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
THE QUEEN'S HEALTH SYSTEMS
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1301 PUNCHBOWL STREET
 
Room/suite
City or town, state or country, and ZIP + 4
HONOLULU, HI96813
D Employer identification number

99-0238120
E Telephone number

G Gross receipts $ 270,139,761
F Name and address of principal officer:
RICHARD C KEENE
1301 Punchbowl Street
HONOLULU,HI96813
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1985
M State of legal domicile: HI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO SUPPORT, PROMOTE AND MAINTAIN THE SUBSIDIARY AND AFFILIATE CORPORATIONS OF THE QUEEN'S HEALTH SYSTEMS AND TO PROMOTE, SUPERVISE, SUPPORT AND OTHERWISE CONTRIBUTE TO HEALTH CARE-RELATED ACTIVITIES
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 29
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 62
6 Total number of volunteers (estimate if necessary) .... 6  
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 69,072
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -82,618
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,841,494 339,610
9 Program service revenue (Part VIII, line 2g) ......... 19,253,451 20,375,832
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,152,518 3,610,300
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 25,247,463 24,325,742
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
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) 13,493,594 14,248,559
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).... 6,099,894 6,633,839
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 19,593,488 20,882,398
19 Revenue less expenses. Subtract line 18 from line 12...... 5,653,975 3,443,344
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 64,019,066 70,705,318
21 Total liabilities (Part X, line 26)............ 29,772,083 29,344,279
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 34,246,983 41,361,039
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: TO SUPPORT, PROMOTE AND MAINTAIN THE SUBSIDIARY AND AFFILIATE CORPORATIONS OF THE QUEEN'S HEALTH SYSTEMS AND TO PROMOTE, SUPERVISE, SUPPORT AND OTHERWISE CONTRIBUTE TO HEALTH CARE-RELATED ACTIVITIES.
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 $ 20,882,398 including grants of $   ) (Revenue $ 24,325,742 )
The Queen's Health Systems ("QHS") is the parent company of The Queen's Medical Center ("QMC"), Queen Emma Land Company, Queen's Development Corporation, Molokai General Hospital ("MGH"), and various other healthcare related entities (collectively referred to as "Queen's"). The mission of Queen's is to fulfill the intent of Queen Emma and King Kamehameha IV to provide in perpetuity quality health care services to improve the well-being of Native Hawaiians and all of the people of Hawaii.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
QHS supports the Queen's mission and fulfills its tax exempt purpose as a charitable healthcare system by providing community benefits totaling approximately $93.6 million on a system-wide basis for the year ended June 30, 2011. See Line 4C (Schedule O, Attachment 1) for a detailed explanation.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
QMC supports Native Hawaiian Health initiatives through many of its programs and services, particularly its Native Hawaiian Health Program (NHH). The focus areas of NHH include improvements in clinical outcomes, healthcare training, research, access and outreach. NHH conducts ongoing assessment and development of QMC programs and services focused on Native Hawaiians, including specific clinical programs in areas such as cardiology, oncology and behavioral health. QMC collaborates and partners to provide healthcare training and education opportunities to Native Hawaiian students and those committed to serving Native Hawaiian communities, for example, the Ulu Kukui Project, which is a pre-college science education program at Stevenson Middle School to promote excellence in science education and the pursuit of biomedical careers by Native Hawaiians and Pacific Islanders. In addition, NHH programs focus on quality improvement and increased access for Native Hawaiians to QMC and collaborate with the Native Hawaiian community in education, research, and community outreach. Through each of these areas of focus, NHH works to provide a framework for the development, implementation and evaluation of clinical initiatives that aim to enhance the ola pono (well being) of Native Hawaiians. In addition to NHH, many of QMC's program services described below provide benefits to Native Hawaiians, including components of charity care and uncompensated care provided to our patients. 1.Uncompensated care - QMC provides medical services to patients who do not have the ability to pay (patients are not billed charity care) and patients who refuse to pay (bad debts). For the year ended June 30, 2011, the estimated losses from providing charity care and for services that were bad debts was $2,382,000 and $12,670,000 respectively. 2.Behavioral Health - QMC provides inpatient and outpatient behavioral health services that are necessary and in certain instances, not generally available in the State of Hawaii. The estimated losses from operations resulting from behavioral health services were $10,122,000 for the year ended June 30, 2011. 3.Queen Emma Clinics - QMC provides outpatient services to indigent patients and others though the Queen Emma Clinics. The losses from operations from the Queen Emma Clinics were approximately $3,904,000 for the year ended June 30, 2011. 4.On call physician compensation - QMC maintains the only Level II trauma center in the State of Hawaii. In order to provide Level II trauma coverage, the Medical Center incurred approximately $6,604,000 in on call physician coverage during the year ended June 30, 2011. 5.Resident and Intern Costs - QMC incurred costs in excess of reimbursement of approximately $5,427,000 during the year ended June 30, 2011 related to resident and intern programs. As a teaching facility, the Medical Center participates in and shares the costs of the Hawaii Residency Program. 6.Hawaii Medical Library - QMC maintains a medical library that benefits healthcare professionals in the State of Hawaii. The operating losses of the Hawaii Medical Library for the year ended June 30, 2011 were $898,000. 7.Transfer Hotline - QMC maintains a cardiac transfer hotline and a referral hotline to assist patients and other healthcare providers with the transfer and/or referral of patients to appropriate healthcare services. The operating losses of providing these services for the year ended June 30, 2011 were $1,356,000. 8.Transportation Services - QMC provides transportation to and from the Medical Center to patients who require assistance. The cost of providing these services was $147,000 for the year ended June 30, 2011. 9.Health and Wellness Education - QMC provides health and wellness education to the community in an effort to promote healthy lifestyles. For the year ended June 30, 2011, losses of providing health and wellness education were $376,000. 10.Research Losses - QMC employs staff and incurs unfunded costs for medical research. For the year ended June 30, 2011, research costs were $1,875,000. 11.Charitable Contributions - QMC makes contributions to outside charitable organizations. For the year ended June 30, 2011, contributions to outside charitable organizations were $1,450,000. Of this amount, $367,000 was for funding to the Department of Native Hawaiian Health under the John A. Burns School of Medicine of the University of Hawaii. In addition, $250,000 was donated to the University of Hawaii Cancer Consortium. 12.Emergency Preparedness - QMC is the only Level II trauma center in the State of Hawaii. QMC allocated resources to plan and test its readiness for community emergencies, including trauma, terrorist attacks and conditions resulting from hazardous material spills. For the year ended June 30, 2011, the costs of emergency preparedness were $721,000. 13.Electrical Generator Project - In order to maintain necessary life support, diagnostic and operating systems, in the event of an emergency, QMC significantly upgraded its power plant by adding two new generators that are capable of providing electrical power for the medical center. For the year ended June 30, 2011, costs incurred for the electrical generator project were $417,000. Total project costs incurred as of June 30, 2011 were approximately $34,086,000. 14.Medicaid Shortfall in Payments - QMC provides inpatient and outpatient services to Medicaid patients in the State of Hawaii. QMC incurred costs in excess of reimbursement of approximately $24,553,000 during the year ended June 30, 2011. 15.Medicare Shortfall in Payments - QMC provides inpatient and outpatient services to Medicare patients in the State of Hawaii. QMC incurred costs in excess of reimbursement based on Medicare Cost reports of approximately $14,200,000 during the year ended June 30, 2011. Consistent with cost report requirements, there are amounts that are excluded from the costs above. 16.Lease Pricing Below Fair Market Value - QMC extended lease rates to the University of Hawaii that are below fair market value. For the year ended June 30, 2011, revenues foregone from lease rates that were below fair market value were $43,000. 17.Programs That Improve Access to Healthcare - QMC improves the community's access to healthcare by helping patients qualify for Medicaid and other types of insurance. For the year ended June 30, 2011, these program costs totaled $849,000. 18.Molokai General Hospital - Queen's supports MGH in providing healthcare services to the island of Molokai. For the year ended June 30, 2011, MGH's loss from operations was $2,700,000. 19.Native Hawaiian Health at QMC - Queen's supports a Native Hawaiian Health program at QMC. For the year ended June 30, 2011, expenses totaled approximately $1,200,000. 20.Kinau Street Off-ramp Improvement Project - In order to improve access to its Emergency Department and hospital, QMC, in conjunction with the state Department of Transportation and City Department of Transportation Services, began construction to the Kinau Street off-ramp. For the year ended June 30, 2011, costs incurred for the improvement project were $679,000. 21.Dental Clinic - QMC provides dental services to indigent patients and others through its Dental Clinic. The losses from operations from the Dental Clinic were approximately $96,000 for the year ended June 30, 2011. 22.Donated Use of Conference Rooms - QMC allows physicians and teachers from the John A. Burns School of Medicine of the University of Hawaii, various governmental entities including the Hawaii Department of Health and other nonprofit organizations the free use of its facilities at The Queen's Conference Center. For the year ended June 30, 2011, the value of the use of the center was $261,000. 23.Job Shadowing Program - QMC sponsors a job shadowing program for students in the state of Hawaii. For the year ended June 30, 2011, costs incurred for the program were $10,000. 24.QMC Nursing Program - QMC provides nursing internships and nurse training that help address the continued need for skilled nurses in the islands. For the year ended June 30, 2011, these costs totaled $700,000. 25.Community Health Improvement - QHS sponsored a health fairs on neighbor islands and QMC sponsored a senior health fair. For the year ended June 30, 2011, non-marketing costs incurred related to the health fairs were $8,000. 26.Community Outreach - QHS employees volunteer their time and experience providing free lectures to members of the community including professionals, students and members of the public. 27.Volunteer Efforts - QHS employees periodically volunteer for other charitable organizations. For the year ended June 30, 2011, these events included the American Heart Association's "Heart Walk", Waikiki Improvement Association's "Beach Clean Up" and the American Diabetes Association's "Step Out" Fundraiser. In addition, QHS employees dedicate many hours serving as volunteer board members for other Hawaii based cha
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 20,882,398
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
 
No
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 I
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..........
18
 
No
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...................
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.....
20a
 
No
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. .....
20b
 
 
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..
21
 
No
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.....
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 M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
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
1,254
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
62
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
29
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
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
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
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
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
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
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
CA
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
CLINTON YEE
1301 PUNCHBOWL STREET
HONOLULU,HI96813
(808) 538-9011
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) Naleen N Andrade MD
CHAIR/TRUSTEE
 4.0 X   X       0 0 0
(2) Paul S Aoki
TRUSTEE
 3.0 X           0 0 0
(3) Evelyn J Black
VC/TRUSTEE
 1.0 X   X       0 0 0
(4) Han P Ching
TRUSTEE
 2.0 X           0 0 0
(5) Norman T S Chong
TRUSTEE
 2.0 X           0 0 0
(6) Neil J Hannahs
Trustee
 1.0 X           0 0 0
(7) Lance M Dunbar
Trustee
 2.0 X           0 0 0
(8) Ernest Fukeda Jr
Trustee
 2.0 X           0 0 0
(9) David C Hulihee
TRUSTEE
 2.0 X           0 0 0
(10) Noreen Mokuau DSW
VC/Trustee
 3.0 X   X       0 0 0
(11) William G Obana MD
Trustee
 2.0 X           0 120,052 0
(12) Caroline Ward Oda
TRUSTEE
 3.0 X           0 0 0
(13) Robb K Ohtani MD
Trustee
 2.0 X           0 48,225 0
(14) Randolph P Perreira
TRUSTEE
 1.0 X           0 0 0
(15) Andrew Schwartz MD
Trustee
 2.0 X           0 0 0
(16) Garrett K Serikawa
TRUSTEE
 1.0 X           0 0 0
(17) Donna Tanoue
Trustee
 2.0 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) William L Thomas Jr MD
Trustee
 1.0 X           0 252,201 27,025
(19) R Brian Tsujimura
Trustee
 1.0 X           0 0 0
(20) Arthur A Ushijima
President & CEO/Trustee
 65.0 X   X       884,694 0 422,887
(21) J D Watumull
Trustee
 1.0 X           0 0 0
(22) Eric K Yeaman
Chair Elect/Trustee
 3.0 X           0 0 0
(23) Julia Wo
Trustee
 2.0 X           0 0 0
(24) James L Grobe Jr MD
Trustee
 1.0 X           0 32,070 0
(25) Christine Gayagas
Trustee
 1.0 X           0 0 0
(26) Peter Hanashiro
Trustee
 1.0 X           0 0 0
(27) Steven Nishida MD
Trustee
 1.0 X           0 0 0
(28) Robert Nobriga
Trustee
 1.0 X           0 0 0
(29) Barry Weinman
Trustee
 1.0 X           0 0 0
(30) Janice Kalanihuia
Vice President
 55.0     X       0 206,804 48,621
(31) Richard C Keene
EVP & CFO/Treasurer
 55.0     X       462,823 0 60,974
(32) Kanoe Margol
VP/Assistant Treasurer
 55.0     X       346,033 0 35,832
(33) Sharlene K Tsuda
VP/Secretary
 55.0     X       226,191 0 50,003
(34) Mark H Yamakawa
Executive VP & COO
 55.0     X       563,595 0 101,958
(35) Eric Martinson
Vice President
 55.0     X       161,517 0 7,877
(36) John Nitao
VP - General Counsel
 55.0         X   321,309 0 55,252
(37) Leslie Chinen
VP - Corporate Development
 55.0         X   387,460 0 39,360
(38) Jeffrey Yu
CTO
 55.0         X   308,833 0 32,086
(39) Hunter Praywell
VP IT/CIO
 55.0         X   233,184 0 28,549
(40) Calvin Saito
VP Strat Plan
 55.0         X   213,100 0 59,759
(41) RICHARD GRIFFITH
FORMER PRESIDENT & CEO
             X 131,584 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,240,323 659,352 970,183
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet23
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
ON POINT LLC - JOSEPH ZACCAGNINO
19 WALL STREET
MADISON,CT06443 		CONSULTING FEES 150,000
DELOITTE AND TOUCHE LLP
1132 Bishop Street Suite 1200
HONOLULU,HI96813 		AUDIT SERVICES 645,406
DELOITTE TAX LLP
1132 Bishop Street Suite 1200
HONOLULU,HI96813 		TAX SERVICES 181,068
WATANABE ING LLP
999 BISHOP STREET SUITE 2300
HONOLULU,HI96813 		LEGAL SERVICES 167,279
PIVOT HEALTH LLC
5500 MARYLAND WAY SUITE 300
BRENTWOOD,TN37027 		CONSULTING FEES 183,332
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet6
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 339,610
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 339,610
Program Service Revenue Business Code
2a SUPPORT SERVICES 561,000 20,375,832 20,375,832    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 20,375,832
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 7,632,319   69,072 7,563,247
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 241,792,000  
b Less: cost or other basis and sales expenses 245,814,019  
c Gain or (loss) -4,022,019  
d Net gain or (loss)..........MediumBullet -4,022,019     -4,022,019
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
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  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 0
12 Total revenue. See Instructions....MediumBullet 24,325,742 20,375,832 69,072 3,541,228
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 0  
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 .... 2,644,853 2,644,853    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 8,253,427 8,253,427    
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 577,350 577,350    
9 Other employee benefits ....... 2,373,746 2,373,746    
10 Payroll taxes ........... 399,183 399,183    
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 320,357 320,357    
c Accounting ........... 416,078 416,078    
d Lobbying ........... 14,500 14,500    
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 1,579,153 1,579,153    
12 Advertising and promotion .... 17,113 17,113    
13 Office expenses ....... 60,320 60,320    
14 Information technology ...... 182,708 182,708    
15 Royalties .. 0      
16 Occupancy ........... 511,012 511,012    
17 Travel ............ 153,722 153,722    
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 190,268 190,268    
20 Interest ........... 12,457 12,457    
21 Payments to affiliates ....... 664,264 664,264    
22 Depreciation, depletion, and amortization ..... 836,619 836,619    
23 Insurance .............. 199,157 199,157    
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 BOOKS, DUES AND SUBSCRIPTIONS 129,366 129,366    
b EQUIPMENT RENTAL & MAINTENANCE 910,065 910,065    
c AMORTIZATION 1,015 1,015    
d ENTERTAINMENT 52,624 52,624    
e GENERAL EXCISE TAX 17,743 17,743    
f All other expenses 365,298 365,298 0 0
25 Total functional expenses. Add lines 1 through 24f 20,882,398 20,882,398 0 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 .......... 222 1 300
2 Savings and temporary cash investments ....... 4,170,451 2 2,222,787
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 137,352 4 388,766
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 ..............   8  
9 Prepaid expenses and deferred charges ............ 117,949 9 113,976
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 9,860,680
b Less: accumulated depreciation. ..... 10b 7,621,756 2,985,891 10c 2,238,924
11 Investments—publicly traded securities .......... 43,415,641 11 40,650,570
12 Investments—other securities. See Part IV, line 11 ...... 5,895,833 12 11,966,523
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 7,295,727 15 13,123,472
16 Total assets. Add lines 1 through 15 (must equal line 34)... 64,019,066 16 70,705,318
Liabilities 17 Accounts payable and accrued expenses . 21,233,883 17 21,447,821
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 .. 2,941,355 23 2,941,355
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 5,596,845 25 4,955,103
26 Total liabilities. Add lines 17 through 25..... 29,772,083 26 29,344,279
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 ..... 34,246,983 27 41,361,039
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
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 ..... 34,246,983 33 41,361,039
34 Total liabilities and net assets/fund balances ..... 64,019,066 34 70,705,318
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
24,325,742
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
20,882,398
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
3,443,344
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
34,246,983
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
3,670,712
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
41,361,039
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
Yes
 
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
Yes
 
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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
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)
 
No
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
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
(1) THE QUEEN'S MEDICAL CENTER
  		990073524 03 Yes   Yes   Yes   0
(2) MOLOKAI GENERAL HOSPITAL
  		990251372 03 Yes   Yes   Yes   0
(3) QUEEN EMMA LAND COMPANY
  		980183769 03 Yes   Yes   Yes   0
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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
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
THE QUEEN'S HEALTH SYSTEMS
  		Employer identification number

99-0238120
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
THE QUEEN'S HEALTH SYSTEMS
  		Employer identification number

99-0238120
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
THE QUEEN'S HEALTH SYSTEMS
  		Employer identification number

99-0238120
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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
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) ...... 0 0
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 14,500 46,088
c Total lobbying expenditures (add lines 1a and 1b) ................... 14,500 46,088
d Other exempt purpose expenditures ........................ 20,867,898 704,062,127
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 20,882,398 704,108,215
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 244,324 134,730 31,942 46,088 457,084
             
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 0 0 0 0 0
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
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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
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 ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
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)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
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 .................   40,104 40,104
b Buildings ................   1,512,386 1,499,945 12,441
c Leasehold improvements ............        
d Equipment ................   8,126,502 6,121,811 2,004,691
e Other .................   181,688   181,688
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 2,238,924
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) QUEEN'S INSURANCE EXCHANGE INC 		462,507 C

(B) QUEEN'S DEVELOPMENT CORP 		2,445,053 C

(C) OTHER INVESTMENTS 		9,058,963 F






Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 11,966,523
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 AFFILIATES 8,829,849
(2) FIRST TRUST ASSET 2,003,130
(3) RABBI TRUST ASSET 2,290,493






Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 13,123,472
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
DUE TO AFFILIATES 4,955,103








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 4,955,103
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 24,325,742
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 20,882,398
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 3,443,344
4 Net unrealized gains (losses) on investments .......................... 4 3,139,827
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 530,884
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 3,670,711
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 7,114,055
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 20,579,516
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 20,579,516
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 3,746,226
c Add lines 4a and 4b....................... 4c 3,746,226
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 24,325,742
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 20,878,967
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 20,878,967
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 3,431
c Add lines 4a and 4b....................... 4c 3,431
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 20,882,398
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
RECONCILIATION OF CHANGE IN NET ASSETS SCH D PART XI LINE 8 ADJUSTMENT TO MINIMUM PENSION LIABILITY $530,884
REVENUE BOOK TO TAX RECONCILIATION SCH D PART XII LINE 4B FUNDS TRANSFERRED FROM AFFILIATES $135,926 INVESTMENT GAIN - UNRESTRICTED $3,610,300 ------------ $3,746,226
EXPENSES BOOK TO TAX RECONCILIATION SCH D PART XIII LINE 4B NON-OPERATING EXPENSE $3,431
ASC 740 SCH D PART X LINE 2 QHS EVALUATES ITS UNCERTAIN TAX POSITIONS AND HAS NO MATERIAL UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2011.
Schedule D (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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
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
Yes
 
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
 
No
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
Yes
 
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
Yes
 
b
Any related organization? .........................
6b
Yes
 
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) Janice Kalanihuia (i)
(ii)		 0
159,877 		0
27,540 		0
19,387 		0
26,200 		0
22,421 		0
255,425 		 
 
(2) Richard C Keene (i)
(ii)		 384,491
0 		58,461
0 		19,871
0 		23,662
0 		37,312
0 		523,797
0 		 
 
(3) Kanoe Margol (i)
(ii)		 203,692
0 		31,950
0 		110,391
0 		11,025
0 		24,807
0 		381,865
0 		 
 
(4) William L Thomas Jr MD (i)
(ii)		 0
206,919 		0
0 		0
45,282 		0
20,167 		0
6,858 		0
279,226 		 
 
(5) Sharlene K Tsuda (i)
(ii)		 176,497
0 		32,317
0 		17,377
0 		27,219
  		22,784
  		276,194
0 		 
 
(6) Arthur A Ushijima (i)
(ii)		 616,935
0 		165,532
0 		102,227
0 		358,148
0 		64,739
0 		1,307,581
0 		 
 
(7) Mark H Yamakawa (i)
(ii)		 427,515
0 		101,891
0 		34,189
0 		58,131
0 		43,827
0 		665,553
0 		 
 
(8) John Nitao (i)
(ii)		 273,169
0 		26,618
0 		21,522
0 		20,691
0 		34,561
0 		376,561
0 		 
 
(9) Leslie Chinen (i)
(ii)		 228,033
0 		0
0 		159,427
0 		11,025
0 		28,335
0 		426,820
0 		 
 
(10) Jeffrey Yu (i)
(ii)		 298,155
0 		10,000
0 		678
0 		16,879
0 		15,207
0 		340,919
0 		 
 
(11) Hunter Praywell (i)
(ii)		 203,556
0 		20,295
0 		9,333
0 		0
0 		28,549
0 		261,733
0 		 
 
(12) Calvin Saito (i)
(ii)		 167,738
0 		30,506
0 		14,856
0 		37,782
0 		21,977
0 		272,859
0 		 
 
(13) Eric Martinson (i)
(ii)		 153,612
0 		0
0 		7,905
0 		0
0 		7,877
0 		169,394
0 		 
 
(14) RICHARD GRIFFITH (i)
(ii)		 0
0 		0
0 		131,584
0 		0
0 		0
0 		131,584
0 		131,584
 


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
COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 3 Compensation committee refers to a committee of the organization's governing body responsible for determining the top management official's compensation package, whether or not the committee has been delegated the authority to make an employment agreement with the top management official on behalf of the organization. The compensation committee may also have other duties.
Arthur A Ushijima Form 990 Part VII Arthur A Ushijima AVERAGE HOURS PER WEEK: 26 hours per week - QHS PARENT COMPANY 2 hours per week - QHS Trustee 65 hrs per week - QHS & affiliates Mr. Ushijima serves as a Trustee for The Queen's Health Systems (parent company) and several other Queen's related affiliates. He is a volunteer Trustee and is not compensated for those services. His hours served as a trustee for QHS is 2 hrs per week. Mr. Ushijima also serves as the President & Chief Executive Officer of The Queen's Health Systems (parent company) and as the President of QMC. The compensation listed on Form 990 Part VII is his total compensation for his various services and the hours listed on Form 990 Part VII are his hours for his QHS roles (parent company only) and also all affiliates combined.
Mark Yamakawa Form 990 Part VII Mark Yamakawa AVERAGE HOURS PER WEEK: 8 hours per week - QHS PARENT COMPANY 55 hrs per week - QHS & affiliates Mr. Yamakawa serves as EVP & COO of the Queen's Health System (parent company), EVP & COO of QMC and chairman of QDC. He is not separately compensated for these various services. The compensation listed on Form 990 Part VII is his total compensation for all services and the hours listed on Form 990 Part VII are his hours for his QHS roles (parent company only) and also all affiliates combined.
Janice Kalanihuia Form 990 Part VII Janice Kalanihuia AVERAGE HOURS PER WEEK: 1 HR PER WEEK - QHS PARENT COMPANY 55 HRS PER WEEK - QHS & AFFILIATES Ms. Kalanihuia serves as VP for The Queen's Health Systems (parent company) and President of MGH. She is not separately compensated for these VARIOUS services. The compensation listed on Form 990 Part VII is her total compensation for all services and the hours listed on Form 990 Part VII are her hours for her QHS roles (parent company only) and also all affiliates combined.
Richard C. Keene Form 990 Part VII Richard C. Keene AVERAGE HOURS PER WEEK: 28 hrs per week - QHS PARENT COMPANY 55 hrs per week - QHS & affiliates Mr. Keene serves as QMC Treasurer, EVP/CFO and Treasurer for the Queen's Health Systems (parent company), Treasurer of QEL and Treasurer of MGH. He is not separately compensated for these services. The compensation listed on Form 990 Part VII is his total compensation for all services and the hours listed on Form 990 Part VII are his hours for his QHS roles (parent company only) and also all affiliates combined.
Sharlene Tsuda Form 990 Part VII Sharlene Tsuda AVERAGE HOURS PER WEEK: 53 hrs per week - QHS PARENT COMPANY 55 hrs per week - QHS & affiliates Ms. Tsuda serves as secretary for QMC and VP/Secretary for the Queen's Health Systems (parent company). She is not separately compensated for these various services. The compensation listed on Form 990 Part VII is her total compensation for all services and the hours listed on Form 990 Part VII are her hours for her QHS roles (parent company only) and also all affiliates combined.
John S. Nitao Form 990 Part VII John S. Nitao AVERAGE HOURS PER WEEK: 54 hour per week - QHS parent company 55 hrs per week - QHS & affiliates Mr. Nitao serves as VP/General Counsel for the Queen's Health Systems (Parent Company) and Secretary of QEL. The compensation listed on Form 990 Part VII is his total compensation for all services.
Eric Martinson Form 990 Part VII Eric Martinson average hours per week: 22 hours per week - QHS parent company 55 hours per week - QHS & Affiliates Mr. Martinson serves as President of QEL and VP for the Queen's Health Systems (parent company). He is not separately compensated for these services. The compensation listed on Form 990 Part VII is his total compensation for all services. WILLIAM G OBANA, MD FORM 990 PART VII DR. OBANA SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS (2 HOURS PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS IS FOR HIS ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER (ESTIMATED AVERAGE OF 11 HOURS PER WEEK). ROBB K OHTANI, MD FORM 990 PART VII DR. OHTANI SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS (2 HOURS PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS IS FOR HIS ON-CALL SPECIALTY SERVICES AT THE QUEEN'S MEDICAL CENTER (ESTIMATED AVERAGE OF 12 HOURS PER WEEK). WILLIAM L THOMAS, MD FORM 990 PART VII DR. THOMAS SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS (1 HOUR PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS IS FOR HIS INTERNAL MEDICINE SERVICES AT MOLOKAI GENERAL HOSPITAL (55 PER WEEK). JAMES L GROBE JR, MD FORM 990 PART VII DR. GROBE SERVES AS A TRUSTEE FOR THE QUEEN'S HEALTH SYSTEMS (1 HOUR PER WEEK). HE IS A VOLUNTEER TRUSTEE AND IS NOT COMPENSATED FOR THESE SERVICES. THE REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS IS FOR HIS ON-CALL PHYSICIAN SERVICES AT THE QUEEN'S MEDICAL CENTER (ESTIMATED AVERAGE OF 6 HOURS PER WEEK).
Discretionary spending account SCHEDULE J, PART I, LINE 1a Discretionary spending account payments are made to certain executives of QHS in lieu of reimbursement for expenses and are included in taxable income of the recipient. The following individuals received discretionary spending account payments from QHS in 2010: Mark Yamakawa - $15,000 Richard C. Keene - $15,000 Kanoe Margol - $8,000 Sharlene Tsuda - $8,000 Arthur A. Ushijima - $20,000 Hunter Praywell - $7,693 John Nitao - $8,000 Leslie Chinen - $8,000 Calvin Saito - $8,000 Eric Martinson - $7,500 Janice Kalanihuia - $8,000
Severance payments SCHEDULE J, PART I, LINE 4a The following individuals received severance payments from QHS in 2010: Leslie Chinen - $13,382 Kanoe Margol - $11,629
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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
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) Donna Tanoue Trustee of QHS 101,425 SEE PART V   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
DONNA TANOUE SCHEDULE L PART IV LINE 1 DONNA TANOUE IS AN OFFICER OF A FINANCIAL INSTITUTION WITH WHICH THE ORGANIZATION HAS A BANKING RELATIONSHIP. DURING THE YEAR, THE ORGANIZATION PAID FEES TO THIS FINANCIAL INSTITUTION TOTALING $101,425.
Schedule L (Form 990 or 990-EZ) 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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
Identifier Return Reference Explanation
FORM 990, PT VI, SECTION A, LINE 7A   The Board of Trustees of QHS elects all of the board members.
FORM 990, PT VI, SECTION A, LINE 11A   The Form 990 for The Queen's Health System (QHS) and the separate forms for each of the not-for-profit subsidiaries of QHS were reviewed by the governing body of QHS prior to the filing of the returns. The QHS Finance Committee, which is comprised of members of the QHS Board of Trustees, was delegated the responsibility to review the returns prior to their filing. The returns were presented to the Committee by management and by the independent public accounting firm that prepared the returns. In addition, compensation related disclosures in the returns were reviewed by the Chairperson of the QHS Compensation Committee prior to filing the returns. Also, a copy of the QHS returns was made available to each of the members of the Board of Trustees prior to the returns being filed with the Internal Revenue Service.
FORM 990, PT VI, SECTION B, LINE 12C   All QHS companies are subject to a written Conflict of Interest Policy. All trustees, officers, designated employees and contractors are required to complete an annual disclosure form. The designated employees are those selected by Executives in the organization who identify those employees (typically manager level and above) who may be in a position to select or influence the selection of a vendor. Disclosures are summarized and maintained by each company's corporate secretary. The contracts management department and legal department have the conflict summaries and check for conflicts of interest at the beginning of the contract process. Any conflict of interest involving a trustee is presented to the Board of Trustees. Any transaction involving a disqualified person is subject to the process of establishing a rebuttable presumption of reasonableness. Any trustee with a conflict of interest is excused for the portion of the meeting where the subject matter is discussed and voted on.
FORM 990, PT VI, SECTION B, LINE 15B   A committee of the Board of Trustees called the Compensation Committee meets regularly to review compensation of all executives of all companies within QHS. Executive compensation is reviewed annually. All decisions regarding executive compensation are made in conformity with the procedures required to establish a rebuttable presumption of reasonableness. Any adjustment to compensation is subject to the process of performance reviews and comparison to comparable compensation data prepared by a nationally recognized independent compensation consultant. Outside counsel assists with the review process and documents the decisions of the committee.
FORM 990, PT VI, SECTION C, LINE 19   QHS Governing Documents are available upon request. QHS does not make its conflict of interest policy or financial statements available to the public.
FORM 990, PT XI, LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES ADJUSTMENT TO MINIMUM PENSION LIABILITY 530,884 UNREALIZED GAINS 3,139,827 ROUNDING 1 ------------ 3,670,712 ------------
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
THE QUEEN'S HEALTH SYSTEMS
 
Employer identification number

99-0238120
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) THE QUEEN'S MEDICAL CENTER

1301 PUNCHBOWL STREET

HONOLULU,HI96813
99-0073524 		MEDICAL SVCS HI 501(c)(3) 3 QHS
 
 
 
(2) QUEEN EMMA LAND COMPANY

1301 PUNCHBOWL STREET

HONOLULU,HI96813
99-0183769 		SUPPORT SVCS HI 501(c)(3) 11 TYPE II QHS
 
 
 
(3) MOLOKAI GENERAL HOSPITAL

PO BOX 408

KAUNAKAKAI,HI96748
99-0251372 		HEALTH CARE HI 501(c)(3) 3 QHS
 
 
 








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
(1) HAMQUEEN'S PET

1301 PUNCHBOWL
HON,HI96813
94-3266916 		PET IMAGING HI NA
  		N/A                












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) THE QUEEN'S DEVELOPMENT CORP & SUBS
1301 PUNCHBOWL STREET
HONOLULU,HI96813
99-0240109 		DEVELOPMENT HI NA
  		C CORP 97,552,673 110,904,115 100.000 %
(2) QUEEN'S INSURANCE EXCHANGE INC
1301 PUNCHBOWL STREET
HONOLULU,HI96813
91-1913839 		INSURANCE HI NA
  		INSURANCE CORP 5,689,414 18,521,081 100.000 %
(3) DIAGNOSTIC LABORATORY SERVICES INC
99-859 IWAIWA STREET
AIEA,HI96701
99-0240499 		MEDICAL LAB SERV HI SUB OF QDC
  		C CORP      








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
 
No
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
 
No
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
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
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) QUEEN'S MEDICAL CENTER

 C 330,635  
(2) QUEEN EMMA LAND COMPANY

 C 8,975  
(3) THE QUEEN'S DEVELOPMENT CORP & SUBS

 O 10,745  
(4) MOLOKAI GENERAL HOSPITAL

 O 28,264  
(5) QUEEN'S MEDICAL CENTER

 O 484,599  
(6) THE QUEEN'S DEVELOPMENT CORP & SUBS

 P 1,976,658  
(7) MOLOKAI GENERAL HOSPITAL

 P 348,236  
(8) QUEEN'S INSURANCE EXCHANGE INC

 P 278,823  
(9) QUEEN EMMA LAND COMPANY

 P 3,870,537  
(10) QUEEN'S MEDICAL CENTER

 P 13,867,764  
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


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