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Nonprofiteer
← KAUAI MEDICAL CLINIC

Form 990 for tax year 2022

Filed by KAUAI MEDICAL CLINIC.

Totals

Total revenue
$68,401,182
Total expenses
$68,551,182
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$68,277,395
Investment income
$123,787
Other revenue
$0
Total assets, end of year
$25,572,554
Total liabilities, end of year
$13,735,827
Net assets or fund balances, end of year
$11,836,727
Program services expenses (Part IX)
$67,248,143
Management and general expenses
$1,303,039
Fundraising expenses
$0
Program service expenses (Part III)
$67,248,143

Program services were 98.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Jay Murphy MD

    Board of Director, Vice Chair

    Total calculated
    $427,713
    From this org
    $0
    From related orgs
    $393,055
    Other
    $34,658
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $363,361 related
    Bonus
    $0 + $3,688 related
    Other
    $0 + $26,006 related
    Deferred
    $0 + $12,200 related
    Nontaxable benefits
    $0 + $22,458 related
    Filer's total
    $0 + $427,713 related

  • Raymond P Vara Jr

    Board of Director, President

    Total calculated
    $4,234,001
    From this org
    $0
    From related orgs
    $2,867,542
    Other
    $1,366,459
    Hours/week
    2 + 60.1 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,158,108 related
    Bonus
    $0 + $1,199,993 related
    Other
    $0 + $509,441 related
    Deferred
    $0 + $1,339,031 related
    Nontaxable benefits
    $0 + $27,428 related
    Filer's total
    $0 + $4,234,001 related

  • Robert Wotring II MD

    Board of Director, Chair

    Total calculated
    $345,410
    From this org
    $0
    From related orgs
    $325,923
    Other
    $19,487
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $278,844 related
    Bonus
    $0 + $1,819 related
    Other
    $0 + $45,260 related
    Deferred
    $0 + $12,200 related
    Nontaxable benefits
    $0 + $7,287 related
    Filer's total
    $0 + $345,410 related

  • Denise Roberts

    Board of Director

    Total calculated
    $0
    Hours/week
    0.2

  • Eugene Tareshawty

    Board of Director

    Total calculated
    $273,454
    From this org
    $0
    From related orgs
    $250,005
    Other
    $23,449
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $237,806 related
    Bonus
    $0 + $944 related
    Other
    $0 + $11,255 related
    Deferred
    $0 + $9,652 related
    Nontaxable benefits
    $0 + $13,797 related
    Filer's total
    $0 + $273,454 related

  • Helen Cox

    Board of Director

    Total calculated
    $0
    Hours/week
    0.2

  • Mike Murakoshi

    Board of Director

    Total calculated
    $0
    Hours/week
    0.2

  • Arthur Gladstone

    EVP & CSO

    Total calculated
    $1,398,477
    From this org
    $0
    From related orgs
    $1,076,309
    Other
    $322,168
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $523,608 related
    Bonus
    $0 + $382,770 related
    Other
    $0 + $169,931 related
    Deferred
    $0 + $297,096 related
    Nontaxable benefits
    $0 + $25,072 related
    Filer's total
    $0 + $1,398,477 related

  • Brandon Wong

    VP - part year

    Total calculated
    $317,575
    From this org
    $0
    From related orgs
    $241,460
    Other
    $76,115
    Hours/week
    0 + 47 related

    Schedule J breakdown matched by us

    Base
    $0 + $184,894 related
    Bonus
    $0 + $39,035 related
    Other
    $0 + $17,531 related
    Deferred
    $0 + $53,657 related
    Nontaxable benefits
    $0 + $22,458 related
    Filer's total
    $0 + $317,575 related

  • Carrie Ann Tsutsui

    VP & System Controller

    Total calculated
    $380,182
    From this org
    $0
    From related orgs
    $298,669
    Other
    $81,513
    Hours/week
    0.1 + 48.3 related

    Schedule J breakdown matched by us

    Base
    $0 + $226,544 related
    Bonus
    $0 + $47,628 related
    Other
    $0 + $24,497 related
    Deferred
    $0 + $68,452 related
    Nontaxable benefits
    $0 + $13,061 related
    Filer's total
    $0 + $380,182 related

  • Charles R Ching

    EVP, General Counsel & Secretary

    Total calculated
    $1,241,693
    From this org
    $0
    From related orgs
    $964,630
    Other
    $277,063
    Hours/week
    0.1 + 39.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $456,173 related
    Bonus
    $0 + $329,628 related
    Other
    $0 + $178,829 related
    Deferred
    $0 + $261,282 related
    Nontaxable benefits
    $0 + $15,781 related
    Filer's total
    $0 + $1,241,693 related

  • David Okabe

    EVP, CFO & Treasurer

    Total calculated
    $1,641,504
    From this org
    $0
    From related orgs
    $1,247,925
    Other
    $393,579
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $577,990 related
    Bonus
    $0 + $416,750 related
    Other
    $0 + $253,185 related
    Deferred
    $0 + $377,798 related
    Nontaxable benefits
    $0 + $15,781 related
    Filer's total
    $0 + $1,641,504 related

  • David Stumbaugh

    VP

    Total calculated
    $385,118
    From this org
    $0
    From related orgs
    $291,863
    Other
    $93,255
    Hours/week
    1.5 + 38.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $226,737 related
    Bonus
    $0 + $47,069 related
    Other
    $0 + $18,057 related
    Deferred
    $0 + $68,047 related
    Nontaxable benefits
    $0 + $25,208 related
    Filer's total
    $0 + $385,118 related

  • Dawn Dunbar

    SVP

    Total calculated
    $547,462
    From this org
    $0
    From related orgs
    $427,166
    Other
    $120,296
    Hours/week
    0 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $302,499 related
    Bonus
    $0 + $85,040 related
    Other
    $0 + $39,627 related
    Deferred
    $0 + $95,618 related
    Nontaxable benefits
    $0 + $24,678 related
    Filer's total
    $0 + $547,462 related

  • Dean Tateyama

    VP

    Total calculated
    $360,590
    From this org
    $0
    From related orgs
    $298,314
    Other
    $62,276
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $223,083 related
    Bonus
    $0 + $36,547 related
    Other
    $0 + $38,684 related
    Deferred
    $0 + $47,395 related
    Nontaxable benefits
    $0 + $14,881 related
    Filer's total
    $0 + $360,590 related

  • Douglas Kwock MD

    VP

    Total calculated
    $648,050
    From this org
    $0
    From related orgs
    $525,329
    Other
    $122,721
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $400,661 related
    Bonus
    $0 + $84,686 related
    Other
    $0 + $39,982 related
    Deferred
    $0 + $98,379 related
    Nontaxable benefits
    $0 + $24,342 related
    Filer's total
    $0 + $648,050 related

  • James Lin MD

    VP

    Total calculated
    $457,183
    From this org
    $0
    From related orgs
    $357,236
    Other
    $99,947
    Hours/week
    0.1 + 47.6 related

    Schedule J breakdown matched by us

    Base
    $0 + $266,760 related
    Bonus
    $0 + $56,884 related
    Other
    $0 + $33,592 related
    Deferred
    $0 + $74,975 related
    Nontaxable benefits
    $0 + $24,972 related
    Filer's total
    $0 + $457,183 related

  • Jennie Chahanovich

    CEO

    Total calculated
    $1,080,179
    From this org
    $0
    From related orgs
    $856,593
    Other
    $223,586
    Hours/week
    10 + 46.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $387,841 related
    Bonus
    $0 + $300,659 related
    Other
    $0 + $168,093 related
    Deferred
    $0 + $210,204 related
    Nontaxable benefits
    $0 + $13,382 related
    Filer's total
    $0 + $1,080,179 related

  • Jessica Lewis

    Assistant Corporate Secretary

    Total calculated
    $215,579
    From this org
    $0
    From related orgs
    $171,486
    Other
    $44,093
    Hours/week
    2.5 + 37.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $170,929 related
    Bonus
    $0
    Other
    $0 + $557 related
    Deferred
    $0 + $17,065 related
    Nontaxable benefits
    $0 + $27,028 related
    Filer's total
    $0 + $215,579 related

  • John McNamara

    SVP & CMO

    Total calculated
    $473,637
    From this org
    $0
    From related orgs
    $413,407
    Other
    $60,230
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $311,476 related
    Bonus
    $0 + $57,312 related
    Other
    $0 + $44,619 related
    Deferred
    $0 + $50,723 related
    Nontaxable benefits
    $0 + $9,507 related
    Filer's total
    $0 + $473,637 related

  • Katie Shigemitsu

    Compliance Officer

    Total calculated
    $262,033
    From this org
    $0
    From related orgs
    $229,191
    Other
    $32,842
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $223,306 related
    Bonus
    $0
    Other
    $0 + $5,885 related
    Deferred
    $0 + $23,670 related
    Nontaxable benefits
    $0 + $9,172 related
    Filer's total
    $0 + $262,033 related

  • Leslie Chun MD

    EVP

    Total calculated
    $1,291,406
    From this org
    $0
    From related orgs
    $1,005,675
    Other
    $285,731
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $545,441 related
    Bonus
    $0 + $365,197 related
    Other
    $0 + $95,037 related
    Deferred
    $0 + $258,279 related
    Nontaxable benefits
    $0 + $27,452 related
    Filer's total
    $0 + $1,291,406 related

  • Lorrie-Ann Luke

    VP

    Total calculated
    $392,617
    From this org
    $0
    From related orgs
    $300,099
    Other
    $92,518
    Hours/week
    0.5 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $225,129 related
    Bonus
    $0 + $46,653 related
    Other
    $0 + $28,317 related
    Deferred
    $0 + $67,446 related
    Nontaxable benefits
    $0 + $25,072 related
    Filer's total
    $0 + $392,617 related

  • Louise Fukumoto

    VP

    Total calculated
    $352,864
    From this org
    $0
    From related orgs
    $289,643
    Other
    $63,221
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $223,039 related
    Bonus
    $0 + $36,547 related
    Other
    $0 + $30,057 related
    Deferred
    $0 + $48,104 related
    Nontaxable benefits
    $0 + $15,117 related
    Filer's total
    $0 + $352,864 related

  • Michael Robinson

    VP

    Total calculated
    $440,836
    From this org
    $0
    From related orgs
    $358,366
    Other
    $82,470
    Hours/week
    0.2 + 49.8 related

    Schedule J breakdown matched by us

    Base
    $0 + $272,152 related
    Bonus
    $0 + $56,686 related
    Other
    $0 + $29,528 related
    Deferred
    $0 + $72,633 related
    Nontaxable benefits
    $0 + $9,837 related
    Filer's total
    $0 + $440,836 related

  • Peter Lewis

    VP & Chief Information Security Officer

    Total calculated
    $367,324
    From this org
    $0
    From related orgs
    $329,209
    Other
    $38,115
    Hours/week
    0.1 + 39.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $265,114 related
    Bonus
    $0 + $40,549 related
    Other
    $0 + $23,546 related
    Deferred
    $0 + $36,795 related
    Nontaxable benefits
    $0 + $1,320 related
    Filer's total
    $0 + $367,324 related

  • Reina (France) Graves

    Privacy Officer

    Total calculated
    $166,704
    From this org
    $0
    From related orgs
    $131,213
    Other
    $35,491
    Hours/week
    1.5 + 38.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $130,089 related
    Bonus
    $0
    Other
    $0 + $1,124 related
    Deferred
    $0 + $12,776 related
    Nontaxable benefits
    $0 + $22,715 related
    Filer's total
    $0 + $166,704 related

  • Shilpa Patel MD

    SVP & CQO

    Total calculated
    $502,790
    From this org
    $0
    From related orgs
    $405,247
    Other
    $97,543
    Hours/week
    0.8 + 39.2 related

    Schedule J breakdown matched by us

    Base
    $0 + $311,682 related
    Bonus
    $0 + $85,243 related
    Other
    $0 + $8,322 related
    Deferred
    $0 + $73,975 related
    Nontaxable benefits
    $0 + $23,568 related
    Filer's total
    $0 + $502,790 related

  • Steven Robertson

    EVP & CIO

    Total calculated
    $1,634,068
    From this org
    $0
    From related orgs
    $1,350,885
    Other
    $283,183
    Hours/week
    0 + 52.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $470,116 related
    Bonus
    $0 + $369,600 related
    Other
    $0 + $511,169 related
    Deferred
    $0 + $267,402 related
    Nontaxable benefits
    $0 + $15,781 related
    Filer's total
    $0 + $1,634,068 related

  • Sunshine Topping

    SVP

    Total calculated
    $563,532
    From this org
    $0
    From related orgs
    $441,947
    Other
    $121,585
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $323,136 related
    Bonus
    $0 + $86,940 related
    Other
    $0 + $31,871 related
    Deferred
    $0 + $97,176 related
    Nontaxable benefits
    $0 + $24,409 related
    Filer's total
    $0 + $563,532 related

  • Troy Branstetter

    VP

    Total calculated
    $367,774
    From this org
    $0
    From related orgs
    $297,700
    Other
    $70,074
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $224,128 related
    Bonus
    $0 + $45,156 related
    Other
    $0 + $28,416 related
    Deferred
    $0 + $62,589 related
    Nontaxable benefits
    $0 + $7,485 related
    Filer's total
    $0 + $367,774 related

  • Warren Chaiko

    SVP

    Total calculated
    $527,444
    From this org
    $0
    From related orgs
    $404,477
    Other
    $122,967
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $270,546 related
    Bonus
    $0 + $77,019 related
    Other
    $0 + $56,912 related
    Deferred
    $0 + $95,145 related
    Nontaxable benefits
    $0 + $27,822 related
    Filer's total
    $0 + $527,444 related

  • William Burke

    VP

    Total calculated
    $410,879
    From this org
    $0
    From related orgs
    $320,250
    Other
    $90,629
    Hours/week
    0 + 52 related

    Schedule J breakdown matched by us

    Base
    $0 + $240,487 related
    Bonus
    $0 + $51,106 related
    Other
    $0 + $28,657 related
    Deferred
    $0 + $73,234 related
    Nontaxable benefits
    $0 + $17,395 related
    Filer's total
    $0 + $410,879 related

  • Amber Elkington

    Manager

    Total calculated
    $175,428
    From this org
    $141,654
    From related orgs
    $0
    Other
    $33,774
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $128,326
    Bonus
    $7,802
    Other
    $5,526
    Deferred
    $10,922
    Nontaxable benefits
    $22,852
    Filer's total
    $175,428

  • Gail Lerch

    Former Officer

    Total calculated
    $251,515
    From this org
    $0
    From related orgs
    $232,089
    Other
    $19,426
    Hours/week
    0.5 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $18,658 related
    Bonus
    $0
    Other
    $0 + $213,431 related
    Deferred
    $0 + $15,683 related
    Nontaxable benefits
    $0 + $3,743 related
    Filer's total
    $0 + $251,515 related

  • Geri Young MD

    Former Officer

    Total calculated
    $338,165
    From this org
    $0
    From related orgs
    $320,752
    Other
    $17,413
    Hours/week
    20 + 5.3 related

    Schedule J breakdown matched by us

    Base
    $0 + $164,084 related
    Bonus
    $0 + $503 related
    Other
    $0 + $156,165 related
    Deferred
    $0 + $8,603 related
    Nontaxable benefits
    $0 + $8,810 related
    Filer's total
    $0 + $338,165 related

  • Kenneth B Robbins MD

    Former Officer

    Total calculated
    $276,195
    From this org
    $0
    From related orgs
    $236,660
    Other
    $39,535
    Hours/week
    6.5 + 48.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $236,660 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $25,194 related
    Nontaxable benefits
    $0 + $14,341 related
    Filer's total
    $0 + $276,195 related

  • Melinda Ashton MD

    Former Officer

    Total calculated
    $1,046,603
    From this org
    $0
    From related orgs
    $810,453
    Other
    $236,150
    Hours/week
    0.1 + 49.2 related

    Schedule J breakdown matched by us

    Base
    $0 + $276,841 related
    Bonus
    $0 + $395,535 related
    Other
    $0 + $138,077 related
    Deferred
    $0 + $221,243 related
    Nontaxable benefits
    $0 + $14,907 related
    Filer's total
    $0 + $1,046,603 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, HAWAI'I PACIFIC HEALTH ('HPH'), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, FORM 990, PART VI, SECTION B, LINE 15A FOR THE PROCESS USED BY HPH TO DETERMINE COMPENSATION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE RESTORATION PLAN WAS DESIGNED TO RESTORE BENEFITS THAT ARE LOST DUE TO LIMITS IMPOSED BY SECTIONS 401 AND 415 OF THE INTERNAL REVENUE CODE ON COMPENSATION CONSIDERED UNDER SUCH PLANS. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $212,216 DAVID OKABE - $141,318 GAIL LERCH - $46,032 STEVEN ROBERTSON - $87,981 CHARLES R. CHING - $56,494 ARTHUR GLADSTONE - $65,492 JENNIE CHAHANOVICH - $32,725 MELINDA ASHTON, M.D. - $52,872 LESLIE CHUN, M.D. - $41,152 ANNUAL INCENTIVE PLAN THE ANNUAL INCENTIVE PLAN IS AFFORDED TO EXECUTIVES BASED ON ANNUAL SYSTEM GOALS THAT ARE NOT BASED ON A PERCENTAGE OF NET EARNINGS. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $1,199,993 DAVID OKABE - $416,750 STEVEN ROBERTSON - $339,600 CHARLES R. CHING - $329,628 ARTHUR GLADSTONE - $382,770 MELINDA ASHTON, M.D. - $345,535 LESLIE CHUN, M.D. - $365,197 DAWN DUNBAR - $85,040 WARREN CHAIKO - $77,019 DOUGLAS KWOCK, M.D. - $84,686 MICHAEL ROBINSON - $56,686 DAVID STUMBAUGH - $47,069 LORRIE-ANN LUKE - $46,653 JAMES LIN, M.D. - $56,129 CARRIE ANN TSUTSUI - $47,628 WILLIAM BURKE - $51,106 SUNSHINE TOPPING - $86,940 TROY BRANSTETTER - $45,156 BRANDON WONG - $39,035 JENNIE CHAHANOVICH - $280,659 JOHN MCNAMARA - $57,312 SHILPA PATEL - $51,188 DEAN TATEYAMA - $24,078 LOUISE FUKUMOTO - $24,078 PETER LEWIS - $40,549 RETENTION INCENTIVE PLAN THE RETENTION INCENTIVE PLAN WAS DESIGNED TO ENCOURAGE CONTINUED INTEREST IN THE SUCCESS OF THE ORGANIZATION AND PROVIDE COMPETITIVE RETIREMENT BENEFITS. THE SOLE PLAN PARTICIPANT IS HAWAI'I PACIFIC HEALTH'S CHIEF EXECUTIVE OFFICER, RAYMOND P. VARA JR. THE PLAN DOES NOT REPLACE THE ANNUAL AND LONG-TERM INCENTIVE PLAN NOR THE SERP RESTORATION PLAN. AMOUNTS PAID OUT DURING THE YEAR BY THE ORGANIZATION: RAYMOND P. VARA JR. - $331,845

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
15 May 2024
IRS schema version
2022v5.0
Source object
202431369349315998

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