2023-05-15T11:44:05-05:00 2022-06-30 FORVIS LLP 77 W UNIVERSITY DR MESA AZ 85201 990 2021-07-01 860253158 Hacienda Inc % LAURA WORTHY HACI 6022434231 1402 E South Mountain Avenue Phoenix AZ 85042 PERRY PETRILLI CEO 6022434231 2023-05-15 true Perry Petrilli 999009999 Jeffrey A Bither P01428424 4808346030 3 2021 2023-04-26 12:10:37Z PERRY PETRILLI 1402 E South Mountain Avenue Phoenix AZ 85042 25663909 false X WWW.HACIENDAINC.ORG/ X 1970 AZ PROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN 5 5 499 5 0 8717959 7651008 16073335 17954022 -19470 40684 0 0 24771824 25645714 48341 0 0 0 15409911 17125301 0 0 0 5860341 4748061 21318593 21873362 3453231 3772352 14483649 14506862 9493890 6228494 4989759 8278368 X PROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN false true 12187271 10592873 INTERMEDIATE CARE FACILITY: THE ORGANIZATION OPERATES A STATE OF THE ART FACILITY WHICH OFFERS THREE SPECIALIZED PROGRAMS. THE HOSPITAL-TO-HOME PROGRAM PROVIDES SHORT-TERM MEDICAL INTERVENTION TO SPEED RECOVERY AND TO ALLOW PATEINTS TO RETURN HOME AS QUICKLY AS POSSIBLE. THIS PROGRAM ALSO PROVIDES FAMILY MEMBERS AND OTHER CAREGIVERS THE TRAINING NEEDED TO CARE FOR THEIR CHILD AT HOME. THE RESPITE CARE PROGRAM PROVIDES SHORT-TERM CARE TO PATIENTS WHILE FAMILIES TAKE TIMEOUT OR ATTEND TO OTHER MATTERS. THE RESIDENTIAL CARE PROGRAM PROVIES LONG-TERM CARE FOR CHRONICALLY ILL PATIENTS SUCH AS MEDICAL AND THERAPEUTIC SERVICES, ON CAMPUS AND PUBLIC SCHOOL EDUCATION, SOCIAL AND RECREATIONAL ACTIVITIES, AND PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES. 7023173 6104367 GROUP HOMES, MEDICAL GROUP HOMES: THE ORGANIZATION OPERATES SEVEN GROUP HOMES IN THE COMMUNITY; FOUR OF THAT ARE MEDICAL FACILITIES AND TWO TRADITIONAL GROUP HOMES AND ONE INDIVIDUAL DESIGNED LIVING ARRANGEMENT IDLA HOME. THE TWO TRADITIONAL GROUP HOMES OFFER 24-HOUR SUPERVISION, THE TEACHING OF HABILITATION SKILLS, DAILY LIVING SKILLS AND INTEGRATION INTO THE COMMUNITY. IN ADDITION TO THE OPPORTUNITIES PROVIDED IN THE TRADITIONAL GROUP HOME SETTING, THE MEDICAL GROUP HOME FACILITIES OFFER AROUND-THE-CLOCK MEDICAL SUPERVISION BY LICENSED PRACTICAL NURSES AND SUPERVISION BY A REGISTERED NURSE. THE INDIVIDUALS IN THESE HOMES REQUIRE SPECIFIC MEDICAL SUPERVISION BY TRAINED PERSONNEL. INDEPENDENT LIVING: THE ORGANIZATION OPERATES AN INDIVIDUAL LIVING PROGRAM WHICH IS DESIGNED TO PROVIDE ASSISTANCE TO PEOPLE WHO LIVE INDEPENDENTLY IN THEIR OWN HOME. PEOPLE WHO ARE SUPPORTED IN THE IDLA PROGRAM RECEIVE SUPPORT BASED ON THEIR LEVEL OF NEED. INDIVIDUALS MAY NEED SUPPORT RANGING FROM AS FEW AS FIVE HOURS PER WEEK TO AS MANY AS FIFTY HOURS PER WEEK. MEMBERS OF THE IDLA PROGRAM RENT OR OWN THEIR HOME AND PAY THE COSTS ASSOCIATED WITH LIVING EXPENSES THROUGH WAGES THEY EARN WORKING IN THEIR JOBS. 1239383 1077241 THE ORGANIZATION OPERATES A DAY TREATMENT program for adults and teenagers with developmental disabilities. 206564 179540 The organization operates a group supported employment program to assess and develop their work skills. 206564 179540 20656391 true true false false false false false false false true true false false false true true true false false false false false false false false false false false false true false false false false false false false false true false false false false true true true false false true 20 0 true 499 true false false false false false false false false false false false false X 5 5 false false false false false false false true true false false false true true true true true true true false AZ X LAURA WORTHY 6022434231 1402 E SOUTH MOUNTAIN AVENUE PHOENIX AZ 85042 PERRY PETRILLI CEO 36.0 4.0 X 248030 0 0 LAURA WORTHY CFO 36.0 4.0 X 182310 0 2526 Kathleen Boegler LPN DRIVER 60.0 0.0 X 166563 0 3187 TERESA DUNLAP DIRECTOR OF NURSING 40.0 0.0 X 150424 0 4722 LINDA STILLMAN DIRECTOR OF HUMAN RESOURCES 36.0 4.0 X 135758 0 4080 DEBI KULKAY DIRECTOR OF REVENUE CYCLE 40.0 0.0 X 114906 0 983 JOON BAIK GROUP HOME/DTA/GSE ADMINISTRAT 40.0 0.0 X 103898 0 0 Gary Orman Board President 1.0 1.0 X X 0 0 0 GEORGE SABOL BOARD VICE PRESIDENT 1.0 1.0 X X 0 0 0 JANET WEIGEL SECRETARY 1.0 1.0 X X 0 0 0 MIKE WADE TREASURER 1.0 1.0 X X 0 0 0 ALEXANDER RYAN BOARD MEMBER 1.0 1.0 X 0 0 0 1101889 0 15498 21 false true false 0 3204440 4242194 204374 148442 7651008 GOVERNMENT PATIENT SERVICE REVENUE 623990 17954022 17954022 17954022 58879 58879 0 0 0 0 0 18195 -18195 -18195 -18195 0 0 0 0 0 0 0 0 0 0 25645714 17954022 40684 0 0 0 0 432886 432886 0 13788551 13788551 0 373575 373575 0 1467724 1467724 0 1062565 901642 160923 0 127864 127864 49208 49208 0 0 18269 18269 283300 282089 1211 29467 23673 5794 8836 48 8788 59627 2056 57571 0 491932 419748 72184 0 0 0 1075 1075 0 723164 583820 139344 1839373 887265 952108 SUPPLIES 1063167 1039784 23383 EQUIPMENT EXPENSE 241840 210199 31641 FOOD 173601 173466 135 BAD DEBT EXPENSE 22574 22574 0 -385236 480177 -865413 21873362 20656391 1216971 0 281133 1008042 0 0 0 0 1491043 1635030 0 0 0 0 0 0 159844 118951 477666 249386 16125069 6447065 9839492 9678004 2234471 1817449 0 0 0 0 0 0 0 0 14483649 14506862 1108229 1475374 0 0 0 0 0 0 0 0 0 0 55093 48153 7840613 3790648 489955 914319 9493890 6228494 X 4965251 8261787 24508 16581 4989759 8278368 14483649 14506862 3772352 -483743 X X false true X false true false X 395974 199071 11760904 8669618 7651008 28676575 24551025 20665536 17506724 16073335 17954022 96750642 0 0 0 24946999 20864607 29267628 24742953 25605030 125427217 2500 3700 1750 2175 17400 27525 0 2500 3700 1750 2175 17400 27525 125399692 9327 8690 34936 14010 58879 125842 0 9327 8690 34936 14010 58879 125842 0 0 24956326 20873297 29302564 24756963 25663909 125553059 0.99878 0.99860 0.00100 0.00060 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3200 3200 3200 3200 38279 35079 3200 41561 3282 38279 104076 54089 116604 41561 1.00000 false false 74000 74000 9751721 2616819 7134902 3192399 1697482 1494917 1117942 951339 166603 1989007 1181425 807582 9678004 0 DEFERRED COMPENSATION LIABILITY 173829 DEFERRED SEVERANCE 240490 SBA LOAN 500000 914319 X 25121128 -483743 -40843 -524586 25645714 25645714 21832519 21832519 40843 40843 21873362 SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: The Organization is exempt from federal and state income taxes under Section 501(c)(3) of the Internal Revenue Code (the "IRC") and similar state provisions. However, income from certain activities not directly related to the Organization's tax-exempt purpose may be subject to taxation as unrelated business income. In addition, the Organization qualifies for the charitable contribution deduction under Section 170(b)(1)(A)(iii) of the IRC and has been classified as an organization other than a private foundation under Section 509(a)(1) of the IRC. The Organization has provided for income taxes on its unrelated business income, which have not been significant, as required by Section 512 of the Code. The Organization accounts for the effect of any uncertain tax positions based on whether it is "more-likely-than-not" that the position will be sustained by the taxing authority upon examination. The Organization routinely evaluates potential uncertain tax positions. The Organization has identified its status as an exempt organization as a tax position; however, the Organization has determined that such tax position does not result in an uncertainty that requires recognition. The Organization files informational and income tax returns in the U.S. federal jurisdiction. As of June 30, 2022, U.S. federal informational and income tax returns for the three most recent years. Interest and penalties, if any, are accrued as a component of management and general expenses when assessed. SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUES PER AUDITED FINANCIALS TO TAX RETURN: Bad Debt Expense $(22,574) INVESTMENT FEES (18,269) ----------------------------------------- TOTAL (40,843) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIALS TO TAX RETURN: Bad Debt Expense $22,574 INVESTMENT FEES 18,269 --------------------------------------- TOTAL 40,843 SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS: TO USE THE INTEREST EARNINGS TO FUND THE ORGANIZATION'S PROGRAM SERVICES AND GENERAL OPERATIONS. X X X false false false false false false false true false PERRY PETRILLI CEO 214762 0 0 0 33268 0 0 0 0 0 248030 0 LAURA WORTHY CFO 158288 0 0 0 24022 0 0 0 2526 0 184836 0 Kathleen Boegler LPN DRIVER 151658 14885 20 0 3187 169750 TERESA DUNLAP DIRECTOR OF NURSING 143505 0 6919 0 4722 155146 SCHEDULE J, PART I, LINE 3 METHOD USED TO ESTABLISH CEO/EXECUTIVE DIRECTOR COMPENSATION: Hacienda Healthcare monitors the competitive rates that other similar healthcare companies offer. THE HACIENDA HEALTHCARE BOARD OF DIRECTORS APPROVES CHANGES IN EXECUTIVE COMPENSATION ANNUALLY BEFORE THE CHANGES TAKE PLACE. Schedule J, Part 1, Line 7 NONFIXED PAYMENTS: THE LPN DRIVER RECEIVES A BONUS THAT INCLUDES A NONFIXED PORTION BASED ON EXTRA SHIFTS WORKED. THESE BONUSES WERE AT THE DISCRETION OF MANAGEMENT. X 4 148442 RETAIL false false false SCHEDULE M, PART I, COLUMN B Number of Contributions: The number in column B represents the number of contributions. FORM 990, PART III, LINE 3 CHANGES IN PROGRAM SERVICES: DUE TO COVID CONCERNS, MANY NEW PROCEDURES WERE PUT INTO PLACE TO PROTECT EMPLOYEES AND CLIENTS INCLUDING THE ADDITION OF AN ISOLATION WARD, COMMITTEE, CLEANING PROCEDURES, ADDITIONAL PPE, SANITATION EQUIPMENT, ADMITTANCE OF OUTSIDE PERSONS, DAILY TEMPERATURE CHECKS AND TESTING. DTA AND TRANSPORTATION TO OUTSIDE ENTITIES CEASED DURING PEAK MONTHS AND ADMINISTRATIVE EMPLOYEES WENT REMOTE. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990: THE ORGANIZATION'S CEO WILL REVIEW AND APPROVE THE FORM 990 PRIOR TO FILING. THE ORGANIZATION'S CEO HAS BEEN AUTHORIZED BY THE BOARD OF DIRECTORS TO SIGN THE FINAL FORM 990. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT ADDRESSES THE CONSIDERATION OF POTENTIAL CONFLICTS OF INTEREST BY THE BOARD OF DIRECTORS, COMMITTEE MEMBERS, KEY EMPLOYEES, AND THEIR RELATIVES. AS PER THE POLICY, SUCH PERSONS MUST MAKE DISCLOSURE OF ANY POTENTIAL CONFLICTS OF INTEREST AND MUST ABSTAIN FROM VOTING ON ANY ACTION IN WHICH THEY MAY HAVE AN INTEREST. ON AN ANNUAL BASIS, ALL BOARD MEMBERS ARE REQUIRED TO SIGN OFF ON AN ANNUAL CONFLICT OF INTEREST FORM, EITHER STATING ANY KNOWN CONFLICTS, OR STATING THAT THERE ARE NONE. FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS FOR DETERMINING COMPENSATION: THE BOARD OF DIRECTORS DETERMINES REASONABLE AND APPROPRIATE SALARIES FOR KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS MADE AVAILABLE TO THE PUBLIC: THE ORGANIZATION GENERALLY DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 3B REQUIRED SINGLE AUDIT: THE ORGANIZATION IS REQUIRED TO UNDERGO A SINGLE AUDIT BUT IT HAS NOT YET BEEN COMPLETED. LOS NINOS HOSPITAL INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 860892673 HOSPITAL AZ 501(C)(3) 10 NA true false false true false false false false false false false false true true true true false false false true LOS NINOS HOSPITAL INC C 3204440 CASH