2023-05-05T19:37:52-05:00 2022-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2021-07-01 990273205 WAIMANALO HEALTH CENTER WAIM 8082597948 41-1347 KALANIANAOLE HWY WAIMANALO HI 96795 JOSEPH ADRIANO CFO 8082597948 2023-05-05 1 JOSEPH ADRIANO 999009999 MELANIE A KING P00220997 8085311040 2023-04-26 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z MARY FRANCES ONEHA 41-1347 KALANIANAOLE HWY WAIMANALO HI 96795 15892810 0 X WWW.WAIMANALOHEALTH.ORG X 1989 HI WAIMANALO HEALTH CENTER IS COMMITTED TO PROVIDING THE HIGHEST LEVEL OF PRIMARY AND PREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TO THE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLY UNDERSERVED, AND IMPROVING THE HEALTH AND WELLNESS OF INDIVIDUALS AND THEIR `OHANA REGARDLESS OF THEIR ABILITY TO PAY. 14 14 146 14 0 0 5779183 7316947 5397323 6619808 7147 532 1185798 1282417 12369451 15219704 0 0 0 0 8246730 9080355 0 0 0 3461212 3408578 11707942 12488933 661509 2730771 20139127 19732141 4959893 1894378 15179234 17837763 X WAIMANALO HEALTH CENTER IS COMMITTED TO PROVIDING THE HIGHEST LEVEL OF PRIMARY AND PREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TO THE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLY UNDERSERVED, AND IMPROVING THE HEALTH AND WELLNESS OF INDIVIDUALS AND THEIR `OHANA REGARDLESS OF THEIR ABILITY TO PAY. 0 0 4877974 7325754 MEDICAL SERVICES: WHC PROVIDES AFFORDABLE MEDICAL, BEHAVIORAL HEALTH, NUTRITION, VISION, AND PATIENT TRANSPORTATION SERVICES TO RESIDENTS OF WAIMANALO AND SURROUNDING COMMUNITIES. AS REPORTED TO HRSA ON WHC'S CALENDAR YEAR 2021 UDS REPORT FOR MEDICAL SERVICES, WHC SERVED 7,663 UNDUPLICATED PATIENTS DURING 23,854 MEDICAL SERVICE PROVIDER VISITS. 1198444 3553 PATIENT SUPPORT SERVICES: INCLUDES CARE MANAGEMENT, HEALTH EDUCATION, HEALTH PROMOTION, ELECTRONIC HEALTH RECORD INFORMATION TECHNOLOGY, QUALITY REPORTING, PATIENT PORTAL AND OTHER SERVICES TO SUPPORT PATIENT CENTERED CARE DELIVERY FOR MEDICAL AND DENTAL SERVICES. 1506663 572918 DENTAL SERVICES: WHC PROVIDES AFFORDABLE DENTAL CARE TO RESIDENTS OF WAIMANALO AND SURROUNDING COMMUNITIES. AS REPORTED TO HRSA ON WHC'S CALENDAR YEAR 2021 UDS REPORT, WHC SERVED 1,590 UNDUPLICATED PATIENTS DURING 4,727 DENTAL PROVIDER VISITS. 1051948 OTHER PROGRAM SERVICES: WHC HOSTS AND SUPPORTS COMMUNITY OUTREACH, ENABLING AND EDUCATION PROGRAMS. PROGRAMS INCLUDE: WOMEN, INFANTS, AND CHILDREN (WIC); ON-SITE ELIGIBILITY WORKERS TO ASSIST FAMILIES WITH BENEFIT PROGRAMS AND HEALTH INSURANCE ENROLLMENT; FAMILY PLANNING; NUTRITION AND HEALTH PROMOTIONS; KU I KA MANA STUDENT MENTORING PROGRAM (KIKM); KEIKI SMILES DENTAL OUTREACH TO THE SCHOOLS; CANCER SCREENING AND AWARENESS UNDER SUSAN G. KOMEN AND THE STATE BREAST AND CERVICAL CANCER PREVENTION PROGRAMS (BCCCP); OUTREACH TO PREVENT HOMELESSNESS; AND OTHERS.THESE PROGRAMS SUPPORTED A CASELOAD OF 1,600 PATIENTS RESULTING IN 14,500 VISITS. 1051948 8635029 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 X 15 0 146 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 HI X JOSEPH ADRIANO 8082597948 41-1347 KALANIANAOLE HWY WAIMANALO HI 96795 KATHY CONNER PRESIDENT 1.00 X X 0 0 0 JOHN KEONI AYLETT VICE PRESIDENT 1.00 X X 0 0 0 JUSTIN LAM 2ND VICE PRESIDENT 1.00 X X 0 0 0 JAMES WOOD TREASURER 1.00 X X 0 0 0 DEBORAH SMITH SECRETARY 1.00 X X 0 0 0 SHANNON ALIVADO DIRECTOR 1.00 X 0 0 0 RUSS AWAKUNI DIRECTOR 1.00 X 0 0 0 JEFF GILBREATH DIRECTOR 1.00 X 0 0 0 ANDREW JAMILA JR DIRECTOR 1.00 X 0 0 0 RENEE KAMA DIRECTOR 1.00 X 0 0 0 SANDRA MAENANI MCAULTON DIRECTOR 1.00 X 0 0 0 JULIE MIJO DIRECTOR 1.00 X 0 0 0 CATHERINE SATO DIRECTOR 1.00 X 0 0 0 WILLIAM SPENCER DIRECTOR 1.00 X 0 0 0 PATRICIA SUTTON CHIEF OPERATIONS OFFICER 40.00 X 0 0 0 MARY FRANCES ONEHA CHIEF EXECUTIVE OFFICER 40.00 X 227452 0 15711 CHRISTINA LEE CHIEF MEDICAL OFFICER 40.00 X 269784 0 34184 ANTHONY KIM DENTAL DIRECTOR 40.00 X 209898 0 33068 ROBERT SLIKE CHIEF INFORMATION OFFICER 40.00 X 133480 0 12891 JOSEPH ADRIANO CHIEF FINANCIAL OFFICER 40.00 X 137295 0 13402 ASHTON HO FORMER CHIEF PERFORMANCE & COMPLIANCE OFFICER 40.00 X 94604 0 28928 JOSHUA W EVANS ASSOC MEDICAL DIRECTOR 40.00 X 187950 0 14298 LEIGH ZIEGLER CLINICAL OPERATIONS DIRECTOR 40.00 X 102059 0 14667 BRETT HONDA DENTIST 40.00 X 137057 0 12999 ISIDRO P HERMOSURA DIRECTOR OF BEHAVIORAL HEALTH 40.00 X 126877 0 30577 DESMOND FOO CALL-IN PROVIDER 25.00 X 119613 0 11861 1746069 0 222586 18 0 1 0 OHIO SHARED INFORMATION SYSTEMS PO BOX 772852 CHICAGO IL 606772852 COMPUTER SERVICES 333066 ERSKINE ARCHITECTS INC 540 LAGOON DRIVE STE 4 HONOLULU HI 96819 ARCHITECTS 183872 COVERALL NORTH AMERICA INC 438 HOBRON LANE PH 4 HONOLULU HI 96815 JANITORIAL 143891 PATTERSON DENTAL 91-291 KALAELOA BLVD STE C-1 KAPOLEI HI 96707 DENTAL SERVICES 129359 JAN-GUARD HAWAII INC 524 KALIHI ST HONOLULU HI 96819 SECURITY SERVICES 112376 5 19709 6352667 944571 7316947 PATIENT SERVICE 621400 5718235 5718235 WRAP PAYMENT 621400 775600 775600 FAMILY MEDICINE 621400 122420 122420 GENERAL & ADMINISTRATIVE 621400 3553 3553 6619808 532 532 1950160 673106 1277054 1277054 OTHER REVENUE 900099 5363 5363 5363 15219704 7902225 0 532 1242603 681768 560835 6176327 5205969 970358 79369 73473 5896 793971 680538 113433 788085 631222 156863 12500 12500 32093 32093 128718 96267 32451 518031 350416 167615 439891 245845 194046 9908 2761 7147 7962 2218 5744 59595 59595 839029 197483 641546 122879 5609 117270 PURCHASED SERVICES 781164 297329 483835 MISCELLANEOUS 271525 110046 161479 DEVELOPMENT AND TRAININ 82965 12999 69966 DUES AND SUBSCRIPTIONS 69283 31100 38183 33035 9986 23049 12488933 8635029 3853904 0 1367657 1215490 2066600 1508070 184680 1173124 885320 482638 66063 101522 201932 21251920 6195167 15310406 15056753 28071 222942 0 20139127 19732141 933728 905210 437204 969414 911822 0 2651729 0 25410 19754 4959893 1894378 X 14399737 17586674 779497 251089 15179234 17837763 20139127 19732141 2730771 -72242 0 X 0 1 X 1 1 1 X 6010487 8285786 5623259 5779183 7316947 33015662 6010487 8285786 5623259 5779183 7316947 33015662 794682 32220980 8351 5727 24949 7147 532 46706 509 509 5714 6302 4490 41361 5363 63230 33126107 30570746 0.97270 0.97010 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2017 AMOUNT: $ 5,714. 2018 AMOUNT: $ 6,302. 2019 AMOUNT: $ 4,490. 2020 AMOUNT: $ 41,361. 2021 AMOUNT: $ 5,363. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17454344 3654321 13800023 3432522 2438012 994510 365054 102834 262220 15056753 CAPITAL LEASE OBLIGATION 19754 19754 X 13955583 98034 98034 13857549 1362155 1362155 15219704 12587381 98034 414 98448 12488933 0 12488933 PART X, LINE 2: U.S. GAAP REQUIRES UNCERTAIN TAX POSITIONS TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THEY ARE MORE LIKELY THAN NOT TO FAIL UPON REGULATORY EXAMINATION. MANAGEMENT EVALUATED THE CENTER'S TAX POSITIONS AS OF JUNE 30, 2022 AND 2021 AND FOR THE YEARS THEN ENDED, AND DETERMINED THAT THE CENTER HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED IN ACCORDANCE WITH U.S. GAAP. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS IN PROGRESS FOR ANY OPEN TAX PERIODS. PART XI, LINE 4B - OTHER ADJUSTMENTS: PPP LOAN FORGIVENESS 1,362,569. COST OF GOODS SOLD -414. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 414. X X 0 0 0 0 0 0 0 0 0 CHRISTINA LEE CHIEF MEDICAL OFFICER 269784 0 0 0 0 0 8094 0 26090 0 303968 0 0 0 MARY FRANCES ONEHA CHIEF EXECUTIVE OFFICER 227452 0 0 0 0 0 6824 0 8887 0 243163 0 0 0 ANTHONY KIM DENTAL DIRECTOR 209898 0 0 0 0 0 6297 0 26771 0 242966 0 0 0 JOSHUA W EVANS ASSOC MEDICAL DIRECTOR 187950 0 0 0 0 0 5638 0 8660 0 202248 0 0 0 ISIDRO P HERMOSURA DIRECTOR OF BEHAVIORAL HEALTH 126877 0 0 0 0 0 3806 0 26771 0 157454 0 0 0 JOSEPH ADRIANO CHIEF FINANCIAL OFFICER 137295 0 0 0 0 0 4119 0 9283 0 150697 0 0 0 BRETT HONDA DENTIST 137057 0 0 0 0 0 4112 0 8887 0 150056 0 0 0 FORM 990, PART V, LINE 2A: THE ORGANIZATION HAS A CO-EMPLOYMENT ARRANGEMENT WITH ALTRES, WHO IS AN OUTSOURCED HR/PAYROLL PROVIDER AND THE EMPLOYER OF RECORD. THE ORGANIZATION IS THE WORKSITE EMPLOYER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CEO AND CFO. A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING AND WILL BE REVIEWED AT THE NEXT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES AND BOARD MEMBERS OF WHC ARE REQUIRED BY POLICY TO REPORT POTENTIAL OR ACTUAL CONFLICTS OF INTEREST. BOARD MEMBERS, MEMBERS OF THE LEADERSHIP TEAM, AND OTHER IDENTIFIED STAFF ARE REQUIRED TO COMPLETE A DISCLOSURE OF EXTERNAL RELATIONSHIPS QUESTIONNAIRE ANNUALLY. POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE MONITORED BY AND REPORTED TO THE CHIEF PERFORMANCE AND COMPLIANCE OFFICER. BOARD MEMBERS WHO HAVE IDENTIFIED A CONFLICT OF INTEREST IN A PARTICULAR TRANSACTION OR SITUATION ARE TO REMOVE THEMSELVES FROM THE DELIBERATIONS AND DECISION-MAKING REGARDING THAT TRANSACTION OR SITUATION. EMPLOYEES WHO IDENTIFY A CONFLICT OF INTEREST WILL BE REMOVED FROM ANY LEVEL OF RESPONSIBILITY REGARDING THE TRANSACTION OR SITUATION. FAILURE TO COMPLY WITH THE POLICY OR TO DISCLOSE A POTENTIAL OR ACTUAL CONFLICT OF INTEREST WILL RESULT IN DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR REMOVAL FROM THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 PERFORMANCE OF THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS. TO DETERMINE CHIEF EXECUTIVE OFFICER (CEO) COMPENSATION, THE BOARD RECRUITMENT COMMITTEE AND/OR THE BOARD PERSONNEL COMMITTEE REVIEWS DOCUMENTS THAT INCLUDE CEO SALARY HISTORY, COMPARISONS WITH INDUSTRY SALARY DATA (FROM SALARY.COM, NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS [NACHC], HAWAII PRIMARY CARE ASSOCIATION [HPCA], CHARITYNAVIGATOR.ORG, OTHER FEDERALLY QUALIFIED HEALTH CENTER [FQHC] CEOS/EDS, ETC.), AND ANNUAL PERFORMANCE REVIEWS. THE PROCEEDINGS OF THESE COMMITTEES ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS MEETINGS. THIS PROCESS WAS LAST UNDERTAKEN IN 2019. FOR TOP MANAGEMENT AND KEY STAFF, THE CEO DETERMINES SALARIES USING INDUSTRY COMPARISONS (FROM NACHC, HPCA, ETC.), AND ANNUAL WRITTEN PERFORMANCE REVIEWS BY SUPERVISORS, PEERS, AND DIRECT REPORT STAFF. WRITTEN PERFORMANCE REVIEWS ARE KEPT ON FILE AT WHC. PERFORMANCE REVIEWS ARE UNDERTAKEN TWICE PER YEAR (MAY AND NOVEMBER) FOR ELIGIBLE EMPLOYEES. 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.