2024-05-13T14:18:36-05:00 2023-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2022-07-01 510437659 MOLOKAI OHANA HEALTH CARE INC MOLO 8085535038 PO BOX 2040 KAUNAKAKAI HI 96748 JAMES RARICK VICE PRESIDENT 8085535038 2024-05-13 1 JAMES RARICK 999009999 0 RODNEY M HARANO P00389596 8085311040 2024-05-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MOLOKAI COMMUNITY HEALTH CTR JAMES RARICK PO BOX 2040 KAUNAKAKAI HI 96748 4118159 0 X WWW.MOLOKAICHC.ORG X 2002 HI TO PROVIDE AND PROMOTE ACCESSIBLE COMPREHENSIVE INDIVIDUAL AND COMMUNITY HEALTH CARE TO THE PEOPLE OF MOLOKAI WITH RESPECT AND ALOHA. 8 8 49 8 0 0 2596810 2365867 1590045 1700048 199 -305511 81783 51977 4268837 3812381 0 0 0 0 3050725 2742255 0 0 0 1873202 2518275 4923927 5260530 -655090 -1448149 5574655 3990877 2662855 2527226 2911800 1463651 TO PROVIDE AND PROMOTE ACCESSIBLE COMPREHENSIVE INDIVIDUAL AND COMMUNITY HEALTH CARE TO THE PEOPLE OF MOLOKAI WITH RESPECT AND ALOHA. 0 0 4166154 1701181 IN CY2022 HEALTH CARE WAS PROVIDED TO 1,548 MEDICAL PATIENTS, 1,446 DENTAL PATIENTS & 244 BEHAVIORAL HEALTH PATIENTS. CHARITY CARE BENEFITS OF $12,700 WERE PROVIDED. 4166154 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 16 0 49 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 HI X RENEE A FILSON CFO 8086602608 30 OKI PLACE PO BOX 2040 KAUNAKAKAI HI 96748 GREGORY KAHN PRESIDENT 2.00 0.50 X X 0 0 0 MAHINA POEPOE VICE PRESIDENT 2.00 0.50 X X 0 0 0 JOHN NASH TREASURER 2.00 0.50 X X 0 0 0 BAHAR YAGHOUBI SECRETARY 2.00 0.50 X X 0 0 0 JAMES RARICK DIRECTOR 1.00 0.50 X 0 0 0 MAKENA FERNANDEZ DIRECTOR 1.00 0.50 X 0 0 0 MICHAEL ARCE DIRECTOR 1.00 0.50 X 0 0 0 JOWELL GUERREIRO DIRECTOR 1.00 0.50 X 0 0 0 HELEN KEKALIA CEO 40.00 2.00 X 109096 0 21513 SHANNA WILLING CFOO 40.00 2.00 X 132410 0 13820 ADAM LONG DENTIST 40.00 X 257599 0 17982 JOSEPH E HORN ASSOCIATE CLINICAL DIRECTOR 40.00 X 115531 0 8770 614636 0 62085 4 0 1 0 RAQUEL I CISNEROS PO BOX 270 KAUNAKAKAI HI 96748 MEDICAL PROVIDER 168143 1 2031528 334339 2365867 PATIENT SERVICE REVENUE 621110 1700048 1700048 1700048 267 267 50844 0 50844 50844 50844 305778 -305778 -305778 -305778 OTHER INCOME 900099 1133 1133 1133 3812381 1701181 0 -254667 280681 280681 1990167 1548061 442106 52383 38130 14253 223991 167911 56080 195033 134306 60727 51621 51621 323327 311020 12307 45613 24512 21101 80708 80611 97 184775 158305 26470 135437 112897 22540 90902 85065 5837 36723 14066 22657 81897 67090 14807 145052 131660 13392 202045 163746 38299 LOCUM SERVICES 762279 762279 SUPPLIES AND MATERIALS 206863 198471 8392 BAD DEBT 160084 160084 TAXES, LICENSES, FEES 6819 6083 736 4130 1857 2273 5260530 4166154 1094376 0 1031925 76935 602344 344723 188233 190128 452238 344985 117941 93969 3753028 826820 3181974 2926208 0 13929 5574655 3990877 456377 378054 15164 11941 1794851 1747231 396463 390000 2662855 2527226 X 2490887 1321792 420913 141859 2911800 1463651 5574655 3990877 -1448149 0 X 0 1 X 1 1 1 X 2011985 2356509 2831391 2596810 2365867 12162562 2011985 2356509 2831391 2596810 2365867 12162562 12162562 123523 82457 63353 57912 51111 378356 4120 1843 24070 1133 31166 12572084 8891327 0.96740 0.95720 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 4,120. 2019 AMOUNT: $ 1,843. 2021 AMOUNT: $ 24,070. 2022 AMOUNT: $ 1,133. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1373912 1373912 1742016 554038 1187978 637100 272782 364318 2926208 DUE TO MCHC HOLDINGS, INC. 390000 390000 X PART X, LINE 2: U.S. GAAP REQUIRES UNCERTAIN TAX POSITIONS TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IF THEY ARE MORE LIKELY THAN NOT TO FAIL UPON REGULATORY EXAMINATION. MANAGEMENT HAS EVALUATED THE ORGANIZATION'S TAX POSITIONS AS OF JUNE 30, 2023 AND 2022 AND FOR THE YEARS THEN ENDED, AND DETERMINED THAT THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED IN ACCORDANCE WITH U.S. GAAP. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS IN PROGRESS FOR ANY OPEN TAX PERIODS. X X X 0 0 0 0 0 0 0 0 0 ADAM LONG DENTIST 257599 0 0 0 0 0 10675 0 7307 0 275581 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS SENT TO ALL BOARD MEMBERS FOR REVIEW VIA EMAIL OR SHAREPOINT UPLOAD. FORM IS THEN REVIEWED BY THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED MEETING. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL BOARD MEMBERS AND OFFICERS ARE REQUIRED TO COMPLETE CONFLICT OF INTEREST FORMS AT THE BEGINNING OF EACH ANNUAL PERIOD OF THEIR TERM. THE EXECUTIVE COMMITTEE DETERMINES WHETHER A CONFLICT ARISES. IF A CONFLICT EXISTS, THE PERSON WITH THE CONFLICT IS RECUSED FROM DISCUSSIONS AND VOTING ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15 OFFICER AND KEY EMPLOYEE COMPENSATION ARE REVIEWED AND APPROVED ANNUALLY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD AND IS BASED ON HIS/HER PERFORMANCE EVALUATION AND COMPARISON WITH THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER (NACHC) SALARY AND BENEFIT REPORT WHICH COMPARES OTHER HAWAII AND NATIONAL COMMUNITY HEALTH CARE ORGANIZATIONS. THE ORGANIZATION'S FINANCIAL CONDITION AND CHANGES TO COST OF LIVING INDICES ARE ALSO CONSIDERED. THE CFOO'S COMPENSATION IS REVIEWED AND APPROVED BY THE CEO AND IS BASED ON EVALUATIONS, COMPARISON WITH OTHER COMMUNITY HEALTH CARE ORGANIZATIONS, AND THE ORGANIZATION'S FINANCIAL CONDITION. DELIBERATIONS AND DETERMINATIONS RELATED TO COMPENSATION ARE DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. MOLOKAI INVESTMENT FUND LLC 30 OKI PLACE PO BOX 2040 KAUNAKAKAI HI 96748 351236133 INV MGMT HI MOHC MCHC HOLDINGS INC 30 OKI PLACE PO BOX 2040 KAUNAKAKAI HI 96748 455433975 HOLD REAL PROPERTY HI 501(C)(2) MOHC 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 0 0 0 0