Pali Momi Medical Center in Honolulu, Hawaii (HI)

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Pali Momi Medical Center
Employer Identification Number (EIN)990274038
Name of OrganizationPali Momi Medical Center
Address55 Merchant Street, Honolulu, HI 96813-4306
SubsectionCharitable Organization
Ruling Date01/2011
DeductibilityContributions are deductible
FoundationHospital or medical research organization
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period06/2010
Assets$50,000,000 to greater
Income$50,000,000 to greater
Filing Requirement990 (all other) or 990EZ return
Asset Amount$87,656,300
Amount of Income$136,101,775
Form 990 Revenue Amount$136,101,775
National Taxonomy of Exempt Entities (NTEE)Health - General and Rehabilitative: Community Health Systems


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Amount of income in 2010: $136,101,775
Pali Momi Medical Center: 

 $136,101,775
Other organizations performing similar types of work: 

 $6,791,313

Assets in 2010: $87,656,300
Pali Momi Medical Center: 

 $87,656,300
Other organizations performing similar types of work: 

 $5,000,000

Expenses in 2007: $120,372,214
Pali Momi Medical Center: 

 $120,372,214
Other organizations performing similar types of work: 

 $5,603,496

Income to expenses ratio in 2007: 1.1
Pali Momi Medical Center: 

 1.1
Other organizations performing similar types of work: 

 1.1

Expenses allocated to program services in 2007: 71.0%
Pali Momi Medical Center: 

 71.0%
Other organizations performing similar types of work: 

 86.4%

Number of employees in 2007: 793
This organization: 

 793
Other organizations performing similar types of work: 

 83

Employees paid over $50,000 in 2007: 45.1%
This organization: 

 45.1%
Other organizations performing similar types of work: 

 30.9%

Grants share in income in 2007: 0.7%
Pali Momi Medical Center: 

 0.7%
Other organizations performing similar types of work: 

 0.5%

Financial snapshot ($)

Revenue for 2007

Assets at end of 2007

Expenses for 2007

Functional Expenses for 2007 ($)

Income-Producing Activities for 2007

Revenue, Expenses, and Changes in Net Assets or Fund Balances
20002001200220032004200520062007
Total revenue$64,591,319$60,868,875$79,847,041$93,504,060$101,321,707$105,159,867$117,000,005$136,101,775
Contributions, gifts, grants, and similar amounts received$183,544$58,340$52,632$26,687$21,608$48,577$78,128$907,010
Contributions to donor advised funds$0$0
Direct public support$160,526$58,340$52,632$26,687$21,608$48,577$78,128$16,120
Indirect public support$23,018$0$0$0$0$0$0$890,890
Government contributions (grants)$0$0$0$0$0$0$0$0
Program service revenue including government fees and contracts$65,128,281$64,084,273$79,755,857$90,586,548$99,275,558$101,050,297$111,981,847$129,598,311
Membership dues and assessments$0$0$0$0$0$0$0$0
Interest on savings and temporary cash investments$0$0$0$0$0$0$0$16,318
Dividends and interest from securities$584,190$703,370$392,487$551,624$674,415$1,311,448$1,141,672$1,281,512
Net rental income or (loss)$644,410$-3,336,692$-3,811$-86,437$35,391$239,257$286,054$0
Gross rents$2,196,616$1,658,837$1,457,420$533,816$269,515$239,257$428,470$0
Less: rental expenses$1,552,206$4,995,529$1,461,231$620,253$234,124$0$142,416$0
Other investment income$0$0$0$0$0$0$2,418,655$0
Gain or (loss) from sales of assets other than inventory$-2,725,702$-1,395,971$-871,189$2,090,362$896,997$1,951,471$453,869$3,656,815
Gross amount from sales of assets other than inventory$71,843,280$26,472,546$9,931,337$16,784,570$3,462,850$6,784,895$970,133$14,455,360
Less: cost or other basis and sales expenses$74,568,982$27,868,517$10,802,526$14,694,208$2,565,853$4,833,424$516,264$10,798,545
Net income or (loss) from special events and activities$0$0$0$0$0$0$0$0
Gross revenue$0$0$0$0$0$0$0$0
Less: direct expenses other than fundraising expenses$0$0$0$0$0$0$0$0
Gross profit or (loss) from sales of inventory$43,292$41,889$45,335$46,670$51,061$52,206$47,485$46,450
Gross sales of inventory, less returns and allowances$96,205$93,086$100,744$103,711$113,469$116,013$113,060$110,595
Less: cost of goods sold$52,913$51,197$55,409$57,041$62,408$63,807$65,575$64,145
Other revenue$733,304$713,666$475,730$288,606$366,677$506,611$592,295$595,359
Total expenses$66,275,893$77,093,531$75,551,002$86,561,172$96,726,441$101,756,196$104,029,914$120,372,214
Program services$47,277,860$44,303,733$55,206,238$60,397,943$67,927,837$70,723,384$73,369,663$85,405,109
Management and general$17,056,474$19,054,605$20,344,764$26,163,229$28,798,604$31,032,812$30,660,251$34,967,105
Fundraising$0$0$0$0$0$0$0$0
Payments to affiliates$1,941,559$13,735,193$0$0$0$0$0$0
Net assets or fund balances at end of year$23,240,878$11,231,516$11,230,831$17,712,642$27,860,995$78,780,366$80,565,755$87,656,300
Excess or (deficit) for the year$-1,684,574$-16,224,656$4,296,039$6,942,888$4,595,266$3,403,671$12,970,091$15,729,561
Net assets or fund balances at beginning of year$30,807,822$23,240,878$11,231,516$11,230,831$17,712,642$27,860,995$78,780,366$80,565,755
Other changes in net assets or fund balances$-5,882,370$4,215,294$-4,296,724$-461,077$5,553,087$47,515,700$-11,184,702$-8,639,016
Statement of Functional Expenses (for 2007)
TotalProgram servicesManagement and generalFundraising
Total functional expenses$120,372,214$85,405,109$34,967,105$0
Grants paid from donor advised funds$0
Other grants and allocations$0
Specific assistance to individuals$0
Benefits paid to or for members$0
Compensation of current officers, directors, key employees, etc.$0$0$0$0
Compensation of former officers, directors, key employees, etc.$0$0$0$0
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0$0$0$0
Salaries and wages of employees not included above$42,779,874$36,888,364$5,891,510$0
Pension plan contributions not included above$2,160,808$0$2,160,808$0
Employee benefits not included above$4,847,560$3,243,548$1,604,012$0
Payroll taxes$3,134,442$2,695,088$439,354$0
Professional fundraising fees$0$0$0$0
Accounting fees$109,003$0$109,003$0
Legal fees$0$0$0$0
Supplies$19,084,672$18,693,606$391,066$0
Telephone$106,825$19,332$87,493$0
Postage and shipping$145,991$29,550$116,441$0
Occupancy$2,606,483$569,370$2,037,113$0
Equipment rental and maintenance$711,751$710,639$1,112$0
Printing and publications$0$0$0$0
Travel$25,641$4,432$21,209$0
Conferences, conventions, and meetings$0$0$0$0
Interest$4,630,847$5,812$4,625,035$0
Depreciation, depletion, etc.$5,987,541$5,798,862$188,679$0
Other expenses not covered above$34,040,776$16,746,506$17,294,270$0
Balance Sheets
20002001200220032004200520062007
Total assets$111,017,999$102,143,013$100,210,428$100,091,177$110,878,293$110,476,918$114,053,248$119,574,743
Cash - non-interest-bearing$0$0$0$0$0$0$0$0
Savings and temporary cash investments$0$0$0$0$2,639,575$2,093,456$0$0
Accounts receivable less allowance for doubtful accounts$9,962,398$8,837,247$9,785,283$10,659,163$14,275,893$11,138,784$12,029,551$14,075,006
Pledges receivable less allowance for doubtful accounts$0$0$0$0$0$0$0$0
Grants receivable$0$0$0$0$0$0$0$0
Receivables from current and former officers, directors, trustees, and key employees$0$0$0$0$0$0$0$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)$0$0
Other notes and loans receivable less allowance for doubtful accounts$0$0$0$0$0$0$0$0
Inventories for sale or use$1,383,681$1,441,160$1,223,704$1,482,780$1,646,699$1,420,160$1,593,910$1,743,696
Prepaid expenses and deferred charges$2,950,852$2,676,811$2,323,627$1,220,313$667,913$290,764$622,027$507,441
Investments - publicly-traded securities$0$0
Investments - other securities$35,569,531$26,844,527$25,653,688$30,322,574$28,712,050$32,401,243$38,091,438$39,137,464
Investments - land, buildings, and equipment less accumulated depreciation$0$0$0$0$0$0$0$0
Investments - other$23,596$23,596$23,596$23,596$23,596$23,596$23,596$45,316
Land, buildings, and equipment less accumulated depreciation$60,809,931$62,151,481$61,161,733$55,769,460$62,357,473$62,820,943$61,045,868$62,135,576
Other assets, including program-related investments$318,010$168,191$38,797$613,291$555,094$287,972$646,858$1,930,244
Total liabilities$87,777,121$90,911,497$88,979,597$82,378,535$83,017,298$31,696,552$33,487,493$31,918,443
Accounts payable and accrued expenses$11,953,921$14,310,588$12,995,009$9,832,944$11,192,773$9,008,345$10,127,059$10,154,101
Grants payable$0$0$0$0$0$0$0$0
Deferred revenue$0$943,545$0$0$3,759,654$939,419$91,509$72,779
Loans from officers, directors, trustees, and key employees$0$0$0$0$0$0$0$0
Tax-exempt bond liabilities$73,834,697$72,481,937$71,039,176$69,511,415$67,888,654$20,739,951$20,781,164$20,822,377
Mortgages and other notes payable$685,296$0$521,575$299,541$172,585$72,384$5,925$0
Other liabilities$1,303,207$3,175,427$4,423,837$2,734,635$3,632$936,453$2,481,836$869,186
Total liabilities and net assets/fund balances$111,017,999$102,143,013$100,210,428$100,091,177$110,878,293$110,476,918$114,053,248$119,574,743
Total net assets or fund balances$23,240,878$11,231,516$11,230,831$17,712,642$27,860,995$78,780,366$80,565,755$87,656,300
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
20002001200220032004200520062007
Total revenue$64,591,319$60,868,875$79,847,041$93,504,060$101,321,707$105,159,867$117,000,005$136,101,775
Total revenue, gains, and other support per audited financial statements$66,196,438$65,915,601$81,363,684$94,181,353$101,618,239$105,010,671$117,727,023$135,146,130
Other expenses$1,605,119$5,046,726$1,516,643$677,294$296,532$98,437$739,660$-955,645
Net unrealized gains on investments$0$0$0$0$0$0$0$-1,050,948
Donated services and use of facilities$0$0$0$0$0$0$0$0
Recoveries of prior year grants$0$0$0$0$0$0$0$0
Other$1,605,119$5,046,726$1,516,643$677,294$296,532$98,437$739,660$95,303
Other revenue$0$0$0$1$0$247,633$12,642$0
Investment expenses$0$0$0$0$0$0$0$0
Other$0$0$0$1$0$247,633$12,642$0
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
20002001200220032004200520062007
Total expenses$66,275,893$77,093,531$75,551,002$86,561,172$96,726,441$101,756,196$104,029,914$120,372,214
Total expenses and losses per audited financial statements$65,860,729$68,391,012$77,086,904$87,240,903$97,012,013$101,614,369$104,765,532$120,467,517
Other revenue$1,605,119$5,046,726$1,535,902$679,731$296,532$98,437$735,618$95,303
Donated services and use of facilities$0$0$0$0$0$0$0$0
Prior year adjustments$0$0$0$0$0$0$0$0
Losses$0$0$0$0$0$0$0$0
Other$1,605,119$5,046,726$1,535,902$679,731$296,532$98,437$735,618$95,303
Other expenses$2,020,283$13,749,245$0$0$10,960$240,264$0$0
Investment expenses$0$0$0$0$0$0$0$0
Other$2,020,283$13,749,245$0$0$10,960$240,264$0$0
Current Officers, Directors, Trustees, and Key Employees
Total number of officers, directors, and trustees permitted to vote on organization business at board meetings10
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?No
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?Yes
Does the organization have a written conflict of interest policy?Yes
Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?No
Was there a liquidation, dissolution, termination, or substantial contraction during the year?No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?Yes
Direct and indirect political expenditures$0
Did the organization file Form 1120-POL for this year?No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members$0
Section 162(e) lobbying and political expenditures$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices$0
Taxable amount of lobbying and political expenditures$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?Yes
Amount of tax imposed on the organization during the year under: section 4911$0
Amount of tax imposed on the organization during the year under: section 4912$0
Amount of tax imposed on the organization during the year under: section 4955$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958$0
Amount of tax above, reimbursed by the organization$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?No
Did the organization acquire a direct or indirect interest in any applicable insurance contract?No
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?No
Number of employees employed in the pay period that includes March 12, 2006793
Analysis of Income-Producing Activities (for 2007)
Unrelated business incomeExcluded by section 512, 513, or 514Related or exempt function income
Business codeAmountExclusion codeAmount
Total$0$5,017,176$130,177,589
Program service revenue
Program service revenue 1000000$000$0$66,364,718
Program service revenue 2000000$000$0$423,803
Program service revenue 3000000$000$0$0
Program service revenue 4000000$000$0$0
Program service revenue 5000000$000$0$0
Medicare/Medicaid payments000000$000$0$62,809,790
Fees and contracts from government agencies000000$000$0$0
Membership dues and assessments000000$000$0$0
Interest on savings and temporary cash investments000000$0Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)$16,318$0
Dividends and interest from securities000000$0Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)$1,281,512$0
Net rental income or (loss) from real estate
debt-financed property000000$000$0$0
not debt-financed property000000$000$0$0
Net rental income or (loss) from personal property000000$000$0$0
Other investment income000000$000$0$0
Gain or (loss) from sales of assets other than inventory000000$0Gain (or loss, to the extent allowed) from the sale of investments and other non-inventory property and from certain property acquired from financial institutions that are in conservatorship or receivership (sections 512(b)(5) and 512(b)(16)(A))$3,656,815$0
Net income or (loss) from special events000000$000$0$0
Gross profit or (loss) from sales of inventory000000$0Income from an activity that is not regularly carried on (section 512(a)(1))$46,450$0
Other revenue000000$0Section 501(c)(3) organization - Income from an activity carried on primarily for the convenience of the organization's members, students, patients, visitors, officers, or employees (hospital parking lot or museum cafeteria, for example) (section 513(a)(2))$16,081$579,278
Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2007)
EIN of corporation, partnership, or disregarded entityPercentage of ownership interestTotal incomeEnd-of-year assets
0000000000%$0$0
0000000000%$0$0
0000000000%$0$0
0000000000%$0$0
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2007)
CompensationContributions to employee benefit plans & deferred compensationExpense account and other allowances
$173,705$36,484$0
$163,653$33,743$0
$160,960$31,537$0
$162,226$28,507$0
$162,970$24,656$0
Total number of other employees paid over $50,000353
Statements About Activities (for 2007)
Expenses paid or incurred in connection with the lobbying activities$1,415
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?No
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?No
Did the organization maintain any donor advised funds?No
Did the organization make any taxable distributions under section 4966?No
Did the organization make a distribution to a donor, donor advisor, or related person?No
The total number of donor advised funds owned at the end of the tax year$0
The aggregate value of assets held in all donor advised funds owned at the end of the tax year$0
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts$0
The aggregate value of assets held in all funds or accounts included above at the end of the tax year$0
Reason for Non-Private Foundation Status
The organization is not a private foundation because it isHospital, or a cooperative hospital service organization
Support Schedule
19992000200120022003200420052006
Total$0$0$0$0$0$0$0$0
Gifts, grants, and contributions received$0$0$0$0$0$0$0$0
Membership fees received$0$0$0$0$0$0$0$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose$0$0$0$0$0$0$0$0
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975$0$0$0$0$0$0$0$0
Net income from unrelated business activities not included above$0$0$0$0$0$0$0$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf$0$0$0$0$0$0$0$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge$0$0$0$0$0$0$0$0
Other income$0$0$0$0$0$0$0$0
Lobbying Expenditures by Electing Public Charities (for 2007)
Total exempt purpose expenditures$0
Total lobbying expenditures$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)$0
Total lobbying expenditures to influence a legislative body (direct lobbying)$0
Other exempt purpose expenditures$0
Lobbying nontaxable amount$0
Grassroots nontaxable amount$0
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Number of organizations performing similar types of work
Alabama6
Arkansas5
Arizona2
California34
Colorado11
Connecticut6
District of Columbia3
Delaware2
Florida20
Georgia23
Hawaii9
Iowa2
Idaho5
Illinois23
Indiana10
Kansas8
Kentucky8
Louisiana5
Massachusetts67
Maryland7
Maine6
Michigan36
Minnesota39
Missouri15
Mississippi4
Montana3
North Carolina27
North Dakota14
Nebraska4
New Hampshire3
New Jersey33
New Mexico3
Nevada2
New York45
Ohio26
Oklahoma7
Oregon6
Pennsylvania46
Rhode Island5
South Carolina2
South Dakota10
Tennessee7
Texas62
Utah3
Virginia29
Vermont2
Washington8
Wisconsin25
West Virginia8
Wyoming1
International1
Total738
All affiliated organizations
AffiliationNameAddressStateEstablishedTotal Income
CentralHawaii Pacific Health, Kapiolani Health55 Merchant Street, Honolulu, HI 96813-4306HI2011-01$155,487,317
SubordinateStraub Clinic & Hospital55 Merchant St Fl 27, Honolulu, HI 96813-4333HI2011-01$272,741,662
SubordinateKapi Olani Medical Center For Women & Children, Kapiolani Med Ctr Women & Children55 Merchant Street, Honolulu, HI 96813-4306HI2011-01$229,634,971
SubordinatePali Momi Medical Center55 Merchant Street, Honolulu, HI 96813-4306HI2011-01$136,101,775
SubordinateWilcox Memorial Hospital3 3420 Kuhio Hwy, Lihue, HI 96766-1099HI2011-01$87,693,461
SubordinateHawaii Pacific Health Group Return55 Merchant St Fl 24, Honolulu, HI 96813-4333HI2011-01$1,075,571,358
Number of affiliated organizations
Hawaii6
Total6

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