Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
55 MERCHANT STREET 24TH FLOOR
 
Room/suite
City or town, state or country, and ZIP + 4
HONOLULU, HI96813
D Employer identification number

38-3835105
E Telephone number

G Gross receipts $ 866,748,687
F Name and address of principal officer:
CHARLES STED
55 MERCHANT ST 24TH FLOOR
HONOLULU,HI96813
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.hawaiipacifichealth.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?Click to see attachment
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5834
K Form of organization:
 
L Year of formation: 2010
M State of legal domicile: HI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 42
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 22
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 4,380
6 Total number of volunteers (estimate if necessary) .... 6 833
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 645,472
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b  
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 5,724,147 2,668,426
9 Program service revenue (Part VIII, line 2g) ......... 780,928,911 827,650,237
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,777,976 5,810,586
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 5,185,307 4,746,727
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 794,616,341 840,875,976
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 77,685 47,100
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 349,893,526 388,555,181
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 381,646,037 401,132,932
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 731,617,248 789,735,213
19 Revenue less expenses. Subtract line 18 from line 12...... 62,999,093 51,140,763
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 527,296,180 531,469,901
21 Total liabilities (Part X, line 26)............ 138,060,953 129,152,839
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 389,235,227 402,317,062
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: SEE SCHEDULE O.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 62,137,639 including grants of $   ) (Revenue $   )
SEE SCHEDULE O.
4b (Code:   ) (Expenses $ 38,912,628 including grants of $   ) (Revenue $   )
SEE SCHEDULE O.
4c (Code:   ) (Expenses $ 35,976,498 including grants of $   ) (Revenue $   )
SEE SCHEDULE O.
4d Other program services. (Describe in Schedule O.)
(Expenses $ 569,130,778 including grants of $ 47,100 ) (Revenue $ 833,466,344 )
4e Total program service expensesMediumBullet$ 706,157,543
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
449
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
4,380
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
42
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
22
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
 
No
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
 
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
 
 
13
Does the organization have a written whistleblower policy? ...............
13
 
No
14
Does the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
ANN HO
55 MERCHANT STREET 24TH FLOOR
HONOLULU,HI96813
(808) 527-2520
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ANDREW DANG MD
BOARD OF DIRECTOR
 40.2 X           0 423,132 28,696
(2) B JEANNIE HEDBERG CPA
BOARD OF DIRECTOR
 .2 X           0 0 0
(3) BEAU NAKAMOTO MD
BOARD OF DIRECTOR
 40.0 X           265,561 0 10,490
(4) BEN GODSEY
BOARD OF DIRECTOR
 .25 X           0 0 0
(5) BETH HOBAN RN
BOARD OF DIRECTOR
 .2 X           0 0 0
(6) BRYAN MATSUMOTO MD
BOARD OF DIRECTOR
 .2 X           0 0 0
(7) CARLETON CHING
BOARD OF DIRECTOR
 .2 X           0 0 0
(8) CHARLES A STED
PRESIDENT, BOARD OF DIRECTOR
 15.0 X           0 1,741,906 370,246
(9) CHRIS ELDRIDGE
BOARD OF DIRECTOR
 .25 X           0 0 0
(10) CHRISTOPHER JORDAN
BOARD OF DIRECTOR
 .2 X           0 296,187 19,584
(11) DOUGLAS DUVAUCHELLE MD
BOARD OF DIRECTOR
 .2 X           0 0 0
(12) DOUGLAS KWOCK MD
BOARD OF DIRECTOR
 .25 X           18,500 0 0
(13) ELLIOT MILLS
BOARD OF DIRECTOR
 .25 X           0 0 0
(14) EUGENE TANABE MD
BOARD OF DIRECTOR
 .2 X           6,000 0 0
(15) FAYE KURREN
BOARD OF DIRECTOR
 .2 X           0 0 0
(16) GORDON HAMMOND
BOARD OF DIRECTOR
 .2 X           0 0 0
(17) GORDON NIHEI
BOARD OF DIRECTOR
 .2 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) JENNIFER SABAS
BOARD OF DIRECTOR
 .25 X           0 0 0
(19) JOHN CULLINEY MD
BOARD OF DIRECTOR
 .2 X           0 506,953 24,131
(20) KATHLEEN CLARK
PRESIDENT & CEO, BOARD OF DIRE
 60.0 X   X       0 294,123 20,684
(21) KEITH MATSUMOTO MD
CHAIR, BOARD OF DIRECTOR
 .3 X   X       0 0 0
(22) KENN SARUWATARI MD
BOARD OF DIRECTOR
 39.6 X           296,084 0 48,828
(23) KENNETH B ROBBINS MD
EVP & CMO, BOARD OF DIRECTOR
 39.0 X   X       0 774,200 131,328
(24) LYLE TABATA
BOARD OF DIRECTOR
 .2 X           0 0 0
(25) LYNN McCRORY
BOARD OF DIRECTOR
 .2 X           0 0 0
(26) MARK GRIEF MD
CHAIR, BOARD OF DIRECTOR
 .2 X   X       0 0 0
(27) MARK PITTS MD
BOARD OF DIRECTOR
 .2 X           24,000 0 0
(28) MICHAEL GIBSON ESQ
CHAIR, BOARD OF DIRECTOR
 .2 X   X       0 0 0
(29) PAUL DOUGLASS
CHAIR, BOARD OF DIRECTOR
 .2 X   X       0 0 0
(30) PETER MCNALLY MD
BOARD OF DIRECTOR
 .25 X           12,000 0 0
(31) RAMON DE LA PENA
BOARD OF DIRECTOR
 .2 X           0 0 0
(32) RAYMOND P VARA JR
EVP & CEO OF OPER, DIRECTOR
 44.5 X   X       0 1,256,151 163,907
(33) ROBERT SCHULZ MD
BOARD OF DIRECTOR
 40.0 X           610,712 0 20,457
(34) SHELLEY WILSON
BOARD OF DIRECTOR
 .25 X           0 0 0
(35) SHIRLEY AKITA
VICE CHAIR, BOARD OF DIRECTOR
 .2 X   X       0 0 0
(36) STEPHEN LIN MD
BOARD OF DIRECTOR
 .25 X           41,500 0 0
(37) STEVEN AI
BOARD OF DIRECTOR
 .25 X           0 0 0
(38) TERENCE CAROLAN MD
BOARD OF DIRECTOR
 .2 X           0 0 0
(39) THOMAS J NORDYKE MD
VICE CHAIR, BOARD OF DIRECTOR
 40.0 X   X       276,312 0 25,059
(40) VIOLETA ARNOBIT RN
VICE CHAIR, BOARD OF DIRECTOR
 .2 X   X       0 0 0
(41) WAYNE KATAYAMA
BOARD OF DIRECTOR
 .2 X           0 0 0
(42) ANN MK PETERS
VP
 4.0     X       0 185,886 21,006
(43) ARTHUR GLADSTONE
VP & CNE
 51.5     X       0 459,256 48,755
(44) CHARLES R CHING
EVP, GEN COUNSEL & SECRETARY
 13.0     X       0 599,319 75,805
(45) DAVID FOX
PRIVACY/INFO SECURITY OFFICER
 30.8     X       0 109,986 18,615
(46) DAVID OKABE
EVP, CFO & TREASURER
 16.0     X       0 795,218 94,276
(47) DAWN CHING
VP
 50.0     X       0 218,457 33,933
(48) EARL INOUYE
VP & SYSTEM CONTROLLER
 24.0     X       0 325,704 51,543
(49) GAIL LERCH
EXECUTIVE VP
 19.0     X       0 604,089 93,486
(50) GIDGET RUSCETTA
VP
 40.0     X       0 0 0
(51) JENNIE CHAHANOVICH
VP & COO
 54.5     X       0 398,182 36,088
(52) JESSICA LEWIS
ASSISTANT CORPORATE SECRETARY
 36.5     X       0 108,668 10,465
(53) KATIE SHIGEMITSU
HPH COMPLIANCE OFFICER
 36.8     X       0 167,726 17,128
(54) KEKA SANBORN
VP
 8.0     X       0 103,318 6,758
(55) MARTHA SMITH
VP & COO
 54.5     X       0 498,389 76,327
(56) MAUREEN FLANNERY
VP
 50.0     X       0 220,712 3,968
(57) MAVIS NIKAIDO
VP & CNE
 40.0     X       187,432 0 18,570
(58) MELINDA ASHTON MD
VP
 7.0     X       0 402,336 44,902
(59) PATRICIA BOECKMANN RN
VP & CNE
 50.0     X       0 351,069 30,926
(60) PAULA DIAS
VP
 34.5     X       0 263,740 23,466
(61) STEVEN ROBERTSON
EVP & CIO
 43.0     X       0 623,242 90,575
(62) SUSAN MASUMOTO-NONAKA
VP
 39.0     X       0 266,449 37,491
(63) THERESA RAMEY
COMPLIANCE OFFICER
 8.0     X       0 117,779 16,287
(64) VIRGINIA PRESSLER-FISHER MD
EVP
 6.0     X       0 615,632 112,590
(65) WARREN CHAIKO
VP
 35.0     X       0 296,040 30,527
(66) BARBARA CRAFT
DIRECTOR OF CLINICLA SVC LINE
 40.0       X     170,951 0 13,545
(67) BONNIE J CLARK
DIRECTOR OF CLINICAL SVC LINE
 40.0       X     153,748 0 7,358
(68) KEITH MIYASHIRO
DIRECTOR OF IMAGING
 40.0       X     0 153,915 21,622
(69) KENT KIKUCHI
DIRECTOR OF PHARMACY
 40.0       X     0 173,478 21,661
(70) LINDA LEAVITT
DIRECTOR OF CLINICAL SVC LINE
 40.0       X     150,621 0 20,250
(71) LOIS NASH
SYSTEM DIRECTOR OF PHARMACY
 40.0       X     0 220,498 19,634
(72) HINGSON M CHUN MD
PHYSICIAN
 40.0         X   846,140 0 25,059
(73) CASS K NAKASONE MD
PHYSICIAN
 40.0         X   773,886 0 20,802
(74) MARK S GERBER MD
PHYSICIAN
 40.0         X   768,755 0 15,176
(75) WESLEY J KAI MD
PHYSICIAN
 40.0         X   768,272 0 20,202
(76) J ROY CHEN MD
PHYSICIAN
 40.0         X   710,358 0 25,059
(77) JOHN HARLACHER
FORMER OFFICER
 40.0           X 118,144 0 20,058
(78) KEOKI CLEMENTE
FORMER OFFICER
             X 0 122,009 15,374
(79) LYNNE JOSEPH
FORMER OFFICER
 50.0           X 0 249,038 34,353
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 6,198,976 13,942,787 2,137,050
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet14
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CLINICAL LABORATORIES OF HAWAII LL
PO BOX 1300
HONOLULU,HI96807 		LABORATORY SERVICES 19,862,349
SODEXO INC AFFILIATES
888 SOUTH KING STREET
HONOLULU,HI96813 		FOOD & ENVIORN SVCS 8,951,614
UNIVERSITY CLINICAL EDUC RESEARC
677 ALA MOANA BLVD SUITE 1003
HONOLULU,HI96813 		PHYSICIAN SERVICES 5,474,260
HAWAII RESIDENCY PROGRAMS INC
1356 LUISTANA STREET 6TH FLOOR
HONOLULU,HI96813 		MEDICAL SERVICES 5,249,347
CONSTRUCTORS HAWAII INC
1728 KAHAI STREET
HONOLULU,HI968193133 		CONSTRUCTION 5,196,210
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet5
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 2,548,423
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		120,003
g Noncash contributions included in lines 1a-1f:$ 82,417
h Total. Add lines 1a-1f.......MediumBullet 2,668,426
Program Service Revenue Business Code
2a NET PATIENT REVENUES 622,110 805,728,430 805,728,430    
b OTHER HEALTHCARE REVENUE 622,110 13,436,131 13,436,131    
c RENTAL INCOME 531,120 4,369,527 4,369,527    
d PREMIUM REVENUE 622,110 2,348,160 2,348,160    
e RENTAL INCOME FROM AFFILIATES 900,099 780,052 780,052    
f All other program service revenue . 987,937 369,116 618,821  
g Total. Add lines 2a–2f........MediumBullet 827,650,237
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 3,350,698 2,247,225   1,103,473
4 Income from investment of tax-exempt bond proceeds..MediumBullet 258,503     258,503
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents 201,414  
b Less: rental expenses 40,402  
c Rental income or (loss) 161,012  
d Net rental income or (loss).......MediumBullet 161,012   23,307 137,705
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 27,406,935 200,248
b Less: cost or other basis and sales expenses 25,141,711 264,087
c Gain or (loss) 2,265,224 -63,839
d Net gain or (loss)..........MediumBullet 2,201,385 -119,613   2,320,998
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a 26,971
b Less: direct expenses ...b 27,984
c Net income or (loss) from fundraising events..MediumBullet -1,013   -1,013
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a 660,087
b Less: cost of goods sold ..b 398,527
c Net income or (loss) from sales of inventory..MediumBullet 261,560     261,560
Miscellaneous Revenue Business Code
11a PARKING 812,930 2,232,269 2,232,269    
b CAFETERIA 722,110 1,095,577 1,095,577    
c SPECIAL EVENTS/CATERING 900,099 457,348 457,348    
d All other revenue .... 539,974 522,122 3,344 14,508
e Total. Add lines 11a–11d ......MediumBullet 4,325,168
12 Total revenue. See Instructions....MediumBullet 840,875,976 833,466,344 645,472 4,095,734
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 47,100 47,100
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 2,294,252 2,204,626 89,626  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 139,377 139,377    
7 Other salaries and wages 310,073,758 307,057,880 3,015,878  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 23,215,403 22,982,675 232,728  
9 Other employee benefits ....... 31,670,931 30,463,263 1,207,668  
10 Payroll taxes ........... 21,161,460 20,989,195 172,265  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 13,240   13,240  
c Accounting ........... 2,480,098   2,480,098  
d Lobbying ........... 17,632   17,632  
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 527,190   527,190  
g Other .......... 115,623,472 102,686,136 12,937,336  
12 Advertising and promotion .... 331,034 16,367 314,667  
13 Office expenses ....... 113,253,156 112,588,420 664,736  
14 Information technology ...... 11,842,928 1,779,223 10,063,705  
15 Royalties .. 0      
16 Occupancy ........... 23,183,927 22,075,000 1,108,927  
17 Travel ............ 1,130,040 948,709 181,331  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 117,494 102,359 15,135  
20 Interest ........... 12,110,002 12,110,002    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 32,472,733 31,315,033 1,157,700  
23 Insurance .............. 8,609,861 8,609,861    
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a CORPORATE ALLOCATION 46,982,260   46,982,260  
b BAD DEBT 26,421,926 26,421,926    
c OTHER PURCHASES 3,707,381 2,876,492 830,889  
d ALL OTHER EXPENSES 109,934 79,624 30,310  
e DEFERRED COMPENSATION 1,000,562   1,000,562  
f All other expenses 1,198,062 664,275 533,787  
25 Total functional expenses. Add lines 1 through 24f 789,735,213 706,157,543 83,577,670 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... -2,898,490 1 -6,314,220
2 Savings and temporary cash investments ....... 7,785,943 2 13,103,329
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 92,567,502 4 81,939,195
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 11,251,666 8 12,815,830
9 Prepaid expenses and deferred charges ............ 1,188,057 9 1,135,587
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 673,872,503
b Less: accumulated depreciation. ..... 10b 425,152,001 249,558,122 10c 248,720,502
11 Investments—publicly traded securities .......... 58,991,470 11 66,911,643
12 Investments—other securities. See Part IV, line 11 ...... 48,486,527 12 57,490,990
13 Investments—program-related. See Part IV, line 11 .. 1,618,557 13 1,618,557
14 Intangible assets ......... 10,573,719 14 0
15 Other assets. See Part IV, line 11 ........... 48,173,107 15 54,048,488
16 Total assets. Add lines 1 through 15 (must equal line 34)... 527,296,180 16 531,469,901
Liabilities 17 Accounts payable and accrued expenses . 68,419,431 17 67,602,758
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 69,641,522 25 61,550,081
26 Total liabilities. Add lines 17 through 25..... 138,060,953 26 129,152,839
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 363,587,834 27 373,761,487
28 Temporarily restricted net assets ..... 16,184,348 28 18,672,769
29 Permanently restricted net assets ..... 9,463,045 29 9,882,806
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 389,235,227 33 402,317,062
34 Total liabilities and net assets/fund balances ..... 527,296,180 34 531,469,901
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
840,875,976
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
789,735,213
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
51,140,763
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
389,235,227
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-38,058,928
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
402,317,062
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
  		Employer identification number

38-3835105
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
  		Employer identification number

38-3835105
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
  		Employer identification number

38-3835105
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 3,793 67,840
c Total lobbying expenditures (add lines 1a and 1b) ................... 3,793 67,840
d Other exempt purpose expenditures ........................ 314,452,218 1,002,392,346
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 314,456,011 1,002,460,186
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 1,000,000
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000 250,000
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		        6,000,000
             
c Total lobbying expenditures 2,488 2,488 2,133 3,793 10,902
             
d Grassroots non-taxable amount 250,000 250,000 250,000 250,000 1,000,000
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		         1,500,000
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
 
 
j
Total. lines 1c through 1i ...................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
POLITICAL EXPENDITURES SCHEDULE C, PART II-A, LINE 1D LOBBYING FEES WERE INCLUDED IN THE ANNUAL MEMERSHIP DUES PAID TO HEALTHCARE ASSOCIATION OF HAWAI'I. AFFILIATED GROUP ATTACHMENT SCHEDULE C, PART II-A HAWAI'I PACIFIC HEALTH 99-0246363 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN 99-0177350 PALI MOMI MEDICAL CENTER 99-0274038 WILCOX MEMORIAL HOSPITAL 99-0074365 KAUA'I MEDICAL CLINIC 99-0326099 PROVIDERS INSURANCE CORPORATION 71-0893000 KAPI'OLANI MEDICAL SPECIALISTS 99-0322406 STRAUB FOUNDATION 99-0109350 WILCOX HEALTH FOUNDATION 99-0204242 KAPI'OLANI HEALTH FOUNDATION 99-0246364 STRAUB CLINIC & HOSPITAL 91-2151670 PALI MOMI FOUNDATION 38-3840327 MAILING ADDRESS FOR ALL MEMBERS OF THE AFFILIATED GROUP IS 55 MERCHANT STREET, 24TH FLOOR, HONOLULU, HI 96813 THE ONLY MEMBER TO MAKE THE ELECTION UNDER SECTION 501(H) WAS STRAUB CLINIC & HOSPITAL
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 114,609,981 102,107,743 123,858,456
b Contributions ........ 1,260,873 1,339,991 3,027,713
c Investment earnings or losses ... 22,509,891 11,175,215 -24,767,339
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses .... 102,546 12,968 11,087
g End of year balance ...... 138,278,199 114,609,981 102,107,743
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet97.000 %
b
Permanent endowment: SchDMd Bullet2.000 %
c
Term endowment: SchDMd Bullet1.000 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
Yes
 
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   19,720,249 19,720,249
b Buildings ................   334,533,464 185,958,817 148,574,647
c Leasehold improvements ............   14,170,162 9,626,024 4,544,138
d Equipment ................   282,417,156 223,965,130 58,452,026
e Other .................   23,031,472 5,602,030 17,429,442
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 248,720,502
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) INVESTMT IN UNCONSOLIDATED SUB 		4,971,277 F

(B) BOARD DESIGNATED SECURITIES 		33,631,270 F

(C) LIMITED PARTNERSHIPS 		18,863,443 F

(D) INVESTMT IN UNCONSOLIDATED SUB 		25,000 C





Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 57,490,990
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM THIRD PARTY PAYORS 2,002,181
(2) OTHER RECEIVABLES 3,836,768
(3) DUE FROM STRAUB FDN 6,703
(4) DUE FROM KAUA'I MEDICAL CLINIC 67,816
(5) DUE FROM KAPI'OLANI HEALTH FDN 346,800
(6) DUE FROM KAPI'OLANI SPECIALIST 78,719
(7) DUE FROM PROVIDERS INSURANCE 368,968
(8) BOARD DESIGNATED INVESTMENTS 16,416,008
(9) INTEREST IN N.A. FOUNDATION 24,906,784
(10) INVESTMENTS IN JOINT VENTURES 84,702
(11) DEPOSITS & NON-CURRENT ASSETS 4,196,429
(12) DUE FROM WILCOX HEALTH FDN 178,914
(13) UNAMORTIZED BOND COSTS 179,511
(14) DUE FROM GOVERNMENT AGENCIES 1,102,182
(15) DECORATIVE ARTWORK 276,003
Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 54,048,488
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
DUE TO STRAUB PHARMACY 4,555,888
DUE TO KAPI'OLANI HEALTH FDN 9,930
DUE TO WILCOX HEALTH FDN 5,632
OTHER LONG TERM LIABILITIES 23,062,878
DUE TO GOVERNMENTAL AGENCIES 694,948
ALLOC OF GROUP TAX EXEMPT BONDS 32,609,613
DUE TO HAWAI'I PACIFIC HEALTH PTRS 2,520
DUE TO KEAHONUIOKALANI 27,123
DUE TO STRAUB FOUNDATION 16,128
DUE TO KAPI`OLANI SPECIALISTS 506,683
DEFERRED EQUIPMENT PURCHASE PLAN 9,300
DUE FROM PACIFIC HEALTH PARTNERS 49,438
Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 61,550,081
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
ENDOWMENT FUNDS INTENDED USES SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS ARE INTENEDED TO BE USED TO PROVIDE MEDICAL AND OTHER CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR SUCH CARE AND FOR OTHER EXPENSES RELATED TO THE EXEMPT PURPOSE OF THE HOPITAL. FIN 48 (ASC 740) FOOTNOTE SCHEDULE D, PART X, LINE 2 THE FOLLOWING IS THE FIN 48 (ASC 740) FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATION'S PARENT: THE TAXABLE AFFILIATES OF THE COMPANY UTILIZE THE LIABILITY METHOD OF ACCOUNTING FOR INCOME TAXES. UNDER THIS METHOD, DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON DIFFERENCES BETWEEN THE FINANCIAL REPORTING AND TAX BASIS OF ASSETS AND LIABILITIES, AND ARE MEASURED USING THE CURRENTLY ENACTED TAX RATES AND LAWS. VALUATION ALLOWANCES ARE USED TO REDUCE DEFERRED TAX ASSETS TO THEIR ESTIMATED NET RELIZABLE VALUES WHEN MANAGEMENT DETERMINES ULTIMATE RECOVERY OF THE DEFERRED TAX ASSETS IS NOT MORE LIKELY THAN NOT TO OCCUR.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

GOLF TOURNAMENT
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

0
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 26,971     26,971
2 Less: Charitable
contributions . . . 		       
3 Gross income (line 1
minus line 2) . . . 		26,971     26,971
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses . 27,984     27,984
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 27,984
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -1,013
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		  10,703 2,366,888 0 2,366,888 0.320 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		  121,909 165,594,291 132,476,988 33,117,303 3.010 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		  132,612 167,961,179 132,476,988 35,484,191 3.330 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		8 3,806 1,237,212 341,431 895,781 0.120 %
f Health professions education
(from Worksheet 5) .. 		2   21,723,902 1,679,749 20,044,153 2.630 %
g Subsidized health services
(from Worksheet 6) .. 		4   10,875,270 8,774,873 2,100,396 0.200 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    123,755 0 123,755 0.020 %
jTotal Other Benefits ... 14 3,806 33,960,139 10,796,053 23,164,085 2.970 %
kTotal. Add lines 7d and 7j. .. 14 136,418 201,921,318 143,273,041 58,648,276 6.300 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     409,912 0 409,912 0.060 %
9 Other     8,865 0 8,865  
10 Total     418,777 0 418,777 0.060 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense (at cost).....
2
9,388,645
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
820,041
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
136,623,770
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
147,006,535
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-10,382,765
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?4
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 KAPI'OLANI MED CTR FOR WOMEN & CHILDREN
1319 PUNAHOU STREET
HONOLULU,HI96826 		X X X X     X    
2 PALI MOMI MEDICAL CENTER
98-1079 MOANALUA ROAD
AIEA,HI96701 		X X         X    
3 STRAUB CLINIC & HOSPITAL
888 SOUTH KING STREET
HONOLULU,HI96813 		X X   X     X    
4 WILCOX MEMORIAL HOSPITAL
3-3420 KUHIO HIGHWAY
LIHUE,HI967661099 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:KAPI'OLANI MED CTR FOR WOMEN & CHILDREN
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:PALI MOMI MEDICAL CENTER
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:STRAUB CLINIC & HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:WILCOX MEMORIAL HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?16
Name and address Type of Facility (Describe)
1 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
2 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
3 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
4 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
5 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
6 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
7 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
8 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
9 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
10 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
11 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
12 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
13 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
14 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
15 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
16 PEARLRIDGE CLINIC
98-151 PALI MOMI STREET
AIEA,HI96701 		CLINIC
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
FORM 990, SCHEDULE H PART I, LINE 3C: N/A PART I, LINE 6A: COMMUNITY BENEFITS ARE INCLUDED IN A REPORT PREPARED BY HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATION'S PARENT. PART I, LINE 7G: NO COSTS OF A PHYSICIAN CLINIC WERE INCLUDED AS SUBSIDIZED HEALTH SERVICES. PART I, LINE 7, COLUMN G: BAD DEBT EXPENSE OF $26,421,926 WAS SUBTRACTED FROM TOTAL EXPENSES TO COMPUTE PERCENTAGES. PART I, LINE 7: COST TO CHARGE RATIO AND SCHEDULE H WORKSHEET WAS USED TO CALCULATE THE COSTS.
PART II COMMUNITY BUILDING ACTIVITIES: WHEN DISCHARGING PATIENTS, PALI MOMI MEDICAL CENTER FOLLOWS THE GUIDELINES OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE PROCEDURES INVOLVED WITH PROVIDING A SAFE DISCHARGE PLAN INCLUDE DESIGNATING A PERMANENT OR TRANSITIONAL DESTINATION FOR ALL PATIENTS LEAVING THE HOSPITAL. HOWEVER, IN SOME CASES, PATIENTS HAVE NO INSURANCE OR ARE PENDING APPROVAL UNDER THE MEDICAID PROGRAM FOR PAST SERVICES PROVIDED. THESE PATIENTS DO NOT REQUIRE FURTHER HOSPITAL-GRADE CARE BUT RATHER, FOLLOW-UP CARE AT A TRANSITIONAL CARE FACILITY, SUCH AS A LICENSED FOSTER CARE HOME OR REHABILITATION CENTER. IN THESE SPECIAL CIRCUMSTANCES, PALI MOMI WILL PAY AN INDEPENDENT CASE MANAGER FROM THE COMMUNITY, USUALLY A NURSE REPRESENTATIVE OF AN INDEPENDENT CASE MANAGEMENT COMPANY, TO ASSUME CARE OF THE PATIENT. THE CASE MANAGER IDENTIFIES AN APPROPRIATE FACILITY, HELPS THE PATIENT TRANSITION THERE, AND MONITORS THE PATIENT. PALI MOMI ASSUMES RESPONSIBILITY FOR THE FINANCIAL COST UNTIL INSURANCE APPROVAL UNDER MEDICAID IS ESTABLISHED. PALI MOMI DOES THIS TO ENSURE THAT A SAFE DISCHARGE PLAN IS BEING FOLLOWED, AND TO MAKE AVAILABLE A HOSPITAL BED FOR AN ACUTE OR CRITICALLY-ILL PATIENT WHO REQUIRES HOSPITAL-GRADE CARE. STRAUB CLINIC & HOSPITAL IS COMMITTED TO ATTRACTING AND RETAINING TOP-QUALITY PHYSICIANS IN HAWAI'I, WHERE LOSING PHYSICIANS TO THE U.S. MAINLAND IS A CONSTANT THREAT. ACCORDING TO HAWAII MEDICAL JOURNAL AND HAWAI'I PHYSICIAN WORKFORCE ASSESSMENT PROJECT, BY 2020, HAWAI'I WILL HAVE 1,500 FEWER PHYSICIANS THAN NEEDED TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. SHORTAGES WILL BE PARTICULARLY SEVERE IN PRIMARY CARE, CARDIOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, GENERAL SURGERY, AND OTHER SPECIALTIES. IN FISCAL YEAR 2011, STRAUB SPENT $409,912 TO ATTRACT PHYSICIANS TO HAWAI'I. THIS INCLUDED HIRING A FULL-TIME RECRUITER AND PHYSICIAN SERVICES MANAGER, PURCHASING A LAPTOP COMPUTER AND "PRACTICE MATCH SERVICES" DATABASE, HIRING PHYSICIAN CONSULTANTS TO RECRUIT MAINLAND PHYSICIANS, OFFICE AND TRAVEL EXPENSES, TRAVEL EXPENSES OF PHYSICIAN CANDIDATES, GENERAL RECRUITMENT ACTIVITIES, AND MOVING EXPENSES OF PHYSICIANS AND THEIR FAMILY MEMBERS. STRAUB COVERS THESE COSTS TO HELP ENSURE THAT THE COMMUNITY'S FUTURE HEALTH CARE NEEDS WILL BE MET. WHEN DISCHARGING PATIENTS, WILCOX MEMORIAL HOSPITAL FOLLOWS THE GUIDELINES OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL STRIVES TO ENSURE THAT A SAFE DISCHARGE PLAN IS PROVIDED TO ALL PATIENTS. THIS MAY INVOLVE PROVIDING SOME PATIENTS WITH TRANSPORTATION TO A PERMANENT OR TRANSITIONAL DESTINATION. IN SOME CASES, INDIGENT PATIENTS ARE READY FOR DISCHARGE, BUT DO NOT HAVE THE ABILITY TO PAY FOR TRANSPORTATION OR HOUSING, MEDICATIONS AND MEDICAL EQUIPMENT, SPECIFIC FOODS REQUIRED AS PART OF A RESTRICTED DIET, OR A NURSE ESCORT DEEMED MEDICALLY NECESSARY. IN THESE SPECIAL CIRCUMSTANCES, WILCOX WILL TEMPORARILY COVER THESE COSTS. BY HELPING ITS MOST VULNERABLE POPULATION OVERCOME FINANCIAL BARRIERS, WILCOX IS HELPING TO ENSURE A SMOOTH TRANSITION TO AN APPROPRIATE CARE SETTING FOR ALL PATIENTS, AS WELL AS MAKING AVAILABLE A HOSPITAL BED FOR AN ACUTE OR CRITICALLY ILL PATIENT WHO REQUIRES HOSPITAL-GRADE CARE.
PART III, LINE 4:   THE ESTIMATE FOR BAD DEBT THAT COULD HAVE POTENTIALLY QUALIFIED FOR CHARITY CARE WAS CALCULATED BY FIRST COMPUTING THE BAD DEBT ASSOCIATED WITH THE UNINSURED, THEN CALCULATING THE COST USING A COST TO CHARGE RATIO (PER SCHEDULE H WORKSHEET 2) AND THEN APPLYING MANAGEMENTS ESTIMATE FOR PORTION OF UNINSURED THAT COULD HAVE QUALIFIED FOR CHARITY CARE. MANAGEMENT CONSERVATIVELY ESTIMATES THAT 15-20% OF THE UNINSURED BAD DEBT COULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE IF SUFFICIENT INFORMATION WAS OBTAINED TO DEMONSTRATE FINANCIAL NEED. PER THE CONSOLIDATED AUDITED FINANCIAL STATEMENT OF HAWAI'I PACIFIC HEALTH ("HPH"), THE FILING ORGANIZATION'S PARENT: THE PROVISION FOR BAD DEBTS EXPENSE IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL AND BUSINESS AND ECONOMIC TRENDS, TRENDS IN HEALTHCARE COVERAGES AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BAD DEBT CONSISTS OF SERVICES FOR WHICH THE COMPANY ANTICIPATED BUT DID NOT RECEIVE PAYMENT BECAUSE OF THE PATIENTS' UNWILLINGNESS TO PAY. BAD DEBT ALSO INCLUDES SERVICES FOR MEDICALLY INDIGENT AND/OR UNINSURED PATIENTS WHO ARE UNABLE TO PAY AND WHO MIGHT HAVE QUALIFIED FOR CHARITY CARE HAD THE PATIENT SELF-IDENTIFIED THEMSELVES AS MEDICALLY INDIGENT ALONG WITH PROVIDING INFORMATION SO THAT PROPER MEANS TESTING COULD HAVE BEEN ACCOMPLISHED TO QUALIFY THE PATIENT FOR CHARITY CARE. PART III, LINE 8: BECAUSE TAX-EXEMPT HOSPITALS MUST PARTICIPATE IN MEDICARE AND MEDICAID AS A CONDITION OF MAINTAINING THEIR FEDERAL TAX-EXEMPT STATUS, MEDICARE UNDERPAYMENTS ARE NOT OPERATING EXPENSES THAT SHOULD BE EXPECTED IN THE ORDINARY COURSE OF BUSINESS. BECAUSE TAX-EXEMPT HOSPITALS MUST ACCEPT MEDICARE RATES THAT ARE IN SOME CASES BELOW COST, THEY SHOULD BE ABLE TO REPORT ANY NEGATIVE DIFFERENCES BETWEEN MEDICARE RATES AND COST AS LOSSES INCURRED BY SERVICING THE COMMUNITY. TOTAL MEDICARE COSTS WERE CALCULATED IN ACCORDANCE WITH THE FEDERAL STANDARD FORM CMS-2552.96. PART III, LINE 9B: COLLECTION PROCEDURES FOR PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE FOLLOW THE SAME POLICY AS ALL OTHER PATIENTS. IN GENERAL THE POLICY INVOLVES SENDING FOLLOW UP STATEMENTS AND DOING FOLLOW UP PHONE CALLS. PAYMENT OPTIONS ARE ALSO PRESENTED TO THE PATIENT AS PART OF THE COLLECTION PROCESS. ACCOUNTS NOT COLLECTED WITHIN THE SPECIFIED TIME PERIOD OUTLINED IN THE POLICY (HOSPITAL AND PHYSICIAN CLAIMS) ARE SENT TO A COLLECTION AGENCY FOR COLLECTION.
NEEDS ASSESSMENT:   THE HOSPITALS OF HAWAI'I PACIFIC HEALTH ARE CURRENTLY IN THE PROCESS OF DEVELOPING A PLAN TO ASSESS THE COMMUNITY NEEDS IN ACCORDANCE WITH IRC SECTION 501(R). PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: WHEN A PATIENT PRESENTS FOR SERVICES AND THE PATIENT DOES NOT HAVE INSURANCE COVERAGE FOR SERVICES TO BE PROVIDED, THE PATIENT, OR GUARANTOR IS ASKED TO SIGN THE "SELF PAY ACKNOWLEDGEMENT" LETTER. THE LETTER DESCRIBES THE TERMS OF THE HAWAI'I PACIFIC HEALTH ("HPH") UNINSURED DISCOUNT PROGRAM, AND BY SIGNING THE LETTER, THE PATIENT ACKNOWLEDGES THAT HE/SHE UNDERSTANDS AVAILABLE UNINSURED PAYMENT TERMS. IN MOST UNINSURED CASES, THE PATIENT WILL BE OFFERED A HAWAI'I STATE MEDICAL ASSISTANCE APPLICATION. THIS IS THE APPLICATION FOR THE HAWAI'I STATE MEDICAID/QUEST PROGRAM. THE HOSPITAL CONTRACTS WITH SERVICE PROVIDERS WHO SPECIALIZE IN ASSISTING PATIENTS WITH THE MEDICAID/QUEST PROGRAM APPLICATION PROCESS. IF THE PATIENT'S APPLICATION FOR MEDICAID/QUEST IS DENIED OR IT IS DETERMINED THAT THE PATIENT IS INELIGIBILE TO APPLY FOR MEDICAID/QUEST, THE PATIENT MAY APPLY FOR HPH FINANCIAL ASSISTANCE EITHER IN THE HOSPITAL FINANCIAL SERVICES DEPARTMENT OR BY MAIL DIRECTLY TO THE HPH BUSINESS SERVICES OFFICE. FINANCIAL COUNSELORS ARE AVAILABLE ON SITE TO REVIEW PAYMENT OPTIONS WITH THE PATIENT OR THE GUARANTOR. THESE OPTIONS INCLUDE THE AFOREMENTIONED HPH UNINSURED DISCOUNT PROGRAM, THE HAWAI'I STATE MEDICAID/QUEST PROGRAM, THE HPH FINANCIAL ASSISTANCE PROGRAM, PAYMENT PLANS AND ANY GRANT OR FUNDING SOURCE THAT MAY BE APPROPRIATE FOR THE SERVICES PROVIDED. IN SOME CASES, HPH DETERMINES THAT A PATIENT OR GUARANTOR MAY NEED ASSISTANCE AFTER SERVICES ARE PROVIDED, AND FINANCIAL INFORMATION IS MAILED TO THE PATIENT. EDUCATION AND ASSISTANCE IS OFTEN PROVIDED VIA PHONE CONTACT IN THESE CASES. PAYMENT PLAN ARRANGEMENTS ARE HANDLED VIA PHONE CONTACT WITH THE PATIENT.
COMMUNITY INFORMATION:   KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN ("KAPI'OLANI") HAS BEEN TREATING WOMEN, CHILDREN AND INFANTS FOR MORE THAN A CENTURY. IT IS HAWAI'I'S ONLY MATERNITY, NEWBORN, AND PEDIATRIC SPECIALTY HOSPITAL. IT IS ALSO A TERTIARY CARE, TEACHING AND RESEARCH FACILITY. IT HAS 207 BEDS AND 66 BASSINETS. FOR WOMEN, IT PROVIDES COMPLETE OBSTETRICAL AND GYNECOLOGICAL CARE. FOR INFANTS AND CHILDREN, IT HAS MORE THAN 100 PHYSICIANS IN MULTIPLE PEDIATRIC SPECIALTIES AND SUBSPECIALTIES. IN FISCAL YEAR 2011, KAPI'OLANI HAD 53,324 IMAGING PROCEDURES, 42,505 WOMEN'S CENTER PROCEDURES, 37,004 ER VISITS, AND 18,013 INPATIENT ADMISSIONS. KAPI'OLANI'S GEOGRAPHIC SERVICE AREA IS THE ENTIRE PACIFIC BASIN, SINCE MANY OF ITS MEDICAL SPECIALTIES ARE NOT PROVIDED ELSEWHERE IN THIS REGION, WHICH STRETCHES FROM THE U.S. WEST COAST TO FAR EAST ASIA. THE PEDIATRIC INTENSIVE CARE UNIT ("PICU"), FOR EXAMPLE, IS THE ONLY PICU BETWEEN LOS ANGELES AND HONG KONG. PALI MOMI MEDICAL CENTER ("PALI MOMI") IS A COMMUNITY-BASED, ACUTE-CARE HOSPITAL THAT OFFERS A FULL RANGE OF SERVICES IN CARDIOLOGY, ORTHOPEDICS, EMERGENCY MEDICINE, GENERAL SURGERY AND MEDICINE, OPHTHALMOLOGY, WOMEN'S SERVICES AND ONCOLOGY. IT HAS DELIVERED MANY MEDICAL FIRSTS FOR THE COMMUNITY, INCLUDING WEST OAHU'S ONLY INTERVENTIONAL CARDIAC CATHETERIZATION UNIT, WOMEN'S CENTER, AND RETINA CENTER. IN FISCAL YEAR 2011, PALI MOMI HAD 88,966 IMAGING PROCEDURES, 44,916 ER VISITS, 25,604 WOMEN'S CENTER PROCEDURES, AND 6,316 INPATIENT ADMISSIONS. PALI MOMI'S GEOGRAPHIC SERVICE AREA IS THE ENTIRE PACIFIC BASIN, SINCE SOME SPECIALTIES HAVE FEW OTHER PROVIDERS IN THE REGION. THE RETINA CENTER, FOR EXAMPLE, OFFERS HIGHLY SPECIALIZED CARE ACCESSED BY RESIDENTS ACROSS THE STATE AND BEYOND. STRAUB CLINIC & HOSPITAL ("STRAUB") HAS BEEN SERVING THE COMMUNITY'S HEALTH CARE NEEDS FOR MORE THAN 80 YEARS. THE FULLY INTEGRATED HEALTH CARE SYSTEM IS MADE UP OF A 159-BED HOSPITAL IN HONOLULU, A NETWORK OF NEIGHBORHOOD CLINICS, AND A VISITING SPECIALIST PROGRAM THAT REACHES THROUGHOUT THE STATE OF HAWAI'I. STRAUB HOUSES AN ARRAY OF PHYSICIAN SPECIALISTS UNDER ONE ROOF, ENABLING PATIENTS TO RECEIVE EXPERT DIAGNOSIS AND TREATMENT IN MORE THAN 32 DIFFERENT SPECIALTIES. IN FISCAL YEAR 2011, STRAUB HAD 109,131 IMAGING PROCEDURES, 24,801 ER VISITS, AND 6,793 INPATIENT ADMISSIONS. STRAUB'S GEOGRAPHIC SERVICE AREA IS THE ENTIRE PACIFIC BASIN, SINCE SOME MEDICAL SPECIALTIES ARE NOT PROVIDED ELSEWHERE IN THE REGION. THE STRAUB BURN UNIT, FOR EXAMPLE, IS THE ONLY DEDICATED BURN TREATMENT FACILITY BETWEEN LOS ANGELES AND HONG KONG. WILCOX MEMORIAL HOSPITAL ("WILCOX") HAS BEEN SERVING RESIDENTS AND VISITORS OF KAUA'I FOR MORE THAN 70 YEARS. THE ACUTE-CARE FACILITY OFFERS MORE THAN 22 SPECIALTIES AND A FULL SUITE OF SERVICES RANGING FROM EMERGENCY, OB/GYN AND PEDIATRICS TO CARDIOLOGY, GASTROENTEROLOGY, OPHTHALMOLOGY, PULMONOLOGY, NEPHROLOGY, COSMETIC SURGERY, INTERNAL MEDICINE, FAMILY PRACTICE, AND WOMEN'S SERVICES. IN FISCAL YEAR 2011, WILCOX HAD 59,878 IMAGING PROCEDURES, 23,974 ER VISITS, AND 3,624 INPATIENT ADMISSIONS. WILCOX'S GEOGRAPHIC SERVICE AREA IS THE ISLAND OF KAUA'I. DEMOGRAPHICS OF THE KAUA'I COMMUNITY IN FISCAL YEAR 2011 INCLUDE A POPULATION OF APPROXIMATELY 67,000 (AND MORE THAN 900,000 VISITORS ANNUALLY). REGARDING WILCOX PATIENTS, 1.7 PERCENT ARE UNINSURED AND 16.7 PERCENT ARE MEDICAID RECIPIENTS. THERE ARE TWO OTHER HOSPITALS IN THE COMMUNITY, AND FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS ARE PRESENT. HAWAI'I PACIFIC HEALTH ("HPH") TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. DEMOGRAPHICS OF HAWAI'I IN FISCAL YEAR 2011 INCLUDE A STATE POPULATION OF 1,375,810 (AND ALMOST 7 MILLION VISITORS ANNUALLY). REGARDING HPH PATIENTS, 1.3 PERCENT ARE UNINSURED AND 21.9 PERCENT ARE MEDICAID RECIPIENTS. THERE ARE 14 OTHER HOSPITALS IN THE STATE THAT PROVIDE ACUTE SERVICES, AND FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS ARE PRESENT.
PROMOTION OF COMMUNITY HEALTH:   KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN ("KAPI'OLANI") IS THE PRIMARY PEDIATRIC AND OBSTETRIC TEACHING HOSPITAL FOR THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE. IN FISCAL YEAR 2011, KAPI'OLANI INVESTED $8,858,000 INTO TEACHING PEDIATRICIANS AND OBSTETRICIANS AND RESEARCH, INCLUDING CLINICAL TRIALS. KAPI'OLANI STRIVES TO HAVE A POSITIVE INFLUENCE ON PUBLIC POLICY TO BENEFIT HAWAI'I'S WOMEN AND CHILDREN. IT ACTIVELY SUPPORTS THE SUSAN G. KOMEN BREAST CANCER FOUNDATION, MARCH OF DIMES AND HAWAI'I CHILDREN'S CANCER FOUNDATION. THE KAPI'OLANI CHILDREN'S MIRACLE NETWORK SUPPORTS THE COST OF PEDIATRIC HEALTH CARE, MEDICAL EQUIPMENT, NEIGHBOR ISLAND TRAVEL, RESEARCH AND PUBLIC AWARENESS. THE HOSPITAL OPERATES THE SEX ABUSE TREATMENT CENTER, WHICH AIMS TO REDUCE SEXUAL VIOLENCE AND ENABLE THE STATE'S FORENSIC TEAMS TO INVESTIGATE AND PROSECUTE SEX OFFENSES, AND THE KAPI'OLANI CHILD PROTECTION CENTER, WHICH PROVIDES EXPERTISE IN RECOGNIZING AND TREATING CHILD ABUSE AND NEGLECT. FOR FIVE CONSECUTIVE YEARS, THE AMERICAN HEART ASSOCIATION HAS RECOGNIZED PALI MOMI MEDICAL CENTER FOR EXCELLENCE IN THE TREATMENT OF CORONARY ARTERY DISEASE. PALI MOMI FOCUSES ON THE MEDICAL NEEDS OF THE WEST O'AHU COMMUNITY. IN FISCAL YEAR 2011, IT HOSTED MANY FREE COMMUNITY EVENTS TO RAISE PUBLIC AWARENESS OF HEALTH AND WELLNESS ISSUES, FROM FAMILY AND SENIOR HEALTH FAIRS TO MULTIPLE SUPPORT GROUPS TO FREE GLUCOSE MONITORING AND BLOOD PRESSURE SCREENING TWICE A MONTH. STRAUB CLINIC & HOSPITAL ("STRAUB") OPERATES SEVERAL SPECIALTY CARE UNITS, INCLUDING THE HEART CENTER AND BONE & JOINT CENTER. THE BURN UNIT IS THE ONLY MULTIDISCIPLINARY BURN TREATMENT CENTER IN THE PACIFIC REGION, PROVIDING BURN VICTIMS WITH IMMEDIATE AND COMPREHENSIVE CARE, CLOSE TO HOME. STRAUB MAINTAINS AN OPEN MEDICAL STAFF IN 19 SPECIALTIES AND AN OPEN/MANAGED MEDICAL STAFF IN 14 SPECIALTIES. STRAUB PROVIDES CHARITY CARE, HEALTH EDUCATION AND PREVENTATIVE PROGRAMS TO THE COMMUNITY. IN FISCAL YEAR 2011, IT PROVIDED FREE PUBLIC HEALTH EDUCATION PROGRAMS AND EVENTS ON PREVENTING OR MANAGING HEART ATTACKS, CANCER, ARTHRITIS, ASTHMA, ALLERGIES, STRESS, OSTEOPOROSIS, OBESITY AND DRUG ABUSE. THESE INCLUDED KIDS FEST, LIVING HEALTHY IN PARADISE, WOMEN'S WAY TO HEALTH, CANCER CARE, BREATHE WITH EASE, VALENTINE IN PARADISE AND GETTING A GRIP ON ARTHRITIS. THE ANNUAL WOMEN'S 10K RUN, ONE OF THE MORE VISIBLE SPORTS EVENTS IN THE COMMUNITY, CELEBRATED ITS 34TH CONSECUTIVE YEAR. WILCOX MEMORIAL HOSPITAL ("WILCOX") IS DEDICATED TO PROVIDING KAUA'I WITH AFFORDABLE AND ACCESSIBLE HEALTH CARE. IN 2011, THE AMERICAN HEART ASSOCIATION RECOGNIZED WILCOX FOR EXCELLENCE IN CARDIAC CARE. WILCOX MAINTAINS AN OPEN MEDICAL STAFF IN MORE THAN 20 SPECIALTIES. IN ADDITION, WILCOX PLAYS AN ACTIVE ROLE IN KAUAI'S COMMUNITY. IN FISCAL YEAR 2011, IT HOSTED VALENTINE IN PARADISE, A TELECONFERENCE ON HEART DISEASE PREVENTION, AND THE WOMEN'S HEALTH SYMPOSIUM, WHICH ATTRACTED MORE THAN 200 ATTENDEES. IT CO-SPONSORS THE ARTHRITIS WALK AND OLD KOLOA SUGAR MILL WALK/RUN, AND SUPPORTS THE PARADE OF LIGHTS, RELAY FOR LIFE, KAUA'I FOOD BANK, KAUA'I LIFEGUARD ASSOCIATION, TOYS FOR TOTS, ALOHA UNITED WAY WALK-A-THON, ALZHEIMER'S MEMORY WALK AND OTHER COMMUNITY EVENTS. EACH AFFILIATE HOSPITAL OF HAWAI'I PACIFIC HEALTH IS A LEADER IN COMMUNITY HEALTH CARE EDUCATION AND ADVOCACY. EACH HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF; THIS ARRANGEMENT GRANTS ADMITTING PRIVILEGES TO NONAFFILITATED PHYSICIAN SPECIALISTS AND BROADENS EACH FACILITY'S ABILITY TO OFFER HIGH-QUALITY, SPECIALIZED CARE TO THEIR COMMUNITY. EACH HOSPITAL IS GOVERNED BY A COMMUNITY BOARD COMPRISED OF PHYSICIANS, COMMUNITY MEMBERS AND KEY LEADERSHIP WITHIN HAWAI'I PACIFIC HEALTH. THESE VOLUNTEER, UNPAID MEMBERS ENSURE THAT EACH FACILITY FULFILLS ITS MISSION-DRIVEN GOALS. AS AFFILIATES OF THE NON-PROFIT HAWAI'I PACIFIC HEALTH NETWORK, EACH HOSPITAL REINVESTS ALL SURPLUS RESOURCES BACK INTO PATIENT CARE AND TO SUBSIDIZE THOSE WHO CANNOT PAY. AFFILIATED HEALTH CARE SYSTEM ROLES: THE HAWAI'I PACIFIC HEALTH SYSTEM INCLUDES FOUR HOSPITALS, 49 OUTPATIENT CLINICS AND SERVICE SITES, AND 1,372 AFFILIATED PHYSICIANS. THE HOSPITALS PROVIDE ACUTE AND SPECIALTY CARE WITH 553 BEDS AND 76 BASSINETS, AND HANDLED 34,746 ADMISSIONS IN FISCAL YEAR 2011. HAWAI'I PACIFIC HEALTH, THE STATE'S LARGEST HEALTH CARE PROVIDER, IS COMMITTED TO PROVIDING THE HIGHEST QUALITY AND MOST ACCESSIBLE MEDICAL CARE AND SERVICES TO THE PEOPLE OF HAWAI'I AND THE PACIFIC REGION. PEOPLE OF HAWAI'I AND THE PACIFIC REGION.
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number
38-3835105
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance






















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
 
3
Enter total number of other organizations ................................ . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Description of Organization's Procedures for Monitoring the Use of Grants FORM 990, SCHEDULE I, PART I, LINE 2 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN AWARDS QUALIFIED STUDENTS SCHOLARSHIPS FROM THE RICHARD DAVI SCHOLARSHIP FUND. AN AWARD LETTER IS MAILED TO THE RECIPIENT TO INFORM THEM OF THIS HONOR, AND TO INSTRUCT THE RECIPIENT THAT A CHECK IN THE AMOUNT OF THE SCHOLARSHIP AWARD WILL BE MADE OUT TO THE SCHOOL. ADDITIONALLY, INSTRUCTION IS GIVEN THAT THE STUDENT SHOULD SUBMIT RECEIPTS FOR TUITION, BOOKS, LABS, ETC. UP TO THE TOTAL AMOUNT OF THE SCHOLARSHIP. A CONTACT TELEPHONE NUMBER FOR THE SCHOLARSHIP COMMITTEE IS PROVIDED FOR QUESTIONS. THE HAWAI'I PACIFIC HEALTH DONATIONS COMMITTEE REVIEWS AND APPROVES DONATIONS TO 501(C)3 ORGANIZATIONS ON AN ANNUAL BASIS. NO FURTHER MONITORING IS NECESSARY SINCE DONATIONS ARE ONLY MADE TO 501(C)3 ORGANIZATIONS.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) ANDREW DANG MD (i)
(ii)		 0
380,331 		0
4,912 		0
37,889 		0
9,800 		0
18,896 		0
451,828 		0
0
(2) ANN MK PETERS (i)
(ii)		 0
138,872 		0
25,032 		0
21,982 		0
8,373 		0
12,633 		0
206,892 		0
0
(3) ARTHUR GLADSTONE (i)
(ii)		 0
278,600 		0
118,519 		0
62,137 		0
27,686 		0
21,069 		0
508,011 		0
9,377
(4) BARBARA CRAFT (i)
(ii)		 156,918
0 		14,033
0 		0
0 		8,155
0 		5,390
0 		184,496
0 		0
0
(5) BEAU NAKAMOTO MD (i)
(ii)		 247,410
0 		9,344
0 		8,807
0 		9,800
0 		690
0 		276,051
0 		0
0
(6) BONNIE J CLARK (i)
(ii)		 140,012
0 		13,736
0 		0
0 		9,032
0 		7,358
0 		170,138
0 		0
0
(7) CHARLES A STED (i)
(ii)		 0
742,711 		0
734,897 		0
264,298 		0
359,765 		0
10,481 		0
2,112,152 		0
448,157
(8) CHARLES R CHING (i)
(ii)		 0
308,285 		0
205,141 		0
85,893 		0
68,009 		0
7,796 		0
675,124 		0
93,424
(9) CHRISTOPHER JORDAN (i)
(ii)		 0
259,225 		0
36,962 		0
0 		0
9,800 		0
9,784 		0
315,771 		0
0
(10) DAVID OKABE (i)
(ii)		 0
408,872 		0
274,875 		0
111,471 		0
82,840 		0
11,436 		0
889,494 		0
157,867
(11) DAWN CHING (i)
(ii)		 0
161,040 		0
43,992 		0
13,425 		0
10,222 		0
23,711 		0
252,390 		0
0
(12) EARL INOUYE (i)
(ii)		 0
228,359 		0
64,393 		0
32,952 		0
35,275 		0
16,268 		0
377,247 		0
2,048
(13) GAIL LERCH (i)
(ii)		 0
318,615 		0
215,782 		0
69,692 		0
79,953 		0
13,533 		0
697,575 		0
112,501
(14) JENNIE CHAHANOVICH (i)
(ii)		 0
252,150 		0
113,537 		0
32,495 		0
25,699 		0
10,389 		0
434,270 		0
3,343
(15) JOHN CULLINEY MD (i)
(ii)		 0
482,245 		0
24,708 		0
0 		0
9,800 		0
14,331 		0
531,084 		0
0
(16) JOHN HARLACHER (i)
(ii)		 109,983
0 		8,111
0 		50
0 		6,838
0 		13,220
0 		138,202
0 		0
0
(17) KATHLEEN CLARK (i)
(ii)		 0
200,072 		0
66,207 		0
27,844 		0
14,824 		0
5,860 		0
314,807 		0
0
(18) KATIE SHIGEMITSU (i)
(ii)		 0
165,166 		0
2,560 		0
0 		0
8,026 		0
9,102 		0
184,854 		0
0
(19) KEITH MIYASHIRO (i)
(ii)		 0
141,112 		0
12,803 		0
0 		0
7,415 		0
14,207 		0
175,537 		0
0
(20) KENN SARUWATARI MD (i)
(ii)		 267,425
0 		23,018
0 		5,641
0 		9,800
9,800 		14,614
14,614 		320,498
24,414 		0
0
(21) KENNETH B ROBBINS MD (i)
(ii)		 0
407,784 		0
266,032 		0
100,384 		0
115,646 		0
15,682 		0
905,528 		0
156,082
(22) KENT KIKUCHI (i)
(ii)		 0
157,507 		0
15,971 		0
0 		0
8,301 		0
13,360 		0
195,139 		0
0
(23) KEOKI CLEMENTE (i)
(ii)		 0
118,584 		0
3,425 		0
0 		0
2,162 		0
13,212 		0
137,383 		0
0
(24) LINDA LEAVITT (i)
(ii)		 137,653
0 		12,968
0 		0
0 		10,125
0 		10,125
0 		170,871
0 		0
0
(25) LOIS NASH (i)
(ii)		 0
193,511 		0
26,987 		0
0 		0
10,440 		0
9,194 		0
240,132 		0
0
(26) LYNNE JOSEPH (i)
(ii)		 0
163,114 		0
52,355 		0
33,569 		0
16,357 		0
17,996 		0
283,391 		0
0
(27) MARTHA SMITH (i)
(ii)		 0
327,273 		0
108,301 		0
62,815 		0
56,218 		0
20,109 		0
574,716 		0
33,498
(28) MAUREEN FLANNERY (i)
(ii)		 0
175,942 		0
28,532 		0
16,238 		0
652 		0
3,316 		0
224,680 		0
0
(29) MAVIS NIKAIDO (i)
(ii)		 173,266
0 		13,822
0 		344
0 		8,887
0 		9,683
0 		206,002
0 		0
0
(30) MELINDA ASHTON MD (i)
(ii)		 0
287,982 		0
79,716 		0
34,638 		0
26,050 		0
18,852 		0
447,238 		0
2,514
(31) PATRICIA BOECKMANN RN (i)
(ii)		 0
253,349 		0
69,172 		0
28,548 		0
14,658 		0
16,268 		0
381,995 		0
0
(32) PAULA DIAS (i)
(ii)		 0
189,990 		0
52,677 		0
21,073 		0
11,638 		0
11,828 		0
287,206 		0
0
(33) RAYMOND P VARA JR (i)
(ii)		 0
598,083 		0
500,563 		0
157,505 		0
149,281 		0
14,626 		0
1,420,058 		0
275,410
(34) ROBERT SCHULZ MD (i)
(ii)		 589,510
0 		14,356
0 		6,846
0 		9,800
0 		10,657
0 		631,169
0 		0
0
(35) STEVEN ROBERTSON (i)
(ii)		 0
312,546 		0
202,187 		0
108,509 		0
66,131 		0
24,444 		0
713,817 		0
110,115
(36) SUSAN MASUMOTO-NONAKA (i)
(ii)		 0
195,503 		0
56,295 		0
14,651 		0
12,565 		0
24,926 		0
303,940 		0
0
(37) THOMAS J NORDYKE MD (i)
(ii)		 262,730
0 		9,069
0 		4,513
0 		9,800
0 		15,259
0 		301,371
0 		0
0
(38) VIRGINIA PRESSLER-FISHER MD (i)
(ii)		 0
321,073 		0
215,850 		0
78,709 		0
85,044 		0
27,546 		0
728,222 		0
123,927
(39) WARREN CHAIKO (i)
(ii)		 0
209,852 		0
60,427 		0
25,761 		0
15,901 		0
14,626 		0
326,567 		0
16
(40) HINGSON M CHUN MD (i)
(ii)		 780,040
0 		63,000
0 		3,100
0 		9,800
0 		15,259
0 		871,199
0 		0
0
(41) CASS K NAKASONE MD (i)
(ii)		 760,786
0 		10,000
0 		3,100
0 		9,800
0 		11,002
0 		794,688
0 		0
0
(42) MARK S GERBER MD (i)
(ii)		 759,346
0 		4,308
0 		5,101
0 		9,800
0 		5,376
0 		783,931
0 		0
0
(43) WESLEY J KAI MD (i)
(ii)		 756,141
0 		2,000
0 		10,131
0 		9,800
0 		10,402
0 		788,474
0 		0
0
(44) J ROY CHEN MD (i)
(ii)		 611,245
0 		70,885
0 		28,228
0 		9,800
0 		15,259
0 		735,417
0 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL COMPENSATION INFORMATION   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 ORGANIZATION TO PROVIDE BENEFITS ON A TAX DERERRED BASIS. KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: MELINDA ASHTON, M.D. $2,514 WARREN CHAIKO $16 ARTHUR GLADSTONE $9,377 EARL INOUYE $2,048 GAIL LERCH $14,788 DAVID OKABE $32,476 VIRGINIA PRESSLER-FISHER, M.D. $25,459 STEVEN ROBERTSON $18,273 MARTHA SMITH $33,498 CHARLES A. STED $106,674 RAYMOND P. VARA, JR. $46,206 PALI MOMI MEDICAL CENTER AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: MELINDA ASHTON, M.D. $2,514 JENNIE CHAHANOVICH $3,343 WARREN CHAIKO $16 ANDREW DANG, M.D. $30,906 ARTHUR GLADSTONE $9,377 EARL INOUYE $2,048 GAIL LERCH $14,788 DAVID OKABE $32,476 VIRGINIA PRESSLER-FISHER, M.D. $25,459 STEVEN ROBERTSON $18,273 CHARLES A. STED $106,674 RAYMOND P. VARA, JR. $46,206 STRAUB CLINIC & HOSPITAL AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: J ROY CHEN, M.D. $25,566 MELINDA ASHTON, M.D. $2,514 WARREN CHAIKO $16 ARTHUR GLADSTONE $9,377 EARL INOUYE $2,048 GAIL LERCH $14,788 DAVID OKABE $32,476 VIRGINIA PRESSLER-FISHER, M.D. $25,459 STEVEN ROBERTSON $18,273 KENNETH B. ROBBINS, M.D. $31,025 CHARLES A. STED $106,674 RAYMOND P. VARA, JR. $46,206 WILCOX MEMORIAL HOSPITAL AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: MELINDA ASHTON, M.D. $2,514 WARREN CHAIKO $16 ARTHUR GLADSTONE $9,377 EARL INOUYE $2,048 GAIL LERCH $14,788 DAVID OKABE $32,476 VIRGINIA PRESSLER-FISHER, M.D. $25,459 STEVEN ROBERTSON $18,273 KENNETH B. ROBBINS, M.D. $31,025 CHARLES A. STED $106,674 RAYMOND P. VARA, JR. $46,206 NON-FIXED PAYMENTS TO PERSON LISTED ON PART VIII, SECTION A, LINE 1A SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS ARE MADE TO EXECUTIVES BASED ON SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. NON-FIXED PAYMENTS MADE TO PHYSICIANS ARE BASED ON CLINICAL PERFORMANCE MEASURES. 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. KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: GAIL LERCH $97,713 DAVID OKABE $125,391 VIRGINIA PRESSLER-FISHER, M.D. $98,468 STEVEN ROBERTSON $91,842 KENNETH B. ROBBINS, M.D. $125,057 RAYMOND VARA, JR. $229,204 CHARLES A. STED $341,483 CHARLES R. CHING $93,424 PALI MOMI MEDICAL CENTER AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: GAIL LERCH $97,713 DAVID OKABE $125,391 VIRGINIA PRESSLER-FISHER, M.D. $98,468 STEVEN ROBERTSON $91,842 CHARLES A. STED $341,483 RAYMOND P. VARA, JR. $229,204 CHARLES R. CHING $93,424 STRAUB CLINIC & HOSPITAL AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: GAIL LERCH $97,713 DAVID OKABE $125,391 VIRGINIA PRESSLER-FISHER, M.D. $98,468 STEVEN ROBERTSON $91,842 KENNETH B. ROBBINS, M.D. $125,057 CHARLES A. STED $341,483 RAYMOND P. VARA, JR. $229,204 CHARLES R. CHING $93,424 WILCOX MEMORIAL HOSPITAL AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: GAIL LERCH $97,713 DAVID OKABE $125,391 VIRGINIA PRESSLER-FISHER, M.D. $98,468 CHARLES R. CHING $93,424 RAYMOND P. VARA, JR. $229,204 STEVEN ROBERTSON $125,057 KENNETH B. ROBBINS, M.D. $125,391 CHARLES A. STED $341,483 CHARLES R. CHING $93,424
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) FIRST HAWAIIAN BANK SEE PART V 109,877 BANK TRANSACTION FEES   No
(2) PACIFIC RADIOPHARMACY LTD SEE PART V 350,328 PURCHASE OF MEDICAL SUPPLIES   No
(3) UNITED LAUNDRY SEE PART V 880,089 PAYMENT FOR LAUNDRY SERVICES   No
(4) PACIFIC MEDICAL COLLECTIONS SEE PART V 219,429 PAYMENT FOR MEDICAL COLLECTION   No
(5) BOSTON SCIENTIFIC CORPORATION SEE PART V 3,626,814 PURCHASE OF MEDICAL SUPPLIES   No
(6) UNITED LAUNDRY SEE PART V 1,136,391 PAYMENT FOR LAUNDRY SERVICES   No
(7) PACIFIC MEDICAL COLLECTIONS SEE PART V 117,598 PAYMENT FOR MEDICAL COLLECTION   No
(8) UNITED LAUNDRY SEE PART 777,009 PAYMENT FOR LAUNDRY SERVICES   No
(9) PACIFIC MEDICAL COLLECTIONS SEE PART V 99,467 PAYMENT FOR MEDICAL COLLECTION   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
BUSINESS TRANSACTION WITH INTERESTED PERSONS FORM 990, SCHEDULE L, PART VI, LINES 1 TO 9, COLUMN B 1) DIR. IS DIR. OF SCH - KURREN 2) DIR. IS VP/COO OF SCH - GLADSTONE 3) DIR. IS DIR. OF SCH - STED 4) DIR. IS VP/CIO OF SCH - ROBERTSON 5) DIR. IS PRGM DIR. OF SCH - CHUN 6) DIR. IS OFC/DIR. OF KMCWC - STED 7) DIR. IS OFC/ OF KMCWC - ROBERTSON 8) DIR. IS OFC/DIR. OF PMMC - STED 9) DIR/ IS OFC/DIR. OF PMMC - ROBERTSON
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( MISCELLANEOUS DONATIONS ) X 0 120,003 COST/SELLING PRICE
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Identifier Return Reference Explanation
STATEMENT OF ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES FORM 990, PART I, LINE 1 THE AFFILIATE HOSPITALS OF HAWAI'I PACIFIC HEALTH - KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB CLINIC & HOSPITAL, AND WILCOX MEMORIAL HOSPITAL - ANCHOR A NONPROFIT HEALTH CARE SYSTEM THAT IS COMMITTED TO PROVIDING THE HIGHEST QUALITY AND MOST ACCESSIBLE MEDICAL CARE AND SERVICES TO THE PEOPLE OF HAWAI'I AND THE PACIFIC REGION. STATEMENT OF ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN IS A NONPROFIT HOSPITAL WHOSE MISSION IS TO IMPROVE AND ADVOCATE FOR THE HEALTH AND WELL-BEING OF WOMEN AND CHILDREN OF HAWAI'I AND THE PACIFIC REGION. PALI MOMI MEDICAL CENTER IS A NONPROFIT HOSPITAL BASED IN WEST O'AHU AND DEDICATED TO THE HEALTH AND WELL-BEING OF ALL HAWAI'I RESIDENTS. STRAUB CLINIC & HOSPITAL IS A NONPROFIT HEALTH CARE SYSTEM WHOSE MISSION IS TO PROVIDE INTEGRATED HEALTH AND MEDICAL SERVICES THAT ARE COMPREHENSIVE, CARING, CONTINUOUSLY IMPROVING AND OF THE HIGHEST QUALITY. WILCOX MEMORIAL HOSPITAL IS A NONPROFIT HOSPITAL WHOSE MISSION IS TO SERVE THE KAUA'I COMMUNITY WITH ACCESSIBLE, QUALITY HEALTH CARE THAT SURPASSES EXPECTATIONS. STATEMENT OF PROGRAM SERVICE ACTIVITIES FORM 990, PART III, LINE 4A - 4D PROGRAM SERVICE #1 INTERNAL MEDICINE IN FISCAL YEAR 2011, THE HOSPITALS OF HAWAI'I PACIFIC HEALTH SPENT $62,137,639 IN DIRECT EXPENSES FOR INTERNAL MEDICINE, AS PART OF OUR MISSION TO PROVIDE ACCESS TO MEDICAL CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. STRAUB CLINIC & HOSPITAL'S BOARD-CERTIFIED INTERNISTS SPECIALIZE IN ADULTS AND ADOLESCENTS. THEY COORDINATE WITH OTHER MEDICAL AND SURGICAL SPECIALISTS, AS NEEDED, WHILE EMPHASIZING PREVENTION, EARLY DIAGNOSIS AND NON-SURGICAL TREATMENT OF MEDICAL CONDITIONS THROUGH A LONG-TERM PERSONAL RELATIONSHIP WITH PATIENTS. KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN'S ("KAPI'OLANI") ADULT HOSPITALIST PROGRAM PROVIDES MEDICAL SERVICES TO PATIENTS ADMITTED WHO MAY NOT HAVE A PRIMARY CARE PHYSICIAN ("PCP") OR WHOSE PCP HAS REQUESTED HOSPITALIST SERVICES. INTERNAL MEDICINE CORE PRIVILEGES INCLUDE THE ABILITY TO DIAGNOSE AND PROVIDE NONSURGICAL TREATMENT, INCLUDING CONSULTATION FOR ADOLESCENT AND ADULT PATIENTS ADMITTED OR IN NEED OF CARE TO TREAT GENERAL MEDICAL PROBLEMS. PATIENTS ADMITTED MAY ALSO RECEIVE INTERNAL MEDICINE SERVICES FROM THEIR PCP IN THE COMMUNITY WHO HAS ADMITTING PRIVILEGES AT KAPI'OLANI. ANY ADULT PATIENT WHOSE IDENTIFIED MEDICAL NEEDS CANNOT BE MET AT KAPI'OLANI IS TRANSFERRED TO STRAUB CLINIC & HOSPITAL. ALL PEDIATRIC PATIENTS WHO REQUIRE GENERAL MEDICAL SERVICES ARE PROVIDED BY THE PATIENT'S PCP WHO HAS PRIVILEGES, IN COLLABORATION WITH A PEDIATRIC SUBSPECIALIST, OR IS PLACED ON THE PEDIATRIC HOSPITALIST SERVICE AT KAPI'OLANI. PALI MOMI MEDICAL CENTER PROVIDES INTERNAL MEDICINE SERVICES TO THE WEST O'AHU COMMUNITY THROUGH ITS HOSPITALIST PROGRAM, WHICH PROVIDES MEDICAL SERVICES TO PATIENTS ADMITTED WHO MAY NOT HAVE A PRIMARY CARE PHYSICIAN ("PCP") OR WHOSE PCP HAS REQUESTED HOSPITALIST SERVICES. INTERNAL MEDICINE CORE PRIVILEGES INCLUDE THE ABILITY TO DIAGNOSE AND PROVIDE NONSURGICAL TREATMENT, INCLUDING CONSULTATION FOR PATIENTS ADMITTED OR IN NEED OF CARE TO TREAT GENERAL MEDICAL PROBLEMS. PATIENTS ADMITTED MAY ALSO RECEIVE INTERNAL MEDICINE SERVICES FROM THEIR PCP IN THE COMMUNITY WHO HAS ADMITTING PRIVILEGES AT PALI MOMI MEDICAL CENTER. WILCOX MEMORIAL HOSPITAL, THROUGH KAUA'I MEDICAL CLINIC AND COMMUNITY PHYSICIANS WITH ADMITTING PRIVILEGES, PROVIDES INTERNAL MEDICAL AND SURGICAL SERVICES TO KAUA'I'S COMMUNITY AND VISITORS. THE HOSPITAL RECENTLY WAS DESIGNATED A TRAUMA III CENTER BY THE STATE DEPARTMENT OF HEALTH. WILCOX MEMORIAL HOSPITAL HAS A HOSPITALIST PROGRAM THAT PROVIDES INTERNAL MEDICAL CARE IN THE HOSPITAL AND COORDINATES CARE WITH THE PATIENT'S PRIMARY CARE PHYSICIAN, THROUGH ITS "EPIC" ELECTRONIC MEDICAL RECORD SYSTEM, ADDED IN FISCAL YEAR 2011. PROGRAM SERVICE #2 WOMEN'S SERVICES - OB/GYN IN FISCAL YEAR 2011, THE HOSPITALS OF HAWAI'I PACIFIC HEALTH SPENT $38,912,630 IN DIRECT EXPENSES FOR WOMEN'S OB/GYN SERVICES, AS PART OF OUR MISSION TO PROVIDE ACCESS TO MEDICAL CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN IS THE ONLY HOSPITAL IN HAWAI'I SPECIALIZING IN MATERNITY CARE. IT IS THE REGIONAL PERINATAL CENTER FOR THE STATE. IN FISCAL YEAR 2011, THE HOSPITAL DELIVERED 6,066 BABIES, REPRESENTING ALMOST 50% OF ALL O'AHU BIRTHS. FOR WOMEN IN HIGH-RISK PREGNANCIES, A DEDICATED TEAM OF MATERNAL FETAL MEDICINE SPECIALISTS ARE AVAILABLE TO ASSIST IN MANAGING HIGH-RISK PREGNANCIES AND DELIVERIES. WHEN NECESSARY, EXPECTANT MOTHERS CAN BE ADMITTED IN ORDER TO MANAGE COMPLICATIONS AND TO HELP PREVENT PRE-TERM BIRTH. KAPI'OLANI MEDICAL CETNER FOR WOMEN & CHILDREN IS A MAJOR TEACHING HOSPITAL FOR THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE'S OB/GYN RESIDENCY TRAINING PROGRAM. PALI MOMI MEDICAL CENTER PERFORMS GYNECOLOGY SERVICES FOR THE WEST O'AHU COMMUNITY, INCLUDING HYSTERECTOMIES, OB/GYN ULTRASOUND PROCEDURES IN THE IMAGING DEPARTMENT, UROLOGY, BARIATRICS, AND INFUSION CHEMOTHERAPY. IT WILL SOON OPEN A DEDICATED WOMEN'S CENTER TO BETTER MEET THE HEALTH CARE NEEDS OF WEST O'AHU'S GROWING COMMUNITY. STRAUB CLINIC & HOSPITAL ("STRAUB") PROVIDES MAMMOGRAPHY SERVICES AT ITS MAIN CAMPUS AND SATELLITE CLINICS; ALL CLINICS HAVE UPGRADED TO DIGITAL MAMMOGRAPHY. THE STRAUB WOMEN'S CLINIC AT WATERFRONT PLAZA IS DEDICATED TO PROVIDING THE HIGHEST-QUALITY WOMEN'S CARE IN A BEAUTIFUL AND HEALING ENVIRONMENT. MANY OF STRAUB'S PRIMARY CARE PHYSICIANS SPECIALIZE IN WOMEN'S HEALTH AND PROVIDE PERSONAL, COMPREHENSIVE AND CONTINUING CARE. STRAUB'S BOARD-CERTIFIED OB/GYN PHYSICIANS PROVIDE GENERAL OBSTETRIC AND GYNECOLOGICAL CARE, INCLUDING FAMILY PLANNING SERVICES, LASER SURGERY, LAPAROSCOPY AND COLPOSCOPY, MENOPAUSE, HORMONE REPLACEMENT THERAPY, AND INFERTILITY TREATMENTS. THE WOMEN'S CENTER AT WILCOX MEMORIAL HOSPITAL PROVIDES DIAGNOSIS, TREATMENT, AND PREVENTIVE HEALTH SERVICES TO KAUAI'S WOMEN, INCLUDING MAMMOGRAPHY AND BONE DENSITY SCREENING. THROUGH KAUA'I MEDICAL CLINIC AND COMMUNITY PHYSICIANS WITH ADMITTING PRIVILEGES, WILCOX MEMORIAL HOSPITAL ALSO PROVIDES COMPREHENSIVE OB/GYN CARE, SUCH AS DELIVERING BABIES, SURGICAL PROCEDURES, AND OTHER WOMEN'S MEDICAL SERVICES. PROGRAM SERVICE #3 OUTPATIENT OPERATING ROOM IN FISCAL YEAR 2011, THE HOSPITALS OF HAWAI'I PACIFIC HEALTH SPENT $35,976,498 IN DIRECT EXPENSES FOR OUTPATIENT OPERATING ROOMS, AS PART OF OUR MISSION TO PROVIDE ACCESS TO MEDICAL CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN IS HOME TO HAWAII'S FIRST FULLY INTEGRATED, MINIMALLY INVASIVE SURGICAL SUITES. PEDIATRIC PROCEDURES INCLUDE THORACIC/HEART, CLEFT LIP/PALATE, EAR NOSE THROAT, ORTHOPEDIC, NEUROLOGIC, UROLOGIC, OPHTHALMOLOGIC, GASTRO-INTESTINAL, PLASTICS AND GENERAL SURGERY. WOMEN'S PROCEDURES INCLUDE BREAST BIOPSIES AND LUMPECTOMIES, HYSTEROSCOPIES, INTERSTIM BLADDER IMPLANT AND SUBURETHRAL SLING TO TREAT INCONTINENCE, TUBAL LIGATION AND ENDOMETRIAL ABLATION. IN FISCAL YEAR 2011, KAPI'OLANI PERFORMED 6,147 OUTPATIENT SURGICAL PROCEDURES. PALI MOMI MEDICAL CENTER HAS A FULLY INTEGRATED, MINIMALLY INVASIVE SURGICAL SUITE EQUIPPED WITH TELEMEDICINE CAPABILITY, TOUCHSCREEN CONTROL PANELS AT THE NURSES' STATION, A SOPHISTICATED VOICE ACTIVATION SYSTEM, AND LIVE VIDEO FEED TO OTHER MEDICAL CENTERS AROUND THE WORLD TO ENHANCE PATIENT CARE. IN FISCAL YEAR 2011, PALI MOMI PERFORMED 5,984 OUTPATIENT SURGICAL PROCEDURES. WILCOX MEMORIAL HOSPITAL HAS A STATE-OF-THE-ART SURGICAL CENTER WITH SIX SURGICAL SUITES, 20 SAME-DAY SURGERY BEDS, VOICE-ACTIVATED ROBOTICS AND COMPUTER-ASSISTED TECHNOLOGY. IN FISCAL YEAR 2011, WILCOX PERFORMED 6,083 OUTPATIENT SURGICAL PROCEDURES. STRAUB CLINIC & HOSPITAL HAS INTEGRATED OUTPATIENT SURGERY CAPABILITIES, WHICH TAKE PLACE WITHIN A 7-ROOM SURGICAL SUITE, TWO-ROOM PLASTIC SURGERY SUITE, AND TWO DEDICATED ROOMS IN THE GENERAL SURGERY DEPARTMENT. OUTPATIENT PROCEDURES ALSO TAKE PLACE IN A TWO-ROOM INTERVENTIONAL CARDIAC CATHETERIZATION LABORATORY, INTERVENTIONAL RADIOLOGY SUITES, AND ENDOSCOPY DEPARTMENT. PROCEDURES RANGE FROM MINOR EXCISIONS THROUGH COMPLEX PERIPHERAL INTRAVASCULAR TECHNIQUES. IN FISCAL YEAR 2011, STRAUB PERFORMED 2,791 OUTPATIENT SURGICAL PROCEDURES.
OTHER PROGRAM SERVICES   KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN ("KAPI'OLANI") IS HAWAII'S ONLY MATERNITY, NEWBORN AND PEDIATRIC SPECIALTY HOSPITAL. IT IS ALSO A TERTIARY CARE HOSPITAL AND TEACHING AND RESEARCH FACILITY. IT HAS 207 BEDS AND 66 BASSINETS, EMPLOYS 1,432 EMPLOYEES AND HAS MORE THAN 600 PHYSICIANS ON ITS MEDICAL STAFF. ALMOST 500 VOLUNTEERS DONATE THEIR TIME HERE. DURING FISCAL YEAR 2011, IT ADMITTED 18,013 PATIENTS FOR A TOTAL OF 68,653 PATIENT DAYS. THERE WERE 37,004 EMERGENCY ROOM AND URGENT CARE VISITS, AND 7,948 SURGERY CASES. ALMOST 50% PERCENT OF ALL OAHU BIRTHS WERE DELIVERED HERE (6,066). CHILDREN'S SERVICES: KAPI'OLANI HAS MORE THAN 100 SUBSPECIALTY PEDIATRIC PHYSICIANS IN MULTIPLE SPECIALTY AREAS. IT MAINTAINS THE STATE'S ONLY 24-HOUR PEDIATRIC EMERGENCY ROOM, NEONATAL AND PEDIATRIC INTENSIVE CARE UNITS, NEONATAL/PEDIATRIC EMERGENCY TRANSPORT TEAM, AND STATE-DESIGNATED REGIONAL PERINATAL CENTER. WOMEN'S SPECIALTY CARE: KAPI'OLANI OPERATES THE STATE'S FIRST WOMEN'S CENTER, COMPREHENSIVE BREAST CENTER, AND WOMEN'S CANCER CENTER. THE BREAST CENTER IS ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY AS A CENTER OF EXCELLENCE. FOR WOMEN IN LABOR, THERE ARE 26 LABOR AND DELIVERY ROOMS, 3 OPERATING ROOMS FOR CAESAREAN-SECTIONS, 24-HOUR IN-HOUSE OBSTETRICAL ANESTHESIA SERVICES, ANTEPARTUM CARE, HIGH-RISK OBSTETRICAL SERVICES, AND A FETAL DIAGNOSTIC CENTER. RESIDENCY PROGRAMS: KAPI'OLANI IS THE OFFICIAL PEDIATRIC AND OBSTETRIC TEACHING HOSPITAL FOR THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE. IN FISCAL YEAR 2011, IT INVESTED $8,800,000 INTO RESEARCH AND TEACHING THE STATE'S NEXT GENERATION OF PEDIATRICIANS AND OBSTETRICIANS. COMMUNITY: KAPI'OLANI SUPPORTS THE SUSAN G. KOMEN BREAST CANCER FOUNDATION, MARCH OF DIMES, AND HAWAI'I CHILDREN'S CANCER FOUNDATION. THE KAPI'OLANI CHILDREN'S MIRACLE NETWORK SUPPORTS THE COST OF PEDIATRIC CARE, EQUIPMENT, NEIGHBOR ISLAND TRAVEL, RESEARCH AND PUBLIC AWARENESS. THE HOSPITAL RUNS THE SEX ABUSE TREATMENT CENTER TO REDUCE SEXUAL VIOLENCE AND THE KAPI'OLANI CHILD PROTECTION CENTER TO RECOGNIZE AND TREAT CHILD ABUSE AND NEGLECT. KAPI'OLANI TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. IN FISCAL YEAR 2011, IT PROVIDED $30,000,000 WORTH OF CARE TO PATIENTS WHO WERE UNINSURED OR UNABLE TO PAY FOR THEIR CARE, AND OTHER COMMUNITY BENEFITS. PALI MOMI MEDICAL CENTER ("PALI MOMI") IS A COMMUNITY-BASED ACUTE CARE HOSPITAL THAT OFFERS A FULL RANGE OF SERVICES IN CARDIOLOGY, ORTHOPEDICS, EMERGENCY MEDICINE, GENERAL SURGERY, OPHTHALMOLOGY, WOMEN'S SERVICES AND ONCOLOGY. IT HAS 116 ACUTE CARE BEDS AND EMPLOYS 951 EMPLOYEES; 370 PHYSICIANS ARE ON THE PALI MOMI'S MEDICAL STAFF. MORE THAN 80 PEOPLE VOLUNTEER HERE. DURING FISCAL YEAR 2011, IT ADMITTED 6,316 PATIENTS FOR A TOTAL OF 39,512 PATIENT DAYS. EMERGENCY VISITS WERE 44,916, WITH 7,663 SURGERIES AND 108,427 OUTPATIENT ENCOUNTERS (NOT EMERGENCIES OR SURGERIES). SPECIALTY UNITS: PALI MOMI HAS WEST OAHU'S ONLY CARDIAC CATHETERIZATION UNIT TO DETECT 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. FOR THE FIFTH YEAR IN A ROW, PALI MOMI RECEIVED A GOLD MEDAL FROM THE AMERICAN HEART ASSOCIATION'S GET WITH THE GUIDELINES PROGRAM. COMMUNITY: IN FISCAL YEAR 2011, THE HOSPITAL HOSTED A VARIETY OF FREE EVENTS TO RAISE PUBLIC AWARENESS OF CURRENT HEALTH CARE AND WELLNESS ISSUES - FROM ITS FAMILY AND SENIOR HEALTH FAIRS TO MULTIPLE SUPPORT GROUPS. IT ALSO OFFERED FREE GLUCOSE MONITORING AND BLOOD PRESSURE SCREENING TWICE A MONTH. PALI MOMI TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. IN FISCAL YEAR 2011, IT PROVIDED $2,500,000 WORTH OF CARE TO INDIVIDUALS WHO WERE UNINSURED OR UNABLE TO PAY FOR THEIR CARE, AS WELL AS IN OTHER COMMUNITY BENEFITS. STRAUB CLINIC & HOSPITAL ("STRAUB") IS AN INTEGRATED HEALTH CARE SYSTEM WITH A MAIN HOSPITAL, NEIGHBORHOOD CLINICS AND VISITING SPECIALIST PROGRAMS THROUGHOUT HAWAI'I. IT HAS 159 BEDS AND EMPLOYS 1,580 STAFF AND 200 EMPLOYED OR CONTRACTED PHYSICIANS. MORE THAN 80 PEOPLE VOLUNTEER HERE. DURING FISCAL 2011, STRAUB ADMITTED 6,793 PATIENTS FOR A TOTAL OF 38,216 PATIENT DAYS. THE EMERGENCY ROOM TREATED 24,801 PATIENTS, WITH 5,036 SURGERY CASES AND 760,875 CLINIC ENCOUNTERS. SPECIALTY SERVICES: STRAUB PROVIDES EXPERTISE IN MORE THAN 32 SPECIALTIES, INCLUDING BONE & JOINT, HEART, CANCER, GASTROENTEROLOGY, INTERNAL MEDICINE, ENDOCRINOLOGY/DIABETES, GERIATRICS, VASCULAR, UROLOGY, ALLERGY, PATHOLOGY, ANESTHESIOLOGY, DERMATOLOGY, NEUROLOGY, NUCLEAR MEDICINE, OPHTHALMOLOGY, OBSTETRICS/GYNECOLOGY, OCCUPATIONAL HEALTH, OTOLARYNGOLOGY, PLASTIC SURGERY, PSYCHIATRY, RADIOLOGY, SPORTS MEDICINE AND RHEUMATOLOGY. SPECIALTY UNITS: STRAUB BROUGHT MINIMALLY INVASIVE OPEN-HEART SURGERY AND TOTAL JOINT REPLACEMENT TO HAWAI'I. THE BURN UNIT IS THE ONLY MULTI-DISCIPLINARY BURN CENTER IN THE PACIFIC. THE HEART CENTER RECEIVED THE HIGHEST DESIGNATION FROM THE NATIONAL SOCIETY FOR THORACIC SURGEONS. THE BONE AND JOINT CENTER OFFERS MINIMALLY INVASIVE HIP AND JOINT REPLACEMENT. COMMUNITY: STRAUB PROVIDES CHARITY CARE, HEALTH EDUCATION AND PREVENTATIVE PROGRAMS TO THE COMMUNITY. IN FISCAL 2011, IT DELIVERED FREE PUBLIC HEALTH EDUCATION PROGRAMS ON HEART ATTACKS, CANCER, ARTHRITIS, ASTHMA, ALLERGIES, STRESS, OSTEOPOROSIS, OBESITY AND DRUG ABUSE. STRAUB TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. IN FISCAL 2011, IT PROVIDED $13,500,000 WORTH OF CARE TO PATIENTS WHO WERE UNINSURED OR UNABLE TO PAY FOR THEIR CARE, AS WELL AS IN OTHER COMMUNITY BENEFITS. WILCOX MEMORIAL HOSPITAL ("WILCOX") IS AN ACUTE CARE HOSPITAL WITH A FULL SUITE OF SERVICES FROM EMERGENCY, OB/GYN AND PEDIATRICS TO CARDIOLOGY, GASTROENTEROLOGY, OPHTHALMOLOGY, PULMONOLOGY, NEPHROLOGY, COSMETIC SURGERY, INTERNAL MEDICINE, FAMILY PRACTICE, AND WOMEN'S SERVICES. IT HAS 71 BEDS, INCLUDING SEVEN INTENSIVE CARE BEDS, 10 BASSINETS, FIVE BIRTHING SUITES AND A 20-BED EMERGENCY DEPARTMENT. IT HAS A MEDICAL STAFF OF 169 PHYSICIANS. DURING FISCAL YEAR 2011, THE HOSPITAL ADMITTED 3,624 ACUTE CARE PATIENTS FOR A TOTAL OF 16,903 PATIENT DAYS, WITH 23,974 EMERGENCY ROOM VISITS. IT CONDUCTED 1,129 INPATIENT SURGERIES, 6,083 OUTPATIENT SURGERIES, AND 3,473 INFUSION SERVICES. SPECIALTY UNITS: WILCOX IS THE ONLY HOSPITAL IN HAWAI'I TO RECEIVE THREE QUALITY PERFORMANCE AWARDS IN ONE YEAR FROM THE AMERICAN HEART ASSOCIATION'S GET WITH THE GUIDELINES PROGRAM. THE FAMILY IMAGING CENTER PROVIDES MRI, CT, NUCLEAR MEDICINE, ULTRASOUND, TELEMEDICINE, MAMMOGRAPHY, AND BONE DENSITOMETRY. THE SURGICAL CENTER HAS SIX SUITES AND 20 SAME-DAY BEDS. COMMUNITY: WILCOX IS COMMITTED TO HEALTH EDUCATION, PREVENTION AND SUPPORT. IN FISCAL YEAR 2011, IT SUPPORTED THE ARTHRITIS WALK, PARADE OF LIGHTS, AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, KAUA'I FOODBANK, KAUA'I LIFEGUARD ASSOCIATION, TOYS FOR TOTS, ALOHA UNITED WAY WALK-A-THON, AND ALZHEIMER'S MEMORY WALK. WILCOX TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS THE COMMUNITY'S SAFETY NET PROVIDER OF HEALTH CARE. IN FISCAL 2011, IT PROVIDED $3,900,000 WORTH OF CARE TO PATIENTS WHO WERE UNINSURED OR UNABLE TO PAY FOR THEIR CARE, AS WELL AS IN OTHER COMMUNITY BENEFITS. TAX EXEMPT BONDS FORM 990, PART IV, LINE 24A KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB CLINIC & HOSPITAL AND WILCOX MEMORIAL HOSPITAL ARE MEMBERS OF THE HAWAI'I PACIFIC HEALTH OBLIGATED GROUP, WHICH HAS ISSUED VARIOUS BOND ISSUES THAT ARE REPORTED ON THE HAWAI'I PACIFIC HEALTH FORM 990.
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 PERSONS 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. DESCRIPTION OF CLASSES OR PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7B HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS THE FOLLOWING RESERVED POWERS WITH RESPECT TO KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN AND PALI MOMI MEDICAL CENTER: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE EXECUTIVE VICE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS; AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THE BYLAWS; (IV) DETERMINE AND EFFECT THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR FOR ONE MILLION DOLLARS ($1,000,000) OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (VII) DETERMINE AND EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (X) CLOSE THE ACUTE CARE HOSPITAL OWNED AND OPERATED BY THE CORPORATION; (XI) AFTER CONSULTING WITH THE BOARD, REMOVE THE EXECUTIVE VICE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER, TREASURER, SECRETARY, OTHER EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, ASSISTANT SECRETARIES, AND/OR ALL VICE PRESIDENTS EXCEPT THE OPERATING UNIT VICE PRESIDENTS; (XII) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION; AND (XIII) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS.
DESCRIPTION OF CLASSES OR PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS (CONTINUATION) HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS THE FOLLOWING POWERS RESERVED TO APPROVE THE FOLLOWING WITH RESPECT TO STRAUB CLINIC & HOSPITAL: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, EXECUTIVE VICE PRESIDENTS OTHER THAN THE EXECUTIVE VICE-PRESIDENT/CHIEF EXECUTIVE OFFICER (THE "EVP/CEO") AND THE; EXECUTIVE VICE-PRESIDENT/CHIEF MEDICAL OFFICER (THE "EVP/CMO") OF THE CORPORATION, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE CLINIC AND HOSPITAL UNIT VICE-PRESIDENTS, AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) REMOVE ANY DIRECTOR FROM THE BOARD; PROVIDED, HOWEVER, THAT THE BOARD MAY REMOVE ANY DIRECTOR FROM THE BOARD IF APPROVED BY THE MEMBER BOARD; (III) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (IV) AMEND THE BYLAWS; (V) THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR FOR ONE MILLION DOLLARS ($1,000,000) OR MORE; (VI) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000); (VII) ACQUIRE SHARES IN ANOTHER CORPORATION; (VIII) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (IX) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (X) DETERMINE AND EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (XI) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (XII) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (XIII) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONSHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; (XIV) CLOSE THE ACUTE CARE HOSPITAL OR CLINIC FACILITIES OWNED AND OPERATED BY THE CORPORATION; (XV) RELOCATE THE ACUTE CARE HOSPITAL OR CLINIC FACILITIES OWNED AND OPERATED BY THE CORPORATION; (XVI) CONVERT THE ACUTE CARE HOSPITAL OWNED AND OPERATED BY THE CORPORATION INTO A NON-ACUTE CARE FACILITY; (XVII) AFTER CONSULTING WITH THE BOARD, REMOVE THE TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, EXECUTIVE VICE-PRESIDENTS OTHER THAN THE EVP/CEO AND THE EVP/CMO, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND/OR ALL VICE-PRESIDENTS EXCEPT THE CLINIC AND HOSPITAL UNIT VICE-PRESIDENTS; AND (XVIII) DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION. THE FOLLOWING ACTIONS REQUIRE APPROVAL FROM THE MEMBER BOARD: (I) ADD ANY DIRECTOR TO THE BOARD; (II) AMEND THE ARTICLES OF INCORPORATION; (III) SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE AMOUNT OF PROPERTY OR ASSETS HELD BY THE ORGANIZATION, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, TO ANY ENTITY THAT IS NOT AN AFFILIATE, EXCEPT THAT IF THE GFS HEALTH PHYSICIAN ADVISORY GROUP (THE "PAG") ELECTS TO INITIATE A SEPARATION ACTION PURSUANT TO ARTICLE XIII OF THE AFFILIATION AGREEMENT BY AND AMONG THE MEMBER, THE ORGANIZATION, AND STRAUB CLINIC AND HOSPITAL, INC., DATED AS OF DECEMBER 23, 2001, THE ORGANIZATION SHALL BE ALLOWED, BY A MAJORITY VOTE OF A QUORUM OF THE BOARD, TO SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE AMOUNT OF THE PROPERTY OR ASSETS HELD BY THE ORGANIZATION, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, AND SHALL NOT BE REQUIRED TO RECEIVE DIRECTION OR APPROVAL TO DO SO FROM THE MEMBER; (IV) IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS; (V) IMPLEMENT INDIVIDUAL PHYSICIAN COMPENSATION ARRANGEMENTS FOR EACH PHYSICIAN OPERATING UNIT IN THE ORGANIZATION; (VI) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE ORGANIZATION WHICH REQUIRE ANNUAL PAYMENTS ON BEHALF OF THE ORGANIZATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VII) ISSUE THE ORGANIZATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (VIII) MERGE THE ORGANIZATION WITH ANY ENTITY; (IX) DISSOLVE THE ORGANIZATION; AND (X) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE. HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS RESERVED POWERS TO APPROVE THE FOLLOWING WITH RESPECT TO WILCOX MEMORIAL HOSPITAL: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS, AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THE BYLAWS; (IV) THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR FOR ONE MILLION DOLLAR ($1,000,000) OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (VII) EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, OR PARTNERSHIP OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (X) EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAW OF THE STATE OF HAWAI`I, SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY WILCOX MEMORIAL HOSPITAL, KAUA'I MEDICAL CLINIC AND WILCOX HEALTH FOUNDATION (THE "WILCOX AFFILIATES"); (XI) EXCEPT AS PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAI`I, SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (XII) CLOSE THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORPORATION; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (XIII) CONVERT THE CLINIC OWNED AND OPERATED BY THE CORPORATION INTO A FACILITY NO LONGER OFFERING MEDICAL SERVICES; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (XIV) AFTER CONSULTING WITH THE BOARD, REMOVE THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, TREASURER, SECRETARY, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS; PROVIDED, HOWEVER, THAT TO REMOVE OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER WILL REQUIRE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE MEMBER TO FULLY COLLABORATE AND CONSULT WITH THE BOARD AND SEEK THE BOARD'S ADVANCE CONSENT FOR SUCH REMOVAL OR TERMINATION. IF THE BOARD DOES NOT CONCUR WITH THE PROPOSED REMOVAL OR TERMINATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SUCH REMOVAL OR TERMINATION WILL REQUIRE THE APPROVAL OF A MAJORITY OF THE MEMBERS ON THE MEMBER BOARD; (XV) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG RANGE AND STRATEGIC PLANS OF THE CORPORATION; AND (XVI) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS.
DESCRIPTION OF CLASSES OR PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF APPROVAL (CONTINUATION) THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER BOARD APPROVAL: (I) ADD ANY DIRECTOR TO THE BOARD; (II) REMOVE ANY DIRECTOR FROM THE BOARD; (III) AMEND THE ARTICLES; (IV) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (V) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000); (VI) ACQUIRE SHARES IN ANOTHER CORPORATION; (VII) SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE WILCOX AFFILIATES; (VIII) SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (IX) SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (X) MERGE THE CORPORATION WITH ANY ENTITY; (XI) DISSOLVE OR LIQUIDATE THE CORPORATION; (XII) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (XIII) 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 (XIV) 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 THE OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPILED 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 HPH BOARD OF DIRECTORS THROUGH A BOARD MEMBER PORTAL FOR REVIEW PRIOR TO THE FILING OF THE 990. COPIES OF THE 990S ARE MADE AVAILABLE TO THE BOARD MEMBERS OF EACH SUBSIDIARY UNIT OF HPH AND ARE PHYSICALLY LOCATED AT EACH FACILITY'S SITE FOR THE BOARD MEMBER TO REVIEW PRIOR TO FILING. THE 990S WILL BE POSTED TO HPH'S WEB SITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURNS WITH THE IRS. ADOPTION OF POLICIES FORM 990, PART VI, LINES 12A, 13, 14 & 16B THE POLICIES IDENTIFIED IN PART VI WERE FORMALLY ADOPTED BY THE BOARD OF HAWAI'I PACIFIC HEALTH ("HPH"), THE SOLE MEMBER OF THE ORGANIZATION. AS THE SOLE MEMBER, THE POLICIES ADOPTED BY HPH MUST BE FOLLOWED BY ALL HPH ORGANIZATIONS. THE POLICIES ARE CURRENTLY BEING ADOPTED BY THE ORGANIZATION'S BOARD. - LINE 12A - WRITTEN CONFLICT OF INTEREST POLICY WAS FORMALLY ADOPTED 12/3/07 BY HPH - LINE 13 - WRITTEN WHISTLEBLOWER POLICY WAS FORMALLY ADOPTED ON 5/26/11 BY HPH - LINE 14 - WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY WAS FORMALLY ADOPTED 5/26/11 BY HPH - LINE 16B - WRITTEN POLICY REGARDING PARTICIPATION IN JOINT VENTURE ARRANGEMENTS WAS FORMALLY ADOPTED ON 5/26/11 BY HPH
MONITORING & ENFORCING 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. OFFICES AND POSITIONS FOR WHICH PROCESS WAS USED, AND YEAR PROCESS WAS LAST COMPLETED FORM 990, PART VI, LINES 15A & 15B 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. THE PROCESS WAS LAST COMPLETED ON MARCH 1, 2011 TO REVIEW PHYSICIAN COMPENSATION, AND ON JULY 12, 2011 AND AUGUST 9, 2011 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 STANDARD 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.
GROUP RETURN LISTING FORM 990, PART VII CHARLES STED SERVES ON THE BOARD FOR THE FOLLOWING ENTITIES: STRAUB CLINIC & HOSPITAL - DIRECTOR PALI MOMI MEDICAL CENTER - DIRECTOR & OFFICER KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN - DIRECTOR & OFFICER WILCOX MEMORIAL HOSPTIAL - DIRECTOR RAYMOND VARA SERVES ON THE BOARD FOR THE FOLLOWING ENTITIES: STRAUB CLINIC & HOSPITAL - DIRECTOR & OFFICER PALI MOMI MEDICAL CENTER - DIRECTOR & OFFICER KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN - DIRECTOR & OFFICER THE FOLLOWING PEOPLE SERVE AS OFFICERS FOR STRAUB CLINIC & HOSPITAL, PALI MOMI MEDICAL CENTER, KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN AND WILCOX MEMORIAL HOSPTIAL: ARTHUR GLADSTONE CHARLES CHING DAVID OKABE DAVID FOX EARL INOUYE GAIL LERCH JESSICA LEWIS KATIE SHIGEMITSU KEKA SANBORN MELINDA ASHTON PAULA DIAS STEVEN ROBERTSON SUSAN MASUMOTO-NONAKA VIRGINIA PRESSLER-FISHER WARREN CHAIKO
RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 88,749 ALTERNATIVE INVESTMENT GAINS (MARK TO MARKET) 10,495,496 OBLIGATED GROUP INTERCOMPANY TRANSFERS (46,927,985) EQUITY TRANSFERS 669,388 CHANGE IN NET UNREALIZED GAINS ON INVESTMENTS 5,674,782 CHANGE IN INTEREST IN KHF/WHF 2,094,028 CHANGE IN INTEREST IN PERPETUAL TRUSTS 394,761 WRITE OFF GOODWILL (10,573,719) OTHER CHANGES 25,572 -------------- (38,058,928) HOURS DEVOTED TO RELATED ORGANIZATION FORM 990, PART VII, COLUMN B INDIVIDUALS LISTED ON PART VII ALSO DEVOTE TIME TO THE RELATED ORGANIZATIONS AS LISTED BELOW: WILCOX HEALTH FOUNDATION CHARLES STED 1.0 CHARLES CHING 0.5 DAVID FOX 0.4 DAVID OKABE 0.5 EARL INOUYE 0.5 GERI YOUNG 1.0 JESSICA LEWIS 0.5 KATHLEEN CLARK 1.0 LYNNE JOHNSON-JOSEPH 1.0 VIRGINIA PRESSLER-FISHER 1.0 KAPI'OLANI HEALTH FOUNDATION CHARLES STED 3.0 CHARLES CHING 0.5 DAVID FOX 0.4 DAVID OKABE 1.0 EARL INOUYE 0.5 JESSICA LEWIS 0.1 VIRGINIA PRESSLER-FISHER 1.0 STRAUB FOUNDATION B. JEANNIE HEDBERG 0.1 CHARLES STED 1.0 CHARLES CHING 0.5 DAVID FOX 0.4 DAVID OKABE 0.5 EARL INOUYE 0.1 JESSICA LEWIS 0.5 KENNETH ROBBINS 0.1 MICHAEL GIBSON 0.1 PATRICIA BOECKMANN 1.0 RAYMOND VARA 0.1 VIRGINIA PRESSLER-FISHER 1.0 HAWAI'I PACIFIC HEALTH ANN PETERS 45.0 ARTHUR GLADSTONE 5.0 CHARLES STED 32.0 CHARLES CHING 30.0 DALE GLENN 0.3 DAVID FOX 2.4 DAVID OKABE 35.0 DELIA KNUDSEN 16.0 EARL INOUYE 25.0 FAYE KURREN 0.3 GAIL LERCH 40.0 GERI YOUNG 0.3 HUGH HAZENFIELD 0.8 JENNIE CHAHANOVICH 0.5 JESSICA LEWIS 0.5 KEKA SANBORN 50.0 KENN SARUWATARI 0.4 KENNETH ROBBINS 10.0 LYLE TABATA 0.3 LYNNE JOHNSON-JOSEPH 1.0 MARTHA SMITH 0.5 MELINDA ASHTON 40.0 PATRICIA BOECKMANN 1.0 PAULA DIAS 20.0 RAYMOND VARA 5.0 ROBERT SCHULZ 0.8 STEVEN ROBERTSON 15.0 SUSAN MASUMOTO-NONAKA 20.0 VIRGINIA PRESSLER-FISHER 45.0 WARREN CHAIKO 15.0 KAUA'I MEDICAL CLINIC DAVID FOX 4.8 DAVID OKABE 1.0 EARL INOUYE 4.0 GAIL LERCH 0.1 GERI YOUNG 38.5 JESSICA LEWIS 2.5 JOHN CULLINEY 40.0 KATIE SHIGEMITSU 2.4 KEKA SANBORN 0.5 KENNETH ROBBINS 10.0 LYNNE JOHNSON-JOSEPH 5.0 MELINDA ASHTON 1.0 PAUAL DIAS 0.5 RAYMOND VARA 5.0 STEVEN ROBERTSON 1.0 SUSAN MASUMOTO-NONAKA 1.0 THERESA RAMEY 32.0 VIRGINIA PRESSLER-FISHER 0.1 WARREN CHAIKO 1.0 KAPI'OLANI MEDICAL SPECIALISTS ANN PETERS 0.2 CHARLES STED 1.0 CHARLES CHING 3.0 DAVID FOX 0.4 DAVID OKABE 1.0 DAWN CHING 1.0 EARL INOUYE 2.0 GAIL LERCH 1.0 JESSICA LEWIS 1.3 JOHN CULLINEY 0.8 KEITH MATSUMOTO 0.2 KEKA SANBORN 0.2 KENNETH ROBBINS 0.2 MARTHA SMITH 5.0 MELINDA ASHTON 1.0 STEVEN ROBERTSON 1.0 SUSAN MASUMOTO-NONAKA 0.2 VIRGINIA PRESSLER-FISHER 0.2 WARREN CHAIKO 1.0 PROVIDERS INSURANCE CORPORATION CHARLES STED 1.0 CHARLES CHING 2.0 DAVID FOX 0.4 DAVID OKABE 1.0 EARL INOUYE 0.5 MELINDA ASHTON 0.1 MICHAEL GIBSON 0.1 RAYMOND VARA 5.0 MICHAEL GIBSON 0.1 RAYMOND VARA 5.0
HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, COLUMN B INDIVIDUALS LISTED ON PART VII ALSO DEVOTE TIME TO THE RELATED ORGANIZATIONS AS LISTED BELOW: WILCOX HEALTH FOUNDATION CHARLES STED 1.0 CHARLES CHING 0.5 DAVID FOX 0.4 DAVID OKABE 0.5 EARL INOUYE 0.5 GERI YOUNG 1.0 JESSICA LEWIS 0.5 KATHLEEN CLARK 1.0 LYNNE JOHNSON-JOSEPH 1.0 VIRGINIA PRESSLER-FISHER 1.0 KAPI'OLANI HEALTH FOUNDATION CHARLES STED 3.0 CHARLES CHING 0.5 DAVID FOX 0.4 DAVID OKABE 1.0 EARL INOUYE 0.5 JESSICA LEWIS 0.1 VIRGINIA PRESSLER-FISHER 1.0 STRAUB FOUNDATION B. JEANNIE HEDBERG 0.1 CHARLES STED 1.0 CHARLES CHING 0.5 DAVID FOX 0.4 DAVID OKABE 0.5 EARL INOUYE 0.1 JESSICA LEWIS 0.5 KENNETH ROBBINS 0.1 MICHAEL GIBSON 0.1 PATRICIA BOECKMANN 1.0 RAYMOND VARA 0.1 VIRGINIA PRESSLER-FISHER 1.0 HAWAI'I PACIFIC HEALTH ANN PETERS 45.0 ARTHUR GLADSTONE 5.0 CHARLES STED 32.0 CHARLES CHING 30.0 DALE GLENN 0.3 DAVID FOX 2.4 DAVID OKABE 35.0 DELIA KNUDSEN 16.0 EARL INOUYE 25.0 FAYE KURREN 0.3 GAIL LERCH 40.0 GERI YOUNG 0.3 HUGH HAZENFIELD 0.8 JENNIE CHAHANOVICH 0.5 JESSICA LEWIS 0.5 KEKA SANBORN 50.0 KENN SARUWATARI 0.4 KENNETH ROBBINS 10.0 LYLE TABATA 0.3 LYNNE JOHNSON-JOSEPH 1.0 MARTHA SMITH 0.5 MELINDA ASHTON 40.0 PATRICIA BOECKMANN 1.0 PAULA DIAS 20.0 RAYMOND VARA 5.0 ROBERT SCHULZ 0.8 STEVEN ROBERTSON 15.0 SUSAN MASUMOTO-NONAKA 20.0 VIRGINIA PRESSLER-FISHER 45.0 WARREN CHAIKO 15.0 KAUA'I MEDICAL CLINIC DAVID FOX 4.8 DAVID OKABE 1.0 EARL INOUYE 4.0 GAIL LERCH 0.1 GERI YOUNG 38.5 JESSICA LEWIS 2.5 JOHN CULLINEY 40.0 KATIE SHIGEMITSU 2.4 KEKA SANBORN 0.5 KENNETH ROBBINS 10.0 LYNNE JOHNSON-JOSEPH 5.0 MELINDA ASHTON 1.0 PAUAL DIAS 0.5 RAYMOND VARA 5.0 STEVEN ROBERTSON 1.0 SUSAN MASUMOTO-NONAKA 1.0 THERESA RAMEY 32.0 VIRGINIA PRESSLER-FISHER 0.1 WARREN CHAIKO 1.0 KAPI'OLANI MEDICAL SPECIALISTS ANN PETERS 0.2 CHARLES STED 1.0 CHARLES CHING 3.0 DAVID FOX 0.4 DAVID OKABE 1.0 DAWN CHING 1.0 EARL INOUYE 2.0 GAIL LERCH 1.0 JESSICA LEWIS 1.3 JOHN CULLINEY 0.8 KEITH MATSUMOTO 0.2 KEKA SANBORN 0.2 KENNETH ROBBINS 0.2 MARTHA SMITH 5.0 MELINDA ASHTON 1.0 STEVEN ROBERTSON 1.0 SUSAN MASUMOTO-NONAKA 0.2 VIRGINIA PRESSLER-FISHER 0.2 WARREN CHAIKO 1.0 PROVIDERS INSURANCE CORPORATION CHARLES STED 1.0 CHARLES CHING 2.0 DAVID FOX 0.4 DAVID OKABE 1.0 EARL INOUYE 0.5 MELINDA ASHTON 0.1 MICHAEL GIBSON 0.1 RAYMOND VARA 5.0 MICHAEL GIBSON 0.1 RAYMOND VARA 5.0
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN
 
Employer identification number

38-3835105
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) PROVIDERS INSURANCE CORPORATION

55 MERCHANT STREET 24TH FLOOR

HONOLULU,HI96813
71-0893000 		NFP INSURANCE HI 501(C)(3) 11B TYPE II NA
 
 
 
(2) KAPI'OLANI HEALTH FOUNDATION

55 MERCHANT STREET 24TH FLOOR

HONOLULU,HI96813
99-0246364 		FUNDRAISING HI 501(C)(3) 7 NA
 
 
 
(3) KAPI'OLANI MEDICAL SPECIALISTS

55 MERCHANT STREET 24TH FLOOR

HONOLULU,HI96813
99-0322406 		HEALTHCARE HI 501(C)(3) 9 NA
 
 
 
(4) WILCOX HEALTH FOUNDATION

55 MERCHANT STREET 24TH FLOOR

HONOLULU,HI96813
99-0204242 		FUNDRAISING HI 501(C)(3) 7 NA
 
 
 
(5) KAUA'I MEDICAL CLINIC

55 MERCHANT STREET 24TH FLOOR

HONOLULU,HI96813
99-0326099 		HOSPITAL HI 501(C)(3) 3 NA
 
 
 
(6) STRAUB FOUNDATION

55 MERCHANT STREET 24TH FLOOR

HONOLULU,HI96813
99-0109350 		FUNDRAISING HI 501(C)(3) 7 NA
 
 
 
(7) PALI MOMI FOUNDATION

55 MERCHANT STREET 24TH FLOOR

HONOLULU,HI96813
38-3840327 		FUNDRAISING HI 501(C)(3) 7 NA
 
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) HAWAI'I PACIFIC HEALTH PARTNERS INC &SUB
55 MERCHANT STREET 24TH FLOOR
HONOLULU,HI96813
99-0318588 		HOLDING COMPANY HI NA
  		C CORP 0 0 0 %
(2) STRAUB PHARMACY INC
888 SOUTH KING STREET
HONOLULU,HI96813
99-0145107 		INACTIVE HI SCH
  		C CORP -3,564 4,996,272 1.000 %










Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) KAPI'OLANI HEALTH FOUNDATION

 C 1,754,847  
(2) STRAUB FOUNDATION

 C 363,448  
(3) WILCOX HEALTH FOUNDATION

 C 351,792  
(4) KAPI'OLANI MEDICAL SPECIALISTS

 N 61,735  
(5) KAPI'OLANI MEDICAL SPECIALISTS

 O 352,772  
(6) KAUA'I MEDICAL CLINIC

 O 1,894,008  
(7) KAPI'OLANI MEDICAL SPECIALISTS

 P 6,291,492  
(8) KAPI'OLANI MEDICAL SPECIALISTS

 Q 227,022  
(9) KAUA'I MEDICAL CLINIC

 Q 86,499  
(10) PROVIDERS INSURANCE CORPORATION

 Q 14,072,985  
(11) KAPI'OLANI MEDICAL SPECIALISTS

 R 98,555  
(12) KAUA'I MEDICAL CLINIC

 R 966,011  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version:  






TY 2010 AffiliateListing
Name:
HAWAI'I PACIFIC HEALTH GROUP RETURN
EIN: 38-3835105

Name Address EIN Name control
Kapiolani Medical Ctr Women Childr 55 Merchant St 24th floor
Honolulu,  HI  96813
99-0177350
 KAPI
Pali Momi Medical Center 55 Merchant St 24th Floor
Honolulu,  HI  96813
99-0274038
 PALI
Straub Clinic & Hospital 55 Merchant St 24th Floor
Honolulu,  HI  96813
91-2151670
 STRA
Wilcox Memorial Hospital 3-3420 Kuhio Hwy
Lihue,  HI  96766
99-0074365
 WILC