2011-11-15T16:11:58-08:00 2010-12-31 TCA Partners LLP 1111 East Herndon Avenue Suite 211 Fresno CA 93720 990 2010-01-01 990260423 North Hawaii Community Hospital NORT 8088814400 67-1125 Mamalahoa Highway Kamuela HI 96743 Jason Paret 2011-11-15 Inger Sullenger CPA 5412056565 X 2010 2016-03-07 17:11:31Z Jason Paret 50403484 false false X northhawaiicommunityhospital.org X 1989 HI Acute Care Hospital 8 6 410 70 0 3085661 4780141 41047683 39483674 181897 627025 1588322 1518617 45903563 46409457 0 0 23285309 22929689 78000 200000 399962 23933120 21974477 47296429 45104166 -1392866 1305291 51765613 46463891 20520062 14079094 31245551 32384797 Acute Care Hospital false false 30221101 40439024 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 39 beds. Admitting physicians are practitioners in the local area. In January 2008, the Hospital retained Quorum Health Resources LLC (QHR) to manage the Hospital. Effective March 2010, the Hospital terminated its agreement with QHR to manage the Hospital.Total outpatient visits for 2010 were: 56,773. Total admissions for 2010 were: 1,893. 30221101 true true false true false false false false false false true false false true true false true false false false false false false true true false true true false false true false false false false false false false false true false false true false false false false false false false false false true 67 0 true 410 true false false false false false false false false false false false 0 false false false false false false false false false false false X 8 6 false false false false false false false true true false false false true true true true true true true true false false X Michael Kendall Controller 8088814675 67-1125 Mamalahoa Hwy Kamuela HI 967438496 William Hutchinson 3.00 X 0 0 0 Wayne Higaki 0.00 X 150771 0 3262 Wayne Allen 50.00 X 270168 0 9889 Robert Momsen 6.00 X 0 0 0 Robert Hastings 3.00 X 0 0 0 Patricia Gunter 40.00 X 178846 0 10973 Mike Luce 3.00 X 0 0 0 Michael Rossi 3.00 X 0 0 0 Linda Clifford 3.00 X 0 0 0 Kahu Billy Mitchell 3.00 X 0 0 0 John White 50.00 X 422491 0 9595 Howard Wong 40.00 X 350742 0 3782 Dr William Park 43.00 X 437861 0 8683 Dr Virginia Pressler 3.00 X 0 0 0 Dr Sharon Vitousek 3.00 X 0 0 0 Dr Dana Lee 3.00 X 0 0 0 Diane Payne 40.00 X 177852 0 12963 Cliff Dias 3.00 X 0 0 0 Carolyn Quick 3.00 X 0 0 0 1988731 59147 22 false true false Phoenix Health Systems 910 Clopper Road Ste 165 Gaithersburg MD 20878 IS Management 733983 Kristin Buehler MD 64-726 Punakea Place Kamuela HI 96743 Anesthesia Physician 446282 Edward Hon MD PO Box 6629 Kamuela HI 96743 Anesthesia Physician 446282 Clinical Labs of Hawaii LLP Box 1300 Honolulu HI 96807 Clinical Laboratory 798038 Aramark CTS Inc 10510 Twin Lakes Parkway Charlotte NC 28269 Maintenance 384321 20 3247398 1532743 56000 4780141 Net patient service 39483674 39483674 39483674 72081 72081 73219 73219 0 373190 373190 373190 373190 3777577 517048 3300151 512749 477426 4299 481725 481725 371204 56000 181127 190077 190077 0 0 Cafe & Other Member Svcs 955350 955350 955350 46409457 40439024 1190292 0 0 0 0 1158687 776354 382333 0 17859199 11966182 5853351 39666 90000 60303 29697 2495795 1672255 809215 14325 1326008 888464 437544 0 4319 2894 1425 164553 110255 54298 62749 42044 20705 200000 200000 0 3779824 2666598 1066356 46870 0 0 0 0 0 116892 78321 36238 2333 0 0 924521 619456 305065 0 2899711 1942891 954180 2640 731016 489802 241214 Utilities 1531632 1026238 505394 Supplies 5181676 3471873 1698576 11227 Purchased Services 4445460 2978587 1429829 37044 Provision for bad debts 1324084 887175 436909 Other 638800 428013 170443 40344 169240 113396 50331 5513 45104166 30221101 14483103 399962 2650 2850 3137127 3871202 3625873 2304831 5991482 4877068 0 0 789385 815027 718756 1143756 586650 734747 62960760 34070706 30734090 28890054 0 0 0 0 6179600 3824356 51765613 46463891 3249445 3012007 12740000 3804011 10816975 726606 250112 20520062 14079094 X 26647347 27840219 4598204 4544578 31245551 32384797 51765613 46463891 X 1305291 -166045 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false true 30580 false false false true 32169 false false 62749 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description The Hospital pays professional organization dues, of which a portion is used for lobbying activities in the form of direct contact with legislators. The amount of dues paid for 2010 was $1,589 7694551 3600000 11294551 20985072 11183824 9801248 4025826 4132752 -106926 25861121 18754130 7106991 794190 794190 28890054 Unamortized Financing Costs 149530 Estimated Third Party Payor Settlements 755386 Asssets limited as to use, bond trustee 2877334 3824356 Implied Capital Lease 250112 250112 46409457 45104166 1305291 153151 -319196 -166045 1139246 46593584 184127 184127 46409457 46409457 45285293 181127 181127 45104166 45104166 Part XIII, Line 2d Part XIII, Line 2d: Other expenses and losses per audited F/S Special Events Reclassifications $181127 Part XII, Line 2d Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 Assets released from restrictions $3000 Special Events Reclassifications $181127 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Assets released from restriction $3000 Assets released from restriction-Capital $934740 Extraordinary Loss-Bond Defeasement $ -319196 Assets released from restriction-Capital $ -934740 Assets released from restriction $ -3000 X X X X true 1-2-1 Philanthr Gen Fundraising false 3191398 200000 2991398 3191398 200000 2991398 HI Cheers 427204 56000 371204 65756 115371 427204 56000 371204 65756 115371 181127 190077 true true X true X true X true true true false true true 125449 125449 0.00280 8168850 2436259 5732591 0.12710 8294299 2436259 5858040 0.12990 8294299 2436259 5858040 0.12990 true 586336 125449 4796619 5975813 -1179194 X true false 1 0 North Hawaii Community Hospita

67-1125 Mamalahoa Highway Kamuela HI 96743

X X X North Hawaii Community Hospita 1 false false false false false false false false false true false false Part VI - Additional Information N/A Part V - Explanation of Number of Facility Type The Hospital operates a general surgery clinic; a women's health clinic; and a home health facility. Part VI - States Where Community Benefit Report Filed HI Part VI - Affilated Health Care System Roles and Promotion N/A Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The organization's Board is comprised of Community members from the Northern Hawaii area. The Hospital conducted approximately 42 different events including health fairs and education days in the local community, hotels, and schools of the area as well as taking a leading role in Breast Cancer Awareness month. Total community people reached was approximately 4,300. Part VI - Community Building Activities N/A Part VI - Community Information North Hawaii Community Hospital (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 1,000 square miles, of the Big Island's 4,028 total square miles. There are currently no other general acute care hospitals in the primary service area. The Hospital was chartered in November 1987 and commenced operations in May 1996. The Hospital is currently licensed for 39 beds. Admitting physicians are practitioners in the local area. Part VI - Patient Education of Eligibility for Assistance Hospital admitting staff members advise and assist all self-pay patients of the options for available assistance. Part VI - Needs Assessment Admitting physicians are practitioners in the local area, and the Board is comprised of community members. This allows the Hospital to assess the needs of the community that it serves. In addition, many community health improvement services are offered in the forms of activities or programs that help to assess and improve community health. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The entire shortfall is attributable to community benefit. Part III, Line 4 - Bad Debt Expense The Hospital provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its charity care policy. Since the Hospital does not pursue collection of amounts determined to qualify as charity care, such amounts are not reported as net patient revenue. The charges at established rates foregone for services and supplies provided by the Hospital in 2010 and 2009 for charity care totaled $283,293 and $643,551, respectively. Part I, Line 7g - Costs Associated With Physicans Clinics N/A Part I, Line 7, Column F - Explanation of Bad Debt Expense 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. Part I, Line 7 - Explanation of Costing Methodology Cost to charge ratio X X X false false false false false false false false false false Wayne Higaki 150771 3262 154033 163246 Wayne Allen 270168 9889 280057 131038 Patricia Gunter 178846 10973 189819 John White 422491 9595 432086 163449 Howard Wong 350742 3782 354524 368868 Dr William Park 437861 8683 446544 432793 Diane Payne 177852 12963 190815 Dr Dana Lee Brd Mem/Contractor 66250 Contracted Physician false Dr William Park Brd Mem/Physician 446544 Compensation as Physician false Dr. William Park is a Board member of the Hospital, whom also serves as a physician employee of the Hospital. Due to this relationship, he was considered a non-independent voting member of the Board and listed as such on Form 990, part I. Dr. Dana Lee is a Board member of the Hospital, who serves as a contracted physician of the Hospital. Due to this relationship, and contractor compensation in excess of $10,000, Dr. Lee was considered a non-independent voting member of the Board and listed as such on Form 990, part I. X 2 4000 FMV/Cost X 52000 FMV/Cost false false false Schedule H, Part V, Facility Info, pages 4-6 The IRS instructions for Part V, state that the questions regarding community health needs assessments (lines 1-7) are optional for tax year 2010. Additionally, Section B, lines 8-21, are also optional for hospital orgainzations reporting a tax year beginning on or before March 23, 2010. North Hawaii Community Hospital (NHCH) qualified for this optional reporting, and did not choose to respond to lines 1-21. However, the tax software program that was utilized in preparing the Form 990 automatically generated responses to questions: 1;8-14; 16; 18; 20 and 21. These responses were the result of a software malfunction and were unable to be removed before the filing deadline. Please disregard those responses, and note that NHCH did not complete them due to the fact they were OPTIONAL. All lines 1-21, in part V Section B, should be blank. Form 990, Part I, Line 4 Dr. William Park is a Board member of the Hospital, whom also serves as a physician employee of the Hospital. Due to this relationship, he was considered a non-independent voting member of the Board and listed as such on Form 990, part I. Dr. Dana Lee is a Board member of the Hospital, who serves as a contracted physician of the Hospital. Due to this relationship, and contractor compensation in excess of $10,000, Dr. Lee was considered a non-independent voting member of the Board and listed as such on Form 990, part I. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Available upon request Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees Obtained salary market studies from contracted management company. Also compared salaries of applicants and former CEO's of the organization. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Reviewed each year by administration Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process Prepared by consultant, reviewed by Controller, CFO, Board Finance Committee, and Board of Directors