2021-05-12T17:41:20-05:00 2020-06-30 930623286 ALDRICH CPAS AND ADVISORS LLP 5665 SW MEADOWS RD SUITE 200 LAKE OSWEGO OR 97035 990 2019-07-01 990222784 BAY CLINIC INC BAYC 8083333600 450 KILAUEA AVE SUITE 105 HILO HI 96720 MARCIE SAQUING CHIEF OPERATING OFFICER 8083333600 2021-05-12 1 ELSA A ROMERO P00485021 5036204489 2021-05-12 2019 2022-09-23 18:48:47Z MARCIE SAQUING 450 KILAUEA AVE SUITE 105 HILO HI 96720 18178270 0 X WWW.BAYCLINIC.ORG X 1983 HI COMMUNITY-DIRECTED HEALTHCARE ORGANIZATION THAT PROVIDES QUALITY PRIMARY AND PREVENTIVE CARE. 11 11 245 11 1396 0 1751756 4279054 14773398 13732780 7745 1418 -12692 2942 16520207 18016194 0 0 0 0 11534230 11962845 0 0 37155 5803026 5151500 17337256 17114345 -817049 901849 15002458 17990110 6108443 8148322 8894015 9841788 A COMMUNITY-DIRECTED HEALTHCARE ORGANIZATION THAT PROVIDES QUALITY PRIMARY AND PREVENTIVE CARE SERVICES TO THE PEOPLE OF EAST HAWAII. WE ENSURE THAT PATIENT CENTERED, CULTURALLY RESPONSIVE, AND AFFORDABLE HEALTHCARE SERVICES ARE LOCALLY ACCESSIBLE IN OUR COMMUNITIES. 0 0 13557493 13896252 THE BAY CLINIC INC. IS A NETWORK OF FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS SERVING 21,040 ETHNICALLY DIVERSE PATIENTS WITH 67,426 VISITS IN THE DISTRICTS OF HILO, PUNA AND KAU IN EAST AND SOUTH HAWAII ISLAND. IN THE FISCAL YEAR ENDING 2020, THE BAY CLINIC, INC. CONTINUED TO EXPAND BEHAVIORAL HEALTH ACCESS FOR THE UNDERSERVED BY PROVIDING ADDITIONAL SERVICES. BAY CLINIC'S STATE-OF-THE-ART MOBILE HEALTH UNIT IS THE FIRST DUAL USE , PRIMARY MEDICAL AND DENTAL, VEHICLE IN THE STATE THE UNIT EXPANDS ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES TO THE MOST REMOTE AND RURAL EAST HAWAI'I COMMUNITIES. 13557493 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 1 0 0 0 0 0 0 0 0 1 30 0 1 245 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X THE BAY CLINIC INC 8089614071 450 KILAUEA AVE SUITE 105 HILO HI 96720 HAROLD WALLACE FORMER CEO TERM 4.30.19 0.00 X 244662 0 27292 SHUANA PAYLOR DEPUTY MEDICAL DIRECTOR 40.00 X 191428 0 30771 YOULSAU BELLS INTERIM CEO/COO 40.00 X 191257 0 19383 MICHAEL TREECE PHYSICIAN 40.00 X 177796 0 7039 BRIAN HIGA DENTIST 40.00 X 168119 0 15445 TAMARA TODD PHYSICIAN 40.00 X 139336 0 0 ANGELA LIND PHYSICIAN 40.00 X 132002 0 0 KOA YAMASHITA DENTIST 40.00 X 121041 0 0 CHRISTIAN ALAMEDA CEO 40.00 X 65852 0 2292 DEBORAH JONES CFO 40.00 X 41059 0 696 KATHARYN DAUB BOARD CHAIR 5.00 X X 0 0 0 BRANDEE MENINO VICE CHAIR 5.00 X X 0 0 0 HAIDEE ABE DIRECTOR 1.00 X 0 0 0 PATRICIA KAY HENSLEY DIRECTOR 1.00 X 0 0 0 BRITTA ZIMMER ND DIRECTOR 1.00 X 0 0 0 MARY KENOI-OKAJIMA DIRECTOR 1.00 X 0 0 0 MIKE SAYAMA DIRECTOR 1.00 X 0 0 0 MIKE MCGEE DIRECTOR 1.00 X 0 0 0 ADAM BAUER DIRECTOR 1.00 X 0 0 0 LISSANDRA C BALDAN-JENKINS DIRECTOR 1.00 X 0 0 0 1472552 0 102918 19 1 1 0 UNIVERSITY CLINICAL EDUCATION & RESEARC PO BOX 31000 HONOLULU HI 96849 PHYSICIAN SERVICES 370793 NINU ALEXANDRI QUIRK PO BOX 5533 PAHOA HI 96778 PHYSICIAN SERVICES 283380 KARL KAHO'ONEI 151 KUAKOLU PLACE HILO HI 96720 CLEANING SERVICES 174285 3 3794820 484234 163479 4279054 PATIENT SERVICES 621110 13722109 13722109 MEDICAL RECORDS INCOME 621110 10671 10671 13732780 1418 1418 163472 162076 1396 1396 1396 REIMBURSEMENTS & REFUNDS 900999 1546 1546 1546 18016194 13732780 1396 2964 692519 692519 9217325 8350471 833102 33752 1111891 1070641 40715 535 941110 695315 242927 2868 1091963 643546 448417 294045 97120 196925 1023967 863002 160965 87147 15496 71651 553100 320798 232302 70846 50786 20060 PHARMACEUTICALS/PATIENT 703972 703972 EQUIPMENT LEASES/EXPENS 487695 165531 322164 0 OTHER EXPENSES 440609 323306 117303 0 NONCASH MEDICAL ITEMS 163479 163479 0 0 234677 94030 140647 17114345 13557493 3519697 37155 3684243 5907588 806230 780405 394220 114790 634222 1739070 198032 285803 13424686 4344656 9186904 9080030 98607 82424 15002458 17990110 1062296 730976 205154 1383394 4820122 4768850 3461 1187 17410 1263915 6108443 8148322 X 8889283 9837056 4732 4732 8894015 9841788 15002458 17990110 X 901849 45924 X 0 1 X 1 1 1 X 1469517 1950147 1652708 1751756 4279054 11103182 14183243 13689772 16078567 14773398 13732780 72457760 15652760 15639919 17731275 16525154 18011834 83560942 0 0 0 83560942 581 552 878 7745 1418 11174 581 552 878 7745 1418 11174 3479 10994 1396 15869 160 1546 1706 15656980 15640471 17743147 16532899 18016194 83589691 0.99970 0.99970 0.00010 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2525547 2525547 6061540 998272 5063268 1193539 934217 259322 1749360 976567 772793 1894700 1435600 459100 9080030 PPP LOAN 1252248 CAPITAL LEASES 11667 1263915 X 18224194 208000 208000 18016194 0 18016194 17276421 162076 162076 17114345 0 17114345 PART X, LINE 2: THE CLINIC FOLLOWS ACCOUNTING STANDARDS GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA RELATED TO THE RECOGNITION OF UNCERTAIN TAX POSITIONS. THESE STANDARDS PROVIDE DETAILED GUIDANCE FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, AND DISCLOSURE OF UNCERTAIN TAX POSITIONS. THESE STANDARDS REQUIRE AN ENTITY TO RECOGNIZE THE FINANCIAL STATEMENT IMPACT OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WOULD NOT BE SUSTAINED IF EXAMINED BY A TAXING AUTHORITY. MANAGEMENT HAS DETERMINED THAT THE CLINIC HAD NO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2020. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT RECOVERY 45,924. RENTAL EXPENSES NETTED WITH REVENUE 162,076. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH REVENUE 162,076. X 0 0 X X X X 0 0 0 0 0 0 0 0 0 HAROLD WALLACE FORMER CEO TERM 4.30.19 199812 0 44850 0 0 0 25000 0 2292 0 271954 0 0 0 SHUANA PAYLOR DEPUTY MEDICAL DIRECTOR 187719 0 3709 0 0 0 23732 0 7039 0 222199 0 0 0 YOULSAU BELLS INTERIM CEO/COO 191257 0 0 0 0 0 12344 0 7039 0 210640 0 0 0 MICHAEL TREECE PHYSICIAN 176902 0 894 0 0 0 0 0 7039 0 184835 0 0 0 BRIAN HIGA DENTIST 168119 0 0 0 0 0 8406 0 7039 0 183564 0 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES - THE ORGANIZATION MAINTAINS A MEMBERSHIP AT A LOCAL SOCIAL CLUB FOR THE PURPOSES OF MEALS WITH PROSPECTIVE AND ACTIVE EMPLOYEES, DONORS, AND BUSINESS ASSOCIATES. THE MEMBERSHIP IS UNDER THE NAME OF THE CHIEF EXECUTIVE OFFICER. DUE TO THE LIMITED AVAILABILITY OF DINING OPPORTUNITIES IN THE LOCAL AREA, THE BOARD OF DIRECTORS FEELS IT IS IMPORTANT TO HAVE THIS OPPORTUNITY AVAILABLE FOR SUCH BUSINESS PURPOSES. THIS HAS NOT BEEN TREATED AS TAXABLE COMPENSATION AS IT IS USED ONLY FOR BUSINESS PURPOSES. IN THE FALL OF 2019, BAY CLINIC, INC. TERMINATED THE MEMBERSHIP. PART I, LINE 1B THE BAY CLINIC, INC. DOES NOT HAVE A WRITTEN REIMBURSEMENT POLICY. HOWEVER, THE CEO AND THE BOARD HAVE A WRITTEN EMPLOYMENT CONTRACT, WHICH INCLUDES ACCOMMODATION FOR SPECIAL TRAVEL REQUIREMENTS THAT IS BASED ON A COMPENSATION SURVEY, AMONG OTHER THINGS, OF COMPARABLE POSITIONS, AND IS APPROVED BY THE BOARD OF DIRECTORS. CHARGES RELATED TO THE SOCIAL CLUB ARE SUBJECT TO THE SAME REVIEW/APPROVAL PROCESS AS OTHER EXPENDITURES AND ARE PAID DIRECTLY TO THE SOCIAL CLUB. X 1 163479 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE INTERIM CEO REVIEWED THE FORM 990 AND THE BOARD REVIEWED AND APPROVED THE FORM 990 AT THE MAY 2021 BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE CLINIC ESTABLISHED A CONFLICT OF INTEREST POLICY WHICH IS PRESENTED IN THE EMPLOYEE HANDBOOK. ALL EMPLOYEES ARE EXPECTED TO ADHERE TO THIS POLICY. THE ORGANIZATION REVIEWS THIS POLICY WITH NEW HIRES. MANAGEMENT MONITORS EMPLOYEES ON ANY ISSUE THAT MAY INVOLVE A CONFLICT OF INTEREST. AN ANNUAL DISCLOSURE FORM IS COMPLETED BY EACH BOARD MEMBER AND MONITORED BY THE BOARD CHAIRPERSON. IF A CONFLICT ARISES, THE ASSOCIATED BOARD PERSON MUST RECUSE THEMSELVES FROM VOTING ON RELATED MATTERS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON THE ORGANIZATION'S BUDGET, MARKET DATA FOR THE POSITION, COMPARABLE STUDIES OF SIMILAR ENTITIES, AND THE LOCAL COMPENSATION RATES. FORM 990, PART VI, SECTION C, LINE 19 THE FORM 990 IS AVAILABLE UPON REQUEST AS WELL AS ON GUIDESTAR.ORG. ALL OTHER GOVERNING DOCUMENTS AND POLICIES, INCLUDING THE CONFLICT OF INTEREST POLICY, IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: BAD DEBT RECOVERY 45,924.