WAIKIKI HEALTH: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- WAIKIKI HEALTH (EIN 99-0159253)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201633209349311563
- Schema version
- 2015v2.1
- 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 | 2016-11-15T14:22:36-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990159253 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAIKIKI HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % TODD OKAMOTO | InCareOfNm |
| Business Name Control | WAIK | BusinessNameControlTxt |
| Phone | 8089224787 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 277 OHUA AVENUE | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96815 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TODD OKAMOTO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2016-07-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHEILA BECKHAM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 277 OHUA AVE | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96815 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,096,630 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WAIKIKIHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY MEDICAL AND SOCIAL SERVICES THAT ARE AFFORDABLE AND ACCESSIBLE FOR EVERYONE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 240 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,499,313 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,596,628 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,480,173 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,500,002 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | -$808 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $12,979,486 | PYTotalRevenueAmt |
| CY Total Revenue | $15,095,822 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $36,928 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $23,314 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,952,078 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,341,595 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,245,671 | PYOtherExpensesAmt |
| CY Other Expenses | $5,697,471 | CYOtherExpensesAmt |
| PY Total Expenses | $13,234,677 | PYTotalExpensesAmt |
| CY Total Expenses | $15,062,380 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$255,191 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $33,442 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,018,953 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,571,747 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,150,263 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,389,040 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,868,690 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,182,707 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH QUALITY MEDICAL AND SOCIAL SERVICES THAT ARE AFFORDABLE AND ACCESSIBLE FOR EVERYONE REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,343,121 | ExpenseAmt |
| Revenue | $4,186,410 | RevenueAmt |
| Desc | OUR PRIMARY CARE CLINIC OFFERS GENERAL AND PREVENTATIVE MEDICAL CARE AND CASE MANAGEMENT THAT IS INTEGRATED WITH TRADITIONAL HAWAIIAN HEALING, MEDICAL NUTRITION THERAPY, AND BEHAVIORAL HEALTH COUNSELING. CHRONIC DISEASE MANAGEMENT IS A KEY COMPONENT AS WE PROVIDE A SAFETY NET TO PEOPLE WHO ARE UNINSURED, UNDERINSURED, AND OFTEN HOMELESS. THIS YEAR WE PROVIDED 29,177 VISITS TO 10,525 PATIENTS, 42% OF WHOM WERE LIVING AT OR BELOW POVERTY LEVEL. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,353,362 | ExpenseAmt |
| Revenue | $1,032,835 | RevenueAmt |
| Desc | OUR HOMELESS OUTREACH PROGRAM SERVED OVER 2,277 INDIVIDUALS WITH MORE THAN 10,972 MEDICAL AND SOCIAL ENCOUNTERS. OUR DROP-IN CENTER OFFERS HEALTH SERVICES, BEHAVIORAL HEALTH SERVICES, CASE MANAGEMENT, SUBSTANCE ABUSE TREATMENT, EMERGENCY FOOD AND CLOTHING, PHONE, AND MESSAGE SERVICE FOR THE NEXT STEP SHELTER. OUR MOBILE MEDICAL CLINIC VISITS VARIOUS PARTS OF THE ISLAND WITH A FULLY EQUIPPED EXAM ROOM. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,502,965 | ExpenseAmt |
| Revenue | $3,749,540 | RevenueAmt |
| Desc | OUR PHARMACY PROGRAM FILLS PRESCRIPTIONS AND PROVIDES OVER THE COUNTER MEDICATIONS TO PATIENTS AT THE OHUA AND MAKAHIKI CLINIC LOCATIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $898,394 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $23,314 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $531,217 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $10,097,842 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | Yes (true) | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 240 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | false | 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 | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | 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 | TODD OKAMOTO | PersonNm |
| Phone | 8087919319 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 277 OHUA AVENUE | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96815 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JANET MONTGOMERY | |||||||||
| PRESIDENT | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PHYLLIS DENDLE | |||||||||
| VICE PRESIDENT | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SCOT STERENBERG | |||||||||
| CHAIR, FINANCE COMMITTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| WING YEUG | |||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBERT GENTRY | |||||||||
| CHAIR, HUMAN RESOURCES | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| HOWARD LEE | |||||||||
| TREASURER/GOVERNANCE CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHARLES DAVID DREHER | |||||||||
| CHAIR MARKETING & DEVELOPMENT | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS SHUICHI NAMIKI | |||||||||
| CHAIR, QUALITY ASSURANCE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL BARNETT | |||||||||
| DIRECTOR BEGINNING 02/15 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT E BETHUNE | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| BARBRA BRYAN | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| HENRY M KANEHAILUA | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| KAINANI M KAHUNANUI | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| KEITH LORENZ | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ASHLEY WILSON | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JESSE JAMES | |||||||||
| DIRECTOR ENDING 06/15 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN HIGH | |||||||||
| DIRECTOR ENDING 02/15 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SHEILA BECKHAM | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 0.0 | Yes (X) | $199,772 | $0 | $18,188 | |||
| JEFF CHAWENSON | |||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.0 | Yes (X) | $67,136 | $0 | $10,290 | |||
| TODD OKAMOTO | |||||||||
| CFO BEGINNING 09/15 | 40.0 | 0.0 | Yes (X) | $28,307 | $0 | $6,764 | |||
| BERNICE PELLER | |||||||||
| CAO BEGINNING 08/15 | 40.0 | 0.0 | Yes (X) | $76,414 | $0 | $9,768 | |||
| ELLIOT KALAUAWA | |||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0.0 | Yes (X) | $216,022 | $0 | $17,565 | |||
| SUZAN LY | |||||||||
| DENTAL DIRECTOR | 40.0 | 0.0 | $161,565 | $0 | $14,323 | Yes (X) | |||
| AHOORA PAYAM | |||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.0 | 0.0 | $186,187 | $0 | $16,073 | Yes (X) | |||
| DANIEL SALTMAN | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $129,297 | $0 | $13,229 | Yes (X) | |||
| TAMMY KAI | |||||||||
| PHARMACY DIRECTOR | 40.0 | 0.0 | $132,001 | $0 | $13,438 | Yes (X) | |||
| RACHEL DIPASQUALE | |||||||||
| DENTIST | 40.0 | 0.0 | $133,738 | $0 | $12,622 | Yes (X) | |||
| FLORIAN SATTELMACHER | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $160,512 | $0 | $14,790 | Yes (X) | |||
| KAREN DANG MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $156,000 | $0 | $6,764 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,646,951 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $153,814 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $149,757 | FederatedCampaignsAmt |
| Government Grants | $4,461,608 | GovernmentGrantsAmt |
| All Other Contributions | $985,263 | AllOtherContributionsAmt |
| Noncash Contributions | $19,123 | NoncashContributionsAmt |
| Total Contributions | $5,596,628 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624100 | $5,365,247 | $5,365,247 |
| PHARMACY SALES | 624100 | $3,826,790 | $3,826,790 |
| OTHER INCOME | 624100 | $307,965 | $307,965 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,500,002 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $808 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$808 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$808 | TotalRevenueColumnAmt |
| Exclusion | -$808 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,095,822 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,500,002 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$808 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,314 | TotalAmt |
| Program Services | $23,314 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $650,226 | TotalAmt |
| Program Services | $233,587 | ProgramServicesAmt |
| Management And General | $416,639 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,085,834 | TotalAmt |
| Program Services | $5,418,696 | ProgramServicesAmt |
| Management And General | $1,667,138 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $224,209 | TotalAmt |
| Program Services | $173,920 | ProgramServicesAmt |
| Management And General | $50,289 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $839,571 | TotalAmt |
| Program Services | $635,609 | ProgramServicesAmt |
| Management And General | $203,962 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $541,755 | TotalAmt |
| Program Services | $397,816 | ProgramServicesAmt |
| Management And General | $143,939 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,223,090 | TotalAmt |
| Management And General | $1,223,090 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,703 | TotalAmt |
| Management And General | $59,703 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,102 | TotalAmt |
| Management And General | $213,102 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,332,008 | TotalAmt |
| Program Services | $890,389 | ProgramServicesAmt |
| Management And General | $441,619 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,220 | TotalAmt |
| Management And General | $115,220 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,198 | TotalAmt |
| Management And General | $154,198 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222 | TotalAmt |
| Management And General | $222 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,912 | TotalAmt |
| Program Services | $210,505 | ProgramServicesAmt |
| Management And General | $104,407 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,251 | TotalAmt |
| Management And General | $96,251 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $2,026,906 | $2,026,906 | |
| LICENSES, DUES, SUBSCRIPTIONS | $74,759 | $74,759 | |
| BAD DEBT | $87,100 | $87,100 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,062,380 | TotalAmt |
| Program Services | $10,097,842 | ProgramServicesAmt |
| Management And General | $4,964,538 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,650 | BOYAmt |
| EOY | $1,608,275 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,604,261 | BOYAmt |
| EOY | $261,160 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $658,398 | BOYAmt |
| EOY | $530,363 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $328,588 | BOYAmt |
| EOY | $671,106 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,797 | BOYAmt |
| EOY | $72,740 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,308 | BOYAmt |
| EOY | $189,887 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,732,052 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,562,718 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,173,319 | BOYAmt |
| EOY | $2,169,334 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,632 | BOYAmt |
| EOY | $68,882 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,018,953 | BOYAmt |
| EOY | $5,571,747 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $788,779 | BOYAmt |
| EOY | $1,262,906 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $340,907 | BOYAmt |
| EOY | $124,157 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,950 | BOYAmt |
| EOY | $1,977 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,627 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,150,263 | BOYAmt |
| EOY | $1,389,040 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,856,190 | BOYAmt |
| EOY | $4,028,671 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,500 | BOYAmt |
| EOY | $154,036 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,868,690 | BOYAmt |
| EOY | $4,182,707 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,018,953 | BOYAmt |
| EOY | $5,571,747 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $33,442 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $280,575 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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 | $4,142,787 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,775,822 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $552,374 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,499,313 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,596,628 | CurrentTaxYearAmt |
| Total | $20,566,924 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,142,787 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,775,822 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $552,374 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,499,313 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,596,628 | CurrentTaxYearAmt |
| Total | $20,566,924 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $20,566,924 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $331 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $330 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $594 | CurrentTaxYearMinus2YearsAmt |
| Total | $1,255 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $20,568,179 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $31,386,502 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99994 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99990 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,865,439 | OtherCostOrOtherBasisAmt |
| Depreciation | $234,408 | DepreciationAmt |
| Book Value | $1,631,031 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,863,991 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,328,310 | DepreciationAmt |
| Book Value | $535,681 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,622 | OtherCostOrOtherBasisAmt |
| Book Value | $2,622 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,169,334 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $15,101,789 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $299,230 | OtherRevenueAmt |
| Revenue Not Reported | $299,230 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,802,559 | RevenueSubtotalAmt |
| Other Revenues Not Included | $293,263 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $293,263 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,095,822 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,976,088 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $808 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $808 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,975,280 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $87,100 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $87,100 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,062,380 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $386,330 NET ASSETS RELEASED FROM RESTRICTION (87,100) BAD DEBT EXPENSE --------- $299,230 |
| SCHEDULE D, PART XI, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $294,071 TEMPORARILY RESTRICTED CONTRIBUTIONS (808) LOSS ON SALE OF FIXED ASSETS --------- $293,263 |
| SCHEDULE D, PART XII, LINE 2D | AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART XI, LINE 25: $ 808 LOSS ON SALE OF FIXED ASSETS |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FOR, 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 87,100 BAD DEBT EXPENSE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY CLINIC OF MAUI INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1881 NANI STREET | AddressLine1Txt |
| City | WAILUKU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96793 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 990303304 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $23,314 | CashGrantAmt |
| Purpose Of Grant | HIV RELATED SRVCS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | GRANT MONITORING: THE ORGANIZATION'S GRANTEES ARE FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS WITH ANNUAL REQUIREMENTS FOR AUDITED FINANCIAL STATEMENTS, UDS REPORTS, QUALITY REVIEWS, AND HRSA OVERSIGHT OF GOVERNANCE AND OPERATIONAL ISSUES. IN ADDITION, GRANTS ARE FOR FUNDING OF SPECIFIC EXPENSES AND INVOICES ARE REVIEWED BY THE ORGANIZATION'S CFO. GRANTEES ALSO PROVIDE QUARTERLY DATA WITH INVOICES AND ANNUAL SITE VISITS ARE MADE TO EACH GRANTEE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHEILA BECKHAM | ||||||||||||
| CHIEF EXECUTIVE OFFICER | $199,772 | $0 | $0 | $0 | $0 | $0 | $8,924 | $0 | $9,264 | $0 | $217,960 | $0 |
| ELLIOT KALAUAWA | ||||||||||||
| CHIEF MEDICAL OFFICER | $216,022 | $0 | $0 | $0 | $0 | $0 | $10,801 | $0 | $6,764 | $0 | $233,587 | $0 |
| SUZAN LY | ||||||||||||
| DENTAL DIRECTOR | $161,565 | $0 | $0 | $0 | $0 | $0 | $7,159 | $0 | $7,164 | $0 | $175,888 | $0 |
| AHOORA PAYAM | ||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | $186,187 | $0 | $0 | $0 | $0 | $0 | $9,309 | $0 | $6,764 | $0 | $202,260 | $0 |
| FLORIAN SATTELMACHER | ||||||||||||
| PHYSICIAN | $160,512 | $0 | $0 | $0 | $0 | $0 | $8,026 | $0 | $6,764 | $0 | $175,302 | $0 |
| KAREN DANG MD | ||||||||||||
| PHYSICIAN | $156,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,764 | $0 | $162,764 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICE ACCOMPLISHMENTS: OUR DENTAL SERVICES PROVIDE SERVICES TO BOTH ADULT AND PEDIATRIC PATIENTS AT OUR MAKAHIKI LOCATION. IN ADDITION, IT PROVIDES EDUCATION TO THE PUBLIC ON THE IMPORTANT OF ORAL HEALTH IN OVERALL PERSONAL WELLBEING. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY MANAGEMENT. A REVIEW IS CONDUCTED BY MANAGEMENT AND COPIES ARE PROVIDED TO THE FINANCE DEPARTMENT FOR REVIEW. HISTORICALLY ALL FORM 990'S HAVE BEEN PREPARED BY A THIRD PARTY WHO WORKS IN CONJUNCTION WITH THE COMPANY'S FINANCE DEPARTMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL EXECUTIVE MANAGEMENT AND BOARD MEMBERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. ANY BUSINESS DEALINGS WITH RELATED PARTIES MUST BE DISCLOSED TO ALL OF THE BOARD OF DIRECTORS. DECISION MAKING IS LIMITED AS IT PERTAINS TO ANY TRANSACTIONS DONE WITH THE RELATED PARTY. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | DETERMINATION OF CEO COMPENSATION: THE COMPENSATION OF THE EXECUTIVE DIRECTOR IS APPROVED BY THE BOARD OF DIRECTORS. THE DIRECTORS MEET IN EXECUTIVE SESSION FOR DISCUSSION. THE PERSONNEL COMMITTEE OF THE BOARD IS RESPONSIBLE FOR MAKING RECOMMENDATIONS TO THE BOARD AND USES THE FOLLOWING RESOURCES: COMPARATIVE DATA FROM HAWAII EMPLOYERS COUNCIL, THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, AND THE HAWAII PRIMARY CARE ASSOCIATION (HPCA). THE CHIEF EXECUTIVE OF THE HPCA, WHO IS INDEPENDENT OF THE BOARD OF DIRECTORS, ACTED AS AN ADVISOR AND CONSULTANT DURING THE 2007 HIRING OF THE NEW EXECUTIVE DIRECTOR. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE EXECUTIVE DIRECTOR, USING THE AVAILABLE EXTERNAL RESOURCES LISTED ABOVE AND WITH INPUT ON COMPARABLE MARKET SALARIES FROM THE HR MANAGER. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENT AVAILABILITY: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON DEMAND. |
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