QUEENS NORTH HAWAII COMMUNITY HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- QUEENS NORTH HAWAII COMMUNITY HOSPITAL (EIN 99-0260423)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-13
- IRS object ID
- 201403179349305235
- Schema version
- 2013v3.1
- 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 D
- Schedule H
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-13T15:57:35-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 370 17TH STREET SUITE 3300 | AddressLine1 |
| City | DENVER | City |
| State | CO | State |
| ZIP Code | 80202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | 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 | BusinessNameLine1 |
| 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 | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | KAMUELA | City |
| State | HI | State |
| ZIP Code | 967438496 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NEIL T KUYPER | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Signature | 2014-11-10 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KELLEY SIMON | PreparerPersonNm |
| PTIN | P00791436 | PTIN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DENNIS STILLMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SAME AS C ABOVE | AddressLine1 |
| City | KAMUELA | City |
| State | HI | State |
| ZIP Code | 967438496 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $52,252,062 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://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 | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 431 | TotalEmployeeCnt |
| Total Volunteers | 74 | TotalVolunteersCnt |
| Total Gross UBI | $15,428 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $14,428 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,857,667 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,575,490 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $51,574,945 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $49,715,736 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$153,751 | PYInvestmentIncomeAmt |
| CY Investment Income | -$30,106 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,571,110 | PYOtherRevenueAmt |
| CY Other Revenue | $924,531 | CYOtherRevenueAmt |
| PY Total Revenue | $54,849,971 | PYTotalRevenueAmt |
| CY Total Revenue | $52,185,651 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,293,970 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,821,176 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $3,409 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $416,034 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,807,598 | PYOtherExpensesAmt |
| CY Other Expenses | $31,662,669 | CYOtherExpensesAmt |
| PY Total Expenses | $57,101,568 | PYTotalExpensesAmt |
| CY Total Expenses | $60,487,254 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,251,597 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,301,603 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $161,337,747 | TotalAssetsBOYAmt |
| Total Assets EOY | $177,455,257 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,277,443 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,130,616 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $146,060,304 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $162,324,641 | NetAssetsOrFundBalancesEOYAmt |
| 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 | $39,260,844 | ExpenseAmt |
| Revenue | $49,715,736 | 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. IN 2013, THE HOSPITAL SERVED PATIENTS THROUGH 70,022 OUTPATIENT VISITS AND 1,687 ADMISSIONS. | Desc |
| Total Program Service Expenses | $39,260,844 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | false | TaxExemptBondsInd |
| 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 | 110 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 431 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | 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 | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHANNON OLSEN | PersonNm |
| Phone | 8088814400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 MAMALAHOA HIGHWAY | AddressLine1 |
| City | KAMUELA | City |
| State | HI | State |
| ZIP Code | 967438496 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT R MOMSEN | ||||||||||
| CHAIR | 6.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| VIRGINIA PRESSLER | ||||||||||
| VICE CHAIR | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| NEIL T KUYPER | ||||||||||
| TREASURER | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROBERT W HASTINGS III | ||||||||||
| SECRETARY | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| RICHARD M LEVY | ||||||||||
| BOARD MEMBER | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT K LINDSEY | ||||||||||
| BOARD MEMBER | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| KAHU BILLY MITCHELL | ||||||||||
| BOARD MEMBER | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| WILLIAM PARK MD | ||||||||||
| BOARD MEMBER/PHYSICIAN | 40.0 | 0.0 | Yes (X) | $427,250 | $0 | $18,911 | ||||
| WILLIAM D HILLER MD | ||||||||||
| BOARD MEMBER/CHIEF OF STAFF | 40.0 | 0.0 | Yes (X) | $524,956 | $0 | $19,594 | ||||
| LOWELL JOHNSON | ||||||||||
| INTERIM CEO | 40.0 | 0.0 | Yes (X) | Yes (X) | $396,000 | $0 | $0 | |||
| HOWARD WONG MD | ||||||||||
| BOARD MEMBER/CHIEF OF STAFF | 40.0 | 0.0 | Yes (X) | $352,696 | $0 | $15,266 | ||||
| PATRICIA GUNTER MD | ||||||||||
| BOARD MEMBER/PHYSICIAN | 40.0 | 0.0 | Yes (X) | $287,577 | $0 | $24,402 | ||||
| JASON PARET | ||||||||||
| CFO | 40.0 | 0.0 | $109,264 | $0 | $18,538 | Yes (X) | ||||
| WAYNE S HIGAKI | ||||||||||
| VP PUBLIC AFFAIRS/CDO | 40.0 | 0.0 | $185,091 | $0 | $11,381 | Yes (X) | ||||
| WILLIAM BROWN | ||||||||||
| VP HUMAN RESOURCES | 40.0 | 0.0 | $184,057 | $0 | $17,069 | Yes (X) | ||||
| LORIE ANN MORTENSEN | ||||||||||
| VP PATIENT CARE | 40.0 | 0.0 | $172,335 | $0 | $11,263 | Yes (X) | ||||
| KERRY HOWELL | ||||||||||
| VP-DEVELOPMENT, MARKETING | 40.0 | 0.0 | $31,935 | $6,717 | Yes (X) | |||||
| DIANE ES PAYNE | ||||||||||
| PHYSICIAN | 40.0 | 0.0 | $382,193 | $0 | $17,167 | Yes (X) | ||||
| JENNIFER S REAL | ||||||||||
| PHYSICIAN | 40.0 | 0.0 | $261,568 | $0 | $18,839 | Yes (X) | ||||
| MALCOM MACDONALD | ||||||||||
| PHYSICIAN | 40.0 | 0.0 | $252,380 | $0 | $17,835 | Yes (X) | ||||
| JONETTE L CRAWFORD | ||||||||||
| PHYSICIAN | 40.0 | 0.0 | $199,050 | $0 | $20,519 | Yes (X) | ||||
| ELISE FULSANG | ||||||||||
| PHYSICIAN | 40.0 | 0.0 | $149,885 | $10,286 | Yes (X) | |||||
| KENNETH F WOOD | ||||||||||
| PRESIDENT/CEO - FORMER | 0.0 | 0.0 | $356,562 | $0 | $16,545 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,272,799 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $244,332 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 44 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HURON CONSULTING SERVICES LLC | |||||
| 3005 MOMENTUM PLACE | CHICAGO | IL | 60689 | CONSULTING SERVICES | $2,873,593 |
| CLINICAL LABS OF HAWAII LP | |||||
| MAIL CODE 60300 PO BOX 1300 | HONOLULU | HI | 96807 | LAB SERVICES | $943,222 |
| CA INDUSTRIES INC | |||||
| PO BOX 3037 | OMAHA | NE | 68103 | STAFFING | $440,615 |
| INFINIPRISE TECHNOLOGIES LLC | |||||
| 5950 CARMICHAEL PLACE STE 104 | MONTGOMERY | AL | 36117 | IT SERVICES | $436,501 |
| ANESTHESIA RELIEF LLC | |||||
| PO BOX 1840 | KAILUA KONA | HI | 96745 | ANESTHESIA SERVICES | $322,028 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $447,892 | GovernmentGrantsAmt |
| All Other Contributions | $1,127,598 | AllOtherContributionsAmt |
| Noncash Contributions | $155,247 | NoncashContributionsAmt |
| Total Contributions | $1,575,490 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 900099 | $45,579,598 | $45,579,598 |
| STATE OF HAWAII SUSTAINABILITY | 900099 | $3,488,370 | $3,488,370 |
| E.H.R MEANINGFUL USE | 900099 | $647,768 | $647,768 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $49,715,736 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,678 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $15,428 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,250 | 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 | $306,116 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $306,116 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $306,116 | TotalRevenueColumnAmt |
| Exclusion | $306,116 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $18,627 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $66,411 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$47,784 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$47,784 | TotalRevenueColumnAmt |
| Exclusion | -$47,784 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 | ExclusionExclusionAmt |
|---|---|---|---|
| MEDICAL ABSTRACTS | 900099 | $12,324 | $12,324 |
| VENDING MACHINE/CAFETERIA SALES | 900099 | $345,780 | $345,780 |
| MISCELLANEOUS REVENUE | 900099 | $260,311 | $260,311 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $618,415 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,185,651 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,715,736 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $15,428 | UnrelatedBusinessRevenueAmt |
| Exclusion | $878,997 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,457,740 | TotalAmt |
| Program Services | $2,105,302 | ProgramServicesAmt |
| Management And General | $352,438 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $373,107 | TotalAmt |
| Management And General | $373,107 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,063,943 | TotalAmt |
| Program Services | $15,960,599 | ProgramServicesAmt |
| Management And General | $4,820,682 | ManagementAndGeneralAmt |
| Fundraising | $282,662 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $386,644 | TotalAmt |
| Program Services | $304,185 | ProgramServicesAmt |
| Management And General | $77,676 | ManagementAndGeneralAmt |
| Fundraising | $4,783 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,908,930 | TotalAmt |
| Program Services | $2,160,400 | ProgramServicesAmt |
| Management And General | $708,124 | ManagementAndGeneralAmt |
| Fundraising | $40,406 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,630,812 | TotalAmt |
| Program Services | $1,235,129 | ProgramServicesAmt |
| Management And General | $376,592 | ManagementAndGeneralAmt |
| Fundraising | $19,091 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,968 | TotalAmt |
| Management And General | $722,968 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,176,020 | TotalAmt |
| Management And General | $1,176,020 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,026 | TotalAmt |
| Management And General | $147,026 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,409 | TotalAmt |
| Fundraising | $3,409 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,881,945 | TotalAmt |
| Program Services | $5,018,425 | ProgramServicesAmt |
| Management And General | $4,847,249 | ManagementAndGeneralAmt |
| Fundraising | $16,271 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,430 | TotalAmt |
| Program Services | $3,821 | ProgramServicesAmt |
| Management And General | $22,586 | ManagementAndGeneralAmt |
| Fundraising | $23 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $408,929 | TotalAmt |
| Program Services | $246,202 | ProgramServicesAmt |
| Management And General | $152,588 | ManagementAndGeneralAmt |
| Fundraising | $10,139 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,087,785 | TotalAmt |
| Management And General | $1,087,785 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,247,357 | TotalAmt |
| Program Services | $28,701 | ProgramServicesAmt |
| Management And General | $2,211,154 | ManagementAndGeneralAmt |
| Fundraising | $7,502 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,689 | TotalAmt |
| Program Services | $91,667 | ProgramServicesAmt |
| Management And General | $46,977 | ManagementAndGeneralAmt |
| Fundraising | $45 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,852 | TotalAmt |
| Program Services | $25,894 | ProgramServicesAmt |
| Management And General | $25,958 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $526,348 | TotalAmt |
| Program Services | $343,534 | ProgramServicesAmt |
| Management And General | $179,038 | ManagementAndGeneralAmt |
| Fundraising | $3,776 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,886,810 | TotalAmt |
| Program Services | $1,839,916 | ProgramServicesAmt |
| Management And General | $1,040,840 | ManagementAndGeneralAmt |
| Fundraising | $6,054 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,429,063 | TotalAmt |
| Program Services | $1,587,574 | ProgramServicesAmt |
| Management And General | $824,125 | ManagementAndGeneralAmt |
| Fundraising | $17,364 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $6,487,877 | $6,275,402 | $211,994 | $481 |
| BAD DEBT | $1,407,674 | $1,407,674 | ||
| LAND LEASE AMORTIZATION | $40,003 | $26,110 | $13,606 | $287 |
| FIXED ASSET ABANDONMENT LOSS | $1,082,642 | $1,082,642 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $913,251 | TotalAmt |
| Program Services | $600,309 | ProgramServicesAmt |
| Management And General | $309,201 | ManagementAndGeneralAmt |
| Fundraising | $3,741 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,487,254 | TotalAmt |
| Program Services | $39,260,844 | ProgramServicesAmt |
| Management And General | $20,810,376 | ManagementAndGeneralAmt |
| Fundraising | $416,034 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $530,166 | BOYAmt |
| EOY | $600,797 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,761,693 | BOYAmt |
| EOY | $2,032,390 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,755,005 | BOYAmt |
| EOY | $1,011,984 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,493,288 | BOYAmt |
| EOY | $5,509,406 | 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 | $356,016 | BOYAmt |
| EOY | $252,051 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,203,955 | BOYAmt |
| EOY | $1,248,054 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $367,392 | BOYAmt |
| EOY | $285,479 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $85,956,415 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $36,865,303 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,244,841 | BOYAmt |
| EOY | $49,091,112 | 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 | $121,625,391 | BOYAmt |
| EOY | $117,423,984 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,337,747 | BOYAmt |
| EOY | $177,455,257 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,008,158 | BOYAmt |
| EOY | $5,516,580 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $8,277,087 | BOYAmt |
| EOY | $7,190,619 | 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 | $1,992,198 | BOYAmt |
| EOY | $2,423,417 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,277,443 | BOYAmt |
| EOY | $15,130,616 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,727,997 | BOYAmt |
| EOY | $43,657,505 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,663,385 | BOYAmt |
| EOY | $6,130,769 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,668,922 | BOYAmt |
| EOY | $112,536,367 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,060,304 | BOYAmt |
| EOY | $162,324,641 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,337,747 | BOYAmt |
| EOY | $177,455,257 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,301,603 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $24,565,940 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| 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 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 | $5,020,278 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $565,011 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $381,643 | GrantsOrScholarshipsAmt |
| Other Expenditures | $33,492 | OtherExpendituresAmt |
| Administrative Expenses | $34,055 | AdministrativeExpensesAmt |
| End Year Balance | $5,136,099 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,911,169 | BeginningYearBalanceAmt |
| Contributions | $123,000 | ContributionsAmt |
| Investment Earnings Or Losses | $519,199 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $476,608 | GrantsOrScholarshipsAmt |
| Other Expenditures | $37,584 | OtherExpendituresAmt |
| Administrative Expenses | $18,898 | AdministrativeExpensesAmt |
| End Year Balance | $5,020,278 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Minus2 Yr Endwmt Fund | CYMinus2YrEndwmtFundGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Prmnnt Endowment Balance EOY | 0.81720 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.18280 | 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 | $16,793,374 | OtherCostOrOtherBasisAmt |
| Book Value | $16,793,374 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,909,896 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,237,040 | DepreciationAmt |
| Book Value | $672,856 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,412,936 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,828,991 | DepreciationAmt |
| Book Value | $25,583,945 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,078,957 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,163,362 | DepreciationAmt |
| Book Value | $5,915,595 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $761,250 | OtherCostOrOtherBasisAmt |
| Depreciation | $635,908 | DepreciationAmt |
| Book Value | $125,342 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $49,091,112 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EQUITY PARKER RANCH FDN TRUST | $109,299,121 |
| CONSTRUCTION IN PROGRESS | $79,419 |
| INVESTMENT IN LIBERTY DIALYSIS | $42,106 |
| LOAN ISSUE COSTS - UNAMORTIZED | $60,615 |
| BENEFICIAL INTERESTS | $5,136,098 |
| CONTRIBUTED USE OF LAND | $2,806,625 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $117,423,984 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASE OBLIGATION | $1,563,517 |
| HMSA ADVANCE | $826,923 |
| OTHER LIABILITIES | $32,977 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,423,417 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $61,818 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $61,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,914,842 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,275,727 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,369,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05670 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,976,660 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,275,727 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,430,933 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05770 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,950 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $639,822 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $424,920 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $214,902 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $649,772 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $424,920 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $224,852 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,626,432 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,700,647 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,655,785 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,407,673 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $201,677 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,694,404 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,225,039 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,530,635 | 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 | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67-1125 MAMALAHOA HWY | AddressLine1 |
| City | KAMUELA | City |
| State | HI | State |
| ZIP Code | 96743 | ZIPCode |
| 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LINE 3 | FOR THE HAWAII COUNTY REPORT, 15 KEY INFORMANTS WERE INTERVIEWED FOR THEIR SPECIFIC KNOWLEDGE OF THE HEALTH NEEDS OF THE COMMUNITY. WHEN CERTAIN TOPIC AREAS WERE LACKING AN INTERVIEW WITH SPECIFIC TO HAWAII COUNTY, FINDINGS FROM THE STATEWIDE PERSPECTIVE WERE INCLUDED. THE INFORMATION OBTAINED FROM THESE INTERVIEWS WAS INCORPORATED INTO THE REPORT IN THREE WAYS. A SUMMARY QUALITATIVE ANALYSIS TOOL CALLED A "WORD CLOUD" WAS PRODUCED USING TAGCROWD.COM TO IDENTIFY THE MOST COMMON THEMES AND TOPICS. WORDS OR PHRASES THAT WERE MENTIONED MOST OFTEN DISPLAY IN THE WORD CLOUD IN THE LARGEST AND DARKEST FONT. NEXT, INPUT FROM THE KEY INFORMANTS WAS INCLUDED IN EACH RELEVANT TOPIC AREA IN SECTION 3.2 OF THE CHNA. |
| LINE 4 | TWENTY-SIX OF TWENTY-EIGHT HAWAII HOSPITALS, LOCATED ON ALL ISLANDS, PARTICIPATED IN THE CHNA PROJECT: CASTLE MEDICAL CENTER HALE HO`OLA HAMAKUA (HAWAII COUNTY) HILO MEDICAL CENTER (HAWAII COUNTY) KAHI MOHALA BEHAVIORAL HEALTH (SERVES HAWAII COUNTY RESIDENTS) KAHUKU MEDICAL CENTER KAISER PERMANENTE MEDICAL CENTER (SERVES HAWAII COUNTY RESIDENTS) KAPI`OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (SERVES HAWAII COUNTY RESIDENTS) KA`U HOSPITAL (HAWAII COUNTY) KAUAI VETERANS MEMORIAL HOSPITAL KOHALA HOSPITAL (HAWAII COUNTY) KONA COMMUNITY HOSPITAL (HAWAII COUNTY) KUAKINI MEDICAL CENTER KULA HOSPITAL LANA`I COMMUNITY HOSPITAL LEAHI HOSPITAL MAUI MEMORIAL MEDICAL CENTER MOLOKAI GENERAL HOSPITAL NORTH HAWAII COMMUNITY HOSPITAL (HAWAII COUNTY) PALI MOMI MEDICAL CENTER REHABILITATION HOSPITAL OF THE PACIFIC (SERVES HAWAII COUNTY RESIDENTS) SAMUEL MAHELONA MEMORIAL HOSPITAL SHRINERS HOSPITALS FOR CHILDREN HONOLULU (SERVES HAWAII COUNTY RESIDENTS) STRAUB CLINIC & HOSPITAL THE QUEEN'S MEDICAL CENTER (SERVES HAWAII COUNTY RESIDENTS) WAHIAWA GENERAL HOSPITAL WILCOX MEMORIAL HOSPITAL |
| LINE 5A | THE CHNA CAN BE FOUND AT: http://www.nhch.com/cms/View.aspx/Show/communitybenefit |
| LINE 7 | THE CHNA IDENTIFIED 20 AREAS OF COMMUNITY HEALTH NEEDS. NORTH HAWAII COMMUNITY HOSPITAL (NHCH) 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. NHCH PLANS TO ADDRESS THE EXERCISE, NUTRITION AND WEIGHT COMMUNITY HEALTH NEED INCLUDED IN THE CHNA. NHCH WILL IMPLEMENT A STRATEGY TO CREATE COMMUNITY AWARENESS OF THE RELATIONSHIP BETWEEN AND THE IMPACT OF EXERCISE, WEIGHT AND NUTRITION ON CHRONIC DISEASES SUCH AS DIABETES AND HEART DISEASE AND TO ENCOURAGE COMMUNITY PARTICIPATION IN ACTIVITIES THAT PROMOTE HEALTHY NUTRITION AND EXERCISE. 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. |
| LINE 9 | 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. |
| LINE 14G | MEASURES TO PUBLICIZE THE POLICY 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 4 | BAD DEBT EXPENSE IS SHOWN AS A PERCENTAGE OF TOTAL EXPENSE OF THE HOSPITAL AND REPRESENTS THE PORTION OF UNREIMBURSED EXPENSE FROM THE HOSPITAL'S APPLICABLE CHARITY CARE PROGRAMS. BAD DEBT FINANCIAL STATEMENT FOOTNOTE - BAD DEBT PROVISIONS ARE MADE FOR THE AMOUNT OF REVENUE THAT WILL NOT BE COLLECTED FROM PATIENTS TO WHOM SERVICES WERE BILLED BUT NOT PAID. THE HOSPITAL HAS DETERMINED THESE PATIENTS ARE NOT FINANCIALLY INDIGENT AND DO NOT QUALIFY FOR THE HOSPITAL'S CHARITY CARE PROGRAM. BAD DEBT PROVISIONS ARE DETERMINED BY MANAGEMENT'S ASSESSMENT WITH CONSIDERATION OF BUSINESS AND ECONOMIC CONDITIONS, CHANGES AND TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE ADEQUECY OF THIS PROVISION IS PERIODICALLY REVIEWED AND FURTHER MODIFIED BASED UPON THE ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. |
| PART III, LINE 9B | 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 SERVICES AT THE TIME OF TREATMENT. THE CAREPAYMENT PROGRAM IS AVAILABLE FOR ELIGIBLE PATIENTS AND PROVIDES LOW MONTHLY PAYMENTS WITH 0% INTEREST. |
| PART VI, LINE 2 | NEEDS ASSESMENT 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 INPROVEMENT 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 2013 TAX YEAR, NORTH HAWAII COMMUNITY HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE ASSISTANCE OF THE HEALTHCARE ASSOCIATION OF HAWAII. |
| 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. APPRORIATE STAFF MEMBERS THAT COMMUNICATE WITH THE PUBLIC REGARDING THEIR BILLS ARE TRAINED AND KNOWLEDGEABLE ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES. |
| PART VI, LINE 4 | COMMUNITY INFORMATION NORTH HAWAII COMMUNITY HOSPITAL ("THE HOSPITAL") IS LOCATED IN KAMUELA, HI, ALSO KNOWN AS WAIMEA, HI, 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 1000 SQUARE MILES, OF THE BIG ISLAND'S 4028 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 1995. THE HOSPITAL IS CURRENTLY LICENSED FOR 35 BEDS. ADMITTING PHYSICIANS ARE PRACTITIONERS IN THE LOCAL AREA. |
| 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 APPROXIMATELY 34 DIFFERENT EVENTS INCLUDING HEALTH FAIRS AND EDUCATION DAYS IN THE LOCAL COMMUNITY, HOTELS, AND SCHOOLS OF THE AREA AS WELL AS TAKING A LEAD ROLE IN BREAST CANCER AWARENESS MONTH. TOTAL COMMUNITY PEOPLE REACHED WAS APPROXIMATELY 13,740. |
| PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM NHCH BECAME A MEMBER OF THE QUEEN'S HEALTH SYSTEMS ("QHS") AFFILIATED GROUP IN DECEMBER 2013. THE GROUP INCLUDES QUEEN'S MEDICAL CENTER ("QMC"), MOLOKAI GENERAL HOSPITAL ("MGH"), QUEEN EMMA LAND COMPANY ("QEL"), QUEEN'S INSURANCE EXCHANGE ("QIE") AND QUEEN'S DEVELOPMENT CORPORATION ("QDC). QHS WILL PROVIDE LEGAL, ACCOUNTING AND ADMINISTRATIVE SUPPORT SERVICES TO NHCH AND QIE WILL PROVIDE MEDICAL MALPRACTICE INSURANCE TO NHCH. IN RETURN, NHCH WILL ASSIST QMC IN FULFILLING ITS MISSION TO PROVIDE IN PERPETUITY QUALITY HEALTH CARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL OF THE PEOPLE OF HAWAII |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM PARK MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $423,998 | $0 | $0 | $0 | $3,252 | $0 | $4,784 | $0 | $14,127 | $0 | $446,161 | $0 | $0 | $0 |
| WILLIAM D HILLER MD | ||||||||||||||
| BOARD MEMBER/CHIEF OF STAFF | $520,048 | $0 | $0 | $0 | $4,908 | $0 | $385 | $0 | $19,209 | $0 | $544,550 | $0 | $0 | $0 |
| LOWELL JOHNSON | ||||||||||||||
| INTERIM CEO | $396,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $396,000 | $0 | $0 | $0 |
| HOWARD WONG MD | ||||||||||||||
| BOARD MEMBER/CHIEF OF STAFF | $351,259 | $0 | $0 | $0 | $1,437 | $0 | $7,020 | $0 | $8,246 | $0 | $367,962 | $0 | $0 | $0 |
| PATRICIA GUNTER MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $285,567 | $0 | $0 | $0 | $2,010 | $0 | $5,690 | $0 | $18,712 | $0 | $311,979 | $0 | $0 | $0 |
| WAYNE S HIGAKI | ||||||||||||||
| VP PUBLIC AFFAIRS/CDO | $184,134 | $0 | $0 | $0 | $957 | $0 | $3,662 | $0 | $7,719 | $0 | $196,472 | $0 | $0 | $0 |
| WILLIAM BROWN | ||||||||||||||
| VP HUMAN RESOURCES | $182,495 | $0 | $0 | $0 | $1,562 | $0 | $3,631 | $0 | $13,438 | $0 | $201,126 | $0 | $0 | $0 |
| LORIE ANN MORTENSEN | ||||||||||||||
| VP PATIENT CARE | $171,560 | $0 | $0 | $0 | $775 | $0 | $3,436 | $0 | $7,827 | $0 | $183,598 | $0 | $0 | $0 |
| DIANE ES PAYNE | ||||||||||||||
| PHYSICIAN | $381,609 | $0 | $0 | $0 | $584 | $0 | $7,615 | $0 | $9,552 | $0 | $399,360 | $0 | $0 | $0 |
| JENNIFER S REAL | ||||||||||||||
| PHYSICIAN | $261,176 | $0 | $0 | $0 | $392 | $0 | $5,202 | $0 | $13,637 | $0 | $280,407 | $0 | $0 | $0 |
| MALCOM MACDONALD | ||||||||||||||
| PHYSICIAN | $224,723 | $0 | $27,000 | $0 | $657 | $0 | $4,486 | $0 | $13,349 | $0 | $270,215 | $0 | $0 | $0 |
| JONETTE L CRAWFORD | ||||||||||||||
| PHYSICIAN | $198,708 | $0 | $0 | $0 | $342 | $0 | $2,056 | $0 | $18,463 | $0 | $219,569 | $0 | $0 | $0 |
| KENNETH F WOOD | ||||||||||||||
| PRESIDENT/CEO - FORMER | $0 | $0 | $0 | $0 | $356,562 | $0 | $0 | $0 | $16,545 | $0 | $373,107 | $0 | $0 | $0 |
| ELISE FULSANG | ||||||||||||||
| PHYSICIAN | $139,374 | $10,000 | $511 | $2,444 | $7,842 | $160,171 | ||||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | SEE SCHEDULE O, PART VI, LINE 15A. |
| PART I, LINE 4A | KENNETH WOOD: SEVERANCE AGREEMENT INCLUDES BI-WEEKLY COMPENSATION OF $13,713.94 FROM 10/1/2012 FOR 24 MONTHS AND COVERAGE FOR MEDICAL AND DENTAL BENEFITS AT A COST OF $529.08 PER MONTH FOR 18 MONTHS. |
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 | 9 | ContributionCnt |
| Noncash Contributions Rpt F990 | $155,247 | 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 | |
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 4 | DESCRIPTION OF SIGNIFICANT CHANGES TO ORGANIZING OR ENABLING DOCUMENT THE QUEEN'S HEALTH SYSTEMS ("QUEEN'S"), CORPORATE PARENT OF THE QUEEN'S MEDICAL CENTER ("QMC") ANNOUNCED ON DECEMBER 16, 2013 THAT IT HAD OFFICIALLY ENTERED INTO AN AFFILIATION AGREEMENT WITH NORTH HAWAII COMMUNITY HOSPITAL ("NHCH"). ON THAT DAY, NHCH AMENDED ITS ARTICLES OF INCORPORATION AND BYLAWS TO REFLECT THE AFFILIATION. THE AMENDED ARTICLES AND BYLAWS NAME THE QUEEN'S HEALTH SYSTEMS (QHS) AS THE SOLE CORPORATE MEMBER AND PROVIDE THEM THE POWER TO ELECT AND REMOVE THE TRUSTEES OF NHCH, AND TO VOTE ON ALL MATTERS. |
| 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, A HAWAII NONPROFIT CORPORATION ("QHS") |
| 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 | DESCRIBE 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 $50,000; 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 11 | DESCRIPTION OF THE PROCESS USED TO REVIEW THE FORM 990 AS OF JANUARY 15, 2014, NORTH HAWAII COMMUNITY HOSPITAL ("NHCH") HAS A SOLE MEMBER, WHICH IS THE QUEEN'S HEALTH SYSTEMS, A HAWAII NONPROFIT CORPORATION ("QHS"). THE FORM 990 FOR NHCH WAS REVIEWED BY THE GOVERNING BODY OF QHS PRIOR TO THE FILING OF THE RETURNS. THE QHS FINANCE 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. ALSO, A COPY OF THE 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 15A | OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE HOSPITAL OBTAINED SALARY MARKET STUDIES FROM A CONTRACTED MANAGEMENT COMPANY TO REVIEW ALL EXECUTIVES' SALARIES. THEY ALSO COMPARED SALARIES OF APPLICANTS AND FORMER CHIEF EXECUTIVE OFFICERS OF THE ORGANIZATION. 2012 WAS THE LAST TIME THE PROCESS WAS COMPLETED. |
| FORM 990, PART VI, LINE 19 | DOCUMENTATION AVAILABLE TO PUBLIC THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL SERVICES PURCHASED SERVICES $4,671,058 MEDICAL SERVICES $5,210,887 ---------- TOTAL $9,881,945 |
| 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS ADJUSTMENT TO NET ASSETS $25,042,159 CHANGE IN VALUE OF BENEFICIAL INTEREST 24,578 RECLASS UNCOLLECTIBLE PLEDGES FROM PRIOR YEAR (500,758) ROUNDING (39) ------------- TOTAL $24,565,940 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| LUCY K HENRIQUES TRUST | ||||||||||
| PO BOX 3170 DEPT 715 | HONOLULU | HI | 968023170 | 996002291 | SUPPORT | AK | 501(C)(3) | 11C, III-FI | NA | false |
| THE QUEEN'S HEALTH SYSTEMS | ||||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990238120 | ADMIN SERVICE | HI | 501(C)(3) | 11 TYPE II | NA | false |
| THE QUEEN'S MEDICAL CENTER | ||||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990073524 | MEDICAL SVCS | HI | 501(C)(3) | 3 | QHS | Yes (true) |
| QUEEN EMMA LAND COMPANY | ||||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990183769 | SUPPORT SVCS | HI | 501(C)(3) | 11 TYPE II | QHS | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAMAMATSUPET | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 PUNCHBOWL STREET | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| 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 | BusinessNameLine1 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt |
|---|---|---|---|---|---|---|---|---|
| THE QUEEN'S DEVELOPMENT CORPORATION | ||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 990240109 | DEVELOPMENT | HI | NA | C CORP |
| QUEEN'S INSURANCE EXCHANGE INC | ||||||||
| 1301 PUNCHBOWL STREET | HONOLULU | HI | 96813 | 911913839 | INSURANCE | HI | NA | C CORP |
| DIAGNOSTIC LABORATORY SERVICES INC | ||||||||
| 99-859 IWAIWA STREET | AIEA | HI | 96701 | 990240499 | MEDICAL LAB SVCS | HI | NA | C CORP |
| 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 | Yes (true) | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUCY K HENRIQUES TRUST | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | S | TransactionTypeTxt |
| Involved | $84,000 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART III | FormAndLineReferenceDesc |
| Explanation | HAMAMATSU/QUEEN'S PET IMAGING CENTER, LLC EIN:94-3266916 ADDRESS: 1301 PUNCHBOWL STREET HONOLULU, HI 96813 | ExplanationTxt |