2025-04-29T00:20:26-05:00 2024-06-30 333709623 COHNREZNICK ADVISORY LLC 14 SYLVAN WAY PARSIPPANY NJ 070543801 990 2023-07-01 990303304 COMMUNITY CLINIC OF MAUI INC COMM 8088717772 1881 NANI STREET WAILUKU HI 96793 JOHN VAZ CHIEF EXECUTIVE OFFICER 8088717772 2025-04-23 1 1 LORI ROTHE YOKOBOSKY P01273422 9732283500 2025-04-23 2023 2025-03-06 01:10:19Z JOHN VAZ 1881 NANI STREET WAILUKU HI 96793 22208056 0 X HTTPS://CCMAUI.ORG X 1993 HI TO PROVIDE COORDINATED PRIMARY CARE SERVICES TO THE COMMUNITY OF MAUI. 9 9 218 10 0 0 7075642 5038428 13799374 16462359 95601 480087 31624 227182 21002241 22208056 0 0 0 0 13465058 16429650 0 0 0 7151426 7410408 20616484 23840058 385757 -1632002 17154282 17445900 5779330 7525620 11374952 9920280 X TO PROVIDE CULTURALLY SENSITIVE, COORDINATED PRIMARY CARE SERVICES EMPHASIZING EDUCATION, PREVENTION, AND ADVOCACY, REGARDLESS OF ONE'S ABILITY TO PAY. 0 0 9447486 8816675 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. 5155572 3770604 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. 2744742 2928615 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. 735025 1001359 OTHER PROGRAM SERVICES: PHARMACY - THE HEALTH CENTER PARTICIPATES IN THE 340B PRESCRIPTION DISCOUNT PROGRAM. 735025 1001359 18082825 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 46 0 1 218 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 HI X MONIQUE VAN DER AA 8088717772 1881 NANI STREET WAILUKU HI 96793 ANDREA POLING DIRECTOR 1.00 X 0 0 0 CHARLES KEOHO TREASURER 2.00 X X 0 0 0 ELPIDIO BUCANEG JR DIRECTOR 1.00 X 0 0 0 GERARD LIVAUDAIS DIRECTOR 1.00 X 0 0 0 JAMES TAVES DIRECTOR 1.00 X 0 0 0 KAREY KAPOI OUTGOING DIRECTOR 1.00 X 0 0 0 LORRIN PANG MD VICE PRESIDENT 1.00 X X 0 0 0 NICOLE GALICINAO DIRECTOR 1.00 X 0 0 0 SHARON LUND SECRETARY 1.00 X X 0 0 0 VANESSA MEDEIROS PRESIDENT 2.00 X X 0 0 0 JOHN R VAZ CEO 40.00 X 296704 0 8719 MONIQUE VAN DER AA CFO 40.00 X 202195 0 10899 ANDREW J VAN WIEREN CMO 40.00 X 282191 0 9420 CASSANDRA SAVELL COO/DEPUTY CEO 40.00 X 191895 0 7346 AARON M ALTURA MD OB/GYN 40.00 X 385102 0 6403 JAIMIE JOHNSON MD OB/GYN 40.00 X 345483 0 6239 MICHAEL C AARONOFF MD OB/GYN 40.00 X 375973 0 8396 TIGIST MAMMO MD INTERNAL MEDICINE 40.00 X 234725 0 6459 ZENA MONJI MD OB/GYN 40.00 X 351054 0 14743 2665322 0 78624 30 0 1 0 CORONIS HEALTH RCM LLC PO BOX 790372 ST LOUIS MO 63179 BILLING SERVICES 620152 ALLIANCE OF CHICAGO 215 W OHIO 4TH FLOOR CHICAGO IL 60654 IT SERVICES 359185 EDEN GRACE YABAN 314 KAHIKI ST KAHULUI HI 96732 CLEANING SERVICES 129896 ALLTEMP INC 239 E PAPA PLACE UNIT 10 KAHULUI HI 96732 AIRCONDITIONER MAINTENANCE SERVICES 112532 DWR SECURITY LLC DBA PONO SECURITY 473 W RIVERSIDE DRIVE ROSEBURG OR 97470 SECURITY STAFFING 111708 5 3268696 1769732 25575 5038428 MEDICAID 621400 10558515 10558515 OTHER THIRD-PARTY PAYORS 621400 2247869 2247869 MEDICARE 621400 1263898 1263898 340B PHARMACY REVENUE 621400 1001359 1001359 RISK POOL REVENUE 621400 811081 811081 579637 579637 16462359 175584 175584 304503 0 304503 304503 304503 PROPERTY INSURANCE SETTLEMENT 900099 106309 106309 120873 54894 65979 227182 22208056 16517253 0 652375 1026191 838863 187328 13017728 10649011 2368717 55994 44950 11044 1164449 934770 229679 1165288 955602 209686 133472 133472 54560 54560 1410293 1143418 266875 226 84 142 185310 142312 42998 793003 518030 274973 358874 261116 97758 174418 112267 62151 109796 63589 46207 175138 175138 948464 948464 203905 154414 49491 SUPPLIES AND MATERIALS 2105946 1814148 291798 REPAIRS AND MAINTENANCE 498147 390520 107627 DUES AND SUBSCRIPTIONS 106755 39898 66857 RECRUITMENT AND RETENTI 104609 8688 95921 47492 11145 36347 23840058 18082825 5757233 0 227909 245981 3878024 2762283 610331 582061 1534772 2901138 35820 17963 259964 368506 21518416 12453493 9143662 9064923 367610 544940 419584 475782 676606 482323 17154282 17445900 1298713 2033500 53311 1137200 3998461 3870393 428845 484527 5779330 7525620 X 11374952 9920280 11374952 9920280 17154282 17445900 -1632002 177330 0 X 0 1 X 1 1 1 X 5798354 5336799 5177382 7075642 5038428 28426605 5798354 5336799 5177382 7075642 5038428 28426605 1418275 27008330 22299 175 2704 97777 175584 298539 289 61177 40857 31624 227182 361129 29086273 63408861 0.92860 0.93490 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2020 AMOUNT: $ 60,970. 2021 AMOUNT: $ 40,857. 2022 AMOUNT: $ 31,624. 2023 AMOUNT: $ 120,873. FUNDRAISING - 2019 AMOUNT: $ 289. 2020 AMOUNT: $ 207. PROPERTY INSURANCE SETTLEMENT - 2023 AMOUNT: $ 106,309. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2628084 2628084 15971899 10785958 5185941 223548 176669 46879 2179363 1490866 688497 515522 515522 9064923 OPERATING LEASE LIABILITIES 484527 484527 X 22385386 177330 177330 22208056 0 22208056 23840058 0 23840058 0 23840058 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT, AS OF JUNE 30, 2024 AND 2023, 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 2021 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. X X X 0 0 0 0 0 0 0 1 0 AARON M ALTURA MD OB/GYN 383102 0 2000 0 0 0 0 0 6403 0 391505 0 0 0 MICHAEL C AARONOFF MD OB/GYN 373973 0 2000 0 0 0 1993 0 6403 0 384369 0 0 0 ZENA MONJI MD OB/GYN 347054 0 4000 0 0 0 0 0 14743 0 365797 0 0 0 JAIMIE JOHNSON MD OB/GYN 341483 0 4000 0 0 0 0 0 6239 0 351722 0 0 0 JOHN R VAZ CEO 271704 0 25000 0 0 0 1762 0 6957 0 305423 0 0 0 ANDREW J VAN WIEREN CMO 259066 0 23125 0 0 0 1323 0 8097 0 291611 0 0 0 TIGIST MAMMO MD INTERNAL MEDICINE 225975 0 8750 0 0 0 0 0 6459 0 241184 0 0 0 MONIQUE VAN DER AA CFO 192195 0 10000 0 0 0 1151 0 9748 0 213094 0 0 0 CASSANDRA SAVELL COO/DEPUTY CEO 181895 0 10000 0 0 0 943 0 6403 0 199241 0 0 0 PART I, LINE 7 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 2023 W2'S. X 1 25575 FMV 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS NUMBER OF CONTRIBUTORS. 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.