2024-03-13T21:09:46-07:00 2023-06-30 990 2022-07-01 854196430 KAUAI REGION PHARMACY-WEST KAUA 8083389407 4643 WAIMEA CANYON DRIVE WAIMEA HI 96796 Christine Asato Treasurer 8083389407 2024-03-13 Christine Asato 999009999 1 1 11 0 AAL2 2022 2023-04-26 12:10:37Z LANCE SEGAWA 4643 WAIMEA CANYON DRIVE WAIMEA HI 96796 632922 0 X X 2020 HI The Corporation operates as a supporting organization to the Hawaii Health Systems Corporation (HHSC), which is an agency and instrumentality of the State of Hawaii. HHSC operates public health facilities in the State of Hawaii. In furtherance of HHSC's purposes, and to lessen the burdens of government, the Corporation operates a pharmacy serving rural communities in West Kauai and supporting Kauai Veterans Memorial Hospital, a hospital owned and operated by HHSC. 4 1 6 0 167 0 22150 0 27345 -17245 24 167 650000 650000 699519 632922 0 0 0 0 492913 485488 0 0 0 565066 634954 1057979 1120442 -358460 -487520 764647 618756 1178854 1520483 -414207 -901727 The Corporation operates as a supporting organization to the Hawaii Health Systems Corporation (HHSC), which is an agency and instrumentality of the State of Hawaii. HHSC operates public health facilities in the State of Hawaii. In furtherance of HHSC's purposes, and to lessen the burdens of government, the Corporation operates a pharmacy serving rural communities in West Kauai and supporting Kauai Veterans Memorial Hospital, a hospital owned and operated by HHSC. 0 0 659463 0 632755 The Corporation's primary program service is to operate a pharmacy serving rural communities in West Kauai and supporting Kauai Veterans Memorial Hospital, a hospital owned and operated by Hawaii Health Systems Corporation (HHSC), the 100% owned controlling entity of the Corporation. The Corporation's objective is to continue to be a critical point of access for medication prescription-filling in the West Kauai Region. 0 0 0 659463 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 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 0 1 0 0 0 1 0 0 6 1 0 0 0 0 0 0 0 0 X 4 1 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 0 0 HI X CHRISTINE ASATO 8083389407 4643 WAIMEA CANYON DRIVE WAIMEA HI 96796 LANCE SEGAWA PRESIDENT 2 40 X X 0 485000 0 RONALD FUJIMOTO VICE PRESIDENT 2 40 X X 0 334000 0 CHRISTINE ASATO SECRETARY AND TREASURER 2 40 X X 0 251000 0 KENNETH VANDENBUSSCHE PHARMACIST 40 0 X 145812 0 0 JONI TOMINAGA PHARMACIST 40 0 X 131669 0 0 277481 1070000 0 2 0 1 0 0 RETAIL PHARMACY SALES 446110 2773730 2773730 0 0 COST OF GOODS SOLD - DRUGS 446110 -976080 -976080 0 0 CONTRACTUAL ADJUSTMENT 446110 -1814895 -1814895 0 0 0 0 0 0 -17245 167 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 CONTRACTED SERVICES 446110 650000 650000 0 0 0 0 0 0 650000 632922 632755 167 0 414490 414490 35238 35238 35760 35760 420000 420000 58128 58128 2514 2514 6851 5138 1713 92223 69167 23056 61 61 21495 16121 5374 3861 0 3861 BANK & MERCHANT FEES 2332 0 2332 0 MINOR EQUIPMENT & EQUIPMENT LEASES 8515 6386 2129 0 TAXES & FREIGHT 18974 18974 0 0 1120442 659463 460979 0 254360 109410 250836 177157 24710 48312 91145 162009 16043 15810 141324 35266 127553 106058 764647 618756 0 56655 1178854 1463828 1178854 1520483 X -414207 -901727 0 0 -414207 -901727 764647 618756 -487520 0 0 0 0 0 X 0 1 X 1 0 X X X 1 HAWAII HEALTH SYSTEMS CORPORATION 943270595 6 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28398 0 1885 26513 112926 0 33381 79545 0 0 0 0 106058 ACCRUED PAYROLL 13295 ACCRUED PAYROLL TAXES 9070 ACCRUED VACATION 45348 RELATED PARTY PAYABLES 1396115 1463828 0 0 0 0 0 0 0 0 0 LANCE SEGAWA PRESIDENT 0 485000 0 0 0 0 0 0 0 0 0 485000 0 0 RONALD FUJIMOTO VICE PRESIDENT 0 334000 0 0 0 0 0 0 0 0 0 334000 0 0 CHRISTINE ASATO SECRETARY AND TREASURER 0 251000 0 0 0 0 0 0 0 0 0 251000 0 0 Form 990, Part VI, Section A, Line 2 The Directors of the Corporation: Lance Segawa, Ronald Fujimoto, and Christine Asato are all employees to Hawaii Health Systems Corporation (HHSC), Kauai Region, and maintain professional business relationships among each other. Form 990, Part VI, Section A, Line 3 The Corporation has a contract with Hawaii Health Systems Corporation (HHSC), Kauai Region, to provide comprehensive management, operational and administrative services related to the business and operations of the Corporation. These service areas include: policies and procedures, bookkeeping and accounting, recordkeeping, recruitment, insurance, planning and budgeting, contracting, day-to-day operations, compensation of Corporation employees, premises, standards of care, subcontractors, and other ventures. Form 990, Part VI, Section B, Line 11b Form 990 was fully reviewed by the finance department of the Corporation's 100% controlling entity, Hawaii Health Systems Corporation (HHSC), and reviewed by the Treasurer of the Corporation, Christine Asato. Form 990, Part VI, Section B, Line 12c The Corporation conducts periodic reviews of each director, principal officer, and member with governing board delegated powers to ensure the Corporation operates in a manner consistent with charitable purposes and does not engage in activities that could jeopardize its tax-exempt status. Form 990, Part VI, Section C, Line 19 The Corporation's governing documents, conflict of interest policy, and financial statements can be made available to the public upon request and approval. KAUAI REGION MEDICAL GROUP 4643 WAIMEA CANYON DRIVE WAIMEA HI 96796 851039176 PROVIDE MEDICAL SERVICES HI 501(c)(3) 509(a)(3) HAWAII HEALTH SYSTEMS CORPORATION 0 KAUAI REGION RECOVERY SERVICES PO BOX 669 WAIMEA HI 96796 863982630 MENTAL HEALTH TREATMENT CENTER HI 501(c)(3) 509(a)(3) HAWAII HEALTH SYSTEMS 0 HAWAII HEALTH SYSTEMS CORPORATION 3675 KILAUEA AVENUE HONOLULU HI 96816 943270595 OPERATE PUBLIC HEALTH FACILITIES HI N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 HAWAII HEALTH SYSTEMS CORPORATION l 650000 AUDITED TRIAL BALANCE FOR THE PERIOD ENDING JUNE 30, 2023. HAWAII HEALTH SYSTEMS CORPORATION m 420000 AUDITED TRIAL BALANCE FOR THE PERIOD ENDING JUNE 30, 2023. KAUAI REGION MEDICAL GROUP s 79813 AUDITED TRIAL BALANCE FOR THE PERIOD ENDING JUNE 30, 2023. HAWAII HEALTH SYSTEMS CORPORATION s 184016 AUDITED TRIAL BALANCE FOR THE PERIOD ENDING JUNE 30, 2023.