2011-05-13T18:04:32-05:00 2010-06-30 Deloitte Tax LLP 1132 BISHOP STREET SUITE 1200 HONOLULU HI 96813 990 2009-07-01 990073524 THE QUEEN'S MEDICAL CENTER QUEE 8085326100 1301 PUNCHBOWL STREET HONOLULU HI 96813 RICHARD C KEENE 8085426117 2011-05-13 true LORI TAIRA 8085430700 2009 2016-03-07 17:11:31Z 687608377 false X WWW.QUEENSMEDICALCENTER.NET X 1859 HI SEE SCHEDULE O ATTACHMENT 2 15 10 4140 360 5718604 -1107725 13626490 25662588 589336421 622500499 -1021737 10279310 14348312 14333018 616289486 672775415 2966626 2689905 0 0 290897069 323050578 0 0 47728 311574195 316235265 605437890 641975748 10851596 30799667 798744269 881785450 556344495 601515918 242399774 280269532 THE MISSION OF QMC IS TO FULFILL THE INTENT OF QUEEN EMMA AND KING KAMEHAMEHA IV TO PROVIDE IN PERPETUITY QUALITY HEALTHCARE SERVICES TO IMPROVE THE WELL-BEING OF NATIVE HAWAIIANS AND ALL OF THE PEOPLE OF HAWAI'I. false false 605734693 2689905 622500499 THE QUEEN'S MEDICAL CENTER IS THE LARGEST PRIVATE, NONPROFIT, ACUTE CARE MEDICAL FACILITY IN HAWAII. ITS STAFF IS DEDICATED TO PROVIDING QUALITY HEALTH CARE TO THE PEOPLE OF HAWAII AND THE PACIFIC. ESTABLISHED IN 1859 BY KING KAMEHAMEHA IV AND QUEEN EMMA, QUEEN'S IS THE FIRST HOSPITAL IN THE UNITED STATES FOUNDED BY ROYALTY. TODAY, IT IS THE LARGEST PRIVATE HOSPITAL IN HAWAII AND THE PACIFIC BASIN. THE QUEEN'S MEDICAL CENTER HAS 505 ACCUTE CARE BEDS AND 28 SUB-ACUTE BEDS. WITH OVER 3,000 EMPLOYEES AND OVER 1,200 PHYSICIANS ON STAFF, IT IS ALSO ONE OF THE STATE OF HAWAII'S LARGEST EMPLOYERS. AS THE LEADING MEDICAL REFERRAL CENTER IN HAWAII AND THE PACIFIC BASIN, QUEEN'S IS WIDELY KNOWN FOR ITS PROGRAMS IN CANCER, CARDIOVASCULAR DISEASE, NEUROSCIENCE, ORTHOPEDICS, SURGERY, TRAUMA, BEHAVIORAL MEDICINE, AND WOMEN'S HEALTH. QUEEN'S OFFERS A COMPREHENSIVE RANGE OF SPECIALTIES, INCLUDING CARDIAC DIAGNOSTICS, GASTROENTEROLOGY, GENETICS, GERIATRICS, GYNECOLOGY, NEONATOLOGY, OBSTRETICS, AND PULMONOLOGY. QUEEN'S IS THE ONLY LEVEL II TRAUMA CENTER IN HAWAII VERIFIED BY THE AMERICAN COLLEGE OF SURGEONS. QUEEN'S IS HOME TO A NUMBER OF RESIDENCY PROGRAMS OFFERED IN CONJUNCTION WITH THE JOHN A. BURNS SCHOOL OF MEDICINE AT THE UNIVERSITY OF HAWAII. THE QUEEN'S MEDICAL CENTER IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS (TJC). QUEEN'S IS ALSO APPROVED TO PARTICIPATE IN RESIDENCY TRAINING BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), AND IS A MEMBER OF VHA, A NATIONAL COOPERATIVE OF OVER 1,400 HOSPITALS. QUEEN'S HAS ACHIEVED MAGNET STATUS - THE HIGHEST INSTITUTIONAL HONOR FOR HOSPITAL EXCELLENCE - FROM THE AMERICAN NURSES CREDENTIALING CENTER. MAGNET RECOGNITION IS HELD BY LESS THAN SEVEN PERCENT OF HOSPITALS IN THE UNITED STATES. QUEEN'S IS THE FIRST HOSPITAL IN HAWAII TO ACHIEVE MAGNET STATUS. TO SUPPORT THE QUEEN'S MISSION AND TO FULFILL ITS TAX EXEMPT PURPOSE AS A CHARITABLE HOSPITAL, THE QUEEN'S MEDICAL CENTER PROVIDED COMMUNITY BENEFITS TOTALING APPROXIMATELY $81,025,000 FOR THE YEAR ENDED JUNE 30, 2010. SEE LINE 4C (SCHEDULE O ATTACHMENT 4) FOR A DETAILED EXPLANATION. The Queen's Medical Center ("QMC") supports Native Hawaiian Health initiatives through many of its programs and services, particularly its Native Hawaiian Health Program (NHH). The focus areas of NHH include improvements in clinical outcomes, healthcare training, research, access and outreach. NHH conducts ongoing assessment and development of QMC programs and services focused on Native Hawaiians, including specific clinical programs in areas such as cardiology, oncology and behavioral health. QMC collaborates and partners to provide healthcare training and education opportunities to Native Hawaiian students and those committed to serving Native Hawaiian communities, for example, the Ulu Kukui Project, which is a pre-college science education program at Stevenson Middle School to promote excellence in science education and the pursuit of biomedical careers by Native Hawaiians and Pacific Islanders. In addition, NHH programs focus on quality improvement and increased access for Native Hawaiians to QMC and collaborate with the Native Hawaiian community in education, research, and community outreach. Through each of these areas of focus, NHH works to provide a framework for the development, implementation and evaluation of clinical initiatives that aim to enhance the ola pono (well being) of Native Hawaiians. In addition to NHH, many of QMC's program services described below provide benefits to Native Hawaiians, including components of charity care and uncompensated care provided to our patients. THE QUEEN'S MEDICAL CENTER ("QMC") PROVIDED APPROXIMATELY $81,025,000 OF COMMUNITY BENEFITS, IN SUPPORT OF ITS MISSION AS A TAX-EXEMPT CHARITABLE HOSPITAL: 1. UNCOMPENSATED CARE - QMC PROVIDES MEDICAL SERVICES TO PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY (PATIENTS ARE NOT BILLED CHARITY CARE) AND PATIENTS WHO REFUSE TO PAY (BAD DEBTS). FOR THE YEAR ENDED JUNE 30, 2010, THE ESTIMATED LOSSES FROM PROVIDING CHARITY CARE AND FOR SERVICES THAT WERE BAD DEBTS WAS $2,628,000 AND $12,200,000 RESPECTIVELY. 2. BEHAVIORAL HEALTH - QMC PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES THAT ARE NECESSARY AND IN CERTAIN INSTANCES, NOT GENERALLY AVAILABLE IN THE STATE OF HAWAII. THE ESTIMATED LOSSES FROM OPERATIONS RESULTING FROM BEHAVIORAL HEALTH SERVICES WERE $8,640,000 FOR THE YEAR ENDED JUNE 30, 2010. 3. QUEEN EMMA CLINICS - QMC PROVIDES OUTPATIENT SERVICES TO INDIGENT PATIENTS AND OTHERS THOUGH THE QUEEN EMMA CLINICS. THE LOSSES FROM OPERATIONS FROM THE QUEEN EMMA CLINICS WERE APPROXIMATELY $3,843,000 FOR THE YEAR ENDED JUNE 30, 2010. 4. ON CALL PHYSICIAN COMPENSATION - QMC MAINTAINS THE ONLY LEVEL II TRAUMA CENTER IN THE STATE OF HAWAII. IN ORDER TO PROVIDE LEVEL II TRAUMA COVERAGE, THE MEDICAL CENTER INCURRED APPROXIMATELY $5,776,000 IN ON CALL PHYSICIAN COVERAGE DURING THE YEAR ENDED JUNE 30, 2010. 5. RESIDENT AND INTERN COSTS - QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $4,491,000 DURING THE YEAR ENDED JUNE 30, 2010 RELATED TO RESIDENT AND INTERN PROGRAMS. AS A TEACHING FACILITY, THE MEDICAL CENTER PARTICIPATES IN AND SHARES THE COSTS OF THE HAWAII RESIDENCY PROGRAM. 6. HAWAII MEDICAL LIBRARY - QMC MAINTAINS A MEDICAL LIBRARY THAT BENEFITS HEALTHCARE PROFESSIONALS IN THE STATE OF HAWAII. THE OPERATING LOSSES OF THE HAWAII MEDICAL LIBRARY FOR THE YEAR ENDED JUNE 30, 2010 WERE $975,000. 7. TRANSFER HOTLINE - QMC MAINTAINS A CARDIAC TRANSFER HOTLINE AND A REFERRAL HOTLINE TO ASSIST PATIENTS AND OTHER HEALTHCARE PROVIDERS WITH THE TRANSFER AND/OR REFERRAL OF PATIENTS TO APPROPRIATE HEALTHCARE SERVICES. THE OPERATING LOSSES OF PROVIDING THESE SERVICES FOR THE YEAR ENDED JUNE 30, 2010 WERE $1,259,000. 8. TRANSPORTATION SERVICES - QMC PROVIDES TRANSPORTATION TO AND FROM THE MEDICAL CENTER TO PATIENTS WHO REQUIRE ASSISTANCE. THE COST OF PROVIDING THESE SERVICES WAS $155,000 FOR THE YEAR ENDED JUNE 30, 2010. 9. HEALTH AND WELLNESS EDUCATION - QMC PROVIDES HEALTH AND WELLNESS EDUCATION TO THE COMMUNITY IN AN EFFORT TO PROMOTE HEALTHY LIFESTYLES. FOR THE YEAR ENDED JUNE 30, 2010, LOSSES OF PROVIDING HEALTH AND WELLNESS EDUCATION WERE $404,000. 10. RESEARCH LOSSES - QMC EMPLOYS STAFF AND INCURS UNFUNDED COSTS FOR MEDICAL RESEARCH. FOR THE YEAR ENDED JUNE 30, 2010, RESEARCH COSTS WERE $1,029,000. 11. CHARITABLE CONTRIBUTIONS - QMC MAKES CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS. FOR THE YEAR ENDED JUNE 30, 2010, CONTRIBUTIONS TO OUTSIDE CHARITABLE ORGANIZATIONS WERE $859,000. 12. EMERGENCY PREPAREDNESS - QMC IS THE ONLY LEVEL II TRAUMA CENTER IN THE STATE OF HAWAII. QMC ALLOCATED RESOURCES TO PLAN AND TEST ITS READINESS FOR COMMUNITY EMERGENCIES, INCLUDING TRAUMA, TERRORIST ATTACKS AND CONDITIONS RESULTING FROM HAZARDOUS MATERIAL SPILLS. FOR THE YEAR ENDED JUNE 30, 2010, THE COSTS OF EMERGENCY PREPAREDNESS WERE $237,000. 13. ELECTRICAL GENERATOR PROJECT - IN ORDER TO MAINTAIN NECESSARY LIFE SUPPORT, DIAGNOSTIC AND OPERATING SYSTEMS, IN THE EVENT OF AN EMERGENCY, QMC SIGNIFICANTLY UPGRADED ITS POWER PLANT BY ADDING TWO NEW GENERATORS THAT ARE CAPABLE OF PROVIDING ELECTRICAL POWER FOR THE MEDICAL CENTER. FOR THE YEAR ENDED JUNE 30, 2010, COSTS INCURRED FOR THE ELECTRICAL GENERATOR PROJECT WERE $4,969,000. TOTAL PROJECT COSTS INCURRED AS OF JUNE 30, 2010 WERE APPROXIMATELY $33,669,000. 14. MEDICAID SHORTFALL IN PAYMENTS - QMC PROVIDES INPATIENT AND OUTPATIENT SERVICES TO MEDICAID PATIENTS IN THE STATE OF HAWAII. QMC INCURRED COSTS IN EXCESS OF REIMBURSEMENT OF APPROXIMATELY $28,398,000 DURING THE YEAR ENDED JUNE 30, 2010. 15. Medicare Shortfall in Payments - QMC provides inpatient and outpatient services to Medicare patients in the State of Hawaii. QMC incurred costs in excess of reimbursement based on Medicare Cost reports of approximately $2,949,000 during the year ended June 30, 2010. Consistent with cost report requirements, there are amounts that are excluded from the costs above. 16. LEASE PRICING BELOW FAIR MARKET VALUE - QMC EXTENDED LEASE RATES TO THE UNIVERSITY OF HAWAII THAT ARE BELOW FAIR MARKET VALUE. FOR THE YEAR ENDED JUNE 30, 2010, REVENUES FOREGONE FROM LEASE RATES THAT WERE BELOW FAIR MARKET VALUE WERE $84,000. 17. PROGRAMS THAT IMPROVE ACCESS TO HEALTHCARE - QMC IMPROVES THE COMMUNITY'S ACCESS TO HEALTHCARE BY HELPING PATIENTS QUALIFY FOR MEDICAID AND OTHER TYPES OF INSURANCE. FOR THE YEAR ENDED JUNE 30, 2010, THESE PROGRAM COSTS TOTALED $1,029,000. 18. KINAU STREET OFF-RAMP IMPROVEMENT - IN ORDER TO IMPROVE ACCESS TO ITS EMERGENCY DEPARTMENT AND HOSPITAL, QMC, IN CONJUNCTION WITH THE STATE DEPARTMENT OF TRANSPORTATION AND CITY DEPARTMENT OF TRANSPORTATION SERVICES, BEGAN CONSTRUCTION TO THE KINAU STREET OFF-RAMP. FOR THE YEAR ENDED JUNE 30, 2010, COSTS INCURRED FOR THE IMPROVEMENT PROJECT WERE $337,000. 19. DENTAL CLINIC - QMC PROVIDES DENTAL SERVICES TO INDIGENT PATIENTS AND OTHERS THROUGH ITS DENTAL CLINIC. THE LOSSES FROM OPERATIONS FROM THE DENTAL CLINIC WERE APPROXIMATELY $71,000 FOR THE YEAR ENDED JUNE 30, 2010. 20. DONATED USE OF CONFERENCE ROOMS - QMC ALLOWS PHYSICIANS AND TEACHERS FROM THE JOHN A. BURNS SCHOOL OF MEDICINE OF THE UNIVERSITY OF HAWAII, VARIOUS GOVERNMENTAL Agencies INCLUDING THE HAWAII DEPARTMENT OF HEALTH, AND OTHER NONPROFIT Agencies THE FREE USE OF ITS FACILITIES AT THE QUEEN'S CONFERENCE CENTER. FOR THE YEAR ENDED JUNE 30, 2010, COSTS INCURRED FOR THE USE OF THE CENTER TOTAL $100,000. 21. JOB SHADOWING PROGRAM - QMC SPONSORS A JOB SHADOWING PROGRAM FOR STUDENTS IN THE STATE OF HAWAII. FOR THE YEAR ENDED JUNE 30, 2010, COSTS INCURRED FOR THE PROGRAM TOTAL $8,000. 22. QMC Nursing Program - QMC provides nursing internships and nurse training that help address the continued need for skilled nurses in the islands. For the year ended June 30, 2010, these costs totaled $584,000. 605734693 true true false true false false false false true true true true false false false false false false true false true true false true true false false false false false false false false false true false false false false false true true false false true 487 0 true 4140 true true true false false false false false false false false 15 10 false false false false true true true true true false false true true true true true true true true true false CA X CLINTON YEE 8085855272 1301 PUNCHBOWL STREET HONOLULU HI 96813 NALEEN N ANDRADE MD 1.0 X 0 0 0 PAUL S AOKI 1.0 X 0 0 0 EVELYN J BLACK 1.0 X 0 0 0 NORMAN T S CHONG 1.0 X 0 0 0 ERNEST H FUKEDA JR 1.0 X 0 0 0 NEIL J HANNAHS 1.0 X 0 0 0 NOREEN MOKUAU DSW 2.0 X 0 0 0 WILLIAM G OBANA MD 2.0 X 87848 0 0 CAROLINE WARD ODA 1.0 X 0 0 0 GARRETT K SERIKAWA 1.0 X 0 0 0 ARTHUR A USHIJIMA 65.0 X X 0 632384 705434 JULIA C WO 1.0 X 0 0 0 ERIC K YEAMAN 1.0 X 0 0 0 Peter Halford MD 1.0 X 122725 0 0 Robb Ohtani MD 1.0 X 42238 0 0 SHARLENE K TSUDA 55.0 X 0 209934 54261 MARK H YAMAKAWA 55.0 X 0 535219 119739 PAULA YOSHIOKA 55.0 X 347215 0 60461 Richard C Keene 55.0 X 0 478951 66039 Clinton Yee 55.0 X 164712 0 30426 Michael H Dang MD 60.0 X 710837 0 19801 Cherylee W J Chang MD 60.0 X 540911 0 29537 DAVID J G FERGUSSON MD 60.0 X 462517 0 18215 CORY T MIYAMOTO MD 60.0 X 443090 0 26018 Scott Raymond Shay MD 60.0 X 464038 0 5072 RIX MAURER III 0.0 X 488457 0 23014 3874588 1856488 1158017 611 true true false AFFILIATED COMPUTER SVS PO BOX 201322 DALLAS TX 753201322 INFO SYS OUTSOURCING 10197588 UCERA 677 ALA MOANA BLVD STE 1025 HONOLULU HI 96813 MEDICAL SERVICE 9518206 HAWAII RESIDENCY PROGRAMS INC 1356 LUSITANA ST 510 HONOLULU HI 96813 MEDICAL SERVICE 8734780 Oracle USA Inc PO Box 44471 SAN FRANCISCO CA 94144 system implement 2813834 SODEXHO MARRIOTT 1301 PUNCHBOWL STREET HONOLULU HI 96813 MANAGEMENT SERVICE 4112160 98 17700 24059804 1585084 25662588 NET PATIENT REVENUE 614441694 614441694 INTERCO PURCHASED 561000 8058805 5407051 2651754 622500499 5094138 -881697 5975835 0 0 800239 800239 800239 572 799667 19974046 14234861 554013 5739185 -554013 5185172 5185172 224175 17700 44088 180087 180087 0 0 SERVICE TAXABLE 812300 1681882 1470269 211613 RESEARCH 621500 2518441 2518441 OTHER SERVICES 621500 4727295 1506232 3221063 4425074 3909775 515299 13352692 672775415 629253462 5718604 12140761 2689905 2689905 0 0 0 775375 265109 510266 0 0 252367013 244724971 7642042 26068746 24966983 1101763 26215081 25214055 1001026 17624363 17072029 552334 0 1461697 1190509 271188 387522 386999 523 22857 22857 0 0 22380098 22217905 162193 727341 669886 57455 325305 204010 121295 249758 218554 31204 0 13714268 13453897 260371 699458 497922 201536 0 910 910 10177640 10177640 31165468 17329740 13835728 36917688 36862812 54876 8279087 292178 7986909 SUPPLIES 102052159 101845048 207011 100 PURCHASED SERVICES 44331068 43165085 1165983 BAD DEBT 29976199 29976199 LICENSE, PERMITS & FEES 2015575 1749745 265280 550 EDUCATION 2296661 2287955 8706 9054506 8251790 755638 47078 641975748 605734693 36193327 47728 25816 29034 29735400 36260220 77313501 80241046 7722961 8284333 7844144 9084695 609826776 366960345 258643848 242866431 332782289 411434750 10384099 9072698 74292211 84512243 798744269 881785450 180740975 209050265 294845000 286220000 80758520 106245653 556344495 601515918 X 225923775 262843000 11375999 11475532 5100000 5951000 242399774 280269532 798744269 881785450 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 22857 31942 22857 31942 605711836 660088389 605734693 660120331 1000000 1000000 250000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 352614 244324 134730 31942 763610 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 6633813 852775 386481 32281 645226 7195562 6236306 710304 42671 80428 275040 6633813 1.00000 false false 18116519 18116519 375992012 222750652 153241360 6548478 1564303 4984175 188043992 136032826 52011166 21125775 6612564 14513211 242866431 OTHER ASSETS RESTRICTED FOR LT 4424824 ASSETS LIMITED - BOND FUND 11911678 INTANGIBLE - DEFERRED FINANCE. 6757696 DUE FROM AFFILIATES 61378560 DEFERRED RENT-UH TOWER 39485 84512243 0 DUE TO AFFILIATES 66077383 DUE TO GOVERNMENT 6018209 CAPITAL LEASE/OTHER OBLIGATION 3852622 TAXABLE COMMERCIAL PAPER 18378645 DUE TO GOVT REIMBURSEMENT 11918794 106245653 672775415 641975748 30799667 2330844 4739247 7070091 37869758 644347506 9663087 9663087 634684419 38090996 38090996 672775415 637438534 -1827555 -1827555 639266089 2709659 2709659 641975748 RECONCILIATION OF CHANGE IN NET ASSETS SCHEDULE D, PART XI, LINE 8 EQUITY IN SUBSIDIARIES 562,420 PENSION FAS 87 ADJUSTMENT (12,234,000) LOSS ON INTEREST RATE SWAP (8,097,684) OTHER THAN TEMPORARY GAIN ON INVESTMENT 24,508,511 -------------- 4,739,247 REVENUE BOOK TO TAX RECONCILIATION SCHEDULE D, PART XII, LINE 2D REVENUE FROM HAMAMATSU/QUEEN'S PET 3,890,768 ELIMINATION (5,796,396) NET ASSETS RELEASED FROM RESTRICTION 11,006,295 EQUITY IN SUBSIDIARIES 562,420 -------------- 9,663,087 REVENUE BOOK TO TAX RECONCILIATION SCHEDULE D, PART XII, LINE 4B INVESTMENT INCOME INCLUDED IN NONOPERATING INCOME 10,465,577 REVENUE - TEMP. RESTRICTED 4,119,628 LOSS FROM SALE OF EQUIPMENT INCLUDED IN NONOPER. INCOME (554,013) TRANSFERS FROM AFFILIATES 24,059,804 ------------- 38,090,996 EXPENSES BOOK TO TAX RECONCILIATION SCHEDULE D, PART XIII, LINE 2D EXPENSES FROM HAMAMATSU/QUEEN'S PET 2,991,903 ELIMINATION (4,819,458) ------------ (1,827,555) EXPENSES BOOK TO TAX RECONCILIATION SCHEDULE D, PART XIII, LINE 4B TRANSFERS TO AFFILIATES 1,830,555 DONATIONS INCLUDED IN NONOPERATING EXPENSE 859,350 NONOPERATING EXPENSE 19,754 ----------- 2,709,659 ENDOWMENT FUNDS Schedule D, Part V, line 4 The Queen's Medical Center uses the earnings on permanently endowed investments for the purposes intended by the donors of these funds. benefit dinner 241875 17700 224175 2718 34981 2363 4026 0 241875 17700 224175 2718 34981 2363 4026 44088 180087 true true true X true X true true false true true 2628000 0 2628000 0.00410 99744000 71346000 28398000 0.04420 0 0 0 0.00000 102372000 71346000 31026000 0.04830 2847000 0 2847000 0.00440 6058000 0 6058000 0.00940 18330000 0 18330000 0.02860 1029000 0 1029000 0.00160 1043000 0 1043000 0.00160 29307000 0 29307000 0.04560 131679000 71346000 60333000 0.09390 5543000 0 5543000 0.00860 5543000 0 5543000 0.00860 true 12200232 0 170957000 173906000 -2949000 X true true HamQueen's PET operate/maint. PET equipment 0.00700 0.00000 0.00000 THE QUEEN'S MEDICAL CENTER

1301 Punchbowl Street HONOLULU HI 96813

X X X X X For patients who are citizens of a foreign country who do not reside in the United States, QMC uses 125% of resident country's minimum wage. Community benefits are reported annually as part of the Form 990. This is not separetely available to the public. A formal report issued by the parent company, The Queen's Health Systems, includes the community benefits of The Queen's Medical Center. This report is published periodically and is separately available to the public. The costing methodology considers all patient segments. Amounts represent the net costs for the various programs and operations, considering actual amounts incurred and calculated benefits based on cost-to-charge ratios and average rates (i.e. wage rates). The Queen Emma Clinics provide comprehensive patient care to indigent patients and serve a large homeless population. The net costs associated with these clininc was $3.8 million. N/A The audited financial statements do not describe bad debt expense. The audited financial statements do describe the Allowance for Uncollectible Accounts. "QMC provides for an allowance against accounts receivable that could become uncollectible by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable vale. QMC estimates the allowance based on the aging of the accounts receivable, historical collection experience by payor, and other relevant factors." The data above is based on the application of a cost-to-charge ratio against the internal accounting of uncollectible accounts. The Medicare amounts above are calculated with data from the June 30, 2010 Medicare cost report. Consistent with cost report requirements, there are amounts that are excluded from the costs listed in line 6 above. When using a fully allocated cost calculation, the Medicare shortfall was approximately $37 million. Every attempt is made before discharge to screen patients who have no documentation or evidence of medical insurance for possible eligibility for discounted care. The granting of charity care discounts are based on a determination of financial need using income and assets thresholds and is in compliance with all state and federal rules and regulations. Patients are required to complete a discounted care application and must submit income and asset verification documents. Once eligibility is confirmed, payment plans are arranged. Billing statements are mailed monthly. When eligible for discounted service, the statements reflect related discounts. N/A QMC's mission is to fulfill the intent of Queen Emma and King Kamehameha IV to provide in perpetuity quality health care services to improve the well-being of Native Hawaiians and all the people of Hawaii. QMC provides guidance and assistance to patients in applying potentially elibible patients to local, state, and/or federal health care programs. This includes contracting with outside vendors to assist with this process. QMC is the leading medical referral center in the Pacific Basin. Located in downtown Honolulu, it's the largest private hospital in Hawaii. According to recent demographic census data, the State of Hawaii is very diverse and includes a population that is approximately 10% Native Hawaiian, other pacific islander, Native Alaskan and American Indian. The amounts in Part II represent costs incurred to ensure continued operations that benefit the community. These include emergency preparedness costs and amounts expended to expand and test back-up power that can service patients in times of emergency. QMC is the leading medical referral center in the Pacific Basin and is designated by the State of Hawaii as a Level II trauma center, both of which require a significant amount of resources to ensure the needs of the population are met. QMC is also approved to participate in residency training by the Accreditation Council for Graduate Medical Education, thus enabling it to contribute to the high quality of professional care in Hawaii and beyond. In addition to The Queen's Medical Center, affiliate organizations of The Queen's Health Systems operate the only hospital on the Island of Moloka'i, provide diagnostic laboratory services, operate pharmacies and provide the hospitals with general and professional liability insurance. true Aha Kane PO Box 31303 Honolulu HI 96820 270502942 501(C)(3) 8200 Purchase of supplies for Men's Health Conference Aloha Medical Mission 810 North Vineyard Blvd HONOLULU HI 96817 990234811 501(C)(3) 60000 Sponsor Free Health Care Services American Cancer Society 2370 Nuuanu Avenue HONOLULU HI 96817 131788491 501(C)(3) 6000 Sponsor Multiple Fundraising Events American Diabetes Association 875 Waimanu Street 601 HONOLULU HI 96813 131623888 501(C)(3) 6000 Sponsor Diabetes Annual Walk American Heart Association 677 Ala Moana Blvd 600 HONOLULU HI 96813 135613797 501(C)(3) 20000 Sponsor Medical Symposium American Red Cross 4155 Diamond Head Road HONOLULU HI 96816 530916605 501(C)(3) 7500 Haiti & American Samoa Disaster Relief Bishop Museum 1525 BERNICE STREET HONOLULU HI 96817 990161980 501(c)(3) 90000 Donation for Queen Emma Display Cases Friends of Iolani Palace PO Box 2259 Honolulu HI 96804 990115665 501(c)(3) 5500 Sponsor "Royal Garden Party" Girl Scouts of Hawaii 420 Wyllie Street HONOLULU HI 96817 990073488 501(c)(3) 6000 Sponsor Woman of Distinction Hawaii Academy of Science 1776 University Ave COE UHM Honolulu HI 96822 996006863 501(c)(3) 10000 Sponsor Science & Engineering Fair Hawaii Health Information Exchange 345 Queen Street 601 Honolulu HI 96813 412201519 501(c)(3) 100000 Contribution to Capital Campaign Hawaii Medical Association 1360 South Beretania St 200 HONOLULU HI 96814 990067306 501(C)(3) 6500 Sponsor Medical Gala Hawaii Pacific University 1060 Bishop St 400 HONOLULU HI 96813 990113930 501(C)(3) 8000 Contribution to President's Fund Hina Mauka 45-845 Pookela Street Kaneohe HI 96744 990173356 501(c)(3) 5500 Sponsor Walk and Benefit Dinner Kapiolani Community College Health Sciences 4303 Diamond Head Road Ilima 212 HONOLULU HI 96816 990085260 501(c)(3) 22500 Native Hawaiian Health Training Scholarship Fund Lunalilo Home 501 Kekauluohi St HONOLULU HI 96825 990075244 501(c)(3) 10000 Support for Indigent Kapuna Na Aikane O Pu'ukohola Heiau P O Box 2470 Kamuela HI 96743 990303698 501(c)(3) 8750 Purchase of health screening supplies St Andrew's Priory School 224 Queen Emma Square HONOLULU HI 96813 990073525 501(c)(3) 7500 Sponsor "The Queen Emma Ball" and Contribution The Queen's Health System 1099 ALAKEA ST 1100 HONOLULU HI 96813 990238120 501(c)(3) 1830555 OPERATING GRANT TO AFFILIATE University of Hawaii Foundation 2444 Dole St Bachman Hall Rm 105 HONOLULU HI 96822 990085260 501(c)(3) 261000 Sponsor Hawaii Nursing Simulation Center and Contributions UH at Manoa Office of Research Services 2530 Dole Street HONOLULU HI 96822 990085260 501(c)(3) 90000 Ike Ao Pono / Native Hawaiian Health Initiative 83 0 ORGANIZATION'S PROCEDURES FOR MONITORING GRANT FUNDS SCHEDULE I GRANTS AND OTHER ASSISTANCE, PART I, LINE 2 The Queens Medical Center makes donations to various tax-exempt organizations with the purpose of providing opportunities for better health and wellness to all the people of Hawaii. There are generally no restrictions placed on the use of those donations and the receiving organizations may use the donations at their discretion in order to further their exempt purpose. Where restrictions are placed on the use of those donations, QMC requests financial reports in order to monitor such use. BISHOP MUSEUM DONATION SCHEDULE I, PART II In Fiscal Year ended June 30, 2009, The Queen's Medical Center made a pledge commitment to Bishop Museum to contribute $90,000 over a period of eight years to sponsor the Queen Emma and King Kamehameha IV cases in Hawaiian Hall. In Fiscal Year ended June 30, 2009, The Queen's Medical Center accrued the first $10,000 payment, and reported the $10,000 on the 2008 tax year Form 990, Schedule I, Part II. In Fiscal Year ended June 30, 2010, The Queen's Medical Center accrued the remaining $80,000 and reported this on the 2009 tax year Schedule I, Part II. In Fiscal Year ended June 30, 2010, The Queen's Medical Center also made two additional donations to Bishop Museum of $5,000 each, for other charitable purposes. X true false X X X X X true true false false false true true true false RIX MAURER III 45366 0 103518 0 339573 0 23014 0 0 0 511471 0 0 0 SHARLENE K TSUDA 0 167681 0 24723 0 17530 0 30121 0 24140 0 264195 0 0 ARTHUR A USHIJIMA 0 585105 0 0 0 47279 0 629284 0 76150 0 1337818 0 0 MARK H YAMAKAWA 0 422305 0 80239 0 32675 0 68802 0 50937 0 654958 0 0 PAULA YOSHIOKA 293059 0 34394 0 19762 0 23305 0 37156 0 407676 0 0 0 Richard C Keene 0 397770 0 64957 0 16224 0 24215 0 41824 0 544990 0 0 Clinton Yee 156590 0 7020 0 1102 0 14207 0 16219 0 195138 0 0 0 Michael H Dang MD 631359 0 65000 0 14478 0 9457 0 10344 0 730638 0 0 0 Cherylee W J Chang MD 462369 0 65172 0 13370 0 20482 0 9055 0 570448 0 0 0 DAVID J G FERGUSSON MD 406986 0 55531 0 0 0 9457 0 8758 0 480732 0 0 0 CORY T MIYAMOTO MD 375663 0 66703 0 724 0 20482 0 5536 0 469108 0 0 0 Scott Raymond Shay MD 464038 0 0 0 0 0 0 0 5072 0 469110 0 0 0 COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 3 Compensation committee refers to a committee of the organization's governing body responsible for determining the top management official's compensation package, whether or not the committee has been delegated the authority to make an employment agreement with the top management official on behalf of the organization. The compensation committee may also have other duties. Arthur A Ushijima FORM 990 PART VII Arthur A Ushijima AVERAGE HOURS PER WEEK: 50 hours per week - QMC President 2 hours per week - QMC & affiliates Trustee 65 hrs per week - QHS & affiliates MR. USHIJIMA SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER, THE QUEEN'S HEALTH SYSTEMS, AND SEVERAL OTHER QUEEN'S RELATED AFFILIATES (2 HOURS PER WEEK). He is a volunteer Trustee and is not compensated for those services. Mr. Ushijima also serves as the President & Chief Executive Officer of The Queen's Health Systems (parent company) and as the President of QMC. The compensation listed on FORM 990 PART VII is his total compensation for his various services. Mark Yamakawa FORM 990 PART VII Mark Yamakawa AVERAGE HOURS PER WEEK: 8 hours per week - QMC 55 hrs per week - QHS & affiliates Mr. Yamakawa serves as QHS EVP & COO (parent company), QMC VP, President of QDC and President of QEL. He is not separately compensated for these various services. The compensation listed on FORM 990 PART VII is his total compensation for his various services. Richard C Keene FORM 990 PART VII Richard C. Keene AVERAGE HOURS PER WEEK: 20 hrs per week - QMC 55 hrs per week - QHS & affiliates Mr. Keene serves as QMC Treasurer, EVP/CFO and Treasurer for Queen's Health Systems (parent company), QEL Treasurer and MGH Treasurer. He is not separately compensated for these services. The compensation listed on FORM 990 PART VII is his total compensation for his various services. Sharlene Tsuda FORM 990 PART VII Sharlene Tsuda AVERAGE HOURS PER WEEK: 2 hrs per week - QMC 55 hrs per week - QHS & affiliates Ms. Tsuda serves as QHS VP/Secretary (parent company) and QMC Secretary. She is not separately compensated for these various services. The compensation listed on FORM 990 PART VII is her total compensation for her various services. Paula Yoshioka FORM 990 PART VII Paula Yoshioka Average Hours Per Week: 54 Hours per week - QMC 55 Hours per week - QHS & Affiliates Ms. Yoshioka serves as EVP/CAO of QMC and EVP/CAD of QDC. She is not separately compensated for these services. The compensation listed on Form 990 Part VII is her total compensation for her various services. WILLIAM G OBANA MD FORM 990 PART VII DR. OBANA SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER (2 HOURS PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THOSE SERVICES. DR. OBANA'S COMPENSATION IS FOR HIS ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER. Peter Halford MD FORM 990 PART VII DR. HALFORD SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER (1 HOUR PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THOSE SERVICES. DR. HALFORD'S COMPENSATION IS FOR HIS SERVICES AS THE CHIEF OF STAFF AND ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER. Robb K Ohtani MD FORM 990 PART VII DR. OHTANI SERVES AS A TRUSTEE FOR THE QUEEN'S MEDICAL CENTER (1 HOUR PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THOSE SERVICES. DR. OHTANI'S COMPENSATION IS FOR HIS ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER. Discretionary spending account SCHEDULE J Part I line 1a Discretionary spending account payments are made to certain executives of QMC in lieu of reimbursement for expenses and are included in taxable income of the recipient. The following individual received discretionary spending account payment in 2009: Paula Yoshioka - $15,000 Department of Budget & Finance State of Hawaii 990266961 419800FB8 2003-12-11 114300000 ADVANCE REFUNDING false false DEPARTMENT OF BUDGET & FINANCE STATE OF HAWAII 990266961 419800FR3 2006-03-16 144875000 Multipurpose Issue false false DEPARTMENT OF BUDGET & FINANCE STATE OF HAWAII 990266961 419800HT7 2009-05-06 78670000 ADVANCE REFUNDING false false 114300000 0 0 0 4667958 292217 0 2003 false true true true 149237584 0 0 4424824 3463358 5170428 76594210 true false false 78670000 0 0 0 1244547 0 0 2009 true false true true false false false false false 0.00000 0.00000 0.00000 true false true true BOA Merrill Lynch 25.6 false false false false true true BOA Merrill Lynch 17.2 false false false false true false false false false Eric K Yeaman Trustee of QMC 344390 see schedule o for description false FORM 990, PT VI, SECTION A, LINE 7A QMC has a sole member, which is The Queen's Health Systems, a Hawaii nonprofit corporation ("QHS"). QHS elects all of the board members of the QMC Board of Trustees. FORM 990, PT VI, SECTION A, LINE 7B Certain major decisions approved by the QMC Board of Trustees must also be approved by QHS. Such decisions include: 1. A change to the purpose of the company; 2. A financing transaction in excess of $500,000; 3. A lease transaction that has a term that is longer than 3 years or has a rent obligation in excess of $1,000,000 over the lease term; 4. A transaction involving the sale, lease, disposition or hypothecation of real property; 5. Annual operational and capital budgets; 6. Strategic plans; 7. Merger or major acquisitions; 8. Creation of a new entity or joint venture; 9. Sale or disposition of all or substantially all of its assets; 10. Dissolution; 11. Amendment of Bylaws; 12. Adoption, amendment or rescission of a Board Policy; 13. Capital expenditures in excess of $2,000,000 for QMC. FORM 990, PT VI, SECTION A, LINE 11A The Form 990 for The Queen's Health System (QHS) and the separate forms for each of the not-for-profit subsidiaries of QHS were 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 and by the independent public accounting firm that prepared the returns. In addition, compensation related disclosures in the returns were reviewed by the Chairperson of the QHS Compensation Committee prior to filing the returns. Also, a copy of the QHS returns was made available to each of the members of the Board of Trustees prior to the returns being filed with the Internal Revenue Service. FORM 990, PT VI, SECTION B, LINE 12C All QHS companies are subject to a written Conflict of Interest Policy. All trustees, officers, designated employees and contractors are required to complete an annual disclosure form. The designated employees are those selected by Executives in the organization who identify those employees (typically manager level and above) who may be in a position to select or influence the selection of a vendor. Disclosures are summarized and maintained by each company's corporate secretary. The contracts management department and legal department have the conflict summaries and check for conflicts of interest at the beginning of the contract process. Any conflict of interest involving a trustee is presented to the Board of Trustees. Any transaction involving a disqualified person is subject to the process of establishing a rebuttable presumption of reasonableness. Any trustee with a conflict of interest is excused for the portion of the meeting where the subject matter is discussed and voted on. FORM 990, PT VI, SECTION B, LINE 15A & 15B A committee of the Board of Trustees called the Compensation Committee meets regularly to review compensation of all executives of all companies within QHS. Executive compensation is reviewed annually. All decisions regarding executive compensation are made in conformity with the procedures required to establish a rebuttable presumption of reasonableness. Any adjustment to compensation is subject to the process of performance reviews and comparison to comparable compensation data prepared by a nationally recognized independent compensation consultant. Outside counsel assists with the review process and documents the decisions of the committee. FORM 990, PT VI, SECTION C, LINE 19 QMC does not make its governing documents, conflict of interest policy or financial statements available to the public. Business Transactions Involving Interested Person Schedule L, Part IV, (d) Description of Transaction: Eric K. Yeaman is an officer of a telecommunications company that provides services to the organization. During the year, the organization paid service fees to this telecommunications company totaling $344,390. Schedule K, Supplemental Information on Tax-Exempt Bonds On December 11, 2003, The Queen's Medical Center issued Special Purpose Revenue Bonds (The Queen's Health System) 2003 Series A, 2003 Series B, and 2003 Series C (the 2003 Issue). The purpose of the 2003 Issue was to advance refund a portion of the 1996 bond series issued on July 18, 1996. On March 16, 2006, The Queen's Medical Center issued Special Purpose Revenue Bonds (The Queen's Health System) 2006 Series A and 2006 Series B (the 2006 issue). The purpose of the 2006 issue was to advance refund a portion of the 1998 bond series issued on July 1, 1998 and to finance approved capital projects. On May 6, 2009, The Queen's Medical Center issued Special Purpose Revenue Bonds (The Queen's Health System) 2009 Series A and 2009 Series B (the 2009 Issue). The purpose of the 2009 issue was to advance refund the 2003C and 2006C bond series issued December 11, 2003 and March 16, 2006, respectively. The Form 8038 filed with the Internal Revenue Service for this issue indicates an incorrect principal amount of $78,760,000. The CUSIP number for 2009 Series A is 419800HT7 and the CUSIP number for 2009 Series B is 419800HV2. The Queen's Medical center believes, and has prepared Schedule K in a manner consistent with such belief, that the Part III exclusion provided in the instructions for bonds that refund a pre-2003 bond issue applies to the 2003 Series A bonds, though no allocations under Regulations section 1.141-13(d) have yet been elected; this submission does not constitute an allocation election under Regulations section 1.141-13(d). The Queen's Medical center believes, and has prepared Schedule K in a manner consistent with such belief, that the Part III exclusion provided in the instructions for bonds that refund a pre-2003 bond issue applies to the 2003 Series B bonds, though no allocations under Regulations section 1.141-13(d) have yet been elected; this submission does not constitute an allocation election under Regulations section 1.141-13(d). The Queen's Medical center believes, and has prepared Schedule K in a manner consistent with such belief, that the Part III exclusion provided in the instructions for bonds that refund a pre-2003 bond issue applies to the 2006 Series A bonds, though no allocations under Regulations section 1.141-13(d) have yet been elected; this submission does not constitute an allocation election under Regulations section 1.141-13(d). The Queen's Medical center believes, and has prepared Schedule K in a manner consistent with such belief, that the Part III exclusion provided in the instructions for bonds that refund a pre-2003 bond issue applies to the 2009 Series A bonds, though no allocations under Regulations section 1.141-13(d) have yet been elected; this submission does not constitute an allocation election under Regulations section 1.141-13(d). The Queen's Medical center believes, and has prepared Schedule K in a manner consistent with such belief, that the Part III exclusion provided in the instructions for bonds that refund a pre-2003 bond issue applies to the 2009 Series B bonds, though no allocations under Regulations section 1.141-13(d) have yet been elected; this submission does not constitute an allocation election under Regulations section 1.141-13(d). For purposes of Part II, QMC assumes that amounts spent to retire prior debt are neither working capital nor capital expenditures, and are not reported herein. Proceeds from the 2003 Issue included $3,276,390 of credit enhancement fees and $1,391,568 of bond issue costs. Proceeds from the 2006 Issue included $2,193,032 of credit enhancement fees and $1,270,326 of bond issue costs. Proceeds from the 2009 Issue included $236,880 of credit enhancement fees and $1,007,667 of bond issue costs. 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