COMMUNITY CLINIC OF MAUI INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY CLINIC OF MAUI INC (EIN 99-0303304)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-04-30
- IRS object ID
- 202601209349300600
- Schema version
- 2024v5.5
- 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 | 2026-04-30T01:32:26-05:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 333709623 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COHNREZNICK ADVISORY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 SYLVAN WAY | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 070543801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990303304 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY CLINIC OF MAUI INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 8088717772 | PhoneNum |
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 |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN VAZ | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8088717772 | PhoneNum |
| Signature | 2026-04-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LORI ROTHE YOKOBOSKY | PreparerPersonNm |
| PTIN | P01273422 | PTIN |
| Phone | 9732283500 | PhoneNum |
| Preparation | 2026-04-28 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN VAZ | PrincipalOfficerNm |
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) |
|---|---|---|
| Gross Receipts | $23,194,560 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://CCMAUI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COORDINATED PRIMARY CARE SERVICES TO THE COMMUNITY OF MAUI. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 245 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,038,428 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,586,039 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,462,359 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,835,161 | CYProgramServiceRevenueAmt |
| PY Investment Income | $480,087 | PYInvestmentIncomeAmt |
| CY Investment Income | $59,854 | CYInvestmentIncomeAmt |
| PY Other Revenue | $227,182 | PYOtherRevenueAmt |
| CY Other Revenue | $154,814 | CYOtherRevenueAmt |
| PY Total Revenue | $22,208,056 | PYTotalRevenueAmt |
| CY Total Revenue | $22,635,868 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,429,650 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,019,275 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,410,408 | PYOtherExpensesAmt |
| CY Other Expenses | $8,183,485 | CYOtherExpensesAmt |
| PY Total Expenses | $23,840,058 | PYTotalExpensesAmt |
| CY Total Expenses | $25,202,760 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,632,002 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,566,892 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,445,900 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,506,302 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,525,620 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,152,914 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,920,280 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,353,388 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE CULTURALLY SENSITIVE, COORDINATED PRIMARY CARE SERVICES EMPHASIZING EDUCATION, PREVENTION, AND ADVOCACY, REGARDLESS OF ONE'S ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,287,395 | ExpenseAmt |
| Revenue | $8,724,894 | RevenueAmt |
| Desc | PRIMARY CARE (ADULT, PEDIATRICS AND INTEGRATED HEALTH) PREVENTIVE HEALTH CARE INCLUDING PHYSICAL EXAMS, IMMUNIZATIONS, COMPREHENSIVE HEPATITIS B & C CARE, DIABETES EDUCATION & MANAGEMENT, HIV CARE, MANAGEMENT OF CHRONIC AND ACUTE ILLNESS, NUTRITION COUNSELING, BEHAVIORAL MANAGEMENT OF CHRONIC MEDICAL CONDITIONS, PAIN MANAGEMENT, BEHAVIOR CHANGE AND TOBACCO CESSATION, PSYCHIATRIC CONSULTATION. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,589,834 | ExpenseAmt |
| Revenue | $4,351,213 | RevenueAmt |
| Desc | WOMEN'S HEALTH (OB/GYN) INCLUDES PRENATAL CASE MANGEMENT, PRENATAL AND POSTPARTUM CARE, BREAST & CERVICAL CANCER SCREENING. FAMILY PLANNING EDUCATIONAL & CLINICAL SERVICES INCLUDES CONFIDENTIAL COUNSELING, PREGNANCY TESTING, CONTRACEPTIVE DISPENSING, PELVIC EXAMS, PAP SMEARS AND STD SCREENING. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,873,799 | ExpenseAmt |
| Revenue | $2,379,764 | RevenueAmt |
| Desc | ORAL HEALTH (DENTAL) CARE PROGRAM CONSISTS OF DIAGNOSTIC EXAMINATIONS AND X-RAYS; PREVENTIVE SERVICES SUCH AS CLEANING, FLUORIDE, AND SEALANTS; RESTORATIVE SERVICES SUCH AS FILLINGS AND CROWNS; REHABILITATIVE SERVICES INCLUDING ENDODONTICS, PERIODONTICS, AND PROSTODONTICS SUCH AS BRIDGES AND DENTURES; ORAL SURGERY SUCH AS EXTRACTIONS AND PALLIATIVE CARE; AND EMERGENCY TREATMENT FOR ORAL INFECTIONS AND INJURIES WHICH THREATEN OR HAVE THE POTENTIAL TO THREATEN A PATIENT'S LIFE. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,145,408 | ExpenseAmt |
| Revenue | $1,456,432 | RevenueAmt |
| Desc | OTHER PROGRAM SERVICES: PHARMACY - THE HEALTH CENTER PARTICIPATES IN THE 340B PRESCRIPTION DISCOUNT PROGRAM. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,145,408 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $1,456,432 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $18,896,436 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 49 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 245 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | HI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ZACHARY JOHNSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8086994661 | PhoneNum |
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 |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| AMY SCHLIFTMAN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDREA POLING | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHARLES KEOHO | ||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GERARD LIVAUDAIS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES TAVES | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LORRIN PANG MD | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARGARET BATANGAN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NICOLE GALICINAO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHARON LUND | ||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| VANESSA MEDEIROS | ||||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN R VAZ | ||||||||
| CEO | 40.00 | $295,259 | $0 | $10,150 | Yes (X) | |||
| MONIQUE VAN DER AA | ||||||||
| CFO | 40.00 | $206,992 | $0 | $11,973 | Yes (X) | |||
| ANDREW J VAN WIEREN | ||||||||
| CMO | 40.00 | $284,618 | $0 | $12,290 | Yes (X) | |||
| CASSANDRA SAVELL | ||||||||
| COO/DEPUTY CEO | 40.00 | $196,386 | $0 | $8,607 | Yes (X) | |||
| AARON ALTURA | ||||||||
| MD OB/GYN | 40.00 | $388,185 | $0 | $6,643 | Yes (X) | |||
| BETHANY AMBROSI | ||||||||
| MD OB/GYN | 40.00 | $352,155 | $0 | $8,347 | Yes (X) | |||
| DUFFY CASEY | ||||||||
| MD OB/GYN | 40.00 | $374,386 | $0 | $25,579 | Yes (X) | |||
| JAIMIE JOHNSON | ||||||||
| MD OB/GYN | 40.00 | $353,946 | $0 | $6,524 | Yes (X) | |||
| ZENA MONJI | ||||||||
| MD OB/GYN | 40.00 | $358,462 | $0 | $14,749 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,810,389 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $104,862 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTH CHOICE NETWORK | |||||
| 9064 NW 13 TERRACE | DORAL | FL | 33172 | ELECTRONIC HEALTH RECORD PROVIDER | $823,281 |
| LIGHTHOUSE HEALTHCARE ADVISORS LLC | |||||
| 14320 VENTURA BLD 408 | SHERMAN OAKS | CA | 91423 | BILLING SERVICES | $161,314 |
| EDEN GRACE YABAN | |||||
| 314 KAHIKI ST | KAHULUI | HI | 96732 | CLEANING SERVICES | $124,800 |
| DWR SECURITY LLC DBA PONO SECURITY | |||||
| 473 W RIVERSIDE DRIVE | ROSEBURG | OR | 97470 | SECURITY STAFFING | $117,851 |
| COHNREZNICK LLP | |||||
| PO BOX 1699 | ALBANY | NY | 12201 | ACCOUNTING SERVICES | $115,310 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,663,133 | GovernmentGrantsAmt |
| All Other Contributions | $1,922,906 | AllOtherContributionsAmt |
| Total Contributions | $5,586,039 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 621400 | $10,959,947 | $10,959,947 |
| OTHER THIRD-PARTY PAYORS | 621400 | $2,084,116 | $2,084,116 |
| 340B PHARMACY REVENUE | 621400 | $1,436,972 | $1,436,972 |
| MEDICARE | 621400 | $1,315,755 | $1,315,755 |
| RISK POOL REVENUE | 621400 | $555,171 | $555,171 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $483,200 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $483,200 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,835,161 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $89,617 | TotalRevenueColumnAmt |
| Exclusion | $89,617 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $528,929 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $544,940 | SecuritiesAmt |
| Other | $13,752 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$16,011 | SecuritiesAmt |
| Other | -$13,752 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$29,763 | TotalRevenueColumnAmt |
| Exclusion | -$29,763 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| PROPERTY INSURANCE SETTLEMENT | 900099 | $77,672 | $77,672 | |
| PHYSICIAN INCENTIVES | 900099 | $70,529 | $70,529 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,613 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,613 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $154,814 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,635,868 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,912,303 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $137,526 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $978,834 | TotalAmt |
| Program Services | $790,173 | ProgramServicesAmt |
| Management And General | $188,661 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,483,603 | TotalAmt |
| Program Services | $10,890,024 | ProgramServicesAmt |
| Management And General | $2,593,579 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,626 | TotalAmt |
| Program Services | $51,564 | ProgramServicesAmt |
| Management And General | $13,062 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,304,727 | TotalAmt |
| Program Services | $1,041,027 | ProgramServicesAmt |
| Management And General | $263,700 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,187,485 | TotalAmt |
| Program Services | $947,983 | ProgramServicesAmt |
| Management And General | $239,502 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $690,611 | TotalAmt |
| Management And General | $690,611 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,150 | TotalAmt |
| Management And General | $66,150 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $904,415 | TotalAmt |
| Program Services | $584,808 | ProgramServicesAmt |
| Management And General | $319,607 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,185 | TotalAmt |
| Program Services | $10,566 | ProgramServicesAmt |
| Management And General | $67,619 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,385 | TotalAmt |
| Program Services | $167,240 | ProgramServicesAmt |
| Management And General | $38,145 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,177,292 | TotalAmt |
| Program Services | $856,699 | ProgramServicesAmt |
| Management And General | $320,593 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,292 | TotalAmt |
| Program Services | $379,913 | ProgramServicesAmt |
| Management And General | $90,379 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,041 | TotalAmt |
| Program Services | $157,310 | ProgramServicesAmt |
| Management And General | $53,731 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,027 | TotalAmt |
| Program Services | $51,623 | ProgramServicesAmt |
| Management And General | $46,404 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,900 | TotalAmt |
| Program Services | $149,512 | ProgramServicesAmt |
| Management And General | $20,388 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $767,155 | TotalAmt |
| Management And General | $767,155 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,486 | TotalAmt |
| Program Services | $217,708 | ProgramServicesAmt |
| Management And General | $76,778 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES AND MATERIALS | $2,283,135 | $2,133,879 | $149,256 |
| REPAIRS AND MAINTENANCE | $411,612 | $350,488 | $61,124 |
| RECRUITMENT AND RETENTI | $149,449 | $53,822 | $95,627 |
| DUES AND SUBSCRIPTIONS | $140,648 | $24,159 | $116,489 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,702 | TotalAmt |
| Program Services | $37,938 | ProgramServicesAmt |
| Management And General | $27,764 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,202,760 | TotalAmt |
| Program Services | $18,896,436 | ProgramServicesAmt |
| Management And General | $6,306,324 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,981 | BOYAmt |
| EOY | $131,432 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,762,283 | BOYAmt |
| EOY | $2,771,889 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $582,061 | BOYAmt |
| EOY | $268,275 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,901,138 | BOYAmt |
| EOY | $1,545,096 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,963 | BOYAmt |
| EOY | $20,449 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $368,506 | BOYAmt |
| EOY | $259,879 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,150,315 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,215,769 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,064,923 | BOYAmt |
| EOY | $8,934,546 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $544,940 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $475,782 | BOYAmt |
| EOY | $329,453 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,323 | BOYAmt |
| EOY | $245,283 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,445,900 | BOYAmt |
| EOY | $14,506,302 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,033,500 | BOYAmt |
| EOY | $1,768,003 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,137,200 | BOYAmt |
| EOY | $1,305,645 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,870,393 | BOYAmt |
| EOY | $3,737,088 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $484,527 | BOYAmt |
| EOY | $342,178 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,525,620 | BOYAmt |
| EOY | $7,152,914 | 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 | $9,920,280 | BOYAmt |
| EOY | $7,353,388 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,920,280 | BOYAmt |
| EOY | $7,353,388 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,445,900 | BOYAmt |
| EOY | $14,506,302 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,566,892 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | 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 | $5,336,799 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,177,382 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,075,642 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,038,428 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,586,039 | CurrentTaxYearAmt |
| Total | $28,214,290 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,336,799 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,177,382 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,075,642 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,038,428 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,586,039 | CurrentTaxYearAmt |
| Total | $28,214,290 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $2,218,084 | SubstantialContributorsTotAmt |
| Public Support Total170 | $25,996,206 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $175 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,704 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $97,777 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $175,584 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $89,617 | CurrentTaxYearAmt |
| Total | $365,857 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $61,177 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $40,857 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,624 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $227,182 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $154,814 | CurrentTaxYearAmt |
| Total | $515,654 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $29,095,801 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $71,706,992 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.89350 | PublicSupportCY170Pct |
| Public Support PY170 | 0.92860 | 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 | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER REVENUE - 2020 AMOUNT: $ 60,970. 2021 AMOUNT: $ 40,857. 2022 AMOUNT: $ 31,624. 2023 AMOUNT: $ 120,873. 2024 AMOUNT: $ 6,613. FUNDRAISING - 2020 AMOUNT: $ 207. PROPERTY INSURANCE SETTLEMENT - 2023 AMOUNT: $ 106,309. 2024 AMOUNT: $ 77,672. PHYSICIAN INCENTIVES - 2024 AMOUNT: $ 70,529. | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,628,084 | OtherCostOrOtherBasisAmt |
| Book Value | $2,628,084 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,372,183 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,332,544 | DepreciationAmt |
| Book Value | $5,039,639 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $269,646 | OtherCostOrOtherBasisAmt |
| Depreciation | $184,480 | DepreciationAmt |
| Book Value | $85,166 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,387,852 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,698,745 | DepreciationAmt |
| Book Value | $689,107 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $492,550 | OtherCostOrOtherBasisAmt |
| Book Value | $492,550 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,934,546 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE LIABILITIES | Desc |
| Amt | $342,178 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $342,178 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,635,868 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $22,635,868 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $22,635,868 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,202,760 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,202,760 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,202,760 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT, AS OF JUNE 30, 2025 AND 2024, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2022 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DUFFY CASEY | ||||||||||||||
| MD OB/GYN | $370,574 | $0 | $3,812 | $0 | $0 | $0 | $3,744 | $0 | $21,835 | $0 | $399,965 | $0 | $0 | $0 |
| AARON ALTURA | ||||||||||||||
| MD OB/GYN | $386,185 | $0 | $2,000 | $0 | $0 | $0 | $0 | $0 | $6,643 | $0 | $394,828 | $0 | $0 | $0 |
| ZENA MONJI | ||||||||||||||
| MD OB/GYN | $353,379 | $0 | $5,083 | $0 | $0 | $0 | $0 | $0 | $14,749 | $0 | $373,211 | $0 | $0 | $0 |
| BETHANY AMBROSI | ||||||||||||||
| MD OB/GYN | $333,572 | $0 | $18,583 | $0 | $0 | $0 | $0 | $0 | $8,347 | $0 | $360,502 | $0 | $0 | $0 |
| JAIMIE JOHNSON | ||||||||||||||
| MD OB/GYN | $348,863 | $0 | $5,083 | $0 | $0 | $0 | $0 | $0 | $6,524 | $0 | $360,470 | $0 | $0 | $0 |
| JOHN R VAZ | ||||||||||||||
| CEO | $274,846 | $0 | $20,413 | $0 | $0 | $0 | $2,953 | $0 | $7,197 | $0 | $305,409 | $0 | $0 | $0 |
| ANDREW J VAN WIEREN | ||||||||||||||
| CMO | $264,370 | $0 | $20,248 | $0 | $0 | $0 | $2,846 | $0 | $9,444 | $0 | $296,908 | $0 | $0 | $0 |
| MONIQUE VAN DER AA | ||||||||||||||
| CFO | $196,992 | $0 | $10,000 | $0 | $0 | $0 | $2,070 | $0 | $9,903 | $0 | $218,965 | $0 | $0 | $0 |
| CASSANDRA SAVELL | ||||||||||||||
| COO/DEPUTY CEO | $186,386 | $0 | $10,000 | $0 | $0 | $0 | $1,964 | $0 | $6,643 | $0 | $204,993 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | INCLUDED ON SCHEDULE J, PART II COLUMN B(II) ARE AMOUNTS REPRESENTING BONUSES. THESE AMOUNTS WERE APPROVED BY THE BOARD AND INCLUDED IN THE INDIVIDUALS 2024 W2'S. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO AND CEO REVIEWS THE FORM 990 FOR ACCURACY PRIOR TO FILING. A COPY OF THE FORM 990 IS DISSEMINATED TO ALL BOARD MEMBERS FOR THEIR REVIEW AND COMMENT PRIOR TO THE FILING OF THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS REVIEW CONFLICT OF INTEREST AND PROCUREMENT CODE OF CONDUCT POLICIES ANNUALLY AND SIGN AN ACKNOWLEDGEMENT. DISINTERESTED DIRECTORS DETERMINE WHETHER ANY CONTRACT, AGREEMENT, TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND IS FAIR AND REASONABLE TO THE CORPORATION AND FURTHER DECIDE WHETHER TO ENTER INTO CONTRACT, AGREEMENT, TRANSACTION OR ARRANGEMENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE SALARY OF THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS. THE PROCEDURE FOR DETERMINING COMPENSATION IS AS FOLLOWS: 1. THE FISCAL HEALTH OF THE ORGANIZATION IS DOCUMENTED BY THE CFO AND VALIDATED BY THE FINANCE COMMITTEE, AS WELL AS THE INDEPENDENT AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS. 2. MANAGEMENT RESEARCH COMPARATIVE DATA OF CEO SALARIES FROM AT LEAST THREE COMPARABLE COMMUNITY HEALTH CENTERS IN THE STATE OF HAWAII AND FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THIS DATA WILL BE PROVIDED IN WRITING TO THE EXECUTIVE COMMITTEE OF THE BOARD, PRIOR TO DISCUSSION OF THE RECOMMENDATION FOR SALARY INCREASE IF MERITED. THE EXECUTIVE COMMITTEE MAY ALSO CONSIDER COMPENSATION SURVEYS PREPARED BY INDEPENDENT FIRMS AND WRITTEN EMPLOYMENT OFFERS FROM SIMILAR ORGANIZATIONS. 3. THE PERCENTAGE OF INCREASE FOR THE CEO WILL BE GUIDED BY THE PERCENTAGE INCREASE OFFERED TO OTHER EMPLOYEES OF CCM, AS RECOMMENDED BY THE FINANCE COMMITTEE AND THE CFO. 4. THE PERFORMANCE EVALUATION OF THE CEO SHOWS PROGRESS IN ACTUALIZING THE ORGANIZATION'S GOALS AND THE CEO'S GOALS OVER THE PREVIOUS YEAR. 5. ALL FORMS OF COMPENSATION PROVIDED TO THE CEO WILL BE TAKEN INTO ACCOUNT, INCLUDING SALARY BONUSES AND BENEFITS. 6. ALL BOARD MEMBERS PARTICIPATE IN THE EVALUATION PROCESS, BUT THE FINAL DOCUMENT WILL BE PREPARED BY THE EXECUTIVE COMMITTEE. THE FINAL DOCUMENT WILL BE PRESENTED AT A CLOSED, FULL BOD MEETING. RECOMMENDATION FOR SALARY INCREASE, IF MERITED, WILL BE PRESENTED AT THAT TIME. 7. DISCUSSION AND VOTE TO ACCEPT THE CEO'S PERFORMANCE EVALUATION AND DETERMINATION OF THE ACTUAL COMPENSATION WILL FOLLOW. 8. MEETING MINUTES WILL BE PREPARED AND APPROVED BEFORE THE LATEST: OF THE NEXT MEETING OF THE BOD OR SIXTY DAYS AFTER APPROVAL OF CEO'S COMPENSATION BY THE BOD. THE MINUTES WILL INCLUDE: (I) THE TERMS OF THE APPROVED COMPENSATION ARRANGEMENT AND THE DATE OF APPROVAL (II) THE BOARD MEMBERS PRESENT DURING DISCUSSION OF THE ARRANGEMENT AND THOSE WHO VOTED ON IT; (III) THE COMPARATIVE DATA USED AND HOW IT WAS OBTAINED; (IV) ANY ACTIONS TAKEN BY BOARD MEMBERS WHO MIGHT HAVE POTENTIAL CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTI AND (V) THE RATIONALE FOR DETERMINING THAT THE ARRANGEMENT IS REASONABLE IF IT EXCEEDS THE RANGE OF THE COMPARABILITY DATA. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST. |