2025-05-15T12:17:14+00:00 2024-06-30 346565596 ERNST & YOUNG US LLP 2005 MARKET STREET PHILADELPHIA PA 19103 990 2023-07-01 990246364 Kapi'olani Health Foundation KAPI 8085357100 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 DAWN DUNBAR PRESIDENT 8085357100 2025-05-15 true Lauren E Bennett P01787029 2154485000 2025-05-11 2023 2025-03-06 01:10:19Z DAWN DUNBAR 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 21147275 false X HTTPS://GIVING.HAWAIIPACIFICHEALTH.ORG X 1986 HI THE MISSION OF KAPI'OLANI HEALTH FOUNDATION IS TO CREATE A HEALTHIER HAWAI'I. 22 20 0 41 0 0 9521617 8544608 0 2604195 4176079 313994 103946 12439806 12824633 2609261 11775269 0 0 0 574315 2486629 2565804 5095890 14341073 7343916 -1516440 126363496 146090402 1288673 9958900 125074823 136131502 THE MISSION OF KAPI'OLANI HEALTH FOUNDATION IS TO CREATE A HEALTHIER HAWAI'I. false false 13046800 11775269 0 SEE SCHEDULE O 13046800 true true false false false false true true true true true false false true true false true false false false false false false true false false true false true false false false false false false false false true false false false false true true true false false true X 0 0 0 false false false false false true true false false false false false false X 22 20 false false false false true true true true true false false true true true true true true false false false HI X X CHENWEI LI 8085357434 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 Brad Nicolai Board of Director, Vice Chair 0.2 0 X X 0 0 0 Paul Marx Board of Director, Chair 0.2 0 X X 0 0 0 Amber Thibaut Board of Director 0.2 0 X 0 0 0 Angela Pratt MD Board of Director 0.2 0.1 X 0 24462 0 Chynna Stone Board of Director 0.2 0 X 0 0 0 Emalia Pietsch Hogan Board of Director 0.2 0 X 0 0 0 Howard Lee Board of Director 0.2 0 X 0 0 0 Karen T Polivka Board of Director 0.2 0 X 0 0 0 Katherine Bennett Board of Director 0.2 0 X 0 0 0 Kathy Carr Board of Director 0.2 0 X 0 0 0 Kelly Sueda Board of Director 0.2 0 X 0 0 0 Linda Woo Board of Director 0.2 0 X 0 0 0 Marilyn Katzman Board of Director 0.2 0 X 0 0 0 Matthew Emerson Board of Director 0.2 0 X 0 0 0 Michelle Bartell Board of Director 0.2 0 X 0 0 0 Nedra Manson Board of Director 0.2 0 X 0 0 0 Paige Pahlmeyer Board of Director 0.2 0 X 0 0 0 Ralph Mesick Board of Director (part year) 0.2 0 X 0 0 0 Raymond P Vara Jr Board of Director 0.2 61.9 X 0 2464885 1946467 Ruth Mills Board of Director 0.2 0 X 0 0 0 Shelley Cramer Board of Director 0.2 0 X 0 0 0 Shelley Wilson Board of Director 0.2 0 X 0 0 0 Thomas Kosasa MD Board of Director 0.2 0 X 0 0 0 Carrie Ann Tsutsui Assistant Treasurer 0.3 48.1 X 0 307290 79120 Charles R Ching Secretary 0.1 39.9 X 0 830806 294495 David Okabe Treasurer 0.2 49.8 X 0 1124153 424421 Dawn Dunbar President 10.4 34.6 X 0 432600 119562 Jessica Lewis Assistant Secretary 0.5 39.5 X 0 183999 45659 0 5368195 2909724 0 false true false 0 65500 107818 8371290 134583 8544608 0 0 0 0 0 2390446 2390446 0 0 9994500 8208866 1785634 0 1785633 1785633 188312 65500 113776 74536 74536 OTHER REVENUE 29410 29410 0 0 0 0 29410 12824633 0 0 4280025 11775269 11775269 14502 14502 256952 256952 888829 389723 278257 220849 14824 14824 51210 26920 24290 42660 42660 59615 59615 300 300 15557 15557 PROGRAM EXPENDITURES 881808 881808 CORPORATE ALLOCATION 127770 127770 PRINTING & DESIGN SERVICES 124983 124983 ANNUAL GIVING GIFTS 26057 26057 60737 0 0 60737 14341073 13046800 719958 574315 19983288 20954500 1385148 1365049 1263265 0 0 0 0 0 88639 93071 56880 56880 0 0 36969144 42264215 61788770 70849848 4407496 6257243 477746 4306476 126363496 146090402 84788 128397 127106 122240 0 0 1076779 9708263 1288673 9958900 X 87873164 101858005 37201659 34273497 125074823 136131502 126363496 146090402 X -1516440 12624988 -51869 X false true X true false X 7844967 7846866 8861796 9521617 8544608 42619854 0 0 7844967 7846866 8861796 9521617 8544608 42619854 4148702 38471152 1027353 1242952 970252 1488371 2390446 7119374 21322 313994 74536 409852 674 1080 0 0 29410 31164 50180244 0 0.7667 0.7634 X Schedule A, Part II, Line 10 Other Income DESCRIPTION - OTHER INCOME, COLUMN A - 674.0, COLUMN B - 1080.0, COLUMN C - , COLUMN D - , COLUMN E - 29410.0, COLUMN F - 31164.0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2362 X false false true X 108995698 8500 12212363 120147 15589 121080825 96803417 2012450 10262471 70986 11654 108995698 106015638 9625 -9128562 80313 12971 96803417 84640785 46615 21409490 69431 11821 106015638 82066540 30286 2587692 35233 8500 84640785 0.94 0.04 0.02 false false 56880 56880 0 0 INVESTMENTS-OTHER SECURITIES 70849848 F 70849848 DUE TO KAPI'OLANI CENTER FOR WOMEN & CHILDREN 9686902 DUE TO HAWAI'I PACIFIC HEALTH 32968 DUE TO WILCOX MEMORIAL HOSPITAL 1861 DUE TO HAWAII PACIFIC HEALTH MEDICAL GROUP 102267 DUE TO AFFILIATES -207253 DUE TO KAPIOLANI MEDICAL SPECIALIST 91518 9708263 X Schedule D, Part III, Line 4 Collections of art - description of collections MISCELLANEOUS ARTWORK USED AS DECORATION. Schedule D, Part IV, Line 2b Explanation of escrow agreement ESCROW LIABILITIES REPRESENT AMOUNTS DUE TO INDIVIDUALS UNDER CHARITABLE REMAINDER TRUST AGREEMENTS. Schedule D, Part V, Line 4 Intended uses of endowment funds ENDOWMENT FUNDS ARE MANAGED TO ENSURE THAT THE RETURNS SUPPORT THE MEDICAL CENTER'S OPERATIONS; HIRING OF STAFF; IMPLEMENTATION OF PROGRAMS; RESEARCH AND EDUCATION; AND PROVIDE QUALITY CARE FOR PATIENTS, ALL IN ACCORDANCE WITH THE DONOR'S INTENT AND THE ORGANIZATION'S MISSION. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote UNCERTAIN TAX POSITIONS AUDITED FINANCIAL STATEMENT FOOTNOTE THE COMPANY HAS NOT RECORDED ANY EXPENSE OR ACCRUED FOR ANY RELATED EXPENSE FOR ANY UNCERTAIN TAX POSITIONS. KCMN NANEA GOLF INVITATION 253812 65500 188312 1887 23290 5801 66660 4856 11282 0 0 253812 65500 188312 1887 23290 5801 66660 4856 11282 113776 74536 true KAPIOLANI MEDICAL CENTER WOMEN & CHILDREN 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 910177350 501(C)(3) 10978435 109258 FMV books, home goods/clothing, food, gift cards, drug/medical supplies, toys GENERAL SUPPORT Kapi'olani Medical Specialists 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990322406 501(C)(3) 589767 0 FMV N/A GENERAL SUPPORT Hawai'i Community Foundation 827 FORT STREET MALL HONOLULU HI 968132817 990261283 501 (C)(3) 45153 0 FMV N/A GENERAL SUPPORT HAWAI'I PACIFIC HEALTH RESEARCH INSTITUTE 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246363 501 (C)(3) 52656 0 FMV N/A GENERAL SUPPORT 4 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. TEMPORARILY RESTRICTED FUNDS RELEASED (& GRANTED) TO THE AFFILIATED ORGANIZATION ARE RELEASED AFTER THE SPECIFIC PURPOSE OF THE FUND HAS BEEN MET. ONCE THE AFFILIATED ORGANIZATION COMMUNICATES THE EXPENSE AND SATISFIES THE SUBSTANTIATION OF THE EXPENSE FOR THE PURPOSE THAT THE FUNDS WERE CONTRIBUTED FOR, THE FOUNDATION RELEASES THE RESTRICTION AND RECORDS THE GRANT TO THE AFFILIATED ORGANIZATION. NO FURTHER MONITORING OF THE FUNDS AFTER DISTRIBUTION IS NECESSARY. false true false false false false false false false Raymond P Vara Jr Board of Director 0 1231412 0 505774 0 727699 0 1923428 0 23039 0 4411352 0 671154 Charles R Ching Secretary 0 474538 0 139662 0 216606 0 278322 0 16173 0 1125301 0 187977 Dawn Dunbar President 0 313399 0 74859 0 44342 0 94230 0 25332 0 552162 0 68960 Jessica Lewis Assistant Secretary 0 176275 0 5000 0 2724 0 18051 0 27608 0 229658 0 0 David Okabe Treasurer 0 601227 0 206576 0 316350 0 408248 0 16173 0 1548574 0 244318 Carrie Ann Tsutsui Assistant Treasurer 0 239446 0 42745 0 25099 0 67840 0 11280 0 386410 0 38265 Schedule J, Part I, Line 3 SUPPLEMENTAL COMPENSATION INFORMATION THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ('HPH'), 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 HPH TO DETERMINE COMPENSATION. Schedule J, Part I, Line 4b SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $307,960 DAVID OKABE - $114,710 CHARLES R. CHING - $77,492 ANNUAL INCENTIVE PLAN THE ANNUAL INCENTIVE PLANS ARE AFFORDED TO EXECUTIVES BASED ON ANNUAL SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNT PAID OUT DURING THE YEAR BY RELATED ORGANIZATIONS: RAYMOND P. VARA JR. - $505,774 DAVID OKABE - $176,576 CHARLES R. CHING - $139,662 DAWN DUNBAR - $74,859 CARRIE ANN TSUTSUI - $42,745 RETENTION INCENTIVE PLAN THE RETENTION INCENTIVE PLAN WAS DESIGNED TO ENCOURAGE CONTINUED INTEREST IN THE SUCCESS OF THE ORGANIZATION AND PROVIDE COMPETITIVE RETIREMENT BENEFITS. THE SOLE PLAN PARTICIPANT IS HAWAI'I PACIFIC HEALTH'S CHIEF EXECUTIVE OFFICER, RAYMOND P. VARA JR. THE PLAN DOES NOT REPLACE THE ANNUAL AND LONG-TERM INCENTIVE PLAN NOR SERP RESTORATION PLAN. AMOUNTS PAID OUT DURING THE YEAR BY A RELATED ORGANIZATION: RAYMOND P. VARA JR. - $500,000 X 250 Other X 913 Other X 2 1271 Other - MARKET VALUE X 8 14127 Other - MARKET VALUE X 1 1300 Other - MARKET VALUE X PREPAID GIFTCARDS 21 57270 Other - MARKET VALUE X TOYS 20 59452 Other - MARKET VALUE 0 false true false Schedule M, Part I COLUMN B COLUMN B REPRESENTS THE NUMBER OF DONORS. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS THE MISSION OF KAPI'OLANI HEALTH FOUNDATION (THE FOUNDATION) IS TO CREATE A HEALTHIER HAWAI'I. KAPI'OLANI MEDICAL CENTER FOR WOMEN & CHILDREN (KAPI'OLANI) IS A NOT-FOR-PROFIT MEDICAL CENTER LOCATED IN HONOLULU THAT IS DEDICATED TO THE HEALTH AND WELL-BEING OF ALL HAWAI'I RESIDENTS. KAPI'OLANI IS HAWAI'I'S ONLY MATERNITY, NEWBORN AND PEDIATRIC SPECIALTY HOSPITAL. KAPI'OLANI IS PART OF HAWAI'I PACIFIC HEALTH, ONE OF THE STATE'S LARGEST HEALTH CARE SYSTEMS. AS A NOT-FOR-PROFIT MEDICAL CENTER, KAPI'OLANI RELIES ON PHILANTHROPIC SUPPORT FROM THE COMMUNITY TO FULFILL ITS MISSION AND CARE FOR ITS PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. CONTRIBUTIONS, BOTH UNRESTRICTED AND DESIGNATED, HELP THE MEDICAL CENTER PROVIDE EXCEPTIONAL MEDICAL CARE IN HAWAI'I. GENEROUS DONATIONS ASSIST, BUT ARE NOT LIMITED TO, THESE AREAS: PATIENT AND SPECIALITY CARE, CAPITAL IMPROVEMENTS, EDUCATION AND RESEARCH, COMMUNITY HEALTH AND UNCOMPENSATED CARE. SERVICES INCLUDE: PATIENT AND SPECIALITY CARE CANCER AND INFUSION CENTER FOR WOMEN & CHILDREN KAPI'OLANI IS PURSUING A FUNDRAISING CAMPAIGN TO BUILD A NEW CANCER CENTER FOR WOMEN AND CHILDREN. THE CENTER WILL BE LOCATED IN THE FORMER EMERGENCY DEPARTMENT SPACE AT THE HOSPITAL. THE NEW CENTER WILL BE MORE THAN 25,000 SQUARE FEET. WITH THE LARGER SPACE KAPI'OLANI WILL BE ABLE TO EXPAND PATIENT CARE SERVICES BY OFFERING A CHEMO-INFUSION PHARMACY, SINGLE FLOOR ACCESS TO OUTPATIENT INFUSION CENTER, SEPARATE ENTRANCES AND WAITING SPACES FOR ADULTS AND CHILDREN, AND AN OUTDOOR HEALING GARDEN. THE PROPOSED SPACE AND SPECIALTY SERVICES WILL FURTHER ENHANCE ONCOLOGY CARE AT KAPI'OLANI FOR BOTH WOMEN AND CHILDREN ACROSS THE ENTIRE STATE. COMMUNITY HEALTH AND UNCOMPENSATED CARE CHILD LIFE SERVICES KAPI'OLANI'S CHILD LIFE PROGRAM WAS ESTABLISHED TO HELP PEDIATRIC PATIENTS AND THEIR FAMILIES COPE WITH HOSPITALIZATION AND TREATMENT. DONATIONS SUPPORT THE FINANCIAL NEEDS OF THE CHILD LIFE PROGRAM INCLUDING THE SALARIES OF CHILD LIFE SPECIALISTS/THERAPISTS, THE BRAIN STATION PROGRAM THAT RELIES ON RESOURCES FOR CLASSROOM ACTIVITIES AND SUPPLIES UNDER THE DIRECTION OF THE EDUCATION LIAISON AND HOSPITAL-BASED TEACHER, AROMATHERAPY STAFFING AND PROGRAM COSTS, AS WELL AS PLAYROOM SUPPLIES AND ACTIVITIES. PATIENT ASSISTANCE FUND: FAMILY FUND THE PURPOSE OF THE PATIENT ASSISTANCE FUND IS TO ASSIST MEDICAL CENTER PATIENTS AND/OR THEIR SUPPORT SYSTEM RECEIVING SERVICES, INCLUDING THE EMERGENCY DEPARTMENT AND OUTPATIENT SERVICES AT THIS FACILITY. THE MANAGEMENT AND DISBURSEMENT OF THE PATIENT ASSISTANCE FUND OR FAMILY FUND IS LEFT TO THE DISCRETION OF THIS FACILITY TO MEET SPECIFIC PATIENT CARE NEEDS. THE FUNDS MAY BE USED FOR PATIENTS AND/OR THEIR SUPPORT SYSTEM THAT HAVE FINANCIAL BARRIERS AND NEED CONTINUED MEDICAL OR PSYCHOSOCIAL SUPPORT OR TO FACILITATE DISCHARGE. NEARLY HALF OF KAPI'OLANI'S PATIENTS COME FROM UNINSURED OR UNDERINSURED FAMILIES. IN OUR COMMITMENT TO SERVE OUR COMMUNITY, NO PATIENT IS TURNED AWAY FROM RECEIVING CARE. Form 990, Part V, Line 1a FORM 1096 REPORTING HAWAI'I PACIFIC HEALTH (HPH), THE ORGANIZATION'S TAX EXEMPT PARENT, PAYS ALL VENDORS. THEREFORE, HPH ISSUES FORMS 1099 UNDER ITS TAX ID. Form 990, Part VI, Line 15 PROCESS OF DETERMINING COMPENSATION THE PRESIDENT, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER BY THE TAX EXEMPT PARENT HAWAI'I PACIFIC HEALTH ("HPH"). FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE PRESIDENT, OFFICERS AND KEY EMPLOYEES' COMPENSATION. COMPENSATION FOR HAWAI'I PACIFIC HEALTH ("HPH") EXECUTIVES (VICE PRESIDENT AND ABOVE) IS SET BY THE HPH COMPENSATION COMMITTEE, WHICH IS COMPOSED SOLELY OF INDEPENDENT, COMMUNITY-BASED MEMBERS OF THE HPH BOARD OF DIRECTORS. ON AN ANNUAL BASIS THE HPH BOARD CHAIRPERSON (WHO IS INDEPENDENT) SELECTS A NEUTRAL THIRD PARTY EXECUTIVE COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVES' COMPENSATION AND BENEFITS. THE CONSULTANT PROVIDES A WRITTEN REPORT TO THE COMPENSATION COMMITTEE AT ITS ANNUAL MEETING. INCLUDED IN THE REPORT IS MARKET BASED DATA FROM LIKE ORGANIZATIONS. THE COMPENSATION COMMITTEE MAKES FINAL DECISIONS REGARDING COMPENSATION AND BENEFITS AT THE MEETING AFTER REVIEW AND DISCUSSION OF THE CONSULTANT'S REPORT, AND SUCH DECISIONS ARE DOCUMENTED IN THE COMPENSATION COMMITTEE MEETING MINUTES. COMMUNITY BASED DIRECTORS OF THE ORGANIZATION ARE NOT COMPENSATED. CERTAIN EMPLOYED PHYSICIANS MAY BE OFFICERS OR AN IDENTIFIED KEY EMPLOYEE OF THE REPORTING OR RELATED ORGANIZATION. PHYSICIAN COMPENSATION IS ALSO HANDLED IN THE SAME MANNER AS EXECUTIVE COMPENSATION, WITH THE HPH COMPENSATION COMMITTEE RECEIVING A REPORT FROM A NEUTRAL CONSULTANT AND FOLLOWING THE SAME PROCESS AS DESCRIBED ABOVE ON AN ANNUAL BASIS. THIS PROCESS WAS LAST COMPLETED ON MARCH 07, 2024 TO REVIEW PHYSICIAN COMPENSATION AND ON AUGUST 08, 2024 TO REVIEW EXECUTIVE COMPENSATION. Form 990, Part VI, Line 6 Classes of members or stockholders 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 Members or stockholders electing members of governing body HAWAI'I PACIFIC HEALTH IS THE SOLE MEMBER, AND HAS THE POWER TO APPROVETHE 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 Decisions requiring approval by members or stockholders HAWAI'I PACIFIC HEALTH, AS MEMBER, HAS EXCLUSIVE POWER TO TAKE AND DIRECT THE FOLLOWING ACTIONS OF THE CORPORATION: (I) NOMINATE CANDIDATES TO THE BOARD FOR THE FOLLOWING POSITIONS: PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE CHAIR OF THE BOARD; (II) AFTER CONSULTATION WITH THE BOARD, REMOVE THE PRESIDENT, VICE-PRESIDENT(S), TREASURER, SECRETARY, ASSISTANT TREASURERS AND SECRETARIES, AND ANY OTHER OFFICER, EXCEPT THE CHAIR AND VICE-CHAIR; (III) REMOVE A DIRECTOR FROM THE BOARD; (IV) DELEGATE MANAGEMENT AUTHORITIES FROM THE BOARD TO OFFICERS OR COMMITTEES OF THE CORPORATION IN ACCORDANCE WITH A DELEGATED AUTHORITIES MATRIX ADOPTED BY THE MEMBER; (V) AMEND THESE BYLAWS; (VI) CAUSE THE CORPORATION'S PARTICIPATION IN ALL LONG TERM FINANCING TRANSACTIONS WHICH ARE IN EXCESS OF ONE (1) YEAR AND/OR ONE MILLION DOLLARS ($1,000,000) OR MORE; (VII) SELECT BANKS, TRUST COMPANIES, OR OTHER DEPOSITORIES TO WHICH THE CORPORATION'S FUNDS SHALL BE DEPOSITED; (VIII) DIRECT, MANAGE AND CONTROL THE CUSTODY, ADVISORY SERVICE, AND ASSET MANAGEMENT OF THE FINANCIAL ASSETS OF THE CORPORATION; (IX) DETERMINE AND EFFECT INTER CORPORATE FUND TRANSFERS BY AND BETWEEN THE CORPORATION AND ANY AFFILIATE; (X) DEVELOP AND IMPLEMENT THE GENERAL POLICIES REGARDING THE CORPORATION'S EXECUTIVE COMPENSATION AND BENEFIT PLANS; (XI) FORM A NEW CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR OTHER ORGANIZATION THAT IS OWNED SOLELY BY THE CORPORATION; (XII) DEVELOP AND PROMULGATE OVERALL CORPORATE GOALS AND THE LONG-RANGE AND STRATEGIC PLAN OF THE CORPORATION; AND (XIII) DEVELOP AND IMPLEMENT THE ANNUAL CAPITAL, OPERATING, AND CASH FLOW BUDGETS. THE CORPORATION SHALL NOT TAKE THE FOLLOWING ACTIONS WITHOUT FIRST OBTAINING MEMBER APPROVAL: (I) ELECT ANY DIRECTOR TO THE BOARD; (II) AMEND THE ARTICLES; (III) MERGE THE CORPORATION WITH ANY ENTITY; (IV) DISSOLVE THE CORPORATION; (V) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS BY OR ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VI) ENTER INTO ANY UNBUDGETED CONTRACTS ON BEHALF OF THE CORPORATION WHICH REQUIRE ANNUAL PAYMENTS BY OR ON BEHALF OF THE CORPORATION EXCEEDING ONE MILLION DOLLARS ($1,000,000) IN VALUE; (VII) ACQUIRE ASSETS WORTH OVER ONE MILLION DOLLARS ($1,000,000) EXCEPT FOR THOSE ASSETS ACQUIRED BY GIFTS, GRANT, OR DONATION; (VIII) ACQUIRE SHARES IN ANOTHER CORPORATION; (IX) SELL, LEASE, EXCHANGE, ENCUMBER OR DISPOSE OF TWENTY-FIVE PERCENT (25%) OR MORE OF THE PROPERTY AND ASSETS HELD BY THE CORPORATION TO ANY ENTITY THAT IS NOT AN AFFILIATE; (X) ISSUE THE CORPORATION'S MEMBERSHIP TO ANYONE OTHER THAN THE MEMBER; (XI) 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 (XII) DEVELOP A NEW LINE OF BUSINESS OR A NEW SERVICE. Form 990, Part VI, Line 11b Review of form 990 by governing body VARIOUS SCHEDULES OF THE FORM 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 OPERATING UNITS, HR, LEGAL, ETC. DISCLOSURE NARRATIVES ARE WRITTEN AND COMPLETED 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 DESCRIBE THE MISSION/PURPOSE AND PROGRAM ACCOMPLISHMENTS OF THEIR ORGANIZATION. SENIOR MANAGEMENT OF THE HEALTH CARE SYSTEM REVIEWS THE FORM 990 OF EACH FILING ORGANIZATION WITHIN THE HEALTH CARE SYSTEM. ONCE SENIOR MANAGEMENT HAS COMPLETED ITS REVIEW, THE FORMS 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 FORM 990 REPORTING AND REVIEWS THE FORM 990 FOR EACH ENTITY PRIOR TO FILING. IN ADDITION, THE FORM 990 FOR EACH ENTITY IS 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 FORM 990. THE FORMS 990 WILL BE POSTED TO HPH'S WEBSITE FOR PUBLIC ACCESS AFTER THE FILING OF THE RETURN WITH THE IRS. Form 990, Part VI, Line 12c 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. 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, Line 19 Required documents available to the public DISCLOSURE OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND STANDARDS 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 Other changes in net assets or fund balances EQUITY TRANSFERS FROM HPH - 42773; OTHER CHANGES IN NET ASSETS - -13620; INTERCOMPANY TRANSFERS WITH FOUNDATIONS - -81018; IMMATERIAL ROUNDING - -4; HAWAI'I PACIFIC HEALTH 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990246363 ADMIN SVCS. HI 501(c)(3) Type III-FI NA false KAPI'OLANI MED CTR FOR WOMEN & CHILDREN 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990177350 HOSPITAL HI 501(c)(3) 3 HPH true KAPI'OLANI MEDICAL SPECIALISTS 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990322406 HEALTHCARE HI 501(c)(3) 3 HPH true KAUA'I MEDICAL CLINIC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990326099 HOSPITAL HI 501(c)(3) 3 HPH true PALI MOMI FOUNDATION 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 383840327 FUNDRAISING HI 501(c)(3) 7 HPH true PALI MOMI MEDICAL CENTER 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990274038 HOSPITAL HI 501(c)(3) 3 HPH true PROVIDERS INSURANCE COMPANY 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 710893000 INSURANCE HI 501(c)(3) Type II HPH true STRAUB CLINIC & HOSPITAL 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 912151670 HOSPITAL HI 501(c)(3) 3 HPH true STRAUB FOUNDATION 55 MERCHANT STREET 26TH FLOOR HONOLULU HI 96813 990109350 FUNDRAISING HI 501(c)(3) 7 HPH true WILCOX HEALTH FOUNDATION 3-3420 KUHIO HIGHWAY LIHUE HI 96766 990204242 FUNDRAISING HI 501(c)(3) 7 HPH true WILCOX MEMORIAL HOSPITAL 3-3420 KUHIO HIGHWAY LIHUE HI 96766 990074365 HOSPITAL HI 501(c)(3) 3 HPH true Honolulu Surgery Center LP 55 Merchant Street 24th Floor Honolulu HI 96813 621506645 AMBU. SURG. CTR. TN NA N/A Specialty Surgical Suites LLC 1401 S Beretania St STE 750 Honolulu HI 96814 461674512 AMBU. SURG. CTR. HI NA N/A HONOLULU IMAGING CENTER LLC 55 MERCHANT STREET 27TH FLOOR HONOLULU HI 96813 871602945 DIAG. IMAGING CTR DE NA N/A ALL ACCESS ORTHO O'ahu LLC AMBU. SURG. CTR. HI NA N/A HAWAI'I ISOTOPE TECHNOLOGY LLC AMBU. SURG. CTR. HI NA N/A HAWAI'I PACIFIC HEALTH PARTNERS INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990318588 HOLDING COMPANY HI NA C Corporation STRAUB PHARMACY INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990145107 INACTIVE HI NA C Corporation HICORD INC 55 MERCHANT STREET 24TH FLOOR HONOLULU HI 96813 990251496 INVESTMENT HI NA C Corporation false true false false false false false false false false false false false false true true true true true KAPI'OLANI MEDICAL CTR FOR WOMEN & CHILDREN B 11087693 FMV KAPI'OLANI MEDICAL CTR FOR WOMEN & CHILDREN Q 160633 FMV PALI MOMI FOUNDATION P 100416 FMV STRAUB FOUNDATION P 117699 FMV KAPIOLANI MEDICAL CTR FOR WOMEN & CHILDREN R 251153 FMV KAPIOLANI MEDICAL SPECIALIST Q 104078 FMV KAPIOLANI MEDICAL SPECIALIST B 589767 FMV STRAUB FOUNDATION S 51683 FMV WILCOX HEALTH FOUNDATION S 147423 FMV WILCOX HEALTH FOUNDATION P 82659 FMV