Form 990 for tax year 2023

Revenue

Part VIII, the statement of revenue.

• 2a · Program service revenue: NET PATIENT SERVICE REVENUE

  total $39,652,221 · related or exempt $39,652,221

• 2b · Program service revenue: PREMIUM REVENUE

  total $9,370,742 · related or exempt $9,370,742

• 2c · Program service revenue: INTER-ENTITY SERVICE REVENUE

  total $19,712,271 · related or exempt $19,712,271

• 2d · Program service revenue: OTHER HEALTH CARE REVENUE

  total $946,797 · related or exempt $946,797

• 2e · Program service revenue: RENTAL INCOME

  total $148,827 · related or exempt $148,827

• 2f · All other program service revenue

  total $80,864 · related or exempt $80,864 · unrelated business $0 · excluded $0

• 3 · Investment income

  total $233,631 · excluded $233,631

• 6c · Rental income or loss

  real property $0 · personal property $0

• 7a · Gross sales of assets other than inventory

  other assets $15,000

• 7c · Gain or loss

  securities $0 · other assets $15,000

• 7d · Net gain or loss

  total $15,000 · related or exempt $15,000

• 11d · All other revenue

  total $0 · related or exempt $0 · unrelated business $0 · excluded $0

• 11e · Other revenue, total

  $0

Functional expenses

Part IX, the statement of functional expenses.

• 7 · Other salaries and wages

  total $9,289,879 · program services $8,741,917 · management and general $547,962

• 8 · Pension plan contributions

  total $530,325 · program services $510,722 · management and general $19,603

• 9 · Other employee benefits

  total $1,731,511 · program services $1,360,320 · management and general $371,191

• 10 · Payroll taxes

  total $693,625 · program services $653,958 · management and general $39,667

• 11c · Fees: accounting

  total $34,347 · management and general $34,347

• 11g · Fees: other

  total $728,111 · program services $557,622 · management and general $170,489 · fundraising $0

• 13 · Office expenses

  total $226,644 · program services $184,889 · management and general $41,755

• 14 · Information technology

  total $150,870 · program services $150,870

• 16 · Occupancy

  total $1,266,507 · program services $1,162,796 · management and general $103,711

• 17 · Travel

  total $18,031 · program services $16,563 · management and general $1,468

• 20 · Interest

  total $16,780 · program services $16,780

• 22 · Depreciation, depletion and amortization

  total $1,110,244 · program services $1,110,244

• 23 · Insurance

  total $69,712 · management and general $69,712

• 24a · Other expenses: INTER ENTITY PURCHASED SVCS.

  total $50,556,029 · program services $50,556,029

• 24b · Other expenses: MEDICAL SUPPLIES

  total $3,835,353 · program services $3,817,822 · management and general $17,531

• 24c · Other expenses: HAWAI'I GENERAL EXCISE TAX

  total $7,045 · program services $1,271 · management and general $5,774

• 24d · Other expenses: F&N CATERING CHARGES

  total $14,909 · program services $1,966 · management and general $12,943

• 24e · All other expenses

  total $43,531 · program services $17,043 · management and general $26,488 · fundraising $0

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  beginning of year $1,172,293 · end of year $1,166,937

• 2 · Savings and temporary cash investments

  beginning of year $6,244,373 · end of year $3,744,647

• 4 · Accounts receivable

  beginning of year $2,794,673 · end of year $3,228,273

• 5 · Loans and receivables from officers and key people

  beginning of year $0 · end of year $0

• 6 · Loans and receivables from disqualified persons

  beginning of year $0 · end of year $0

• 9 · Prepaid expenses and deferred charges

  beginning of year $90,465 · end of year $92,189

• 10a · Land, buildings and equipment: cost or other basis

  $21,339,945

• 10b · Land, buildings and equipment: accumulated depreciation

  $12,007,796

• 10c · Land, buildings and equipment, net

  beginning of year $9,442,901 · end of year $9,332,149

• 12 · Investments: other securities

  beginning of year $0

• 13 · Investments: program-related

  beginning of year $0

• 15 · Other assets

  beginning of year $5,827,849 · end of year $4,978,592

• 17 · Accounts payable and accrued expenses

  beginning of year $1,489,552 · end of year $1,549,879

• 22 · Loans and payables to officers and key people

  beginning of year $0 · end of year $0

• 25 · Other liabilities

  beginning of year $12,246,275 · end of year $9,316,796

• 27 · Net assets without donor restrictions

  beginning of year $11,836,727 · end of year $11,676,112

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation

THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER 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, SECTION B, LINE 15A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION.

Schedule J, Part I, Line 4a Severance or change-of-control payment

THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS, INCLUDED IN PART II, COLUMN (B)(III), DURING THE 2023 CALENDAR YEAR: BRANDON WONG - $133,092

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

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. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $307,960 DAVID OKABE - $114,710 STEVEN ROBERTSON - $94,544 ARTHUR GLADSTONE - $83,383 CHARLES R. CHING - $77,492 LESLIE CHUN - $60,329 JENNIE CHAHANOVICH - $53,405 ANNUAL INCENTIVE PLAN THE ANNUAL INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $505,774 LESLIE CHUN - $181,467 DAVID OKABE - $176,576 ARTHUR GLADSTONE - $160,613 STEVEN ROBERTSON - $143,887 CHARLES R. CHING - $139,662 JENNIE CHAHANOVICH - $126,291 SUNSHINE TOPPING - $84,627 DAWN DUNBAR - $74,859 DOUGLAS KWOCK, M.D. - $73,135 SHILPA PATEL - $72,211 WARREN CHAIKO- $67,798 MICHAEL ROBINSON - $49,914 JAMES LIN - $49,423 PETER LEWIS - $48,447 JOHN McNAMARA - $45,747 WILLIAM BURKE- $45,000 DAVID STUMBAUGH - $43,837 LORRIE-ANN LUKE - $43,449 CARRIE ANN TSUTSUI - $42,745 TROY BRANSTETTER - $42,056 LOUISE FUKUMOTO - $40,805 DEAN TATEYAMA - $40,805 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 THE SERP RESTORATION PLAN. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $500,000

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

• Honolulu Surgery Center LP

  N/A · AMBU. SURG. CTR. · TN

  Directly controlled by NA

• Specialty Surgical Suites LLC

  N/A · AMBU. SURG. CTR. · HI

  Directly controlled by NA

• HONOLULU IMAGING CENTER LLC

  N/A · DIAG. IMAGING CTR · DE

  Directly controlled by NA

• HAWAI'I ISOTOPE TECHNOLOGY LLC

  N/A · PHARMACEUTICAL MANUFACTURING · HI

  Directly controlled by NA

• ALL ACCESS ORTHO OAHU LLC

  N/A · URGENT CARE CLINICS · HI

  Directly controlled by NA

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• HAWAI'I PACIFIC HEALTH PARTNERS INC

  C Corporation · HOLDING COMPANY · HI

  Directly controlled by NA

• STRAUB PHARMACY INC

  C Corporation · INACTIVE · HI

  Directly controlled by NA

• HICORD INC

  C Corporation · INVESTMENT · HI

  Directly controlled by NA