TY 2015 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) CHRIS ELDRIDGE...................................................................... Board of Director	0.3 ................. 0.0	X		0	0
(2) BEN GODSEY...................................................................... Board of Director	0.3 ................. 0.0	X		0	0
(3) DOUGLAS KWOCK MD...................................................................... Board of Director, Chair	1.3 ................. 0.0	X	X	3,846	0
(4) STEPHEN LIN MD...................................................................... Board of Director	1.3 ................. 0.0	X		7,512	0
(5) PETER MCNALLY MD...................................................................... Board of Director	0.3 ................. 0.0	X		0	0
(6) ELLIOT MILLS...................................................................... Board of Director	0.3 ................. 0.0	X		0	0
(7) MICHAEL O'MALLEY ESQ...................................................................... Board of Director	1.3 ................. 0.0	X		0	0
(8) MARTHA SMITH...................................................................... Board of Director, CEO	45.0 ................. 11.0	X	X	642,492	155,529
(9) RAYMOND P VARA JR...................................................................... B.O.D., President & CEO	8.0 ................. 54.1	X	X	1,619,202	657,628
(10) SHELLEY WILSON...................................................................... Board of Director	0.3 ................. 0.0	X		0	0
(11) MARK YAMAKAWA...................................................................... Board of Director	0.3 ................. 0.0	X		0	0
(12) LOREN YAMAMOTO MD...................................................................... Board of Director	0.3 ................. 0.0	X		0	0
(13) JENNIFER SABAS...................................................................... Board of Director (Part Year)	0.3 ................. 0.0	X		0	0
(14) ARTHUR GLADSTONE...................................................................... BOD, CEO, VP & System CNE	43.2 ................. 12.2	X	X	613,451	153,514
(15) VIOLETA ARNOBIT RN...................................................................... Board of Director, Vice Chair	0.2 ................. 0.1	X	X	0	0
(16) MARK BAKER MD...................................................................... Board of Director	1.2 ................. 0.0	X		37,406	0
(17) BETH HOBAN RN...................................................................... Board of Director	0.2 ................. 1.0	X		0	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) NEIL MANAGO MD........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(19) DAWN MIURA MD........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(20) GORDON NIHEI........................................................................ Board of Director, Chair	0.2 .......................0.0	X	X			0	0	0
(21) FRED PAINE........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(22) MARK PITTS MD........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(23) CARLETON CHING........................................................................ Board of Director (Part Year)	0.2 .......................0.0	X				0	0	0
(24) ANDREW DANG MD........................................................................ Board of Director (Part Year)	40.0 .......................0.0	X				393,515	0	31,148
(25) MARK GRIEF MD........................................................................ Board of Director (Part Year)	0.2 .......................0.0	X				0	0	0
(26) BRYAN MATSUMOTO MD........................................................................ Board of Director (Part Year)	0.2 .......................0.0	X				0	0	0
(27) DAVID CHO MD........................................................................ Board of Director	40.0 .......................0.0	X				378,833	0	31,634
(28) GORDON HAMMOND........................................................................ Board of Director, Chair	0.2 .......................0.0	X	X			0	0	0
(29) RICHANNE LAM........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(30) AVI MANNIS........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(31) BEAU NAKAMOTO MD........................................................................ Board of Director, Vice Chair	40.0 .......................0.0	X	X			404,627	0	0
(32) MONICA PRICE MD........................................................................ Board of Director	40.0 .......................0.0	X				172,875	0	25,882
(33) KENNETH B ROBBINS MD........................................................................ Board of Director, EVP & CMO	40.0 .......................16.0	X	X			0	732,193	274,111
(34) KENN SARUWATARI MD........................................................................ Board of Director (Part Year)	40.0 .......................0.0	X				259,537	0	33,196
(35) JENNIE CHAHANOVICH........................................................................ BOD, PRESIDENT & CEO	40.0 .......................22.0	X	X			0	505,647	124,158
(36) CAROL FUJIYOSHI MD........................................................................ Board of Director	0.2 .......................40.0	X				0	320,115	16,978
(37) TAD JACKSON MD........................................................................ Board of Director, Vice Chair	0.2 .......................0.0	X	X			0	0	0
(38) WAYNE KATAYAMA........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(39) CLYDE KODANI........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(40) GERALD MCKENNA MD........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(41) R CRAIG NETZER........................................................................ Board of Director	0.2 .......................40.0	X				0	177,112	7,353
(42) DANIELLE RAMOS........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(43) LYLE TABATA........................................................................ Board of Director	0.2 .......................0.2	X				0	0	0
(44) MICHAEL YAMANE........................................................................ Board of Director	0.2 .......................0.0	X				0	0	0
(45) JOHN CULLINEY MD........................................................................ Board of Director (Part Year)	0.2 .......................40.0	X				0	485,709	29,134
(46) LYNN MCCRORY........................................................................ Board of Director (Part Year)	0.2 .......................0.6	X				0	0	0
(47) DAWN CHING........................................................................ VP	50.0 .......................2.0		X			0	249,886	66,546
(48) MAVIS NIKAIDO........................................................................ VP & CNE	49.0 .......................1.0		X			0	291,637	54,737
(49) SUSAN MASUMOTO-NONAKA........................................................................ VP	47.0 .......................6.1		X			0	297,153	67,431
(50) PAULA DIAS........................................................................ VP	48.0 .......................3.0		X			0	292,504	60,131
(51) LORRIE-ANN LUKE........................................................................ VP	2.0 .......................46.0		X			0	157,671	53,818
(52) MICHAEL ROBINSON........................................................................ VP	0.6 .......................52.4		X			0	216,195	39,408
(53) BRANDT FARIAS........................................................................ VP	4.0 .......................51.0		X			0	77,243	29,911
(54) KATIE SHIGEMITSU........................................................................ Compliance Officer	29.0 .......................15.0		X			0	178,214	22,615
(55) DAVID FOX........................................................................ PRIVACY & INFO SECURITY OFICER	17.0 .......................23.0		X			0	142,843	25,167
(56) ALAN ITO........................................................................ Information Security Officer	17.0 .......................23.0		X			0	153,291	25,158
(57) JESSICA LEWIS........................................................................ Assistant Corporate Secretary	16.0 .......................24.0		X			0	128,274	25,615
(58) DAVID OKABE........................................................................ EVP, CFO & Treasurer	11.0 .......................44.4		X			0	727,747	271,732
(59) GAIL LERCH........................................................................ EVP	4.0 .......................51.4		X			0	683,748	220,054
(60) CHARLES R CHING........................................................................ EVP, GEN COUNSEL & SECRETARY	13.0 .......................44.5		X			0	613,655	218,402
(61) STEVEN ROBERTSON........................................................................ EVP & CIO	13.0 .......................40.5		X			0	601,130	226,186
(62) MELINDA ASHTON MD........................................................................ SVP & CQO	7.0 .......................43.1		X			0	510,699	105,148
(63) THOMAS MUNDELL........................................................................ SVP	0.4 .......................61.6		X			0	319,598	78,217
(64) EARL INOUYE........................................................................ VP & System Controller	10.0 .......................41.0		X			0	323,923	66,330
(65) WARREN CHAIKO........................................................................ VP	30.0 .......................20.0		X			0	307,709	71,951
(66) GIDGET RUSCETTA RN........................................................................ COO	43.0 .......................10.1		X			0	280,538	74,987
(67) BRIGITTE MCKALE........................................................................ VP & CNE	50.0 .......................1.1		X			0	260,508	60,432
(68) PATRICIA BOECKMANN RN........................................................................ COO	50.0 .......................2.0		X			0	361,439	100,699
(69) MAUREEN FLANNERY........................................................................ VP	50.0 .......................5.0		X			0	290,778	67,312
(70) CASS K NAKASONE MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		973,086	0	31,134
(71) MARK S GERBER MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		867,340	0	17,068
(72) HINGSON M CHUN MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		751,971	0	28,035
(73) STEVEN S GLAZIER MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		743,035	0	29,507
(74) SCOTT N CRAWFORD MD........................................................................ PHYSICIAN	40.0 .......................0.0			X		714,147	0	29,535
(75) CHARLES A STED........................................................................ FORMER DIRECTOR & OFFICER	0.0 .......................0.0				X	0	848,183	8,564
(76) KATHLEEN A CLARK........................................................................ Former Ofcr (BOD, PRES & CEO)	0.0 .......................0.0				X	0	288,616	10,565
(77) MARK R YATES........................................................................ Former Officer	0.0 .......................0.0				X	0	219,071	1,606
(78) THOMAS J NORDYKE MD........................................................................ FORMER OFFICER	40.0 .......................0.0				X	293,993	0	30,023
(79) JOHN LA FORGIA........................................................................ FORMER OFFICER	0.0 .......................0.0				X	0	402,813	5,653

(A) Name and business address	(B) Description of services	(C) Compensation
LAYTON DCK JOINT VENTURE, 9090 SOUTH SANDY PKWY SANDY,UT84070	CONSTRUCTION SVCS	61,147,784
CLINICAL LABORATORIES OF HAWAII LL, PO BOX 1300 HONOLULU,HI968071300	laboratory services	25,216,776
SODEXO INC AFFILIATES, 9801 WASHINGTONIAN BLVD GAITHERSBURG,MD20878	FOOD & ENVIRON SVCS	8,598,903
NORDIC PCL CONST INC, 1099 ALAKEA STREET HONOLULU,HI96813	CONSTRUCTION SVCS	5,895,644
HAWAI'I RESIDENCY PROGRAMS INC, 1356 LUSITANA ST STE 510 HONOLULU,HI96813	CONSTRUCTION SVCS	5,203,636
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 158

- 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

2015

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 (Form 990 or 990-EZ))

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 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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—2014. 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—2015. 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—2014. 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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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—2014. 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) 2015

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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

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

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Page 6

Part V

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

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

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) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6			0
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)		0
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......0
e From 2014.......0
fTotal of lines 3a through e	0
g Applied to underdistributions of prior years		0
h Applied to 2015 distributable amount			0
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.	0
4Distributions for 2015 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years		0
b Applied to 2015 distributable amount			0
c Remainder. Subtract lines 4a and 4b from 4.	0
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)		0
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)			0
7 Excess distributions carryover to 2016. Add lines 3j and 4c.	0
8 Breakdown of line 7:
a
b
c Excess from 2013.......0
d From 2014.......0
e From 2015.......0

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

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) 2015

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

2015

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 other 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization HAWAI'I PACIFIC HEALTH GROUP RETURN		Employer identification number 38-3835105

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

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.) $ 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) (2015)

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

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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) 2012	(b) 2013	(c) 2014	(d) 2015	(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) 2015

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 on 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

53,743

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

53,743

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) 2015

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," on 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

2015

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" on 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

$ 1,900

(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 on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	167,123,775	170,982,165	151,507,463	135,652,768	138,278,199
b	Contributions ...	340,551	564,521	418,132	493,306	1,573,144
c	Net investment earnings, gains, and losses	-3,972,004	-4,243,274	19,077,175	15,453,147	-4,110,118
d	Grants or scholarships ...		0	0	0
e	Other expenditures for facilities and programs ...	117,712	167,884	0	0
f	Administrative expenses ....		11,753	20,605	91,758	88,457
g	End of year balance ......	163,374,610	167,123,775	170,982,165	151,507,463	135,652,768

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

Board designated or quasi-endowment SchDMd Bullet

99.370 %

Permanent endowment SchDMd Bullet

0.630 %

Temporarily restricted endowment SchDMd Bullet

0 %

The percentages on 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" on 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' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	19,720,249		19,720,249
b	Buildings	409,427,711	248,544,756	160,882,955
c	Leasehold improvements	25,337,119	17,112,654	8,224,465
d	Equipment ...	286,211,530	222,601,791	63,609,739
e	Other ...	223,030,558	2,995,272	220,035,286
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				472,472,694

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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) BOARD DESIGNATED SECURITIES	52,358,843	F
(B) INVESTMT IN UNCONSOLIDATED SUB	4,971,708	F
(C) LIMITED PARTNERSHIPS	613,805	F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	57,944,356

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1) INT IN NET ASSETS OF FDNS				48,462,301
(2) BOARD DESIGNATED INVESTMENTS				15,982,164
(3) DEPOSITS & NON-CURRENT ASSETS				7,838,868
(4) OTHER RECEIVABLES				6,711,051
(5) INTEREST IN PERPETUAL TRUST				4,547,454
(6) DECORATIVE ARTWORK				533,304
(7) INVESTMENT IN JOINT VENTURES				25,000
(8) DUE FROM THIRD PARTY PAYORS				24,607,714
(9) DUE FROM KAPI'OLANI HLTH FDN				1,316,905
(10) HAWAI'I HEALTH PARTNERS				1,047,262
(11) HAWAI'I PACIFIC HEALTH				681,708
(12) KAUA'I MEDICAL CLINIC				286,178
(13) PALI MOMI FOUNDATION				148,779
(14) WILCOX HEALTH FOUNDATION				139,448
(15) STRAUB FOUNDATION				112,915
(16) KAPI'0LANI MEDICAL SPECIALISTS				30,586
(17) HAWAI'I PACIFIC HEALTH PTNRS				18,316
(18) HICORD				21
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				112,489,974

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
OTHER LONG TERM LIABILITIES	41,247,031
ESCHEAT LIABILITY	258,880
THIRD PARTY PAYORS	12,794,032
STRAUB PHARMACY INC	4,555,888
KAPI'OLANI MEDICAL SPECIALISTS	794,544
HAWAI'I HEALTH PARTNERS	675,511
PROVIDERS INSURANCE CORPORATION	176,622
CURRENT PORTION OF LONG TERM LIAB	148,213
KEAHONUIOKALANI	96,793
HAWAI'I PACIFIC HEALTH PTNRS	38,968
KAPI'OLANI HEALTH FOUNDATION	21,035
STRAUB FOUNDATION	17,391
WILCOX HEALTH FOUNDATION	10,191
PALI MOMI FOUNDATION	3,187
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	60,838,286
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on 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 PURPOSE OF THE HOSPITAL.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on 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

2015

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) . . .		8,541	2,741,837		2,741,837	0.260 %
b	Medicaid (from Worksheet 3, column a) . . . . .		209,385	259,844,632	223,730,994	36,113,638	3.420 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		217,926	262,586,469	223,730,994	38,855,475	3.680 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	67	54,652	2,615,012	291,038	2,323,974	0.220 %
f	Health professions education (from Worksheet 5) . . .	10	1,773	6,994,848	1,427,349	5,567,502	0.530 %
g	Subsidized health services (from Worksheet 6) . . . .	12	310	31,931,226	10,364,715	21,566,511	2.040 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	15	10	2,707,075		2,707,075	0.260 %
j	Total. Other Benefits . .	104	56,745	44,248,161	12,083,102	32,165,062	3.050 %
k	Total. Add lines 7d and 7j .	104	274,671	306,834,630	235,814,096	71,020,537	6.730 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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)	(b) Persons served (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
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	3	378	400,956	400,956	0.040 %
9	Other
10	Total	3	378	400,956	400,956	0.040 %

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. ......

23,595,993

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. ......

2,030,559

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).....

129,336,009

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

148,769,935

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

-19,433,926

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) 2015

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 PUNAHOU 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) 2015

Page 4

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 15

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

6 a

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 16

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

12b

If "Yes" on 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

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) 2015

Page 6

Part VFacility Information (continued)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized 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 19. (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) 2015

Page 7

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	KAPIOLANI MEDICAL CENTER FOR WOMEN AND CHILDREN (KAPIOLANI) IN CONDUCTING KAPIOLANIS MOST RECENT CHNA, ADOPTED MARCH 2016, INTERVIEWS WERE HELD WITH 19 COMMUNITY REPRESENTATIVES WITH PUBLIC HEALTH EXPERTISE IN THE TOP TEN HEALTH AREAS IDENTIFIED FOR WOMEN AND CHILDREN IN THE STATE OF HAWAII 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, EXCERPTS FROM THE INTERVIEWS WERE CODED BY RELEVANT TOPIC AREAS 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. COMMUNITY REPRESENTATIVES WHO PROVIDED INPUT WERE FROM THE FOLLOWING AGENCIES AND ORGANIZATIONS: AMERICAN DIABETES ASSOCIATION, CATHOLIC CHARITIES HAWAII, DEPARTMENT OF EDUCATION, STATE DEPARTMENT OF HEALTH, DEPARTMENT OF HEALTH BEHAVIORAL HEALTH SERVICES, DEPARTMENT OF HEALTH DISEASE OUTBREAK AND CONTROL DIVISION, DEPARTMENT OF HUMAN SERVICES, EXECUTIVE OFFICE ON AGING, GOVERNORS OFFICE, HAWAII DENTAL SERVICE, HAWAII MEDICAL SERVICE ASSOCIATION, HAWAII PRIMARY CARE ASSOCIATION, STATE HOMELESS PROGRAMS OFFICE, JOHN A BURNS SCHOOL OF MEDICINE, HAWAII STATE SENATE, HAWAII CHAPTER AMERICAN ASSOCIATION OF PEDIATRICS, KAPIOLANI MEDICAL CENTER FOR WOMEN AND CHILDREN, UNIVERSITY WOMENS HEALTH SPECIALISTS. STRAUB MEDICAL CENTER (STRAUB) IN CONDUCTING STRAUBS MOST RECENT CHNA, ADOPTED MARCH 2016, INTERVIEWS WERE HELD WITH 15 COMMUNITY REPRESENTATIVES WITH PUBLIC HEALTH EXPERTISE IN THE TOP TEN HEALTH TOPIC AREAS IDENTIFIED FOR THE STATE OF HAWAII 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, EXCERPTS FROM THE INTERVIEWS WERE CODED BY RELEVANT TOPIC AREAS 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. COMMUNITY REPRESENTATIVES WHO PROVIDED INPUT WERE FROM THE FOLLOWING AGENCIES AND ORGANIZATIONS: AMERICAN DIABETES ASSOCIATION, CATHOLIC CHARITIES HAWAII, DEPARTMENT OF EDUCATION, STATE DEPARTMENT OF HEALTH, DEPARTMENT OF HEALTH BEHAVIORAL HEALTH SERVICES, DEPARTMENT OF HEALTH DISEASE OUTBREAK AND CONTROL DIVISION, DEPARTMENT OF HUMAN SERVICES, EXECUTIVE OFFICE ON AGING, GOVERNORS OFFICE, HAWAII DENTAL SERVICE, HAWAII MEDICAL SERVICE ASSOCIATION, HAWAII PRIMARY CARE ASSOCIATION, STATE HOMELESS PROGRAMS OFFICE, JOHN A BURNS SCHOOL OF MEDICINE, HAWAII STATE SENATE. PALI MOMI MEDICAL CENTER (PALI MOMI) IN CONDUCTING PALI MOMIS MOST RECENT CHNA, ADOPTED MARCH 2016, INTERVIEWS WERE HELD WITH 24 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, EXCERPTS FROM THE INTERVIEWS WERE CODED BY RELEVANT TOPIC AREAS 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. COMMUNITY REPRESENTATIVES WHO PROVIDED INPUT WERE FROM THE FOLLOWING AGENCIES AND ORGANIZATIONS: ALOHA UNITED WAY, AOHACARE, CARERESOURCE HAWAII, STATE DEPARTMENT OF HEALTH, HELPING HANDS HAWAII, HILOPA`A FAMILY TO FAMILY HEALTH INFORMATION CENTER, HONOLULU EMERGENCY MEDICAL SERVICES DEPARTMENT, HAWAII INITIATIVE FOR CHILDHOOD OBESITY RESEARCH AND EDUCATION, JOHN A BURNS SCHOOL OF MEDICINE, MENTAL HEALTH AMERICA HAWAII, FILIPINO COMMUNITY CENTER, HAWAII HOUSE OF REPRESENTATIVES, HAWAII STATE SENATE, INSTITUTE FOR HUMAN SERVICES, PALI MOMI MEDICAL CENTER, KAHI MOHALA, WAHIAWA CENTER FOR COMMUNITY HEALTH, UNIVERSITY WOMENS HEALTH SPECIALISTS, WAIANAE COAST COMPREHENSIVE HEALTH CENTER, WAIKIKI HEALTH CENTER, WAIMANALO HEALTH CENTER. WILCOX MEDICAL CENTER (WILCOX) IN CONDUCTING WILCOXS MOST RECENT CHNA, ADOPTED MARCH 2016, INTERVIEWS WERE HELD WITH 14 COMMUNITY REPRESENTATIVES WITH PUBLIC HEALTH EXPERTISE IN THE TOP TEN HEALTH AREAS IDENTIFIED FOR THE ISLAND OF KAUAI 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, EXCERPTS FROM THE INTERVIEWS WERE CODED BY RELEVANT TOPIC AREAS 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. COMMUNITY REPRESENTATIVES WHO PROVIDED INPUT WERE FROM THE FOLLOWING AGENCIES AND ORGANIZATIONS: DEPARTMENT OF HEALTH KAUAI DISTRICT OFFICE, GET FIT KAUAI HEALTH, HALE OPIO, HAWAII HEALTH SYSTEMS CORPORATION, HO`OLA LAHUI, KAUAI COMMUNITY MENTAL HEALTH CENTER, KAUAI MAYORS OFFICE, MCKENNA RECOVERY CENTER, OHANA PACIFIC MANAGEMENT COMPANY, STAY AT HOME HEALTH SERVICES, SUGIHARA PLANNING AND CONSULTING, WILCOX HEALTH FOUNDATION, WILCOX MEDICAL CENTER, YWCA OF KAUAI.
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/5003/2016_chna_kapiolani_final.p df PALI MOMI MEDICAL CENTER https://www.hawaiipacifichealth.org/media/5007/2016-chna_pali-momi_final.p df STRAUB CLINIC & HOSPITAL https://www.hawaiipacifichealth.org/media/5011/2016-chna_straub_final.pdf WILCOX MEMORIAL HOSPITAL https://www.hawaiipacifichealth.org/media/5015/2016-chna_wilcox_final.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/5134/2016-chi-plan_kapiolani_19o ct2016.pdf PALI MOMI MEDICAL CENTER https://www.hawaiipacifichealth.org/media/5131/2016-chi-plan_pali-momi_21s ep2016.pdf STRAUB CLINIC & HOSPITAL https://www.hawaiipacifichealth.org/media/5132/2016-chi-plan_straub_10nov2 016.pdf WILCOX MEMORIAL HOSPITAL https://www.hawaiipacifichealth.org/media/5133/2016-chi-plan_wilcox-_27oct 2016.pdf
SCHEDULE H, PART V, SECTION B, LINE 11	KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN THE FOLLOWING COMMUNITY BENEFIT ACTIVITIES WERE CONDUCTED IN FISCAL YEAR 2016 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 THREE TO EXECUTE A THREE-YEAR IMPLEMENTATION STRATEGY. IN ADDITION, IN FISCAL YEAR 2016 KAPI'OLANI CONDUCTED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPED A RELATED IMPLEMENTATION STRATEGY WHICH WAS ADOPTED OCTOBER 19, 2016. PRIORITIZED NEEDS FROM THE 2016 CHNA AND A DESCRIPTION OF HOW THEY ARE BEING ADDRESSED WILL BE PROVIDED WITH THE SCHEDULE H IN SUBSEQUENT TAX YEARS. KAPI'OLANI'S 2013 AND 2016 CHNAS AND IMPLEMENTATION STRATEGIES MAY BE VIEWED ONLINE AT: HTTP://WWW.HAWAIIPACIFICHEALTH.ORG/ABOUT-US/COMMUNITY/ PRIORITY 1: ACCESS TO HEALTH SERVICES BREAST AND CERVICAL CANCER CONTROL PROGRAM: OFFERED STATEWIDE IN PARTNERSHIP WITH THE STATE DEPARTMENT OF HEALTH, THE PROGRAM PROVIDES FREE MAMMOGRAMS AND PAP SMEARS TO LOW-INCOME WOMEN AGES 40-64 WHO HAVE LITTLE OR NO MEDICAL INSURANCE OR WHO CANNOT AFFORD A CO-PAYMENT. THE PROGRAMS GOAL IS TO REDUCE MORTALITY FROM BREAST AND CERVICAL CANCER AMONG UNINSURED OR UNDERINSURED WOMEN, WITH A PRIORITY ON NATIVE HAWAIIANS, FILIPINOS, AND PACIFIC ISLANDERS, WHO HAVE A HIGHER RATE OF MORTALITY FROM THESE DISEASES THAN OTHER POPULATIONS IN HAWAI'I. MEDICAL TRANSPORT SERVICES: AS THE ONLY WOMEN'S AND CHILDREN'S SPECIALTY HOSPITAL IN THE STATE, KAPI'OLANI PROVIDES INTER-HOSPITAL TRANSPORTS FROM THE NEIGHBOR ISLANDS TO O'AHU, WHERE KAPI'OLANI IS LOCATED, AND TO THE MAINLAND, FOR CRITICAL NEONATAL AND PEDIATRIC PATIENTS REQUIRING ACCESS TO SPECIALTY CARE NOT AVAILABLE IN THEIR COMMUNITIES. HEALTH PROFESSIONALS EDUCATION: KAPI'OLANI PROVIDED CLINICAL TRAINING AND RESIDENCIES FOR MEDICAL STUDENTS AND 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 IN HAWAI'I. PRIORITY 2: MATERNAL, FETAL AND INFANT HEALTH PASSENGER SAFETY PROGRAM: THE CHILD PASSENGER SAFETY PROGRAM PROMOTES PUBLIC AWARENESS OF THE IMPORTANCE OF USING CHILD PASSENGER RESTRAINTS AND SEAT BELTS TO PREVENT CHILD INJURIES, AND PROVIDES ASSISTANCE WITH THE PROPER FIT AND INSTALLATION OF VARIOUS CAR SEATS AND BOOSTER SEATS AT A VARIETY OF COMMUNITY EVENTS AND LOCATIONS. THE PROGRAM ALSO ASSISTS FAMILIES THAT MEET FINANCIAL NEED CRITERIA TO OBTAIN LOW- OR NO-COST CHILD SAFETY SEATS. KEIKI INJURY PREVENTION COALITION: KAPI'OLANI MEDICAL CENTER SPONSORS THE KEIKI INJURY PREVENTION COALITION (KIPC), WHICH INCLUDES MORE THAN 40 AGENCIES AND STAKEHOLDERS COMMITTED TO IMPROVING CHILD SAFETY. KIPC SUPPORTS COMMUNITY EVENTS AND EDUCATION FOR CHILDREN AND FAMILIES ON WAYS TO PREVENT INJURIES 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. SWEETER CHOICE DIABETIC INTERVENTION PROGRAM: THE SWEETER CHOICE PROGRAM TARGETS 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. IN 2016, KAPI'OLANI BEGAN OFFERING THE SWEETER CHOICE PROGRAM TO PATIENTS ON-SITE AT KOKUA KALIHI VALLEY, A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). KAPI'OLANI'S CERTIFIED DIABETIC EDUCATOR NURSE TRAVELS TWICE A MONTH TO CONDUCT THE PROGRAM AT THE HEALTH CENTER. IN ADDITION, KAPI'OLANI PROVIDES FUNDING FOR HEALTHY MEAL TICKETS, WHICH ALLOW PROGRAM PARTICIPANTS TO RECEIVE A FREE MEAL AT THE HEALTH CENTER'S DINING ROOM, WHICH FEATURES HEALTHY FARM-TO-TABLE ENTREES. N.E.W. KEIKI WEIGHT MANAGEMENT PROGRAM: THE N.E.W. (NUTRITION EXERCISE WEIGHT) KEIKI CHILD AND ADOLESCENT WEIGHT MANAGEMENT PROGRAM WAS CO-CREATED BY KAPI'OLANI AND THE YMCA OF HONOLULU. N.E.W. KEIKI IS AN INTENSIVE, FAMILY-BASED PROGRAM TO COMBAT CHILDHOOD OBESITY. BASED ON BEST PRACTICES IDENTIFIED BY THE U.S. PREVENTIVE SERVICES TASK FORCE, THE PROGRAM IS HAWAI'I'S ONLY FAMILY-BASED MULTI-DISCIPLINARY INTERVENTION WORKING WITH THE CHILD AND FAMILY UNIT TOGETHER TO DEVELOP A HEALTHY LIFESTYLE FOR THE WHOLE FAMILY. AMONG THE CHILDREN ENROLLED, 71 PERCENT WERE OF NATIVE HAWAIIAN, PACIFIC ISLANDER OR FILIPINO ANCESTRY, WHICH ARE POPULATION GROUPS THAT HAVE DISPROPORTIONATELY HIGH RATES OF OBESITY AND ARE MEDICALLY-UNDERSERVED. "HAPAI" APP: HAPAI IS A FREE COMPREHENSIVE SMART-PHONE APP FOR EXPECTANT AND NEW MOTHERS. IT WAS CREATED 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. COMMUNITY HEALTH FORUMS: THE POPULAR ANNUAL HAWAI'I PACIFIC HEALTH KIDS FEST USES HANDS-ON ACTIVITIES, SUCH AS A TEDDY BEAR CLINIC AND FIRE SAFETY HOUSE, TO TEACH CHILDREN AND THEIR FAMILIES ABOUT HEALTHY LIFESTYLES, WELLNESS, NUTRITION, AND INJURY PREVENTION. KIDS FEST IS A COLLABORATION OF HAWAI'I PACIFIC HEALTH'S FOUR HOSPITALS. KAPI'OLANI ALSO PARTNERED WITH THE OTHER HOSPITALS OF HAWAI'I PACIFIC HEALTH TO PRESENT FREE COMMUNITY HEALTH FORUMS ON WOMEN'S HEALTH, CANCER CARE, HEART HEALTH, AND ARTHRITIS. SIGNIFICANT COMMUNITY HEALTH NEEDS NOT BEING ADDRESSED: THE FOLLOWING AREAS OF NEED IDENTIFIED IN KAPI'OLANI'S 2013 CHNA ARE NOT BEING ADDRESSED IN THE HOSPITAL'S IMPLEMENTATION STRATEGY BECAUSE THEY WERE NOT SELECTED AS THE HIGHEST PRIORITY FOR KAPI'OLANI, BASED ON MAGNITUDE/SEVERITY OF PROBLEM, OPPORTUNITY TO INTERVENE AT PREVENTION LEVEL, ALIGNMENT WITH KAPI'OLANI'S MISSION/STRENGTHS/PROGRAMS, OPPORTUNITY FOR PARTNERSHIP, SOLUTION COULD IMPACT MULTIPLE PROBLEMS, FEASIBILITY OF CHANGE, AND IMPORTANCE OF PROBLEM TO COMMUNITY: CANCER, DIABETES, DISABILITIES, ECONOMY, EDUCATION, ENVIRONMENT, EXERCISE, NUTRITION & WEIGHT, FAMILY PLANNING, HEART DISEASE & STROKE, IMMUNIZATIONS & INFECTIOUS DISEASES, INJURY PREVENTION & SAFETY, MENTAL HEALTH & MENTAL DISORDERS, OLDER ADULTS & AGING, ORAL HEALTH, RESPIRATORY DISEASES, SOCIAL ENVIRONMENT, SUBSTANCE ABUSE & LIFESTYLE, AND TRANSPORTATION. PALI MOMI MEDICAL CENTER PALI MOMI MEDICAL CENTER (PALI MOMI) CONDUCTED THE FOLLOWING ACTIVITIES IN FISCAL YEAR 2016 TO ADDRESS THE PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN ITS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: HEART DISEASE AND STROKE, EXERCISE, NUTRITION AND WEIGHT, AND ACCESS TO HEALTH SERVICES. THESE ACTIVITIES REFLECT STEPS TAKEN IN YEAR THREE TO EXECUTE A THREE-YEAR IMPLEMENTATION STRATEGY. IN ADDITION, IN FISCAL YEAR 2016 PALI MOMI CONDUCTED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPED A RELATED IMPLEMENTATION STRATEGY WHICH WAS ADOPTED SEPTEMBER 21, 2016. PRIORITIZED NEEDS FROM THE 2016 CHNA AND A DESCRIPTION OF HOW THEY ARE BEING ADDRESSED WILL BE PROVIDED WITH THE SCHEDULE H IN SUBSEQUENT TAX YEARS. PALI MOMI'S 2013 AND 2016 CHNAS AND IMPLEMENTATION STRATEGIES MAY BE VIEWED ONLINE AT: HTTP://WWW.HAWAIIPACIFICHEALTH.ORG/ABOUT-US/COMMUNITY/ PRIORITY 1: HEART DISEASE AND STROKE FREE SCREENINGS FOR HEART DISEASE AND STROKE: PALI MOMI PARTNERED WITH PEARLRIDGE CENTER (THE COMMUNITY'S LARGEST SHOPPING MALL) TO PROVIDE FREE BI-MONTHLY BLOOD PRESSURE AND DIABETES SCREENINGS. INDIVIDUALS AT RISK FOR DISEASE WERE PROVIDED WITH EDUCATIONAL MATERIALS AND RECOMMENDATIONS. PALI MOMI ALSO OFFERED FREE SCREENINGS AND PROVIDED HEALTH EDUCATION ABOUT OPTIMUM EXERCISE, NUTRITION, CHRONIC DISEASE PREVENTION AND HEALTHY LIVING AT A VARIETY OF COMMUNITY EVENTS AND HEALTH FAIRS. BE HEART SMART: PALI MOMI PRESENTED A SERIES OF FREE COMMUNITY EDUCATION EVENTS WHERE PALI MOMI PHYSICIANS AND REGISTERED DIETITIANS SHARED INFORMATION ON VARIOUS HEART CONDITIONS AND WAYS TO LEAD A HEART-HEALTHY LIFESTYLE. PRIORITY 2: EXERCISE, NUTRITION AND WEIGHT NEW KEIKI: THE N.E.W. (NUTRITION EXERCISE WEIGHT) KEIKI WEIGHT MANAGEMENT PROGRAM IS A PARTNERSHIP OF THE YMCA OF HONOLULU AND THE HOSPITALS OF HAWAI'I PACIFIC HEALTH. PALI MOMI PARTNERED TO EXPAND THE PROGRAM TO O'AHU'S LEEWARD SIDE. N.E.W. KEIKI IS AN INTENSIVE, FAMILY-BASED INTERVENTION TO COMBAT CHILDHOOD OBESITY. IT IS HAWAI'I'S ONLY FAMILY-BASED MULTI-DISCIPLINARY INTERVENTION WORKING WITH THE CHILD AND FAMILY UNIT TO DEVELOP A HEALTHY LIFESTYLE FOR THE WHOLE FAMILY. AMONG THE CHILDREN ENROLLED, 71 PERCENT WERE OF NATIVE HAWAIIAN, PACIFIC ISLANDER OR FILIPINO ANCESTRY, WHICH ARE POPULATION GROUPS THAT HAVE DISPROPORTIONATELY HIGH RATES OF OBESITY AND ARE MEDICALLY-UNDERSERVED. PALI MOMI WELLNESS STATION AT PEARLRIDGE CENTER: PALI MOMI MEDICAL CENTER INSTALLED A TECHNOLOGY BAR AT PEARLRIDGE CENTER UPTOWN THAT PROMOTES HEALTH AND WELLNESS TOPICS USING MULTIMEDIA DISPLAYS AND INTERACTIVE TECHNOLO
SCHEDULE H, PART V, SECTION B, LINE 11 (CONTINUED)	STRAUB MEDICAL CENTER STRAUB MEDICAL CENTER (STRAUB) CONDUCTED THE FOLLOWING ACTIVITIES IN FISCAL YEAR 2016 TO ADDRESS THE TWO PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN ITS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: HEART DISEASE AND STROKE, AND ACCESS TO HEALTH SERVICES. THESE ACTIVITIES REFLECT STEPS TAKEN IN YEAR THREE TO EXECUTE A THREE-YEAR IMPLEMENTATION STRATEGY. IN ADDITION, IN FISCAL YEAR 2016 STRAUB CONDUCTED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPED A RELATED IMPLEMENTATION STRATEGY WHICH WAS ADOPTED NOVEMBER 10, 2016. PRIORITIZED NEEDS FROM THE 2016 CHNA AND A DESCRIPTION OF HOW THEY ARE BEING ADDRESSED WILL BE PROVIDED WITH THE SCHEDULE H IN SUBSEQUENT TAX YEARS. STRAUB'S 2013 AND 2016 CHNAS AND IMPLEMENTATION STRATEGIES MAY BE VIEWED ONLINE AT: HTTP://WWW.HAWAIIPACIFICHEALTH.ORG/ABOUT-US/COMMUNITY/ PRIORITY 1: HEART DISEASE AND STROKE WINDWARD SCHOOL FITNESS PARTNERSHIP: STRAUB ASSISTED THE DEPARTMENT OF EDUCATION WITH FITNESS ASSESSMENTS FOR STUDENTS ON O'AHU'S WINDWARD SIDE WHO PARTICIPATED IN THE NATIONAL PRESIDENTIAL PHYSICAL FITNESS PROGRAM. STUDENTS WERE GIVEN FEEDBACK ON THEIR LEVELS OF FITNESS AND EDUCATED ABOUT HEALTHY LIFESTYLE CHOICES TO IMPROVE AND MAINTAIN THEIR PHYSICAL FITNESS. SCREENINGS FOR HEART DISEASE AND STROKE: STRAUB CARE COORDINATORS, HEALTH EDUCATORS AND CARDIOLOGISTS PROVIDED EDUCATIONAL MATERIALS AND CONDUCTED FREE SCREENINGS FOR HEART DISEASE, STROKE AND DIABETES RISK FACTORS ANNUALLY ON O'AHU AT THE AMERICAN HEART ASSOCIATION HEART WALK, AMERICAN DIABETES ASSOCIATION'S DIABETES WALK, WAIMANALO HEALTH FAIR, FILIPINO SENIORS FAIR AND THE HAWAI'I PACIFIC HEALTH WOMEN'S 10K RACE. STRAUB ALSO SENT CARE COORDINATORS AND HEALTH EDUCATORS TO THE ISLAND OF LANA'I TO CONDUCT COMMUNITY HEALTH FAIRS. PRIORITY 2: ACCESS TO HEALTH SERVICES VISITING PHYSICIANS: SPECIALTY PHYSICIANS FROM STRAUB REGULARLY TRAVEL TO FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED POPULATION AREAS LOCATED THROUGHOUT THE STATE OF HAWAI'I TO PROVIDE ACCESS TO MEDICAL CARE FOR SPECIALTIES THAT ARE NOT OTHERWISE AVAILABLE IN THESE REGIONS. WAHIAWA CENTER FOR COMMUNITY HEALTH: STRAUB CONTRIBUTED FINANCIAL SUPPORT FOR THE DEVELOPMENT OF THE WAHIAWA CENTER FOR COMMUNITY HEALTH (WCCH), A PROPOSED NEW FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN WAHIAWA, ONE OF THE MOST ECONOMICALLY DISADVANTAGED AREAS OF O'AHU, AND A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED POPULATION AREA. FEDERALLY QUALIFIED HEALTH CENTERS ARE IMPORTANT COMMUNITY-BASED SAFETY NET PROVIDERS THAT OFFER COMPREHENSIVE PRIMARY CARE SERVICES ON A SLIDING FEE SCALE TO RURAL, LOW-INCOME, UNDERSERVED COMMUNITIES. DIABETES SELF-MANAGEMENT TRAINING: STRAUB COLLABORATED WITH COMMUNITY PARTNERS TO PROVIDE A SERIES OF FREE CLASSES FOR DIABETICS ON HOW TO BETTER MANAGE THEIR DIABETES. THE PROGRAM TARGETED VULNERABLE POPULATIONS AND UNDER-INSURED. PHYSICIAN RECRUITMENT: TO IMPROVE ACCESS TO QUALITY SPECIALTY CARE FOR HAWAI'I RESIDENTS, STRAUB ACTIVELY RECRUITED PHYSICIANS WITH SPECIALTIES FOR WHICH HAWAI'I HAS A DOCUMENTED SHORTAGE TO SERVE COMMUNITIES THROUGHOUT THE STATE. HEALTH PROFESSIONALS EDUCATION: STRAUB PROVIDED CLINICAL TRAINING AND RESIDENCIES FOR MEDICAL STUDENTS AND 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 IN HAWAI'I. KIDS FEST: THIS ANNUAL HEALTH FAIR FOR CHILDREN AND FAMILIES OFFERS HANDS-ON ACTIVITIES, SUCH AS A TEDDY BEAR CLINIC AND FIRE SAFETY HOUSE, TO TEACH PARTICIPANTS ABOUT CHILD HEALTH, NUTRITION AND INJURY PREVENTION. KIDS FEST IS A COLLABORATION OF HAWAI'I PACIFIC HEALTH'S FOUR HOSPITALS. COMMUNITY HEALTH EDUCATION FORUMS: STRAUB ALSO PARTNERED WITH THE OTHER HOSPITALS OF HAWAI'I PACIFIC HEALTH TO PRESENT FREE COMMUNITY EDUCATION EVENTS ON HEART HEALTH, CANCER CARE, AND MANAGING ARTHRITIS. THE EVENTS WERE HELD AT A CENTRALLY-LOCATED DOWNTOWN HONOLULU VENUE, AND ALSO PROVIDED TO WEST O'AHU AND ON KAUA'I ISLAND VIA VIDEO-CONFERENCES. SIGNIFICANT COMMUNITY HEALTH NEEDS NOT BEING ADDRESSED THE FOLLOWING AREAS OF NEED IDENTIFIED IN STRAUB'S 2013 CHNA ARE NOT BEING ADDRESSED IN THE IMPLEMENTATION STRATEGY BECAUSE THEY WERE NOT SELECTED AS THE HIGHEST PRIORITIES FOR STRAUB, BASED ON THE FOLLOWING CRITERIA: STRAUB'S COMMUNITY BENEFIT RESOURCES AND EXPERTISE, MAGNITUDE/SEVERITY OF PROBLEM, OPPORTUNITY TO INTERVENE AT PREVENTION LEVEL, SOLUTION COULD IMPACT MULTIPLE PROBLEMS, FEASIBILITY OF CHANGE, AND IMPORTANCE OF PROBLEM TO COMMUNITY. CANCER; DIABETES; DISABILITIES; ECONOMY; EDUCATION; ENVIRONMENT; EXERCISE, NUTRITION & WEIGHT; FAMILY PLANNING IMMUNIZATIONS & INFECTIOUS; DISEASES; INJURY PREVENTION & SAFETY; MATERNAL, FETAL & INFANT HEALTH; MENTAL HEALTH & MENTAL DISORDERS; OLDER ADULTS & AGING ORAL HEALTH; RESPIRATORY DISEASES; SOCIAL ENVIRONMENT; SUBSTANCE ABUSE & LIFESTYLE TRANSPORTATION. IT IS EXPECTED THAT THE TWO PRIORITIES THAT WERE SELECTED, ACCESS TO HEALTH SERVICES AND HEART DISEASE AND STROKE, WILL INCORPORATE ACTIVITIES THAT HAVE IMPACT ON MULTIPLE TOPIC AREAS, INCLUDING DIABETES, EXERCISE, NUTRITION, AND WEIGHT, AND RESPIRATORY DISEASE. WILCOX MEDICAL CENTER WILCOX MEDICAL CENTER (WILCOX) CONDUCTED THE FOLLOWING ACTIVITIES IN FISCAL YEAR 2016 TO ADDRESS THE 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 THREE TO EXECUTE A THREE-YEAR IMPLEMENTATION STRATEGY. IN ADDITION, IN FISCAL YEAR 2016 WILCOX CONDUCTED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOPED A RELATED IMPLEMENTATION STRATEGY WHICH WAS ADOPTED OCTOBER 27, 2016. PRIORITIZED NEEDS FROM THE 2016 CHNA AND A DESCRIPTION OF HOW THEY ARE BEING ADDRESSED WILL BE PROVIDED WITH THE SCHEDULE H IN SUBSEQUENT TAX YEARS. WILCOX'S 2013 AND 2016 CHNAS AND IMPLEMENTATION STRATEGIES MAY BE VIEWED ONLINE AT: HTTP://WWW.HAWAIIPACIFICHEALTH.ORG/ABOUT-US/COMMUNITY/ PRIORITY 1: ACCESS TO HEALTH SERVICES PNEUMONIA & FLU VACCINATION CLINICS: WILCOX PROVIDED FREE BACTERIAL PNEUMONIA VACCINATIONS IN THE COMMUNITY FOR ELIGIBLE SENIORS, AND FREE FLU VACCINATIONS FOR ELIGIBLE ADULTS. THE PROGRAM TARGETED THE WEST SIDE OF KAUA'I WHICH HAD THE LOWEST RATE OF VACCINATION IN THE STATE IN THE 2013 CHNA, AND IS ALSO THE MOST SOCIO-ECONOMICALLY DISADVANTAGED AREA OF KAUA'I. FISCAL YEAR 2016 FOCUSED ON AN ISLAND-WIDE OUTREACH EFFORT ALONGSIDE HO'OLA LAHUI HAWAI'I, A FEDERALLY QUALIFIED HEALTH CENTER, AT LOCAL CHURCH FOOD PANTRIES TO REACH TO MOST VULNERABLE AND ECONOMICALLY DISADVANTAGED POPULATIONS. KAUA'I MENTAL HEALTH CONSORTIUM: THE CONSORTIUM, SPEARHEADED BY WILCOX, WAS FORMED TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES THROUGH BETTER COORDINATION AMONG PROVIDERS. WILCOX PUBLISHED AND MAINTAINS A PROVIDER TO PROVIDER DIRECTORY OF MENTAL HEALTH SERVICE PRACTITIONERS, AND HOSTS REGULAR NETWORKING EVENTS FOR MENTAL HEALTH PROFESSIONALS AND PRIMARY CARE PROVIDERS. A COMPREHENSIVE BEHAVIORAL HEALTH REPORT HAS BEEN DEVELOPED BY THE CONSORTIUM TO IMPROVE THE REPORTING MECHANISM FROM MENTAL HEALTH CARE PROVIDERS TO PRIMARY CARE PROVIDERS FOR THEIR PATIENTS. AFTER HOURS PHARMACY: WILCOX'S AFTER HOURS PHARMACY IS THE ONLY PHARMACY OPEN AFTER NORMAL BUSINESS HOURS ON THE ISLAND OF KAUA'I. IT PROVIDES CRITICAL AND TIME SENSITIVE MEDICATIONS TO THE COMMUNITY DURING EVENING HOURS WHEN OTHER PHARMACIES ON THE ISLAND ARE CLOSED. CARDIAC REHABILITATION: 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. CHEMOTHERAPY: WILCOX'S CHEMOTHERAPY CENTER IS THE ONLY ONE AVAILABLE ON THE ISLAND, LESSENING THE NEED FOR ISLAND RESIDENTS WITH CANCER TO FLY TO O'AHU OR TO THE MAINLAND FOR CARE. HEALTH PROFESSIONALS EDUCATION: WILCOX PROVIDED CLINICAL TRAINING AND PHARMACY RESIDENCIES FOR UNIVERSITY OF HAWAI'I AT HILO PHARMACY STUDENTS, AND CLINICAL TRAINING FOR NURSING STUDENTS FROM KAUA'I COMMUNITY COLLEGE AND THE UNIVERSITY OF HAWAI'I AT MANOA. "LIVE HEALTHY KAUA'I" WEBSITE: CREATED AND MAINTAINED BY WILCOX, THE WEBSITE IS A WELLNESS RESOURCE FOR THE KAUA'I COMMUNITY, FOCUSING ON LOCAL AND CULTURALLY APPROPRIATE RESOURCES FOR HEALTH AND WELLNESS. COMMUNITY HEALTH EDUCATION: WILCOX OFFERED A VARIETY OF WORKSHOPS AND HEALTH EDUCATION EVENTS ON IDENTIFIED COMMUNITY HEALTH NEEDS, INCLUDING: SKIN CANCER AWARENESS AND SUN PROTECTION, ONCOLOGY SUPPORT GROUP, SENIOR FALLS PREVENTION WORKSHOPS, KEIKI BIKE AND SAFETY DAY, AND ADVANCE CARE PLANNING WORKSHOPS. WILCOX ALSO PARTNERED WITH THE OTHER HOSPITALS OF HAWAI'I PACIFIC HEALTH TO OFFER A SERIES OF FREE COMMUNITY HEALTH FORUMS. EACH EVENT ADDRESSED A HEALTH TOPIC IDENTIFIED AS AN IMPORTANT COMMUNITY HEALTH NEED: WOMEN'S HEALTH, CANCER CARE, ARTHRITIS AND HEART HEALTH. THE CONFERENCES WERE HELD AT A DOWNTOWN H
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) 2015

Page 8

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	STRAUB MILILANI FAMILY HEALTH CENTER 95-1249 MEHEULA PKWY UNIT 187 MILILANI,HI96789	CLINIC
4	KAPI'OLANI WOMEN'S CENTER 1907 BERETANIA STREET 1st 5th Fl HONOLULU,HI96826	CLINIC
5	STRAUB HAWAI'I KAI FAMILY HEALTH CENTER 7192 KALANIANAOLE HIGHWAY STE A200 HONOLULU,HI96825	CLINIC
6	DOCS ON CALL - SHERATON 2255 KALAKAUA AVE HONOLULU,HI96815	CLINIC
7	STRAUB KANEOHE FAMILY HEALTH CENTER 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 HEALTH CENTER 602 KAILUA ROAD SUITE 200 KAILUA,HI96734	CLINIC
10	STRAUB CLINIC AT 1ST INSURANCE CENTER 1100 WARD AVE SUITE 700 HONOLULU,HI96813	CLINIC
11	STRAUB LANA'I FAMILY HEALTH CENTER 628-B SEVENTH STREET LANAI CITY,HI96763	CLINIC
12	STRAUB KONA CLINIC 75-240 NANI KAILUA DRIVE STE 6B KAILUAKONA,HI96740	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	STRAUB HILO CLINIC 75 PUUHONU PLACE STTE 207 HILO,HI96720	CLINIC
17	ARTESIAN SATELLITE 1907 BERETANIA ST 5TH FLOOR HONOLULU,HI96826	CLINIC
18	PALI MOMI CANCER CENTER 98-1005 MOANALUA RD FS4 AEIA,HI96701	CLINIC
19	KUAKINI CLINIC 321 NORTH KUAKINI STREET STE 504 HONOLULU,HI96817	CLINIC
20	WINDWARD HEART CENTER 25 MALUNIU AVE SUITE 201 KAILUA,HI96734	CLINIC
21	STRAUB'S WOMEN SERVICES 1319 PUNAHOU ST SUITE 520 HONOLULU,HI96826	CLINIC

Schedule H (Form 990) 2015

Page 9

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 THE HOSPITALS OF HAWAI'I PACIFIC HEALTH ARE COMMITTED TO ATTRACTING AND RETAINING TOP-QUALITY PHYSICIANS IN HAWAI'I. ACCORDING TO HAWAI'I MEDICAL JOURNAL AND THE HAWAI'I PHYSICIAN WORKFORCE ASSESSMENT PROJECT, BY 2020, HAWAI'I WILL HAVE 1,500 FEWER PHYSICIANS THAN NEEDED TO MEET THE STATE'S HEALTH CARE NEEDS. STRAUB MEDICAL CENTER INVESTED $304,765, AND PALI MOMI MEDICAL CENTER INVESTED $94,580 TO ATTRACT PHYSICIANS TO HAWAI'I TO HELP ENSURE THAT THE COMMUNITY'S HEALTH CARE NEEDS WILL BE MET. THIS INCLUDED PAYING RECRUITERS, PHYSICIAN SERVICES MANAGERS, AND 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. WILCOX MEDICAL CENTER PROMOTES AN INTEREST IN HEALTH CAREERS AMONG KAUA'I YOUTH BY WORKING WITH THE DEPARTMENT OF EDUCATION TO CONDUCT A HEALTH PROFESSIONS MENTORING PROGRAM FOR KAUA'I HIGH SCHOOL STUDENTS.
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 MARCH 2016. 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 375 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 ANALYSIS 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 HAWAI'I PACIFIC HEALTHS MEDICAL CENTERS TREAT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS SAFETY NET PROVIDERS OF HEALTH CARE FOR THE COMMUNITY. 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 243 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 2016, KAPI'OLANI HAD 54,577 IMAGING PROCEDURES, 43,709 WOMEN'S CENTER PROCEDURES, 44,727 ER VISITS, AND 17,010 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. IT HAS BEEN DESIGNATED AS A LEVEL III TRAUMA CENTER BY THE STATE OF HAWAI'I AND IT IS ALSO A CERTIFIED PRIMARY STROKE CENTER. IN FISCAL YEAR 2016, PALI MOMI HAD 90,189 IMAGING PROCEDURES, 48,866 ER VISITS, 43,912 WOMEN'S CENTER PROCEDURES, AND 5,893 INPATIENT ADMISSIONS. PALI MOMI'S GEOGRAPHIC SERVICE AREA IS PRIMARILY CENTRAL O'AHU, WEST O'AHU AND THE NORTH SHORE. STRAUB MEDICAL CENTER HAS SERVED THE PEOPLE OF HAWAI'I FOR 90+ YEARS. IT IS A FULLY INTEGRATED HEALTH CARE PROVIDER WITH A 159-BED HOSPITAL IN HONOLULU, A 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 2016, STRAUB HAD 95,016 IMAGING PROCEDURES, 32,642 ER VISITS, AND 6,982 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 MEDICAL CENTER HAS SERVED KAUA'I FOR 75+ YEARS. THE ACUTE-CARE FACILITY OFFERS OVER 20 SPECIALTIES AND A FULL SUITE OF SERVICES RANGING FROM EMERGENCY AND GENERAL SURGERY TO CARDIOLOGY, GASTROENTEROLOGY, GYNECOLOGY, INTERNAL MEDICINE, OBSTETRICS, ORTHOPEDICS, PALLATIVE CARE, PEDIATRICS, NEUROLOGY, AND WOMEN'S SERVICES. IN FISCAL YEAR 2016, WILCOX HAD 64,039 IMAGING PROCEDURES, 24,311 ER VISITS, AND 3,734 INPATIENT ADMISSIONS. WILCOX'S GEOGRAPHIC SERVICE AREA IS THE ISLAND OF KAUA'I. DEMOGRAPHICS OF THE KAUA'I COMMUNITY IN FISCAL YEAR 2016 INCLUDE AN ESTIMATED POPULATION OF APPROXIMATELY 70,000 (AND MORE THAN 1.1M VISITORS ANNUALLY). 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 2016, 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 2015, 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 MEDICAL CENTERS, MORE THAN 70 LOCATIONS, AND 1,700 AFFILIATED PHYSICIANS. THE MEDICAL CENTERS PROVIDE ACUTE AND SPECIALTY CARE WITH 566 BEDS, AND HANDLED 33,619 ADMISSIONS IN FISCAL YEAR 2016. 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 2016, KAPI'OLANI INVESTED $4,531,877 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. PALI MOMI MEDICAL CENTER CONTINUES TO FOCUS ON MEETING THE NEEDS OF THE COMMUNITIES OF CENTRAL AND WEST O'AHU AND THE NORTH SHORE. IN FISCAL YEAR 2016, PALI MOMI WAS DESIGNATED AS A LEVEL III TRAUMA CENTER BY THE STATE OF HAWAI'I. IT WAS SELECTED BECAUSE OF ITS KEY GEOGRAPHIC LOCATION AND ADVANCED HOSPITAL CAPABILITIES THAT ENABLE IT TO PROVIDE THIS CRITICALLY NEEDED SERVICE TO THE COMMUNITY. IN FISCAL YEAR 2016, PALI MOMI ALSO HOSTED FREE COMMUNITY HEALTH EVENTS, INCLUDING FAMILY AND SENIOR HEALTH FAIRS, EDUCATIONAL SPEAKERS' SERIES, SUPPORT GROUPS, AND GLUCOSE MONITORING AND BLOOD PRESSURE SCREENINGS. IN ADDITION, PALI MOMI PROVIDED SUPPORT TO THE WAHIAWA CENTER FOR COMMUNITY HEALTH SO IT COULD CONTINUE AND EXPAND ITS EFFORTS TO PROVIDE AFFORDABLE, HIGH-QUALITY HEALTH CARE FOR WAHIAWA RESIDENTS AND THE SURROUNDING RURAL COMMUNITIES. STRAUB MEDICAL CENTER 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 2016, 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,"GETTING A GRIP ON ARTHRITIS." "THE HPH WOMEN'S 10K RACE" IS HAWAI'I'S PREMIER FEMALE-ONLY FITNESS EVENT, WHICH CELEBRATED ITS 39TH YEAR. WILCOX MEDICAL CENTER IS DEDICATED TO PROVIDING KAUA'I WITH AFFORDABLE AND ACCESSIBLE HEALTH CARE. IN 2016, 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 2016, 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, "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,"OLD KOLOA SUGAR MILL RUN."
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT N/A

Schedule H (Form 990) 2015

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," on 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

2015

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" on 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	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) MARCH OF DIMES FOUNDATION 1580 MAKALOA ST STE 1200 HONOLULU,HI96814	13-1846366	501(C)(3)	10,000	GENERAL SUPPORT
(2) AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS,TX75231	13-5613797	501(C)(3)	55,000	GENERAL SUPPORT
(3) ARTHRITIS FOUNDATION HAWAI'I 2752 WOODLAWN DR 5-2048 HONOLULU,HI96822	58-1341679	501(C)(3)	15,000	GENERAL SUPPORT
(4) KAUA'I PATH INC PO BOX 81 LIHUE,HI96766	27-3343903	501(C)(3)	20,000	GENERAL SUPPORT
(5) UNIVERSITY OF HAWAI'I FOUNDATION PO BOX 11270 HONOLULU,HI96828	99-0085260	501(C)(3)	30,000	GENERAL SUPPORT
(6) WAHIAWA CENTER FOR COMMUNITY HEALTH PO BOX 860339 WAHIAWA,HI96786	45-5114944	501(C)(3)	40,000	GENERAL SUPPORT
(7) WAHIAWA GENERAL HOSPITAL 128 LEHUA STREET WAHIAWA,HI96786	99-0269825	501(C)(3)	1,222,100	GENERAL SUPPORT
(8) HAWAI'I CANCER CONSORTIUM 737 BISHOP ST 2360 HONOLULU,HI96813	45-2280259	501(C)(3)	1,000,000	GNERAL SUPPORT
(9) University Clinical Education & Research Assoc PO Box 31000 Honolulu,HI96849	99-0307152	501(C)(3)	250,000	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) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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) 2015

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" on 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

2015

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 on 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 on 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 on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on 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 ............

Yes

Were any amounts reported on 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" on 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) 2015

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 on 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 on 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)
1DAWN CHINGVP	(i) (ii)	0 ------------- 208,054	0 ------------- 32,724	0 ------------- 9,108	0 ------------- 45,399	0 ------------- 21,147	0 ------------- 316,432	0 ------------- 16,362
2MAVIS NIKAIDOVP & CNE	(i) (ii)	0 ------------- 231,267	0 ------------- 35,320	0 ------------- 25,050	0 ------------- 54,371	0 ------------- 366	0 ------------- 346,374	0 ------------- 17,660
3SUSAN MASUMOTO-NONAKAVP	(i) (ii)	0 ------------- 220,854	0 ------------- 34,603	0 ------------- 41,696	0 ------------- 50,603	0 ------------- 16,828	0 ------------- 364,584	0 ------------- 17,302
4PAULA DIASVP	(i) (ii)	0 ------------- 216,628	0 ------------- 36,113	0 ------------- 39,763	0 ------------- 46,477	0 ------------- 13,654	0 ------------- 352,635	0 ------------- 18,057
5LORRIE-ANN LUKEVP	(i) (ii)	0 ------------- 133,999	0 ------------- 7,951	0 ------------- 15,721	0 ------------- 32,517	0 ------------- 21,301	0 ------------- 211,489	0 ------------- 0
6MICHAEL ROBINSONVP	(i) (ii)	0 ------------- 193,143	0 ------------- 19,823	0 ------------- 3,229	0 ------------- 35,572	0 ------------- 3,836	0 ------------- 255,603	0 ------------- 0
7KATIE SHIGEMITSUCompliance Officer	(i) (ii)	0 ------------- 176,224	0 ------------- 500	0 ------------- 1,490	0 ------------- 8,463	0 ------------- 14,152	0 ------------- 200,829	0 ------------- 0
8DAVID FOXPRIVACY & INFO SECURITY OFICER	(i) (ii)	0 ------------- 141,217	0 ------------- 500	0 ------------- 1,126	0 ------------- 6,867	0 ------------- 18,300	0 ------------- 168,010	0 ------------- 0
9ALAN ITOInformation Security Officer	(i) (ii)	0 ------------- 152,069	0 ------------- 500	0 ------------- 722	0 ------------- 5,328	0 ------------- 19,830	0 ------------- 178,449	0 ------------- 0
10JESSICA LEWISAssistant Corporate Secretary	(i) (ii)	0 ------------- 127,774	0 ------------- 500	0 ------------- 0	0 ------------- 6,349	0 ------------- 19,266	0 ------------- 153,889	0 ------------- 0
11MARTHA SMITHBoard of Director, CEO	(i) (ii)	0 ------------- 375,015	0 ------------- 141,805	0 ------------- 125,672	0 ------------- 139,901	0 ------------- 15,628	0 ------------- 798,021	0 ------------- 95,338
12RAYMOND P VARA JRB.O.D., President & CEO	(i) (ii)	0 ------------- 893,498	0 ------------- 388,324	0 ------------- 337,380	0 ------------- 634,530	0 ------------- 23,098	0 ------------- 2,276,830	0 ------------- 296,712
13DAVID OKABEEVP, CFO & Treasurer	(i) (ii)	0 ------------- 450,780	0 ------------- 152,265	0 ------------- 124,702	0 ------------- 257,404	0 ------------- 14,328	0 ------------- 999,479	0 ------------- 94,882
14GAIL LERCHEVP	(i) (ii)	0 ------------- 367,240	0 ------------- 130,858	0 ------------- 185,650	0 ------------- 210,958	0 ------------- 9,096	0 ------------- 903,802	0 ------------- 95,902
15CHARLES R CHINGEVP, GEN COUNSEL & SECRETARY	(i) (ii)	0 ------------- 338,812	0 ------------- 123,416	0 ------------- 151,427	0 ------------- 198,040	0 ------------- 20,362	0 ------------- 832,057	0 ------------- 89,031
16STEVEN ROBERTSONEVP & CIO	(i) (ii)	0 ------------- 365,310	0 ------------- 95,556	0 ------------- 140,264	0 ------------- 211,358	0 ------------- 14,828	0 ------------- 827,316	0 ------------- 93,921
17MELINDA ASHTON MDSVP & CQO	(i) (ii)	0 ------------- 361,811	0 ------------- 81,977	0 ------------- 66,911	0 ------------- 91,008	0 ------------- 14,140	0 ------------- 615,847	0 ------------- 40,989
18THOMAS MUNDELLSVP	(i) (ii)	0 ------------- 225,815	0 ------------- 45,416	0 ------------- 48,367	0 ------------- 64,643	0 ------------- 13,574	0 ------------- 397,815	0 ------------- 0
19EARL INOUYEVP & System Controller	(i) (ii)	0 ------------- 246,127	0 ------------- 38,502	0 ------------- 39,294	0 ------------- 51,458	0 ------------- 14,872	0 ------------- 390,253	0 ------------- 19,251
20ARTHUR GLADSTONEBOD, CEO, VP & System CNE	(i) (ii)	0 ------------- 374,221	0 ------------- 128,476	0 ------------- 110,754	0 ------------- 133,714	0 ------------- 19,800	0 ------------- 766,965	0 ------------- 79,308
21WARREN CHAIKOVP	(i) (ii)	0 ------------- 225,987	0 ------------- 38,010	0 ------------- 43,712	0 ------------- 50,187	0 ------------- 21,764	0 ------------- 379,660	0 ------------- 19,005
22ANDREW DANG MDBoard of Director (Part Year)	(i) (ii)	375,824 ------------- 0	8,602 ------------- 0	9,089 ------------- 0	10,600 ------------- 0	20,548 ------------- 0	424,663 ------------- 0	0 ------------- 0
23GIDGET RUSCETTA RNCOO	(i) (ii)	0 ------------- 215,360	0 ------------- 35,754	0 ------------- 29,424	0 ------------- 61,346	0 ------------- 13,641	0 ------------- 355,525	0 ------------- 17,877
24BRIGITTE MCKALEVP & CNE	(i) (ii)	0 ------------- 210,568	0 ------------- 32,089	0 ------------- 17,851	0 ------------- 47,095	0 ------------- 13,337	0 ------------- 320,940	0 ------------- 16,045
25DAVID CHO MDBoard of Director	(i) (ii)	353,200 ------------- 0	3,211 ------------- 0	22,422 ------------- 0	10,600 ------------- 0	21,034 ------------- 0	410,467 ------------- 0	0 ------------- 0
26BEAU NAKAMOTO MDBoard of Director, Vice Chair	(i) (ii)	333,221 ------------- 0	11,345 ------------- 0	60,061 ------------- 0	0 ------------- 0	0 ------------- 0	404,627 ------------- 0	0 ------------- 0
27MONICA PRICE MDBoard of Director	(i) (ii)	153,906 ------------- 0	7,786 ------------- 0	11,183 ------------- 0	6,737 ------------- 0	19,145 ------------- 0	198,757 ------------- 0	0 ------------- 0
28KENNETH B ROBBINS MDBoard of Director, EVP & CMO	(i) (ii)	0 ------------- 439,859	0 ------------- 115,817	0 ------------- 176,517	0 ------------- 259,966	0 ------------- 14,145	0 ------------- 1,006,304	0 ------------- 125,319
29PATRICIA BOECKMANN RNCOO	(i) (ii)	0 ------------- 282,382	0 ------------- 42,115	0 ------------- 36,942	0 ------------- 79,688	0 ------------- 21,011	0 ------------- 462,138	0 ------------- 21,058
30MAUREEN FLANNERYVP	(i) (ii)	0 ------------- 231,715	0 ------------- 37,585	0 ------------- 21,478	0 ------------- 53,028	0 ------------- 14,284	0 ------------- 358,090	0 ------------- 18,793
31KENN SARUWATARI MDBoard of Director (Part Year)	(i) (ii)	222,548 ------------- 0	9,036 ------------- 0	27,953 ------------- 0	10,188 ------------- 0	23,008 ------------- 0	292,733 ------------- 0	0 ------------- 0
32JENNIE CHAHANOVICHBOD, PRESIDENT & CEO	(i) (ii)	0 ------------- 319,595	0 ------------- 92,969	0 ------------- 93,083	0 ------------- 111,690	0 ------------- 12,468	0 ------------- 629,805	0 ------------- 70,850
33CAROL FUJIYOSHI MDBoard of Director	(i) (ii)	0 ------------- 296,919	0 ------------- 3,524	0 ------------- 19,672	0 ------------- 10,600	0 ------------- 6,378	0 ------------- 337,093	0 ------------- 0
34R CRAIG NETZERBoard of Director	(i) (ii)	0 ------------- 155,338	0 ------------- 1,197	0 ------------- 20,577	0 ------------- 6,986	0 ------------- 367	0 ------------- 184,465	0 ------------- 0
35JOHN CULLINEY MDBoard of Director (Part Year)	(i) (ii)	0 ------------- 428,608	0 ------------- 1,197	0 ------------- 55,904	0 ------------- 10,600	0 ------------- 18,534	0 ------------- 514,843	0 ------------- 0
36CASS K NAKASONE MDPHYSICIAN	(i) (ii)	932,843 ------------- 0	11,395 ------------- 0	28,848 ------------- 0	10,600 ------------- 0	20,534 ------------- 0	1,004,220 ------------- 0	0 ------------- 0
37MARK S GERBER MDPHYSICIAN	(i) (ii)	815,131 ------------- 0	8,262 ------------- 0	43,947 ------------- 0	10,600 ------------- 0	6,468 ------------- 0	884,408 ------------- 0	0 ------------- 0
38HINGSON M CHUN MDPHYSICIAN	(i) (ii)	683,153 ------------- 0	35,997 ------------- 0	32,821 ------------- 0	10,600 ------------- 0	17,435 ------------- 0	780,006 ------------- 0	0 ------------- 0
39STEVEN S GLAZIER MDPHYSICIAN	(i) (ii)	696,550 ------------- 0	2,263 ------------- 0	44,222 ------------- 0	9,673 ------------- 0	19,834 ------------- 0	772,542 ------------- 0	0 ------------- 0
40SCOTT N CRAWFORD MDPHYSICIAN	(i) (ii)	663,748 ------------- 0	22,350 ------------- 0	28,049 ------------- 0	10,600 ------------- 0	18,935 ------------- 0	743,682 ------------- 0	0 ------------- 0
41CHARLES A STEDFORMER DIRECTOR & OFFICER	(i) (ii)	0 ------------- 5,389	0 ------------- 0	0 ------------- 842,794	0 ------------- 0	0 ------------- 8,564	0 ------------- 856,747	0 ------------- 0
42KATHLEEN A CLARKFormer Ofcr (BOD, PRES & CEO)	(i) (ii)	0 ------------- 146,444	0 ------------- 72,434	0 ------------- 69,738	0 ------------- 7,358	0 ------------- 3,207	0 ------------- 299,181	0 ------------- 65,147
43MARK R YATESFormer Officer	(i) (ii)	0 ------------- 67,337	0 ------------- 0	0 ------------- 151,734	0 ------------- 0	0 ------------- 1,606	0 ------------- 220,677	0 ------------- 0
44THOMAS J NORDYKE MDFORMER OFFICER	(i) (ii)	262,530 ------------- 0	7,172 ------------- 0	24,291 ------------- 0	12,588 ------------- 0	17,435 ------------- 0	324,016 ------------- 0	0 ------------- 0
45JOHN LA FORGIAFORMER OFFICER	(i) (ii)	0 ------------- 57,466	0 ------------- 0	0 ------------- 345,347	0 ------------- 2,145	0 ------------- 3,508	0 ------------- 408,466	0 ------------- 0

Schedule J (Form 990) 2015

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 INDIVIDUALS RECEIVED A SEVERANCE PAYMENT FROM A RELATED ORGANIZATION: CHARLES A. STED - $756,578 MARK YATES - $125,000 JOHN LA FORGIA - $303,035
SCHEDULE J, PART I, QUESTION 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 - $41,935 JENNIE CHAHANOVICH - $24,365 RAYMOND P. VARA JR. - $132,595 KATHLEEN CLARK - $28,930 KENNETH B. ROBBINS, M.D. - $67,410 ARTHUR GLADSTONE - $32,570 DAVID OKABE - $36,249 GAIL LERCH - $47,973 CHARLES R. CHING - $44,823 STEVEN ROBERTSON - $46,143 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 - $106,805 JENNIE CHAHANOVICH - $92,969 RAYMOND P. VARA JR. - $328,234 KATHLEEN CLARK - $72,434 KENNETH B. ROBBINS, M.D. - $115,817 ARTHUR GLADSTONE - $93,476 DAVID OKABE - $117,265 GAIL LERCH - $95,858 CHARLES R. CHING - $88,416 STEVEN ROBERTSON - $95,556 MELINDA ASHTON, M.D. - $81,977 EARL INOUYE - $38,502 WARREN CHAIKO - $38,010 DAWN CHING - $32,724 MAVIS NIKAIDO - $35,320 SUSAN MASUMOTO-NONAKA - $34,603 PAULA DIAS - $36,113 GIDGET RUSCETTA, R.N. - $35,754 BRIGITTE MCKALE - $32,089 PATRICIA BOECKMANN, R.N. - $42,115 MAUREEN FLANNERY - $37,585
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) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

HAWAI'I PACIFIC HEALTH GROUP RETURN

Employer identification number

38-3835105

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JANNY CHEN	SEE PART V	185,715	PHYSICIAN COMPENSATION		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
FORM 990, SCHEDULE L, PART IV, COLUMN B	JANNY CHEN IS A FAMILY MEMBER OF DAVID CHO, MD CURRENT BOARD OF DIRECTOR.

Schedule L (Form 990 or 990-EZ) 2015

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

2015

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 ....	X	1	1,900	FMV
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	0	1,187	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) (2015)

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) (2015)

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

2015

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 III, LINE 1	ORGANIZATION'S MISSION HAWAI'I PACIFIC HEALTH IS A NOT-FOR-PROFIT HEALTH CARE SYSTEM WITH OVER 70 LOCATIONS STATEWIDE INCLUDING MEDICAL CENTERS, CLINICS, PHYSICIANS AND OTHER CAREGIVERS COMMITTED TO THE ORGANIZATION'S MISSION TO CREATE A HEALTHIER HAWAI'I. ITS FOUR MEDICAL CENTERS KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB MEDICAL CENTER AND WILCOX MEDICAL CENTER SPECIALIZE IN INNOVATIVE PROGRAMS IN WOMENS HEALTH, PEDIATRIC CARE, CARDIOVASCULAR SERVICES, CANCER CARE, BONE AND JOINT SERVICES AND MORE. HAWAI'I PACIFIC HEALTH IS RECOGNIZED NATIONALLY FOR ITS EXCELLENCE IN PATIENT CARE AND THE USE OF ELECTRONIC HEALTH RECORDS TO IMPROVE QUALITY AND PATIENT SAFETY.
FORM 990, PART III, LINES 4A-4D	PROGRAM SERVICE ACCOMPLISHMENTS PROGRAM SERVICE #1 WOMEN'S SERVICES OBSTETRICS-GYNECOLOGY IN FISCAL YEAR 2016, HAWAI'I PACIFIC HEALTH SPENT $51,373,215 IN DIRECT EXPENSES FOR WOMEN'S OB-GYN SERVICES AS PART OF ITS COMMITMENT TO PROVIDE HIGH-QUALITY MEDICAL CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. KAPI'OLANI IS THE ONLY MEDICAL CENTER 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. ITS WOMENS CENTER, LOCATED AT ARTESIAN PLAZA, WAS THE FIRST OAHU FACILITY TO BE NAMED A BREAST IMAGING CENTER OF EXCELLENCE AND PROVIDES BREAST HEALTH SERVICES, BONE HEALTH SCREENINGS, REHABILITATION SERVICES, COUNSELING, AND HEALTH AND WELLNESS CLASSES. IN FISCAL YEAR 2016, KAPI'OLANI DELIVERED 6,215 BABIES. THE WOMEN'S CENTER PERFORMED 43,709 PROCEDURES. PALI MOMI PROVIDES COMPREHENSIVE WOMEN'S HEALTH SERVICES, PRIMARILY FOR THE CENTRAL, WEST O'AHU AND NORTH SHORE COMMUNITIES, THROUGH ITS PALI MOMI WOMENS CENTER LOCATED IN THE PALI MOMI MEDICAL PAVILION NEXT TO PEARLRIDGE CENTER UPTOWN. THE WOMENS CENTER COMBINES EXCELLENT CARE AND PATIENT SAFETY, ALL IN A RELAXING, HEALING ENVIRONMENT. SERVICES AVAILABLE INCLUDE OB-GYN ULTRASOUNDS, UROLOGY, INFUSION CHEMOTHERAPY, BREAST HEALTH SERVICES, BONE HEALTH SCREENINGS, PATIENT NAVIGATION SERVICES, A CANCER SUPPORT GROUP AND RESOURCE LIBRARY. IN FISCAL YEAR 2016, PALI MOMI'S WOMEN'S CENTER PERFORMED 43,912 PROCEDURES. STRAUB'S MAIN HOSPITAL AND CERTAIN NEIGHBORHOOD CLINICS PROVIDE DIGITAL MAMMOGRAPHY SERVICES. 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. WILCOX MEDICAL CENTER PROVIDES PREVENTIVE AND TREATMENT SERVICES TO MEET THE HEALTH NEEDS OF KAUAI WOMEN. ITS 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, INCLUDING DELIVERY, SURGERY AND OTHER SERVICES. IN FISCAL YEAR 2016, WILCOX DELIVERED 541 BABIES. PROGRAM SERVICE #2 OUTPATIENT OPERATING ROOMS IN FISCAL YEAR 2016, HAWAI'I PACIFIC HEALTH HOSPITALS AND CLINICS SPENT $52,518,938 IN DIRECT EXPENSES FOR OUTPATIENT OPERATING ROOMS AND SURGICAL PROCEDURES, AS PART OF OUR COMMITMENT 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 AND THROAT, ORTHOPEDIC, NEUROLOGIC, UROLOGIC, OPHTHALMOLOGIC, GASTROINTESTINAL, 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 MEDICAL CENTER 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 2016, KAPI'OLANI PERFORMED 5,466 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 2016, PALI MOMI PERFORMED 3,813 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. 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 2016, STRAUB PERFORMED 3,504 OUTPATIENT SURGERIES. 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 2016, WILCOX PERFORMED 3,339 OUTPATIENT SURGERIES. PROGRAM SERVICE #3 OUTPATIENT EMERGENCY ROOMS IN FISCAL YEAR 2016, HAWAI'I PACIFIC HEALTH HOSPITALS SAW 150,546 ER PATIENTS AND SPENT $51,672,343 IN DIRECT EXPENSES FOR OUTPATIENT ER SERVICES, AS PART OF OUR COMMITMENT 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 2016, THE KAPI'OLANI ER RECEIVED 44,727 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 2016, THE PALI MOMI ER RECEIVED 48,866 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 2016, THE STRAUB ER RECEIVED 32,642 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 2016, THE WILCOX ER RECEIVED 24,311 PATIENTS.
FORM 990, PART III, LINES 4A-4D CONTINUED	PROGRAM SERVICE #4 OTHER PROGRAMS HAWAI'I PACIFIC HEALTH IS ONE OF THE STATE'S LARGEST HEALTH CARE PROVIDERS WITH FOUR MEDICAL CENTERS, MORE THAN 70 LOCATIONS, 1,700 AFFILIATED PHYSICIANS, 6,600+ 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 2016, THE MEDICAL CENTERS ADMITTED 33,619 PATIENTS. KAUA'I MEDICAL CLINIC HAD 339,933 TOTAL CLINIC ENCOUNTERS. KAPI`OLANI MEDICAL SPECIALISTS HAD 79,122 PATIENT VISITS. AFFILIATES AND SUBSIDIARIES KAPI'OLANI MEDICAL SPECIALISTS IS 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 MEDICAL CENTERS. 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 SYSTEM INCLUDES: THE PACIFIC REGION'S ONLY FULL-SERVICE WOMEN'S AND CHILDREN'S MEDICAL CENTER AND ONLY DEDICATED BURN CENTER, STATE-OF-THE-ART IMAGING CENTER ON KAUA'I, WEST O'AHU'S ONLY CARDIAC CATHETERIZATION LABS, 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 AS ONE OF THE STATES LARGEST HEALTH CARE PROVIDERS, HAWAI'I PACIFIC HEALTH HAS A RESPONSIBILITY TO IMPROVE THE HEALTH OF HAWAI'I RESIDENTS AND, THROUGH ITS MISSION, IS COMMITTED TO CREATING A HEALTHIER HAWAI'I. EACH YEAR, IT SPONSORS HEALTH EDUCATION, TEACHING AND RESEARCH, AND SUPPORTS LIKE-MINDED ORGANIZATIONS. IN FISCAL YEAR 2016, HAWAI'I PACIFIC HEALTH SPENT $10.3 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 RESIDENTS ON HEALTH, WELLNESS AND DISEASE-PREVENTION STRATEGIES. HAWAI'I PACIFIC HEALTH SPECIALISTS DELIVERED FREE PUBLIC HEALTH EDUCATION PROGRAMS THAT HELPED THOUSANDS OF PEOPLE LEARN WAYS TO PREVENT OR MANAGE HEART ATTACKS, CANCER, ARTHRITIS, ASTHMA, ALLERGIES, STRESS, OBESITY, OSTEOPOROSIS AND DRUG ABUSE. THEY INCLUDE "HPH KIDS FEST," "WOMEN'S WAY TO HEALTH," "CANCER CARE," "VALENTINE IN PARADISE,"GETTING A GRIP ON ARTHRITIS." IN FISCAL 2016, HAWAI'I PACIFIC HEALTH SPONSORED OR SUPPORTED NUMEROUS HEALTH EVENTS, INCLUDING "HPH WOMEN'S 10K," "AHA HEARTWALK," "SUSAN G. KOMEN RACE FOR THE CURE," "ARTHRITIS FOUNDATION'S ARTHRITIS WALK,MORE. HAWAI'I PACIFIC HEALTH PARTICIPATED IN SYMPOSIA AND MEETINGS FOR HEALTH CARE PROFESSIONALS, HIRED STUDENTS AS SUMMER INTERNS, AND SPONSORED WORKSHOPS FOR VOLUNTEERS. TO TRAIN HEALTH CARE PROVIDERS, HAWAI'I PACIFIC HEALTH HAS ALLIANCES WITH THE UNIVERSITY OF HAWAI'I JOHN A. BURNS SCHOOL OF MEDICINE AND HAWAI'I PACIFIC UNIVERSITY. HAWAI'I PACIFIC HEALTH INVESTS MORE THAN $5,567,502 EACH YEAR IN TEACHING AND RESEARCH AS A PEDIATRIC AND OB-GYN TRAINING FACILITY FOR THE UNIVERSITY OF HAWAI'I. KAPI'OLANI IS ACTIVELY INVOLVED IN CLINICAL TRIALS AND RESEARCH IN PEDIATRICS, ONCOLOGY, OPHTHALMOLOGY AND CARDIOLOGY. PUBLIC POLICY HAWAI'I PACIFIC HEALTH HAS A RESPONSIBILITY TO OFFER THOUGHTFUL AND INNOVATIVE INPUT TO LAWMAKERS REGARDING HEALTH CARE POLICY AND LEGISLATION. DURING THE MOST RECENT STATE SESSION, HAWAI'I PACIFIC HEALTH SUPPORTED LEGISLATION TO: REQUIRE INFLUENZA VACCINATIONS FOR HEALTH CARE WORKERS, MAINTAIN HOSPITAL DISCHARGE POLICIES THAT SUPPORT LAY CARE GIVERS CARING FOR ILL FAMILY MEMBERS, EXPAND THE SCOPE OF PRACTICE FOR ADVANCED PRACTICE REGISTERED NURSES, REDUCE SUGAR SWEETENED BEVERAGES IN SCHOOLS TO IMPROVE CHILDREN'S HEALTH, AND EXTEND THE HOSPITAL SUSTAINABILITY PROGRAM WHICH SUPPORTS ACCESS TO CARE FOR MEDICAID-INSURED PATIENTS. OTHER HAWAI'I PACIFIC HEALTH MEDICAL CENTERS TREAT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS A SAFETY NET PROVIDER OF HEALTH CARE FOR THE COMMUNITY. AN ESTABLISHED CHARITY CARE POLICY SETS GUIDELINES BY WHICH IT IS DETERMINED IF PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. HAWAI'I PACIFIC HEALTH CONTRIBUTES MORE THAN $1 BILLION TO THE STATE ECONOMY EACH YEAR, SUPPORTING ITS 6,600+ EMPLOYEES, THEIR FAMILIES, AND MANY BUSINESSES THROUGH PURCHASES MADE BY ITS MEDICAL CENTERS AND CLINICS.
FORM 990, PART IV, LINE 10	ENDOWMENT FUNDS KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (KMCWC), PALI MOMI MEDICAL CENTER (PMMC) AND STRAUB CLINIC & HOSPITAL (SCH) HELD ASSETS IN ENDOWMENT FUNDS. WILCOX MEMORIAL HOSPITAL DID NOT HOLD ASSETS IN ENDOWMENT FUNDS. 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 29 NON-CASH CONTRIBUTIONS GREATER THAN $25,000 KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (KMCWC) RECEIVED NON-CASH CONTRIBUTIONS GREATER THAN $25,000. PALI MOMI MEDICAL CENTER (PMMC), STRAUB CLINIC & HOSPITAL (SCH), AND WILCOX MEMORIAL HOSPITAL (WMH) DID NOT RECEIVE NON-CASH CONTRIBUTIONS GREATER THAN $25,000.
FORM 990, PART V, LINE 1A	HAWAI'I PACIFIC HEALTH (HPH), THE ORGANIZATION'S TAX EXEMPT PARENT, PAYS ALL VENDORS. THEREFORE, HPH ISSUES FORM 1099S UNDER ITS TAX ID.
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.
FORM 990, PART VI, LINE 7B CONTINUED	HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS RESERVED POWERS TO APPROVE THE FOLLOWING WITH RESPECT TO WILCOX MEMORIAL HOSPITAL: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: THE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER, SECRETARY, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS, AS SUCH TERM IS DEFINED IN THE BYLAWS; (II) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER BOARD; (III) AMEND THE BYLAWS; (IV) THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR FOR ONE MILLION DOLLAR ($1,000,000) OR MORE; (V) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VI) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (VII) EFFECT INTER-CORPORATE TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (VIII) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S PHYSICIAN AND EXECUTIVE COMPENSATION AND BENEFIT PLANS; (IX) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, OR PARTNERSHIP OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (X) EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAW OF THE STATE OF HAWAI'I, SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY WILCOX MEMORIAL HOSPITAL, KAUA'I MEDICAL CLINIC AND WILCOX HEALTH FOUNDATION (THE "WILCOX AFFILIATES"); (XI) EXCEPT AS PROVIDED IN THE BYLAWS OR AS REQUIRED BY THE LAWS OF THE STATE OF HAWAI'I, SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (XII) CLOSE THE CLINICAL FACILITIES OWNED AND OPERATED BY THE CORPORATION; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (XIII) CONVERT THE CLINIC OWNED AND OPERATED BY THE CORPORATION INTO A FACILITY NO LONGER OFFERING MEDICAL SERVICES; PROVIDED, THAT, AFTER THE EFFECTIVE DATE OF THE BYLAWS, ANY ELIMINATION OF A CLINICAL SERVICE PROVIDED BY THE CORPORATION MUST ALSO BE APPROVED BY THE BOARD; (XIV) AFTER CONSULTING WITH THE BOARD, REMOVE THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE-PRESIDENT/CHIEF FINANCIAL OFFICER, TREASURER, SECRETARY, OTHER EXECUTIVE VICE-PRESIDENTS, SENIOR VICE-PRESIDENTS, ASSISTANT SECRETARIES, AND ALL VICE-PRESIDENTS EXCEPT THE OPERATING UNIT VICE-PRESIDENTS; PROVIDED, HOWEVER, THAT TO REMOVE OR TERMINATE THE PRESIDENT/CHIEF EXECUTIVE OFFICER WILL REQUIRE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE MEMBER TO FULLY COLLABORATE AND CONSULT WITH THE BOARD AND SEEK THE BOARD'S ADVANCE CONSENT FOR SUCH REMOVAL OR TERMINATION. IF THE BOARD DOES NOT CONCUR WITH THE PROPOSED REMOVAL OR TERMINATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SUCH REMOVAL OR TERMINATION WILL REQUIRE THE APPROVAL OF A MAJORITY OF THE MEMBERS ON THE MEMBER BOARD; (XV) AFTER CONSULTING WITH THE BOARD, DEVELOP AND PROMULGATE THE CORPORATE GOALS AND THE LONG RANGE AND STRATEGIC PLANS OF THE CORPORATION; AND (XVI) AFTER CONSULTING WITH THE BOARD, DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER BOARD APPROVAL: (I) ADD ANY DIRECTOR TO THE BOARD; (II) REMOVE ANY DIRECTOR FROM THE BOARD; (III) AMEND THE ARTICLES; (IV) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (V) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000); (VI) ACQUIRE SHARES IN ANOTHER CORPORATION; (VII) SELL, LEASE OR OTHERWISE TRANSFER FIFTY PERCENT (50%) OR MORE OF THE THEN CURRENT AMOUNT, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE TOTAL ASSETS HELD BY THE WILCOX AFFILIATES; (VIII) SELL, LEASE, EXCHANGE OR DISPOSE OF FIFTY PERCENT (50%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (IX) SELL, LEASE OR TRANSFER OF OPERATIONS OR ACTIVITIES OF THE WILCOX AFFILIATES WHICH GENERATE FIFTY PERCENT (50%) OR MORE OF THE TOTAL NET REVENUES, AS REPORTED UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, OF THE WILCOX AFFILIATES DURING THE PRIOR FISCAL YEAR; (X) MERGE THE CORPORATION WITH ANY ENTITY; (XI) DISSOLVE OR LIQUIDATE THE CORPORATION; (XII) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (XIII) FORM A JOINT VENTURE OR OTHER BUSINESS RELATIONSHIP (OTHER THAN THE ORDINARY COURSE OF BUSINESS CONTRACTS) BETWEEN THE CORPORATION AND ANY PERSON OR ENTITY; AND (XIV) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE.
FORM 990, PART VI, LINE 11B	REVIEW OF THE 990 BY THE ORGANIZATION'S GOVERNING BODY VARIOUS SCHEDULES OF THE 990 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 990 OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE 990 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 990 FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE 990 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 990 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; 4) HAS DISCLOSED ANY CONFLICTS OR POTENTIAL CONFLICTS OR ECONOMIC INTERESTS AS REQUIRED; AND 5) 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	PROCESS OF DETERMINING COMPENSATION 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 MARCH 11, 2016 TO REVIEW PHYSICIAN COMPENSATION AND ON AUGUST 26, 2016 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 $(35,299,230) CHANGE IN INTEREST IN KHF/WHF $ 1,252,196 CHANGE IN INTEREST IN PERPETUAL TRUSTS $( 355,350) OTHER CHANGES IN NET ASSETS $ 1,846 ------------- TOTAL $(34,400,538)
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT & RECURRING SERVICES TOTAL FEES:45904302
FORM 990 PART IX LINE 11G	DESCRIPTION:INTERNAL SVC PROVIDED EXPENSE TOTAL FEES:40740116
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:27629393
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIRS & MAINTENANCE TOTAL FEES:14293587
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER SERVICES TOTAL FEES:12321410
FORM 990 PART IX LINE 11G	DESCRIPTION:REGISTRY SERVICES TOTAL FEES:6645118
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL SERVICES TOTAL FEES:3942998
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER TEMPORARY LABOR SERVICES TOTAL FEES:1864258
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION FEES SERVICES TOTAL FEES:1383928
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING SERVICES TOTAL FEES:680594
FORM 990 PART IX LINE 11G	DESCRIPTION:TEMPORARY LABOR ADMIN SVCS TOTAL FEES:385574
FORM 990 PART IX LINE 11G	DESCRIPTION:FUNDRAISING SERVICES TOTAL FEES:1300
FORM 990 PART IX LINE 11G	DESCRIPTION:LAUNDRY SERVICES TOTAL FEES:-1155335
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER EXPENSE RECOVERY TOTAL FEES:-1742240

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN, PALI MOMI MEDICAL CENTER, STRAUB MEDICAL CENTER AND WILCOX MEDICAL CENTER'S MISSION IS TO CREATE A HEALTHIER HAWAI'I.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	38
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	27
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	6,114
6	Total number of volunteers (estimate if necessary) .............	6	726
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	598,568
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-23,487

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,590,778	4,024,550
9	Program service revenue (Part VIII, line 2g) .........	1,115,441,150	1,152,640,538
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,063,229	-2,185,713
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,432,101	6,467,796
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,132,527,258	1,160,947,171
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	161,580	2,725,326
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)	509,057,974	539,388,506
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)....	488,127,929	513,747,465
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	997,347,483	1,055,861,297
19	Revenue less expenses. Subtract line 18 from line 12.......	135,179,775	105,085,874
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	805,615,080	920,581,653
21	Total liabilities (Part X, line 26).............	126,684,853	171,438,146
22	Net assets or fund balances. Subtract line 21 from line 20.....	678,930,227	749,143,507

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 51,373,215 including grants of $ 0 ) (Revenue $ 0 )
	SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 52,518,938 including grants of $ 0 ) (Revenue $ 0 )
	SEE SCHEDULE O.

4c	(Code: ) (Expenses $ 51,672,343 including grants of $ 0 ) (Revenue $ 0 )
	SEE SCHEDULE O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 761,548,691 including grants of $ 2,725,326 ) (Revenue $ 1,158,615,583 )
4e	Total program service expenses917,113,187

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,952,959	14,369,751	3,763,942

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,716,695
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	307,855

g	Noncash contributions included in lines 1a-1f:$ 67,442
h Total.Add lines 1a-1f.......		4,024,550

		Business Code
2a	NET PATIENT REVENUES	622110	1,129,787,221	1,129,787,221	0
b	OTHER HEALTHCARE REVENUE	622110	13,146,922	13,146,922
c	RENTAL INCOME	531120	3,551,471	3,539,311	12,160
d	PREMIUM REVENUE	622110	2,922,533	2,922,533
e	INTER-ENTITY SERVICE REVENUE	900099	1,945,749	1,945,749
f	All other program service revenue.			1,286,642	707,587	579,055
g Total.Add lines 2a–2f.....			1,152,640,538

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			2,519,391			2,519,391
4 Income from investment of tax-exempt bond proceeds			732,264			732,264
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		130,734
b	Less: rental expenses
c	Rental income or (loss)	0	130,734
d	Net rental income or (loss)......			130,734			130,734
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		80,102,275
b	Less: cost or other basis and sales expenses	297,932	85,241,711
c	Gain or (loss)	-297,932	-5,139,436
d	Net gain or (loss).....			-5,437,368			-5,437,368
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		850,443
b	Less: cost of goods sold ..b		495,779
c	Net income or (loss) from sales of inventory..			354,664			354,664
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		722110	2,695,953	2,695,953
b	PARKING REVENUE		812930	2,551,145	2,551,145
c	EXPENSE REIMBURSEMENT		900099	327,472	327,472
d	All other revenue ....			407,828	400,475	7,353	0
e	Total. Add lines 11a–11d ......			5,982,398
12	Total revenue. See Instructions......			1,160,947,171	1,158,024,368	598,568	-1,700,315

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	2,725,326	2,725,326
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	2,172,268	2,119,022	53,246
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	297,752	297,752
7	Other salaries and wages	429,992,683	425,381,871	4,610,812	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	30,801,238	30,046,247	754,991
9	Other employee benefits .......	47,181,792	39,362,036	7,819,756
10	Payroll taxes ...........	28,942,773	28,634,906	307,867
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	8,590	8,590
c	Accounting ...........	2,967,269	1,502	2,965,767
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	437,619		437,619
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	152,895,003	131,436,675	21,458,328
12	Advertising and promotion ....	638,043	119,850	518,193
13	Office expenses .......	160,895,458	160,562,718	332,740
14	Information technology ......	5,505,617	3,581,813	1,923,804
15	Royalties ..	0
16	Occupancy ...........	26,121,446	24,438,125	1,683,321
17	Travel ............	1,046,072	968,374	77,698
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	218,767	205,458	13,309
20	Interest ...........	11,372,986	11,372,986
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	36,424,202	36,424,202
23	Insurance ...	13,483,858	12,574,178	909,680
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	75,406,456		75,406,456
b	OTHER PURCHASES	25,550,669	6,588,244	18,962,425
c	AFFILIATE EXPENSES	395,601		395,601
d	SPECIFIC PURPOSE DONATION	117,712	117,712
e	All other expenses	262,097	145,600	116,497
25	Total functional expenses. Add lines 1 through 24e	1,055,861,297	917,113,187	138,748,110	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).

1	Cash–non-interest-bearing ........			-994,898	1	-853,297
2	Savings and temporary cash investments .........			4,725,385	2	10,949,757
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			161,686,592	4	162,013,837
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 ........			15,932,722	8	16,626,837
9	Prepaid expenses and deferred charges ......			1,231,072	9	2,202,733
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	963,727,167
b	Less: accumulated depreciation	10b	491,254,473	373,115,058	10c	472,472,694
11	Investments—publicly traded securities .			83,745,203	11	85,116,205
12	Investments—other securities. See Part IV, line 11 .....			68,273,753	12	57,944,356
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 ...........			96,281,636	15	112,489,974
16	Total assets. Add lines 1 through 15 (must equal line 34)...			805,615,080	16	920,581,653

17	Accounts payable and accrued expenses .....	92,730,907	17	110,599,860
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	33,953,946	25	60,838,286
26	Total liabilities. Add lines 17 through 25..	126,684,853	26	171,438,146

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	622,486,126	27	691,901,208
28	Temporarily restricted net assets ...........	45,723,128	28	47,524,996
29	Permanently restricted net assets	10,720,973	29	9,717,303
	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 ...........	678,930,227	33	749,143,507
34	Total liabilities and net assets/fund balances ........	805,615,080	34	920,581,653

(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	INSURANCE	HI	501(C)(3)	11B, 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 3-3420 KUHIO HIGHWAY LIHUE,HI96766 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 26TH 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	P	590,629	FMV
(2) KAPI'OLANI MEDICAL SPECIALISTS	R	123,724	FMV
(3) KAUA'I MEDICAL CLINIC	S	403,587	FMV
(4) KAUA'I MEDICAL CLINIC	R	292,246	FMV
(5) PROVIDERS INSURANCE CORPORATION	R	11,972,242	FMV
(6) PALI MOMI FOUNDATION	C	192,633	FMV
(7) KAUA'I MEDICAL CLINIC	P	1,695,074	FMV
(8) WILCOX HEALTH FOUNDATION	C	682,307	FMV
(9) STRAUB FOUNDATION	C	374,156	FMV
(10) KAPI'OLANI MEDICAL SPECIALISTS	S	167,620	FMV
(11) KAPI'OLANI MEDICAL SPECIALISTS	Q	9,143,354	FMV
(12) KAPI'OLANI HEALTH FOUNDATION	S	209,232	FMV
(13) KAPI'OLANI HEALTH FOUNDATION	C	2,054,425	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

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