EAST HAWAII STATE VETERANS HOME: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- EAST HAWAII STATE VETERANS HOME (EIN 85-3650364)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-15
- IRS object ID
- 202321359349308762
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-15T13:33:15-04:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 990303190 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARBONARO CPAS & MANAGEMENT GROUP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1885 MAIN ST STE 408 | AddressLine1Txt |
| City | WAILUKU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96793 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 853650364 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST HAWAII STATE VETERANS HOME | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EAST | BusinessNameControlTxt |
| Phone | 8089611500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1180 WAIANUENUE AVE | AddressLine1Txt |
| City | HILO | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96720 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JONI WALTJEN | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 8089611500 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JONI | PersonFirstNm |
| Person Last | WALTJEN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GRETCHEN KREMEYER | PreparerPersonNm |
| PTIN | P00768528 | PTIN |
| Phone | 8082425002 | PhoneNum |
| Preparation | 2023-05-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAN BRINKMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1190 WAIANUENUE AVE | AddressLine1Txt |
| City | HILO | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96720 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,704,179 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | YUKIOOKUTSUSTATEVETERANSHOME.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2020 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | TO OPERATE A STATE VETERAN'S HOME SERVING VETERANS DISABLED BY AGE, DISEASE, OR OTHERWISE, WHO BY REASON OF SUCH DISABILITY ARE INCAPABLE OF EARNING A LIVING IN THE COUNTY OF HAWAII. THE CORPORATION WILL PROVIDE QUALITY OF CARE TO VETERANS IN NEED OF NURSING HOME AND ADULT DAY HEALTH CARE. TO PROMOTE THE HEALTH OF THE VETERAN COMMUNITY OF THE COUNTY OF HAWAII THROUGH THE PROVISION OF HIGH-QUALITY LONG-TERM CARE AND ADULT DAY HEALTH SERVICES, MEETING UNITED STATES VETERANS AFFAIRS DEPARTMENT AND UNITED STATES CENTERS FOR MEDICARE & MEDICAID SERVICES STANDARDS. TO SERVE AS A SUPPORTING ORGANIZATION TO THE HAWAII HEALTH SYSTEMS CORPORATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 93 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,743,121 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,532,507 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,856 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,371 | CYInvestmentIncomeAmt |
| CY Other Revenue | $166,301 | CYOtherRevenueAmt |
| PY Total Revenue | $4,746,977 | PYTotalRevenueAmt |
| CY Total Revenue | $9,704,179 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,840,367 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,115,344 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,908,757 | PYOtherExpensesAmt |
| CY Other Expenses | $4,037,139 | CYOtherExpensesAmt |
| PY Total Expenses | $5,749,124 | PYTotalExpensesAmt |
| CY Total Expenses | $10,152,483 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,002,147 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$448,304 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,387,913 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,552,665 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,390,060 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,003,116 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,002,147 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,450,451 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO OPERATE A STATE VETERAN'S HOME SERVING VETERANS DISABLED BY AGE, DISEASE, OR OTHERWISE, WHO BY REASON OF SUCH DISABILITY ARE INCAPABLE OF EARNING A LIVING IN THE COUNTY OF HAWAII. THE CORPORATION WILL PROVIDE QUALITY OF CARE TO VETERANS IN NEED OF NURSING HOME AND ADULT DAY HEALTH CARE. TO PROMOTE THE HEALTH OF THE VETERAN COMMUNITY OF THE COUNTY OF HAWAII THROUGH THE PROVISION OF HIGH-QUALITY LONG-TERM CARE AND ADULT DAY HEALTH SERVICES, MEETING UNITED STATES VETERANS AFFAIRS DEPARTMENT AND UNITED STATES CENTERS FOR MEDICARE & MEDICAID SERVICES STANDARDS. TO SERVE AS A SUPPORTING ORGANIZATION TO THE HAWAII HEALTH SYSTEMS CORPORATION. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,350,089 | ExpenseAmt |
| Revenue | $9,698,808 | RevenueAmt |
| Desc | TO OPERATE A STATE VETERAN'S HOME. | Desc |
| Total Program Service Expenses | $9,350,089 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 93 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EAST HAWAII STATE VETERANS HOME | PersonNm |
| Phone | 8089323411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1180 WAIANUENUE AVE | AddressLine1Txt |
| City | HILO | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96720 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| JERRY GRAY | |||||||
| PRESIDENT | 0.10 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DAN BRINKMAN | |||||||
| VICE PRESIDE | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $409,218 | $88,814 |
| JONI WALTJEN | |||||||
| TREASURER | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $217,572 | $52,218 |
| DENISE MACKEY | |||||||
| SECRETARY | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $200,400 | $57,694 |
| BRENDA HO | |||||||
| DIRECTOR | 0.01 | 0.02 | Yes (X) | $0 | $0 | $0 | |
| SHELLYANN K CHARTRAND | |||||||
| ADMINISTRATO | 38.00 | 2.00 | Yes (X) | $0 | $157,289 | $52,866 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $984,479 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $251,592 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HILO MEDICAL CENTER | |||||
| 1190 WAIANUENUE AVE | HILO | HI | 96720 | MANAGEMENT | $755,052 |
| PHARMACY CORPORATION OF AMERICA | |||||
| PO BOX 409251 | ATLANTA | GA | 303849251 | PHARMACY | $294,149 |
| CLINICAL LABORATORIES LLP | |||||
| 33 LANIHULI STREET | HILO | HI | 96720 | MEDICAL TESTS | $181,752 |
| DAVIS WRIGHT TREMAINE LLP | |||||
| 920 FIFTH AVENUE SUITE 3300 | SEATTLE | WA | 981041610 | LEGAL | $140,096 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NURSING HOME SERVICES | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $9,532,507 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,532,507 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,532,507 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,371 | TotalRevenueColumnAmt |
| Exclusion | $5,371 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $166,301 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $166,301 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $166,301 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,704,179 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,698,808 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,371 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,622,845 | TotalAmt |
| Program Services | $4,622,845 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,032,036 | TotalAmt |
| Program Services | $1,032,036 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,463 | TotalAmt |
| Program Services | $460,463 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $713,807 | TotalAmt |
| Program Services | $107,071 | ProgramServicesAmt |
| Management And General | $606,736 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,928 | TotalAmt |
| Management And General | $146,928 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,382,107 | TotalAmt |
| Program Services | $1,382,107 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,183 | TotalAmt |
| Program Services | $3,183 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,345 | TotalAmt |
| Program Services | $4,759 | ProgramServicesAmt |
| Management And General | $1,586 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,620 | TotalAmt |
| Program Services | $33,620 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $621,750 | TotalAmt |
| Program Services | $621,750 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33 | TotalAmt |
| Program Services | $33 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,575 | TotalAmt |
| Program Services | $141,431 | ProgramServicesAmt |
| Management And General | $47,144 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| FOOD | $298,913 | $298,913 |
| MEDICAL SUPPLIES & DRUGS | $216,390 | $216,390 |
| SUPPLIES | $212,232 | $212,232 |
| LINEN / BEDDING | $165,407 | $165,407 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,849 | TotalAmt |
| Program Services | $47,849 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,152,483 | TotalAmt |
| Program Services | $9,350,089 | ProgramServicesAmt |
| Management And General | $802,394 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $757,789 | BOYAmt |
| EOY | $897,482 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,341,804 | BOYAmt |
| EOY | $4,271,711 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $648,780 | BOYAmt |
| EOY | $1,327,754 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,473 | BOYAmt |
| EOY | $7,600 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $589,067 | BOYAmt |
| EOY | $48,118 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,387,913 | BOYAmt |
| EOY | $6,552,665 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,042,464 | BOYAmt |
| EOY | $854,040 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,686 | BOYAmt |
| EOY | $386,325 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,341,804 | BOYAmt |
| EOY | $5,341,804 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,832,106 | BOYAmt |
| EOY | $1,420,947 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,390,060 | BOYAmt |
| EOY | $8,003,116 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,002,147 | BOYAmt |
| EOY | -$1,450,451 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,002,147 | BOYAmt |
| EOY | -$1,450,451 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,387,913 | BOYAmt |
| EOY | $6,552,665 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$448,304 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII HEALTH SYSTEMS CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300421262 | EIN |
| Organization Type | 6 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $10,152,483 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $10,152,483 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (true) | MajorityDirTrstSupportedOrgInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY PAYABLES | Desc |
| Amt | $1,420,947 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,420,947 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 2, PART IV, LINE 2B | FormAndLineReferenceDesc |
| Explanation | EAST HAWAII STATE VETERANS HOME MAINTAINS A CAPITAL RESERVE BALANCE OF 5,314,804 AS OF JUNE 30, 2022. THE ACCOUNT REFLECTS PAYMENTS RECEIVED BY THE ORGANIZATION, WHICH BELONG TO HAWAII HEALTH SYSTEMS CORPORATION (HHSC), AN INSTRUMENTALITY AND AGENCY OF THE STATE OF HAWAII. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|
| DAN BRINKMAN | ||||
| VICE PRESIDENT | $409,218 | $61,600 | $27,214 | $498,032 |
| JONI WALTJEN | ||||
| TREASURER | $217,572 | $52,218 | $269,790 | |
| DENISE MACKEY | ||||
| SECRETARY | $200,400 | $48,909 | $8,785 | $258,094 |
| SHELLYANN K CHARTRAND | ||||
| ADMINISTRATOR | $157,289 | $35,788 | $17,078 | $210,155 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO OPERATE A STATE VETERAN'S HOME SERVING VETERANS DISABLED BY AGE, DISEASE, OR OTHERWISE, WHO BY REASON OF SUCH DISABILITY ARE INCAPABLE OF EARNING A LIVING IN THE COUNTY OF HAWAII. THE CORPORATION WILL PROVIDE QUALITY OF CARE TO VETERANS IN NEED OF NURSING HOME AND ADULT DAY HEALTH CARE. TO PROMOTE THE HEALTH OF THE VETERAN COMMUNITY OF THE COUNTY OF HAWAII THROUGH THE PROVISION OF HIGH-QUALITY LONG-TERM CARE AND ADULT DAY HEALTH SERVICES, MEETING UNITED STATES VETERANS AFFAIRS DEPARTMENT AND UNITED STATES CENTERS FOR MEDICARE & MEDICAID SERVICES STANDARDS. TO SERVE AS A SUPPORTING ORGANIZATION TO THE HAWAII HEALTH SYSTEMS CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF THE EAST HAWAII STATE VETERANS HOME IS THE HAWAII HEALTH SYSTEMS CORPORATION, A PUBLIC BODY CORPORATE AND POLITIC AND AN AGENCY AND INSTRUMENTALITY OF THE STATE OF HAWAII. BYLAWS OF THE EAST HAWAII STATE VETERANS HOME STATE THAT THE SOLE MEMBER SHALL BE THE HAWAII HEALTH SYSTEMS CORPORATION, A PUBLIC BODY CORPORATE AND POLITIC AND AGENCY AND INSTRUMENTALITY OF THE STATE OF HAWAII. THE MEMBER SHALL NOT BE REQUIRED TO PAY ANY DUES, ASSESSMENTS, FEES, OR ANY OTHER CHARGES TO BE OR TO REMAIN A MEMBER. THE MEMBER IS ENTITLE TO INSPECT THE RECORDS AND DEMAND ANNUAL FINANCIAL STATEMENTS FORM THE EAST HAWAII STATE VETERANS HOME. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH A PERSON: A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTANDS THE CORPORATION IS CHARITABLE ORGANIZATION AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | PER THE BYLAWS, OFFICERS SHALL SERVE WITHOUT REMUNERATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, INCLUDING THE FORM 990, ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | MEDICAL/PHYSICIAN SERVICES 61,537 0 0 ON-CALL CONTRACT PHYSICIANS 36,900 0 0 OTHER CONTRACTED SERVICES 671,901 0 0 PURCHASED SERVICES 597,751 0 0 CONSULTANTS 14,018 0 0 TOTAL 1,382,107 0 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HAWAII HEALTH SYSTEMS CORPORATION | |||||||||
| 1190 WAIANUENUE AVE | HILO | HI | 96720 | 300421262 | HEALTH | HI | GOV | N/A | false |
| HILO MEDICAL CENTER | |||||||||
| 1190 WAIANUENUE AVE | HILO | HI | 96720 | 943282424 | HOSPITAL | HI | GOV | N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HAWAII HEALTH SYSTEMS CORP | ||
| E | $1,420,947 | BOOK VALUE |
| HAWAII HEALTH SYSTEMS CORP | ||
| L | $229,505 | BOOK VALUE |
| HILO MEDICAL CENTER | ||
| M | $1,046,598 | BOOK VALUE |
| HAWAII HEALTH SYSTEMS CORP | ||
| N | $783,300 | BOOK VALUE |
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