QUEENS NORTH HAWAII COMMUNITY HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- QUEENS NORTH HAWAII COMMUNITY HOSPITAL (EIN 99-0260423)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-07
- IRS object ID
- 201831279349301733
- Schema version
- 2016v3.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-07T14:49:14-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 370 17TH STREET 3300 | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990260423 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH HAWAII COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % SHANNON OLSEN | InCareOfNm |
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 8088814400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 MAMALAHOA HIGHWAY | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 967438496 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MONEY ATWAL | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Signature | 2018-05-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KELLEY SIMON | PreparerPersonNm |
| PTIN | P00791436 | PTIN |
| Phone | 7209314000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CYNTHIA KAMIKAWA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 MAMALAHOA HIGHWAY | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 967438496 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,045,469 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NHCH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | ACUTE CARE HOSPITAL WITH THE MISSION TO IMPROVE THE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 487 | TotalEmployeeCnt |
| Total Volunteers | 48 | TotalVolunteersCnt |
| Total Gross UBI | $44,725 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $39,274 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $846,533 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,031,605 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $57,204,021 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $52,140,288 | CYProgramServiceRevenueAmt |
| PY Investment Income | $29,518 | PYInvestmentIncomeAmt |
| CY Investment Income | $13,126 | CYInvestmentIncomeAmt |
| PY Other Revenue | $763,127 | PYOtherRevenueAmt |
| CY Other Revenue | $860,450 | CYOtherRevenueAmt |
| PY Total Revenue | $58,843,199 | PYTotalRevenueAmt |
| CY Total Revenue | $56,045,469 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $250 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,539,925 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,095,178 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $20,012 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $17,800 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $110,904 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $36,275,252 | PYOtherExpensesAmt |
| CY Other Expenses | $46,231,139 | CYOtherExpensesAmt |
| PY Total Expenses | $67,835,189 | PYTotalExpensesAmt |
| CY Total Expenses | $78,344,367 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$8,991,990 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$22,298,898 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $195,066,195 | TotalAssetsBOYAmt |
| Total Assets EOY | $193,558,179 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $44,565,934 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $65,094,934 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $150,500,261 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $128,463,245 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ACUTE CARE HOSPITAL WITH THE MISSION TO IMPROVE THE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $53,998,830 | ExpenseAmt |
| Grant | $250 | GrantAmt |
| Revenue | $52,315,820 | RevenueAmt |
| Desc | 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 7/1/2016 - 6/30/2017 THROUGH OUTPATIENT VISITS WAS 78,595 AND THE NUMBER OF ADMISSIONS WAS 1,784. | Desc |
| Total Program Service Expenses | $53,998,830 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 50 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 487 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHANNON OLSEN | PersonNm |
| Phone | 8088814675 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 MAMALAHOA HIGHWAY | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MAENETTE BENHAM EDD | ||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| KENNETH GRAHAM | ||||||||
| PRESIDENT/TRUSTEE (PART YEAR) | 54.0 | 1.0 | Yes (X) | $0 | $262,855 | $0 | Yes (X) | |
| LYLE HARADA | ||||||||
| TRUSTEE | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT HASTINGS II | ||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CYNTHIA KAMIKAWA | ||||||||
| PRESIDENT/TRUSTEE | 54.0 | 1.0 | Yes (X) | $0 | $393,323 | $127,450 | Yes (X) | |
| NEIL KUYPER | ||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD LEVY PHD | ||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT LINDSEY | ||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KAHU BILLY MITCHELL | ||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT MOMSEN | ||||||||
| TRUSTEE | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | ||
| ARTHUR USHIJIMA | ||||||||
| CHAIR/TRUSTEE | 3.0 | 62.0 | Yes (X) | $0 | $1,479,422 | $85,825 | Yes (X) | |
| ERIC YEAMAN | ||||||||
| TRUSTEE | 1.0 | 6.0 | Yes (X) | $0 | $0 | $0 | ||
| MONEY ATWAL | ||||||||
| ASSISTANT TREASURER | 45.0 | 10.0 | $0 | $187,685 | $14,509 | Yes (X) | ||
| SHARIANN GONSALVES | ||||||||
| ASSISTANT SECRETARY | 40.0 | 0.0 | $59,487 | $0 | $13,273 | Yes (X) | ||
| MIQUEL SIMMS | ||||||||
| VICE PRESIDENT (PART YEAR) | 55.0 | 0.0 | $135,123 | $0 | $12,701 | Yes (X) | ||
| LILINOE WATANABE | ||||||||
| TREASURER | 3.0 | 52.0 | $0 | $180,964 | $37,083 | Yes (X) | ||
| SHARLENE TSUDA | ||||||||
| SECRETARY | 1.0 | 54.0 | $0 | $297,177 | $89,285 | Yes (X) | ||
| ALISTAIR BAIROS MD | ||||||||
| PHYSICIAN | 50.0 | 0.0 | $238,768 | $0 | $9,114 | Yes (X) | ||
| JOHN BELLATTI MD | ||||||||
| PHYSICIAN | 50.0 | 0.0 | $474,133 | $0 | $36,659 | Yes (X) | ||
| WILLIAM HILLER MD | ||||||||
| PHYSICIAN | 50.0 | 0.0 | $388,016 | $0 | $12,477 | Yes (X) | ||
| LYN LAM MD | ||||||||
| PHYSICIAN | 50.0 | 0.0 | $322,981 | $0 | $15,532 | Yes (X) | ||
| HOWARD WONG MD | ||||||||
| PHYSICIAN | 50.0 | 0.0 | $389,890 | $0 | $13,199 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,008,398 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,801,426 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $467,107 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 44 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SODEXO AMERICA LLC | |||||
| DEPARTMENT 880328 | LOS ANGELES | CA | 90088 | CAFETERIA MANAGEMENT | $615,000 |
| INFINIPRISE TECHNOLOGIES LLC | |||||
| 5950 CARMICHAEL PLACE STE 104 | MONTGOMERY | AL | 36117 | IT SERVICES | $201,276 |
| INTEGRITY WEB DESIGN | |||||
| 75-5806 KAKALINA STREET | KAILUAKONA | HI | 96740 | IT SERVICES | $189,602 |
| MICHELLE HUBER DAGDAG | |||||
| PO BOX 437382 | KAMUELA | HI | 96743 | MEDICAL SERVICES | $104,930 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $0 | FundraisingAmt |
| Government Grants | $352,000 | GovernmentGrantsAmt |
| All Other Contributions | $2,679,605 | AllOtherContributionsAmt |
| Noncash Contributions | $115,735 | NoncashContributionsAmt |
| Total Contributions | $3,031,605 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | $46,978,209 | $46,978,209 | $0 | $0 |
| STATE OF HAWAII SUSTAINABILITY | 900099 | $5,032,139 | $5,032,139 | $0 | $0 |
| E.H.R. MEANINGFUL USE | 900099 | $784 | $784 | $0 | $0 |
| INTERCOMPANY INCOME | 900099 | $129,156 | $129,156 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $52,140,288 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,165 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $44,725 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$56,890 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $211,590 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $211,590 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $211,590 | TotalRevenueColumnAmt |
| Exclusion | $211,590 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $961 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $961 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $961 | TotalRevenueColumnAmt |
| Exclusion | $961 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PHYSICIAN CONTRACTS | 900099 | $65,397 | $0 | $0 | $65,397 |
| VENDING MACHINE/CAFETERIA | 900099 | $407,931 | $0 | $0 | $407,931 |
| MISCELLANEOUS REVENUE | 900099 | $175,532 | $175,532 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $648,860 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,045,469 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $52,315,820 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $44,725 | UnrelatedBusinessRevenueAmt |
| Exclusion | $628,989 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250 | TotalAmt |
| Program Services | $250 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,797 | TotalAmt |
| Program Services | $54,329 | ProgramServicesAmt |
| Management And General | $71,468 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,405,295 | TotalAmt |
| Program Services | $20,453,485 | ProgramServicesAmt |
| Management And General | $5,888,745 | ManagementAndGeneralAmt |
| Fundraising | $63,065 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $445,073 | TotalAmt |
| Program Services | $342,316 | ProgramServicesAmt |
| Management And General | $101,465 | ManagementAndGeneralAmt |
| Fundraising | $1,292 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,375,162 | TotalAmt |
| Program Services | $2,447,669 | ProgramServicesAmt |
| Management And General | $917,575 | ManagementAndGeneralAmt |
| Fundraising | $9,918 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,743,851 | TotalAmt |
| Program Services | $1,332,458 | ProgramServicesAmt |
| Management And General | $406,791 | ManagementAndGeneralAmt |
| Fundraising | $4,602 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,246 | TotalAmt |
| Program Services | $288,246 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,263 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $34,263 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,800 | TotalAmt |
| Fundraising | $17,800 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $10 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,740,986 | TotalAmt |
| Program Services | $9,913,974 | ProgramServicesAmt |
| Management And General | $2,826,252 | ManagementAndGeneralAmt |
| Fundraising | $760 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,015 | TotalAmt |
| Management And General | $60,915 | ManagementAndGeneralAmt |
| Fundraising | $100 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $506,031 | TotalAmt |
| Program Services | $354,762 | ProgramServicesAmt |
| Management And General | $142,575 | ManagementAndGeneralAmt |
| Fundraising | $8,694 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $376,041 | TotalAmt |
| Program Services | $44,323 | ProgramServicesAmt |
| Management And General | $331,718 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,525,760 | TotalAmt |
| Program Services | $406,933 | ProgramServicesAmt |
| Management And General | $2,118,827 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,439 | TotalAmt |
| Program Services | $143,268 | ProgramServicesAmt |
| Management And General | $205,691 | ManagementAndGeneralAmt |
| Fundraising | $480 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,757 | TotalAmt |
| Program Services | $28,680 | ProgramServicesAmt |
| Management And General | $31,077 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $580,510 | TotalAmt |
| Program Services | $5,622 | ProgramServicesAmt |
| Management And General | $574,888 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,656,412 | TotalAmt |
| Program Services | $2,461,244 | ProgramServicesAmt |
| Management And General | $1,194,907 | ManagementAndGeneralAmt |
| Fundraising | $261 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $593,913 | TotalAmt |
| Program Services | $1,756 | ProgramServicesAmt |
| Management And General | $592,157 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $12,547,445 | $12,170,257 | $377,188 | $0 |
| INERCOMPANY PAYMENTS | $9,575,184 | $2,199,280 | $7,375,904 | $0 |
| PROVIDER TAX | $1,187,529 | $1,187,529 | $0 | $0 |
| REHAB PROJECT - LOSS | $426,839 | $0 | $426,839 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721,759 | TotalAmt |
| Program Services | $162,449 | ProgramServicesAmt |
| Management And General | $555,378 | ManagementAndGeneralAmt |
| Fundraising | $3,932 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,344,367 | TotalAmt |
| Program Services | $53,998,830 | ProgramServicesAmt |
| Management And General | $24,234,633 | ManagementAndGeneralAmt |
| Fundraising | $110,904 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,180,519 | BOYAmt |
| EOY | $2,274,542 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $347,543 | BOYAmt |
| EOY | $4,999,403 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,485,662 | BOYAmt |
| EOY | $1,063,193 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,772,695 | BOYAmt |
| EOY | $13,193,662 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,069 | BOYAmt |
| EOY | $17,849 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,926,396 | BOYAmt |
| EOY | $1,979,866 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $499,111 | BOYAmt |
| EOY | $381,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $82,740,812 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,020,448 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,601,481 | BOYAmt |
| EOY | $53,720,364 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,234,719 | BOYAmt |
| EOY | $115,927,587 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,066,195 | BOYAmt |
| EOY | $193,558,179 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,332,856 | BOYAmt |
| EOY | $6,806,387 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,000,000 | BOYAmt |
| EOY | $5,667,455 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,233,078 | BOYAmt |
| EOY | $52,621,092 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,565,934 | BOYAmt |
| EOY | $65,094,934 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,991,078 | BOYAmt |
| EOY | $9,371,012 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,928,252 | BOYAmt |
| EOY | $10,575,165 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,580,931 | BOYAmt |
| EOY | $108,517,068 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,500,261 | BOYAmt |
| EOY | $128,463,245 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,066,195 | BOYAmt |
| EOY | $193,558,179 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$22,298,898 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $504 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $261,378 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Media Advertisements | $0 | MediaAdvertisementsAmt |
| Mailings Members | false | MailingsMembersInd |
| Mailings Members | $0 | MailingsMembersAmt |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmt |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $0 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Rallies Demonstrations | $0 | RalliesDemonstrationsAmt |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,171 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,171 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENSES ARE THE PORTION OF DUES PAID TO HEALTHCARE ASSOCIATIONS ALLOCATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,715,923 | BeginningYearBalanceAmt |
| Contributions | $1,217 | ContributionsAmt |
| Investment Earnings Or Losses | $385,499 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $414,534 | OtherExpendituresAmt |
| Administrative Expenses | $26,579 | AdministrativeExpensesAmt |
| End Year Balance | $4,661,526 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,930,827 | BeginningYearBalanceAmt |
| Contributions | $440,000 | ContributionsAmt |
| Investment Earnings Or Losses | -$195,847 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $423,897 | OtherExpendituresAmt |
| Administrative Expenses | $35,160 | AdministrativeExpensesAmt |
| End Year Balance | $4,715,923 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,093,346 | BeginningYearBalanceAmt |
| Contributions | $12,488 | ContributionsAmt |
| Investment Earnings Or Losses | $170,059 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $296,875 | OtherExpendituresAmt |
| Administrative Expenses | $48,191 | AdministrativeExpensesAmt |
| End Year Balance | $4,930,827 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,136,099 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $248,000 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $233,658 | OtherExpendituresAmt |
| Administrative Expenses | $57,095 | AdministrativeExpensesAmt |
| End Year Balance | $5,093,346 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,020,278 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $565,011 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $415,135 | OtherExpendituresAmt |
| Administrative Expenses | $34,055 | AdministrativeExpensesAmt |
| End Year Balance | $5,136,099 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.93260 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.06740 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,210,000 | OtherCostOrOtherBasisAmt |
| Book Value | $12,210,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,300,661 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,931,254 | DepreciationAmt |
| Book Value | $24,369,407 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,001,619 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,089,194 | DepreciationAmt |
| Book Value | $9,912,425 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,228,532 | OtherCostOrOtherBasisAmt |
| Book Value | $7,228,532 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $53,720,364 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EQUITY IN PARKER RANCH FDN TRU | $104,159,728 |
| INVESTMENT IN LIBERTY DIALYSIS | $42,106 |
| BENEFICIAL INTERESTS | $4,661,526 |
| CONTRIBUTED USE OF LAND | $7,021,378 |
| DUE FROM MGH | $42,849 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $115,927,587 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $52,515,937 |
| CAPITAL LEASE OBLIGATION | $11,261 |
| GENERAL AND PROF TAIL LIABILITY | $78,794 |
| DUE TO GOVT PROGRAMS | $15,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $52,621,092 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | INTENDED USE OF ENDOWMENT FUNDS THE ORGANIZATION HAS BENEFICIAL INTERESTS IN SEVERAL ENDOWMENTS, ALL WITH THE PURPOSE OF PROVIDING RESOURCES TO BE USED TO ENHANCE HEALTH CARE SERVICES IN NORTH HAWAII. |
| SCHEDULE D, PART X, LINE 2 | FIN 48 (ASC 740) FOOTNOTE QHS EVALUATES ITS UNCERTAIN TAX POSITIONS AND HAS NO MATERIAL UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2017. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $296,620 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $296,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,877,403 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,141,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,735,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09870 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,174,023 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,141,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,032,353 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10250 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $427,329 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $350,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $77,329 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $614,737 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $560,013 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $54,724 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,042,066 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $910,013 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $132,053 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,216,089 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,051,683 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,164,406 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10420 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,624,518 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $561,679 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,039,736 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $15,076,156 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,036,420 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH HAWAII COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 MAMALAHOA HIGHWAY | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 967438496 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWWW.NHCH.COM | WebsiteAddressTxt |
| State License | 39-H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | NORTH HAWAII MEDICAL GROUP AND KOHALA HOME HEALTH AGENCY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH HAWAII COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C, PART V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SECTION C, PART V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 | INPUT FROM COMMUNITY REPRESENTATIVES THE QUALITATIVE DATA USED IN THIS ASSESSMENT CONSISTS OF KEY INFORMANT INTERVIEWS COLLECTED BY STORYLINE CONSULTING. KEY INFORMANTS ARE INDIVIDUALS RECOGNIZED FOR THEIR KNOWLEDGE OF COMMUNITY HEALTH IN ONE OR MORE HEALTH AREAS, AND WERE NOMINATED AND SELECTED BY THE HEALTHCARE ASSOCIATION OF HAWAII (HAH) ADVISORY COMMITTEE IN SEPTEMBER 2014. FIFTEEN KEY INFORMANTS WERE INTERVIEWED FOR THEIR KNOWLEDGE ABOUT COMMUNITY HEALTH NEEDS, BARRIERS, STRENGTHS, AND OPPORTUNITIES (INCLUDING NEEDS FOR VULNERABLE AND UNDERSERVED POPULATIONS AS REQUIRED BY IRS REGULATIONS). INTERVIEW TOPICS WERE NOT RESTRICTED TO THE HEALTH AREA FOR WHICH A KEY INFORMANT WAS NOMINATED. KEY INFORMANTS INCLUDED REPRESENTATIVES FROM: AMERICAN DIABETES ASSOCIATION CATHOLIC CHARITIES HAWAII HAWAII DEPARTMENT OF EDUCATION HAWAII DEPARTMENT OF HEALTH, BEHAVIOR HEALTH SERVICES HAWAII DEPARTMENT OF HEALTH, DISEASE OUTBREAK AND CONTROL DIVISION HAWAII DEPARTMENT OF HUMAN SERVICES EXECUTIVE OFFICE OF AGING HAWAII GOVERNORS OFFICE HAWAII DENTAL SERVICES HAWAII MEDICAL SERVICE ASSOCIATION HAWAII PRIMARY CARE ASSOCIATION HAWAII STATE DEPARTMENT OF HEALTH HOMELESS PROGRAMS OFFICE JOHN A. BURNS SCHOOL OF MEDICINE STATE SENATE EXCERPTS FROM THE INTERVIEW TRANSCRIPTS WERE CODED BY RELEVANT TOPIC AREAS AND OTHER KEY TERMS USING THE QUALITATIVE ANALYTIC TOOL DEDOOSE. THE FREQUENCY WITH WHICH A TOPIC AREA WAS DISCUSSED IN KEY INFORMANT INTERVIEWS WAS ONE FACTOR USED TO ASSESS THE RELATIVE URGENCY OF THAT TOPIC AREAS HEALTH AND SOCIAL NEEDS. |
| Schedule H, Part V, Section B, Line 6A | FIFTEEN HOSPITALS, LOCATED ACROSS THE STATE, PARTICIPATED IN THE CHNA PROJECT: CASTLE MEDICAL CENTER SUTTER HEALTH KAHI MOHALA BEHAVIORAL HEALTH (SERVES HAWAII COUNTY RESIDENTS) KAISER PERMANENTE MEDICAL CENTER (SERVES HAWAII COUNTY RESIDENTS) KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (SERVES HAWAII COUNTY RESIDENTS) KUAKINI MEDICAL CENTER MOLOKAI GENERAL HOSPITAL NORTH HAWAII COMMUNITY HOSPITAL (HAWAII COUNTY) PALI MOMI MEDICAL CENTER REHABILITATION HOSPITAL OF THE PACIFIC (SERVES HAWAII COUNTY RESIDENTS) SHRINERS HOSPITAL FOR CHILDREN - HONOLULU (SERVES HAWAII COUNTY RESIDENTS) STRAUB CLINIC & HOSPITAL THE QUEEN'S MEDICAL CENTER (SERVES HAWAII COUNTY RESIDENTS) THE QUEEN'S MEDICAL CENTER WEST OAHU WAHIAWA GENERAL HOSPITAL WILCOX MEMORIAL HOSPITAL |
| Schedule H, Part V, Section B, Line 6B | CHNA OTHER THAN HOSPITAL FACILITIES THE HEALTHCARE ASSOCIATION OF HAWAII PARTNERED WITH HEALTHY COMMUNITIES INSTITUTE TO CONDUCT A CHNA FOR HAWAII COUNTY. |
| Schedule H, Part V, Section B, LINE 7A | THE CHNA CAN BE FOUND AT: http://www.nhch.com/cms/View.aspx/Show/Assessment-Report |
| Schedule H, Part V, Section B, Line 11 | NEEDS ASSESSED THE CHNA IDENTIFIED 20 AREAS OF COMMUNITY HEALTH NEEDS. NORTH HAWAII COMMUNITY HOSPITAL RECOGNIZES THE IMPORTANCE OF THESE NEEDS AND HAS SUPPORTED EFFORTS TO ADDRESS MANY OF THEM, IT IS ALSO RECOGNIZED THAT THERE ARE HEALTH NEEDS THAT NHCH WILL NOT DIRECTLY BE ADDRESSING DUE TO RESOURCE CONSTRAINTS. ONE OF THE MAJOR THEMES PRESENTED IN THE 2015-2016 REPORT IS "ACCESS TO CARE." HAWAII COUNTY HAS SIGNIFICANT UNMET HEALTHCARE ACCESS NEEDS DUE TO PROVIDER SHORTAGES, LIMITED ORAL HEALTH SERVICES AND COVERAGE, AND INADEQUATE COORDINATION IN MENTAL HEALTH CARE. RESIDENTS ALSO FACE SUBSTANTIAL RATES OF POVERTY AND CHALLENGES IN TRANSPORTATION, FURTHER EXACERBATING ACCESS ISSUES. TO ADDRESS THIS NEED, NHCHS GOAL IS TO PROMOTE AND IMPROVE ACCESS TO CARE FOR THE PEOPLE OF HAWAII, SPECIFICALLY HAWAII ISLAND, THROUGH OUTREACH TO UNDERSERVED FAMILIES, EDUCATION, TECHNOLOGY, AND PHYSICIAN RECRUITMENT IN THE AREAS OF PRIMARY CARE, OB/GYN, AND GENERAL SURGERY THROUGH THE FOLLOWING OBJECTIVES. 1. IMPROVE ACCESS TO UNDERSERVED POPULATIONS BY INCREASING THE NUMBER OF NEW PATIENTS AND DECREASING WAIT TIME FOR FIRST APPOINTMENTS. 2. INCREASE PHYSICIAN RECRUITING, SPECIFICALLY FOR PRIMARY CARE, OB/GYN AND GENERAL SURGERY. 3. SHORTEN THE LENGTH OF TIME BETWEEN DIAGNOSIS OF CANCER AND INITIATION OF TREATMENT. 4. INCREASE TRANSLATION SERVICES TO IMPROVE CULTURAL COMPETENCY AND TO STRENGTHEN CARE. IN THE FISCAL YEAR ENDED JUNE 30, 2017, NHCH WAS ABLE TO RECRUIT PHYSICIANS IN THE AREAS OF PRIMARY CARE, ORTHOPEDIC, AND OB/GYN AND PLANS TO CONTINUE ITS EFFORTS TO HIRE QUALITY HEALTH CARE PROVIDERS IN THE IDENTIFIED AREAS. IN ADDITION, IN RESPONSE TO OBJECTIVE 3, NHCH WAS ABLE TO RECRUIT AN ONCOLOGIST TO THE CANCER CENTER AND WAS SUCCESSFUL IN REDUCING THE TIME BETWEEN CANCER DIAGNOSIS AND TREATMENT FROM A BASELINE OF 31 DAYS TO AN AVERAGE OF 17 DAYS. GOING FORWARD, NHCH WILL CONTINUE TO WORK ON THE OTHER OBJECTIVES IDENTIFIED IN ITS IMPLEMENTATION STRATEGY. 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 13B | INCOME LEVEL OTHER THAN FPG FOR CITIZENS OF FOREIGN COUNTRIES, THE INCOME QUALIFYING LEVEL IS BASED ON THE RESIDENTS COUNTRYS MINIMUM WAGE. |
| SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C | THE FINANCIAL ASSITANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE NORTH HAWAII COMMUNITY HOSPITAL WEBSITE AT: HTTP://WWW.NHCH.COM/CMS/VIEW.ASPX/SHOW/FINANCIALOPTIONS SCHEDULE H, PART V, SECTION B, LINE 16H THE HOSPITAL WAS MADE AWARE IN FEBRUARY OF 2018 THAT PROCEDURES WERE NOT IN PLACE TO COMMUNICATE THE FINANCIAL ASSISTANCE POLICY TO MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE OUTSIDE OF PATIENTS SERVED BY THE HOSPITAL. UPON DISCOVERY IN FEBRUARY OF 2018, THE HOSPITAL IMPLEMENTED A PROCESS TO PUBLISH THE AVAILABILITY OF FINANCIAL ASSISTANCE IN EDUCATIONAL RADIO CAMPAIGNS AND PROMOTE THE POLICY AT HEALTH FAIRS GOING FORWARD. |
| 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. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 NORTH HAWAII COMMUNITY HOSPITAL. THIS REPORT IS PUBLISHED PERIODICALLY AND IS SEPARATELY AVAILABLE TO THE PUBLIC. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY THE COSTING METHODOLOGY CONSIDERS ALL PATIENT SEGMENTS. AMOUNTS REPRESENT THE NET COSTS FOR THE VARIOUS PROGRAMS AND OPERATIONS, CONSIDERING ACTUAL AMOUNTS INCURRED AND CALCULATED BENEFITS BASED ON COST-TO-CHARGE RATIOS AND AVERAGE RATES (I.E. WAGE RATES). |
| SCHEDULE H, PART III, LINE 2 | BAD DEBT METHODOLOGY NHCH PROVIDES AN ALLOWANCE AGAINST ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE BY ESTABLISHING AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. NHCH ESTIMATES THE ALLOWANCE BASED ON THE AGING OF THE ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR AND OTHER RELEVANT FACTORS. NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER NHCH'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED ON THE COST-TO-CHARGE RATIO. |
| SCHEDULE H, PART III, LINE 3 | BAD DEBT AS COMMUNITY BENEFIT THE PORTION OF THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO TO THE TOTAL BAD DEBT EXPENSE. BAD DEBT PERTAINING TO PATIENT CARE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE, CONSISTENT WITH NHCHS MISSION, PATIENTS RECEIVE CARE REGARDLESS OF WHETHER NHCH COLLECTS PAYMENT FOR SERVICES PERFORMED. |
| SCHEDULE H, PART III, LINE 4 | BAD DEBT EXPENSE FOOTNOTE NHCH PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED - CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). THE AUDITED FINANCIAL STATEMENTS DO NOT DESCRIBE BAD DEBT EXPENSE. THE AUDITED FINANCIAL STATEMENTS DO DESCRIBE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. "NHCH PROVIDES FOR 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." |
| SCHEDULE H, PART III, LINE 8 | TREATMENT OF MEDICARE SHORTFALL COMMUNITY BENEFIT THE HOSPITAL MUST TREAT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE GOVERNMENT SETS NON-NEGOTIABLE MEDICARE RATES AND THE REIMBURSEMENT HAS NOT KEPT PACE WITH THE RISING COSTS OF PROVIDING THESE SERVICES. DUE TO THE REQUIREMENT TO PROVIDE CARE AND THE INABILITY OF THE MEDICARE REIMBURSEMENT TO KEEP PACE WITH THE COST OF PROVIDING SERVICES, WE FEEL THAT THE LOSS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES IS PART OF NHCHS MISSION AND IS A BENEFIT TO THE COMMUNITY. MEDICARE COSTING METHODOLOGY THE MEDICARE AMOUNTS ABOVE ARE CALCULATED WITH DATA FROM THE JUNE 30, 2017 COST REPORT USING THE STEP DOWN METHOD. |
| SCHEDULE H, PART III, LINE 9B | APPLICATION OF THE COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE CHARITY CARE WILL BE GRANTED TO ALL UNDERINSURED AND UNINSURED PATIENTS. THE SCREENING PROCESS WILL OPTIMALLY OCCUR AT THE TIME OF SERVICE, BUT MAY OCCUR ANYTIME DURING THE COLLECTION PROCESS INCLUDING POST ASSIGNMENT TO AN OUTSIDE COLLECTION AGENCY. ACCOUNTS FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE IDENTIFIED FOR A YEAR AND ASSESSED ANNUALLY AND/OR DURING SUBSEQUENT VISITS TO THE HOSPITAL. PROMPT PAYMENT DISCOUNTS ARE AVAILABLE FOR PATIENTS WHO PAY FOR SERVICE AT THE TIME OF TREATMENT. THE CARE PAYMENT PROGRAM IS AVAILABLE FOR ELIGIBLE PATIENTS AND PROVIDES LOW MONTHLY PAYMENTS WITH 0% INTEREST. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS 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 2016 TAX YEAR, NORTH HAWAII COMMUNITY HOSPITAL COMPLETED A CHNA WITH THE ASSISTANCE OF THE HEALTHCARE ASSOCIATION OF HAWAII. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE NOTICES ARE POSTED IN ALL PATIENT REGISTRATION, BILLING OFFICE AND EMERGENCY DEPARTMENT AREAS REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME AND UNINSURED PATIENTS. THIS INFORMATION IS ALSO POSTED ON THE HOSPITAL WEBSITE AND ON PATIENT BILLING STATEMENTS. APPROPRIATE STAFF MEMBERS THAT COMMUNICATE WITH THE PUBLIC REGARDING THEIR BILLS ARE TRAINED AND KNOWLEDGEABLE ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION 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 5 | PROMOTION OF COMMUNITY HEALTH THE MAJORITY OF THE ORGANIZATION'S BOARD IS COMPRISED OF COMMUNITY MEMBERS FROM THE NORTHERN HAWAII AREA AND HAS AN OPEN MEDICAL STAFF. THE HOSPITAL CONDUCTED DIFFERENT EVENTS, INCLUDING HEALTH FAIRS AND EDUCATION DAYS IN THE LOCAL COMMUNITY, HOTELS AND SCHOOLS OF THE AREA. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM NHCH IS A MEMBER OF THE QUEEN'S HEALTH SYSTEMS (QHS) AFFILIATED GROUP. THE GROUP INCLUDES QUEEN'S MEDICAL CENTER (QMC), QUEEN EMMA LAND COMPANY (QEL), QUEEN'S INSURANCE EXCHANGE (QIE), QUEEN'S DEVELOPMENT CORPORATION (QDC) 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 7 | STATE FILING OF COMMUNITY BENEFIT REPORT N/A |
| 501(R) COMPLIANCE | THE HOSPITAL IDENTIFIED AND CORRECTED A GAP IN ITS 501(R) COMPLIANCE. FOR MORE INFORMATION, SEE DISCLOSURE IN PART V, SECTION C, CORRESPONDING TO PART V, SECTION B, LINE 16H. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH GRAHAM | ||||||||||||||
| PRESIDENT/TRUSTEE (PART YEAR) | $0 | $262,855 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $262,855 | $0 | $0 |
| CYNTHIA KAMIKAWA | ||||||||||||||
| PRESIDENT/TRUSTEE | $0 | $317,204 | $0 | $50,036 | $0 | $26,083 | $0 | $113,228 | $0 | $14,222 | $0 | $520,773 | $0 | $0 |
| ARTHUR USHIJIMA | ||||||||||||||
| CHAIR/TRUSTEE | $0 | $853,963 | $0 | $308,920 | $0 | $316,539 | $0 | $70,534 | $0 | $15,291 | $0 | $1,565,247 | $0 | $0 |
| MONEY ATWAL | ||||||||||||||
| ASSISTANT TREASURER | $0 | $180,655 | $0 | $6,200 | $0 | $830 | $0 | $1,042 | $0 | $13,467 | $0 | $202,194 | $0 | $0 |
| LILINOE WATANABE | ||||||||||||||
| TREASURER | $0 | $165,481 | $0 | $8,400 | $0 | $7,083 | $0 | $29,129 | $0 | $7,954 | $0 | $218,047 | $0 | $0 |
| SHARLENE TSUDA | ||||||||||||||
| SECRETARY | $0 | $223,541 | $0 | $49,092 | $0 | $24,544 | $0 | $74,454 | $0 | $14,831 | $0 | $386,462 | $0 | $0 |
| ALISTAIR BAIROS MD | ||||||||||||||
| PHYSICIAN | $216,406 | $0 | $0 | $0 | $22,362 | $0 | $4,218 | $0 | $4,896 | $0 | $247,882 | $0 | $0 | $0 |
| JOHN BELLATTI MD | ||||||||||||||
| PHYSICIAN | $467,275 | $0 | $0 | $0 | $6,858 | $0 | $14,300 | $0 | $22,359 | $0 | $510,792 | $0 | $0 | $0 |
| WILLIAM HILLER MD | ||||||||||||||
| PHYSICIAN | $382,872 | $0 | $0 | $0 | $5,144 | $0 | $0 | $0 | $12,477 | $0 | $400,493 | $0 | $0 | $0 |
| LYN LAM MD | ||||||||||||||
| PHYSICIAN | $318,899 | $0 | $0 | $0 | $4,082 | $0 | $1,982 | $0 | $13,550 | $0 | $338,513 | $0 | $0 | $0 |
| HOWARD WONG MD | ||||||||||||||
| PHYSICIAN | $388,648 | $0 | $0 | $0 | $1,242 | $0 | $5,300 | $0 | $7,899 | $0 | $403,089 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | THE ORGANIZATION RELIED ON THE QUEENS HEALTH SYSTEM (QHS) 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 ALL 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 | COMPENSATION PAID FOR SERVICES ARTHUR A. USHIJIMA MR. USHIJIMA SERVES AS A TRUSTEE FOR THE QUEENS HEALTH SYSTEMS AND SEVERAL OTHER QUEENS 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 QUEENS MEDICAL CENTER (QMC). HIS HOURS SERVED AS A TRUSTEE OF NORTH HAWAII COMMUNITY HOSPITAL (NHCH) ARE 3 HOURS 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. KENNETH GRAHAM MR. GRAHAM SERVED AS VP OF QHS AND AS PRESIDENT OF NHCH THROUGH JULY 2016. HE WAS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED WAS HIS TOTAL COMPENSATION FOR ALL SERVICES. CYNTHIA KAMIKAWA MS. KAMIKAWA SERVES AS VP OF QHS AND AS PRESIDENT OF NHCH. 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. LILINOE WATANABE MS. WATANABE SERVES AS DIRECTOR OF CORPORATE PLANNING AND ANALYSIS FOR QMC AND TREASURER OF NHCH. SHE IS NOT SEPARATELY COMPENSATED FOR THESE SERVICES. THE COMPENSATION LISTED IS HER TOTAL COMPENSATION FOR ALL SERVICES. MONEY ATWAL MR. ATWAL SERVES AS DIRECTOR OF FINANCE AND INFORMATION TECHNOLOGY AND ASSISTANT 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEPT OF BUDGET & FINANCE STATE OF HI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 990266961 | BondIssuerEIN |
| CUSIP | 419800LM7 | CUSIPNum |
| Bond Issued | 2015-01-29 | BondIssuedDt |
| Issue Price | $350,356,476 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $0 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $350,362,507 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $4,726,000 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $156,477,605 | CapitalExpendituresAmt |
| Other Spent Proceeds | $160,009,007 | OtherSpentProceedsAmt |
| Unspent | $29,149,894 | UnspentAmt |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | Yes (true) | AnyResearchAgreementsInd |
| Engage Bond Counsel Research | Yes (true) | EngageBondCounselResearchInd |
| Private Bus Use By Others | 0 | PrivateBusUseByOthersPct |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (true) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ML CAPITAL SERVICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 6.5 | TermOfHedgePct |
| Superintegrated Hedge | false | SuperintegratedHedgeInd |
| Hedge Terminated | false | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K | NORTH HAWAII COMMUNITY HOSPITALS (NHCH) SOLE CORPORATE MEMBER, THE QUEENS HEALTH SYSTEMS (QHS), BORROWED ON BEHALF OF ITSELF AND ITS AFFILIATES, NHCH AND THE QUEENS MEDICAL CENTER (QMC). INFORMATION REPORTED ON SCHEDULE K IS FOR THE ENTIRE BOND ISSUE. THE OUTSTANDING BOND LIABILITY IS ALLOCATED BETWEEN ENTITIES AND REPORTED SEPARATELY ON FORM 990, PART X. NHCHS SHARE OF THE OUTSTANDING LIABILITY IS $5,667,455. |
| PART I, LINE A, COLUMN (F) | DESCRIPTION OF PURPOSE THE BONDS ARE ISSUED FOR THE BENEFIT OF THE BORROWER (THE QUEENS 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 QUEENS MEDICAL CENTER AND 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 QUEENS 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 |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $115,735 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp | |
| Drugs And Medical Supplies | DrugsAndMedicalSuppliesGrp | |
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, COLUMN B | FormAndLineReferenceDesc |
| Explanation | THE AMOUNTS REPORTED IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | TO SUPPORT THE NHCHS MISSION AND TO FULFILL THE TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, NHCH PROVIDED THE FOLLOWING COMMUNITY BENEFITS, TOTALING APPROXIMATELY $13,762,505 FOR THE YEAR ENDED JUNE 30, 2017. 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, 2017, THE ESTIMATED COST OF PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $296,620 AND $561,679, RESPECTIVELY. 2. MEDICAID SHORTFALL IN PAYMENTS - NHCH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICAID PATIENTS IN THE STATE OF HAWAII. NHCH INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $7,735,733 DURING THE YEAR ENDED JUNE 30, 2017. 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 $5,036,420 DURING THE YEAR ENDED JUNE 30, 2017. CONSISTENT WITH COST REPORT REQUIREMENTS, THERE ARE AMOUNTS THAT ARE EXCLUDED FROM THE COSTS ABOVE. 4. COMMUNITY HEALTH IMPROVEMENT NHCH PROVIDES SERVICES AND PROGRAMS TO THE COMMUNITY IN AN EFFORT TO PROMOTE HEALTHY LIFESTYLES. PROGRAMS INCLUDE HEALTH & SAFETY FAIRS, HEALTHY EATING PROGRAMS FOR THE LOCAL COMMUNITY AND AFTER SCHOOL PROGRAMS AT A LOCAL CHARTER SCHOOL. THE COST OF PROVIDING THESE SERVICES WAS $77,329 FOR THE YEAR ENDED JUNE 30, 2017. 5. SUBSIDIZED HEALTH SERVICES NHCH PROVIDES MEDICAL SERVICES THROUGH THE KOHALA HOME HEALTH CARE PROGRAM. KOHALA HOME HEALTH CARE PROVIDES QUALITY CARE FOR HOMEBOUND PATIENTS BY OFFERING A NETWORK OF SERVICES DESIGNED TO MEET THE EMOTIONAL AND PHYSICAL NEEDS OF BOTH PATIENT AND FAMILY. NHCH INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $54,724 DURING THE YEAR ENDED JUNE 30, 2017. |
| FORM 990, PART VI, LINE 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS NHCH HAS A SOLE MEMBER, WHICH IS THE QUEEN'S HEALTH SYSTEMS (QHS), A HAWAII NONPROFIT CORPORATION. |
| FORM 990, PART VI, LINE 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS QHS ELECTS ALL OF THE BOARD MEMBERS OF THE NHCH BOARD OF TRUSTEES. |
| FORM 990, PART VI, LINE 7B | DESCRIPTION OF CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS CERTAIN MAJOR DECISIONS APPROVED BY THE NHCH BOARD OF TRUSTEES MUST ALSO BE APPROVED BY QHS. SUCH DECISIONS INCLUDE: 1. A CHANGE TO THE PURPOSE OF THE COMPANY; 2. A FINANCING TRANSACTION IN EXCESS OF $500,000; 3. A LEASE TRANSACTION THAT HAS A TERM THAT IS LONGER THAN 3 YEARS OR HAS A RENT OBLIGATION IN EXCESS OF $1,000,000 OVER THE LEASE TERM; 4. A TRANSACTION INVOLVING THE SALE, LEASE, DISPOSITION OR HYPOTHECATION OF REAL PROPERTY; 5. ANNUAL OPERATIONAL AND CAPITAL BUDGETS; 6. STRATEGIC PLANS; 7. MERGER OR MAJOR ACQUISITIONS; 8. CREATION OF A NEW ENTITY OR JOINT VENTURE; 9. SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; 10. DISSOLUTION; 11. AMENDMENT OF BYLAWS; 12. ADOPTION, AMENDMENT OR RESCISSION OF A BOARD POLICY; 13. CAPITAL EXPENDITURES IN EXCESS OF $1,000,000 FOR NHCH. |
| FORM 990, PART VI, LINE 11B | DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR THE GOVERNING BODY TO REVIEW 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 NORTH HAWAII COMMUNITY HOSPITAL (NHCH) RETURN WAS MADE AVAILABLE TO EACH OF THE MEMBERS OF THE NHCH BOARD OF TRUSTEES PRIOR TO THE RETURNS BEING FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, LINE 12, 13 & 14 | 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 12C | 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 MANAGER DEPARTMENT AND LEGAL DEPARTMENT HAVE THE CONFLICT OF INTEREST SUMMARIES AND CHECK FOR CONFLICTS OF INTEREST AT THE BEGINNING OF THE CONTRACT PROCESS. ANY CONFLICT OF INTEREST INVOLVING A TRUSTEE IS PRESENTED TO THE BOARD OF TRUSTEES. ANY CONFLICT OF INTEREST INVOLVING A DISQUALIFIED PERSON IS SUBJECT TO THE PROCESS OF ESTABLISHING A REBUTTABLE PRESUMPTION OF REASONABLENESS. ANY TRUSTEE WITH A CONFLICT OF INTEREST IS EXCUSED FOR THE PORTION OF THE MEETING WHERE THE SUBJECT MATTER IS DISCUSSED AND VOTED ON. |
| FORM 990, PART VI, LINE 15A & 15B | PROCESS 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. NHCHS 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 2017. OUTSIDE COUNSEL ASSISTS WITH THE REVIEW PROCESS AND DOCUMENTS THE DECISIONS OF THE COMMITTEE. |
| FORM 990, PART VI, LINE 19 | AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE GENERAL PUBLIC NHCHS 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 ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS CHANGE IN BENEFICIAL INTEREST $ 261,382 ROUNDING ($ 4) ----------- TOTAL $ 261,378 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:5770391 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL SERVICES TOTAL FEES:6861585 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING SERVICES TOTAL FEES:108250 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER SERVICES TOTAL FEES:760 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MOLOKAI GENERAL HOSPITAL | ||||||||||
| PO BOX 408 | KAUNAKAKAI MOLOKAI | HI | 96748 | 990251372 | MEDICAL SVCS | HI | 501(c)(3) | 3 | QHS | Yes (true) |
| LUCY C HENRIQUES TRUST | ||||||||||
| PO BOX 3170 DEPT 715 | HONOLULU | HI | 96802 | 996002291 | SUPPORT | HI | 501(c)(3) | 12c | NA | false |
| PARKER RANCH FOUNDATION TRUST | ||||||||||
| 66-1304 MAMALAHOA HIGHWAY | KAMUELA | HI | 96743 | 996064620 | PROPERTY MGMT | HI | 501(c)(3) | 12a | NA | false |
| THE QUEEN'S HEALTH SYSTEMS | ||||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990238120 | ADMIN SERVICE | HI | 501(c)(3) | 12c | NA | false |
| QUEEN EMMA LAND COMPANY | ||||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990183769 | SUPPORT SVCS | HI | 501(c)(3) | 12A | QHS | Yes (true) |
| THE QUEEN'S MEDICAL CENTER | ||||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990073524 | MEDICAL SVCS | HI | 501(c)(3) | 3 | QHS | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAMAMATSUQUEEN'S PET IMAGING | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 PUNCHBOWL STREET | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 943266916 | EIN |
| Primary Activities | PET IMAGING | PrimaryActivitiesTxt |
| Legal Domicile State | HI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| THE QUEEN'S DEVELOPMENT CORPORATION | |||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990240109 | DEVELOPMENT | HI | NA | C Corp | Yes (true) |
| QUEEN'S INSURANCE EXCHANGE | |||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 911913839 | INSURANCE | HI | NA | C Corp | Yes (true) |
| DIAGNOSTIC LABORATORY SERVICES INC | |||||||||
| 99-859 IWAIWA STREET | AIEA | HI | 96701 | 990240499 | MEDICAL LAB SVCS | HI | NA | C Corp | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DIAGNOSTIC LABORATORY SERVICES INC | ||
| J | $128,497 | FMV |
| DIAGNOSTIC LABORATORY SERVICES INC | ||
| M | $1,448,853 | FMV |
| THE QUEEN'S MEDICAL CENTER | ||
| M | $514,770 | FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART III | FormAndLineReferenceDesc |
| Explanation | IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP HAMAMATSU/QUEEN'S PET IMAGING CENTER, LLC EIN: 94-3266916 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 | ExplanationTxt |