TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) DOUGLAS KWOCK MD........................................................................ Board of Director, Chair	1.3 .......................0.0	X	X	0	18,500	0
(2) MARK GRIEF MD........................................................................ Board of Director, Chair	0.2 .......................0.0	X	X	0	46,684	0
(3) GORDON HAMMOND........................................................................ Board of Director, Chair	0.2 .......................0.0	X	X	0	0	0
(4) LYNN MCCRORY........................................................................ Board of Director, Chair	0.2 .......................0.6	X	X	0	0	0
(5) VIOLETA ARNOBIT RN........................................................................ Board of Director, Vice Chair	0.2 .......................0.1	X	X	0	0	0
(6) BEAU NAKAMOTO MD........................................................................ Board of Director, Vice Chair	40.0 .......................0.0	X	X	332,212	0	27,900
(7) THOMAS J NORDYKE MD........................................................................ B.O.D, Vice Chair (Part Year)	40.0 .......................0.0	X	X	265,073	0	45,208
(8) JOHN CULLINEY MD........................................................................ Board of Director, Vice Chair	0.2 .......................40.0	X	X	0	446,529	51,843
(9) BEN GODSEY........................................................................ Board of Director	0.3 .......................0.0	X		0	0	0
(10) CHRIS ELDRIDGE........................................................................ Board of Director	0.3 .......................0.0	X		0	0	0
(11) ELLIOT MILLS........................................................................ Board of Director	0.3 .......................0.0	X		0	0	0
(12) JENNIFER SABAS........................................................................ Board of Director	0.3 .......................0.0	X		0	0	0
(13) MICHAEL O'MALLEY ESQ........................................................................ Board of Director	1.3 .......................0.0	X		0	0	0
(14) LOREN YAMAMOTO MD........................................................................ Board of Director	0.3 .......................40.0	X		0	87,375	20,540
(15) PETER MCNALLY MD........................................................................ Board of Director	0.3 .......................0.0	X		0	0	0
(16) SHELLEY WILSON........................................................................ Board of Director	0.3 .......................0.0	X		0	0	0
(17) STEPHEN LIN MD........................................................................ Board of Director	1.3 .......................0.0	X		0	24,506	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) STEVEN AI........................................................................ B.O.D (Part Year)	0.3 .......................0.0	X				0	0	0
(19) ANDREW DANG MD........................................................................ Board of Director	40.0 .......................0.0	X				375,665	0	45,245
(20) BETH HOBAN RN........................................................................ Board of Director	0.2 .......................1.0	X				0	0	0
(21) BRYAN MATSUMOTO MD........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(22) CARLETON CHING........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(23) GORDON NIHEI........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(24) JAMES KAKUDA MD........................................................................ B.O.D (Part Year)	1.2 .......................0.0	X				0	28,107	0
(25) MARK BAKER MD........................................................................ Board of Director	1.2 .......................0.0	X				0	57,812	0
(26) AVI MANNIS........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(27) MONICA PRICE MD........................................................................ Board of Director	0.2 .......................40.0	X				158,792	0	37,247
(28) KENN SARUWATARI MD........................................................................ Board of Director	40.0 .......................0.0	X				257,036	0	50,321
(29) RICHANNE LAM........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(30) CLYDE KODANI........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(31) DANIELLE RAMOS........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(32) GERALD MCKENNA MD........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(33) R CRAIG NETZER........................................................................ Board of Director	0.2 .......................40.0	X				0	167,418	21,030
(34) RAMON DE LA PENA........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(35) TAD JACKSON MD........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(36) WAYNE KATAYAMA........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(37) MICHAEL YAMANE........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(38) MARTHA SMITH........................................................................ Board of Director, CEO	45.0 .......................11.0	X	X			0	579,746	146,344
(39) JENNIE CHAHANOVICH........................................................................ Board of Director, CEO	52.0 .......................3.1	X	X			0	437,653	119,056
(40) RAYMOND P VARA JR........................................................................ B.O.D, PRES & CEO	8.0 .......................54.1	X	X			0	1,498,310	490,418
(41) KATHLEEN CLARK........................................................................ B.O.D, PRES & CEO	60.0 .......................1.0	X	X			0	414,422	106,868
(42) KENNETH B ROBBINS MD........................................................................ B.O.D.	40.0 .......................16.0	X	X			0	732,549	237,733
(43) ARTHUR GLADSTONE........................................................................ B.O.D.	43.2 .......................12.2	X	X			0	541,232	135,486
(44) DAVID OKABE........................................................................ EVP, CFO & Treasurer	11.0 .......................44.4		X			0	705,697	203,504
(45) GAIL LERCH........................................................................ EVP	4.0 .......................51.4		X			0	631,229	190,572
(46) VIRGINIA PRESSLER-FISHER MD........................................................................ EVP	6.0 .......................49.1		X			0	607,717	84,951
(47) CHARLES R CHING........................................................................ EVP, GEN Counsel & Secretary	13.0 .......................44.5		X			0	592,918	193,341
(48) STEVEN ROBERTSON........................................................................ EVP & CIO	12.0 .......................43.1		X			0	628,131	196,621
(49) MELINDA ASHTON MD........................................................................ SVP & CQO	7.0 .......................43.1		X			0	496,019	90,378
(50) JOHN LA FORGIA........................................................................ SVP & Chief Marketing Officer	4.0 .......................46.0		X			0	395,986	32,045
(51) EARL INOUYE........................................................................ VP & System Controller	10.0 .......................41.0		X			0	313,526	73,411
(52) WARREN CHAIKO........................................................................ VP	35.0 .......................17.1		X			0	285,289	62,569
(53) SUSAN MASUMOTO-NONAKA........................................................................ VP	47.0 .......................6.1		X			0	288,271	67,230
(54) DAWN CHING........................................................................ VP	50.0 .......................2.0		X			0	238,062	72,475
(55) GIDGET RUSCETTA RN........................................................................ VP	43.0 .......................10.1		X			0	259,215	60,149
(56) PAULA DIAS........................................................................ VP	48.0 .......................3.0		X			0	274,251	65,051
(57) MAUREEN FLANNERY........................................................................ VP	50.0 .......................0.4		X			0	272,396	60,723
(58) MAVIS NIKAIDO........................................................................ VP & CNE	49.0 .......................1.0		X			0	263,569	53,313
(59) BRIGITTE MCKALE........................................................................ VP & CNE	50.0 .......................1.1		X			0	236,627	57,490
(60) PATRICIA BOECKMANN RN........................................................................ VP & CNE	50.0 .......................2.0		X			0	335,972	71,778
(61) RANDY YATES MD........................................................................ CMO	40.0 .......................0.0		X			0	409,001	41,885
(62) ALAN ITO........................................................................ Information Security Officer	17.0 .......................23.0		X			0	103,112	15,696
(63) JESSICA LEWIS........................................................................ Assistant Corporate Secretary	16.0 .......................24.0		X			0	123,094	26,184
(64) DAVID FOX........................................................................ Privacy & Info Security OFCR	17.0 .......................23.0		X			0	139,351	44,937
(65) KATIE SHIGEMITSU........................................................................ Compliance Officer	29.0 .......................15.0		X			0	174,515	42,698
(66) CASS K NAKASONE MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		870,696	0	46,343
(67) MARK S GERBER MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		776,186	0	35,277
(68) STEVEN S GLAZIER MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		716,104	0	36,843
(69) HINGSON M CHUN MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		705,880	0	45,245
(70) WESLEY J KAI MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		656,022	0	45,827
(71) CHARLES A STED........................................................................ FORMER DIRECTOR OFFICER	0.0 .......................0.0				X	0	875,587	11,332
(72) ANN PETERS........................................................................ FORMER OFFICER	0.0 .......................0.0				X	0	194,292	453

(A) Name and business address	(B) Description of services	(C) Compensation
LAYTON DCK JOINT VENTURE, 9090 SOUTH SANDY PKWY SANDY,UT84070	CONSTRUCTION SVCS	30,774,444
CLINICAL LABORATORIES OF HAWAII LL, PO BOX 1300 HONOLULU,HI968071300	laboratory services	24,738,367
SODEXO INC AFFILIATES, 9801 WASHINGTONIAN BLVD GAITHERSBURG,MD20878	FOOD & ENVIRON SVCS	7,025,108
UNIVERSITY CLINICAL EDU RESEACH, PO BOX 31000 HONOLULU,HI968495647	PHYSICIAN SVCS	4,595,730
HAWAI'I RESIDENCY PROGRAMS INC, 1356 LUSITANA ST STE 510 HONOLULU,HI96813	CONSTRUCTION SVCS	4,223,816
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 146

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 domestic organizations and domestic governments. See Part IV, line 21 ....	161,580	161,580
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 ....	1,633,364	1,600,236	33,128
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 ....	405,835,852	402,544,258	3,291,594
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	30,342,995	29,941,764	401,231
9	Other employee benefits .......	43,854,383	36,078,824	7,775,559
10	Payroll taxes ...........	27,391,380	27,148,779	242,601
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	1,389	-1,293	2,682
c	Accounting ...........	2,739,996		2,739,996
d	Lobbying ...........	42,566		42,566
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	565,000		565,000
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	149,225,103	130,328,516	18,896,587
12	Advertising and promotion ....	198,137	86,770	111,367
13	Office expenses .......	151,088,775	150,714,243	374,532
14	Information technology ......	16,429,211	2,903,711	13,525,500
15	Royalties ..	0
16	Occupancy ...........	27,037,168	25,437,808	1,599,360
17	Travel ............	1,167,759	984,412	183,347
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	214,863	201,212	13,651
20	Interest ...........	11,526,678	11,526,678
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	35,456,341	35,456,341
23	Insurance ..............	7,611,951	6,965,008	646,943
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	CORPORATE ALLOCATION	60,848,435		60,848,435
b	OTHER PURCHASES	23,050,000	5,257,246	17,792,754
c	AFFILIATE EXPENSES	542,357		542,357
d	PROGRAM SERVICE EXPENDITURES	183,036	168,023	15,013
e	All other expenses	199,164	102,747	96,417
25	Total functional expenses. Add lines 1 through 24e	997,347,483	867,606,863	129,740,620	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	-1,018,069	1	-994,898
2	Savings and temporary cash investments .........	4,381,059	2	4,725,385
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	141,671,643	4	161,686,592
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	14,505,573	8	15,932,722
9	Prepaid expenses and deferred charges ..........	1,468,125	9	1,231,072
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	905,268,803
b	Less: accumulated depreciation .....	10b	532,153,745	306,324,905	10c	373,115,058
11	Investments—publicly traded securities ..........	87,553,785	11	83,745,203
12	Investments—other securities. See Part IV, line 11 .....	68,788,561	12	68,273,753
13	Investments—program-related. See Part IV, line 11 .....	1,618,557	13	1,618,557
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	94,814,056	15	96,281,636
16	Total assets. Add lines 1 through 15 (must equal line 34)......	720,108,195	16	805,615,080
	17	Accounts payable and accrued expenses .........	94,636,203	17	92,730,907
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	33,948,059	25	33,953,946
26	Total liabilities. Add lines 17 through 25.........	128,584,262	26	126,684,853
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	536,363,153	27	622,486,126
28	Temporarily restricted net assets ...........	44,492,198	28	45,723,128
29	Permanently restricted net assets ...........	10,668,582	29	10,720,973
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	591,523,933	33	678,930,227
34	Total liabilities and net assets/fund balances ........	720,108,195	34	805,615,080

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1	0
2	Recoveries of prior-year distributions	2	0
3	Other gross income (see instructions)	3	0
4	Add lines 1 through 3	4	0
5	Depreciation and depletion	5	0
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6	0
7	Other expenses (see instructions)	7	0
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8	0

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a	0
b	Average monthly cash balances	1b	0
c	Fair market value of other non-exempt-use assets	1c	0
d	Total (add lines 1a, 1b, and 1c)	1d	0
e	Discount claimed for blockage or other factors (explain in detail in Part VI): 0
2	Acquisition indebtedness applicable to non-exempt use assets	2	0
3	Subtract line 2 from line 1d	3	0
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4	0
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5	0
6	Multiply line 5 by .035	6	0
7	Recoveries of prior-year distributions	7	0
8	Minimum Asset Amount (add line 7 to line 6)	8	0

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1	0
2	Enter 85% of line 1	2	0
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3	0
4	Enter greater of line 2 or line 3	4	0
5	Income tax imposed in prior year	5	0
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6	0
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes		0
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity		0
3 Administrative expenses paid to accomplish exempt purposes of supported organizations		0
4 Amounts paid to acquire exempt-use assets		0
5 Qualified set-aside amounts (prior IRS approval required)		0
6 Other distributions (describe in Part VI). See instructions		0
7Total annual distributions. Add lines 1 through 6.		0
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions		0
9 Distributable amount for 2014 from Section C, line 6		0
10 Line 8 amount divided by Line 9 amount		0 %

Section E - Distribution Allocations (see instructions)	(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6			0
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)		0
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......0
fTotal of lines 3a through e	0
g Applied to underdistributions of prior years		0
h Applied to 2014 distributable amount			0
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.	0
4Distributions for 2014 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years		0
b Applied to 2014 distributable amount			0
c Remainder. Subtract lines 4a and 4b from 4.	0
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)		0
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)			0
7 Excess distributions carryover to 2015. Add lines 3j and 4c.	0
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......0
e From 2014.......0

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization HAWAI'I PACIFIC HEALTH GROUP RETURN

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization HAWAI'I PACIFIC HEALTH GROUP RETURN

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose 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

(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

(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

(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) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

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 SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	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) .................
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? ......................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

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)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

42,566

Total. Add lines 1c through 1i ...............................

42,566

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B	LOBBYING EXPENDITURES LOBBYING EXPENSES ARE THE PORTION OF AMOUNTS PAID TO HEALTHCARE ASSOCIATONS THAT ENGAGED IN LEGISLATIVE LOBBYING ON BEHALF OF ITS MEMBERS.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

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 (ASC 958) relating to these items:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	170,982,165	151,507,463	135,652,768	138,278,199	114,609,981
b	Contributions ........	564,521	418,132	493,306	1,573,144	1,260,873
c	Net investment earnings, gains, and losses	-4,243,274	19,077,175	15,453,147	-4,110,118	22,509,891
d	Grants or scholarships .....	0	0	0
e	Other expenditures for facilities and programs ........	167,884	0	0
f	Administrative expenses ....	11,753	20,605	91,758	88,457	102,546
g	End of year balance ......	167,123,775	170,982,165	151,507,463	135,652,768	138,278,199

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

96.000 %

Permanent endowment SchDMd Bullet

4.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	19,720,249		19,720,249
b	Buildings ................	394,899,905	234,690,872	160,209,033
c	Leasehold improvements ............	23,201,208	14,923,339	8,277,869
d	Equipment ................	324,382,800	274,495,199	49,887,601
e	Other .................	143,064,641	8,044,335	135,020,306
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				373,115,058

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other (A) INVESTMT IN UNCONSOLIDATED SUB	4,971,708	F
(B) LIMITED PARTNERSHIPS	737,110	F
(C) BOARD DESIGNATED SECURITIES	62,564,935	F
(D) RESTRICTED INVESTMENT	1,618,557	F





Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	69,892,310

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) OTHER RECEIVABLES				6,595,934
(2) BOARD DESIGNATED INVESTMENTS				16,970,609
(3) INT IN NET ASSETS OF FDNS				47,210,106
(4) DEPOSITS & NON-CURRENT ASSETS				2,427,327
(5) INTEREST IN PERPETUAL TRUST				9,612,471
(6) DECORATIVE ARTWORK				326,992
(7) INVESTMENT IN JOINT VENTURES				25,000
(8) THIRD PARTY PAYORS				10,987,280
(9) PALI MOMI FOUNDATION				16,566
(10) STRAUB FOUNDATION				86,713
(11) KAUA'I MEDICAL CLINIC				137,748
(12) KAPI'OLANI HEALTH FOUNDATION				963,201
(13) KAPI'OLANI MEDICAL SPECIALISTS				77,445
(14) PROVIDER INSURANCE CORP				90,423
(15) WILCOX FOUNDATION				274,881
(16) HAWAI'I HEALTH PARTNERS				468,345
(17) HICORD				12
(18) HAWAI'I PACIFIC HEALTH PTNRS				10,582
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				96,281,635

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
OTHER LONG TERM LIABILITIES		21,495,726
ESCHEAT LIABILITY		203,658
KAPI'OLANI HEALTH FOUNDATION		12,215
STRAUB PHARMACY INC		4,555,888
WILCOX HEALTH FOUNDATION		10,191
PALI MOMI FOUNDATION		3,232
THIRD PARTY PAYORS		6,091,417
KEAHONUIOKALANI		66,344
STRAUB FOUNDATION		17,436
KAPI'OLANI MEDICAL SPECIALISTS		756,430
HAWAI'I PACIFIC HEALTH PARTNERS		29,936
KAUA'I MEDICAL CLINIC		289,722
HAWAI'I HEALTH PARTNERS		421,751
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		33,953,946
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2014

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART V, LINE 4	ENDOWMENT FUNDS INTENDED USES ENDOWMENT FUNDS ARE INTENDED TO BE USED TO PROVIDE MEDICAL AND OTHER CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR SUCH CARE AND FOR OTHER EXPENSES RELATED TO THE EXEMPT PURCHASE OF THE HOSPITAL.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..		6,796	2,276,130	0	2,276,130	0.230 %
b	Medicaid (from Worksheet 3, column a) ....		200,844	236,039,172	215,835,678	20,203,494	2.030 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .		0	0	0	0
d	Total Financial Assistance and Means-Tested Government Programs .		207,640	238,315,302	215,835,678	22,479,624	2.260 %
Other Benefits		70	82,630	3,384,466	240,281	3,144,185	0.320 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	70	82,630	3,384,466	240,281	3,144,185	0.320 %
f	Health professions education (from Worksheet 5) ..	10	1,476	6,335,112	1,491,097	4,844,015	0.490 %
g	Subsidized health services (from Worksheet 6) ..	11	101	32,089,955	11,027,525	20,609,769	2.110 %
h	Research (from Worksheet 7)	1	0	2,762	0	2,762
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	8	115	196,140	0	196,140	0.020 %
j	Total. Other Benefits ..	100	84,322	42,008,435	12,758,903	28,796,871	2.940 %
k	Total. Add lines 7d and 7j .	100	291,962	280,323,737	228,594,581	51,276,495	5.200 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	2	48,062	48,062
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	3	530,003	530,003	0.050 %
9	Other
10	Total	5	578,065	578,065	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

24,828,457

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

2,124,961

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

127,024,511

Enter Medicare allowable costs of care relating to payments on line 5.....

146,486,245

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-19,461,734

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2014

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?4 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)							Facility reporting group
1	KAPI'OLANI MEDICAL CENTER FOR WOMEN 1319 PUNAHOUR STREET HONOLULU,HI96826 www.hawaiipacifichealth.org/kapiolani 6-H	X	X	X	X	X	A
2	PALI MOMI MEDICAL CENTER 98-1079 MOANALUA ROAD AIEA,HI96701 www.hawaiipacifichealth.org/pali-momi 37-H	X	X			X	A
3	STRAUB CLINIC & HOSPITAL 888 SOUTH KING ST HONOLULU,HI96813 www.hawaiipacifichealth.org/straub 32-H	X	X		X	X	A
4	WILCOX MEMORIAL HOSPITAL 3-3420 KUHIO HIGHWAY LIHUE,HI967661099 www.hawaiipacifichealth.org/wilcox 23-H	X	X			X	A

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H, PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	A
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

The FAP application form was widely available on a website (list url):

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
SCHEDULE H, PART V, SECTION B, LINE 5	FACILITY 1 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN (KMCWC) IN CONDUCTING KMCWC'S MOST RECENT CHNA, ADOPTED JUNE 2013, INTERVIEWS WERE HELD WITH 22 COMMUNITY REPRESENTATIVES WITH PUBLIC HEALTH EXPERTISE IN THE TOP TEN HEALTH AREAS IDENTIFIED FOR WOMEN AND CHILDREN IN THE STATE OF HAWAI'I AND/OR POSSESSING SPECIAL KNOWLEDGE OF VULNERABLE POPULATIONS, INCLUDING (BUT NOT LIMITED TO) LOW-INCOME, MENTALLY ILL, OR PARTICULAR RACIAL/ETHNIC GROUPS. THE INPUT FROM THE INTERVIEWS WAS TAKEN INTO ACCOUNT IN THE CHNA IN THE FOLLOWING WAYS: A SUMMARY QUALITATIVE ANALYSIS TOOL CALLED A "WORD CLOUD" WAS PRODUCED TO IDENTIFY THE MOST COMMON THEMES AND TOPICS RAISED BY THE COMMUNITY REPRESENTATIVES; AND RELEVANT INPUT WAS SUMMARIZED UNDER EACH HEALTH TOPIC AREA ANALYZED IN THE CHNA AND FACTORED INTO THE QUALITATIVE EVALUATION OF THE HEALTH NEED. IN ADDITION, 3 COMMUNITY LEADERS BROADLY REPRESENTING COMMUNITY HEALTH ISSUES FOR THE KMCWC SERVICE AREA WERE CONSULTED TO VALIDATE THE CHOSEN PRIORITY COMMUNITY HEALTH NEEDS. PERSONS CONSULTED STATE DIRECTOR, HAWAII NUTRITION AND PHYSICAL ACTIVITY COALITION, DEPARTMENT OF EDUCATION EXPERTISE: EXERCISE, NUTRITION & WEIGHT DEPUTY DIRECTOR, BEHAVIORAL HEALTH SERVICES ADMINISTRATION, HAWAII DEPARTMENT OF HEALTH EXPERTISE: MENTAL HEALTH & MENTAL DISORDERS ADMINISTRATOR, DEPARTMENT OF HUMAN SERVICES, MED-QUEST DIVISION EXPERTISE: ACCESS TO HEALTH SERVICES DIRECTOR, HAWAII STATE DEPARTMENT OF HEALTH EXPERTISE: MENTAL HEALTH & MENTAL DISORDERS, SUBSTANCE ABUSE/VALIDATION OF PRIORITIZED HEALTH NEEDS HEALTHCARE TRANSFORMATION OFFICER, OFFICE OF THE GOVERNOR EXPERTISE: ACCESS TO HEALTH SERVICES, ORAL HEALTH/VALIDATION OF PRIORITIZED HEALTH NEEDS STATE SENATOR, EXECUTIVE MEDICAL DIRECTOR, HAWAII INDEPENDENT PHYSICIANS ASSOCIATION, EMERGENCY ROOM PHYSICIAN. EXPERTISE: DIABETES, SUBSTANCE ABUSE CEO, HAWAII PRIMARY CARE ASSOCIATION EXPERTISE: RESPIRATORY DISEASE, SOCIAL ENVIRONMENT HEALTHY HAWAII INITIATIVE, TOBACCO SETTLEMENT PROJECT MANAGER, HAWAII DEPARTMENT OF HEALTH EXPERTISE: CANCER, EXERCISE, NUTRITION & WEIGHT, RESPIRATORY DISEASE PROFESSOR OF OBSTETRICS/GYNECOLOGY, DIRECTOR OF FAMILY PLANNING, JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAI'I EXPERTISE: FAMILY PLANNING EXECUTIVE DIRECTOR, AMERICAN DIABETES ASSOCIATION HAWAI'I EXPERTISE: DIABETES CEO, KAMEHAMEHA SCHOOLS EXPERTISE: EDUCATION/VALIDATION OF PRIORITIZED HEALTH NEEDS SUPERINTENDENT OF EDUCATION, HAWAII STATE DEPARTMENT OF EDUCATION EXPERTISE: MENTAL HEALTH & MENTAL DISORDERS DIRECTOR, MOUNTAIN-PACIFIC QUALITY HEALTH EXPERTISE: HEART DISEASE, OLDER ADULTS & AGING DIRECTOR, HAWAII INITIATIVE FOR CHILDHOOD OBESITY RESEARCH AND EDUCATION, JOHN A. BURNS SCHOOL OF MEDICINE, PEDIATRICS, UNIVERSITY OF HAWAII EXPERTISE: EXERCISE, NUTRITION & WEIGHT CHIEF MEDICAL OFFICER, HAWAII MEDICAL SERVICE ASSOCIATION EXPERTISE: MATERNAL, FETAL & INFANT HEALTH PROFESSOR, JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAI'I EXPERTISE: ACCESS TO HEALTH SERVICES, CANCER CHIEF, DISEASE OUTBREAK CONTROL DIVISION, DEPARTMENT OF HEALTH EXPERTISE: IMMUNIZATIONS & INFECTIOUS DISEASE CHIEF, EMERGENCY MEDICAL SERVICES AND INJURY PREVENTION SYSTEMS BRANCH, HAWAII STATE DEPARTMENT OF HEALTH EXPERTISE: INJURY PREVENTION & SAFETY DEPUTY DIRECTOR, HEALTH SERVICES, HAWAII STATE DEPARTMENT OF HEALTH EXPERTISE: MENTAL HEALTH & MENTAL DISORDERS ADMINISTRATOR, CAREERSOURCE HAWAII, EXPERTISE: OLDER ADULTS & AGING, TRANSPORTATION HARDY SPOEHR, EXECUTIVE DIRECTOR, PAPA OLA LOKAHI EXPERTISE: ACCESS TO HEALTH SERVICES, SOCIAL ENVIRONMENT EXECUTIVE DIRECTOR, AMERICAN HEART ASSOCIATION, HAWAII CHAPTER EXPERTISE: HEART DISEASE CHIEF STAFF OFFICER, HIGH PLAINS DIVISION, AMERICAN CANCER SOCIETY HAWAII SITE EXPERTISE: CANCER PRESIDENT & CEO, HOSPICE HAWAII EXPERTISE: OLDER ADULTS & AGING FACILITY 2 PALI MOMI MEDICAL CENTER (PMMC) IN CONDUCTING PMMC'S MOST RECENT CHNA, ADOPTED JUNE 2013, INTERVIEWS WERE HELD WITH 17 COMMUNITY REPRESENTATIVES WITH PUBLIC HEALTH EXPERTISE IN THE TOP TEN HEALTH AREAS IDENTIFIED FOR HONOLULU COUNTY AND/OR POSSESSING SPECIAL KNOWLEDGE OF VULNERABLE POPULATIONS, INCLUDING (BUT NOT LIMITED TO) LOW-INCOME, MENTALLY ILL, OR PARTICULAR RACIAL/ETHNIC GROUPS. THE INPUT FROM THE INTERVIEWS WAS TAKEN INTO ACCOUNT IN THE CHNA IN THE FOLLOWING WAYS: A SUMMARY QUALITATIVE ANALYSIS TOOL CALLED A "WORD CLOUD" WAS PRODUCED TO IDENTIFY THE MOST COMMON THEMES AND TOPICS RAISED BY THE COMMUNITY REPRESENTATIVES; AND RELEVANT INPUT WAS SUMMARIZED UNDER EACH HEALTH TOPIC AREA ANALYZED IN THE CHNA AND FACTORED INTO THE QUALITATIVE EVALUATION OF THE HEALTH NEED. IN ADDITION, 2 INDIVIDUALS BROADLY REPRESENTING COMMUNITY HEALTH CONCERNS FOR THE PMMC SERVICE AREA WERE CONSULTED TO VALIDATE THE CHOSEN PRIORITY COMMUNITY HEALTH NEEDS. PERSONS CONSULTED CHIEF OPERATION OFFICER, ALOHA UNITED WAY EXPERTISE: OLDER ADULTS & AGING, SOCIAL ENVIRONMENT PRESIDENT & CEO, YMCA OF HONOLULU EXPERTISE: EXERCISE, NUTRITION, & WEIGHT, OLDER ADULTS & AGING STATE DIRECTOR, HAWAI'I, NUTRITION AND PHYSICAL ACTIVITY COALITION, DEPARTMENT OF EDUCATION EXPERTISE: EXERCISE, NUTRITION, & WEIGHT EXECUTIVE DIRECTOR, KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES EXPERTISE: MATERNAL, FETAL & INFANT HEALTH, SOCIAL ENVIRONMENT DIRECTOR, HAWAII STATE DEPARTMENT OF HEALTH EXPERTISE: SUBSTANCE ABUSE & LIFESTYLE/VALIDATION OF PRIORITIZED HEALTH NEEDS HEALTHCARE TRANSFORMATION OFFICER, OFFICE OF THE GOVERNOR EXPERTISE: ORAL HEALTH EXECUTIVE DIRECTOR, MENTAL HEALTH AMERICA OF HAWAII EXPERTISE: MENTAL HEALTH & MENTAL DISORDERS STATE SENATOR, EXECUTIVE MEDICAL DIRECTOR, HAWAII INDEPENDENT PHYSICIANS ASSOCIATION EMERGENCY ROOM PHYSICIAN EXPERTISE: DIABETES, SUBSTANCE ABUSE & LIFESTYLE CEO, HAWAII PRIMARY CARE ASSOCIATION EXPERTISE: RESPIRATORY DISEASES DIRECTOR, EMERGENCY SERVICES, CITY AND COUNTY OF HONOLULU EXPERTISE: INJURY PREVENTION & SAFETY HEALTHY HAWAII INITIATIVE, TOBACCO SETTLEMENT PROJECT MANAGER, HAWAII STATE DEPARTMENT OF HEALTH EXPERTISE: RESPIRATORY DISEASES PROFESSOR OF OBSTETRICS/GYNECOLOGY, DIRECTOR OF FAMILY PLANNING, JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAII EXPERTISE: FAMILY PLANNING EXECUTIVE DIRECTOR, HALE NA'AU PONO EXPERTISE: MENTAL HEALTH & MENTAL DISORDERS EXECUTIVE DIRECTOR, AMERICAN DIABETES ASSOCIATION HAWAII EXPERTISE: DIABETES ADMINISTRATOR, PEARL CITY NURSING HOME, EXPERTISE: OLDER ADULTS & AGING CHIEF OF MEDICINE, PALI MOMI MEDICAL CENTER EXPERTISE: INJURY PREVENTION & SAFETY CEO, KAMEHAMEHA SCHOOLS, EXPERTISE: EDUCATION/VALIDATION OF PRIORITIZED HEALTH NEEDS PROFESSOR AND CHAIR OF PEDIATRICS, JOHN A. BURNS SCHOOL OF MEDICINE, UNIVERSITY OF HAWAII, MEDICAL DIRECTOR, KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN EXPERTISE: IMMUNIZATIONS & INFECTIOUS DISEASES CHIEF MEDICAL OFFICER, ALOHA CARE EXPERTISE: ACCESS TO HEALTH SERVICES, SOCIAL ENVIRONMENT DIRECTOR, HAWAII INITIATIVE FOR CHILDHOOD OBESITY RESEARCH AND EDUCATION, JOHN A. BURNS SCHOOL OF MEDICINE DEPARTMENT OF PEDIATRICS, UNIVERSITY OF HAWAII EXPERTISE: ACCESS TO HEALTH SERVICES, EXERCISE, NUTRITION, & WEIGHT CHIEF MEDICAL OFFICER, HAWAII MEDICAL SERVICE ASSOCIATION EXPERTISE: MATERNAL, FETAL & INFANT HEALTH, OLDER ADULTS & AGING DIRECTOR, HILOPA'A FAMILY TO FAMILY HEALTH INFORMATION CENTER EXPERTISE: IMMUNIZATIONS & INFECTIOUS DISEASES CHIEF, EMERGENCY MEDICAL SERVICES AND INJURY PREVENTION SYSTEMS BRANCH, HAWAII STATE DEPARTMENT OF HEALTH EXPERTISE: INJURY PREVENTION & SAFETY ADMINISTRATOR, CARERESOURCE HAWAII EXPERTISE: TRANSPORTATION EXECUTIVE DIRECTOR, ST. FRANCIS HOME HEALTH CARE SERVICES EXPERTISE: CANCER, OLDER ADULTS & AGING RESEARCH DIRECTOR, PAPA OLA LOKAHI EXPERTISE: CANCER, HEART DISEASE & STROKE FACILITY 3 STRAUB CLINIC AND HOSPITAL (STRAUB) IN CONDUCTING STRAUB'S MOST RECENT CHNA, ADOPTED JUNE 2013, INTERVIEWS WERE HELD WITH 22 COMMUNITY REPRESENTATIVES WITH PUBLIC HEALTH EXPERTISE IN THE TOP TEN HEALTH TOPIC AREAS IDENTIFIED FOR THE STATE OF HAWAI'I AND/OR POSSESSING SPECIAL KNOWLEDGE OF VULNERABLE POPULATIONS, INCLUDING (BUT NOT LIMITED TO) LOW-INCOME, MENTALLY ILL, OR PARTICULAR RACIAL/ETHNIC GROUPS. THE INPUT FROM THE INTERVIEWS WAS TAKEN INTO ACCOUNT IN THE CHNA IN THE FOLLOWING WAYS: A SUMMARY QUALITATIVE ANALYSIS TOOL CALLED A "WORD CLOUD" WAS PRODUCED TO IDENTIFY THE MOST COMMON THEMES AND TOPICS RAISED BY THE COMMUNITY REPRESENTATIVES; AND RELEVANT INPUT WAS SUMMARIZED UNDER EACH HEALTH TOPIC AREA ANALYZED IN THE CHNA AND FACTORED INTO THE QUALITATIVE EVALUATION OF THE HEALTH NEED. IN ADDITION, 2 COMMUNITY LEADERS BROADLY REPRESENTING COMMUNITY HEALTH CONCERNS FOR THE STRAUB SERVICE AREA WERE CONSULTED TO VALIDATE THE CHOSEN PRIORITY COMMUNITY HEALTH NEEDS: DIRECTOR OF THE HAWAII DEPARTMENT OF HEALTH, AND A STATE SENATOR. PERSONS CONSULTED STATE DIRECTOR, HAWAII NUTRITION AND PHYSICAL ACTIVITY COALITION, DEPARTMENT OF EDUCATION EXPERTISE: EXERCISE, NUTRITION & WEIGHT DEPUTY DIRECTOR, BEHAVIORAL HEALTH SERVICES ADMINISTRATION, HAWAII DEPARTMENT OF HEALTH EXPERTISE: MENTAL HEALTH & MENTAL DISORDER
SCHEDULE H, PART V, SECTION B, LINE 6A	THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED COLLABORATIVELY BY THE FOLLOWING FACILITIES: KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN PALI MOMI MEDICAL CENTER STRAUB CLINIC & HOSPITAL WILCOX MEMORIAL HOSPITAL
SCHEDULE H, PART V, SECTION B, LINE 6B	THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH THE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES LISTED BELOW: HEALTH CARE ASSOCIATION OF HAWAII HEALTHY COMMUNITIES INSTITUTE
SCHEDULE H, PART V, SECTION B, LINE 7A	COMMUNITY HEALTH NEEDS ASSESSMENT WEBSITE KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN HTTPS://WWW.HAWAIIPACIFICHEALTH.ORG/MEDIA/1716/CHNA-KAPIOLANI.PDF PALI MOMI MEDICAL CENTER HTTPS://WWW.HAWAIIPACIFICHEALTH.ORG/MEDIA/1718/CHNA-PALIMOMI.PDF STRAUB CLINIC & HOSPITAL HTTPS://WWW.HAWAIIPACIFICHEALTH.ORG/MEDIA/1715/CHNA-STRAUB.PDF WILCOX MEMORIAL HOSPITAL HTTPS://WWW.HAWAIIPACIFICHEALTH.ORG/MEDIA/1709/CHNA-WILCOX.PDF
SCHEDULE H, PART V, SECTION B, LINE 10A	IMPLEMENTATION STRATEGY PLAN WEBSITE KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN https://www.hawaiipacifichealth.org/media/1064/kapiolani-implementation-st rategy-plan_final.pdf PALI MOMI MEDICAL CENTER https://www.hawaiipacifichealth.org/media/1083/pali-momi-medicalcenter-imp lementation-strategy-plan_final.pdf STRAUB CLINIC & HOSPITAL https://www.hawaiipacifichealth.org/media/1082/straub-implementation-strat egyplan.pdf WILCOX MEMORIAL HOSPITAL https://www.hawaiipacifichealth.org/media/1080/wilcoxmemorial-hospital-imp lementation-strategyplan.pdf
SCHEDULE H, PART V, SECTION B, LINE 11	KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN THE FOLLOWING ACTIVITIES WERE CONDUCTED IN FISCAL YEAR 2015 BY KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (KAPI'OLANI) TO ADDRESS THE TWO PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN ITS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: ACCESS TO HEALTH SERVICES, AND MATERNAL, FETAL AND INFANT HEALTH. THESE ACTIVITIES REFLECT STEPS TAKEN IN YEAR TWO TO EXECUTE A THREE-YEAR IMPLEMENTATION STRATEGY. KAPI'OLANI MEDICAL CENTER'S 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY MAY BE VIEWED ONLINE AT: HTTP://WWW.HAWAIIPACIFICHEALTH.ORG/ABOUT-US/COMMUNITY/ PRIORITY AREA 1: ACCESS TO HEALTH SERVICES HEALTH PROFESSIONS EDUCATION KAPI'OLANI MEDICAL CENTER PROVIDED CLINICAL TRAINING AND RESIDENCIES FOR MEDICAL RESIDENTS, NURSING STUDENTS AND ALLIED HEALTH PROFESSIONALS TO INCREASE THE CAPACITY OF THE LOCAL HEALTH CARE WORKFORCE AND IMPROVE THE AVAILABILITY OF, AND ACCESS TO, QUALITY SPECIALTY MEDICAL CARE FOR WOMEN AND CHILDREN IN THE STATE OF HAWAI`I. - THE PHYSICIAN MEDICAL RESIDENCY PROGRAM TRAINED 44 PHYSICIANS IN FAMILY PRACTICE, INTERNAL MEDICINE, PEDIATRICS, PSYCHIATRY, NEONATAL, OBSTETRICS AND GYNECOLOGY, ORTHOPEDICS, PATHOLOGY AND SURGERY. THE PROGRAM WAS OFFERED IN PARTNERSHIP WITH THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE AND TRIPLER ARMY MEDICAL CENTER. KAPI'OLANI MEDICAL CENTER ALSO TRAINED MEDICAL STUDENTS IN PARTNERSHIP WITH THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE. - THE NURSING STUDENT TRAINING PROGRAM PROVIDES CLINICAL TRAINING FOR STUDENT NURSES IN PARTNERSHIP WITH THE UNIVERSITY OF HAWAI'I SCHOOL OF NURSING AND HAWAI'I PACIFIC UNIVERSITY. - THE ALLIED PROFESSIONAL AND TECHNICIAN TRAINING PROGRAM CONDUCTED CLINICAL TRAINING FOR RESPIRATORY THERAPISTS, CHILD LIFE SPECIALISTS, RADIOLOGY TECHNICIANS AND OTHER SPECIALIZED CLINICIANS IN ALLIED HEALTH SPECIALTIES, IN PARTNERSHIP WITH HAWAI'I UNIVERSITIES, COMMUNITY COLLEGES AND TECHNICAL SCHOOLS. - KAPI'OLANI MEDICAL CENTER OPERATES OB-GYN CLINICS FIVE DAYS A WEEK THAT PROVIDE SPECIALTY TRAINING IN OBSTETRICS AND GYNECOLOGY FOR MEDICAL RESIDENTS. BREAST AND CERVICAL CANCER CONTROL PROGRAM THE BREAST AND CERVICAL CANCER CONTROL PROGRAM, OFFERED STATEWIDE, PROVIDES BREAST AND CERVICAL CANCER SCREENING FOR HIGH RISK POPULATIONS. SERVICES INCLUDE OUTREACH, PROFESSIONAL EDUCATION, TRACKING, FOLLOW-UP AND PUBLIC EDUCATION. THE GOAL IS TO REDUCE THE MORTALITY DISCREPANCY AMONG NATIVE HAWAIIANS, FILIPINOS, UNINSURED OR UNDERINSURED, AND WOMEN AGES 50-64. THE PROGRAM IS PARTIALLY FUNDED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION THROUGH THE HAWAI'I STATE DEPARTMENT OF HEALTH. HAWAI'I COMMUNITY GENETICS PROGRAM HAWAI'I COMMUNITY GENETICS IS THE ONLY PROGRAM IN THE STATE DEDICATED TO CARING FOR INDIVIDUALS OF ALL AGES WHO ARE AFFECTED BY BIRTH DEFECTS, DEVELOPMENTAL CONCERNS AND GENETIC CONDITIONS. IT IS A UNIQUE COLLABORATION BETWEEN KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN, KAPI'OLANI MEDICAL SPECIALISTS, THE STATE OF HAWAI'I DEPARTMENT OF HEALTH, AND THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE. THE SERVICE OFFERS CONSULTATIONS TO INDIVIDUALS THROUGHOUT THE STATE, CONDUCTING MONTHLY NEIGHBOR ISLAND OUTREACH CLINICS AND PROVIDING TELEMEDICINE SERVICES FOR FAMILIES RESIDING ON THE NEIGHBOR ISLANDS. THE FOLLOWING SPECIALTY CLINICS ARE ALSO OFFERED: HEMOGLOBINOPATHY CLINIC CLEFT AND CRANIOFACIAL CENTER KULANA MULAMA OUTREACH CLINIC ADULT CANCER RISK ASSESSMENT PROGRAM METABOLIC GENETICS CLINIC FETAL ALCOHOL SPECTRUM DISORDER (FASD) DIAGNOSTIC CLINIC MEDICAL TRANSPORT SERVICES AS THE ONLY WOMEN'S AND CHILDREN'S HOSPITAL IN THE STATE OF HAWAI'I, KAPI'OLANI MEDICAL CENTER PROVIDES SUPPORT FOR INTER-HOSPITAL TRANSPORT FROM THE NEIGHBOR ISLANDS TO O'AHU AND TO THE MAINLAND FOR CRITICAL NEONATAL AND PEDIATRIC PATIENTS REQUIRING ACCESS TO SPECIALTY CARE NOT AVAILABLE IN THEIR COMMUNITIES. PRIORITY AREA 2: MATERNAL, FETAL AND INFANT HEALTH CHILD INJURY PREVENTION - CHILD PASSENGER SAFETY THE CHILD PASSENGER SAFETY PROGRAM PROMOTES PUBLIC AWARENESS OF THE NEED TO USE CHILD PASSENGER RESTRAINTS (CAR SEATS AND BOOSTER SEATS) AND SEAT BELTS, AND PROVIDES ASSISTANCE WITH THE PROPER FIT AND INSTALLATION OF VARIOUS CAR SEATS AND BOOSTER SEATS AT A VARIETY OF COMMUNITY VENUES. THE PROGRAM ALSO ASSISTS FAMILIES THAT MEET FINANCIAL NEED CRITERIA TO OBTAIN LOW- OR NO-COST CHILD SAFETY SEATS. KAPI'OLANI MEDICAL CENTER STAFF PROVIDED FREE CAR SEAT CHECKS, TRAININGS AND EDUCATIONAL PROGRAMS AT 22 COMMUNITY EVENTS IN FY15, ASSISTING OVER 500 FAMILIES WITH CAR SEAT INSTALLATION AND CHILD SAFETY EDUCATION. - KEIKI INJURY PREVENTION COALITION AND SAFE KIDS KAPI'OLANI MEDICAL CENTER SPONSORS THE KEIKI INJURY PREVENTION COALITION (KIPC), WHICH INCLUDES MORE THAN 40 AGENCIES AND STAKEHOLDERS COMMITTED TO IMPROVING CHILD SAFETY. THE COALITION IS AFFILIATED WITH THE NATIONAL CHAPTER OF SAFE KIDS WORLDWIDE, A GLOBAL ORGANIZATION DEDICATED TO PREVENTING INJURIES IN CHILDREN, AND KAPI'OLANI IS THE SAFE KIDS LEAD HOSPITAL FOR THE STATE OF HAWAI'I. KIPC PROGRAMS AND ACTIVITIES IN FY15 INCLUDED: - SPONSORSHIP OF QUARTERLY KIPC MEETINGS. - MULTIPLE HEALTH FAIRS THAT EDUCATED CHILDREN AND FAMILIES ON ALL ASPECTS OF INJURY PREVENTION, INCLUDING CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, WATER AND SWIM SAFETY, SPORTS INJURY PREVENTION, BIKE AND WHEELED VEHICLE SAFETY, BURN PREVENTION, POISON PREVENTION, WINDOW FALLS PREVENTION, SHAKEN BABY SYNDROME PREVENTION AND SAFE SLEEP/SIDS PREVENTION. - PROVISION OF MORE THAN 500 BIKE/MULTISPORT HELMETS FREE OF CHARGE TO CHILDREN AND YOUTH. SWEETER CHOICE DIABETIC INTERVENTION PROGRAM THE SWEETER CHOICE PROGRAM WORKS WITH HIGH-RISK PREGNANT WOMEN TO REDUCE GESTATIONAL AND PRE-GESTATIONAL DIABETES BY HELPING THEM DEVELOP HEALTHY DIET AND EXERCISE HABITS, RESULTING IN A DECREASE IN THE NUMBER OF LOW BIRTH-WEIGHT BABIES. A TOTAL OF 482 PREGNANT WOMEN AND NEW MOTHERS PARTICIPATED IN FY15. IN ADDITION, KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN CONTINUED ITS PARTNERSHIP WITH THE STATE DEPARTMENT OF HEALTH AND IN FY14 BEGAN TO EXPAND THE SWEETER CHOICE PROGRAM TO FEDERALLY QUALIFIED HEALTH CENTERS ON OAHU. A TRAINING CURRICULUM WAS DEVELOPED BY KAPI'OLANI AND IN FY15 MEETINGS TO INTRODUCE THE PROGRAM WERE HELD WITH STAFF PERSONS FROM SEVEN O'AHU FEDERALLY-QUALIFIED HEALTH CENTERS. "HAPAI" APP "HAPAI" (MEANING "PREGNANT" IN HAWAIIAN) IS A COMPREHENSIVE PREGNANCY APP FOR EXPECTANT MOMS. FROM WEEK-TO-WEEK UPDATES AND EDUCATION ON BOTH PRENATAL AND FETAL CARE, TO TOOLS LIKE A CONTRACTION COUNTER AND A FEEDING LOG- HAPAI HELPS EXPECTANT MOM'S LEARN, PLAN AND PREPARE FOR THEIR BABY'S ARRIVAL. THE APP IS FREE TO ALL AND AVAILABLE IN BOTH THE ANDROID AND IPHONE APP STORES. HAPAI WAS ADDED TO KAPI'OLANI'S IMPLEMENTATION STRATEGY IN FY15 TO ADDRESS THE NEED FOR IMPROVED PRENATAL CARE AND BREAST FEEDING PRACTICES IDENTIFIED IN KAPI'OLANI'S 2013 COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH FOUND THE FREQUENCY OF LOW BIRTH WEIGHT BABIES IN HAWAI'I IS HIGHER THAN THE NATIONAL AVERAGE. IN ADDITION, HAWAI'I HAS NOT ACHIEVED NATIONAL GOALS FOR NEWBORN AND INFANT BREASTFEEDING. HAPAI WAS DESIGNED TO BE AN EASILY ACCESSIBLE SOURCE OF INFORMATION TO HELP WOMEN IN HAWAI'I ACHIEVE HEALTHY BIRTH OUTCOMES, WITH A FOCUS ON LOCAL RESOURCES AND LOCAL CULTURAL PERSPECTIVES. N.E.W. KEIKI WEIGHT MANAGEMENT PROGRAM THE NEW KEIKI ("KEIKI" MEANS CHILD IN HAWAIIAN) PROGRAM WAS ADDED TO KAPI'OLANI'S IMPLEMENTATION STRATEGY IN FY14. IT IS AN EVIDENCE-BASED INTERVENTION WITH A DEMONSTRATED IMPACT ON ADDRESSING CHILDHOOD OBESITY, WHICH WAS FOUND TO BE A SIGNIFICANT AND INCREASING HEALTH CONCERN IN KAPI'OLANI'S 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. THE N.E.W. (NUTRITION EXERCISE WEIGHT) KEIKI WEIGHT MANAGEMENT PROGRAM, CREATED BY KAPI'OLANI IN PARTNERSHIP WITH THE YMCA OF HONOLULU, IS A FAMILY-BASED INTERVENTION TO COMBAT CHILDHOOD OBESITY. IT USES A MULTI-DISCIPLINARY APPROACH, WORKING WITH THE CHILD AND FAMILY UNIT TO DEVELOP A HEALTHY LIFESTYLE FOR THE WHOLE FAMILY. THE PROGRAM INCLUDES EDUCATION ON PROPER NUTRITION, COOKING CLASSES FOR THE WHOLE FAMILY, AN EXERCISE COMPONENT THAT INCLUDES HIKES AND OTHER OUTINGS, MENTAL HEALTH INTERVENTIONS, FAMILY SUPPORT AND COMMUNITY BUILDING. IN FY15, NEW KEIKI WAS EXPANDED TO LEEWARD O'AHU IN COLLABORATION WITH PALI MOMI MEDICAL CENTER, AND TO THE WINDWARD SIDE IN COLLABORATION WITH CASTLE MEDICAL CENTER. THREE COHORTS WERE CONDUCTED, WITH 77 CHILDREN AND ADOLESCENTS AND THEIR FAMILIES COMPLETING THE PROGRAM. HAWAI'I PACIFIC HEALTH KIDS' FEST THIS ANNUAL HEALTH FAIR FOR FAMILIES AND CHILDREN IS A COLLABORATION OF HAWAI'I PACIFIC HEALTH'S FOUR HOSPITALS - KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB CLINIC & HOSPITAL AND WILCOX MEMORIAL HOSPITAL - HOSTED BY BISHOP MUSEUM. HANDS-ON ACTIVITIES, SUCH AS A TEDDY BEAR CLINIC, KEIKI ZUMBA, BALLOON OLYMPICS, WHEEL OF NUTRITION AND FIRE SAFETY HOUSE, AIM TO TEACH CHILDREN ABOUT HEALTHY
SCHEDULE H, PART V, SECTION B, LINE 11 (CONTINUED)	WILCOX MEMORIAL HOSPITAL WILCOX MEMORIAL HOSPITAL (WILCOX) CONDUCTED THE FOLLOWING ACTIVITIES IN FISCAL YEAR 2015 TO ADDRESS THE TWO PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN ITS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: ACCESS TO HEALTH SERVICES AND EXERCISE, NUTRITION, AND WEIGHT. THESE ACTIVITIES REFLECT STEPS TAKEN IN YEAR TWO TO EXECUTE A THREE-YEAR IMPLEMENTATION STRATEGY. WILCOX'S 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY MAY BE VIEWED ONLINE AT: HTTP://WWW.HAWAIIPACIFICHEALTH.ORG/HEALTHASSESSMENT PRIORITY AREA 1: ACCESS TO HEALTH SERVICES COMMUNITY HEALTH FAIRS AND SCREENINGS - KIDS' SUMMER FEST: WILCOX'S ANNUAL KIDS' SUMMER FEST WAS HELD FOR KAUA'I FAMILIES ON JUNE 13, 2015 AT SMITH'S TROPICAL PARADISE. AN ESTIMATED 957 PEOPLE ATTENDED THE FREE EVENT, WHICH PROVIDED HANDS-ON WORKSHOPS FOCUSED ON HEALTHY, ACTIVE LIFESTYLES, EXERCISE AND NUTRITION AND INJURY PREVENTION. PHYSICALS AND VISION TESTING ALSO WERE OFFERED TO CHILDREN ON-SITE. COMMUNITY PARTNERS AND PARTICIPANTS INCLUDED ALOHA CARE, AMERICAN MEDICAL RESPONSE, COALITION FOR A TOBACCO-FREE HAWAI'I, GARDEN ISLAND 4-H RANCHERS, HAWAI'I DENTAL SERVICES, HAWAI'I LIFE FLIGHT, HO'OLA LAHUI HAWAI'I, KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN, HMSA, KAUA'I FIRE DEPARTMENT PREVENTION BUREAU, KAUA'I LIFEGUARD ASSOCIATION, KAUA'I MEDICAL CLINIC, KAUA'I MEDICAL RESERVE CORP, P.A.T.C.H AND UNITED HEALTHCARE COMMUNITY PLAN. - KIDS' FEST: WILCOX PARTICIPATED IN THE HAWAI'I PACIFIC HEALTH'S ANNUAL KIDS' FEST HELD ON OCTOBER 26, 2014 AT THE BISHOP MUSEUM ON O'AHU. AN ESTIMATED 5,957 PEOPLE ATTENDED THE FREE EVENT, WHICH PROVIDED HANDS-ON WORKSHOPS FOCUSED ON HEALTHY LIFESTYLES. WILCOX'S PHYSICAL THERAPY DEPARTMENT CONDUCTED A WORKSHOP ON THE IMPORTANCE OF STRENGTH AND BALANCE FOR DAILY AND RECREATIONAL ACTIVITIES. WILCOX ALSO PARTNERED WITH THE KAUA'I LIFEGUARD ASSOCIATION TO PROVIDE A WORKSHOP ON OCEAN SAFETY TO PREVENT DROWNINGS IN HAWAI'I'S VERY POWERFUL AND UNPREDICTABLE WATERS. - SKIN CANCER AWARENESS AND SUN PROTECTION CAMPAIGN: WILCOX IMPLEMENTED AN EDUCATION PROGRAM TO HELP THE COMMUNITY BETTER UNDERSTAND THE IMPORTANCE OF SKIN CANCER PREVENTION, INCLUDING THE DANGERS OF UV RAYS AND THE IMPORTANCE OF USING AND REAPPLYING SUNSCREEN. (KAUA'I COUNTY HAS A HIGHER AVERAGE RATE OF MELANOMA CASES THAN THE STATE.) THE HOSPITAL PARTNERED WITH THE AMERICAN CANCER SOCIETY TO SHARE IMPORTANT INFORMATION AND DISTRIBUTE SUN PROTECTION RESOURCES, SUCH AS A FREE SUNSCREEN BOOTH FOR OVER 200 CHILDREN AND ADULTS AT THE IRON BROTHER PINE TREES KEIKI SURF CLASSIC, THE LARGEST SURF CONTEST ON THE ISLAND FOR CHILDREN, HELD APRIL 18, 2015 IN HANALEI ON THE NORTH SHORE OF KAUA'I. A BASELINE SURVEY WAS CONDUCTED TO OBTAIN THE SUN PROTECTION HABITS OF THOSE ATTENDING THE EVENT. 73% OF THE 138 RESPONDENTS (BOTH CHILDREN AND ADULTS) SPENT MORE THAN FIVE HOURS IN THE SUN AND USUALLY OR ALWAYS USED SUNSCREEN. FOR THOSE WHO ALWAYS USED SUNSCREEN, MOST OCCASIONALLY REAPPLIED IT. ANOTHER SURVEY WILL BE CONDUCTED IN FY16 TO DETERMINE THE IMPACT OF THE EDUCATION PROGRAM. - STAYING ACTIVE WITH ARTHRITIS: WILCOX IMPLEMENTED AN EDUCATION PROGRAM TO INFORM INDIVIDUALS WITH ARTHRITIS ON THE IMPORTANCE OF STAYING PHYSICALLY ACTIVE. THIS FREE WORKSHOP WAS HELD OCTOBER 4, 2014 AND PROVIDED IMPORTANT INFORMATION TO RESIDENTS ON THE WESTSIDE OF KAUAI TO HELP THEM PREVENT CHRONIC CONDITIONS THAT ARE COMMON AMONG ADULTS WITH ARTHRITIS, SUCH AS DIABETES, HEART DISEASE AND OBESITY. THE HOSPITAL'S GOAL IS TO ADDRESS THE GROWING TREND OF OBESITY AMONG ADULTS, WHICH IS WORSENING ON KAUA'I. - VIDEO TELECONFERENCES ON HEALTH TOPICS: IN PARTNERSHIP WITH THE OTHER HOSPITALS OF HAWAI'I PACIFIC HEALTH, FREE COMMUNITY HEALTH EDUCATION EVENTS THAT WERE PRESENTED ON O'AHU, WERE BROUGHT TO KAUA'I RESIDENTS VIA VIDEO TELECONFERENCE ON-SITE AT WILCOX MEMORIAL HOSPITAL. TOPICS INCLUDED: WOMEN'S HEALTH, CURRENT ISSUES IN CANCER CARE, HEART HEALTH, AND ARTHRITIS. A TOTAL OF 283 INDIVIDUALS ATTENDED THE VIDEO CONFERENCE EVENTS ON KAUA'I. - SENIOR FALL PREVENTION: THE GOAL OF THE SENIOR FALL PREVENTION WORKSHOPS WERE TO PREVENT SENIORS FROM VISITING THE ER DUE TO FALL-RELATED INJURIES ACCORDING TO THE IPCP OVERVIEW OF INJURY AMONG SENIORS IN HAWAI'I, 2015, EVERY DAY ON AVERAGE 22 SENIORS ARE TREATED FOR FALL-RELATED INJURIES IN HAWAII'S HOSPITALS, OR NEARLY ONE EVERY HOUR. OVER 90% OF HIP FRACTURES ARE THE RESULT OF FALLS. WILCOX'S TRAUMA PROGRAM PARTNERED WITH THE DEPARTMENT OF PARKS AND RECREATION TO CONDUCT A FALL PREVENTION WORKSHOP AT SENIOR ASSEMBLY DAYS AT FOUR NEIGHBORHOOD CENTERS ISLAND-WIDE. THE PROGRAM FOCUSED ON PREVENTION EDUCATION, INCLUDING MEDICATION REVIEWS BY THE PHARMACY PROGRAM AT THE UNIVERSITY OF HAWAI'I AT HILO TO IDENTIFY MEDICINES THAT MAY CAUSE SIDE EFFECTS OR INTERACTIONS SUCH AS DIZZINESS OR DROWSINESS. BALANCE TESTING WAS CONDUCTED BY THE WILCOX PHYSICAL THERAPY DEPARTMENT TO ASSESS MOBILITY. IN ADDITION, A WORKSHOP WAS CONDUCTED AT THE KAUAI PRIMETIME WELLNESS FAIR. THE SENIOR FALL PREVENTION WORKSHOPS IMPACTED 390 INDIVIDUALS. - KEIKI BIKE AND SAFETY DAY: WILCOX PARTNERED WITH SEVERAL COMMUNITY ORGANIZATIONS TO CONDUCT A KAUA'I KEIKI BIKE AND SAFETY DAY DURING NATIONAL BIKE MONTH. THE EVENT PROVIDED A BIKE AND SKATEBOARD SKILLS COURSE, CAR SEAT SAFETY INSPECTIONS, ACTIVITY BOOTHS AND FREE HELMETS IN AN EFFORT TO INCREASE AWARENESS OF SAFE RIDING AND PREVENTABLE INJURIES, SUCH AS HEAD TRAUMA. THE MAY 2, 2015 EVENT DREW 115 CHILDREN. COMMUNITY PARTNERS INCLUDED KAUA'I PATH, KAUA'I SKATE OHANA, AMERICAN MEDICAL RESPONSE, KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN, KAUA'I POLICE DEPARTMENT, HAWAI'I LIFE FLIGHT, DEPARTMENT OF HEALTH, KAUA'I MEDICAL RESERVE CORP, DEPARTMENT OF TRANSPORTATION, BOY SCOUTS OF AMERICA, AND THE LIONS CLUB. - PREVENTION OF UNINTENTIONAL DROWNING: WILCOX SUPPORTED AN INITIATIVE BY THE KAUA'I LIFEGUARD ASSOCIATION TOWARDS THE DEVELOPMENT OF 250,000 KAUA'I BEACH SAFETY GUIDES. KAUA'I COUNTY HAS THE SECOND HIGHEST UNINTENTIONAL DROWNING DEATH RATE IN THE STATE. THE KAUA'I BEACH SAFETY GUIDES PROVIDED CRITICAL INFORMATION TO PREVENT OCEAN-RELATED INJURIES AND DEATHS DUE TO UNINTENTIONAL DROWNING. - OPEN AIRWAYS ASTHMA CLASS: WILCOX MEMORIAL HOSPITAL PROVIDED THE DEPARTMENT OF EDUCATION WITH PEAK FLOW METERS TO MEASURE LUNG CAPACITY AND ASTHMA TEACHING KITS FOR STUDENTS AND PARENTS PARTICIPATING IN THE OPEN AIRWAYS ASTHMA CLASS AT KEKAHA ELEMENTARY SCHOOL LOCATED ON THE WEST SIDE OF THE ISLAND. PNEUMONIA & FLU VACCINATION CAMPAIGNS WILCOX PROVIDED FREE BACTERIAL PNEUMONIA VACCINATIONS FOR ELIGIBLE ADULTS, AGES 65 AND OLDER, AT THE KAUA'I ELDER LAW FAIR. PARTNERS WITH WILCOX INCLUDED THE LEGAL AID SOCIETY OF HAWAII- KAUA'I. WILCOX ALSO CONDUCTED FREE FLU VACCINATIONS CLINICS FOR ELIGIBLE ADULTS, WITH THE MAJORITY AGES 65 AND OLDER. IMMUNIZATIONS AND INFECTIOUS DISEASE RANKED EIGHTH AMONG KAUAI COUNTY'S AREAS OF NEED. THE KAUA'I AGENCY ON ELDERLY AFFAIRS ASSISTED WITH REGISTRATION AND LANGUAGE TRANSLATION; KAUA'I DEPARTMENT OF PARKS AND RECREATION SCHEDULED CLINICS ON SENIOR ASSEMBLY DAYS AT THE NEIGHBORHOOD CENTERS AND PROVIDED LOGISTICS ASSISTANCE AND PROMOTION; AND THE PHARMACY PROGRAM AT THE UNIVERSITY OF HAWAI'I AT HILO ASSISTED WITH REGISTRATIONS AND FIELDED QUESTIONS. FLU VACCINATION CLINICS WERE ALSO HELD AT THE QUEEN LILI'UOKALANI CHILDREN'S CENTER'S OHANA RAISING KEIKI CONFERENCE, KAMEHAMEHA ISLAND SCHOOL IN KAUMAKANI FOR TEACHERS, MCDONALD'S FIT AND HEALTH FAIR, AND THE KAUA'I ECONOMIC OPPORTUNITY'S TRANSITIONAL HOUSING CENTER. AFTER HOURS PHARMACY WILCOX'S AFTER HOURS PHARMACY IS THE ONLY PHARMACY OPEN AFTER NORMAL BUSINESS HOURS ON THE ISLAND OF KAUA'I, A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED POPULATION AREA. IT PROVIDES CRITICAL AND TIME SENSITIVE MEDICATIONS TO THE COMMUNITY DURING EVENING HOURS WHEN OTHER PHARMACIES ON THE ISLAND ARE CLOSED. IN FY15, 1,487 PRESCRIPTIONS WERE FILLED/REFILLED DURING THESE LATE HOURS. CARDIAC REHABILITATION SERVICES WILCOX PROVIDED FREE PHYSICAL REHABILITATION SERVICES TO KAUA'I RESIDENTS TO SUPPORT RECOVERY FROM CONGESTIVE HEART FAILURE, CARDIAC SURGERY AND CARDIAC EVENTS. CARDIAC REHABILITATION SERVICES ARE NOT OTHERWISE AVAILABLE ON KAUA'I. IN FY15, 84 INDIVIDUALS BENEFITED FROM THIS SERVICE. A NUTRITION COMPONENT WAS ADDED TO THE PROGRAM AND INCLUDED CLASSES TAUGHT BY REGISTERED DIETITIANS SPECIFICALLY TAILORED TO LOWERING CHOLESTEROL AND REDUCING SALT INTAKE, INCLUDING A HEART HEALTHY DIET. THE FIRST SERIES OF FREE CLASSES ENROLLED A TOTAL OF 17 INDIVIDUALS. CHEMOTHERAPY WILCOX'S CHEMOTHERAPY CENTER IS THE ONLY ONE AVAILABLE ON THE ISLAND OF KAUA'I. IT PROVIDES TREATMENTS THAT WOULD OTHERWISE NOT BE AVAILABLE TO THE COMMUNITY AND LESSENS THE NEED FOR ISLAND RESIDENTS WITH CANCER TO FLY TO O'AHU OR TO THE MAINLAND FOR CARE. THE AMERICAN CANCER SOCIETY, A PARTNER WITH WILCOX, IS PART OF THE HOSPITAL'S CANCER COMMITTEE. DURING FY15, THERE WERE 1,780 PATIENT VISITS TO THE CHEMOTHERAPY CENTER. ADVANCE CARE PLAN
SCHEDULE H, PART V, SECTION B, LINE 16I	HPH PUBLISHES THE AVAILABILITY OF A FINANCIAL AID POLICY ON ITS WEB SITE AND VIA TENT CARDS DISPLAYED IN ADMISSION, FINANCIAL SERVICES AND PATIENT CARE DEPARTMENTS.
SCHEDULE H, PART V, SECTION B, LINE 22D	All bills and patient statements are based on gross charges. FAP-eligible patients received fixed percentage discounts from gross charges based on income level and do not pay gross charge.

Schedule H (Form 990) 2014

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?21
Name and address		Type of Facility (describe)
1	STRAUB PEARLRIDGE CLINIC 98-151 PALI MOMI STREET SUITE 142 AIEA,HI96701	CLINIC
2	PALI MOMI PAVILLIONWOMEN'S CENTER 98-1005 MOANALUA RD FS2 AEIA,HI96701	CLINIC
3	KAPI'OLANI WOMEN'S CENTER 1907 BERETANIA STREET 1st 5th Fl HONOLULU,HI96826	CLINIC
4	STRAUB MILILANI FAMILY HLTH CNTR 95-1249 MEHEULA PKWY UNIT 187 MILILANI,HI96789	CLINIC
5	STRAUB HAWAI'I KAI FAMILY HLTH CNTR 7192 KALANIANAOLE HIGHWAY STE A200 HONOLULU,HI96825	CLINIC
6	DOCS ON CALL-PRINCESS KAIULANI HOTEL 120 KAIULANI AVE LOBBY LEVEL HONOLULU,HI96815	CLINIC
7	STRAUB KANEOHE FAMILY HLTH CNTR 46-056 KAMEHAMEHA HWY SUITE 221 KANEOHE,HI96744	CLINIC
8	PALI MOMI CLINIC 98-1079 MOANALUA RD STE 640/630/590 AIEA,HI96701	CLINIC
9	STRAUB KAILUA FAMILY HLTH CNTR 602 KAILUA ROAD SUITE 200 KAILUA,HI96734	CLINIC
10	STRAUB LANAI FAMILY HLTH CNTR 628-B SEVENTH STREET LANAI CITY,HI96763	CLINIC
11	STRAUB KONA CLINIC 75-240 NANI KAILUA DRIVE STE 6B KAILUAKONA,HI96740	CLINIC
12	ARTESIAN SATELLITE 1907 BERETANIA ST 5TH FLOOR HONOLULU,HI96826	CLINIC
13	STRAUB CLINIC AT WATERFRONT PLAZA 500 ALA MOANA BLVD TOWER 7 STE 23 HONOLULU,HI96813	CLINIC
14	DOCS ON CALL-HILTON HAWAIIAN VILLAGE 2005 KALIA ROAD 2ND FLOOR HONOLULU,HI96815	CLINIC
15	STRAUB KAPOLEI CLINIC 590 FARRINGTTON HIGHWAY 100 KAPOLEI,HI96707	CLINIC
16	KUAKINI CLINIC 321 NORTH KUAKINI STREET STE 504 HONOLULU,HI96817	CLINIC
17	STRAUB HILO CLINIC 75 PUUHONU PLACE STTE 207 HILO,HI96720	CLINIC
18	WINDWARD HEART CENTER 25 MALUNIU AVE SUITE 201 KAILUA,HI96734	CLINIC
19	STRAUB'S WOMEN SERVICES 1319 PUNAHOU ST SUITE 520 HONOLULU,HI96826	CLINIC
20	STRAUB CLINIC AT 1ST INSUR CNTR 1100 WARD AVE SUITE 700 HONOLULU,HI96813	CLINIC
21	DOCS ON CALL - SHERATON 2255 KALAKAUA AVE HONOLULU,HI96815	CLINIC

Schedule H (Form 990) 2014

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SCHEDULE H, PART I, LINE 3C	N/A
SCHEDULE H, PART I, LINE 6A	COMMUNITY BENEFITS ARE INCLUDED IN A REPORT PREPARED BY HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATIONS' PARENT.
SCHEDULE H, PART I, LINE 7G	NO COSTS OF A PHYSICIAN CLINIC WERE INCLUDED AS SUBSIDIZED HEALTH SERVICES.
SCHEDULE H, PART I, LINE 7	COST TO CHARGE RATIO AND SCHEDULE H WORKSHEET WAS USED TO CALCULATE THE COSTS.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES WHEN DISCHARGING PATIENTS, PALI MOMI MEDICAL CENTER FOLLOWS THE GUIDELINES OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE PROCEDURES INVOLVED WITH PROVIDING A SAFE DISCHARGE PLAN INCLUDE DESIGNATING A PERMANENT OR TRANSITIONAL DESTINATION FOR ALL PATIENTS LEAVING THE HOSPITAL. HOWEVER, IN SOME CASES, PATIENTS HAVE NO INSURANCE OR ARE PENDING APPROVAL UNDER THE MEDICAID PROGRAM FOR PAST SERVICES PROVIDED. THESE PATIENTS DO NOT REQUIRE FURTHER HOSPITAL-GRADE CARE BUT RATHER, FOLLOW-UP CARE AT A TRANSITIONAL CARE FACILITY, SUCH AS A LICENSED FOSTER CARE HOME OR REHABILITATION CENTER. IN THESE SPECIAL CIRCUMSTANCES, PALI MOMI WILL PAY AN INDEPENDENT CASE MANAGER FROM THE COMMUNITY, USUALLY A NURSE REPRESENTATIVE OF AN INDEPENDENT CASE MANAGEMENT COMPANY, TO ASSUME CARE OF THE PATIENT. THE CASE MANAGER IDENTIFIES AN APPROPRIATE FACILITY, HELPS THE PATIENT TRANSITION THERE, AND MONITORS THE PATIENT. PALI MOMI ASSUMES RESPONSIBILITY FOR THE FINANCIAL COST UNTIL INSURANCE APPROVAL UNDER MEDICAID IS ESTABLISHED. PALI MOMI DOES THIS TO ENSURE THAT A SAFE DISCHARGE PLAN IS BEING FOLLOWED, AND TO MAKE AVAILABLE A HOSPITAL BED FOR AN ACUTE OR CRITICALLY-ILL PATIENT WHO REQUIRES HOSPITAL-GRADE CARE. STRAUB CLINIC & HOSPITAL IS COMMITTED TO ATTRACTING AND RETAINING TOP-QUALITY PHYSICIANS IN HAWAI'I, WHERE LOSING PHYSICIANS TO THE U.S. MAINLAND IS A CONSTANT THREAT. ACCORDING TO HAWAI'I MEDICAL JOURNAL AND HAWAI'I PHYSICIAN WORKFORCE ASSESSMENT PROJECT, BY 2020, HAWAI'I WILL HAVE 1,500 FEWER PHYSICIANS THAN NEEDED TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. SHORTAGES WILL BE PARTICULARLY SEVERE IN PRIMARY CARE, CARDIOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, GENERAL SURGERY, AND OTHER SPECIALTIES. IN FISCAL YEAR 2015, STRAUB SPENT $466,319 TO ATTRACT PHYSICIANS TO HAWAI'I. THIS INCLUDED HIRING A FULL-TIME RECRUITER AND PHYSICIAN SERVICES MANAGER, PURCHASING A LAPTOP COMPUTER AND "PRACTICE MATCH SERVICES" DATABASE, HIRING PHYSICIAN CONSULTANTS TO RECRUIT MAINLAND PHYSICIANS, OFFICE AND TRAVEL EXPENSES, TRAVEL EXPENSES OF PHYSICIAN CANDIDATES, GENERAL RECRUITMENT ACTIVITIES, AND MOVING EXPENSES OF PHYSICIANS AND THEIR FAMILY MEMBERS. STRAUB COVERS THESE COSTS TO HELP ENSURE THAT THE COMMUNITY'S FUTURE HEALTH CARE NEEDS WILL BE MET. WHEN DISCHARGING PATIENTS, WILCOX MEMORIAL HOSPITAL FOLLOWS THE GUIDELINES OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL STRIVES TO ENSURE THAT A SAFE DISCHARGE PLAN IS PROVIDED TO ALL PATIENTS. THIS MAY INVOLVE PROVIDING SOME PATIENTS WITH TRANSPORTATION TO A PERMANENT OR TRANSITIONAL DESTINATION. IN SOME CASES, INDIGENT PATIENTS ARE READY FOR DISCHARGE, BUT DO NOT HAVE THE ABILITY TO PAY FOR TRANSPORTATION OR HOUSING, MEDICATIONS AND MEDICAL EQUIPMENT, SPECIFIC FOODS REQUIRED AS PART OF A RESTRICTED DIET, OR A NURSE ESCORT DEEMED MEDICALLY NECESSARY. IN THESE SPECIAL CIRCUMSTANCES, WILCOX WILL TEMPORARILY COVER THESE COSTS. BY HELPING ITS MOST VULNERABLE POPULATION OVERCOME FINANCIAL BARRIERS, WILCOX IS HELPING TO ENSURE A SMOOTH TRANSITION TO AN APPROPRIATE CARE SETTING FOR ALL PATIENTS, AS WELL AS MAKING AVAILABLE A HOSPITAL BED FOR AN ACUTE OR CRITICALLY ILL PATIENT WHO REQUIRES HOSPITAL-GRADE CARE.
SCHEDULE H, PART III, LINE 4	THE ESTIMATE FOR BAD DEBT THAT COULD HAVE POTENTIALLY QUALIFIED FOR CHARITY CARE WAS CALCULATED BY FIRST COMPUTING THE BAD DEBT ASSOCIATED WITH THE UNINSURED, THEN CALCULATING THE COST USING A COST TO CHARGE RATIO (PER SCHEDULE H WORKSHEET 2) AND THEN APPLYING MANAGEMENTS ESTIMATE FOR PORTION OF UNINSURED THAT COULD HAVE QUALIFIED FOR CHARITY CARE. MANAGEMENT CONSERVATIVELY ESTIMATES THAT 15-20% OF THE UNINSURED BAD DEBT COULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE IF SUFFICIENT INFORMATION WAS OBTAINED TO DEMONSTRATE FINANCIAL NEED. PER THE CONSOLIDATED AUDITED FINANCIAL STATEMENT OF HAWAI'I PACIFIC HEALTH ("HPH"), THE FILING ORGANIZATION'S PARENT: THE PROVISION FOR BAD DEBTS EXPENSE IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL AND BUSINESS AND ECONOMIC TRENDS, TRENDS IN HEALTHCARE COVERAGES AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BAD DEBT CONSISTS OF SERVICES FOR WHICH THE COMPANY ANTICIPATED BUT DID NOT RECEIVE PAYMENT BECAUSE OF THE PATIENTS' UNWILLINGNESS TO PAY. BAD DEBT ALSO INCLUDES SERVICES FOR MEDICALLY INDIGENT AND/OR UNINSURED PATIENTS WHO ARE UNABLE TO PAY AND WHO MIGHT HAVE QUALIFIED FOR CHARITY CARE HAD THE PATIENT SELF-IDENTIFIED THEMSELVES AS MEDICALLY INDIGENT ALONG WITH PROVIDING INFORMATION SO THAT PROPER MEANS TESTING COULD HAVE BEEN ACCOMPLISHED TO QUALIFY THE PATIENT FOR CHARITY CARE.
SCHEDULE H, PART III, LINE 8	BECAUSE TAX-EXEMPT HOSPITALS MUST PARTICIPATE IN MEDICARE AND MEDICAID AS A CONDITION OF MAINTAINING THEIR FEDERAL TAX-EXEMPT STATUS, MEDICARE UNDERPAYMENTS ARE NOT OPERATING EXPENSES THAT SHOULD BE EXPECTED IN THE ORDINARY COURSE OF BUSINESS. BECAUSE TAX-EXEMPT HOSPITALS MUST ACCEPT MEDICARE RATES THAT ARE IN SOME CASES BELOW COST, THEY SHOULD BE ABLE TO REPORT ANY NEGATIVE DIFFERENCES BETWEEN MEDICARE RATES AND COST AS LOSSES INCURRED BY SERVICING THE COMMUNITY. TOTAL MEDICARE COSTS WERE CALCULATED IN ACCORDANCE WITH THE FEDERAL STANDARD FORM CMS-2552.96.
SCHEDULE H, PART III, LINE 9B	COLLECTION PROCEDURES FOR PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE FOLLOW THE SAME POLICY AS ALL OTHER PATIENTS. IN GENERAL THE POLICY INVOLVES SENDING FOLLOW UP STATEMENTS AND DOING FOLLOW UP PHONE CALLS. PAYMENT OPTIONS ARE ALSO PRESENTED TO THE PATIENT AS PART OF THE COLLECTION PROCESS. ACCOUNTS NOT COLLECTED WITHIN THE SPECIFIED TIME PERIOD OUTLINED IN THE POLICY (HOSPITAL AND PHYSICIAN CLAIMS) ARE SENT TO A COLLECTION AGENCY FOR COLLECTION.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT THE HOSPITALS OF HAWAI'I PACIFIC HEALTH PARTNERED WITH THE HEALTHCARE ASSOCIATION OF HAWAII AND THE HEALTHY COMMUNITIES INSTITUTE TO CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) FOR EACH OF THE COMMUNITIES SERVED BY THE HOSPITALS. THE CHNAS WERE COMPLETED IN JUNE 2013. OUR APPROACH FOLLOWED THE PUBLIC HEALTH MODEL OF ASSESSING AND UNDERSTANDING COMMUNITY HEALTH HOLISTICALLY. A FRAMEWORK FOR ANALYSIS WAS CONSTRUCTED BASED ON DETERMINANTS OF HEALTH; THE FRAMEWORK INCLUDED A BROAD DEFINITION OF COMMUNITY HEALTH THAT CONSIDERS SECONDARY DATA ON THE SOCIAL, ECONOMIC, AND PHYSICAL ENVIRONMENTS, AS WELL AS HEALTH RISKS AND OUTCOMES. SPECIAL ATTENTION WAS GIVEN TO IDENTIFYING HEALTH DISPARITIES, THE NEEDS OF VULNERABLE POPULATIONS, AND UNMET HEALTH NEEDS OR GAPS IN SERVICES. A BROAD ARRAY OF SECONDARY AND PRIMARY DATA WAS COLLECTED AND SYNTHESIZED TO DETERMINE COMMUNITY NEEDS. OVER 140 INDICATORS FROM OVER 20 SOURCES FROM A DATABASE MAINTAINED BY THE HAWAI'I DEPARTMENT OF HEALTH WERE ANALYZED USING A SYSTEMATIC AND QUANTITATIVE APPROACH THAT INCORPORATED MULTIPLE BENCHMARKS AND COMPARISONS. ADDITIONAL ANALYSES INCLUDED PREVENTABLE CAUSES OF HOSPITALIZATION USING DATA PROVIDED BY THE HAWAII HEALTH INFORMATION CORPORATION, AND INFORMATION FROM RECENTLY PUBLISHED REPORTS ON ACCESS TO CARE, HEALTH DISPARITIES, PRIMARY CARE NEEDS, AND BEHAVIORAL HEALTH NEEDS. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS HAVING SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS, HEALTH DISPARITIES, AND VULNERABLE POPULATIONS IN THE IDENTIFIED COMMUNITIES.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE WHEN A PATIENT PRESENTS FOR SERVICES AND THE PATIENT DOES NOT HAVE INSURANCE COVERAGE FOR SERVICES TO BE PROVIDED, THE PATIENT, OR GUARANTOR IS ASKED TO SIGN THE "SELF-PAY ACKNOWLEDGEMENT" LETTER. THE LETTER DESCRIBES THE TERMS OF THE HAWAI'I PACIFIC HEALTH ("HPH") UNINSURED DISCOUNT PROGRAM, AND BY SIGNING THE LETTER, THE PATIENT ACKNOWLEDGES THAT HE/SHE UNDERSTANDS AVAILABLE UNINSURED PAYMENT TERMS. IN MOST UNINSURED CASES, THE PATIENT WILL BE OFFERED A HAWAI'I STATE MEDICAL ASSISTANCE APPLICATION. THIS IS THE APPLICATION FOR THE HAWAI'I STATE MEDICAID/QUEST PROGRAM. THE HOSPITAL CONTRACTS WITH SERVICE PROVIDERS WHO SPECIALIZE IN ASSISTING PATIENTS WITH THE MEDICAID/QUEST PROGRAM APPLICATION PROCESS. IF THE PATIENT'S APPLICATION FOR MEDICAID/QUEST IS DENIED OR IT IS DETERMINED THAT THE PATIENT IS INELIGIBLE TO APPLY FOR MEDICAID/QUEST, THE PATIENT MAY APPLY FOR HPH FINANCIAL ASSISTANCE EITHER IN THE HOSPITAL FINANCIAL SERVICES DEPARTMENT OR BY MAIL DIRECTLY TO THE HPH BUSINESS SERVICES OFFICE. FINANCIAL COUNSELORS ARE AVAILABLE ON SITE TO REVIEW PAYMENT OPTIONS WITH THE PATIENT OR THE GUARANTOR. THESE OPTIONS INCLUDE THE AFOREMENTIONED HPH UNINSURED DISCOUNT PROGRAM, THE HAWAI'I STATE MEDICAID/QUEST PROGRAM, THE HPH FINANCIAL ASSISTANCE PROGRAM, PAYMENT PLANS AND ANY GRANT OR FUNDING SOURCE THAT MAY BE APPROPRIATE FOR THE SERVICES PROVIDED. IN SOME CASES, HPH DETERMINES THAT A PATIENT OR GUARANTOR MAY NEED ASSISTANCE AFTER SERVICES ARE PROVIDED, AND FINANCIAL INFORMATION IS MAILED TO THE PATIENT. EDUCATION AND ASSISTANCE IS OFTEN PROVIDED VIA PHONE CONTACT IN THESE CASES. PAYMENT PLAN ARRANGEMENTS ARE HANDLED VIA PHONE CONTACT WITH THE PATIENT.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION THE AFFILIATE HOSPITALS OF HAWAI'I PACIFIC HEALTH TREAT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS SAFETY NET PROVIDERS OF HEALTH CARE FOR THE COMMUNITY. DEMOGRAPHICS OF THE STATE OF HAWAI'I INCLUDE 1.4M RESIDENTS AND 8.2M VISITORS (2013 DATA). UNINSURED PATIENTS EQUAL 1.41 PERCENT OF HAWAI'I PACIFIC HEALTH'S TOTAL AND 23.15 PERCENT ARE MEDICAID RECIPIENTS. THERE ARE 30 OTHER HOSPITALS IN THE STATE THAT PROVIDE ACUTE SERVICES, INCLUDING THOSE THAT ARE COMMUNITY ACCESS HOSPITALS. AREAS AND POPULATIONS DESIGNATED AS MEDICALLY-UNDERSERVED BY THE FEDERAL GOVERNMENT ARE PRESENT. KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN HAS BEEN TREATING WOMEN, CHILDREN AND INFANTS FOR MORE THAN A CENTURY. IT IS HAWAI'I'S ONLY MATERNITY, NEWBORN AND PEDIATRIC SPECIALTY HOSPITAL WITH 207 BEDS. IT IS ALSO A TERTIARY CARE, TEACHING AND RESEARCH FACILITY. FOR WOMEN, KAPI'OLANI PROVIDES COMPLETE OBSTETRICAL AND GYNECOLOGICAL CARE. FOR INFANTS AND CHILDREN, IT HAS MORE THAN 100 PEDIATRIC SPECIALISTS AND SUBSPECIALISTS. IN FISCAL YEAR 2015, KAPI'OLANI HAD 54,415 IMAGING PROCEDURES, 39,776 WOMEN'S CENTER PROCEDURES, 43,397 ER VISITS, AND 17,243 INPATIENT ADMISSIONS. ITS GEOGRAPHIC SERVICE AREA IS THE ENTIRE PACIFIC BASIN AS MANY SPECIALTIES OFFERED ARE NOT AVAILABLE ELSEWHERE. PALI MOMI MEDICAL CENTER IS A COMMUNITY-BASED, ACUTE-CARE HOSPITAL THAT OFFERS A FULL RANGE OF SERVICES IN CARDIOLOGY, ORTHOPEDICS, EMERGENCY MEDICINE, GENERAL SURGERY AND MEDICINE, OPHTHALMOLOGY, WOMEN'S SERVICES, ONCOLOGY AND MORE. IT HAS DELIVERED MANY MEDICAL FIRSTS FOR THE COMMUNITY, INCLUDING WEST O'AHU'S ONLY INTERVENTIONAL CARDIAC CATHETERIZATION UNIT, A WOMEN'S CENTER AND RETINA CENTER. IN FISCAL YEAR 2015, PALI MOMI HAD 93,800 IMAGING PROCEDURES, 48,942 ER VISITS, 42,805 WOMEN'S CENTER PROCEDURES, AND 6,255 INPATIENT ADMISSIONS. PALI MOMI'S GEOGRAPHIC SERVICE AREA IS PRIMARILY CENTRAL O'AHU, WEST O'AHU AND THE NORTH SHORE. HOWEVER, FOR A FEW SELECT SERVICES, PALI MOMI IS ONE OF JUST A HANDFUL OF PROVIDERS ACROSS THE REGION. THE RETINA CENTER, FOR EXAMPLE, OFFERS HIGHLY SPECIALIZED CARE SOUGHT BY RESIDENTS ACROSS THE STATE AND FROM AS FAR AWAY AS JAPAN. STRAUB CLINIC & HOSPITAL HAS SERVED THE PEOPLE OF HAWAI'I FOR 90+ YEARS. THE FULLY INTEGRATED HEALTH CARE SYSTEM HAS A 159-BED HOSPITAL IN HONOLULU, NETWORK OF NEIGHBORHOOD CLINICS, AND A VISITING SPECIALISTS PROGRAM TO IMPROVE ACCESS TO MEDICAL SERVICES FOR NEIGHBOR ISLAND RESIDENTS. STRAUB HOUSES AN ARRAY OF PHYSICIAN SPECIALISTS UNDER ONE ROOF, ENABLING PATIENTS TO RECEIVE DIAGNOSIS AND TREATMENT IN MORE THAN 32 MEDICAL SPECIALTIES. IN FISCAL YEAR 2015, STRAUB HAD 117,417 IMAGING PROCEDURES, 30,471 ER VISITS, AND 6,846 INPATIENT ADMISSIONS. STRAUB IS PROUD TO PROVIDE SERVICES THAT ARE NOT OFFERED BY ANY OTHER PROVIDERS IN THE REGION. THE BURN CENTER, FOR EXAMPLE, IS THE ONLY DEDICATED BURN TREATMENT FACILITY IN HAWAI'I AND TREATS MILITARY AND CIVILIAN PATIENTS THROUGHOUT THE PACIFIC REGION. WILCOX MEMORIAL HOSPITAL HAS SERVED KAUA'I FOR 75+ YEARS. THE ACUTE-CARE FACILITY OFFERS Over 20 SPECIALTIES AND A FULL SUITE OF SERVICES RANGING FROM EMERGENCYAND GENERAL SURGERY TO CARDIOLOGY, GASTROENTEROLOGY, GYNECOLOGY, INTERNAL MEDICINE, OBSTETRICS, ORTHOPEDICS, PALLATIVE CARE, PEDIATRICS, NEUROLOGY, AND WOMEN'S SERVICES. IN FISCAL YEAR 2015, WILCOX HAD 61,281 IMAGING PROCEDURES, 24,654 ER VISITS, AND 3,533 INPATIENT ADMISSIONS. WILCOX'S GEOGRAPHIC SERVICE AREA IS THE ISLAND OF KAUA'I. DEMOGRAPHICS OF THE KAUA'I COMMUNITY IN FISCAL YEAR 2015 INCLUDE AN ESTIMATED POPULATION OF APPROXIMATELY 70,000 (AND MORE THAN 1.1M VISITORS ANNUALLY). REGARDING WILCOX PATIENTS, 1.7 PERCENT ARE UNINSURED AND 16.7 PERCENT ARE MEDICAID RECIPIENTS. THERE ARE TWO OTHER HOSPITALS IN THE COMMUNITY, AND FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS ARE PRESENT.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH WHEN DISCHARGING PATIENTS, PALI MOMI MEDICAL CENTER FOLLOWS THE GUIDELINES OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE PROCEDURES INVOLVED WITH PROVIDING A SAFE DISCHARGE PLAN INCLUDE DESIGNATING A PERMANENT OR TRANSITIONAL DESTINATION FOR ALL PATIENTS LEAVING THE HOSPITAL. HOWEVER, IN SOME CASES, PATIENTS HAVE NO INSURANCE OR ARE PENDING APPROVAL UNDER THE MEDICAID PROGRAM FOR PAST SERVICES PROVIDED. THESE PATIENTS DO NOT REQUIRE FURTHER HOSPITAL-GRADE CARE BUT RATHER, FOLLOW-UP CARE AT A TRANSITIONAL CARE FACILITY, SUCH AS A LICENSED FOSTER CARE HOME OR REHABILITATION CENTER. IN THESE SPECIAL CIRCUMSTANCES, PALI MOMI WILL PAY AN INDEPENDENT CASE MANAGER FROM THE COMMUNITY, USUALLY A NURSE REPRESENTATIVE OF AN INDEPENDENT CASE MANAGEMENT COMPANY, TO ASSUME CARE OF THE PATIENT. THE CASE MANAGER IDENTIFIES AN APPROPRIATE FACILITY, HELPS THE PATIENT TRANSITION THERE, AND MONITORS THE PATIENT. PALI MOMI ASSUMES RESPONSIBILITY FOR THE FINANCIAL COST UNTIL INSURANCE APPROVAL UNDER MEDICAID IS ESTABLISHED. PALI MOMI DOES THIS TO ENSURE THAT A SAFE DISCHARGE PLAN IS BEING FOLLOWED, AND TO MAKE AVAILABLE A HOSPITAL BED FOR AN ACUTE OR CRITICALLY-ILL PATIENT WHO REQUIRES HOSPITAL-GRADE CARE. STRAUB CLINIC & HOSPITAL IS COMMITTED TO ATTRACTING AND RETAINING TOP-QUALITY PHYSICIANS IN HAWAI'I, WHERE LOSING PHYSICIANS TO THE U.S. MAINLAND IS A CONSTANT THREAT. ACCORDING TO HAWAII MEDICAL JOURNAL AND HAWAI'I PHYSICIAN WORKFORCE ASSESSMENT PROJECT, BY 2020, HAWAI'I WILL HAVE 1,500 FEWER PHYSICIANS THAN NEEDED TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. SHORTAGES WILL BE PARTICULARLY SEVERE IN PRIMARY CARE, CARDIOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, GENERAL SURGERY, AND OTHER SPECIALTIES. STRAUB FOCUSED ON BOTH RECRUITING AND RETAINING PHYSICIANS IN FISCAL YEAR 2014, WHO WERE TRAINED IN OR FROM THE STATE OF HAWAI'I. THERE WAS A STRONG EMPHASIS ON RECRUITING PHYSICIANS WITH BACKGROUNDS IN PRIMARY CARE AND PREVENTION. STRAUB ALSO CONTINUED TO STRENGTHEN ITS SPORTS MEDICINE FELLOWSHIP PROGRAM IN FISCAL YEAR 2014, IN CONJUNCTION WITH THE UNIVERSITY OF HAWAI'I. ADDITIONALLY, STRAUB SUPPORTED OFFICE AND TRAVEL EXPENSES, TRAVEL EXPENSES OF PHYSICIAN CANDIDATES, GENERAL RECRUITMENT ACTIVITIES, AND MOVING EXPENSES OF PHYSICIANS AND THEIR FAMILY MEMBERS. STRAUB COVERS THESE COSTS TO HELP ENSURE THAT THE COMMUNITY'S FUTURE HEALTH CARE NEEDS WILL BE MET. WHEN DISCHARGING PATIENTS, WILCOX MEMORIAL HOSPITAL FOLLOWS THE GUIDELINES OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL STRIVES TO ENSURE THAT A SAFE DISCHARGE PLAN IS PROVIDED TO ALL PATIENTS. THIS MAY INVOLVE PROVIDING SOME PATIENTS WITH TRANSPORTATION TO A PERMANENT OR TRANSITIONAL DESTINATION. IN SOME CASES, INDIGENT PATIENTS ARE READY FOR DISCHARGE, BUT DO NOT HAVE THE ABILITY TO PAY FOR TRANSPORTATION OR HOUSING, MEDICATIONS AND MEDICAL EQUIPMENT, SPECIFIC FOODS REQUIRED AS PART OF A RESTRICTED DIET, OR A MEDICALLY NECESSARY NURSE ESCORT. IN THESE SPECIAL CIRCUMSTANCES, WILCOX WILL COVER THESE COSTS. BY HELPING ITS MOST VULNERABLE POPULATION OVERCOME FINANCIAL BARRIERS, WILCOX IS HELPING TO ENSURE A SMOOTH TRANSITION TO AN APPROPRIATE CARE SETTING FOR ALL PATIENTS, AS WELL AS MAKING AVAILABLE A HOSPITAL BED FOR AN ACUTE OR CRITICALLY ILL PATIENT WHO REQUIRES HOSPITAL-GRADE CARE. EACH AFFILIATE HOSPITAL OF HAWAI'I PACIFIC HEALTH IS A LEADER IN COMMUNITY HEALTH CARE EDUCATION AND ADVOCACY, AND MAINTAINS AN OPEN MEDICAL STAFF; THIS ARRANGEMENT GRANTS ADMITTING PRIVILEGES TO NONAFFILIATED PHYSICIAN SPECIALISTS AND BROADENS EACH FACILITY'S ABILITY TO OFFER HIGH-QUALITY, SPECIALIZED CARE TO THEIR RESPECTIVE COMMUNITY. EACH HOSPITAL IS GOVERNED BY A COMMUNITY BOARD COMPRISED OF PHYSICIANS, COMMUNITY MEMBERS AND KEY LEADERSHIP WITHIN HAWAI'I PACIFIC HEALTH. THESE VOLUNTEER, UNPAID MEMBERS ENSURE THAT EACH FACILITY FULFILLS ITS MISSION-DRIVEN GOALS. AS AFFILIATES OF THE NOT-FOR-PROFIT HAWAI'I PACIFIC HEALTH NETWORK, EACH HOSPITAL REINVESTS ALL SURPLUS RESOURCES BACK INTO PATIENT CARE AND TO SUBSIDIZE THOSE WHO CANNOT PAY.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM HAWAI'I PACIFIC HEALTH, ONE OF THE STATE'S LARGEST HEALTH CARE PROVIDERS, IS COMMITTED TO PROVIDING HIGH-QUALITY, ACCESSIBLE CARE AND SERVICES TO THE PEOPLE OF HAWAI'I AND THE PACIFIC REGION. THE HAWAI'I PACIFIC HEALTH SYSTEM INCLUDES FOUR HOSPITALS, MORE THAN 80 LOCATIONS, AND 1,900 AFFILIATED PHYSICIANS. THE HOSPITALS PROVIDE ACUTE AND SPECIALTY CARE WITH 566 BEDS, AND HANDLED 33,877 ADMISSIONS IN FISCAL YEAR 2015. KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN IS THE PRIMARY PEDIATRIC AND OBSTETRIC TEACHING HOSPITAL FOR THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE. IN FISCAL YEAR 2015, KAPI'OLANI INVESTED $3,695,064 IN TEACHING PEDIATRICIANS AND OBSTETRICIANS AND FOR RESEARCH, INCLUDING CLINICAL TRIALS. KAPI'OLANI STRIVES TO INFLUENCE PUBLIC POLICY TO BENEFIT HAWAI'I'S WOMEN AND CHILDREN. IT ACTIVELY SUPPORTS THE SUSAN G. KOMEN BREAST CANCER FOUNDATION, MARCH OF DIMES, HAWAI'I CHILDREN'S CANCER FOUNDATION, AND MORE. THE KAPI'OLANI CHILDREN'S MIRACLE NETWORK SUPPORTS THE COST OF PEDIATRIC HEALTH CARE, MEDICAL EQUIPMENT, NEIGHBOR ISLAND TRAVEL, RESEARCH AND PUBLIC AWARENESS. THE HOSPITAL ALSO OPERATES THE KAPI'OLANI SEX ABUSE TREATMENT CENTER, WHICH AIMS TO REDUCE SEXUAL VIOLENCE AND ENABLE THE STATE'S FORENSIC TEAMS TO INVESTIGATE AND PROSECUTE SEX OFFENSES, AND THE KAPI'OLANI CHILD PROTECTION CENTER, WHICH PROVIDES EXPERTISE IN RECOGNIZING AND TREATING CHILD ABUSE AND NEGLECT. IN FISCAL YEAR 2015, PALI MOMI MEDICAL CENTER EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL AND THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S HEART-CHECK MARK FOR ADVANCED CERTIFICATION FOR PRIMARY STROKE CENTERS. PALI MOMI FOCUSES ON MEETING THE NEEDS OF CENTRAL AND WEST O'AHU AND THE NORTH SHORE. IN FISCAL YEAR 2015, IT HOSTED FREE COMMUNITY HEALTH EVENTS, INCLUDING FAMILY AND SENIOR HEALTH FAIRS, EDUCATIONAL SPEAKERS' SERIES, SUPPORT GROUPS, AND GLUCOSE MONITORING AND BLOOD PRESSURE SCREENINGS. PALI MOMI IS ALSO WORKING TO INCREASE THE NUMBER OF INDIVIDUALS TRAINED IN CPR AND THE AVAILABILITY OF AUTOMATED EXTERNAL DEFIBRILLATORS (AEDS) IN THE COMMUNITY, DONATING THREE TO AREA PUBLIC LIBRARIES. STRAUB CLINIC & HOSPITAL HAS MANY SPECIALTY CARE UNITS. THE BURN CENTER IS THE STATE'S ONLY MULTIDISCIPLINARY BURN TREATMENT CENTER, PROVIDING VICTIMS WITH IMMEDIATE AND COMPREHENSIVE CARE CLOSE TO HOME. STRAUB HAS AN OPEN MEDICAL STAFF IN 19 SPECIALTIES AND AN OPEN/MANAGED MEDICAL STAFF IN 14 SPECIALTIES. IT PROVIDES CHARITY CARE, HEALTH EDUCATION AND PREVENTIVE PROGRAMS TO THE COMMUNITY. IN FISCAL YEAR 2015, STRAUB PROVIDED FREE HEALTH EDUCATION PROGRAMS ON PREVENTING AND MANAGING HEART ATTACKS, CANCER, ARTHRITIS, ASTHMA, ALLERGIES, OSTEOPOROSIS, OBESITY AND DRUG ABUSE. EVENTS INCLUDED "HPH KIDS FEST," "WOMEN'S WAY TO HEALTH," "CANCER CARE," "VALENTINE IN PARADISE," AND "GETTING A GRIP ON ARTHRITIS." "THE HPH WOMEN'S 10K RACE" IS HAWAI'I'S PREMIER FEMALE-ONLY FITNESS EVENT, NOW IN ITS 38TH YEAR. WILCOX MEMORIAL HOSPITAL IS DEDICATED TO PROVIDING KAUA'I WITH AFFORDABLE AND ACCESSIBLE HEALTH CARE. IN 2015, THE AMERICAN HEART ASSOCIATION ONCE AGAIN RECOGNIZED IT FOR EXCELLENCE IN CARDIAC CARE. IT MAINTAINS AN OPEN MEDICAL STAFF IN MORE THAN 20 SPECIALTIES. ALSO, WILCOX IS AN ACTIVE COMMUNITY PARTNER. IN FISCAL 2015, ITS HEALTH EDUCATION, PREVENTION PROGRAMS AND SUPPORT GROUPS FOCUSED ON DIABETES, OBESITY, CANCER, HEART ATTACK/STROKE, IMMUNIZATION, SPORTS MEDICINE, WATER SAFETY, INJURY PREVENTION, AND HEALTH FAIRS. TOGETHER WITH KAUA'I MEDICAL CLINIC, WILCOX HOSTED OR SPONSORED A VARIETY OF COMMUNITY HEALTH EDUCATION EVENTS, AND STAFF SUPPORTED THEIR COMMUNITY BY PARTICIPATING IN ANNUAL CHARITABLE ENDEAVORS. THESE INCLUDED "KIDS SUMMER FEST," "KIDS FEST," "KAUAI MARATHON KEIKI RUN," SEVERAL PHYSICIAN-LED COMMUNITY WALKS, "RELAY FOR LIFE," "HOEDOWN FOR HOPE," "KEIKI BIKE AND SAFETY DAY," "CANCER CARE VIDEO TELECONFERENCE," "WOMEN'S WAY TO HEALTH VIDEO TELECONFERENCE," "VALENTINE IN PARADISE CARDIOLOGY VIDEO TELECONFERENCE," "ACTIVE WITH ARTHRITIS COMMUNITY HEALTH EVENT," AND "OLD KOLOA SUGAR MILL RUN."
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT N/A

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number
38-3835105

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) MARCH OF DIMES FOUNDATION 1580 MAKALOA ST HONOLULU,HI96814	13-1846366	501(C)(3)	10,000	GENERAL SUPPORT
(2) CENTRAL UNION CHURCH 1660 S BERETANIA ST HONOLULU,HI96826	99-0076013	501(C)(3)	6,500	GENERAL SUPPORT
(3) UNIVERSITY OF HAWAI'I FOUNDATION 1337 LOWER CAMPUS ROAD HONOLULU,HI96822	99-0085260	501(C)(3)	44,400	GENERAL SUPPORT
(4) WAHIAWA CENTER FOR COMMUNITY HEALTH PO BOX 860339 WAHIAWA,HI96786	45-5114944	501(C)(3)	20,000	GENERAL SUPPORT
(5) GIRL SCOUTS OF HAWAI'I 410 ATKINSON DR HONOLULU,HI96814	99-0073488	501(C)(3)	25,000	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2014

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
FORM 990, SCHEDULE I, PART I, LINE 2	DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS THE HAWAI'I PACIFIC HEALTH DONATIONS COMMITTEE REVIEWS AND APPROVES DONATIONS TO 501(C)(3) ORGANIZATIONS ON AN ANNUAL BASIS. NO FURTHER MONITORING IS NECESSARY SINCE DONATIONS ARE ONLY MADE TO 501(c)(3)Organizations.

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

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, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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 in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1BEAU NAKAMOTO MDBoard of Director, Vice Chair	(i) (ii)	264,271 ............................... 0	60,496 ............................... 0	7,445 ............................... 0	27,900 ............................... 0	0 ............................... 0	360,112 ............................... 0	0 ............................... 0
2THOMAS J NORDYKE MDB.O.D, Vice Chair (Part Year)	(i) (ii)	244,341 ............................... 0	14,731 ............................... 0	6,001 ............................... 0	27,863 ............................... 0	17,345 ............................... 0	310,281 ............................... 0	0 ............................... 0
3JOHN CULLINEY MDBoard of Director, Vice Chair	(i) (ii)	0 ............................... 403,357	0 ............................... 0	0 ............................... 43,172	0 ............................... 33,400	0 ............................... 18,443	0 ............................... 498,372	0 ............................... 0
4ANDREW DANG MDBoard of Director	(i) (ii)	365,629 ............................... 0	3,000 ............................... 0	7,036 ............................... 0	27,900 ............................... 0	17,345 ............................... 0	420,910 ............................... 0	0 ............................... 0
5MONICA PRICE MDBoard of Director	(i) (ii)	147,976 ............................... 0	7,000 ............................... 0	3,816 ............................... 0	15,909 ............................... 0	21,338 ............................... 0	196,039 ............................... 0	0 ............................... 0
6KENN SARUWATARI MDBoard of Director	(i) (ii)	225,195 ............................... 0	24,250 ............................... 0	7,591 ............................... 0	32,977 ............................... 0	17,344 ............................... 0	307,357 ............................... 0	0 ............................... 0
7R CRAIG NETZERBoard of Director	(i) (ii)	0 ............................... 155,898	0 ...............................	0 ............................... 11,520	0 ............................... 14,862	0 ............................... 6,168	0 ............................... 188,448	0 ............................... 0
8MARTHA SMITHBoard of Director, CEO	(i) (ii)	0 ............................... 350,933	0 ............................... 138,673	0 ............................... 90,140	0 ............................... 130,725	0 ............................... 15,619	0 ............................... 726,090	0 ............................... 84,857
9JENNIE CHAHANOVICHBoard of Director, CEO	(i) (ii)	0 ............................... 298,437	0 ............................... 78,894	0 ............................... 60,322	0 ............................... 106,237	0 ............................... 12,819	0 ............................... 556,709	0 ............................... 55,205
10RAYMOND P VARA JRB.O.D, PRES & CEO	(i) (ii)	0 ............................... 833,937	0 ............................... 356,878	0 ............................... 307,495	0 ............................... 469,840	0 ............................... 20,578	0 ............................... 1,988,728	0 ............................... 280,473
11KATHLEEN CLARKB.O.D, PRES & CEO	(i) (ii)	0 ............................... 261,365	0 ............................... 93,859	0 ............................... 59,198	0 ............................... 100,534	0 ............................... 6,334	0 ............................... 521,290	0 ............................... 49,449
12KENNETH B ROBBINS MDB.O.D.	(i) (ii)	0 ............................... 431,271	0 ............................... 116,774	0 ............................... 184,504	0 ............................... 224,330	0 ............................... 13,403	0 ............................... 970,282	0 ............................... 167,154
13ARTHUR GLADSTONEB.O.D.	(i) (ii)	0 ............................... 333,230	0 ............................... 124,352	0 ............................... 83,650	0 ............................... 114,695	0 ............................... 20,791	0 ............................... 676,718	0 ............................... 65,503
14DAVID OKABEEVP, CFO & Treasurer	(i) (ii)	0 ............................... 437,387	0 ............................... 143,234	0 ............................... 125,076	0 ............................... 189,185	0 ............................... 14,319	0 ............................... 909,201	0 ............................... 103,792
15GAIL LERCHEVP	(i) (ii)	0 ............................... 357,550	0 ............................... 131,651	0 ............................... 142,028	0 ............................... 181,485	0 ............................... 9,087	0 ............................... 821,801	0 ............................... 129,755
16VIRGINIA PRESSLER-FISHER MDEVP	(i) (ii)	0 ............................... 339,093	0 ............................... 91,944	0 ............................... 176,680	0 ............................... 64,598	0 ............................... 20,353	0 ............................... 692,668	0 ............................... 148,690
17CHARLES R CHINGEVP, GEN Counsel & Secretary	(i) (ii)	0 ............................... 328,714	0 ............................... 124,147	0 ............................... 140,057	0 ............................... 172,988	0 ............................... 20,353	0 ............................... 786,259	0 ............................... 113,586
18STEVEN ROBERTSONEVP & CIO	(i) (ii)	0 ............................... 355,651	0 ............................... 96,346	0 ............................... 176,134	0 ............................... 181,802	0 ............................... 14,819	0 ............................... 824,752	0 ............................... 157,407
19MELINDA ASHTON MDSVP & CQO	(i) (ii)	0 ............................... 338,068	0 ............................... 82,075	0 ............................... 75,876	0 ............................... 76,376	0 ............................... 14,002	0 ............................... 586,397	0 ............................... 59,157
20JOHN LA FORGIASVP & Chief Marketing Officer	(i) (ii)	0 ............................... 295,607	0 ............................... 54,449	0 ............................... 45,930	0 ............................... 17,295	0 ............................... 14,750	0 ............................... 428,031	0 ............................... 27,225
21EARL INOUYEVP & System Controller	(i) (ii)	0 ............................... 240,794	0 ............................... 37,723	0 ............................... 35,009	0 ............................... 54,638	0 ............................... 18,773	0 ............................... 386,937	0 ............................... 24,285
22WARREN CHAIKOVP	(i) (ii)	0 ............................... 219,272	0 ............................... 36,592	0 ............................... 29,425	0 ............................... 40,815	0 ............................... 21,754	0 ............................... 347,858	0 ............................... 20,240
23SUSAN MASUMOTO-NONAKAVP	(i) (ii)	0 ............................... 211,473	0 ............................... 44,037	0 ............................... 32,761	0 ............................... 52,631	0 ............................... 14,599	0 ............................... 355,501	0 ............................... 17,148
24DAWN CHINGVP	(i) (ii)	0 ............................... 199,496	0 ............................... 30,980	0 ............................... 7,586	0 ............................... 50,570	0 ............................... 21,905	0 ............................... 310,537	0 ............................... 15,490
25GIDGET RUSCETTA RNVP	(i) (ii)	0 ............................... 201,682	0 ............................... 34,098	0 ............................... 23,435	0 ............................... 46,644	0 ............................... 13,505	0 ............................... 319,364	0 ............................... 17,049
26PAULA DIASVP	(i) (ii)	0 ............................... 208,240	0 ............................... 33,752	0 ............................... 32,259	0 ............................... 51,532	0 ............................... 13,519	0 ............................... 339,302	0 ............................... 16,908
27MAUREEN FLANNERYVP	(i) (ii)	0 ............................... 211,575	0 ............................... 43,992	0 ............................... 16,829	0 ............................... 46,584	0 ............................... 14,139	0 ............................... 333,119	0 ............................... 17,274
28MAVIS NIKAIDOVP & CNE	(i) (ii)	0 ............................... 206,745	0 ............................... 39,066	0 ............................... 17,758	0 ............................... 46,853	0 ............................... 6,460	0 ............................... 316,882	0 ............................... 14,533
29BRIGITTE MCKALEVP & CNE	(i) (ii)	0 ............................... 195,891	0 ............................... 29,035	0 ............................... 11,701	0 ............................... 44,297	0 ............................... 13,193	0 ............................... 294,117	0 ............................... 14,518
30PATRICIA BOECKMANN RNVP & CNE	(i) (ii)	0 ............................... 268,096	0 ............................... 41,236	0 ............................... 26,640	0 ............................... 50,945	0 ............................... 20,833	0 ............................... 407,750	0 ............................... 27,655
31RANDY YATES MDCMO	(i) (ii)	0 ............................... 335,110	0 ............................... 52,472	0 ............................... 21,419	0 ............................... 35,387	0 ............................... 6,498	0 ............................... 450,886	0 ............................... 26,236
32DAVID FOXPrivacy & Info Security OFCR	(i) (ii)	0 ............................... 138,982	0 ............................... 0	0 ............................... 369	0 ............................... 24,204	0 ............................... 20,733	0 ............................... 184,288	0 ............................... 0
33KATIE SHIGEMITSUCompliance Officer	(i) (ii)	0 ............................... 172,613	0 ............................... 0	0 ............................... 1,902	0 ............................... 28,639	0 ............................... 14,059	0 ............................... 217,213	0 ............................... 0
34CASS K NAKASONE MDPHYSICIAN	(i) (ii)	849,436 ............................... 0	2,000 ............................... 0	19,260 ............................... 0	27,900 ............................... 0	18,443 ............................... 0	917,039 ............................... 0	0 ............................... 0
35MARK S GERBER MDPHYSICIAN	(i) (ii)	749,442 ............................... 0	2,000 ............................... 0	24,744 ............................... 0	27,900 ............................... 0	7,377 ............................... 0	811,463 ............................... 0	0 ............................... 0
36STEVEN S GLAZIER MDPHYSICIAN	(i) (ii)	693,904 ............................... 0	............................... 0	22,200 ............................... 0	16,600 ............................... 0	20,243 ............................... 0	752,947 ............................... 0	0 ............................... 0
37HINGSON M CHUN MDPHYSICIAN	(i) (ii)	626,913 ............................... 0	2,000 ............................... 0	76,967 ............................... 0	27,900 ............................... 0	17,345 ............................... 0	751,125 ............................... 0	0 ............................... 0
38WESLEY J KAI MDPHYSICIAN	(i) (ii)	629,924 ............................... 0	3,000 ............................... 0	23,098 ............................... 0	33,400 ............................... 0	12,427 ............................... 0	701,849 ............................... 0	0 ............................... 0
39CHARLES A STEDFORMER DIRECTOR OFFICER	(i) (ii)	0 ............................... 0	0 ............................... 0	0 ............................... 875,587	0 ............................... 0	0 ............................... 11,332	0 ............................... 886,919	0 ............................... 0
40ANN PETERSFORMER OFFICER	(i) (ii)	0 ............................... 4,997	0 ............................... 0	0 ............................... 189,295	0 ............................... 453	0 ............................... 0	0 ............................... 194,745	0 ............................... 0

Schedule J (Form 990) 2014

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART I, QUESTION 3	SUPPLEMENTAL COMPENSATION INFORMATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FORM 990 PART VI, LINE 15A FOR THE PROCESS USED BY HAWAI'I PACIFIC HEALTH TO DETERMINE COMPENSATION.
SCHEDULE J, PART I, QUESTION 4A	SEVERANCE PAY THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT FROM A RELATED ORGANIZATION: CHARLES A. STED - $866,867 ANN PETERS - $189,495
SCHEDULE J, PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. THE CAPITAL ACCUMULATION ACCOUNT (CAA) IS A SECTION 457(F) PROGRAM THAT WAS PREVIOUSLY AFFORDED TO EXECUTIVE OFFICERS OF THE ORGANIZATION TO PROVIDE BENEFITS ON A TAX DEFERRED BASIS. AMOUNTS PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: MARTHA SMITH - $33,021 JENNIE CHAHANOVICH - $15,758 RAYMOND P. VARA JR. - $127,035 KATHLEEN CLARK - $15,019 KENNETH B. ROBBINS, M.D. - $76,808 ARTHUR GLADSTONE - $20,828 DAVID OKABE - $44,675 GAIL LERCH - $48,092 VIRGINIA PRESSLER-FISHER, M.D. - $61,709 CHARLES R. CHING - $54,619 STEVEN ROBERTSON - $52,522 MELINDA ASHTON, M.D. - $23,120 EARL INOUYE - $5,423 WARREN CHAIKO - $1,944 SUSAN MASUMOTO-NONAKA - $130 MAUREEN FLANNERY - $278 PATRICIA BOECKMANN, R.N. - $7,038 HUGH N. HAZENFIELD, MD - $5,607 LONG TERM INCENTIVE PLAN THE LONG TERM INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL AND LONG TERM SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATION: MARTHA SMITH - $103,673 JENNIE CHAHANOVICH - $78,894 RAYMOND P. VARA JR. - $306,878 KATHLEEN CLARK - $68,859 KENNETH B. ROBBINS, M.D. - $116,774 ARTHUR GLADSTONE - $89,352 DAVID OKABE - $118,234 GAIL LERCH - $96,651 VIRGINIA PRESSLER-FISHER, M.D. - $91,944 CHARLES R. CHING - $89,147 STEVEN ROBERTSON - $96,346 MELINDA ASHTON, M.D. - $72,075 EARL INOUYE - $37,723 WARREN CHAIKO - $36,592 SUSAN MASUMOTO-NONAKA - $34,037 DAWN CHING - $30,980 GIDGET RUSCETTA, R.N. - $34,098 MAUREEN FLANNERY - $33,992 MAVIS NIKAIDO - $29,066 BRIGITTE MCKALE - $29,035 PATRICIA BOECKMANN, R.N. - $41,236 RANDY YATES, M.D. - $52,472 HUGH N. HAZENFIELD, MD - $39,528
SCHEDULE J, PART I, LINE 7	NON-FIXED PAYMENTS ARE MADE TO EXECUTIVES BASED ON SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( MISCELLANEOUS ITEMS )	X	3	137,282	FMV
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2014)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PART I, COLUMN B	THE NUMBER LISTED IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.

Schedule M (Form 990) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Return Reference	Explanation
FORM 990, PART I, LINE 1	STATEMENT OF ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES THE AFFILIATE, NOT-FOR-PROFIT HOSPITALS OF HAWAI'I PACIFIC HEALTH - KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB CLINIC & HOSPITAL, AND WILCOX MEMORIAL HOSPITAL - ANCHOR A HEALTH CARE SYSTEM THAT IS COMMITTED TO PROVIDING HIGH-QUALITY, ACCESSIBLE MEDICAL PROGRAMS AND SERVICES FOR THE PEOPLE OF HAWAI'I AND THE PACIFIC REGION.
FORM 990, PART III, LINE 1	STATEMENT OF ORGANIZATION'S MISSION KAPI'OLANI MEDICAL CENTER'S MISSION IS TO IMPROVE AND ADVOCATE FOR THE HEALTH AND WELL-BEING OF WOMEN AND CHILDREN OF HAWAI'I AND THE PACIFIC REGION. PALI MOMI IS BASED IN WEST O'AHU AND DEDICATED TO THE HEALTH AND WELL-BEING OF ALL HAWAI'I RESIDENTS. STRAUB IS A HEALTH CARE SYSTEM WHOSE MISSION IS TO PROVIDE INTEGRATED HEALTH AND MEDICAL SERVICES THAT ARE COMPREHENSIVE, CARING, CONTINUOUSLY IMPROVING AND OF THE HIGHEST QUALITY. WILCOX SERVES THE KAUA'I COMMUNITY WITH ACCESSIBLE, QUALITY HEALTH CARE THAT SURPASSES EXPECTATIONS.
FORM 990, PART III, LINES 4A-4D	PROGRAM SERVICE ACCOMPLISHMENTS PROGRAM SERVICE #1 WOMEN'S SERVICES - OBSTETRICS/GYNECOLOGY IN FISCAL YEAR 2015, HAWAI'I PACIFIC HEALTH SPENT $48,983,402 IN DIRECT EXPENSES FOR WOMEN'S OB/GYN SERVICES AS PART OF ITS MISSION TO PROVIDE MEDICAL CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. KAPI'OLANI IS THE ONLY HOSPITAL IN HAWAI'I SPECIALIZING IN MATERNITY AND GYNECOLOGICAL CARE. IT IS THE REGIONAL PERINATAL CENTER FOR THE STATE. IT HAS SPECIALTY AND SUB-SPECIALTY OB/GYN PHYSICIANS ON STAFF 24/7, SUCH AS MATERNAL FETAL MEDICINE SPECIALISTS TO MANAGE HIGH-RISK PREGNANCIES AND DELIVERIES. IT PROVIDES GYNECOLOGIC ONCOLOGY SERVICES AND FEATURES A HIGH-RISK BREAST PROGRAM. IT IS A MAJOR TEACHING HOSPITAL FOR THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE'S OB/GYN RESIDENCY PROGRAM. IN FISCAL YEAR 2015, KAPI'OLANI DELIVERED 6,094 BABIES. THE WOMEN'S CENTER PERFORMED 39,776 PROCEDURES. STRAUB'S MAIN HOSPITAL AND ALL FAMILY HEALTH CENTERS PROVIDE DIGITAL MAMMOGRAPHY SERVICES. THE WOMEN'S CLINIC PROVIDES HIGH-QUALITY CARE IN A CALMING, HEALING, ENVIRONMENT. BOARD-CERTIFIED SPECIALISTS PROVIDE OB/GYN CARE, FAMILY PLANNING, LASER SURGERY, LAPAROSCOPY AND COLPOSCOPY, MENOPAUSE, HORMONE REPLACEMENT THERAPY, AND INFERTILITY TREATMENT. MANY OF STRAUB'S PRIMARY CARE PHYSICIANS ALSO SPECIALIZE IN WOMEN'S HEALTH WITH PERSONAL, COMPREHENSIVE AND CONTINUING CARE. PALI MOMI PROVIDES COMPREHENSIVE WOMEN'S HEALTH SERVICES, PRIMARILY FOR THE CENTRAL, WEST O'AHU AND NORTH SHORE COMMUNITIES. SERVICES AVAILABLE INCLUDE HYSTERECTOMIES, OB/GYN ULTRASOUNDS, UROLOGY, INFUSION CHEMOTHERAPY, BREAST HEALTH SERVICES AND BONE HEALTH SCREENINGS. THE PALI MOMI WOMEN'S CENTER ALSO OFFERS THE STATE'S ONLY AUTOMATED WHOLE BREAST ULTRASOUND, THE LATEST TECHNOLOGY AVAILABLE TO DETECT BREAST CANCER FOR WOMEN WHO HAVE BEEN DIAGNOSED WITH DENSE BREAST TISSUE. IN FISCAL YEAR 2015, PALI MOMI'S WOMEN'S CENTER PERFORMED 42,805 PROCEDURES. THE WILCOX WOMEN'S CENTER PROVIDES DIAGNOSIS, TREATMENT, MAMMOGRAPHY WITH TOMOSYNTHESIS AND STEREOTACTIC CAPABILITIES, BONE DENSITY SCREENING, ULTRASOUND AND OTHER PREVENTIVE HEALTH SERVICES. THROUGH KAUA'I MEDICAL CLINIC, WILCOX PROVIDES COMPREHENSIVE OB/GYN CARE: DELIVERY, SURGERY AND OTHER SERVICES. PROGRAM SERVICE #2 OUTPATIENT OPERATING ROOMS IN FISCAL YEAR 2015, HAWAI'I PACIFIC HEALTH HOSPITALS AND CLINICS SPENT $54,784,729 IN DIRECT EXPENSES FOR OUTPATIENT OPERATING ROOMS AND SURGICAL PROCEDURES, AS PART OF OUR MISSION TO PROVIDE CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. PEDIATRIC SURGERIES AT KAPI'OLANI INCLUDE THORACIC/HEART, CLEFT LIP/PALATE, EAR NOSE THROAT, ORTHOPEDIC, NEUROLOGIC, UROLOGIC, OPHTHALMOLOGIC, GASTRO-INTESTINAL, PLASTIC AND GENERAL PROCEDURES. WOMEN'S SURGERIES INCLUDE BREAST BIOPSIES, LUMPECTOMIES, MASTECTOMIES AND RECONSTRUCTION, HYSTEROSCOPIES, INTERSTIM BLADDER IMPLANT AND SUB URETHRAL SLING TO TREAT INCONTINENCE, TUBAL LIGATION AND ENDOMETRIAL ABLATION. KAPI'OLANI IS THE ONLY HOSPITAL IN THE STATE PROVIDING DA VINCI ROBOT-AIDED PEDIATRIC SURGERY. ADDITIONALLY, THE ROBOT IS UTILIZED IN PERFORMING GYNECOLOGICAL SURGICAL SERVICES. THE MINIMALLY INVASIVE SURGERIES PERFORMED USING THE DA VINCI PROVIDE INCREASED BENEFITS FOR PATIENTS, INCLUDING LESS PAIN, LOWER RISK OF INFECTION, AND LESS BLOOD LOSS. IN FISCAL YEAR 2015, KAPI'OLANI PERFORMED 5,354 OUTPATIENT SURGERIES. STRAUB OFFERS INTEGRATED OUTPATIENT SURGERY IN A 7-ROOM SUITE, 2-ROOM PLASTIC SURGERY SUITE, 2-ROOM GENERAL SURGERY DEPARTMENT, 2-ROOM INTERVENTIONAL CARDIAC CATHETERIZATION LABORATORY, INTERVENTIONAL RADIOLOGY SUITES, AND ENDOSCOPY DEPARTMENT. PROCEDURES PERFORMED RANGE FROM MINOR EXCISIONS TO COMPLEX PERIPHERAL INTRAVASCULAR TECHNIQUES. IN FISCAL YEAR 2015, STRAUB PERFORMED 3,610 OUTPATIENT SURGERIES. PALI MOMI HAS A FULLY INTEGRATED, MINIMALLY INVASIVE SURGICAL SUITE EQUIPPED WITH TELEMEDICINE CAPABILITY, TOUCHSCREEN CONTROL PANELS AT THE NURSES' STATION, VOICE ACTIVATION SYSTEM, AND LIVE VIDEO FEED TO MEDICAL CENTERS AROUND THE WORLD. IN FISCAL YEAR 2015, PALI MOMI PERFORMED 3,858 OUTPATIENT SURGERIES. PALI MOMI UTILIZES THE DA VINCI FIREFLY ROBOT-AIDED SYSTEM TO ASSIST WITH MINIMALLY INVASIVE SURGERY. THE MINIMALLY INVASIVE SURGERIES PERFORMED USING THE DA VINCI PROVIDE INCREASED BENEFITS FOR PATIENTS INCLUDING LESS PAIN, LOWER RISK OF INFECTION, AND LESS BLOOD LOSS. WILCOX HAS A STATE-OF-THE-ART SURGICAL CENTER WITH 6 SURGICAL SUITES, 20 SAME-DAY SURGERY BEDS, VOICE-ACTIVATED ROBOTICS AND OTHER COMPUTER-ASSISTED TECHNOLOGIES. IN FISCAL YEAR 2015, WILCOX PERFORMED 6,129 OUTPATIENT SURGERIES. PROGRAM SERVICE #3 OUTPATIENT EMERGENCY ROOMS IN FISCAL YEAR 2015, HAWAI'I PACIFIC HEALTH HOSPITALS SAW 147,464 ER PATIENTS AND SPENT $46,984,102 IN DIRECT EXPENSES FOR OUTPATIENT ER SERVICES, AS PART OF OUR MISSION TO PROVIDE CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. THE KAPI'OLANI ER IS THE ONLY ONE IN THE STATE WITH PEDIATRIC SPECIALISTS AVAILABLE 24/7. IT HAS A TEAM FOR ADULTS AND ANOTHER DEDICATED TO PEDIATRICS, WHERE BOARD-CERTIFIED PEDIATRIC EMERGENCY PHYSICIANS CAN QUICKLY DIAGNOSE AND TREAT A FULL RANGE OF MEDICAL CONDITIONS IN BABIES, CHILDREN AND TEENS, FROM RARE INFECTIONS TO SPORTS INJURIES. IN FISCAL YEAR 2015, THE KAPI'OLANI ER RECEIVED 43,397 PATIENTS. THE STRAUB ER HAS BOARD-CERTIFIED EMERGENCY PHYSICIANS ON STAFF 24/7, 365 DAYS A YEAR, WITH WHEELCHAIR TRANSPORT AND VALET SERVICES AVAILABLE. IN FISCAL YEAR 2015, THE STRAUB ER RECEIVED 30,471 PATIENTS. THE PALI MOMI ER IS THE ONLY ONE IN THE STATE THAT USES A TEAM TRIAGE APPROACH, WHERE PATIENTS ARE PROMPTLY EVALUATED BY A PHYSICIAN. IN FISCAL YEAR 2015, THE PALI MOMI ER RECEIVED 48,942 PATIENTS. THE WILCOX 20-BED ER IS THE FIRST NEIGHBOR ISLAND FACILITY TO OBTAIN A LEVEL III TRAUMA DESIGNATION. IT IMPLEMENTED A TRIAGE BEST PRACTICE, "RAPID TRIAGE AND IMMEDIATE BED PLACEMENT," TO DECREASE DOOR-TO-BED AND DOOR-TO-DOC TIMES, ALLOW SOME PATIENTS TO BYPASS THE TRIAGE AREA, AND LET NURSE ASSESSMENT AND ER PHYSICIAN EVALUATION OCCUR SIMULTANEOUSLY. THIS IMPROVES SERVICE, QUALITY AND SAFETY. IN FISCAL YEAR 2015, THE WILCOX ER RECEIVED 24,654 PATIENTS. PROGRAM SERVICE #4 HAWAI'I PACIFIC HEALTH IS ONE OF THE STATE'S LARGEST HEALTH CARE PROVIDERS WITH FOUR HOSPITALS, MORE THAN 80 LOCATIONS, 1,900 AFFILIATED PHYSICIANS, 6,500+ EMPLOYEES, AND HUNDREDS OF VOLUNTEERS FROM THE COMMUNITY. HAWAI'I RESIDENTS AND VISITORS RELY ON HAWAI'I PACIFIC HEALTH FOR ITS FULL RANGE OF PRIMARY, SECONDARY AND SELECT TERTIARY CARE SERVICES. IN FISCAL YEAR 2015, THE HOSPITALS ADMITTED 33,877 PATIENTS. KAUA'I MEDICAL CLINIC HAD 319,850 TOTAL CLINIC ENCOUNTERS. KAPI`OLANI MEDICAL SPECIALISTS HAD 65,674 PATIENT VISITS. AFFILIATES AND SUBSIDIARIES KAPI'OLANI MEDICAL SPECIALISTS ARE A SPECIALTY PHYSICIANS GROUP ORGANIZED TO SUPPORT KAPI'OLANI MEDICAL CENTER. THE FOUNDATIONS OF HAWAI'I PACIFIC HEALTH CONSIST OF KAPI'OLANI HEALTH FOUNDATION, PALI MOMI HEALTH FOUNDATION, STRAUB FOUNDATION AND WILCOX HEALTH FOUNDATION. THESE CHARITABLE ENTITIES SUPPORT HEALTH RESEARCH, FACILITY ENHANCEMENTS, TECHNOLOGY INVESTMENTS, EDUCATIONAL PROGRAMS AND OTHER RESOURCES FOR THEIR RESPECTIVE HOSPITALS. HAWAI'I PACIFIC HEALTH PARTNERS, INC. IS A FOR-PROFIT SUBSIDIARY THAT SERVES AS THE JOINT VENTURE PARTNER WHEN HAWAI'I PACIFIC HEALTH WORKS WITH OTHER PROVIDERS. PROVIDERS INSURANCE CORPORATION IS A CAPTIVE INSURANCE COMPANY THAT PROVIDES PROFESSIONAL LIABILITY INSURANCE FOR HAWAI'I PACIFIC HEALTH-AFFILIATED EMPLOYED PHYSICIANS. PATIENT CARE HAWAI'I PACIFIC HEALTH HAS STRATEGIC INITIATIVES IN WOMEN'S HEALTH, PEDIATRIC CARE, CARDIOVASCULAR SERVICES, BONE & JOINT SERVICES, AND CANCER CARE. IT IS RECOGNIZED NATIONALLY FOR ITS EXCELLENCE IN HEALTH INFORMATION TECHNOLOGY, SPECIFICALLY THE USE OF ELECTRONIC HEALTH RECORDS TO IMPROVE QUALITY OF CARE AND PATIENT SAFETY. THE HAWAI'I PACIFIC HEALTH NETWORK INCLUDES: THE PACIFIC REGION'S ONLY FULL-SERVICE WOMEN'S AND CHILDREN'S HOSPITAL AND ONLY DEDICATED BURN CENTER, STATE-OF-THE-ART IMAGING CENTER ON KAUA'I, WEST O'AHU'S ONLY CARDIAC CATHETERIZATION LAB, MINIMALLY INVASIVE BONE & JOINT CENTER, SLEEP DISORDERS CENTER, STATE'S FIRST WOMEN'S CENTER, STATE'S ONLY BREAST AND WOMEN'S CANCER CENTERS, AND OTHER SPECIALIZED SERVICES CONSIDERED CRITICAL TO THE REMOTE HAWAIIAN ARCHIPELAGO. COMMUNITY ROLE/ACTIVITY HAWAI'I PACIFIC HEALTH HAS A RESPONSIBILITY TO IMPROVE THE HEALTH OF HAWAI'I RESIDENTS. EACH YEAR, IT SPONSORS HEALTH EDUCATION, TEACHING AND RESEARCH AND SUPPORTS LIKE-MINDED ORGANIZATIONS. IN FISCAL YEAR 2015, HAWAI'I PACIFIC HEALTH SPENT $11.2 MILLION ON COMMUNITY BENEFIT PROGRAMS, INCLUDING THE KAPI'OLANI SEX ABUSE TREATMENT CENTER, KAPI'OLANI CHILD PROTECTION CENTER, HEART DISEASE PREVENTION, BREAST AND CERVICAL CANCER SCREENING FOR UNINSURED PERSONS, WOMEN AND INFANT HEALTH AND NUTRITION, REHABILITATION SERVICES, SUPPORT GROUPS, FREE GLUCOSE MONITORING AND BLOOD PRESSURE SCREENING, HEMOPHILIA PROGRAMS, AND OTHER EDUCATION AND SCREENINGS FOR HAWAI'I RESIDE
FORM 990, PART IV, LINE 11B	INVESTMENTS - OTHER SECURITIES 5% OR MORE OF TOTAL ASSETS KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (KMCWC) AND PALI MOMI MEDICAL CENTER (PMMC) BOTH REPORTED INVESTMENTS IN OTHER SECURITIES GREATER OR EQUAL TO 5% OF TOTAL ASSETS. STRAUB CLINIC & HOSPITAL (SCH) AND WILCOX MEMORIAL HOSPITAL (WMH) BOTH DID NOT REPORT INVESTMENTS IN OTHER SECURITIES GREATER OR EQUAL TO 5% OF TOTAL ASSETS.
FORM 990, PART IV, LINE 11D	OTHER ASSETS 5% OR MORE OF TOTAL ASSETS KMCWC, SCH, AND WMH ALL REPORTED OTHER ASSETS GREATER OR EQUAL TO 5% OF TOTAL ASSETS. PMMC DID NOT REPORT OTHER ASSETS GREATER OR EQUAL TO 5% OF TOTAL ASSETS.
FORM 990, PART VI, LINE 6	MEMBERS AND RIGHTS HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER WHO HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE WITH THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND/OR APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARD.
FORM 990, PART VI, LINE 7A	DESCRIPTION OF CLASSES OF PERSON AND THE NATURE OF THEIR RIGHTS HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER, AND HAS THE POWER TO APPROVE THE ELECTION OF MEMBERS OF THE GOVERNING BODY. HAWAI'I PACIFIC HEALTH, AS MEMBER, ALSO HAS THE POWER TO ELECT ONE OR MORE EX OFFICIO VOTING MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, LINE 7B	DESCR CLASSES OF PERSONS, DECISIONS REQ APPROVAL & TYPE OF VOTING RIGHTS HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS THE FOLLOWING RESERVED POWERS WITH RESPECT TO KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN AND PALI MOMI MEDICAL CENTER: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE EXECUTIVE VICE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS; AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THE BYLAWS; (IV) DETERMINE AND EFFECT THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR FOR ONE MILLION DOLLARS ($1,000,000) OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (VII) DETERMINE AND EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (X) CLOSE THE ACUTE CARE HOSPITAL OWNED AND OPERATED BY THE CORPORATION; (XI) AFTER CONSULTING WITH THE BOARD, REMOVE THE EXECUTIVE VICE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER, TREASURER, SECRETARY, OTHER EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, ASSISTANT SECRETARIES, AND/OR ALL VICE PRESIDENTS EXCEPT THE OPERATING UNIT VICE PRESIDENTS; (XII) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION; AND (XIII) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS THE FOLLOWING POWERS RESERVED TO APPROVE THE FOLLOWING WITH RESPECT TO STRAUB CLINIC & HOSPITAL: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, EXECUTIVE VICE PRESIDENTS OTHER THAN THE EXECUTIVE VICE-PRESIDENT/CHIEF EXECUTIVE OFFICER (THE "EVP/CEO") AND THE; EXECUTIVE VICE-PRESIDENT/CHIEF MEDICAL OFFICER (THE "EVP/CMO") OF THE CORPORATION, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE CLINIC AND HOSPITAL UNIT VICE-PRESIDENTS, AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) REMOVE ANY DIRECTOR FROM THE BOARD; PROVIDED, HOWEVER, THAT THE BOARD MAY REMOVE ANY DIRECTOR FROM THE BOARD IF APPROVED BY THE MEMBER BOARD; (III) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (IV) AMEND THE BYLAWS; (V) THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR FOR ONE MILLION DOLLARS ($1,000,000) OR MORE; (VI) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000); (VII) ACQUIRE SHARES IN ANOTHER CORPORATION; (VIII) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (IX) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (X) DETERMINE AND EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (XI) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (XII) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (XIII) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONSHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; (XIV) CLOSE THE ACUTE CARE HOSPITAL OR CLINIC FACILITIES OWNED AND OPERATED BY THE CORPORATION; (XV) RELOCATE THE ACUTE CARE HOSPITAL OR CLINIC FACILITIES OWNED AND OPERATED BY THE CORPORATION; (XVI) CONVERT THE ACUTE CARE HOSPITAL OWNED AND OPERATED BY THE CORPORATION INTO A NON-ACUTE CARE FACILITY; (XVII) AFTER CONSULTING WITH THE BOARD, REMOVE THE TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, EXECUTIVE VICE-PRESIDENTS OTHER THAN THE EVP/CEO AND THE EVP/CMO, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND/OR ALL VICE-PRESIDENTS EXCEPT THE CLINIC AND HOSPITAL UNIT VICE-PRESIDENTS; AND (XVIII) DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION. THE FOLLOWING ACTIONS REQUIRE APPROVAL FROM THE MEMBER BOARD: (I) ADD ANY DIRECTOR TO THE BOARD; (II) AMEND THE ARTICLES OF INCORPORATION; (III) SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE AMOUNT OF PROPERTY OR ASSETS HELD BY THE ORGANIZATION, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, TO ANY ENTITY THAT IS NOT AN AFFILIATE, EXCEPT THAT IF THE GFS HEALTH PHYSICIAN ADVISORY GROUP (THE "PAG") ELECTS TO INITIATE A SEPARATION ACTION PURSUANT TO ARTICLE XIII OF THE AFFILIATION AGREEMENT BY AND AMONG THE MEMBER, THE ORGANIZATION, AND STRAUB CLINIC AND HOSPITAL, INC., DATED AS OF DECEMBER 23, 2001, THE ORGANIZATION SHALL BE ALLOWED, BY A MAJORITY VOTE OF A QUORUM OF THE BOARD, TO SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE AMOUNT OF THE PROPERTY OR ASSETS HELD BY THE ORGANIZATION, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, AND SHALL NOT BE REQUIRED TO RECEIVE DIRECTION OR APPROVAL TO DO SO FROM THE MEMBER; (IV) IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS; (V) IMPLEMENT INDIVIDUAL PHYSICIAN COMPENSATION ARRANGEMENTS FOR EACH PHYSICIAN OPERATING UNIT IN THE ORGANIZATION; (VI) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE ORGANIZATION WHICH REQUIRE ANNUAL PAYMENTS ON BEHALF OF THE ORGANIZATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VII) ISSUE THE ORGANIZATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (VIII) MERGE THE ORGANIZATION WITH ANY ENTITY; (IX) DISSOLVE THE ORGANIZATION; AND (X) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE. HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS RESERVED POWERS TO APPROVE THE FOLLOWING WITH RESPECT TO WILCOX MEMORIAL HOSPITAL: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS, AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THE BYLAWS; (IV) THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR FOR ONE MILLION DOLLAR ($1,000,000) OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (VII) EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, OR PARTNERSHIP OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (X) EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAW OF THE STATE OF HAWAI'I, SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY WILCOX MEMORIAL HOSPITAL, KAUA'I MEDICAL CLINIC AND WILCOX HEALTH FOUNDATION (THE "WILCOX AFFILIATES"); (XI) EXCEPT AS PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAI'I, SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (XII) CLOSE THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORPORATION; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATI
FORM 990, PART VI, LINES 11B	REVIEW OF THE 990S BY THE ORGANIZATION'S GOVERNING BODY VARIOUS SCHEDULES OF THE 990S ARE PREPARED PRIMARILY BY STAFF WITHIN THE ACCOUNTING AREA OF THE ORGANIZATION WORKING WITH VARIOUS OTHER AREAS OF THE ORGANIZATION SUCH AS MANAGEMENT OF THE OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPILED INTERNALLY BASED ON INPUT AND DISCUSSION WITH FINANCIAL ANALYSTS AND THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF THE REPORTING ENTITY. THE CHIEF OPERATING OFFICER / EXECUTIVE DIRECTOR OF EACH REPORTING ENTITY REVIEWS AND APPROVES THE DISCLOSURE NARRATIVES WHICH DESCRIBES THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYSTEM REVIEWS THE 990S OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE 990S ARE THEN PROVIDED TO THE GOVERNANCE AND NOMINATING COMMITTEE OF THE HEALTH CARE SYSTEM'S BOARD OF DIRECTORS FOR THEIR REVIEW. THE GOVERNANCE AND NOMINATING COMMITTEE OF THE PARENT ENTITY'S (HAWAI'I PACIFIC HEALTH "HPH") BOARD PROVIDES OVERSIGHT FOR THE 990 REPORTING AND REVIEWS THE 990S FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE 990S FOR EACH ENTITY ARE MADE AVAILABLE TO THE BOARD MEMBERS OF EACH SUBSIDIARY UNIT OF HPH AND THE HPH BOARD OF DIRECTORS THROUGH A BOARD MEMBER PORTAL FOR REVIEW PRIOR TO THE FILING OF THE 990. THE 990S WILL BE POSTED TO HPH'S WEB SITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURNS WITH THE IRS.
FORM 990, PART VI, LINE 12C	MONITORING & ENFORCING CONFLICT OF INTEREST POLICY ANNUALLY, EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) RECEIVED A COPY OF THE CONFLICT OF INTEREST ("COI") POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE IN-HOUSE LEGAL DEPARTMENT DISTRIBUTES THE STATEMENT REQUEST AND REVIEWS THE COI STATEMENTS RETURNED. IDENTIFIED CONFLICTS OF INTEREST ARE PRESENTED TO THE BOARD FOR REVIEW, DELIBERATION AND CONFIRMATION/REFUTATION THAT A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST HAS BEEN FOUND, THE INDIVIDUAL MAY ADDRESS THE BOARD AND EXPLAIN THE TRANSACTION OR ARRANGEMENT CAUSING THE CONFLICT. AFTER THE PRESENTATION, THE INDIVIDUAL IS EXCUSED FROM THE MEETING AND SHALL NOT PARTICIPATE WITH ANY DISCUSSION OR VOTE ON MATTERS PERTAINING TO THE TRANSACTION OR ARRANGEMENT. IN MEETINGS WHERE APPLICATION OF THE COI POLICY OCCURS, THE MEETING MINUTES INCLUDE NATURE OF THE FINANCIAL INTEREST/CONFLICT, NAME(S) OF THE PERSON(S) WITH THE POTENTIAL OR ACTUAL CONFLICT, ANY ACTION TAKEN TO ASSIST IN THE DETERMINATION OF WHETHER A CONFLICT EXISTED, INCLUDING ANY DISCUSSION OF ALTERNATIVE ARRANGEMENTS, THE BOARD'S DECISION(S) REGARDING THE CONFLICT AND NAMES OF PERSON PRESENT IN THE DISCUSSION AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT.
FORM 990, PART VI, LINES 15A & 15B	OFFICES AND POSITIONS WHICH PROCESS WAS USED & YEAR PROCESS WAS BEGUN THE CEO OF THE ORGANIZATION IS NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER BY THE TAX-EXEMPT PARENT, HPH. FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE CEO'S COMPENSATION. COMPENSATION FOR HAWAI'I PACIFIC HEALTH ('HPH") EXECUTIVES (VICE PRESIDENT AND ABOVE) IS SET BY THE INDEPENDENT BOARD MEMBERS OF THE HAWAI'I PACIFIC BOARD'S COMPENSATION COMMITTEE. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE'S COMPENSATION AND BENEFITS. THE CONSULTANT PROVIDES A WRITTEN REPORT TO THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING. INCLUDED IN THE REPORT IS MARKET BASED DATA FROM LIKE ORGANIZATIONS. THE COMPENSATION COMMITTEE MAKES FINAL DECISIONS REGARDING COMPENSATION AND BENEFITS AT THE MEETING AFTER REVIEW AND DISCUSSION OF THE CONSULTANT'S REPORT. COMMUNITY BASED DIRECTORS OF THE ORGANIZATION ARE NOT COMPENSATED. CERTAIN EMPLOYED PHYSICIANS MAY BE OFFICERS OR AN IDENTIFIED KEY EMPLOYEE OF THE REPORTING OR RELATED ORGANIZATION. PHYSICIAN COMPENSATION IS ALSO HANDLED IN THE SAME MANNER AS EXECUTIVE COMPENSATION, WITH THE HPH COMPENSATION COMMITTEE RECEIVING A REPORT FROM A NEUTRAL CONSULTANT AND FOLLOWING THE SAME PROCESS AS DESCRIBED ABOVE ON AN ANNUAL BASIS. THIS PROCESS WAS MOST RECENTLY COMPLETED ON FEBRUARY 17, 2015 TO REVIEW PHYSICIAN COMPENSATION AND ON AUGUST 26, 2015 TO REVIEW EXECUTIVE COMPENSATION.
FORM 990, PART VI, LINE 19	DISCLOSURE OF GOV DOCS, CONFLICT OF INTEREST POLICY & FINANCIAL STMTS THE CONFLICT OF INTEREST POLICY AND STANDARD OF CONDUCT ARE AVAILABLE ON THE HAWAI'I PACIFIC HEALTH WEBSITE. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE HAWAI'I PACIFIC HEALTH WEBSITE.
FORM 990, PART XI, LINE 9	RECONCILIATION OF NET ASSETS OBLIGATED GROUP INTERCOMPANY TRANSFERS $(38,555,613) CHANGE IN INTEREST IN KHF/WHF $ 1,410,650 CHANGE IN INTEREST IN PERPETUAL TRUSTS $( 50,038) Restricted Grants and Contributions $ 1,493,280 Net Assets Released from Restriction $( 1,494,987) Other Changes in Net Assets $ 100 ------------- TOTAL $(37,196,608)
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:26443201
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL SERVICES TOTAL FEES:4255128
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING SERVICES TOTAL FEES:782716
FORM 990 PART IX LINE 11G	DESCRIPTION:REGISTRY SERVICES TOTAL FEES:2728887
FORM 990 PART IX LINE 11G	DESCRIPTION:TEMPORARY LABOR ADMIN SVCS TOTAL FEES:495059
FORM 990 PART IX LINE 11G	DESCRIPTION:TEMPORARY OTHER LABOR SVCS TOTAL FEES:1122138
FORM 990 PART IX LINE 11G	DESCRIPTION:LAUNDRY SERVICES TOTAL FEES:4444498
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT RECURRING SERVICES TOTAL FEES:40151061
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION FEE SERVICES TOTAL FEES:1032436
FORM 990 PART IX LINE 11G	DESCRIPTION:BUS PASS SERVICES TOTAL FEES:31592
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER SERVICES TOTAL FEES:11270632
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIRS & MAINTENACE SVCS TOTAL FEES:18935334
FORM 990 PART IX LINE 11G	DESCRIPTION:INTERNAL SVC PROVIDER EXP TOTAL FEES:39309727
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER EXPENSE RECOVERY TOTAL FEES:-1777306

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	40
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	23
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	5,886
6	Total number of volunteers (estimate if necessary) .............	6	864
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	590,928
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-19,956

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,169,162	3,590,778
9	Program service revenue (Part VIII, line 2g) .........	1,073,867,376	1,115,441,150
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,805,372	7,063,229
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,269,804	6,432,101
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	1,092,111,714	1,132,527,258
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	161,150	161,580
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)	480,111,418	509,057,974
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	469,819,941	488,127,929
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	950,092,509	997,347,483
19	Revenue less expenses. Subtract line 18 from line 12.......	142,019,205	135,179,775
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	720,108,195	805,615,080
21	Total liabilities (Part X, line 26).............	128,584,262	126,684,853
22	Net assets or fund balances. Subtract line 21 from line 20.....	591,523,933	678,930,227

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 48,983,402 including grants of $ 0 ) (Revenue $ 0 )
	SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 54,784,729 including grants of $ 0 ) (Revenue $ 0 )
	SEE SCHEDULE O.

4c	(Code: ) (Expenses $ 46,984,102 including grants of $ 0 ) (Revenue $ 0 )
	SEE SCHEDULE O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 716,854,630 including grants of $ 161,580 ) (Revenue $ 1,120,878,126 )
4e	Total program service expenses867,606,863

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	5,113,666	13,924,670	3,563,560

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		3,217,011
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		373,767

g	Noncash contributions included in lines 1a-1f:$		137,282
h	Total. Add lines 1a-1f.......			3,590,778
			Business Code
2a	NET PATIENT REVENUES		622110	1,089,215,650	1,088,809,207	406,443
b	OTHER HEALTHCARE REVENUE		622110	17,273,039	17,273,039
c	RENTAL INCOME		531120	3,251,998	3,237,747	14,251
d	PREMIUM REVENUE		622110	2,788,770	2,788,770
e	INTER-ENTITY SERVICE REVENUE		900099	2,050,439	2,050,439
f	All other program service revenue .			861,254	706,907	154,347
g	Total. Add lines 2a–2f........			1,115,441,150
3	Investment income (including dividends, interest, and other similar amounts).......			3,327,709			3,327,709
4	Income from investment of tax-exempt bond proceeds..			727,704			727,704
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	138,452
b	Less: rental expenses
c	Rental income or (loss)	138,452	0
d	Net rental income or (loss).......			138,452			138,452
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	103,234,454	162,906
b	Less: cost or other basis and sales expenses	100,310,193	79,351
c	Gain or (loss)	2,924,261	83,555
d	Net gain or (loss)..........			3,007,816			3,007,816
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..			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...			0
10a	Gross sales of inventory, less returns and allowances .
	a		639,225
b	Less: cost of goods sold ..b		373,479
c	Net income or (loss) from sales of inventory..			265,745			265,745
Miscellaneous Revenue			Business Code
11a	PARKING REVENUE		812930	2,459,305	2,459,305
b	CAFETERIA REVENUE		722110	2,623,632	2,623,632
c	EXPENSE REIMBURSEMENT		900099	321,869	321,869
d	All other revenue ....			623,098	607,211	15,887
e	Total. Add lines 11a–11d ......			6,027,904
12	Total revenue. See Instructions......			1,132,527,258	1,120,878,126	590,928	7,467,426


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			-1,018,069	1	-994,898
2	Savings and temporary cash investments .........			4,381,059	2	4,725,385
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			141,671,643	4	161,686,592
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			14,505,573	8	15,932,722
9	Prepaid expenses and deferred charges ..........			1,468,125	9	1,231,072
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	905,268,803
b	Less: accumulated depreciation .....	10b	532,153,745	306,324,905	10c	373,115,058
11	Investments—publicly traded securities ..........			87,553,785	11	83,745,203
12	Investments—other securities. See Part IV, line 11 .....			68,788,561	12	68,273,753
13	Investments—program-related. See Part IV, line 11 .....			1,618,557	13	1,618,557
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			94,814,056	15	96,281,636
16	Total assets. Add lines 1 through 15 (must equal line 34)......			720,108,195	16	805,615,080
17	Accounts payable and accrued expenses .........			94,636,203	17	92,730,907
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			33,948,059	25	33,953,946
26	Total liabilities. Add lines 17 through 25.........			128,584,262	26	126,684,853
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			536,363,153	27	622,486,126
28	Temporarily restricted net assets ...........			44,492,198	28	45,723,128
29	Permanently restricted net assets ...........			10,668,582	29	10,720,973
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			591,523,933	33	678,930,227
34	Total liabilities and net assets/fund balances ........			720,108,195	34	805,615,080

(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 entity?
(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	Yes	No
(1) PROVIDERS INSURANCE CORPORATION 55 MERCHANT STREET 24TH FLOOR HONOLULU,HI96813 71-0893000	NFP INSURANCE	HI	501(C)(3)	11B TYPE II	NA	Yes
(2) KAPI'OLANI HEALTH FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU,HI96813 99-0246364	FUNDRAISING	HI	501(C)(3)	7	NA	Yes
(3) KAPI'OLANI MEDICAL SPECIALISTS 55 MERCHANT STREET 24TH FLOOR HONOLULU,HI96813 99-0322406	HEALTHCARE	HI	501(C)(3)	9	NA	Yes
(4) WILCOX HEALTH FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU,HI96813 99-0204242	FUNDRAISING	HI	501(C)(3)	7	NA	Yes
(5) KAUA'I MEDICAL CLINIC 55 MERCHANT STREET 24TH FLOOR HONOLULU,HI96813 99-0326099	HOSPITAL	HI	501(C)(3)	3	NA	Yes
(6) STRAUB FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU,HI96813 99-0109350	FUNDRAISING	HI	501(C)(3)	7	NA	Yes
(7) PALI MOMI FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU,HI96813 38-3840327	FUNDRAISING	HI	501(C)(3)	7	NA	Yes

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ASC PACIFIC VENTURES LLC	AMBU. SURG. C	AL	NA

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) KAPI'OLANI MEDICAL SPECIALISTS	Q	54,535	FMV
(2) KAPI'OLANI MEDICAL SPECIALISTS	R	123,854	FMV
(3) Kaua'i MEDICAL CLINIC	S	338,571	FMV
(4) Kaua'i MEDICAL CLINIC	R	209,148	FMV
(5) PROVIDERS INSURANCE CORPORATION	R	3,199,731	FMV
(6) PROVIDERS INSURANCE CORPORATION	R	645,290	FMV
(7) PALI MOMI FOUNDATION	C	134,568	FMV
(8) Hawai'i HEALTH PARTNERS	S	87,718	FMV
(9) Kapi'olani MEDICAL SPECIALISTS	Q	8,243,142	FMV
(10) Kapi'olani MEDICAL SPECIALISTS	P	123,932	FMV
(11) Kapi'olani MEDICAL SPECIALISTS	S	277,549	FMV
(12) Kaua'i MEDICAL CLINIC	P	79,611	FMV
(13) PROVIDERS INSURANCE CORPORATION	R	1,750,250	FMV
(14) Kapi'olani HEALTH FOUNDATION	C	1,635,994	FMV
(15) Kapi'olani HEALTH FOUNDATION	P	67,388	FMV
(16) Kapi'olani HEALTH FOUNDATION	S	118,086	FMV
(17) PROVIDERS INSURANCE CORPORATION	R	266,758	FMV
(18) WILCOX HEALTH FOUNDATION	C	823,845	FMV
(19) WILCOX HEALTH FOUNDATION	P	62,103	FMV
(20) KAUA'I MEDICAL CLINIC	Q	55,828	FMV
(21) KAUA'I MEDICAL CLINIC	S	76,175	FMV
(22) KAUA'I MEDICAL CLINIC	P	1,780,749	FMV

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No