FIVE MOUNTAINS HAWAII INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- FIVE MOUNTAINS HAWAII INC (EIN 99-0330168)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-07-25
- IRS object ID
- 201622079349301377
- 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 | 2016-07-25T18:10:04-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 | 2015-01-01 | 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 | 65-1158 MAMALAHOA HWY RM/STE 2D | 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 | 2016-07-15 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GRETCHEN KREMEYER | PreparerPersonNm |
| PTIN | P00768528 | PTIN |
| Phone | 8082425002 | PhoneNum |
| Preparation | 2016-07-25 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| 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 | 65-1158 MAMALAHOA HWY STE 2D | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96743 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $565,410 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | KIPUKAKEALO.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 | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $240,705 | PYContributionsGrantsAmt |
| CY Contributions Grants | $101,627 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $168,745 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $461,038 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $2,745 | CYOtherRevenueAmt |
| PY Total Revenue | $409,450 | PYTotalRevenueAmt |
| CY Total Revenue | $565,410 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $246,684 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $587,861 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $63,063 | PYOtherExpensesAmt |
| CY Other Expenses | $100,159 | CYOtherExpensesAmt |
| PY Total Expenses | $309,747 | PYTotalExpensesAmt |
| CY Total Expenses | $688,020 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $99,703 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$122,610 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $130,765 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,006 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,960 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $39,811 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $101,805 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$20,805 | 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 | $532,791 | ExpenseAmt |
| Revenue | $463,783 | RevenueAmt |
| Desc | KIPUKA O KE OLA: DESIGNED TO PROVIDE A FULL RANGE OF BIO-PSYCHO-SOCIAL SERVICES TO THE RESIDENTS OF NORTH HAWAI'I, WITH SPECIAL FOCUS ON NATIVE HAWAIIANS. IT PROVIDES CULTURALLY-INFORMED DIRECT SERVICES, ACTIVELY COLLABORATES WITH OTHER LIKE-SPIRITED INDIVIDUALS AND ORGANIZATIONS AND IS LED BY THE COMMUNITY IN WHICH IT SERVES. | Desc |
| Total Program Service Expenses | $532,791 | 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 | false | 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 | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | 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 | 10 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 4 | 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 |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WENDY CYPRIANO | PersonNm |
| Phone | 8089366329 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65-1158 MAMALAHOA HWY 2D | AddressLine1Txt |
| City | KAMUELA | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96743 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 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 |
|---|---|---|---|---|---|---|---|
| JENNIFER BRYAN | |||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOSEPH KEALOHA | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| WALLY LAU | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BOB LINDSEY | |||||||
| VICE PRESIDE | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RUSSELL PAIO | |||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KAHU SONNY SHIMAOKA | |||||||
| PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CLAREN KEALOHA-BEAUDET PSY D | |||||||
| EXECUTIVE DI | 40.00 | 0.00 | Yes (X) | $130,170 | $0 | $0 | |
| FRANCO ACQUARO PHD | |||||||
| ASSOCIATE DI | 40.00 | 0.00 | Yes (X) | $105,843 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $236,013 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $27,400 | GovernmentGrantsAmt |
| All Other Contributions | $74,227 | AllOtherContributionsAmt |
| Total Contributions | $101,627 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INSURANCE PAYMENTS | 621300 | $436,343 | $436,343 |
| PATIENT PAYMENTS | 621300 | $24,648 | $24,648 |
| MEDICAL RECORDS | 621300 | $47 | $47 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $461,038 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Total Revenue Column | $2,745 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,745 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,745 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $565,410 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $463,783 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,013 | TotalAmt |
| Program Services | $188,810 | ProgramServicesAmt |
| Management And General | $47,203 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $351,848 | TotalAmt |
| Program Services | $281,478 | ProgramServicesAmt |
| Management And General | $70,370 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,329 | TotalAmt |
| Program Services | $1,747 | ProgramServicesAmt |
| Management And General | $582 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,367 | TotalAmt |
| Program Services | $18,275 | ProgramServicesAmt |
| Management And General | $6,092 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,449 | TotalAmt |
| Program Services | $4,837 | ProgramServicesAmt |
| Management And General | $1,612 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,525 | TotalAmt |
| Program Services | $17,644 | ProgramServicesAmt |
| Management And General | $5,881 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212 | TotalAmt |
| Program Services | $159 | ProgramServicesAmt |
| Management And General | $53 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127 | TotalAmt |
| Management And General | $127 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,813 | TotalAmt |
| Program Services | $1,360 | ProgramServicesAmt |
| Management And General | $453 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,953 | TotalAmt |
| Program Services | $3,977 | ProgramServicesAmt |
| Management And General | $3,976 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REIMBURSEMENTS | $13,589 | $10,192 | $3,397 |
| ADMINISTRATIVE EXPENSES | $12,342 | $12,342 | |
| OTHER EXPENSES | $5,107 | $3,830 | $1,277 |
| SUBSCRIPTIONS FEES | $1,480 | $1,480 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $866 | TotalAmt |
| Program Services | $482 | ProgramServicesAmt |
| Management And General | $384 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $688,020 | TotalAmt |
| Program Services | $532,791 | ProgramServicesAmt |
| Management And General | $155,229 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,744 | BOYAmt |
| EOY | $6,117 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $100 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,051 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,262 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,021 | BOYAmt |
| EOY | $12,789 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,765 | BOYAmt |
| EOY | $19,006 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284 | BOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,601 | BOYAmt |
| EOY | $9,138 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,075 | BOYAmt |
| EOY | $5,167 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $25,506 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,960 | BOYAmt |
| EOY | $39,811 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,805 | BOYAmt |
| EOY | -$20,805 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,000 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,805 | BOYAmt |
| EOY | -$20,805 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,765 | BOYAmt |
| EOY | $19,006 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$122,610 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| 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 | $173,925 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $367,409 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $115,951 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $240,705 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $101,627 | CurrentTaxYearAmt |
| Total | $999,617 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $173,925 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $367,409 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $115,951 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $240,705 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $101,627 | CurrentTaxYearAmt |
| Total | $999,617 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $999,617 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $69 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $59 | CurrentTaxYearMinus2YearsAmt |
| Total | $149 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,745 | CurrentTaxYearAmt |
| Total | $2,745 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,002,511 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $463,783 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99710 | PublicSupportCY170Pct |
| Public Support PY170 | 0.74460 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | 2,745 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,896 | OtherCostOrOtherBasisAmt |
| Depreciation | $400 | DepreciationAmt |
| Book Value | $8,496 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,155 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,862 | DepreciationAmt |
| Book Value | $4,293 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,789 | TotalBookValueLandBuildingsAmt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR CLAREN KEALOHA-BEAUDET PSYD | PersonNm |
| Relationship With Org | PHYSICIAN | RelationshipWithOrgTxt |
| Loan Purpose | GENERAL SUPPORT | LoanPurposeTxt |
| Loan To Organization | Yes (X) | LoanToOrganizationInd |
| Original Principal | $17,766 | OriginalPrincipalAmt |
| Balance Due | $5,167 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | Yes (true) | BoardOrCommitteeApprovalInd |
| Written Agreement | false | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $5,167 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 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 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 19 | GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS ALSO AVAILABLE ON GUIDESTAR.ORG. |