KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES (EIN 99-0149797)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-15
- IRS object ID
- 202331359349319753
- Schema version
- 2021v4.2
- 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 | 2023-05-15T19:34:51-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 261659234 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CW ASSOCIATES CPAS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 1040 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | 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 | 990149797 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY | BusinessNameLine1Txt |
| Business Name Line2 | SERVICES | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KOKU | BusinessNameControlTxt |
| Phone | 8087919400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2239 NORTH SCHOOL STREET | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96819 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID DERAUF | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8087919400 | PhoneNum |
| Signature | 2023-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAVID | PersonFirstNm |
| Person Last | DERAUF | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MELANIE A KING | PreparerPersonNm |
| PTIN | P00220997 | PTIN |
| Phone | 8085311040 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| 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 | DAVID DERAUF | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2239 NORTH SCHOOL STREET | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96819 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,354,362 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.KKV.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | KOKUA KALIHI VALLEY AND AFFILIATE (THE "CENTER") WERE INCORPORATED IN THE STATE OF HAWAII IN MAY 1972 TO PROMOTE HEALTH AND TO PROVIDE COMPREHENSIVE FAMILY SERVICES IN THE KALIHI VALLEY COMMUNITY IN THE CITY & COUNTY OF HONOLULU, HAWAII. THE CENTER IS A FEDERALLY-QUALIFIED HEALTH CENTER THAT PROVIDES A BROAD RANGE OF HEALTH AND SOCIAL SERVICES TO A LARGELY MEDICALLY-UNDERSERVED IMMIGRANT POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 308 | TotalEmployeeCnt |
| Total Volunteers | 780 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $14,619,464 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,956,128 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,389,523 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,223,129 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,024 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,342 | CYInvestmentIncomeAmt |
| PY Other Revenue | $225,738 | PYOtherRevenueAmt |
| CY Other Revenue | $10,345 | CYOtherRevenueAmt |
| PY Total Revenue | $24,242,749 | PYTotalRevenueAmt |
| CY Total Revenue | $25,197,944 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,351,695 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,571,578 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,811,598 | PYOtherExpensesAmt |
| CY Other Expenses | $5,899,055 | CYOtherExpensesAmt |
| PY Total Expenses | $21,163,293 | PYTotalExpensesAmt |
| CY Total Expenses | $21,470,633 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,079,456 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,727,311 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,871,872 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,586,907 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,829,066 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,909,267 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,042,806 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,677,640 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TOGETHER WE WORK TO ADVANCE HEALTH, TO INSPIRE HEALING, TO FOSTER RECONCILIATION, AND TO CELEBRATE ABUNDANCE IN THE AHUPUA'A OF KALIHI THROUGH STRONG RELATIONSHIPS THAT HONOR CULTURE AND PLACE. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,926,309 | ExpenseAmt |
| Revenue | $11,233,474 | RevenueAmt |
| Desc | SERVICES PERFORMED TO PROVIDE ACCESS TO MEDICAL, DENTAL AND SOCIAL SERVICES IN THE KALIHI VALLEY COMMUNITY. | Desc |
| Total Program Service Expenses | $16,926,309 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 56 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 308 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | HI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHAN HOU LEI CHIEF FINANCIAL OFFIC | PersonNm |
| Phone | 8087919400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2239 NORTH SCHOOL STREET | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96819 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| SANDRA HARVEY | ||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| THOMAS KUSATSU | ||||||||
| VICE PRESIDENT/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| VANESSA DACUMOS | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PUA AUYONG | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| EDWARD KEMPER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GEOFFREY PANG | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN FOX | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICKEY MURASHIGE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PAULINA ROBERT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID NAKAMOTO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MOMI AKIMSEU | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID DERAUF | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $234,475 | $0 | $54,882 | |||
| CHAN HOU LEI | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $103,005 | $0 | $23,516 | |||
| YUET MUI KONG | ||||||||
| CHIEF OPERATIONG OFFICER | 40.00 | Yes (X) | $85,591 | $0 | $10,383 | |||
| LAURA DEVILBISS | ||||||||
| CLINICAL DIRECTOR | 40.00 | $234,312 | $0 | $27,190 | Yes (X) | |||
| MELISSA MCKINNEY | ||||||||
| PHYSICIAN | 40.00 | $182,066 | $0 | $16,589 | Yes (X) | |||
| NATHAN TAN | ||||||||
| PHYSICIAN | 40.00 | $165,181 | $0 | $28,803 | Yes (X) | |||
| MYA HLA | ||||||||
| PSYCHIATRIST DIR OF BH | 40.00 | $152,395 | $0 | $40,140 | Yes (X) | |||
| ANGELICA AGAPITO | ||||||||
| PHYSICIAN | 40.00 | $163,697 | $0 | $14,572 | Yes (X) | |||
| JASON HIRAMOTO | ||||||||
| CO-DENTAL DIRECTOR | 40.00 | $146,913 | $0 | $20,311 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,467,635 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $236,386 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CVS PHARMACY | |||||
| ONE CVS DRIVE | WOONSOCKET | RI | 02895 | PHARMACY DISPENSING FEE | $400,936 |
| E-MDS | |||||
| PO BOX 679493 | DALLAS | TX | 75267 | MEDICAL BILLING | $328,167 |
| TIMES PHARMACY | |||||
| 1620 NORTH SCHOOL STREET | HONOLULU | HI | 96817 | PHARMACY DISPENSING FEE | $221,609 |
| ZR SYSTEMS GROUP LLC | |||||
| 98-810 MOANALUA ROAD SUITE H-4 | AIEA | HI | 96701 | INFORMATION TECH SUPPORT | $191,752 |
| VPLS | |||||
| DEPT LA 25225 | PASADENA | CA | 91185 | INFORMATION TECH SUPPORT | $122,444 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $10,389,213 | GovernmentGrantsAmt |
| All Other Contributions | $3,566,915 | AllOtherContributionsAmt |
| Total Contributions | $13,956,128 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 624110 | $6,438,787 | $6,438,787 |
| PHARMACY | 624110 | $2,500,839 | $2,500,839 |
| PRIVATE INSURANCE | 624110 | $1,468,513 | $1,468,513 |
| CAPITATION FEES | 624110 | $632,278 | $632,278 |
| MEDICARE | 624110 | $157,374 | $157,374 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,338 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,338 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,223,129 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,342 | TotalRevenueColumnAmt |
| Exclusion | $8,342 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $106,033 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $156,418 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$50,385 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$50,385 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 624110 | BusinessCd |
| Total Revenue Column | $60,730 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,730 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $60,730 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,197,944 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,233,474 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,342 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $830,794 | TotalAmt |
| Program Services | $274,611 | ProgramServicesAmt |
| Management And General | $556,183 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,348,226 | TotalAmt |
| Program Services | $8,919,820 | ProgramServicesAmt |
| Management And General | $1,428,406 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $686,025 | TotalAmt |
| Program Services | $591,076 | ProgramServicesAmt |
| Management And General | $94,949 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,761,371 | TotalAmt |
| Program Services | $2,337,233 | ProgramServicesAmt |
| Management And General | $424,138 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $945,162 | TotalAmt |
| Program Services | $782,484 | ProgramServicesAmt |
| Management And General | $162,678 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,677 | TotalAmt |
| Management And General | $46,677 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,969,337 | TotalAmt |
| Program Services | $1,488,020 | ProgramServicesAmt |
| Management And General | $481,317 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,117,376 | TotalAmt |
| Program Services | $1,872,581 | ProgramServicesAmt |
| Management And General | $244,795 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,426 | TotalAmt |
| Program Services | $76,154 | ProgramServicesAmt |
| Management And General | $154,272 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,970 | TotalAmt |
| Program Services | $46,018 | ProgramServicesAmt |
| Management And General | $2,952 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $829,515 | TotalAmt |
| Program Services | $167,278 | ProgramServicesAmt |
| Management And General | $662,237 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,877 | TotalAmt |
| Management And General | $65,877 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS AND MAINTENANCE | $271,177 | $144,024 | $127,153 |
| MISCELLANEOUS | $141,145 | $92,985 | $48,160 |
| PATIENT SERVICES | $62,002 | $62,002 | |
| DUES AND SUBSCRIPTIONS | $45,006 | $27,063 | $17,943 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,547 | TotalAmt |
| Program Services | $44,960 | ProgramServicesAmt |
| Management And General | $26,587 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,470,633 | TotalAmt |
| Program Services | $16,926,309 | ProgramServicesAmt |
| Management And General | $4,544,324 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,441,478 | BOYAmt |
| EOY | $2,402,536 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,790,391 | BOYAmt |
| EOY | $9,348,482 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $741,231 | BOYAmt |
| EOY | $1,235,867 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,475,776 | BOYAmt |
| EOY | $1,913,715 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,990 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,334 | BOYAmt |
| EOY | $1,643 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,312,651 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,638,977 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,421,662 | BOYAmt |
| EOY | $9,673,674 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,871,872 | BOYAmt |
| EOY | $24,586,907 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,829,066 | BOYAmt |
| EOY | $1,909,267 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,000,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,829,066 | BOYAmt |
| EOY | $1,909,267 | 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 | $15,520,674 | BOYAmt |
| EOY | $17,844,933 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,522,132 | BOYAmt |
| EOY | $4,832,707 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,042,806 | BOYAmt |
| EOY | $22,677,640 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,871,872 | BOYAmt |
| EOY | $24,586,907 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,727,311 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$92,477 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,214,416 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,372,631 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,989,833 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,619,464 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,956,128 | CurrentTaxYearAmt |
| Total | $55,152,472 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,214,416 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,372,631 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,989,833 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,619,464 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,956,128 | CurrentTaxYearAmt |
| Total | $55,152,472 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $18,233 | SubstantialContributorsTotAmt |
| Public Support Total170 | $55,134,239 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $71,391 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $100,910 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $71,578 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $35,943 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,342 | CurrentTaxYearAmt |
| Total | $288,164 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $38,062 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,910 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $34,980 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $60,730 | CurrentTaxYearAmt |
| Total | $161,682 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $55,602,318 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $48,690,112 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99160 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98850 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME AND FEES - 2017 AMOUNT: $ 38,062. 2018 AMOUNT: $ 27,910. 2019 AMOUNT: $ 34,980. 2021 AMOUNT: $ 60,730. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,288,000 | OtherCostOrOtherBasisAmt |
| Book Value | $2,288,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,693,406 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,393,098 | DepreciationAmt |
| Book Value | $4,300,308 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,232,453 | OtherCostOrOtherBasisAmt |
| Depreciation | $210,700 | DepreciationAmt |
| Book Value | $1,021,753 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,921,495 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,459,378 | DepreciationAmt |
| Book Value | $462,117 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,177,297 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,575,801 | DepreciationAmt |
| Book Value | $1,601,496 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,673,674 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,326,225 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $295,017 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$12,576 | OtherRevenueAmt |
| Revenue Not Reported | $282,441 | RevenueNotReportedAmt |
| Revenue Subtotal | $22,043,784 | RevenueSubtotalAmt |
| Other Revenues Not Included | $3,154,160 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $3,154,160 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $25,197,944 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,016,070 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $387,494 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $157,943 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $545,437 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,470,633 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,470,633 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | U.S. GAAP REQUIRES UNCERTAIN TAX POSITIONS TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IF THEY ARE MORE LIKELY THAN NOT TO FAIL UPON REGULATORY EXAMINATION. MANAGEMENT HAS EVALUATED KKV AND AFFILIATE'S TAX POSITIONS AS OF JUNE 30, 2022 AND 2021 AND FOR THE YEARS THEN ENDED, AND DETERMINED THAT KKV AND AFFILIATE HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED IN ACCORDANCE WITH U.S. GAAP. KKV AND AFFILIATE ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS IN PROGRESS FOR ANY OPEN TAX PERIODS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | REVENUE FROM KALIHI VALLEY COMMUNITY FOUNDATION (REPORTED SEPARATELY) -12,576. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INCREASE (DECREASE) IN NET ASSETS WITH DONOR RESTRICTIONS 1,310,578. COST OF GOODS SOLD -156,418. GAIN ON FORGIVENESS OF SBA PPP LOANS 2,000,000. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | COST OF GOODS SOLD 156,418. EXPENSES FROM KALIHI VALLEY COMMUNITY FOUNDATION (REPORTED SEPARATELY) 1,525. |
| PART XI, LINE 2B - DONATED SERVICES AND USE OF FACILITIES | CONTRIBUTED MEDICAL SERVICES: $244,825 CONTRIBUTED RENT: $36,487 |
| PART XII, LINE 2A - DONATED SERVICES AND USE OF FACILITIES | CONTRIBUTED MEDICAL SERVICES: $244,825 CONTRIBUTED RENT: $36,487 CONTRIBUTED RENT RELATED TO CAPITALIZED LEASEHOLD INTEREST: $92,477 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID DERAUF | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $234,475 | $0 | $0 | $0 | $0 | $0 | $19,908 | $0 | $34,974 | $0 | $289,357 | $0 | $0 | $0 |
| LAURA DEVILBISS | ||||||||||||||
| CLINICAL DIRECTOR | $234,312 | $0 | $0 | $0 | $0 | $0 | $19,872 | $0 | $7,318 | $0 | $261,502 | $0 | $0 | $0 |
| MELISSA MCKINNEY | ||||||||||||||
| PHYSICIAN | $182,066 | $0 | $0 | $0 | $0 | $0 | $1,701 | $0 | $14,888 | $0 | $198,655 | $0 | $0 | $0 |
| NATHAN TAN | ||||||||||||||
| PHYSICIAN | $165,181 | $0 | $0 | $0 | $0 | $0 | $14,019 | $0 | $14,784 | $0 | $193,984 | $0 | $0 | $0 |
| MYA HLA | ||||||||||||||
| PSYCHIATRIST DIR OF BH | $152,395 | $0 | $0 | $0 | $0 | $0 | $12,930 | $0 | $27,210 | $0 | $192,535 | $0 | $0 | $0 |
| ANGELICA AGAPITO | ||||||||||||||
| PHYSICIAN | $163,697 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,572 | $0 | $178,269 | $0 | $0 | $0 |
| JASON HIRAMOTO | ||||||||||||||
| CO-DENTAL DIRECTOR | $146,913 | $0 | $0 | $0 | $0 | $0 | $12,464 | $0 | $7,847 | $0 | $167,224 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | STARTED KOKUA PHARMACY, A 340B AND RETAIL PHARMACY FOR OUR PATIENTS |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | A COPY OF THIS POLICY IS GIVEN TO ALL BOARD MEMBERS UPON COMMENCEMENT OF SUCH PERSON'S RELATIONSHIP WITH THE ORGANIZATION. EACH BOARD MEMBER SIGNS AND DATES THE POLICY AT THE BEGINNING OF HER/HIS TERM OF SERVICE OR EMPLOYMENT AND EACH YEAR THEREAFTER. FAILURE TO SIGN DOES NOT NULLIFY THE POLICY. THE POLICY AND DISCLOSURE FORM MUST BE FILED ANNUALLY BY ALL SPECIFIED PARTIES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO'S SALARY IS DETERMINED BY THE BOARD OF DIRECTORS. ALL OTHER STAFF COMPENSATION IS DETERMINED BY THE SALARY COMMITTEE AND APPROVED BY THE CEO. THE BOARD OF DIRECTORS APPROVES THE STAFF SALARY SCALE. COMPARABLE DATA IS OBTAINED FROM HAWAII PRIMARY CARE ASSOCIATION AND HAWAII ALLIANCE OF NONPROFIT ORGANIZATIONS (HANO). THIS PROCESS IS DOCUMENTED IN THE SALARY COMMITTEE MINUTES AND HR RECORDS. THIS WAS LAST UNDERTAKEN IN MAY 2022. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CAPITALIZED LEASEHOLD INTEREST - NET CHANGE -92,477. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KALIHI VALLEY COMMUNITY FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2239 NORTH SCHOOL STREET | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96819 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990329894 | EIN |
| Primary Activities | PROVIDE FINANCIAL SUPPORT TO CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KOKUA KALIHI VALLEY COMP FAMILY SVCS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments