2025-05-15T22:27:37-05:00 2024-06-30 421539623 KMH LLP 1003 BISHOP STREET SUITE 2400 HONOLULU HI 96813 990 2023-07-01 300206692 WAHIAWA HOSPITAL FOUNDATION WAHI 8086218411 128 LEHUA STREET WAHIAWA HI 96786 JOHN KAMPFER CEO 8086218411 2025-05-15 1 0 CHRISTOPHER CASSIDY P01237316 8085262255 2023 2025-03-06 01:10:19Z X MARCUS OSHIRO 128 LEHUA STREET WAHIAWA HI 96786 42795 0 X N/A X 2000 HI TO BE RESPONSIVE AND TO SUPPORT AND BENEFIT THE ACTIVITIES AND PURPOSE OF WAHIAWA GENERAL HOSPITAL AND ITS AFFILATED ENTITIES AND OTHER HEALTHCARE SERVICES ORGANIZATIONS. X 8 8 0 0 0 0 50 0 0 0 50476 42124 0 0 50526 42124 116237 656998 0 0 0 0 0 0 0 24741 18732 140978 675730 -90452 -633606 633730 0 0 0 633730 0 X SEE SCHEDULE OORGANIZATION'S MISSIONTO SUPPORT WAHIAWA GENERAL HOSPITAL AND OTHER HIGH QUALITY HEALTHCAREWITHIN THE CENTRAL AND NORTH SHORE REGIONS OF THE ISLAND OF OAHU, THEWAHIAWA HOSPITAL FOUNDATION WILL RAISE AWARENESS OF THEREGION'S HEALTHCARE NEEDS, CULTIVATE RESPONSIBLE, ETHICALLY SOUNDRELATIONSHIPS WITH INDIVIDUALS, CORPORATIONS AND FOUNDATIONS AND WILLFORWARD CONTRIBUTIONS TO CHARITABLE ORGANIZATIONS AND PURPOSES IN THECENTRAL AND NORTH SHORE REGIONS OF OAHU. 0 0 656998 656998 TO BE RESPONSIVE TO AND TO SUPPORT AND BENEFIT THE ACTIVITIES AND PURPOSE OF WAHIAWA GENERAL HOSPITAL AND ITS AFFILIATED ENTITIES AND OTHER HEALTHCARE SERVICES ORGANIZATIONS. FUND TRANSFERS ARE MADE TO THE HOSPITAL ONLY. 656998 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 HI X BRIAN CUNNINGHAM 8084592722 128 LEHUA STREET WAHIAWA HI 96786 X JOHN KAMPFER CHAIRMAN 0.08 0.38 X X 0 0 0 MARCUS OSHIRO VICE CHAIR 0.13 0.46 X X 0 0 0 ROBERT BUNDA DIRECTOR 0.17 0.52 X 0 0 0 WENDELL ODA TREASURER 0.15 0.20 X X 0 0 0 JAY GARCIA DIRECTOR 0.15 X 0 0 0 RYAN LEE MD DIRECTOR 0.15 X 0 0 0 MICHAEL DUICK MD DIRECTOR 0.13 X 0 0 0 LUKE ESTES DIRECTOR 0.17 X 0 0 0 BRIAN CUNNINGHAM CEO 1.00 41.00 X 0 0 0 0 0 0 0 0 0 0 0 42795 42795 671 -671 -671 -671 42124 0 0 42124 X 656998 656998 3489 3489 175 175 12639 12639 1031 1031 BANK FEES 1398 1398 675730 656998 18732 0 0 17111 0 0 0 0 0 0 0 0 0 24103 0 0 0 0 592516 0 633730 0 0 0 X 633730 0 633730 0 633730 0 X -633606 -124 X 0 0 0 X X 1 WAHIAWA GENERAL HOSPITAL 990269825 3 1 58367 0 1 58367 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 THE QUEEN'S HEALTH SYSTEMS 1301 PUNCHBOWL STREET HONOLULU HI 96813 990238120 501(C)(3) 0 598631 N/A ASSIGNMENT OF PROMISSORY NOTES OUTSTANDNG FROM WAHIAWA GENERAL HOSPITAL AS SUCCESSOR HOSPITAL BENEFICIARY OF ASSETS HELD BY COOKSEY TRUST THAT WAS MANAGED BY WAHIAWA HOSPITAL FOUNDATION SINCE WAHIAWA GENERAL HOSPITAL CEASED TO OPERATE. WAHIAWA GENERAL HOSPITAL 128 LEHUA STREET WAHIAWA HI 96786 990269825 501(C)(3) 58367 0 N/A N/A GENERAL ASSISTANCE PART I, LINE 2: ALL FUNDS AND TRANSFERS FROM WAHIAWA HOSPITAL FOUNDATION TO WAHIAWA GENERAL HOSPITAL ARE APPROVED BY THE RESPECTIVE BOARD OF DIRECTORS. ALL DISBURSEMENTS MADE BY WAHIAWA GENERAL HOSPITAL ARE FIRST APPROVED BY ITS BOARD OF DIRECTORS. X 0 0 0 0 0 0 0 0 0 CASH 2024-04-02 5042 990269825 WAHIAWA GENERAL HOSPITAL 128 LEHUA STREET WAHIAWA HI 96786 501C3 RELATED PARTY RECEIVABLE 2024-04-02 598631 990238120 THE QUEEN'S HEALTH SYSTEMS 1301 PUNCHBOWL STREET HONOLULU HI 96813 501C3 0 0 0 0 1 1 1 1 0 PART I, LINE 1 A $124 LIQUIDATING ADJUSTMENT WAS PROPOSED BY THE TAX PREPARER TO PROPERLY RECORD THE LIQUIDATION OF THE ORGANIATION'S ASSETS. THE ORGANIZATION BELIEVES THE $124 WAS LIQUIDATED THROUGH FINAL ADMINISTRATIVE EXPENSES RELATED TO THE DISSOLUTION OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS AND RIGHTS WAHIAWA GENERAL HOSPITAL IS THE SOLE MEMBER OF WAHIAWA HOSPITAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS AS A SOLE MEMBER, WAHIAWA GENERAL HOSPITAL, ELECTS ALL MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPR & VOTING RIGHTS WHILE THE BOARD OF DIRECTORS OF THE FOUNDATION IS GIVEN THE GENERAL AUTHORITY IN THE DIRECTION AND MANAGEMENT OF THE AFFAIRS OF THE FOUNDATION, THE MEMBER RETAINS THE EXCLUSIVE RIGHT TO MAKE OR APPROVE CERTAIN FINANCIAL DECISIONS OF THE FOUNDATION, WHICH ACTIONS, UNLESS OTHERWISE REQUIRED BY LAW (INCLUDING REQUIREMENTS TO OBTAIN OR MAINTAIN TAX EXEMPTION), SHALL BE TAKEN ONLY FOLLOWING CONSULTATION WITH THE BOARD OF DIRECTORS OF THE FOUNDATION. SUCH FINANCIAL DECISIONS OF THE FOUNDATION INCLUDE: A. THE ADOPTION OF THE ANNUAL OPERATING AND CAPITAL BUDGETS AND OTHER EXPENDITURE PLANS OF THE FOUNDATION, RECOGNIZING THAT ANNUAL BUDGETS AND OTHER EXPENDITURE PLANS SHALL BE DEVELOPED AND ADOPTED BY THE BOARD OF DIRECTORS OF THE FOUNDATION AND SUBMITTED TO THE MEMBER FOR APPROVAL; B. THE SALE, LEASE, ASSIGNMENT OR EXCHANGE OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE FOUNDATION; C. THE CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION; D. THE DISSOLUTION OF THE FOUNDATION; E. THE INCURRING OF ANY FINANCIAL OBLIGATION OR MAKING OF EXPENDITURE WHICH IS NOT BUDGETED OR WHICH DEVIATES FROM THE FOUNDATION'S ANNUAL OPERATING AND CAPITAL BUDGETS IF THE AMOUNT OF SUCH FINANCIAL OBLIGATION EXPENDITURE EXCEEDS $2,000; F. THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, GRANT OF SECURITY INTEREST, OR OTHER TRANSFER OR ENCUMBRANCE (COLLECTIVELY, "TRANSFER") OF: (I) ANY OF THE REAL PROPERTY OR FIXTURES OF THE FOUNDATION; (II) ANY OF THE PERSONAL PROPERTY AND ASSETS OF THE FOUNDATION, IF THE AMOUNT OF VALUE OF ANY SUCH TRANSFER EXCEEDS $5,000; G. THE BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTY OF ANOTHER'S DEBT OR SIMILAR ACTION; AND H. THE GIVING OR APPROVAL OF GRANTS OR CONTRIBUTIONS TO ANY PARTY OTHER THAN THE HOSPITAL IN EXCESS OF $10,000; I. THE ENGAGEMENT OF ANY MANAGEMENT COMPANY OR OTHER ENTITY OR INDIVIDUAL FOR THE PURPOSE OF DIRECTING OR MANAGING ALL OR SUBSTANTIALLY ALL OF THE PROPERTIES OR BUSINESS AFFAIRS OF THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 - THE FORM 990 WAS APPROVED BY THE BOARD BEFORE SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTION OF CONFLICT OF INTEREST BOARD MEMBERS COMPLETE THE CONFLICT OF INTEREST FORM ANNUALLY AND SUBMIT IT TO ADMINISTRATION. ANY CONFLICTS ARE DISCLOSED TO THE BOARD. FOUNDATION CURRENTLY DOES NOT HAVE ANY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS TO THE GENERAL PUBLIC - THE FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. GOVERNING DOCUMENTS ARE NOT AVAILABLE AT THIS TIME. FORM 990 - GOOD FAITH STATEMENT WAHIAWA GENERAL HOSPITAL ("HOSPITAL") WAS FORMED BY THE WAHIAWA HOSPITAL ASSOCIATION ("ASSOCIATION") IN 1989 TO OWN, MANAGE AND OPERATE ITS HOSPITAL-BASED HEALTHCARE SERVICES THE ASSOCIATION IS THE SOLE MEMBER OF THE HOSPITAL. THE HOSPITAL ESTABLISHED WAHIAWA HOSPITAL FOUNDATION ("FOUNDATION") IN 2000 TO SUPPORT FUND RAISING, CHARITABLE, EDUCATIONAL AND SCIENTIFIC ACTIVITIES FOR THE HOSPITAL. THE HOSPITAL IS THE SOLE MEMBER OF THE FOUNDATION. THE HOSPITAL HAS FACED LONG-STANDING FINANCIAL CHALLENGES FOR A DECADE OR MORE AND HAS PURSUED VARIOUS OPPORTUNITIES TO BECOME PART OF A LARGER HOSPITAL ORGANIZATION TO FULFILL THE HOSPITAL'S MISSION TO PROVIDE QUALITY HEALTHCARE TO THE CENTRAL OAHU AND NORTH SHORE COMMUNITIES. AS A RESULT, EFFECTIVE OCTOBER 27, 2023, THE HOSPITAL AND ASSOCIATION ENTERED INTO A PURCHASE AND SALE AGREEMENT TO SELL CERTAIN LAND, BUILDING, FURNITURE, EQUIPMENT AND INVENTORY OF THE HOSPITAL AND SKILLED NURSING FACILITY TO THE QUEEN'S HEALTH SYSTEMS (QHS), A 501(C)(3). THE SALES PRICE EXCEEDS THE CARRYING VALUE OF THE ASSETS AND THE CLOSING DATE AND THE SALE CLOSED ON APRIL 2, 2024. EFFECTIVE DECEMBER 20, 2023, THE HOSPITAL AND ASSOCIATION'S BOARD APPROVED A PLAN TO BEGIN WINDING DOWN THE OPERATIONS OF THE HOSPITAL UPON COMPLETION OF THE SALE OF CERTAIN LAND, BUILDING, FURNITURE, EQUIPMENT AND INVENTORY TO THE QHS. THE BOARD OF DIRECTORS OF THE HOSPITAL DETERMINED THAT AFTER WINDING UP THE REMAINING BUSINESS AFFAIRS OF THE HOSPITAL, THE HOSPITAL WOULD BE DISSOLVED. ARTICLES OF DISSOLUTION WERE SUBSEQUENTLY FILED WITH THE STATE OF HAWAII FOR THE HOSPITAL AND THE ENTITY IS SHOWN AS DISSOLVED AS OF JUNE 28, 2024. ON FEBRUARY 7, 2024, THE FOUNDATION'S BOARD OF DIRECTORS DETERMINED THAT WITH THE DISSOLUTION OF THE HOSPITAL, THE PURPOSE OF THE FOUNDATION WILL HAVE BEEN FULFILLED AND COMPLETED, AND THAT THE FOUNDATION SHOULD BE DISSOLVED. ON APRIL 3, 2024, THE FOUNDATION'S BOARD ADOPTED THE FINAL RESOLUTION TO DISSOLVE THE FOUNDATION AND ARTICLES OF DISSOLUTION WERE SUBSEQUENTLY FILED WITH THE STATE OF HAWAII AND THE ENTITY IS SHOWN AS DISSOLVED AS OF MAY 16, 2024. PART OF THE FOUNDATION'S ASSETS INCLUDED COOKSEY TRUST ASSETS WHICH CALLED FOR THE SUCCESSOR HOSPITAL IN WAHIAWA TO BECOME THE BENEFICIARY OF THE TRUST IN THE EVENT THAT THE HOSPITAL CEASED TO OPERATE. THE PROMISSORY NOTES OUTSTANDING, REFLECTING THE OBLIGATIONS OF THE HOSPITAL TO PAY THE FOUNDATION, WERE ASSIGNED TO QHS UPON DISSOLUTION. ACCORDING TO THE BOARD'S RESOLUTION, THE REMAINING ASSETS OF THE FOUNDATION AFTER PAYMENT OF ALL OUTSTANDING DEBTS AND OBLIGATIONS WOULD BE DONATED AND DISTRIBUTED TO THE HOSPITAL. THE ASSOCIATION PLANS TO CONTINUE ON WITH ITS OPERATIONS TO THE BEST OF ITS ABILITY. HISTORICALLY, THE ACCOUNTING PERSONNEL OF THE HOSPITAL HAD TAKEN CARE OF THE ACCOUNTING FOR THE FOUNDATION AND ASSOCIATION. UPON THE HOSPITAL'S DISSOLUTION AND SALE OF SUBSTANTIALLY ALL ASSETS TO QHS, THE ACCOUNTING PERSONNEL MOVED ON TO DIFFERENT JOBS AFTER WRAPPING UP AS MUCH AS THEY COULD OF THE BOOKS AND ARE NO LONGER WORKING WITH ANY OF THE ENTITIES. AS THE ENTITY HAS DISSOLVED, THERE IS A SUBSTANTIAL LACK OF INFORMATION AVAILABLE, AND THE RETURN WAS COMPLETED WITH AS MUCH INFORMATION AS POSSIBLE. THE ORGANIZATION HAS MADE ITS BEST EFFORTS TO COMPLY WITH TAX LAWS BASED UPON THE INFORMATION AVAILABLE AT THE TIME OF FILING. RATHER THAN FILE A DELINQUENT TAX RETURN, THE ORGANIZATION AND TAX PROFESSIONALS MADE THEIR BEST EFFORTS TO DETERMINE THE PROPER TAX TREATMENT AND REPORTING OF VARIOUS ITEMS BASED ON THE ORGANIZATION'S AUDITED FINANCIALS. FORM 990, PART XI, LINE 9: LIQUIDATING ADJUSTMENT -124. WAHIAWA GENERAL HOSPITAL 128 LEHUA STREET WAHIAWA HI 96786 990269825 HEALTHCARE HI 501(C)(3) LINE 3 WAHIAWA HOSPITAL ASSOCIATION INC 1 WAHIAWA HOSPITAL ASSOCIATION INC 94 -1221 KA UKA BLVD UNIT 108-322 WAIPAHU HI 96797 990073529 HEALTHCARE HI 501(C)(3) LINE 12B, II N/A 0 WAHIAWA GENERAL HOSPITAL AUXILIARY 128 LEHUA STREET WAHIAWA HI 96786 996009028 HEALTHCARE HI 501(C)(3) LINE 10 N/A 0 WAHIAWA HOSPITAL SERVICES CORPORATION 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC ADOLESCENT CENTER INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC HEALTH CENTER INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 WAHIAWA-PACIFIC HEALTH CENTER 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC HEALTH COMMUNITY INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 WAHIAWA-CENTRAL OAHU HEALTH CENTER INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC WOMEN'S CENTER INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC WELLNESS CENTER INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC BIOTECH INSTITUTE INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC SPORTS MEDICINE & RESEARCH CTR 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC SAGING CENTER INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC COMMUNITY HEALTH & WELLNESS 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 PACIFIC CARDIAC INSTITUTE INC 128 LEHUA STREET WAHIAWA HI 96786 INACTIVE HI WHA C 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WAHIAWA GENERAL HOSPITAL B 58367 FMV