Center 1 false false true X X X X X X X X X 18 true true true true X SEE SCHEDULE H, PART V, SECTION C X true 18 false true false true X 150. 250. 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 THIS YEAR'S 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 THE PEOPLE AND THE ISLANDS OF HAWAII. SCHEDULE H, PART V, SECTION B, LINE 7A 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. 19 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 QMC - PAIN & SPINE 550 S BERETANIA STREET STE 703/70 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 QMC - TRANSPLANT CENTER 550 S BERETANIA STREET STE 404/40 HONOLULU HI 96813 ORGAN TRANSPLANT CENTER QUEEN'S IMAGING 91-2139 FORT WEAVER ROAD STE 108 EWA BEACH HI 96706 IMAGING SERVICES QMC - VALVE & STRUCTURAL HEART 551 S BERETANIA STREET STE 702 HONOLULU HI 96813 CARDIAC CARE CENTER QMC - LIVER CENTER 550 S BERETANIA STREET STE 405 HONOLULU HI 96813 MANAGEMENT OF LIVER HEALTH AND ILLNESS PHYSICIAN CENTER 91-2135 FORT WEAVER ROAD STE 150 EWA BEACH HI 96706 PHYSICIAN CENTER 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 QMC - PULMONOLOGY 1331 LUSITANA STREET STE 704 HONOLULU HI 96813 PULMONOLOGY QMC - ACUTE CARE SURGICAL CENTER 550 S BERETANIA STREET STE 509 HONOLULU HI 96813 ACUTE CARE SERVICES QMC - RESEARCH SERVICES 1330 LUSITANA STREET STE 107 HONOLULU HI 96813 RESEARCH DIABETES COMMUNITY EDUCATION 91-2135 FORT WEAVER ROAD STE 180 EWA BEACH HI 96706 DIABETES EDUCATION CENTER QMC - HEAD AND NECK 1380 LUSITANA STREET STE 615 HONOLULU HI 96813 HEAD AND NECK INSTITUTE QMC NEUROSCIENCE INSTITUTE 549 S BERETANIA STREET STE 400 HONOLULU HI 96813 NEROSCIENCE SERVICES 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 PLAN 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, 2019. 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, 2019 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 $78,538,000. 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 Ahahui O Na Kauka 677 Ala Moana Boulevard Honolulu HI 96814 990337991 501(c)(3) 25000 American Cancer Society 2370 Nuuanu Avenue Honolulu HI 96817 131788491 501(c)(3) 15000 American Diabetes Association 875 Waimanu Street Honolulu HI 96813 131623888 501(c)(3) 60000 American Heart Association 677 Ala Moana Blvd 600 Honolulu HI 96813 135613797 501(c)(3) 30000 American Red Cross 4155 Diamond Head Road Honolulu HI 96816 530196605 501(c)(3) 25000 Arthritis Foundation 1355 Peachtree Street NE Atlanta GA 30309 581341679 501(c)(3) 10000 Assistance Dogs of Hawaii 675 Kealaloa Avenue Makawao HI 96768 990353694 501(c)(3) 15000 Bishop Museum 1525 Bernice Street Honolulu HI 968172704 990161980 501(c)(3) 10000 Friends of Youth Outreach Hawaii 91-1264 kaiopua Street Ewa Beach HI 96706 812102826 501(c)(3) 7500 Hale Kipa Inc 615 Piikoi Street Honolulu HI 96814 237061499 501(c)(3) 10000 Hawaii Academy of Science 1776 University Avenue Honolulu HI 96822 996006863 501(c)(3) 30000 Hawaii Childrens Cancer Foundation 1814 Liliha Street Honolulu HI 96817 990299937 501(c)(3) 7500 Hawaii Foodbank Inc 2611 Kilihau Street Honolulu HI 96819 990220699 501(c)(3) 6000 Hawaii Symphony Orchestra 3610 Waialae Avenue Honolulu HI 96816 452861988 501(c)(3) 7500 Hina Mauka 45-845 Pookela Street Kaneohe HI 96744 990173356 501(c)(3) 10000 Hospice Hawaii Inc 860 Iwilei Road Honolulu HI 96817 990203930 501(c)(3) 5500 Island Pacific Academy 909 Haumea St Kapolei HI 96707 680534162 501(c)(3) 21000 Japanese Cultural Center of Hawaii 2454 S Beretania Street Honolulu HI 96826 990256147 501(c)(3) 10000 Legacy of Life Hawaii 405 N Kuakini Street Honolulu HI 96817 990257883 501(c)(3) 26500 March of Dimes Foundation 1451 South King Street Honolulu HI 96814 131846366 501(c)(3) 13000 Mothers Against Drunk Driving 511 E John Carpenter Fwy Irving TX 75062 942707273 501(c)(3) 10000 National Kidney Foundation of Hawaii 1314 South King Street Honolulu HI 96814 990266733 501(c)(3) 52500 Pacific Health Ministry 1245 Young Street Honolulu HI 96814 990281185 501(c)(3) 10000 Polynesian Football Hall of Fame PO Box 11266 Honolulu HI 96828 463158865 501(c)(3) 25000 Polynesian Voyaging Society 10 Sand Island Parkway Honolulu HI 96819 237302232 501(c)(3) 25000 Public Schools of Hawaii Foundation PO Box 4148 Honolulu HI 96812 880243449 501(c)(3) 15000 PulsePoint Foundation PO Box 12594 Pleasanton CA 94588 452725805 501(c)(3) 18000 Rehab Foundation 226 North Kuakini Street Honolulu HI 96817 990241634 501(c)(3) 9000 Sacred Hearts Academy 3253 Waialae Avenue Honolulu HI 96816 990093012 501(c)(3) 20000 SJ Foundation 88 Piikoi Street Honolulu HI 96814 205687012 501(c)(3) 7500 St Andrews Schools 224 Queen Emma Square Honolulu HI 96813 990073525 501(c)(3) 25000 St Francis Healthcare Foundation of HI 2228 Liliha Street Honolulu HI 96817 990240060 501(c)(3) 25000 Susan G Komen Breast Cancer Fdn 3555 Harding Ave Ste 2D Honolulu HI 96816 751835298 501(c)(3) 15000 Teach For America - Hawaii 315 West 36th Street New York NY 10018 133541913 501(c)(3) 8000 The Institute for Human Services Inc 546 Kaaahi Street Honolulu HI 96819 990199107 501(c)(3) 26000 UCERA - UNIVERSITY CLINICAL ED & RSCH 677 Ala Moana Boulevard Honolulu HI 968135485 990307152 501(c)(3) 250000 University of Hawaii Foundation 2444 Dole Street Honolulu HI 96822 990085260 501(C)(3) 539158 Variety School of Hawaii 710 Palekaua Street Honolulu HI 96816 990105604 501(c)(3) 10000 Waikiki Community Center 310 Paoakalani Avenue Honolulu HI 96815 990179392 501(c)(3) 11000 Hawaii Cancer Consortium 55 Merchant Street Honolulu HI 96813 452280259 501(c)(3) 1000000 Healthcare Association of Hawaii 707 Richards Street Honolulu HI 96813 990105817 501(c)(6) 35000 City and County of Honolulu 530 S King Street Honolulu HI 96813 996001257 GOVT 10000 Mililani Town Association 95-303 Kaloapau Street Mililani HI 96789 996015708 501(c)(4) 5759 Native Hawaiian Chamber of Commerce PO Box 597 Honolulu HI 96809 990207564 501(c)(6) 5500 Kapolei Chamber of Commerce 1001 Kamokila Blvd Kapolei HI 96707 262216335 501(c)(6) 6400 University of Hawaii JABSON PO Box 11270 Honolulu HI 968280270 996000354 GOVT 561000 42 4 SCHEDULE I, PART I, LINE 2 DESCRIPTION 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 PEOPLE 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 ROBERT HONG MD TRUSTEE - PART YEAR 408481 0 45666 0 3726 0 12375 0 7291 0 477539 0 0 0 ROBB OHTANI MD TRUSTEE 0 348108 0 0 0 0 0 0 0 0 0 348108 0 0 ARTHUR USHIJIMA TRUSTEE/PRESIDENT 0 928409 0 526920 0 147263 0 77010 0 14302 0 1693904 0 0 MICHEL RICCIONI TREASURER 0 527493 0 239850 0 2322 0 44931 0 14100 0 828696 0 0 SUSAN MURRAY VP/COO - QMC WEST OAHU 369346 0 147110 0 45339 0 61134 0 14774 0 637703 0 0 0 JASON CHANG EVP/COO 541021 0 246769 0 540 0 33985 0 21795 0 844110 0 0 0 JOHN NITAO VP/GENERAL COUNSEL 0 392238 0 134869 0 43037 0 42585 0 23231 0 635960 0 0 SHARLENE TSUDA SECRETARY 0 244998 0 83752 0 26247 0 46690 0 14745 0 416432 0 0 CLINTON YEE ASSISTANT TREASURER 0 184933 0 16760 0 9093 0 21681 0 23650 0 256117 0 0 WHITNEY LIMM MD SENIOR VICE PRESIDENT 0 538578 0 245016 0 72015 0 98223 0 15239 0 969071 0 0 JEFFREY MING SHAN LAU MD PHYSICIAN 431947 0 299561 0 0 0 12456 0 14289 0 758253 0 0 0 SUNG BAE LEE MD PHYSICIAN 613112 0 347866 0 116086 0 37929 0 25329 0 1140322 0 0 0 JEFFREY LOH MD PHYSICIAN 451719 0 765471 0 18491 0 38543 0 22138 0 1296362 0 0 0 TODD SETO MD PHYSICIAN 384074 0 305916 0 15909 0 49848 0 7719 0 763466 0 0 0 MAHDI VEILLET-CHOWDHURY MD PHYSICIAN 320160 0 461236 0 32302 0 18841 0 12375 0 844914 0 0 0 ERIC MARTINSON FORMER TREASURER 0 468468 0 216151 0 61223 0 58034 0 24440 0 828316 0 0 SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON THE QUEEN'S HEALTH SYSTEM (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 SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS AND SEVERAL OTHER QUEEN'S RELATED AFFILIATES. MR. USHIJIMA ALSO SERVES 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 IS 1 HOUR PER WEEK. HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HIS TOTAL COMPENSATION FOR HIS VARIOUS SERVICES. JASON CHANG MR. CHANG SERVES AS EVP OF QHS AND EVP AND COO 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. 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 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. ROBERT HONG, MD DR. HONG SERVES AS A TRUSTEE AND CHIEF OF STAFF OF 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. 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. 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 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 170381148 160009007 15246352 true false false true A false false false true true 0 false false true A false true false false true true ML CAPITAL SERVICES 6.5 false false false 0 false true A true SCHEDULE K DESCRIPTION OF ARRANGEMENT RELATED ORGANIZATION REPORTING THE 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 $334,437,505. 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 BONDS. THE ISSUANCE DATES FOR THE BONDS WERE: 12/11/2003 05/06/2009 03/16/2006 X 2 29939 FMV X GICLEE ON CANVAS 1 9000 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 QMC HAS 505 ACUTE CARE BEDS AND 28 SUB-ACUTE CARE BEDS. WITH OVER 5,200 EMPLOYEES AND OVER 1,300 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 COMMISSION (TJC). QMC IS ALSO APPROVED TO PARTICIPATE IN RESIDENCY TRAINING BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (QCGME), AND IS A MEMBER OF VIZIENT, 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 QMC MISSION AND TO FULFILL THE TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, QMC PROVIDED THE FOLLOWING COMMUNITY BENEFITS, TOTALING APPROXIMATELY $186M ON A SYSTEM-WIDE BASIS, FOR THE YEAR ENDED JUNE 30, 2019. 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, 2019, THE ESTIMATED COST OF PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $2,991,000 AND $53,921,000, 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 $839,000 FOR THE YEAR ENDED JUNE 30, 2019. 3. ON-CALL PHYSICIAN COMPENSATION - QMC MAINTAINS THE ONLY LEVEL II TRAUMA CENTER IN THE STATE OF HAWAII. IN ORDER TO PROVIDE LEVEL II TRAUMA COVERAGE, THE MEDICAL CENTER INCURRED APPROXIMATELY $10,876,000 IN ON-CALL PHYSICIAN COVERAGE DURING THE YEAR ENDED JUNE 30, 2019. 4. FELLOWSHIP, RESIDENT AND INTERN COSTS - QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $16,637,000 DURING THE YEAR ENDED JUNE 30, 2019 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. 5. 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, 2019 WAS $593,000. 6. 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, 2019 WAS $1,246,000. 7. RESEARCH LOSSES - QMC EMPLOYS STAFF AND INCURS UNFUNDED COSTS FOR MEDICAL RESEARCH. FOR THE YEAR ENDED JUNE 30, 2019, RESEARCH COSTS WERE $692,000. 8. CHARITABLE CONTRIBUTIONS - QMC MAKES CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2019, CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS CONSISTENT WITH QMC'S EXEMPT PURPOSE WERE $2,874,000. OF THIS AMOUNT, $561,000 WAS FOR FUNDING TO THE DEPARTMENT OF NATIVE HAWAIIAN HEALTH UNDER THE JOHN A. BURNS SCHOOL OF MEDICINE OF THE UNIVERSITY OF HAWAII AND $1,000,000 WAS DONATED TO THE UNIVERSITY OF HAWAII CANCER CONSORTIUM. 9. 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 $56,381,000 DURING THE YEAR ENDED JUNE 30, 2019. 10. 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 $33,520,000 DURING THE YEAR ENDED JUNE 30, 2019. CONSISTENT WITH COST REPORT REQUIREMENTS, THERE ARE AMOUNTS THAT ARE EXCLUDED FROM THE COSTS ABOVE. 11. 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, 2019, REVENUES FOREGONE FROM LEASE RATES THAT WERE BELOW FAIR MARKET VALUE WERE $45,000. 12. KINAU STREET OFF-RAMP IMPROVEMENT PROJECT - IN ORDER TO IMPROVE ACCESS TO ITS EMERGENCY DEPARTMENT AND HOSPITAL, QMC, IN CONJUNCTION WITH THE STATE DEPARTMENT OF TRANSPORTATION AND CITY DEPARTMENT OF TRANSPORTATION SERVICES, SUPPORTED CONSTRUCTION OF THE KINAU STREET OFF-RAMP. FOR THE YEAR ENDED JUNE 30, 2019, COSTS INCURRED FOR THE IMPROVEMENT PROJECT WERE $9,000. FORM 990, PART III, LINE 4A - CONTINUED 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 $939,000 FOR THE YEAR ENDED JUNE 30, 2019. 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 QMC CONFERENCE CENTER. FOR THE YEAR ENDED JUNE 30, 2019, THE VALUE OF THE USE OF THE CENTER WAS $327,000. 15. TUTU BERT'S HOUSE - TUTU BERT'S HOUSE IS AN 8-BED PRIVATE MEDICAL RESPITE HOUSE IN PARTNERSHIP WITH THE QMC AND HOMEAID HAWAII. TUTU BERT'S HOUSE OFFERS MEDICALLY FRAIL HOMELESS DISCHARGED FROM THE QMC 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, 2019 COSTS INCURRED FOR THE PROGRAM WERE $826,000. 16. OHANA HOUSE - OHANA HOUSE IS A 14-BED PRIVATE MEDICAL RESPITE HOUSE IN PARTNERSHIP WITH THE QMC 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, 2019 COSTS INCURRED FOR THE PROGRAM WERE $522,000. 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, 2019 COSTS INCURRED FOR THE PROGRAM WERE $647,000. 18. 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, 2019, THE COST OF PROVIDING HEALTH AND WELLNESS EDUCATION WAS $153,000. 19. 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, 2019, THESE PROGRAM COSTS TOTALED $1,705,000. 20. JOB SHADOWING PROGRAM - QMC SPONSORS A JOB SHADOWING PROGRAM FOR STUDENTS IN THE STATE OF HAWAII. FOR THE YEAR ENDED JUNE 30, 2018, COSTS INCURRED FOR THE PROGRAM WERE $3,000. 21. 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. 22. VOLUNTEER EFFORTS - QMC EMPLOYEES PERIODICALLY VOLUNTEER FOR OTHER CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2019, 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, LINES 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 2019. 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 ($17,192,925) CHANGE IN INTEREST IN SUBSIDIARY ($ 3,376,659) NET ASSETS RELEASED FROM RESTRICTION $ 862,145 ROUNDING ($ 1) ------------- TOTAL ($19,707,440) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:90150845 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:33799114 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:2241108 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER SERVICES TOTAL FEES:4239730 QUEEN'S CLINICALLY INTG PHYS NETWORK LLC 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 PHYS NETWORK HI 3485138 7352345 QMC QUEEN'S 'AKOAKOA LLC 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 PHYS NETWORK HI 656815 0 QMC 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: $11,352,731 501(H) ELECTION: YES SHARE OF EXCESS LOBBYING EXPENDITURES: $0 NAME: QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL ADDRESS: 67-1125 MAMALAHOA HIGHWAY KAMUELA, HI 96743-8496 EIN: 99-0260423 EXPENSES: $49,406,204 501(H) ELECTION: NO SHARE OF EXCESS LOBBYING EXPENDITURES: $0