| FORM 990, PART IV, LINE 12B AND PART XII, LINE 2B |
SIMILAR TO PRIOR YEARS, THE ORGANIZATION'S FINANCIAL STATEMENTS WILL BE INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS THAT ARE AUDITED BY AN INDEPENDENT ACCOUNTANT. HOWEVER, THE AUDIT HAS NOT BEEN COMPLETED AT THE TIME OF FILING. |
| FORM 990, PART IV, LINE 21 |
THE $129,959 OF GRANTS REPORTED ON FORM 990, PART IX, LINE 1 REPRESENTS THE NET AMOUNT PAID TO WAHIAWA GENERAL HOSPITAL AND IS RELATED TO THE $309,423 TOTAL GRANT THAT WAS REPORTED ON THE FYE 6/30/20 SCHEDULE I. AS SUCH, FORM 990, PART IV, LINE 21 HAS BEEN ANSWERED NO AND SCHEDULE I HAS NOT BEEN PREPARED FOR FYE 6/30/21. |
| 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 |
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS TO GEN PUBLIC - THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. ITS GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| FORM 990, PART VI, SECTION A, LINE 4 |
ARTICLES OF AMENDMENT TO CHANGE CORPORATE NAME WERE FILED WITH THE STATE OF HAWAII TO REFLECT THE ORGANIZATION'S NAME CHANGE FROM WAHIAWA HEALTH CARE SERVICES FOUNDATION TO WAHIAWA HOSPITAL FOUNDATION. THE NAME CHANGE IS BEING REFLECTED ON THIS FORM 990 AS IT WAS NOT PREVIOUSLY REFLECTED ON PRIOR YEAR FORMS 990. AS THE AMENDMENT DID NOT TAKE PLACE IN THE CURRENT YEAR, THIS QUESTION HAS BEEN ANSWERED NO. A COPY OF THE ARTICLES OF AMENDMENT TO CHANGE CORPORATE NAME HAS ALSO BEEN ATTACHED TO THIS RETURN. |
| FORM 990, PART VII, SECTION A, LINE 1A |
MARILYN MATSUNAGA WAS CONTRACTED TO SERVE AS THE FOUNDATION'S EXECUTIVE DIRECTOR DURING THE FISCAL YEAR ENDING JUNE 30, 2021. THE FOUNDATION DOES NOT HAVE RECORDS OF HER AVERAGE HOURS PER WEEK AND AS SUCH IS REPORTING AN ESTIMATE. |
| FORM 990, PART IX, LINE 11G |
CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 42,526. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,526. |
| FORM 990 - GOOD FAITH STATEMENT |
THE ORGANIZATION HAS MADE ITS BEST EFFORTS TO COMPLY WITH TAX LAWS BASED UPON THE INFORMATION AVAILABLE AT THE TIME OF FILING. AT THE TIME OF FILING, THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS HAS NOT BEEN COMPLETED. 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 UNAUDITED FINANCIALS. THE ORGANIZATION WILL AMEND THIS RETURN IF UPON COMPLETION OF THE AUDIT IT'S DETERMINED THAT THE INFORMATION REPORTED ON THIS RETURN IS MATERIALLY INCORRECT OR INACCURATE. |
Attach to Form 990 or 990-EZ.