2014-05-08T12:06:04-05:00 2013-06-30 ERNST & YOUNG US LLP 4370 LA JOLLA VILLAGE DR STE 500 SAN DIEGO CA 92122 990 2012-07-01 383840327 PALI MOMI FOUNDATION % ANN HO PALI 8085357100 55 MERCHANT STREET 24TH FLOOR Suite HONOLULU HI 968134333 EARL INOUYE 2014-05-07 8585357200 2012 2015-11-30 17:44:51Z MICHAEL ROBINSON 55 MERCHANT STREET 26TH FLOOR HONOLULU HI 968134333 460396 false X WWW.PALIMOMIGIFT.ORG X 2010 HI THE MISSION OF THE PALI MOMI FOUNDATION IS TO IMPROVE THE HEALTH OF HAWAI'I'S PEOPLE THROUGH FUNDING OF MEDICAL CARE, HEALTH EDUCATION & RESEARCH AT PALI MOMI MEDICAL CENTER. 6 5 0 4 0 399428 400178 0 0 -6372 6907 -10207 27589 382849 434674 66502 344627 0 0 0 0 0 0 24922 136767 60603 203269 405230 179580 29444 563427 539865 2002 2836 561425 537029 X THE MISSION OF THE PALI MOMI FOUNDATION IS TO IMPROVE THE HEALTH OF HAWAI'I'S PEOPLE THROUGH FUNDING OF MEDICAL CARE, HEALTH EDUCATION & RESEARCH AT PALI MOMI MEDICAL CENTER. false false 348843 344627 0 SEE SCHEDULE O. 348843 true true false false false false false false false false false true false false false false false true false false false false false false true false false true false true false false false false false false false false false false false false false true true true false false true 10 0 true 0 false false false false false true true false false false false false false false X 6 5 false false false false true true true true true false false true true true true true true false false false HI X X ANN HO 8085272520 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 968134333 BETH HOBAN RN 0.1 0.2 X X 0 0 0 VIOLETA ARNOBIT RN 0.1 0.2 X 0 0 0 VICKI GAYNOR 0.1 0.0 X 0 0 0 CLINTON GOO 0.1 0.2 X 0 0 0 GREGG T KOKAME MD 0.1 0.2 X 0 0 0 DON WILCOX MD 0.1 0.0 X 0 0 0 CHARLES A STED 1.0 59.0 X 0 1733229 45535 EMILY KURAOKA 0.1 0.0 X 0 0 0 RAYMOND P VARA JR 1.0 59.0 X 0 1183271 318255 MICHAEL ROBINSON 1.0 40.0 X 0 202904 17638 CHARLES R CHING 0.1 52.0 X 0 561651 117352 EARL INOUYE 0.1 43.0 X 0 306408 75801 DAVID OKABE 0.1 55.0 X 0 735788 156303 VIRGINIA PRESSLER-FISHER MD 0.1 54.0 X 0 594421 149714 JESSICA LEWIS 0.1 40.0 X 0 112417 15739 0 5430089 896337 0 false true false 0 1800 398378 14294 400178 0 6837 6837 0 0 0 0 0 6931 6861 70 70 70 46450 1800 18861 27589 27589 0 0 0 434674 34496 X 344627 344627 0 0 0 0 0 0 0 0 0 0 0 241 241 0 0 463 463 30669 23067 7602 262 262 3101 2144 957 12342 12342 0 0 407 407 0 0 0 0 0 4494 4494 PROGRAM SERVICE EXPENSES 4216 4216 CORP ALLOCATION 1056 1056 OTHER PURCHASES 2201 2201 OTHER EXPENSES 1151 1151 405230 348843 31465 24922 0 0 355029 275291 0 0 72167 134721 0 0 0 0 0 0 0 0 0 0 0 71300 76377 45142 40991 0 0 0 0 19789 12485 563427 539865 2002 2836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2002 2836 X -24456 -110872 585881 647901 0 0 561425 537029 563427 539865 X 29444 5665 -59505 X false true X true false X 0 0 0 399428 400178 799606 0 0 0 0 0 399428 400178 799606 105082 694524 2258 6837 9095 0 0 0 808701 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED UNRESTRICTED INVESTMENTS 40991 F 40991 GOLF TOURNAMENT 48250 1800 46450 18861 0 48250 1800 46450 18861 18861 27589 true PALI MOMI MEDICAL CENTER 55 MERCHANT ST 24TH FL HONOLULU HI 96813 990274038 501(C)(3) 337194 7433 HOSPITAL EQUIPMENT GENERAL SUPPORT 1 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS FORM 990, SCHEDULE I TEMPORARILY RESTRICTED FUNDS RELEASED (& GRANTED) TO THE AFFILIATED ORGANIZATIONS ARE RELEASED AFTER THE SPECIFIC PURPOSE OF THE FUND HAS BEEN MET. ONCE THE AFFILIATED ORGANIZATION COMMUNICATES THE EXPENSE AND SATISFIES THE SUBSTANTIATION OF THE EXPENSE FOR THE PURPOSE THAT THE FUNDS WERE CONTRIBUTED FOR, THE FOUNDATION RELEASES THE RESTRICTION AND RECORDS THE GRANT TO THE AFFILIATED ORGANIZATION. NO FURTHER MONITORING OF THE FUNDS AFTER DISTRIBUTION IS NECESSARY. false false false false false false false false false CHARLES A STED 0 766059 0 451050 0 516120 0 28913 0 16622 0 1778764 0 552685 MICHAEL ROBINSON 0 188604 0 10925 0 3375 0 10594 0 7044 0 220542 0 0 CHARLES R CHING 0 326252 0 144862 0 90537 0 115097 0 2255 0 679003 0 94292 EARL INOUYE 0 231900 0 36374 0 38134 0 54068 0 21733 0 382209 0 28392 DAVID OKABE 0 431997 0 183650 0 120141 0 143391 0 12912 0 892091 0 121653 VIRGINIA PRESSLER-FISHER MD 0 340354 0 132739 0 121328 0 128412 0 21302 0 744135 0 121235 RAYMOND P VARA JR 0 645920 0 325816 0 211535 0 296596 0 21659 0 1501526 0 220993 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, QUESTION 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR 990 PART VI, LINE 15B FOR THE PROCESS USED BY HAWAI'I PACIFIC HEALTH TO DETERMINE COMPENSATION. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. THE CAPITAL ACCUMULATION ACCOUNT (CAA) IS A SECTION 457(F) PROGRAM THAT WAS PREVIOUSLY AFFORDED TO EXECUTIVE OFFICERS OF THE ORGANIZAITON TO PROVIDE BENEFITS ON A TAX DEFERRED BASIS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: $ 70,464 - VIRGINIA PRESSLER-FISHER $ 41,295 - CHARLES CHING $ 50,005 - DAVID OKABE $364,357 - CHARLES A. STED $ 89,128 - RAYMOND P. VARA, JR. $ 10,333 - EARL INOUYE LONG TERM INCENTIVE PLAN THE LONG TERM INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL AND LONG TERM SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: $132,739 - VIRGINIA PRESSLER-FISHER $131,362 - CHARLES CHING $171,650 - DAVID OKABE $451,050 - CHARLES A. STED $305,816 - RAYMOND P. VARA, JR. $ 36,374 - EARL INOUYE PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4 THE MISSION OF THE PALI MOMI FOUNDATION (PMF) IS TO IMPROVE THE HEALTH OF HAWAI'I'S PEOPLE THROUGH FUNDING MEDICAL CARE, HEALTH EDUCATION AND RESEARCH AT PALI MOMI MEDICAL CENTER (PALI MOMI). PALI MOMI IS A NONPROFIT HOSPITAL LOCATED IN WEST O'AHU DEDICATED TO ENSURING THE HEALTH AND WELL-BEING OF ALL HAWAI'I RESIDENTS. WITH 116 BEDS AND MORE THAN 398 PHYSICIANS ON ITS MEDICAL STAFF, PALI MOMI OFFERS A FULL RANGE OF SERVICES. IT HAS DELIVERED MANY MEDICAL FIRSTS FOR THE COMMUNITY, INCLUDING WEST O'AHU'S ONLY INTERVENTIONAL CARDIAC CATHETERIZATION UNIT FOR THE DETECTION AND TREATMENT OF HEART DISEASE, A FULLY INTEGRATED MINIMALLY INVASIVE SURGICAL SUITE, CT SCAN AND MRI SERVICES, EMERGENCY SERVICES, A WOMEN'S CENTER AND THE STATE'S FIRST RETINA CENTER. AS A NON-PROFIT HOSPITAL, PALI MOMI RELIES ON COMMUNITY SUPPORT TO FULFILL ITS MISSION. OUR GENEROUS DONORS, THROUGH CONTRIBUTIONS TO PMF, HELP THE HOSPITAL PROVIDE EXCEPTIONAL MEDICAL CARE TO THEIR PATIENTS. IN FISCAL YEAR 2013, PMF FOCUSED ITS FUNDRAISING ON SUPPORTING CRITICAL PROGRAMS AND UNRESTRICTED SUPPORT TO THE HOSPITAL. PALI MOMI'S RETINA CENTER, WHICH IS FUNDED BY PHILANTHROPY, PERFORMS APPROXIMATELY 15 SURGERIES EACH WEEK TO HELP PREVENT AND TREAT RETINAL DISEASES, THE NUMBER ONE CAUSE OF BLINDNESS IN THE STATE. BECAUSE OF ITS WORK, THE RETINA CENTER IS RECOGNIZED INTERNATIONALLY AS A LEADING CLINICAL AND RESEARCH CENTER FOR DISEASES OF THE RETINA. ALSO FUNDED THROUGH PMF IS THE PALI MOMI CARDIAC CATHETERIZATION LAB. IT IS THE ONLY INTERVENTIONAL "CATH LAB" IN WEST O'AHU TO DETECT AND TREAT HEART ATTACKS IN A TIMELY MANNER. PMF RAISED MONEY TO SUPPORT THE OHANA FUND, WHICH PROVIDES FINANCIAL SUPPORT TO PATIENTS AND THEIR FAMILIES FOR ITEMS THAT INSURANCE SIMPLY DOES NOT COVER SUCH AS DISCHARGE MEDICATION, DISCHARGE GROUND TRANSPORTATION, AND EVEN CRUTCHES AND BANDAGES. TO HELP PROVIDE THE HIGHEST LEVEL OF CARE AND BEST POSSIBLE EXPERIENCE TO AN AVERAGE OF 123 PATIENTS PER DAY, PALI MOMI RECENTLY UNDERWENT A RENOVATION AND EXPANSION OF ITS EMERGENCY DEPARTMENT, THANKS IN PART TO THE GENEROUS ANNUAL SUPPORT OF DONORS. TODAY, THE BRIGHT NEW EMERGENCY DEPARTMENT RECEPTION AREA AT PALI MOMI HIDES THE CONSTANT DRUM OF ACTIVITY OCCURRING JUST THROUGH THE DOOR AT THE CENTRAL NURSES' STATION. MEMBERS AND RIGHTS FORM 990, PART VI, LINE 6 HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARD. DESCRIPTION OF CLASSES OF PERSON AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER, AND HAS THE POWER TO APPROVE THE ELECTION OF MEMBERS OF THE GOVERNING BODY. HAWAI'I PACIFIC HEALTH, AS MEMBER, ALSO HAS THE POWER TO ELECT ONE OR MORE EX OFFICIO VOTING MEMBERS OF THE GOVERNING BODY. DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7B HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS EXCLUSIVE POWER TO TAKE AND DIRECT THE FOLLOWING ACTIONS OF THE CORPORATION: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR OF THE BOARD; (II) AFTER CONSULTATION WITH THE BOARD, REMOVE THE PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR; (III) REMOVE A DIRECTOR FROM THE BOARD; (IV) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER; (V) AMEND THESE BYLAWS; (VI) CAUSE THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR ONE MILLION DOLLARS ($1,000,000) OR MORE; (VII) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VIII) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (IX) DETERMINE AND EFFECT INTER-CORPORATE FUND TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (X) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S EXECUTIVE COMPENSATION AND BENEFIT PLANS; (XI) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (XII) DEVELOP AND PROMULGATE OVERALL CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION; AND (XIII) DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER APPROVAL: (I) ELECT ANY DIRECTOR TO THE BOARD; (II) AMEND THE ARTICLES; (III) MERGE THE CORPORATION WITH ANY ENTITY; (IV) DISSOLVE THE CORPORATION; (V) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS BY OR ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VI) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000) EXCEPT FOR THOSE ASSETS ACQUIRED BY GIFTS, GRANT, OR DONATION; (VII) ACQUIRE SHARES IN ANOTHER CORPORATION; (VIII) SELL, LEASE, EXCHANGE, ENCUMBER OR DISPOSE OF TWENTY-FIVE PERCENT (25%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (IX) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (X) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONSHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; AND (XI) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE. REVIEW OF THE 990S BY THE ORGANIZATION'S GOVERNING BODY FORM 990, PART VI, LINE 11B VARIOUS SCHEDULES OF THE 990S ARE PREPARED PRIMARILY BY STAFF WITHIN THE ACCOUNTING AREA OF THE ORGANIZATION WORKING WITH VARIOUS OTHER AREAS OF THE ORGANIZATION SUCH AS MANAGEMENT OF OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPLETED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER/EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYSTEM REVIEWS THE 990S OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE 990S ARE THEN PROVIDED TO THE GOVERNANCE AND NOMINATING COMMITTEE OF THE HEALTH CARE SYSTEM'S BOARD OF DIRECTORS FOR THEIR REVIEW. THE GOVERNANCE AND NOMINATING COMMITTEE OF THE PARENT ENTITY'S (HAWAI'I PACIFIC HEALTH "HPH") BOARD PROVIDES OVERSIGHT FOR THE 990 REPORTING AND REVIEWS THE 990S FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE 990S FOR EACH ENTITY ARE MADE AVAILABLE TO THE BOARD MEMBERS OF EACH SUBSIDIARY UNIT OF HPH AND THE HPH BOARD OF DIRECTORS THROUGH A BOARD MEMBER PORTAL FOR REVIEW PRIOR TO THE FILING OF THE 990. THE 990S WILL BE POSTED TO HPH'S WEBSITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURN WITH THE IRS. MONITORING & ENFORCING OF CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C ANNUALLY, EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) RECEIVED A COPY OF THE CONFLICT OF INTEREST ("COI") POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION, AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE IN-HOUSE LEGAL DEPARTMENT DISTRIBUTES THE STATEMENT REQUEST AND REVIEWS THE COI STATEMENTS RETURNED. IDENTIFIED CONFLICTS OF INTEREST ARE PRESENTED TO THE BOARD FOR REVIEW, DELIBERATION AND CONFIRMATION /REFUTATION THAT A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST HAS BEEN FOUND, THE INDIVIDUAL MAY ADDRESS THE BOARD AND EXPLAIN THE TRANSACTION OR ARRANGEMENT CAUSING THE CONFLICT. AFTER THE PRESENTATION, THE INDIVIDUAL IS EXCUSED FROM THE MEETING AND SHALL NOT PARTICIPATE WITH ANY DISCUSSION OR VOTE ON MATTERS PERTAINING TO THE TRANSACTION OR ARRANGEMENT. IN MEETINGS WHERE APPLICATION OF THE COI POLICY OCCURS, THE MEETING MINUTES INCLUDE NATURE OF THE FINANCIAL INTEREST/CONFLICT, NAME(S) OF THE PERSON(S) WITH THE POTENTIAL OR ACTUAL CONFLICT, ANY ACTION TAKEN TO ASSIST IN THE DETERMINATION OF WHETHER A CONFLICT EXISTED, INCLUDING ANY DISCUSSION OF ALTERNATIVE ARRANGEMENTS, THE BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT. BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT. OFFICES AND POSITIONS FOR WHICH PROCESS WAS USED, AND YEAR PROCESS WAS LAST COMPLETED FORM 990, PART VI, LINES 15A & 15B THE CEO, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER BY THE TAX EXEMPT PARENT HAWAI'I PACIFIC HEALTH ("HPH"). FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE CEO, OFFICERS AND KEY EMPLOYEES' COMPENSATION. COMPENSATION FOR HAWAI'I PACIFIC HEALTH ("HPH") EXECUTIVES (VICE PRESIDENT AND ABOVE) IS SET BY THE HPH COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT, COMMUNITY-BASED MEMBERS OF THE HPH BOARD OF DIRECTORS. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVES' COMPENSATION AND BENEFITS. THE CONSULTANT PROVIDES A WRITTEN REPORT TO THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING. INCLUDED IN THE REPORT IS MARKET BASED DATA FROM LIKE ORGANIZATIONS. THE COMPENSATION COMMITTEE MAKES FINAL DECISIONS REGARDING COMPENSATION AND BENEFITS AT THE MEETING AFTER REVIEW AND DISCUSSION OF THE CONSULTANT'S REPORT, AND SUCH DECISIONS ARE DOCUMENTED IN THE COMPENSATION COMMITTEE MEETING MINUTES. COMMUNITY BASED DIRECTORS OF THE ORGANIZATION ARE NOT COMPENSATED. CERTAIN EMPLOYED PHYSICIANS MAY BE OFFICERS OR AN IDENTIFIED KEY EMPLOYEE OF THE REPORTING OR RELATED ORGANIZATION. PHYSICIAN COMPENSATION IS ALSO HANDLED IN THE SAME MANNER AS EXECUTIVE COMPENSATION, WITH THE HPH COMPENSATION COMMITTEE RECEIVING A REPORT FROM A NEUTRAL CONSULTANT AND FOLLOWING THE SAME PROCESS AS DESCRIBED ABOVE ON AN ANNUAL BASIS. THIS PROCESS WAS LAST COMPLETED ON MARCH 5, 2013 TO REVIEW PHYSICIAN COMPENSATION AND ON AUGUST 7, 2013 TO REVIEW EXECUTIVE COMPENSATION. DISCLOSURE OF GOV DOCS, CONFLICT OF INTEREST POLICY & FINANCIAL STMTS FORM 990, PART VI, LINE 19 THE CONFLICT OF INTEREST POLICY AND STANDARDS OF CONDUCT ARE AVAILABLE ON THE HAWAI'I PACIFIC HEALTH WEBSITE. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE HAWAI'I PACIFIC HEALTH WEBSITE. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 $( 11,698) - EQUITY TRANSFER WITH HPH $( 64,882) - RECLASS OF MEDSTAFF DUES TO PMMC $ 17,075 - TRANSFERS ---------- $( 59,505) - TOTAL ========== FEES FOR SERVICES (NON-EMPLOYEES) - OTHER Part IX Functional expenses, Line 11G $ 7,602 - CONSULTING EXPENSE $23,067 - INTERNAL SERVICES PROVIDED EXPENSES -------- $30,699 - TOTAL ======== HAWAI'I PACIFIC HEALTH 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246363 HOLDING CO. HI 501(C)(3) 11B TYPE II NA false WILCOX HEALTH FOUNDATION 3-3420 KUHIO HIGHWAY LIHUE HI 96766 990204242 FUNDRAISING HI 501(C)(3) 7 NA true KAPI'OLANI HEALTH FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246364 FUNDRAISING HI 501(C)(3) 7 NA true PROVIDERS INSURANCE CORPORATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 710893000 NFP INSURANCE HI 501(C)(3) 11B TYPE II NA true KAPI'OLANI MEDICAL CTR WOMEN & CHILDREN 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990177350 HOSPITAL HI 501(C)(3) 3 NA true KAPI'OLANI MEDICAL SPECIALISTS 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990322406 HEALTHCARE HI 501(C)(3) 9 NA true PALI MOMI MEDICAL CENTER 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990274038 HOSPITAL HI 501(C)(3) 3 NA true WILCOX MEMORIAL HOSPITAL 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990074365 HOSPITAL HI 501(C)(3) 3 NA true KAUA'I MEDICAL CLINIC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990326099 HOSPITAL HI 501(C)(3) 3 NA true STRAUB CLINIC & HOSPITAL 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 912151670 HOSPITAL HI 501(C)(3) 3 NA true STRAUB FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990109350 RESEARCH/EDU HI 501(C)(3) 7 NA true ASC PACIFIC VENTURES LLC AMBU. SURG. CNTR AL NA N/A HAWAI'I PACIFIC HEALTH PARTNERS INC &SUB 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990318588 HOLDING COMPA HI NA C CORP STRAUB PHARMACY INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990145107 INACTIVE HI NA C CORP HICORD INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990251496 INVESTMENT HI NA C CORP false true false false false false false false false false false false false true true true true true KAPI'OLANI HEALTH FOUNDATION S 78154 PALI MOMI MEDICAL CENTER B 213230 PALI MOMI MEDICAL CENTER Q 77499 RELATED ORG. TAXABLE AS PARTNERSHIP SCHEDULE R, PART III ASC PACIFIC VENTURES, LLC EIN: 27-0540034 ADDRESS: 3000 RIVERCHASE GALLERIA, STE 500 BIRMINGHAM, AL 35244