FIVE MOUNTAINS HAWAII INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FIVE MOUNTAINS HAWAII INC (EIN 99-0330168)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-05-31
- IRS object ID
- 202201519349300440
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-31T11:26:49-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 990303190 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARBONARO CPAS & MANAGEMENT GROUP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1885 MAIN ST STE 408 | AddressLine1Txt |
| City | WAILUKU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96793 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990330168 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FIVE MOUNTAINS HAWAII INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FIVE | BusinessNameControlTxt |
| Phone | 8088855900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 64-1035 MAMALALOHA HWY SUITE F | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96743 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLAREN KEALOHA-BEAUDET PSY D | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8088855900 | PhoneNum |
| Signature | 2022-05-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CLAREN | PersonFirstNm |
| Person Last | KEALOHA-BEAUDET | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GRETCHEN KREMEYER | PreparerPersonNm |
| PTIN | P00768528 | PTIN |
| Phone | 8082425002 | PhoneNum |
| Preparation | 2022-05-31 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KIPUKA O KE OLA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CLAREN KEALOHA-BEAUDET PSY D | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 64-1035 MAMALAHOA HWY SUITE F | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,292,413 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | KIPUKAOKEOLA.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | FIVE MOUNTAINS HAWAII PROVIDES A FULL RANGE OF BIO-PSYCHO-SOCIAL SERVICES TO THE RESIDENTS OF NORTH HAWAI'I, WITH A SPECIAL EMPHASIS ON ADDRESSING THE PHYSICAL AND MENTAL HEALTH DISPARITIES OF THE KANAKA MAOLI (NATIVE HAWAIIAN) POPULATION. THIS MISSION IS OUR KULEANA (PROFOUND RESPONSIBILITY). | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 21 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $514,775 | PYContributionsGrantsAmt |
| CY Contributions Grants | $971,843 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,015,047 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,319,201 | CYProgramServiceRevenueAmt |
| CY Investment Income | $252 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,729 | PYOtherRevenueAmt |
| CY Other Revenue | $1,117 | CYOtherRevenueAmt |
| PY Total Revenue | $1,533,551 | PYTotalRevenueAmt |
| CY Total Revenue | $2,292,413 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,122,607 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,510,346 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $44,828 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $516,428 | PYOtherExpensesAmt |
| CY Other Expenses | $462,435 | CYOtherExpensesAmt |
| PY Total Expenses | $1,639,035 | PYTotalExpensesAmt |
| CY Total Expenses | $1,972,781 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$105,484 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $319,632 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,136,780 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,321,469 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $276,493 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $141,550 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $860,287 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,179,919 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | FIVE MOUNTAINS HAWAII PROVIDES A FULL RANGE OF BIO-PSYCHO-SOCIAL SERVICES TO THE RESIDENTS OF NORTH HAWAI'I, WITH A SPECIAL EMPHASIS ON ADDRESSING THE PHYSICAL AND MENTAL HEALTH DISPARITIES OF THE KANAKA MAOLI (NATIVE HAWAIIAN) POPULATION. THIS MISSION IS OUR KULEANA (PROFOUND RESPONSIBILITY). | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,505,356 | ExpenseAmt |
| Revenue | $1,320,318 | RevenueAmt |
| Desc | KIPUKA O KE OLA: KIPUKA O KE OLA (KOKO) WAS DESIGNED TO PROVIDE A FULL RANGE OF BIO-PSYCHO- SOCIAL SERVICES IN NORTH HAWAI'I. IT STRIVES TO PROVIDE CULTURALLY-INFORMED DIRECT SERVICES, WHILE ACTIVELY COLLABORATING WITH OTHER LIKE-SPIRITED INDIVIDUALS/ORGANIZATIONS. KOKO IS PROUD TO BE LED BY THE COMMUNITY IN WHICH IT SERVES. KOKO SERVES ALL OF THE RESIDENTS OF NORTH HAWAI`I, AND GIVES SPECIAL EMPHASIS TO PROVIDING SERVICES IN A MANNER WHICH ARE CULTURALLY-SENSITIVE FOR THE NATIVE HAWAIIAN HOST CULTURE - WHICH SUFFERS FROM SIGNIFICANT HEALTH DISPARITIES. KOKO OFFERS BOTH PRIMARY CARE SERVICES AND BEHAVIORAL HEALTH SERVICES (PSYCHOLOGICAL AND PSYCHIATRIC) VIA AN INTEGRATED HEALTH MODEL KNOWN AS THE PATIENT-CENTERED MEDICAL HOME, FOR WHICH KOKO IS NATIONALLY ACCREDITED. IN ADDITION, KOKO IS ACCREDITED AS THE VERY FIRST INDEPENDENT RURAL HEALTH CLINIC IN THE STATE OF HAWAI`I, WHICH ENSURES KOKO'S STANDARDS AND PRACTICES ARE CONSISTENT WITH INDUSTRY BEST PRACTICES. | Desc |
| Total Program Service Expenses | $1,505,356 | 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 |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| 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 | Yes (true) | 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 | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | 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 | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 21 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (true) | 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 | FIVE MOUNTAINS HAWAII INC | PersonNm |
| Phone | 8088855900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 64-1035 MAMALAHOA HWY SUITE F | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96743 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| OLIVER SHIMAOKA | ||||||||
| PRESIDENT | 0.31 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LILA MALANI DEAGUIAR | ||||||||
| VICE PRESIDE | 0.31 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KATHY MANUEL | ||||||||
| SECRETARY | 0.31 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RUSSELL PAIO | ||||||||
| TREASURER | 0.31 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT K LINDSEY JR | ||||||||
| DIRECTOR | 0.31 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| WALLY LAU | ||||||||
| DIRECTOR | 0.31 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERTA KEAKEALANI | ||||||||
| DIRECTOR | 0.31 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH KEALOHA | ||||||||
| DIRECTOR | 0.31 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER BRYAN | ||||||||
| DIRECTOR | 0.31 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CLAREN KEALOHA-BEAUDET PSY D | ||||||||
| EXECUTIVE DI | 40.00 | 0.00 | Yes (X) | $149,654 | $0 | $0 | ||
| FRANCO ACQUARO PHD | ||||||||
| ASSOCIATE DI | 40.00 | 0.00 | Yes (X) | $144,654 | $0 | $0 | ||
| JOHN KURAP | ||||||||
| PROVIDER | 40.00 | 0.00 | $209,620 | $0 | $12,894 | Yes (X) | ||
| MICHAEL FARNSWORTH | ||||||||
| PROVIDER | 40.00 | 0.00 | $176,717 | $0 | $23,765 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $680,645 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $36,659 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $552,729 | GovernmentGrantsAmt |
| All Other Contributions | $419,114 | AllOtherContributionsAmt |
| Total Contributions | $971,843 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INSURANCE PAYMENTS | 621300 | $1,222,530 | $1,222,530 |
| PATIENT PAYMENTS | 621300 | $96,671 | $96,671 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,319,201 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $252 | TotalRevenueColumnAmt |
| Exclusion | $252 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL RECORDS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,117 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,117 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,117 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,292,413 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,320,318 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $252 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,308 | TotalAmt |
| Program Services | $234,005 | ProgramServicesAmt |
| Management And General | $52,106 | ManagementAndGeneralAmt |
| Fundraising | $8,197 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $927,150 | TotalAmt |
| Program Services | $737,180 | ProgramServicesAmt |
| Management And General | $164,147 | ManagementAndGeneralAmt |
| Fundraising | $25,823 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,887 | TotalAmt |
| Program Services | $131,898 | ProgramServicesAmt |
| Management And General | $29,369 | ManagementAndGeneralAmt |
| Fundraising | $4,620 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,001 | TotalAmt |
| Program Services | $97,798 | ProgramServicesAmt |
| Management And General | $21,777 | ManagementAndGeneralAmt |
| Fundraising | $3,426 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,258 | TotalAmt |
| Program Services | $11,848 | ProgramServicesAmt |
| Management And General | $7,934 | ManagementAndGeneralAmt |
| Fundraising | $476 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,899 | TotalAmt |
| Program Services | $33,861 | ProgramServicesAmt |
| Management And General | $22,677 | ManagementAndGeneralAmt |
| Fundraising | $1,361 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,883 | TotalAmt |
| Management And General | $1,883 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,762 | TotalAmt |
| Program Services | $18,301 | ProgramServicesAmt |
| Management And General | $17,766 | ManagementAndGeneralAmt |
| Fundraising | $695 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,893 | TotalAmt |
| Program Services | $114,001 | ProgramServicesAmt |
| Management And General | $35,892 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,606 | TotalAmt |
| Program Services | $6,606 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,604 | TotalAmt |
| Program Services | $1,268 | ProgramServicesAmt |
| Management And General | $336 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,546 | TotalAmt |
| Program Services | $19,803 | ProgramServicesAmt |
| Management And General | $6,743 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,880 | TotalAmt |
| Program Services | $16,568 | ProgramServicesAmt |
| Management And General | $3,312 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $90,125 | $76,160 | $13,735 | $230 |
| DUES AND SUBSCRIPTIONS | $47,438 | $6,059 | $41,379 | |
| OTHER EXPENSES | $2,285 | $2,285 | ||
| BAD DEBT EXPENSE | $1,256 | $1,256 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,972,781 | TotalAmt |
| Program Services | $1,505,356 | ProgramServicesAmt |
| Management And General | $422,597 | ManagementAndGeneralAmt |
| Fundraising | $44,828 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,794 | BOYAmt |
| EOY | $121,083 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $681,820 | BOYAmt |
| EOY | $705,228 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $156,210 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,355 | BOYAmt |
| EOY | $114,683 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,306 | BOYAmt |
| EOY | $9,306 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $334,896 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $121,837 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $239,605 | BOYAmt |
| EOY | $213,059 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,900 | BOYAmt |
| EOY | $1,900 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,136,780 | BOYAmt |
| EOY | $1,321,469 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,844 | BOYAmt |
| EOY | $94,758 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,649 | BOYAmt |
| EOY | $46,792 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,493 | BOYAmt |
| EOY | $141,550 | 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 | $860,287 | BOYAmt |
| EOY | $1,179,919 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $860,287 | BOYAmt |
| EOY | $1,179,919 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,136,780 | BOYAmt |
| EOY | $1,321,469 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $319,632 | ReconcilationRevenueExpnssAmt |
| 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 | false | FederalGrantAuditRequiredInd |
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 | $228,669 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $474,488 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $428,544 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $514,775 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $971,843 | CurrentTaxYearAmt |
| Total | $2,618,319 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $228,669 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $474,488 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $428,544 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $514,775 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $971,843 | CurrentTaxYearAmt |
| Total | $2,618,319 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $573,516 | SubstantialContributorsTotAmt |
| Public Support Total170 | $2,044,803 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $252 | CurrentTaxYearAmt |
| Total | $252 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,117 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,470 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,373 | CurrentTaxYearMinus2YearsAmt |
| Total | $35,960 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,654,531 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $5,917,264 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.77030 | PublicSupportCY170Pct |
| Public Support PY170 | 0.75530 | 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $292,850 | OtherCostOrOtherBasisAmt |
| Depreciation | $88,538 | DepreciationAmt |
| Book Value | $204,312 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,046 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,299 | DepreciationAmt |
| Book Value | $8,747 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $213,059 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,292,413 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $2,292,413 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,292,413 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,972,781 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $1,972,781 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,972,781 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | FIVE MOUNTAINS HAWAII, INC. IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3), AND EXEMPT FROM STATE INCOME TAXES UNDER SECTION 416-19 AND 416-20 OF THE HAWAII REVISED STATUTES. THEREFORE, NO PROVISION FOR FEDERAL OR STATE INCOME TAXES IS REQUIRED. THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THAT GUIDANCE, THE ORGANIZATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THE ORGANIZATION AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES FOR YEAR 2021. THE ORGANIZATION FILES ITS FORMS 990 IN THE U.S. FEDERAL JURISDICTION AND THE OFFICE OF THE STATE'S ATTORNEY GENERAL FOR THE STATE OF HAWAII. THE ORGANIZATION IS GENERALLY NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2018. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| JOHN KURAP | |||
| PROVIDER | $209,620 | $12,894 | $222,514 |
| MICHAEL FARNSWORTH | |||
| PROVIDER | $176,717 | $23,765 | $200,482 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | FIVE MOUNTAINS HAWAII PROVIDES A FULL RANGE OF BIO-PSYCHO-SOCIAL SERVICES TO THE RESIDENTS OF NORTH HAWAI'I, WITH A SPECIAL EMPHASIS ON ADDRESSING THE PHYSICAL AND MENTAL HEALTH DISPARITIES OF THE KANAKA MAOLI (NATIVE HAWAIIAN) POPULATION. THIS MISSION IS OUR KULEANA (PROFOUND RESPONSIBILITY). |
| FORM 990, PAGE 2, PART III, LINE 4A | KIPUKA O KE OLA: KIPUKA O KE OLA (KOKO) WAS DESIGNED TO PROVIDE A FULL RANGE OF BIO-PSYCHO- SOCIAL SERVICES IN NORTH HAWAI'I. IT STRIVES TO PROVIDE CULTURALLY-INFORMED DIRECT SERVICES, WHILE ACTIVELY COLLABORATING WITH OTHER LIKE-SPIRITED INDIVIDUALS/ORGANIZATIONS. KOKO IS PROUD TO BE LED BY THE COMMUNITY IN WHICH IT SERVES. KOKO SERVES ALL OF THE RESIDENTS OF NORTH HAWAI`I, AND GIVES SPECIAL EMPHASIS TO PROVIDING SERVICES IN A MANNER WHICH ARE CULTURALLY-SENSITIVE FOR THE NATIVE HAWAIIAN HOST CULTURE - WHICH SUFFERS FROM SIGNIFICANT HEALTH DISPARITIES. KOKO OFFERS BOTH PRIMARY CARE SERVICES AND BEHAVIORAL HEALTH SERVICES (PSYCHOLOGICAL AND PSYCHIATRIC) VIA AN INTEGRATED HEALTH MODEL KNOWN AS THE PATIENT-CENTERED MEDICAL HOME, FOR WHICH KOKO IS NATIONALLY ACCREDITED. IN ADDITION, KOKO IS ACCREDITED AS THE VERY FIRST INDEPENDENT RURAL HEALTH CLINIC IN THE STATE OF HAWAI`I, WHICH ENSURES KOKO'S STANDARDS AND PRACTICES ARE CONSISTENT WITH INDUSTRY BEST PRACTICES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS AND APPROVED PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD OF DIRECTORS IS REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST AND RECUSE THEMSELVES FROM VOTING IF A CONFLICT ARISES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS APPROVES COMPENSATION FOR TOP MANAGEMENT USING THE ORGANIZATION'S BUDGET AND COMPARABLE STUDIES OF SIMILAR, LOCAL ENTITIES. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE BOARD OF DIRECTORS APPROVES COMPENSATION FOR OFFICERS AND KEY EMPLOYEES USING THE ORGANIZATION'S BUDGET AND COMPARABLE STUDIES OF SIMILAR, LOCAL ENTITIES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |