Hawaiian cruise ideas Recommendations

Hawaiian cruise ideas - Hawaii Travel - MSNBC.com Skip navigation Travel Winter Travel Family Travel Cruising Vacations Travel Deals Luxury Travel Romantic Getaways Active Travel Olympics Travel Business Travel Destinations Travel Tips Your World Photos U.S. News World News Business Sports Entertainment Tech / Science Health Weather Travel Blogs Etc. Local News Newsweek Multimedia News Video Most Popular NBC NEWS MSNBC TV Today Show Nightly News Meet the Press Dateline NBC MSNBC Home Travel Hawaii Travel Hawaiian cruise ideas Recommendations for your entire itinerary Slide show Aloha! The Hawaiian Islands offer tropical adventures you will never forget. Lucy Pemoni / Reuters By CruiseCritic staff GETTING THERE For most travelers, the challenge of getting to and from Hawaii is the only negative on this itinerary. Flights from the East Coast typically connect in Los Angeles and San Francisco, which means you're adding a five-plus hour flight to the six hours it took to get there from New York, say, or Boston. If you have little ones with you and can spare the time, you may want to consider spending a night or two in California to break up the travel time. Obviously, West Coast residents have a shorter haul, and folks in some central gateways, such as Minneapolis and Dallas, can find direct flights to Honolulu International Airport that take about 8 1/2 hours each. Keep in mind that the Christmas holiday season - from about Dec. 21 to Jan. 4 - is high season, which means that air prices are at their most expensive. Summer is also popular because it's "family season." Thanksgiving to mid-December is considered "low season" and offers the best bargains. While NCL is currently the only cruise line originating and ending in Hawaii, other lines offer Hawaii itineraries that sail to or from the west coast of the U.S., Mexico or Canada. The advantage of cruising from the mainland is that you eliminate one or both flights, but keep in mind that you could be adding as many as eight days at sea to the duration of the voyage. Also remember that one-way air fares can be expensive, so you may be better off booking air through the cruise lines and taking advantage of their bulk air rates. THE ISLANDS The islands you are likely to visit on a roundtrip Honolulu cruise and cruises to-and-from the West Coast are Oahu (Honolulu), Maui, the Big Island (ports of Kona or Hilo), Kauai and even Fanning Island in the Republic of Kiribati. Lanai and Molokai are typically only available as shore excursions from the main islands. Repositioning cruises may only visit Oahu and Maui, while also incorporating such South Seas destinations as Bora Bora, Tahiti, Fiji and New Zealand. MANEUVERING AROUND HONOLULU Oahu's cruise port, the Aloha Tower Marketplace, is located about 15 minutes from the airport, and transportation from the airport to area hotels (about seven miles) is a snap via shuttle service (about $18 roundtrip on Aloha Hawaii Trans, for example), taxi or car rental. If you rent a car at the airport, keep in mind that, unlike some other islands you may have visited, Honolulu operates like any other American city - which means you won't experience culture shock navigating the roads. If you are simply transferring from the airport to the cruise port, plan on a 15-minute cab ride. Be aware, however, that the return trip from the cruise port to the airport can be another matter entirely - with daunting crowds at the buses (we suggest springing for a cab) and long delays at some of the terminals at the security check point. Waits of up to two hours are not unheard of if you're trying to leave at the same time as everyone else. Our advice? Stay a few extra days (Oahu deserves a week if you can swing it) or at least consider departing at night for a red eye flight home that will put you on the West Coast in time for breakfast or on the East Coast in the afternoon. BEING THERE Most Hawaiian Island cruises begin and/or end in Honolulu, on the island of Oahu - the most logical in terms of air access. It being the port of embarkation - or debarkation - means passengers often are hurrying from the airport to the ship or hustling away to catch a flight home. But don't forego a pre- or post-cruise stay if you can afford the time because there is so much to see on Oahu. From whale watching and surfing on the stunning beaches of the North Shore to the Polynesian Cultural Center and Pearl Harbor, the island has attractions to appeal to a wide variety of interests. Sign up for Cruise Critic's free newsletters! Get cruise reviews, news, bargains and more! CONTINUED: Choosing an itinerary 1 | 2 | 3 | Next > Print this Email this MORE FROM HAWAII TRAVEL The far side of Paradise . Polynesian delights . 'Lost' in Hawaii . Diving the Big Island . Real Hawaiian adventures . Becoming a believer in Maui . Hawaiian cruise ideas . The far side of Paradise . Hawaiian Islands- A diver's paradise . Tripso: 5 cheap thrills on Kauai . Web sources for vacation on Maui . Hawaii Travel Section Front Palestinianshead topolls WP: Hamas poised for new role Bush to visit NSA, defend program Pinochet's daughter detained in D.C. 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Hawaii rental Waikoloa Beach

Rentals Hawaii vacation rental - condo / house - Kihei - Maui Hawaii Wailea - Maui Hawaii Kaunakakai - Molokai Hawaii Poipu Beach - Kauai Hawaii Waikoloa - Hawaii Hawaii Makaha - Oahu Hawaii Kapalua - Maui Hawaii Punalu'u - Oahu Hawaii vacation condo or house rental Home Page = USA Vacation Rentals = Hawaii Vacation Rentals Rentals in Hawaii Vacation Rental Properties A new window will open for each individual rental property clicked on. (#) - pictures - availability calendar Vacation Property for rent in Hawaii include: (cities are added as listings become available) 2005-12-27  Kapalua - Maui Makaha - Oahu Waikoloa - Hawaii Kaunakakai - Molokai Poipu Beach - Kauai Wailea - Maui Kihei - Maui Punalu'u - Oahu Kapalua - Maui Hawaii vacation rental return to top of Hawaii page or return to state list of USA vacation rentals Kapalua - Maui Hawaii vacation rental Kapalua Ridge Oceanview Condo Ocean and Sunrise Views (3) Listing #100 Kapalua - Maui Accom:  1 Bedroom 2 Full Baths Condo Sleeps up to 4: Weekly Rate (USA Dollars): $1120.00 - $1330.00 Kaunakakai - Molokai Hawaii vacation rentals return to top of Hawaii page or return to state list of USA vacation rentals Kaunakakai - Molokai Hawaii vacation rentals Luxury Oceanfront Condo Adults Only - No Smoking (3) Listing #146 Kaunakakai - Molokai Accom:  1 Bedroom 1 Full Bath Condo Sleeps up to 2: Weekly Rate (USA Dollars): 735 - 735 Kihei - Maui Hawaii vacation rental return to top of Hawaii page or return to state list of USA vacation rentals Kihei - Maui Hawaii vacation rental Sugar Beach Oceanfront Condo 5 Miles of Open Beach (1) Listing #198 Kihei - Maui Accom:  1 Bedroom 1 Full Bath Condo Sleeps up to 4: Weekly Rate (USA Dollars): $875.00 - $1435.00 Kihei - Maui Hawaii vacation rentals Ground Floor Ocean Front Deluxe Condo with Master Suite Listing #71 Kihei - Maui Accom:  2 Bedrooms 2 Full Baths Condo Sleeps up to 6: Weekly Rate (USA Dollars): 826 - 1190 Kihei - Maui Hawaii vacation rental Nice Maui Beach Condo-$85+FUN Fab 1BR, slps 4, nr. #1 beach Listing #407 Kihei - Maui Accom:  1 Bedroom 1 Full Bath Condo Sleeps up to 4: Daily Rate (USA Dollars): 85 - 125 Makaha - Oahu Hawaii vacation rentals return to top of Hawaii page or return to state list of USA vacation rentals Makaha - Oahu Hawaii vacation rentals AFFORDABLE & BEACHFRONT MAKAHA Spectacular 180 Ocean View (3) Listing #255 Makaha - Oahu Accom:  1 Bedroom 1 Full Bath Condo Sleeps up to 2: Weekly Rate (USA Dollars): $795 - $945 Poipu Beach - Kauai Hawaii vacation rental return to top of Hawaii page or return to state list of USA vacation rentals Poipu Beach - Kauai Hawaii vacation rental Views of Spectacular Sunsets Beach Just a Short Walk Away (3) Listing #96 Poipu Beach - Kauai Accom:  2 Bedrooms 2 Full Baths Condo Sleeps up to 4: Weekly Rate (USA Dollars): $975 - $1225 Punalu'u - Oahu Hawaii vacation rentals return to top of Hawaii page or return to state list of USA vacation rentals Punalu'u - Oahu vacation rentals Hawaii Beachfront Rentals Oahu's North Shore in Punalu'u (3) Listing #121 Punalu'u - Oahu Accom:  1 Bedroom 1 Full Bath Condo Sleeps up to 4: Weekly Rate (USA Dollars): $795. - $995. Waikoloa - Hawaii Hawaii vacation rental return to top of Hawaii page or return to state list of USA vacation rentals Waikoloa - Hawaii Hawaii rental Waikoloa Beach Resort OceanView Unit (3) Listing #215 Waikoloa - Hawaii Accom:  2 Bedrooms 2 Full Baths Condo Sleeps up to 6: Weekly Rate (USA Dollars): $1050 - $1050 Wailea - Maui Hawaii vacation rentals return to top of Hawaii page or return to state list of USA vacation rentals Wailea - Maui Hawaii rentals Wailea Ekahi Village 20E Beautiful Beachfront Location (3) Listing #240 Wailea - Maui Accom:  1 Bedroom 2 Full Baths Condo Sleeps up to 5: Daily Rate (USA Dollars): $195 - $240 Wailea - Maui Hawaii vacation rental Wailea Ekahi Ocean View Condo Oceanfront Village (3) Listing #98 Wailea - Maui Accom:  1 Bedroom 1 Full Bath Condo Sleeps up to 4: Weekly Rate (USA Dollars): 1365 - 1540 Wailea - Maui Hawaii vacation rentals Wailea Ekahi Village Condo 20A 2 Bedroom Maui Owner Rental (3) Listing #405 Wailea - Maui Accom:  2 Bedrooms 2 Full Baths Condo Sleeps up to 6: Daily Rate (USA Dollars): 335 - 390

Hawaiian ~ The Calling

Hawaiian Language - Basic Lessons - Table of Contents Hawaiian Language Beginner Lessons Ka Papa Kuhikuhi ~ Table of Contents E `olu `olu (Please), bookmark this page for your easy reference. Nâ Kumu ~ The Basics Dedication / Forward / Disclaimer Reasons for Learning Hawaiian ~ The Calling The Hawaiian Alphabet ~ Ka Pî`âpâ Hawai`i The Alphabet Song ~ Ka Mele Pî`âpâ Transliteration: Converting English Words into Hawaiian ********** Pronunciation Guide ********** Diacritical Marks: `Okina & Kahakô Common Mispronunciations of the Hawaiian Language Is it Hah-wah-ee or Hah-vah-ee? Say it and Spell it Right Pronunciation Practice Hawaiian Language Links - Reference Links Coconut Boyz On-Line Hawaiian Dictionary Mamaka Kaiao On-line Hawaiian Dictionary Hawaiian Language Beginner Lessons These lessons are in the order in which they were created. Feel free to hop, skip, and jump to those subjects which most interest you. 1. The First 101 Words to Learn in ANY Language 2. 101 of the Easiest Hawaiian Words You'll Ever Learn 3. Numbers ~ Nâ Huahelu More on Numbers 4. Colors ~ Nâ Waiho`olu`u More on Colors 5. Hawaiian Proverbs & Poetical Sayings ~ Nâ `Ôlelo No`eau 6. Riddles ~ Nâ Nane 7. Chants (with Literal Translations) ~ Nâ Oli E Ala E! ~ Arise! E Hô Mai! ~ Grant Me! Nâ `Aumâkua ~ The Ancestral Spirits 8. Songs (with Literal Translations) ~ He Mau Mele Hawai`i Aloha Hawai`i Pono`i He Hawai`i Au Aloha `Oe 9. Speak Hawaiian Like a Local ;- ) 10. The Delectable Fish of Hawai`i ~ Nâ I`a `Ono Loa o Hawai`i More Information for the Fish Connoisseur Hawaiian Proverbs & Poetical Sayings of Fish ~ `Ôlelo No`eau O Ka I`a 11. Hawaiian Values 12. Hawaiian 101 Vocabulary List 13. The Hula Pages: Hula Pages Home Table of Contents Welcome Mahalo to Mary Kawena Pukui Hula Proverbs Chant Basic Hula Words Different Types of Hula Hula Styles & Steps Hula Implements Hawaiian Musical Instruments Hula Dress & Accessories Greenery for the Hula Altar Hula Reflections Lyrics Ka Lokomaika`i Hula-Related Links Pronunciation Guide 14. Basic Conversational Hawaiian Idioms, Catch Phrases, Expletives & Interjections Greetings / Salutations Pleasantries "Getting to Know You, Getting to Know All About You..." Talking About the Weather Closing Statements Conversational Acknowledgments (Instead of Hmmhmmm, Uh-huh, and Nods) Conversational Q&As: Questions and Answers 15. Do's and Don'ts The Do's (Commands/Imperatives) The Don'ts 16. Hawaiian Hospitality 17. Hawaiian Gift-giving 18. Time: Days, Months, and Seasons 19. Sounds in Hawaiian: Human Speech Human Sounds Animal Sounds Water Sounds 20. Food and Eating: Breakfast Foods Drinks / Beverages Condiments Meat / Poultry / Seafood / Etc. Carbohydrates Dairy Products Produce Desserts & Sweets Tablesetting 21. Toiletries / Household Items & Furniture: Toiletries Bathroom Bedroom 22. Sacred Hawai`i 23. Music: Music Words / Terminology Ka Mele a me Ka Oli ~ Song,Poetry & Chant Musical Instruments The`Ukulele 24. Heavenly Bodies: The Sun, the Moon and the Stars Nâ Kino o ka Lani: Ka Lâ, ka Mahina, a me nâ Hôkû `Ôlelo No`eau / Proverbs & Sayings 25. Thanksgiving & Table Conversation 26. Aloha: What Is It? Aloha Words A Glossary of Words of Aloha (English to Hawaiian) `Ôlelo No`eau (Proverbs and Poetical Sayings): Aloha Let Me Call You Sweetheart... More Terms of Endearment Nâ Lila Aloha / Lyrics of Love 27. A Hawaiian Valentine's Mini-Lesson Valentine's Candy Mini-Lesson 28. Aloha Cyber-card 29. Hawaiian for Your Pet Pet Names in Hawaiian Top Ten Dog Names in Hawaiian 30. Happy Easter! 31. Fragrances Pre-Contact Fragrances 32. New Word Lists 33. Common Mispronunciations of the Hawaiian Language 34. The Family The Extended Family Back to the Hawaiian Language Home Page: >> http://hawaiianlanguage.com hawaiian language | hawaiian language lessons | lânai | nâ `ânela kelekî | pronunciation guide | the aloha spirit | EMERGENCY dog links | the hula pages | hawaiian music lyrics & chords | hawaiian cultural calendar Disclaimer © 1996-2000 Aloha a hui hou, Aunty D

Hawaiian Recipes 6 recipes

Atlantic / Hawaiian | Recipe*zaar ADVERTISEMENT - Remove ads with Recipezaar Premium You are Here: Home > Atlantic > Hawaiian Get our free newsletter Eater's Digest : | Sign in Home Recipes My Stuff Community Tools Marketplace Help Search: All Recipes Only My Cookbook by Ingredient by Recipe ID # Kitchen Dictionary Member Names for advanced... Organize your recipes online Recipezaar Premium only $24.95 — Take the Tour Atlantic Hawaiian Recipes 6 recipes sorted by most recently posted highest rated photos fastest to make alphabetical Top 40 Atlantic Hawaiian Recipes | Recently Reviewed Atlantic Hawaiian Recipes | ( what is this? ) Search within this set: Filter results by category: ( What is this? ) You do not have JavaScript enabled so the category list below will not function properly. Please click "what is this?" above for more information. Remove all filters Course Appetizers Dips Spreads Beverages Cocktails Smoothies Shakes Breakfast Pancakes & Waffles Lunch/Snacks Snacks Main Dish Salads Side Dishes Main Ingredient Beans Eggs/Dairy Cheese Eggs Fruit Pitted Peaches Tropical Pineapple Vegetables Greens Lettuces Tomatoes Meat Beef Ground Beef Cuisine North American Canadian Atlantic British Columbian Ontario Prairies Quebec Northern Central American Caribbean Costa Rican Guatemalan Honduran Mexican Baja Central Gulf Coast Oaxacan Pacific United States Midwestern Northeastern Southern Southwestern Western Native American Oceania Australian Hawaiian New Zealand European Western English Southern (Mediterranean) Preparation Equipment Refrigerator Stove Top Small Appliance Mixer Inexpensive Number of Servings For Large Groups Presentation Finger Food Served Cold Served Hot Simple 5 or Less Ingredients Beginner Cook 3 or Less Steps Time to Make Technique No Cook Occasion Brunch Dinner Party Gifts Holiday/Event Historical/Traditional Non-Religious Independence Day New Years Thanksgiving Valentines Day Superbowl Wedding Religious Christmas Easter Hanukkah Passover Novelty Seasonal Fall Spring Summer Winter Taste/Mood Comfort Food Romantic Savory Sweet To Go... Picnic Potluck Brown Bag Dietary High in... High Calcium Kid Pleaser Toddlers Vegetarian Low in... Low Sodium Taco Salad Supreme by Heather Beldin (3 reviews) My husband loves this and I make it about once a week for him. Friends and family have asked me to make this for them and for get togethers. This salad is basicly put together with anything you like in a salad. So you can add or not use what is... #78535 Save to My Cookbook Cheeseball 3 by Heather Beldin (2 reviews) I had just made this for thanksgiving and my brother ate half of it LOL:) I love this and my family loves it too. I am looking foward to sharing this with you. Cook time includes chilling time. #78534 Save to My Cookbook Cheeseball 2 by Heather Beldin (1 reviews) This is another family recipe along with Cheeseball 1. This is also very good. Cook time includes the chill time. Hope you enjoy. #77620 Save to My Cookbook Cheeseball 1 by Heather Beldin This cheeseball is a family recipe, and I am such a fan of cheese. The taste is so good. I will never buy store bought. #77618 Save to My Cookbook Brandied Eggnog by Heather Beldin A friend made this at a christmas party and it was so good. I had to get the recipe..Now I am sharing it with you..Hope you enjoy it as much as I did.:) #77596 Save to My Cookbook Mouth Watering Nectarine French Toast (LOW FAT) by KitchenManiac Nothing got my housemates out of bed faster than these mouth watering french toast. It is fantastic too cos it is low in fat, though you would NEVER realise this when you pop some in your mouth. #54790 Save to My Cookbook Having Trouble? Try these... Search within these results for: Use the Category List on the left to narrow results. Post a Request for the Recipe and we'll help you find it. Ask a chef your question in our Cooking Q & A forum. ADVERTISEMENT Remove ads with Recipezaar Premium Your Ad Here ADVERTISEMENT - Remove ads with Recipezaar Premium Back to Top | E-mail this Page You are Here: Home > Atlantic > Hawaiian Your Account My Stuff My Cookbook My Shopping List Edit My Profile Premium Membership Logout Recipes Browse Categories Browse Cookbooks Search Request a Recipe Post Your Recipe Recipes A-Z Explore Community Forums Marketplace Site News A Random Recipe Recent Searches Help F.A.Q. Support Forum Cooking Q & A Forum Kitchen Dictionary Measurements Convertor Contact Us Fine Print Terms of Service Privacy Policy About Us Jobs Add Recipes to Your Site Advertise Here © 1999-2006 Recipezaar 10.0.0.2 Page generated in 0.19 seconds 0.01,0.18, Page generated in 0.14 seconds 0.11,0.01,0.02,0.00, Page generated in 0.11 seconds 0.00,0.05,0.05,0.00,

Hawaiian City Garden

StopMoskowitz :: The Coalition for Justice in Hawaiian Gardens and Jerusalem Support the Coalition with your Donation Donation Amount $25.00 $50.00 $100.00 $250.00 $500.00 $1000.00 thank you The Coalition for Justice in Hawaiian Gardens and Jerusalem P.O. 67903, Los Angeles CA 90067 310 553-1146 email -- Tri-City Hospital's Tax-Exempt Status - An Abuse of Public Trust? An organization is not a non-profit simply because it says so. There are state and federal standards that non-profit entities must meet in order to maintain their legal status -- and to qualify for tax-exemption. A review of California state health care data, Internal Revenue Service non-profit guidelines as well as Tri-City Regional Medical Center's lease with owner Irving Moskowitz all strongly suggest that rather than serving the health needs of Hawaiian Gardens and the surrounding community, the hospital is mainly operating as a private surgical facility for a wealthy physician's stomach stapling practice. Meeting the Community Benefit Standard Providing health care is not enough to qualify as a non-profit. According to IRS guidelines, a hospital may qualify for tax-exemption only if it is organized and operated exclusively for charitable purposes and if it meets the community benefit standards. 1 Tri-City fails on both scores. The IRS defines community benefit as the operation of a hospital in a way that helps the community as a whole. For the IRS, Tri-City's failure to provide charity care to poor patients should be a red flag. The IRS gives points to organizations that have a formal policy to provide free care to patients who are too poor to pay. 2 Tri-City has such a policy - it just doesn't follow it. When it applied for 501c(3) status, the hospital's application declared, "With regard to charity cases, the Hospital's policy is simple. The Hospital will not turn away any patient for financial reasons. When a charity patient is admitted, the case is handled individually on a case by case basis. In some cases, the Hospital absorbs costs associated with providing services to charity patients." 3 But in 2000 and 2001 the hospital provided zero charity care, despite net income of over $2 million in 2001 alone. Tri-City also reneged on another policy it presented to the IRS when it filed for tax-exempt status - its commitment to pre-natal care. The hospital's administration promised that, "Prenatal Services will provide care for the female patient during pregnancy, labor, delivery and the post-partum period." 4 There were no babies delivered in Hawaiian Gardens in 2000 and 2001. 5 Tri-City's administration might argue that its failure to provide obstetric services is the result of a lack of demand from the community. But by the IRS' lights, it would be hard for the hospital to know what the health care needs of the surrounding area are unless it consults with the community. As part of its review, the IRS looks for a governing or community board composed of civic leaders rather than ones dominated by hospital administrators, physicians and other professionals connected to the hospital. 6 Again, Tri-City looks good on paper but failed to live up to its promises. In its application for 501c(3) status, the hospital touted its 25 member community advisory board which consisted of "school officials, clergymen, business owners, city government and community organizations. The board assesses and determines the prevalent health care problems in the community." 7 According to one former city official who sat on the hospital's community board, the advisory board ceased meeting soon after it was formed. Citing the high cost of treatment at Tri-City and the lack of charity care, he said few residents of Hawaiian Gardens use the hospital now. State health care data backs that assertion up - despite its proximity only 13.7% of all Hawaiian Gardens residents who were hospitalized in Los Angeles County last year were admitted to Tri-City Regional Medical Center. Hawaiian Garden residents admitted to the hospital represented an even smaller percentage of Tri-City's total patient census - just 5.4% (Less than a fifth of the patients treated by Tri-City lived within a five-mile radius of the hospital). 8 Hospital charges were also higher than the norm - no one from Hawaiian Gardens was discharged with less than $2,900 in charges, less than one in ten left with charges under $5,000. 9 This includes patients who used the emergency room for relatively simple complaints such as a cut, chest pains or a child's broken bone. On average - Tri-City patients from Hawaiian Gardens were charged well over $10,000. 10 Many of the residents of Hawaiian Gardens are immigrants without insurance to cover their health care costs, so for them, Tri-City's high charges are all but unaffordable. Beyond the degree to which a hospital serves the community, the IRS also considers whether or not the majority of its activities promotes a tax-exempt purpose. 11 Arguably, Tri-City is doing more to advance the business of Dr. Mathias Fobi than it is to promote the health of the surrounding community. The for-profit Center for the Surgical Treatment of Obesity is located within the Tri-City Hospital campus. The center, which provides surgical stomach shrinking services to the morbidly obese, generates at least one quarter of the hospital's surgical cases and probably a good deal more. Last year, 439 of Tri-City's patients underwent the stomach stapling procedure and on average, they racked up $50,000 in hospital charges each. Total charges for those patients totaled $21,936,400 - representing close to a third of the hospital's gross charges for the year. 12 Another 15 patients received "tummy tucks," their total charges ranged $24,000 to $100,344. 13 And more than 200 of the hospital's other patient discharges involved some sort of abdominal procedure such as an abdominal CAT-Scan, a procedure which is often associated with stomach stapling. 14 The hospital discharge data strongly suggests that perhaps as much as half of Tri-City's surgical practice is tied to the Obesity Center. Insiders, Disqualified Persons and Private Benefit While Fobi charges for the surgeries he performs, the hospital also would typically bill patients for the use of its operating and recovery rooms and other medical services it provides. Tri-City's IRS form 990 from 2001 (the most recent one that is publicly available) indicates that year it paid Fobi's private firm, FOCA Management Company, $2,293,044 -- more than its next four highest paid contractors combined. 15 Stomach stapling accounts for a large part of Tri-City Hospital's tiny patient census. Whether the firm is managing all or just part of the hospital's patient care - $2.3 million is an extraordinarily large amount for a non-profit of Tri-City's size (the hospital has less than 130 licensed beds) to pay for an administrative service. At minimum, it suggests the potential for a conflict of interest on Fobi's part, particularly if the firm's fees are based on revenues. 16 At worst, it could represent a violation of federal anti-kickback laws governing doctor-hospital relationships. The payment to the management firm also has the potential to put Tri-City's tax-exempt status in jeopardy. IRS guidelines expressly forbid those having an interest in the hospital from benefiting from its net earnings. 17 A public trust? The same rule that draws into question the large payment Fobi received also applies to the hospital's former for-profit owner, Irving Moskowitz. Moskowitz is neither a board member nor a Tri-City executive and, at least technically, he does not maintain ownership of the hospital. But Cerritos Gardens General Hospital Company, a private firm run by Moskowitz, has received more than a million dollars in annual rent from Tri-City since it spun off the hospital as a non-profit in late 1996. 18 The rental agreement alone does not necessarily jeopardize the hospital's tax-exempt status. However, both members of Tri-City's two-person governing board and the hospital's president (who is also one of the two board members) are long-time Moskowitz associates. And, a review of Tri-City's financial circumstances indicates that Moskowitz retains a level of de facto control over Tri-City. Immediately after Tri-City Regional Medical Center was converted into a non-profit, the Irving I. Moskowitz Foundation 19 donated $4.9 million in tax-free proceeds from its Hawaiian Gardens bingo to the hospital. 20 California state financing records show that in 2000 the foundation made an additional transfer of funds to Tri-City. The state financing statement does not record the amount of the loan but it does indicate that the hospital pledged its accounts receivable as collateral. 21 Two additional state financing records, dated February 2, 1999 and January 25, 2001, show the hospital also is indebted to its landlord - Cerritos Gardens General Hospital Company. What's more, a clause in the lease signed between Tri-City and Cerritos Gardens grants Moskowitz's private firm the right to resume control of the property at any time, regardless of whether the lease remains in effect or not. It states that the "Lessor may re-enter or resume possession of the Hospital, and remove Lessee and Lessee's property there from, and at its option either terminate this lease, or without terminating it, lease the Hospital for the account of the Lessee for the remainder of the term or terms as Lessor shall see fit." 22 The social contract of tax exemption for charitable organizations is based on the assets of those organizations being held in trust for the public - not for the benefit of an individual or a group that controls a charity. A case could be made for Moskowitz and his firm making a calculated decision to rid themselves of the inconvenience of paying state and federal tax on the facility while continuing to reap a profit through sizable rent payments (subsidized first by a grant from his own foundation and later, from the net earnings derived from business generated by the for-profit obesity center). All the while he and his firm would be able to maintain control through the hospital's financial obligations to the company and his foundation. And, if that did not work or was no longer the optimal business model, the for-profit firm could resume possession of the land and the building at any time. It is a classic case of having one's cake and eating it too. It is also an affront to the basic tenets of public trust and hardly what the federal government had in mind when it established tax-exempt status for non-profits. 1 J.E. Gitterman and M. Friedlander, "Health Care Provider Reference Guide," Internal Revenue Service, 2003, p. 2, "The promotion of health for the benefit of the community is a charitable purpose. Engaging in health care activities alone does not necessarily further charitable purposes." and p. 9 "The test used fro determining if a health care provider satisfies the IRC 501c(3) operational test is the "community benefit standard" enunciated in Revenue Ruling 68-545, 1969-2 C.B. 117, and court cases that apply Rev. Rul. 69-545. The community benefit standard is the test used to determine whether a hospital, clinic or other health care provider is operated to promote health in a way that accomplishes a charitable purpose." 2 J.E. Gitterman and M. Friedlander, "Health Care Provider Reference Guide," Internal Revenue Service, 2003. p. 9, "Prior to Rev. Rule 69-545, tax-exempt hospitals were required by rev. Rul 56-185, 1956-1 C.B. 202 to admit and treat patients who were unable to payAlthough a formal policy to provide charity care is still relevant, the new standard also takes into account a number of additional factors indicating that the operation of the hospital benefits the community as a whole." 3 Gardens Regional Hospital and Medical Center, Inc. 1023 IRS application for Recognition of Exemption Under Section 501c3 of the Internal Revenue Code Addendum to Schedule C - Hospital and Medical Research Organizations, November 25, 1997. 4 Gardens Regional Hospital and Medical Center, Inc. 1023 IRS application for Recognition of Exemption Under Section 501c(3) of the Internal Revenue Code -Exhibit B "Statement of Activities," November 25, 1997. 5 California Office of Statewide Health Planning and Development (OSHPD), Patient Discharge Database, 2000 and OSHPD Annual Utilization Report of Hospitals, 2001. 6 J.E. Gitterman and M. Friedlander, "Health Care Provider Reference Guide," Internal Revenue Service, 2003, p. 10, "As used with regard to a hospital, the "Community benefit standard" in Rev. Rul. 69-545 includes the following factors: Does the hospital have a governing board, community board, board of trustees, or board of directors composed of prominent civic leaders rather than exclusively members who are hospital administrators, physicians or other professionally connected to the hospital?" 7 Gardens Regional Hospital and Medical Center, Inc. 1023 IRS application for Recognition of Exemption, Exhibit B, November 25, 1997. 8 According to the 2002 OSHPD Public Patient Discharge Data, 136 Tri-City discharges came from the Hawaiian Gardens zip code (90716) and Tri-City Regional Medical Center discharged a total of 2519 patients that year. Less than 500 patients discharged from Tri-City lived in zip codes that were within a five-mile radius of the hospital. 9 2002 OSHPD Public Patient Discharge Data 10 Ibid. 11 J.E. Gitterman and M. Friedlander, "Health Care Provider Reference Guide," Internal Revenue Service, 2003, p. 33, "Each director, principal officer and member of a committee with board delegated powers shall annually sign a statement which affirms that such person understands that the Corporation is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes." 12 2002 OSHPD Public Patient Discharge Data and OSHPD Annual Utilization Report of Hospitals and 2001 OSHPD financial data. and The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), National Center for Health Statistics, 2002. 13 2002 OSHPD Patient Discharge Data and The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), National Center for Health Statistics, 2002. 14 Ibid. 15 Gardens Regional Hospital - DBA Tri-City Regional Medical - 2001 federal tax return. 16 J.E. Gitterman and M. Friedlander, "Health Care Provider Reference Guide," Internal Revenue Service, 2003, p. 18, "If compensation is based on revenues, the potential for unreasonable compensation warrants a close review." 17 J.E. Gitterman and M. Friedlander, "Health Care Provider Reference Guide," Internal Revenue Service, 2003, p. 4, "IRC 501 c(3) expressly provides that to qualify for exemption, no part of an organization's net earnings shall to the benefit of private shareholders or individualsin practice the inurement prohibition applies to insidersIn the health care setting physicians may be insiders depending upon whether they exercise control." p. 8 also notes that insider status is not necessarily a pre-requisite for a violation of the inurement prohibition, "if the charity confers a private benefit on non-insiders, the charity is nor operating exclusively in the public interest and its exemption may be jeopardized if the private benefit is substantial." 18 According to Los Angeles County property records Cerritos Gardens Hospital Company currently owns the property at the hospital's address. Irving Moskowitz is identified as the company's managing general partner in his casino application submitted to the city of Hawaiian Gardens. Hawaiian Gardens Card Club, Inc., Information in Support of Application for Card Club License, January 25, 1995. 19 Moskowitz and his wife Cherna have presided over the Foundation as President and Secretary Treasurer since at least as far back as 1988. Irving I. Moskowitz Foundation 990s, 1987-2001. 20 The Irving I. Moskowitz Foundation 1997 990, Statement 7, p. 28 (On p. 23 the Foundation notes that, "Concerning grants and allocations to Gardens Regional Hospital and American Friends of Mercaz Harav which are listed on statement 7: the donees have agreed under specified circumstances to return a portion of the grant to the Irving Moskowitz Foundation."). 21 UCC Record, California Secretary of State, May 15, 2000, debtors: Gardens Regional Hospital and Medical Center, Inc. and Tri-City Regional Medical Center, Secured Parties: Irving I. Moskowitz Foundation. 22 Gardens Regional Hospital and Medical Center, Inc. 1997 1023 IRS application for Recognition of Exemption Under Section 501c3 of the Internal Revenue Code - Exhibit E, "Lease by and Between Cerritos Gardens General Hospital Company, a CA limited partnership and Gardens Regional Hospital and Medical Center," November 25, 1997. The lease agreement notes that the hospital's dba (doing business as) name is Tri-City Regional Medical Center. p. 36, Para 25.1. J.E. Gitterman and M. Friedlander, "Health Care Provider Reference Guide," Internal Revenue Service, 2003, p.17 - Retained Rights - A review of the underlying docs is necessary to determine if there is retained authority by the seller and on p. 11 it states, "Financial control may include the right to approve annual operating and capital budgets, strategic planning initiatives, and significant sales, leases, mortgages, or other transfers of encumbrances of real estate or personal property." It is worth noting that the lease between and Between Cerritos Gardens General Hospital Company and Tri-City includes a demand for an annual review of the non-profits financial statements. View all news reports 2003 the Coalition for Justice in Hawaiian Gardens and Jerusalem