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SEE STRAUB FOUNDATION'S FORM 990 FOR A DESCRIPTION OF HOW THE ENDOWMENT FUNDS ARE USED."},{"identifier":"SCHEDULE D - FIN 48 FOOTNOTE","form_and_line_reference":"PART X, LINE 2","explanation":"FOLLOWING IS THE FIN 48 FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATION'S PARENT. THE TAXABLE AFFILIATES OF THE COMPANY UTILIZE THE LIABILITY METHOD OF ACCOUNTING FOR INCOME TAXES. UNDER THIS METHOD, DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON DIFFERENCES BETWEEN THE FINANCIAL REPORTING AND TAX BASIS OF ASSETS AND LIABILITIES, AND ARE MEASURED USING THE CURRENTLY EXACTED TAX RATES AND LAWS. VALUATION ALLOWANCES ARE USED TO REDUCE DEFERRED TAX ASSETS TO THEIR ESTIMATED NET REALIZABLE VALUES WHEN MANAGEMENT DETERMINES ULTIMATE RECOVERY OF THE DEFERRED TAX ASSETS IS NOT MORE LIKELY THAN NOT TO OCCUR."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_400":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":3075056,"bad_debt_expense_attributable_to_financial_assistance":302054,"reimbursed_by_medicare":68119457,"cost_of_care_reimbursed_by_medicare":72152915,"medicare_surplus_or_shortfall":-4033458,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"persons_served":6755,"total_community_benefit_expense":621738,"net_community_benefit_expense":621738,"total_expense_percentage":0.0022},"unreimbursed_medicaid":{"persons_served":46394,"total_community_benefit_expense":26838854,"direct_offsetting_revenue":21616248,"net_community_benefit_expense":5222606,"total_expense_percentage":0.0183},"total_financial_assistance":{"persons_served":53149,"total_community_benefit_expense":27460592,"direct_offsetting_revenue":21616248,"net_community_benefit_expense":5844344,"total_expense_percentage":0.0205},"community_health_services":{"total_community_benefit_expense":645363,"direct_offsetting_revenue":181493,"net_community_benefit_expense":463870,"total_expense_percentage":0.0016},"health_professions_education":{"activities_or_programs":2,"total_community_benefit_expense":835090,"direct_offsetting_revenue":329499,"net_community_benefit_expense":505591,"total_expense_percentage":0.0018},"subsidized_health_services":{"activities_or_programs":4,"total_community_benefit_expense":6699516,"direct_offsetting_revenue":5349393,"net_community_benefit_expense":1350123,"total_expense_percentage":0.0047},"cash_and_inkind_contributions":{"total_community_benefit_expense":48763,"net_community_benefit_expense":48763,"total_expense_percentage":0.0002},"total_other_benefits":{"activities_or_programs":6,"total_community_benefit_expense":8228732,"direct_offsetting_revenue":5860385,"net_community_benefit_expense":2368347,"total_expense_percentage":0.0083},"total_community_benefits":{"activities_or_programs":6,"persons_served":53149,"total_community_benefit_expense":35689324,"direct_offsetting_revenue":27476633,"net_community_benefit_expense":8212691,"total_expense_percentage":0.0288}},"community_building":{"workforce_development":{"total_community_benefit_expense":347780,"net_community_benefit_expense":347780,"total_expense_percentage":0.0012},"total_community_building_activities":{"total_community_benefit_expense":347780,"net_community_benefit_expense":347780,"total_expense_percentage":0.0012}},"hospital_facilities":[{"business_name_line1":"STRAUB CLINIC & HOSPITAL","address_line1":"888 SOUTH KING STREET","city":"HONOLULU","state":"HI","zip":"96813","licensed_hospital":true,"general_medical_and_surgical":true,"teaching_hospital":true,"emergency_room_24_hours":true,"name":"STRAUB CLINIC & HOSPITAL","address":"888 SOUTH KING STREET, HONOLULU, HI, 96813"},{"business_name_line1":"KAILUA CLINIC","address_line1":"602 KAILUA ROAD 2ND FLOOR","city":"KAILUA","state":"HI","zip":"96734","other_description":"CLINIC","name":"KAILUA CLINIC","address":"602 KAILUA ROAD 2ND FLOOR, KAILUA, HI, 96734"},{"business_name_line1":"WINDWARD MALL CLINIC","address_line1":"46-056 KAMEHAMEHA HWY SUITE 221","city":"KANEOHE","state":"HI","zip":"96744","other_description":"CLINIC","name":"WINDWARD MALL CLINIC","address":"46-056 KAMEHAMEHA HWY SUITE 221, KANEOHE, HI, 96744"},{"business_name_line1":"HAWAI'I KAI CLINIC","address_line1":"7192 KALANIANAOLE HIGHWAY SUITE A20","city":"HONOLULU","state":"HI","zip":"96825","other_description":"CLINIC","name":"HAWAI'I KAI CLINIC","address":"7192 KALANIANAOLE HIGHWAY SUITE A20, HONOLULU, HI, 96825"},{"business_name_line1":"PALI MOMI CLINIC","address_line1":"98-1079 MOANALUA ROAD SUITE 640","city":"AIEA","state":"HI","zip":"96701","other_description":"CLINIC","name":"PALI MOMI CLINIC","address":"98-1079 MOANALUA ROAD SUITE 640, AIEA, HI, 96701"},{"business_name_line1":"KAPOLEI CLINIC","address_line1":"590 FARRINGTON HIGHWAY SUITE 590","city":"KAPOLEI","state":"HI","zip":"96707","other_description":"CLINIC","name":"KAPOLEI CLINIC","address":"590 FARRINGTON HIGHWAY SUITE 590, KAPOLEI, HI, 96707"},{"business_name_line1":"ARTESIAN SATELLITE","address_line1":"1907 BERETANIA ST 5TH FLOOR","city":"HONOLULU","state":"HI","zip":"96826","other_description":"CLINIC","name":"ARTESIAN SATELLITE","address":"1907 BERETANIA ST 5TH FLOOR, HONOLULU, HI, 96826"},{"business_name_line1":"HILO CLINIC","address_line1":"73 PUUHOU PLACE","city":"HILO","state":"HI","zip":"96720","other_description":"CLINIC","name":"HILO CLINIC","address":"73 PUUHOU PLACE, HILO, HI, 96720"},{"business_name_line1":"KONA CLINIC","address_line1":"75-240 NANI KAILUA DRIVE SUITE 157","city":"KAILUAKONA","state":"HI","zip":"96740","other_description":"CLINIC","name":"KONA CLINIC","address":"75-240 NANI KAILUA DRIVE SUITE 157, KAILUAKONA, HI, 96740"},{"business_name_line1":"PEARLRIDGE CLINIC","address_line1":"98-151 PALI MOMI STREET","city":"AIEA","state":"HI","zip":"96701","other_description":"CLINIC","name":"PEARLRIDGE CLINIC","address":"98-151 PALI MOMI STREET, AIEA, HI, 96701"},{"business_name_line1":"LANAI CLINIC","address_line1":"628-B SEVENTH STREET","city":"LANAI CITY","state":"HI","zip":"96763","other_description":"CLINIC","name":"LANAI CLINIC","address":"628-B SEVENTH STREET, LANAI CITY, HI, 96763"},{"business_name_line1":"DOCTORS ON CALL -HILTON HAWAIIAN VILLAGE","address_line1":"2005 KALIA ROAD","city":"HONOLULU","state":"HI","zip":"96815","other_description":"CLINIC","name":"DOCTORS ON CALL -HILTON HAWAIIAN VILLAGE","address":"2005 KALIA ROAD, HONOLULU, HI, 96815"},{"business_name_line1":"DOCTORS ON CALL -PRINCESS KAIULANI HOTEL","address_line1":"120 KAIULANI AVENUE LOBBY LEVEL","city":"HONOLULU","state":"HI","zip":"96815","other_description":"CLINIC","name":"DOCTORS ON CALL -PRINCESS KAIULANI HOTEL","address":"120 KAIULANI AVENUE LOBBY LEVEL, HONOLULU, HI, 96815"},{"business_name_line1":"MILILANI CLINIC","address_line1":"95-1249 MEHEULA PKWY SUITE C-2","city":"MILILANI","state":"HI","zip":"96789","other_description":"CLINIC","name":"MILILANI CLINIC","address":"95-1249 MEHEULA PKWY SUITE C-2, MILILANI, HI, 96789"}],"part_vi_explanations":{"affiliated_health_care_system":"THE HAWAI'I PACIFIC HEALTH CARE SYSTEM INCLUDES FOUR AFFILIATED HOSPITALS, 49 OUTPATIENT CLINICS AND SERVICE SITES, AND MORE THAN 1,300 PHYSICIANS. THE FOUR HOSPITALS PROVIDE ACUTE AND SPECIALTY CARE WITH 553 BEDS AND 76 BASSINETS, AND HANDLE MORE THAN 34,000 ADMISSIONS ANNUALLY. HAWAI'I PACIFIC HEALTH, THE STATE'S LARGEST HEALTH CARE PROVIDER, IS COMMITTED TO PROVIDING THE HIGHEST QUALITY AND MOST ACCESSIBLE MEDICAL CARE AND SERVICES TO THE PEOPLE OF HAWAI'I AND THE PACIFIC REGION.","annual_community_benefit":"COMMUNITY BENEFITS ARE INCLUDED IN A REPORT PREPARED BY HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATION'S PARENT.","bad_debt_footnote":"THE ESTIMATE OF BAD DEBT COST IS BASED ON THE COST TO CHARGE RATIO AND THE ESTIMATE OF CHARITY CARE COST IS BASED ON THE COST TO CHARGE RATIO ATTRIBUTED TO MANAGEMENT'S ESTIMATE OF THE PORTION OF THE UN-INSURED PATIENT THAT COULD HAVE QUALIFIED FOR CHARITY CARE. PER THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAI'I PACIFIC HEALTH, 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 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 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.","community_building_activities":"STRAUB CLINIC & HOSPITAL(\"STRAUB\") IS COMMITTED TO ATTRACTING AND RETAINING TOP-QUALITY PHYSICIANS. IN HAWAI'I, THE THREAT OF LOSING PHYSICIANS TO THE U.S. MAINLAND IS CONSTANT. ACCORDING TO THE HAWAI'I MEDICAL JOURNAL AND HAWAI'I PHYSICIAN WORKFORCE ASSESSMENT PROJECT, BY 2020, HAWAI'I WILL HAVE 1,500 FEWER PHYSICIANS THAN ARE NEEDED TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. SHORTAGES WILL BE PARTICULARLY SEVERE IN PRIMARY CARE, CARDIOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, GENERAL SURGERY, AND OTHER SPECIALTIES. IN FISCAL 2010, STRAUB SPENT $347,780 TO ATTRACT PHYSICIANS TO HAWAI'I. THIS INCLUDED STAFF EXPENSES: THE SALARY AND BENEFITS OF A FULL-TIME RECRUITER, A PHYSICIAN SERVICES MANAGER; THE PURCHASE OF A LAPTOP COMPUTER AND SOFTWARE, THE \"PRACTICE MATCH SERVICES\" DATABASE FOR LOCATING PHYSICIANS AS POTENTIAL CANDIDATES; CONSULTING FEES FOR IN-STATE PHYSICIANS WHO RECRUIT MAINLAND PHYSICIANS; AND MISCELLANEOUS OFFICE AND TRAVEL EXPENSES. IN ADDITION, STRAUB PAID THE TRAVEL EXPENSES OF PHYSICIAN CANDIDATES WHO INTERVIEWED AT STRAUB, INCLUDING AIRFARE, HOTEL, CAR RENTAL, MEALS AND GENERAL RECRUITMENT ACTIVITIES. STRAUB ALSO PAID THE MOVING EXPENSES OF PHYSICIANS WHO COMMITTED TO PRACTICING AT THE HOSPITAL, INCLUDING AIRFARE, SHORT-TERM HOUSING, CAR RENTAL, FOOD, RELOCATION SERVICES FOR MOVING/SHIPPING PERSONAL ITEMS, AND RELATED EXPENSES OF ANY FAMILY MEMBERS. BY COVERING THESE COSTS, STRAUB IS INVESTING IN HAWAII'S FUTURE, AND ENSURING THAT THE COMMUNITY'S HEALTH CARE NEEDS WILL BE MET.","community_information":"STRAUB CLINIC & HOSPITAL (\"STRAUB\") HAS BEEN SERVING THE COMMUNITY'S HEALTH CARE NEEDS FOR MORE THAN 80 YEARS. IT IS A FULLY INTEGRATED, NONPROFIT HEALTH CARE SYSTEM WITH A 159-BED HOSPITAL IN HONOLULU, A NETWORK OF NEIGHBORHOOD CLINICS, AND A VISITING SPECIALIST PROGRAM THAT REACHES THROUGHOUT THE STATE OF HAWAI'I. STRAUB HOUSES AN ARRAY OF PHYSICIAN SPECIALISTS UNDER ONE ROOF, ENABLING THE HOSPITAL TO PROVIDE EXPERT DIAGNOSIS AND TREATMENT IN MORE THAN 32 DIFFERENT SPECIALTIES. THUS, PATIENTS WITH COMPLEX MEDICAL PROBLEMS FROM ALL ISLANDS AND COMMUNITIES OF HAWAI'I COME HERE TO QUICKLY RECEIVE FOCUSED CARE. IN FISCAL 2010, STRAUB HAD MORE THAN 110,000 IMAGING PROCEDURES, 23,003 ER VISITS, AND 6,300 INPATIENT ADMISSIONS. IT TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. STRAUB'S GEOGRAPHIC SERVICE AREA IS THE ENTIRE PACIFIC BASIN, SINCE MANY OF ITS MEDICAL SPECIALTIES ARE NOT PROVIDED ELSEWHERE IN THIS REGION, WHICH STRETCHES FROM THE U.S. WEST COAST TO FAR EAST ASIA. THE STRAUB BURN UNIT, FOR EXAMPLE, IS THE ONLY DEDICATED BURN TREATMENT FACILITY BETWEEN LOS ANGELES AND HONG KONG. DEMOGRAPHICS OF THE COMMUNITY IN FISCAL 2010 INCLUDE A STATE POPULATION OF 1.4 MILLION, WITH 10.7 PERCENT OF RESIDENTS HAVING INCOMES BELOW THE FPG, 7.6 PERCENT OF STRAUB PATIENTS ARE UNINSURED AND 15.6 PERCENT ARE MEDICAID RECIPIENTS. THERE ARE 10 OTHER HOSPITALS IN THE STATE, AND FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS ARE PRESENT.","costing_method_used":"COST TO CHARGE RATIO AND SCHEDULE H WORKSHEET WAS USED","debt_collection_policy":"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 COLLECTIONS.","needs_assessment":"THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF DEVELOPING A PLAN TO ASSESS THE COMMUNITY NEEDS IN ACCORDANCE WITH IRC SECTION 501(R)","other_information":"STRAUB CLINIC & HOSPITAL (\"STRAUB\") OPERATES SEVERAL HIGHLY REGARDED SPECIALTY CARE UNITS, INCLUDING THE HEART CENTER AND BONE AND JOINT CENTER. THE BURN UNIT IS THE ONLY MULTIDISCIPLINARY BURN TREATMENT CENTER IN THE PACIFIC REGION, PROVIDING BURN VICTIMS WITH IMMEDIATE AND COMPREHENSIVE CARE, CLOSE TO HOME. STRAUB MAINTAINS AN OPEN MEDICAL STAFF IN 19 SPECIALTIES AND AN OPEN/MANAGED MEDICAL STAFF IN 14 SPECIALTIES. THIS ARRANGEMENT, WHICH GRANTS HOSPITAL PRIVILEGES TO NONAFFILITATED PHYSICIAN SPECIALISTS, ALSO BROADENS STRAUB'S ABILITY TO OFFER HIGH-QUALITY, SPECIALIZED CARE TO THE COMMUNITY. STRAUB 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 STRAUB FULFILLS ITS MISSION-DRIVEN GOALS. AS AN AFFILIATE OF THE NON-PROFIT HAWAI'I PACIFIC HEALTH NETWORK, STRAUB REINVESTS ALL SURPLUS RESOURCES BACK INTO PATIENT CARE AND TO SUBSIDIZE THOSE WHO CANNOT PAY. IN ADDITION, STRAUB PROVIDES CHARITY CARE, HEALTH EDUCATION AND PREVENTATIVE PROGRAMS TO THE COMMUNITY. IN FISCAL 2010, ITS MEDICAL SPECIALISTS DELIVERED FREE PUBLIC HEALTH EDUCATION PROGRAMS AND EVENTS THAT HELPED THOUSANDS OF INDIVIDUALS LEARN THE LATEST STRATEGIES FOR PREVENTING OR MANAGING HEART ATTACKS, CANCER, ARTHRITIS, ASTHMA, ALLERGIES, STRESS, OSTEOPOROSIS, OBESITY AND DRUG ABUSE. THESE EVENTS INCLUDED KIDS FEST, LIVING HEALTHY IN PARADISE, WOMEN'S WAY TO HEALTH, CANCER CARE: CURRENT ISSUES, BREATHE WITH EASE, VALENTINE IN PARADISE AND GETTING A GRIP ON ARTHRITIS. THE ANNUAL WOMEN'S 10K RUN, ONE OF THE MORE VISIBLE SPORTS EVENTS IN THE COMMUNITY, CELEBRATED ITS 33ND CONSECUTIVE YEAR.","patient_education_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. THIS 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 ASSISTANCE 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.","percent_of_total_expense":"BAD DEBT EXPENSE OF $8,365,449 WAS SUBTRACTED FROM TOTAL EXPENSES TO COMPUTE PERCENTAGES","shortfall_as_community_benefit":"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 COSTS ARE LOSSES INCURRED BY SERVING THE COMMUNITY. TOTAL MEDICARE ALLOWABLE COSTS WERE CALCULATED IN ACCORDANCE WITH THE FEDERAL STANDARD MEDICARE REPORTING FORM CMS-2552-96.","subsidized_health_services":"VARIOUS CLINICS (DOCTORS ON CALL, LANAI, HILO AND KONA). THE COST ASSOCIATED WITH THESE CLINICS IS REPORTED ON PART I, LINE 7G."}},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":9500,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":9500,"no_grant_over_5000":true,"total_domestic_grants":9500,"total_domestic_program_services":9500,"supplemental_information":[{"identifier":"FORM 990, SCHEDULE I","form_and_line_reference":"DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS","explanation":"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."}],"grant_monitoring":{"claims_monitoring_procedures":false,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false}},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":true,"initial_contract_exception":false,"severance_payment":true,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"THOMAS J NORDYKE 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AFFILIATED GROUP TOTAL ALSO INCLUDES FEES PAID TO A REGISTERED LOBBYIST WHO PROVIDES GENERAL ADVICE ON LEGISLATIVE ACTIVITIES INCLUDING INFORMATION AND INSIGHT ON LEGISLATIVE ACTIONS THAT MAY BE OF INTEREST TO HAWAI'I PACIFIC HEALTH."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":14001855,"investment_earnings_or_losses":783751,"end_year_balance":14785606},"current_year_minus1":{"beginning_year_balance":15671969,"investment_earnings_or_losses":-1670114,"end_year_balance":14001855},"board_designated_eoy_percentage":1.0,"held_by_unrelated_organizations":false,"held_by_related_organizations":true,"related_organizations_listed_schedule_r":true},"land_buildings_equipment":{"land":{"other_cost_or_other_basis":8709732,"book_value":8709732},"buildings":{"other_cost_or_other_basis":71756590,"book_value":51989864,"depreciation":19766726},"leasehold_improvements":{"other_cost_or_other_basis":7643690,"book_value":3680000,"depreciation":3963690},"equipment":{"other_cost_or_other_basis":62618293,"book_value":20359757,"depreciation":42258536},"other_land_buildings":{"other_cost_or_other_basis":1328529,"book_value":1328529,"depreciation":0},"total_book_value":86067882},"other_assets":{"assets":[{"description":"DUE FROM THIRD PARTY PAYORS","book_value":2044875},{"description":"OTHER RECEIVABLES","book_value":448652},{"description":"DUE FROM STRAUB FOUNDATION","book_value":11574},{"description":"BOARD DESIGNATED INVESTMENTS","book_value":14785606},{"description":"BENEFICIAL INT. 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SEE STRAUB FOUNDATION'S FORM 990 FOR A DESCRIPTION OF HOW THE ENDOWMENT FUNDS ARE USED."},{"identifier":"SCHEDULE D - FIN 48 FOOTNOTE","form_and_line_reference":"PART X, LINE 2","explanation":"FOLLOWING IS THE FIN 48 FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATION'S PARENT. THE TAXABLE AFFILIATES OF THE COMPANY UTILIZE THE LIABILITY METHOD OF ACCOUNTING FOR INCOME TAXES. UNDER THIS METHOD, DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON DIFFERENCES BETWEEN THE FINANCIAL REPORTING AND TAX BASIS OF ASSETS AND LIABILITIES, AND ARE MEASURED USING THE CURRENTLY EXACTED TAX RATES AND LAWS. VALUATION ALLOWANCES ARE USED TO REDUCE DEFERRED TAX ASSETS TO THEIR ESTIMATED NET REALIZABLE VALUES WHEN MANAGEMENT DETERMINES ULTIMATE RECOVERY OF THE DEFERRED TAX ASSETS IS NOT MORE LIKELY THAN NOT TO OCCUR."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_400":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":3075056,"bad_debt_expense_attributable_to_financial_assistance":302054,"reimbursed_by_medicare":68119457,"cost_of_care_reimbursed_by_medicare":72152915,"medicare_surplus_or_shortfall":-4033458,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"persons_served":6755,"total_community_benefit_expense":621738,"net_community_benefit_expense":621738,"total_expense_percentage":0.0022},"unreimbursed_medicaid":{"persons_served":46394,"total_community_benefit_expense":26838854,"direct_offsetting_revenue":21616248,"net_community_benefit_expense":5222606,"total_expense_percentage":0.0183},"total_financial_assistance":{"persons_served":53149,"total_community_benefit_expense":27460592,"direct_offsetting_revenue":21616248,"net_community_benefit_expense":5844344,"total_expense_percentage":0.0205},"community_health_services":{"total_community_benefit_expense":645363,"direct_offsetting_revenue":181493,"net_community_benefit_expense":463870,"total_expense_percentage":0.0016},"health_professions_education":{"activities_or_programs":2,"total_community_benefit_expense":835090,"direct_offsetting_revenue":329499,"net_community_benefit_expense":505591,"total_expense_percentage":0.0018},"subsidized_health_services":{"activities_or_programs":4,"total_community_benefit_expense":6699516,"direct_offsetting_revenue":5349393,"net_community_benefit_expense":1350123,"total_expense_percentage":0.0047},"cash_and_inkind_contributions":{"total_community_benefit_expense":48763,"net_community_benefit_expense":48763,"total_expense_percentage":0.0002},"total_other_benefits":{"activities_or_programs":6,"total_community_benefit_expense":8228732,"direct_offsetting_revenue":5860385,"net_community_benefit_expense":2368347,"total_expense_percentage":0.0083},"total_community_benefits":{"activities_or_programs":6,"persons_served":53149,"total_community_benefit_expense":35689324,"direct_offsetting_revenue":27476633,"net_community_benefit_expense":8212691,"total_expense_percentage":0.0288}},"community_building":{"workforce_development":{"total_community_benefit_expense":347780,"net_community_benefit_expense":347780,"total_expense_percentage":0.0012},"total_community_building_activities":{"total_community_benefit_expense":347780,"net_community_benefit_expense":347780,"total_expense_percentage":0.0012}},"hospital_facilities":[{"business_name_line1":"STRAUB CLINIC & HOSPITAL","address_line1":"888 SOUTH KING STREET","city":"HONOLULU","state":"HI","zip":"96813","licensed_hospital":true,"general_medical_and_surgical":true,"teaching_hospital":true,"emergency_room_24_hours":true,"name":"STRAUB CLINIC & HOSPITAL","address":"888 SOUTH KING STREET, HONOLULU, HI, 96813"},{"business_name_line1":"KAILUA CLINIC","address_line1":"602 KAILUA ROAD 2ND FLOOR","city":"KAILUA","state":"HI","zip":"96734","other_description":"CLINIC","name":"KAILUA CLINIC","address":"602 KAILUA ROAD 2ND FLOOR, KAILUA, HI, 96734"},{"business_name_line1":"WINDWARD MALL CLINIC","address_line1":"46-056 KAMEHAMEHA HWY SUITE 221","city":"KANEOHE","state":"HI","zip":"96744","other_description":"CLINIC","name":"WINDWARD MALL CLINIC","address":"46-056 KAMEHAMEHA HWY SUITE 221, KANEOHE, HI, 96744"},{"business_name_line1":"HAWAI'I KAI CLINIC","address_line1":"7192 KALANIANAOLE HIGHWAY SUITE A20","city":"HONOLULU","state":"HI","zip":"96825","other_description":"CLINIC","name":"HAWAI'I KAI CLINIC","address":"7192 KALANIANAOLE HIGHWAY SUITE A20, HONOLULU, HI, 96825"},{"business_name_line1":"PALI MOMI CLINIC","address_line1":"98-1079 MOANALUA ROAD SUITE 640","city":"AIEA","state":"HI","zip":"96701","other_description":"CLINIC","name":"PALI MOMI CLINIC","address":"98-1079 MOANALUA ROAD SUITE 640, AIEA, HI, 96701"},{"business_name_line1":"KAPOLEI CLINIC","address_line1":"590 FARRINGTON HIGHWAY SUITE 590","city":"KAPOLEI","state":"HI","zip":"96707","other_description":"CLINIC","name":"KAPOLEI CLINIC","address":"590 FARRINGTON HIGHWAY SUITE 590, KAPOLEI, HI, 96707"},{"business_name_line1":"ARTESIAN SATELLITE","address_line1":"1907 BERETANIA ST 5TH FLOOR","city":"HONOLULU","state":"HI","zip":"96826","other_description":"CLINIC","name":"ARTESIAN SATELLITE","address":"1907 BERETANIA ST 5TH FLOOR, HONOLULU, HI, 96826"},{"business_name_line1":"HILO CLINIC","address_line1":"73 PUUHOU PLACE","city":"HILO","state":"HI","zip":"96720","other_description":"CLINIC","name":"HILO CLINIC","address":"73 PUUHOU PLACE, HILO, HI, 96720"},{"business_name_line1":"KONA CLINIC","address_line1":"75-240 NANI KAILUA DRIVE SUITE 157","city":"KAILUAKONA","state":"HI","zip":"96740","other_description":"CLINIC","name":"KONA CLINIC","address":"75-240 NANI KAILUA DRIVE SUITE 157, KAILUAKONA, HI, 96740"},{"business_name_line1":"PEARLRIDGE CLINIC","address_line1":"98-151 PALI MOMI STREET","city":"AIEA","state":"HI","zip":"96701","other_description":"CLINIC","name":"PEARLRIDGE CLINIC","address":"98-151 PALI MOMI STREET, AIEA, HI, 96701"},{"business_name_line1":"LANAI CLINIC","address_line1":"628-B SEVENTH STREET","city":"LANAI CITY","state":"HI","zip":"96763","other_description":"CLINIC","name":"LANAI CLINIC","address":"628-B SEVENTH STREET, LANAI CITY, HI, 96763"},{"business_name_line1":"DOCTORS ON CALL -HILTON HAWAIIAN VILLAGE","address_line1":"2005 KALIA ROAD","city":"HONOLULU","state":"HI","zip":"96815","other_description":"CLINIC","name":"DOCTORS ON CALL -HILTON HAWAIIAN VILLAGE","address":"2005 KALIA ROAD, HONOLULU, HI, 96815"},{"business_name_line1":"DOCTORS ON CALL -PRINCESS KAIULANI HOTEL","address_line1":"120 KAIULANI AVENUE LOBBY LEVEL","city":"HONOLULU","state":"HI","zip":"96815","other_description":"CLINIC","name":"DOCTORS ON CALL -PRINCESS KAIULANI HOTEL","address":"120 KAIULANI AVENUE LOBBY LEVEL, HONOLULU, HI, 96815"},{"business_name_line1":"MILILANI CLINIC","address_line1":"95-1249 MEHEULA PKWY SUITE C-2","city":"MILILANI","state":"HI","zip":"96789","other_description":"CLINIC","name":"MILILANI CLINIC","address":"95-1249 MEHEULA PKWY SUITE C-2, MILILANI, HI, 96789"}],"part_vi_explanations":{"affiliated_health_care_system":"THE HAWAI'I PACIFIC HEALTH CARE SYSTEM INCLUDES FOUR AFFILIATED HOSPITALS, 49 OUTPATIENT CLINICS AND SERVICE SITES, AND MORE THAN 1,300 PHYSICIANS. THE FOUR HOSPITALS PROVIDE ACUTE AND SPECIALTY CARE WITH 553 BEDS AND 76 BASSINETS, AND HANDLE MORE THAN 34,000 ADMISSIONS ANNUALLY. HAWAI'I PACIFIC HEALTH, THE STATE'S LARGEST HEALTH CARE PROVIDER, IS COMMITTED TO PROVIDING THE HIGHEST QUALITY AND MOST ACCESSIBLE MEDICAL CARE AND SERVICES TO THE PEOPLE OF HAWAI'I AND THE PACIFIC REGION.","annual_community_benefit":"COMMUNITY BENEFITS ARE INCLUDED IN A REPORT PREPARED BY HAWAI'I PACIFIC HEALTH, THE FILING ORGANIZATION'S PARENT.","bad_debt_footnote":"THE ESTIMATE OF BAD DEBT COST IS BASED ON THE COST TO CHARGE RATIO AND THE ESTIMATE OF CHARITY CARE COST IS BASED ON THE COST TO CHARGE RATIO ATTRIBUTED TO MANAGEMENT'S ESTIMATE OF THE PORTION OF THE UN-INSURED PATIENT THAT COULD HAVE QUALIFIED FOR CHARITY CARE. PER THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAI'I PACIFIC HEALTH, 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 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 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.","community_building_activities":"STRAUB CLINIC & HOSPITAL(\"STRAUB\") IS COMMITTED TO ATTRACTING AND RETAINING TOP-QUALITY PHYSICIANS. IN HAWAI'I, THE THREAT OF LOSING PHYSICIANS TO THE U.S. MAINLAND IS CONSTANT. ACCORDING TO THE HAWAI'I MEDICAL JOURNAL AND HAWAI'I PHYSICIAN WORKFORCE ASSESSMENT PROJECT, BY 2020, HAWAI'I WILL HAVE 1,500 FEWER PHYSICIANS THAN ARE NEEDED TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. SHORTAGES WILL BE PARTICULARLY SEVERE IN PRIMARY CARE, CARDIOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, GENERAL SURGERY, AND OTHER SPECIALTIES. IN FISCAL 2010, STRAUB SPENT $347,780 TO ATTRACT PHYSICIANS TO HAWAI'I. THIS INCLUDED STAFF EXPENSES: THE SALARY AND BENEFITS OF A FULL-TIME RECRUITER, A PHYSICIAN SERVICES MANAGER; THE PURCHASE OF A LAPTOP COMPUTER AND SOFTWARE, THE \"PRACTICE MATCH SERVICES\" DATABASE FOR LOCATING PHYSICIANS AS POTENTIAL CANDIDATES; CONSULTING FEES FOR IN-STATE PHYSICIANS WHO RECRUIT MAINLAND PHYSICIANS; AND MISCELLANEOUS OFFICE AND TRAVEL EXPENSES. IN ADDITION, STRAUB PAID THE TRAVEL EXPENSES OF PHYSICIAN CANDIDATES WHO INTERVIEWED AT STRAUB, INCLUDING AIRFARE, HOTEL, CAR RENTAL, MEALS AND GENERAL RECRUITMENT ACTIVITIES. STRAUB ALSO PAID THE MOVING EXPENSES OF PHYSICIANS WHO COMMITTED TO PRACTICING AT THE HOSPITAL, INCLUDING AIRFARE, SHORT-TERM HOUSING, CAR RENTAL, FOOD, RELOCATION SERVICES FOR MOVING/SHIPPING PERSONAL ITEMS, AND RELATED EXPENSES OF ANY FAMILY MEMBERS. BY COVERING THESE COSTS, STRAUB IS INVESTING IN HAWAII'S FUTURE, AND ENSURING THAT THE COMMUNITY'S HEALTH CARE NEEDS WILL BE MET.","community_information":"STRAUB CLINIC & HOSPITAL (\"STRAUB\") HAS BEEN SERVING THE COMMUNITY'S HEALTH CARE NEEDS FOR MORE THAN 80 YEARS. IT IS A FULLY INTEGRATED, NONPROFIT HEALTH CARE SYSTEM WITH A 159-BED HOSPITAL IN HONOLULU, A NETWORK OF NEIGHBORHOOD CLINICS, AND A VISITING SPECIALIST PROGRAM THAT REACHES THROUGHOUT THE STATE OF HAWAI'I. STRAUB HOUSES AN ARRAY OF PHYSICIAN SPECIALISTS UNDER ONE ROOF, ENABLING THE HOSPITAL TO PROVIDE EXPERT DIAGNOSIS AND TREATMENT IN MORE THAN 32 DIFFERENT SPECIALTIES. THUS, PATIENTS WITH COMPLEX MEDICAL PROBLEMS FROM ALL ISLANDS AND COMMUNITIES OF HAWAI'I COME HERE TO QUICKLY RECEIVE FOCUSED CARE. IN FISCAL 2010, STRAUB HAD MORE THAN 110,000 IMAGING PROCEDURES, 23,003 ER VISITS, AND 6,300 INPATIENT ADMISSIONS. IT TREATS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS SERVING AS ONE OF THE COMMUNITY'S SAFETY NET PROVIDERS OF HEALTH CARE. STRAUB'S GEOGRAPHIC SERVICE AREA IS THE ENTIRE PACIFIC BASIN, SINCE MANY OF ITS MEDICAL SPECIALTIES ARE NOT PROVIDED ELSEWHERE IN THIS REGION, WHICH STRETCHES FROM THE U.S. WEST COAST TO FAR EAST ASIA. THE STRAUB BURN UNIT, FOR EXAMPLE, IS THE ONLY DEDICATED BURN TREATMENT FACILITY BETWEEN LOS ANGELES AND HONG KONG. DEMOGRAPHICS OF THE COMMUNITY IN FISCAL 2010 INCLUDE A STATE POPULATION OF 1.4 MILLION, WITH 10.7 PERCENT OF RESIDENTS HAVING INCOMES BELOW THE FPG, 7.6 PERCENT OF STRAUB PATIENTS ARE UNINSURED AND 15.6 PERCENT ARE MEDICAID RECIPIENTS. THERE ARE 10 OTHER HOSPITALS IN THE STATE, AND FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS ARE PRESENT.","costing_method_used":"COST TO CHARGE RATIO AND SCHEDULE H WORKSHEET WAS USED","debt_collection_policy":"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. 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