2018-05-07T14:49:14-05:00 2017-06-30 ERNST & YOUNG US LLP 370 17TH STREET 3300 DENVER CO 80202 990 2016-07-01 990260423 NORTH HAWAII COMMUNITY HOSPITAL % SHANNON OLSEN NORT 8088814400 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 967438496 MONEY ATWAL TREASURER 2018-05-01 true KELLEY SIMON P00791436 7209314000 2016 2022-09-23 18:48:47Z CYNTHIA KAMIKAWA 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 967438496 56045469 false X WWW.NHCH.COM X 1989 HI ACUTE CARE HOSPITAL WITH THE MISSION TO IMPROVE THE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII. 11 9 487 48 44725 39274 846533 3031605 57204021 52140288 29518 13126 763127 860450 58843199 56045469 0 250 0 0 31539925 32095178 20012 17800 110904 36275252 46231139 67835189 78344367 -8991990 -22298898 195066195 193558179 44565934 65094934 150500261 128463245 X ACUTE CARE HOSPITAL WITH THE MISSION TO IMPROVE THE HEALTH AND WELLNESS OF THE PEOPLE OF NORTH HAWAII. false false 53998830 250 52315820 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. 53998830 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false false false true false false false false true true true false false true 50 0 true 487 true true true false false false false false false false false false X 11 9 false false false false true true true true true false false true false false false false false true false X SHANNON OLSEN 8088814675 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 96743 X MAENETTE BENHAM EDD TRUSTEE 1.0 2.0 X 0 0 0 KENNETH GRAHAM PRESIDENT/TRUSTEE (PART YEAR) 54.0 1.0 X X 0 262855 0 LYLE HARADA TRUSTEE 1.0 3.0 X 0 0 0 ROBERT HASTINGS II TRUSTEE 1.0 0.0 X 0 0 0 CYNTHIA KAMIKAWA PRESIDENT/TRUSTEE 54.0 1.0 X X 0 393323 127450 NEIL KUYPER TRUSTEE 1.0 0.0 X 0 0 0 RICHARD LEVY PHD TRUSTEE 1.0 0.0 X 0 0 0 ROBERT LINDSEY TRUSTEE 1.0 0.0 X 0 0 0 KAHU BILLY MITCHELL TRUSTEE 1.0 0.0 X 0 0 0 ROBERT MOMSEN TRUSTEE 1.0 4.0 X 0 0 0 ARTHUR USHIJIMA CHAIR/TRUSTEE 3.0 62.0 X X 0 1479422 85825 ERIC YEAMAN TRUSTEE 1.0 6.0 X 0 0 0 MONEY ATWAL ASSISTANT TREASURER 45.0 10.0 X 0 187685 14509 SHARIANN GONSALVES ASSISTANT SECRETARY 40.0 0.0 X 59487 0 13273 MIQUEL SIMMS VICE PRESIDENT (PART YEAR) 55.0 0.0 X 135123 0 12701 LILINOE WATANABE TREASURER 3.0 52.0 X 0 180964 37083 SHARLENE TSUDA SECRETARY 1.0 54.0 X 0 297177 89285 ALISTAIR BAIROS MD PHYSICIAN 50.0 0.0 X 238768 0 9114 JOHN BELLATTI MD PHYSICIAN 50.0 0.0 X 474133 0 36659 WILLIAM HILLER MD PHYSICIAN 50.0 0.0 X 388016 0 12477 LYN LAM MD PHYSICIAN 50.0 0.0 X 322981 0 15532 HOWARD WONG MD PHYSICIAN 50.0 0.0 X 389890 0 13199 2008398 2801426 467107 44 false true false SODEXO AMERICA LLC DEPARTMENT 880328 LOS ANGELES CA 90088 CAFETERIA MANAGEMENT 615000 INFINIPRISE TECHNOLOGIES LLC 5950 CARMICHAEL PLACE STE 104 MONTGOMERY AL 36117 IT SERVICES 201276 INTEGRITY WEB DESIGN 75-5806 KAKALINA STREET KAILUAKONA HI 96740 IT SERVICES 189602 MICHELLE HUBER DAGDAG PO BOX 437382 KAMUELA HI 96743 MEDICAL SERVICES 104930 4 0 352000 2679605 115735 3031605 NET PATIENT SERVICE REVENUE 900099 46978209 46978209 0 0 STATE OF HAWAII SUSTAINABILITY 900099 5032139 5032139 0 0 E.H.R. 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SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE QHS EVALUATES ITS UNCERTAIN TAX POSITIONS AND HAS NO MATERIAL UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2017. true true X true X true X true true true false true true 296620 296620 0.00380 15877403 8141670 7735733 0.09870 16174023 8141670 8032353 0.10250 427329 350000 77329 0.00100 614737 560013 54724 0.00070 1042066 910013 132053 0.00170 17216089 9051683 8164406 0.10420 true 5624518 561679 10039736 15076156 -5036420 X true true 1 1 NORTH HAWAII COMMUNITY HOSPITAL 67-1125 MAMALAHOA HIGHWAY KAMUELA HI 967438496 WWWW.NHCH.COM 39-H X X X NORTH HAWAII MEDICAL GROUP AND KOHALA HOME HEALTH AGENCY NORTH HAWAII COMMUNITY HOSPITAL 1 false false true X X X X X X X X X 15 true true true true X SEE PART V, SECTION C X true 15 false true false true X 150. 250. X X X X X true true X X X true X SEE SECTION C, PART V X SEE SECTION C, PART V X SEE SECTION C X X X X X X true X false X X X true X false false 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. 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. false false false false false false false true false KENNETH GRAHAM PRESIDENT/TRUSTEE (PART YEAR) 0 262855 0 0 0 0 0 0 0 0 0 262855 0 0 CYNTHIA KAMIKAWA PRESIDENT/TRUSTEE 0 317204 0 50036 0 26083 0 113228 0 14222 0 520773 0 0 ARTHUR USHIJIMA CHAIR/TRUSTEE 0 853963 0 308920 0 316539 0 70534 0 15291 0 1565247 0 0 MONEY ATWAL ASSISTANT TREASURER 0 180655 0 6200 0 830 0 1042 0 13467 0 202194 0 0 LILINOE WATANABE TREASURER 0 165481 0 8400 0 7083 0 29129 0 7954 0 218047 0 0 SHARLENE TSUDA SECRETARY 0 223541 0 49092 0 24544 0 74454 0 14831 0 386462 0 0 ALISTAIR BAIROS MD PHYSICIAN 216406 0 0 0 22362 0 4218 0 4896 0 247882 0 0 0 JOHN BELLATTI MD PHYSICIAN 467275 0 0 0 6858 0 14300 0 22359 0 510792 0 0 0 WILLIAM HILLER MD PHYSICIAN 382872 0 0 0 5144 0 0 0 12477 0 400493 0 0 0 LYN LAM MD PHYSICIAN 318899 0 0 0 4082 0 1982 0 13550 0 338513 0 0 0 HOWARD WONG MD PHYSICIAN 388648 0 0 0 1242 0 5300 0 7899 0 403089 0 0 0 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. A DEPT OF BUDGET & FINANCE STATE OF HI 990266961 419800LM7 2015-01-29 350356476 SEE PART VI false false false A 0 0 350362507 0 0 0 4726000 0 0 156477605 160009007 29149894 true false false true A false false false true true 0 false false true A false true false false true true ML CAPITAL SERVICE 6.5 false false false 0 false true A true 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 X 2 115735 FMV false false false SCHEDULE M, PART I, COLUMN B THE AMOUNTS REPORTED IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART III, LINE 4A 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 MOLOKAI GENERAL HOSPITAL PO BOX 408 KAUNAKAKAI MOLOKAI HI 96748 990251372 MEDICAL SVCS HI 501(c)(3) 3 QHS 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 true THE QUEEN'S MEDICAL CENTER 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 MEDICAL SVCS HI 501(c)(3) 3 QHS true HAMAMATSUQUEEN'S PET IMAGING 1301 PUNCHBOWL STREET HONOLULU HI 96813 943266916 PET IMAGING HI NA N/A THE QUEEN'S DEVELOPMENT CORPORATION 1301 PUNCHBOWL STREET HONOLULU HI 96813 990240109 DEVELOPMENT HI NA C Corp true QUEEN'S INSURANCE EXCHANGE 1301 PUNCHBOWL STREET HONOLULU HI 96813 911913839 INSURANCE HI NA C Corp true DIAGNOSTIC LABORATORY SERVICES INC 99-859 IWAIWA STREET AIEA HI 96701 990240499 MEDICAL LAB SVCS HI NA C Corp true false false false false false false false false false true false false true false false true false false false DIAGNOSTIC LABORATORY SERVICES INC J 128497 FMV DIAGNOSTIC LABORATORY SERVICES INC M 1448853 FMV THE QUEEN'S MEDICAL CENTER M 514770 FMV SCHEDULE R, PART III 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