HACIENDA INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HACIENDA INC (EIN 86-0253158)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-12
- IRS object ID
- 202201329349305100
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-12T13:10:20-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 860271207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHMIDT WESTERGARD & COMPANY PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 77 WEST UNIVERSITY DRIVE | AddressLine1Txt |
| City | MESA | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 852015830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860253158 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HACI | BusinessNameControlTxt |
| Phone | 6022434231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E SOUTH MOUNTAIN AVENUE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PERRY PETRILLI | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6022434231 | PhoneNum |
| Signature | 2022-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PERRY | PersonFirstNm |
| Person Last | PETRILLI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY A BITHER | PreparerPersonNm |
| PTIN | P01428424 | PTIN |
| Phone | 4808346030 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PERRY PETRILLI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E SOUTH MOUNTAIN AVENUE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,830,586 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.HACIENDAINC.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN | ActivityOrMissionDesc |
| Voting Members Governing Body | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 451 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,760,904 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,717,959 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,506,724 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,073,335 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,768 | PYInvestmentIncomeAmt |
| CY Investment Income | -$19,470 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $29,276,396 | PYTotalRevenueAmt |
| CY Total Revenue | $24,771,824 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $48,341 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,455,755 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,409,911 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,677,943 | PYOtherExpensesAmt |
| CY Other Expenses | $5,860,341 | CYOtherExpensesAmt |
| PY Total Expenses | $22,133,698 | PYTotalExpensesAmt |
| CY Total Expenses | $21,318,593 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,142,698 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,453,231 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,385,069 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,483,649 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,959,510 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,493,890 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,425,559 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,989,759 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $12,610,718 | ExpenseAmt |
| Grant | $48,341 | GrantAmt |
| Revenue | $10,053,245 | RevenueAmt |
| Desc | 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. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,771,253 | ExpenseAmt |
| Revenue | $5,667,933 | RevenueAmt |
| Desc | GROUP HOMES, MEDICAL GROUP HOMES: THE ORGANIZATION OPERATES EIGHT GROUP HOMES IN THE COMMUNITY; FIVE 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.THE AUTISM GROUP HOME IS AN INDEPENDENT LIVING PROGRAM FOR INDIVIDUALS WITH AUTISM SPECTRUM DISORDER (ASD). IN ADDITION TO THE OPPORTUNITIES PROVIDED IN THE TRADITIONAL GROUP HOME SETTING, INDIVIDUALS WITH ASD HAVE THE OPPORTUNITY TO EXPERIENCE SIX WORK ENVIRONMENTS WHICH INCLUDE DIETARY, HOUSEKEEPING, LAUNDRY, MAINTENANCE, LANDSCAPE, AND BUSINESS OPERATIONS. THE PROGRAM ASSISTS PARTICIPANTS IN LEARNING AND MASTERING THE PERSONAL AND INTERPERSONAL CHARACTERISTICS THAT ARE KEY FOR ALL INDIVIDUALS TO BE SUCCESSFUL IN THEIR CHOSEN PROFESSION. PARTICIPANTS ARE PROVIDED THE OPPORTUNITY TO EXPERIENCE AREAS OF EMPLOYMENT SO THEY CAN SELECT THE TYPE OF WORK THAT MOST INTERESTS THEM. THE PROGRAM PROVIDES PARTICIPANTS THE SKILLS AND KNOWLEDGE TO DEVELOP AND HONE WORK RELATED SKILLS NECESSARY TO SECURE GAINFUL EMPLOYMENT IN THE COMMUNITY IN THEIR SELECTED LINE OF WORK. AS PARTICIPANTS BECOME READY TO GRADUATE THEY WILL BE GIVEN ASSISTANCE IN SECURING POST-PROGRAM EMPLOYMENT WHICH WILL INCLUDE PROVIDING THEM WITH A LETTER OF RECOMMENDATION THAT SPECIFIES THE TRAINING RECEIVED AND THE SKILLS THEY POSSESS.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. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $518,453 | ExpenseAmt |
| Revenue | $318,677 | RevenueAmt |
| Desc | THE ORGANIZATION OPERATES A DAY TREATMENT JOB AND TRAINING PROGRAM IN PHOENIX, ARIZONA FOR ADULTS AND TEENAGERS WITH DEVELOPMENTAL DISABILITIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $18,900,424 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 451 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6022434231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E SOUTH MOUNTAIN AVENUE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DEBRA KULKAY | ||||||||
| DIRECTOR OF REVENUE CYCLE | 40.00 | Yes (X) | $122,366 | $0 | $3,145 | |||
| LAURA WORTHY | ||||||||
| FINANCE DIRECTOR | 40.00 | Yes (X) | $150,177 | $0 | $3,153 | |||
| LINDA STILLMAN | ||||||||
| DIRECTOR OF HUMAN RESOURCE | 40.00 | Yes (X) | $120,852 | $0 | $4,605 | |||
| LORENA BOWERS | ||||||||
| DIRECTOR OF RESPIRATORY SERVICES | 40.00 | Yes (X) | $112,427 | $0 | $4,405 | |||
| PERRY PETRILLI | ||||||||
| CEO | 40.00 | Yes (X) | $237,081 | $0 | $0 | 10.00 | Yes (X) | |
| PETER NICOLA | ||||||||
| DIRECTOR IT | 40.00 | Yes (X) | $103,101 | $0 | $2,917 | |||
| TERESA DUNLAP | ||||||||
| DIRECTOR OF NURSING, ICF | 40.00 | Yes (X) | $153,462 | $0 | $3,834 | |||
| GARY ORMAN | ||||||||
| BOARD PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HEATHER TEAFORD | ||||||||
| RN | 40.00 | $115,357 | $0 | $4,795 | Yes (X) | |||
| SIERRA WALLWORK KAMELA | ||||||||
| VP MARKETING/PR | 40.00 | $113,248 | $0 | $4,720 | Yes (X) | |||
| JOON BAIK | ||||||||
| ADMINISTRATOR | 40.00 | $111,689 | $0 | $0 | Yes (X) | |||
| RONELLE DONGMO | ||||||||
| LPN | 40.00 | $121,455 | $0 | $6,091 | Yes (X) | |||
| HEATHER MYERS | ||||||||
| SENIOR ACCOUNTANT | 40.00 | $108,825 | $0 | $2,142 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,570,040 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $39,807 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JC SIBLEY CONSULTING LLC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3821 LS MANCHA LN | AddressLine1Txt |
| City | DENTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | ICF CONSULTING | ServicesDesc |
| Compensation | $526,900 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $6,965,041 | RelatedOrganizationsAmt |
| Government Grants | $945,983 | GovernmentGrantsAmt |
| All Other Contributions | $806,935 | AllOtherContributionsAmt |
| Noncash Contributions | $507,535 | NoncashContributionsAmt |
| Total Contributions | $8,717,959 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| GOVERNMENT PATIENT SERVICE REVENU | 623990 | $16,066,277 | $16,066,277 |
| MEALS INCOME | 900099 | $7,058 | $7,058 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,073,335 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,010 | TotalRevenueColumnAmt |
| Exclusion | $14,010 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $25,282 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $58,762 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$33,480 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$33,480 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$33,480 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,771,824 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,039,855 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,010 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,341 | TotalAmt |
| Program Services | $48,341 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,131,531 | TotalAmt |
| Management And General | $1,131,531 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,346,468 | TotalAmt |
| Program Services | $11,010,455 | ProgramServicesAmt |
| Management And General | $336,013 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,530 | TotalAmt |
| Program Services | $330,725 | ProgramServicesAmt |
| Management And General | $14,805 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,724,428 | TotalAmt |
| Program Services | $1,522,189 | ProgramServicesAmt |
| Management And General | $202,239 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $861,954 | TotalAmt |
| Program Services | $694,900 | ProgramServicesAmt |
| Management And General | $167,054 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,043 | TotalAmt |
| Management And General | $214,043 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,705 | TotalAmt |
| Management And General | $57,705 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,130 | TotalAmt |
| Management And General | $6,130 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $832,673 | TotalAmt |
| Program Services | $830,418 | ProgramServicesAmt |
| Management And General | $2,255 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,809 | TotalAmt |
| Program Services | $10,938 | ProgramServicesAmt |
| Management And General | $10,871 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,016 | TotalAmt |
| Program Services | $2,396 | ProgramServicesAmt |
| Management And General | $7,620 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,542 | TotalAmt |
| Program Services | $689 | ProgramServicesAmt |
| Management And General | $39,853 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $796,431 | TotalAmt |
| Program Services | $743,285 | ProgramServicesAmt |
| Management And General | $53,146 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,896 | TotalAmt |
| Management And General | $1,896 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $786,633 | TotalAmt |
| Program Services | $751,557 | ProgramServicesAmt |
| Management And General | $35,076 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $987,434 | TotalAmt |
| Program Services | $927,752 | ProgramServicesAmt |
| Management And General | $59,682 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $1,292,071 | $1,267,152 | $24,919 |
| EQUIPMENT EXPENSE | $292,824 | $247,995 | $44,829 |
| FOOD | $150,455 | $150,455 | |
| BAD DEBT EXPENSE | $59,900 | $59,900 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $309,779 | TotalAmt |
| Program Services | $301,277 | ProgramServicesAmt |
| Management And General | $8,502 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,318,593 | TotalAmt |
| Program Services | $18,900,424 | ProgramServicesAmt |
| Management And General | $2,418,169 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,705,359 | BOYAmt |
| EOY | $281,133 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,415,568 | BOYAmt |
| EOY | $1,491,043 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $221,813 | BOYAmt |
| EOY | $159,844 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $513,983 | BOYAmt |
| EOY | $477,666 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,968,610 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,129,118 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,263,935 | BOYAmt |
| EOY | $9,839,492 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $264,411 | BOYAmt |
| EOY | $2,234,471 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,385,069 | BOYAmt |
| EOY | $14,483,649 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,227,073 | BOYAmt |
| EOY | $1,108,229 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,923 | BOYAmt |
| EOY | $55,093 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,165,613 | BOYAmt |
| EOY | $7,840,613 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $504,901 | BOYAmt |
| EOY | $489,955 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,959,510 | BOYAmt |
| EOY | $9,493,890 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,394,647 | BOYAmt |
| EOY | $4,965,251 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,912 | BOYAmt |
| EOY | $24,508 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,425,559 | BOYAmt |
| EOY | $4,989,759 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,385,069 | BOYAmt |
| EOY | $14,483,649 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,453,231 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $110,969 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $684,047 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $395,974 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $199,071 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,760,904 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,669,618 | CurrentTaxYearAmt |
| Total | $21,709,614 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,894,872 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,551,025 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,665,536 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,506,724 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,073,335 | CurrentTaxYearAmt |
| Total | $102,691,492 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,578,919 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,946,999 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,864,607 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,267,628 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,742,953 | CurrentTaxYearAmt |
| Total | $124,401,106 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,550 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,700 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,750 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,175 | CurrentTaxYearAmt |
| Total | $28,675 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,550 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,700 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,750 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,175 | CurrentTaxYearAmt |
| Total | $28,675 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $124,372,431 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,870 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,327 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,690 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $34,936 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,010 | CurrentTaxYearAmt |
| Total | $73,833 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,870 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,327 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,690 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $34,936 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,010 | CurrentTaxYearAmt |
| Total | $73,833 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $74,547 | CurrentTaxYearMinus4YearsAmt |
| Total | $74,547 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,660,336 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,956,326 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,873,297 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,302,564 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,756,963 | CurrentTaxYearAmt |
| Total | $124,549,486 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99860 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99840 | PublicSupportPY509Pct |
| Investment Income CY | 0.00060 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00050 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,200 | BeginningYearBalanceAmt |
| End Year Balance | $3,200 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $38,279 | BeginningYearBalanceAmt |
| Other Expenditures | $35,079 | OtherExpendituresAmt |
| End Year Balance | $3,200 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $41,561 | BeginningYearBalanceAmt |
| Other Expenditures | $3,282 | OtherExpendituresAmt |
| End Year Balance | $38,279 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $104,076 | BeginningYearBalanceAmt |
| Contributions | $54,089 | ContributionsAmt |
| Other Expenditures | $116,604 | OtherExpendituresAmt |
| End Year Balance | $41,561 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,942 | BeginningYearBalanceAmt |
| Contributions | $299,522 | ContributionsAmt |
| Other Expenditures | $211,388 | OtherExpendituresAmt |
| End Year Balance | $104,076 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $74,000 | OtherCostOrOtherBasisAmt |
| Book Value | $74,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,128,190 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,423,906 | DepreciationAmt |
| Book Value | $6,704,284 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,659,726 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,821,590 | DepreciationAmt |
| Book Value | $1,838,136 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,845,451 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,639,683 | DepreciationAmt |
| Book Value | $205,768 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,261,243 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,243,939 | DepreciationAmt |
| Book Value | $1,017,304 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,839,492 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION LIABILITY | $249,465 |
| DEFERRED SEVERANCE | $240,490 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $489,955 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $24,768,422 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $110,969 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$114,371 | OtherRevenueAmt |
| Revenue Not Reported | -$3,402 | RevenueNotReportedAmt |
| Revenue Subtotal | $24,771,824 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $24,771,824 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,204,222 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,204,222 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $114,371 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $114,371 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,318,593 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | 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, 2021, 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. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE INCLUDED IN EXPENSES -59,900. INVESTMENT FEE INCLUDED IN EXPENSES -6,130. CONTRIBUTION TO HACIENDA SKILLED NURSING FACILITY, INC. -48,341. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE INCLUDED IN EXPENSES 59,900. INVESTMENT FEE INCLUDED IN EXPENSES 6,130. CONTRIBUTION TO HACIENDA SKILLED NURSING FACILITY, INC. 48,341. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA SKILLED NURSING FACILITY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 EAST SOUTH MOUNTAIN AVE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 141906233 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $48,341 | CashGrantAmt |
| Purpose Of Grant | TO FULFILL THE ORGANIZATION'S CHARTIABLE PURPOSE | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE RELATED ORGANIZATIONS' GOVERNING BOARDS MONITOR THE USE OF GRANTS BETWEEN RELATED ENTITIES | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PERRY PETRILLI | ||||||||||||||
| CEO | $237,081 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $237,081 | $0 | $0 | $0 |
| TERESA DUNLAP | ||||||||||||||
| DIRECTOR OF NURSING, ICF | $153,462 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $3,834 | $0 | $157,296 | $0 | $31 | $0 |
| LAURA WORTHY | ||||||||||||||
| FINANCE DIRECTOR | $150,177 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $3,153 | $0 | $153,330 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | HACIENDA HEALTHCARE COMPLETES AN ANNUAL EXECUTIVE COMPENSATION COMPARABILITY DATA STUDY TO ENSURE THAT THE VALUE OF THE SERVICES PROVIDED BY ITS EXECUTIVES IS COMMENSURATE WITH THEIR COMPENSATION. THIS ANNUAL PROCESS DOCUMENTS HOW IMPORTANT THIS MATTER IS TO HACIENDA HEALTHCARE. IN ARIZONA MOST NON-PROFIT ORGANIZATIONS ONLY DO AN EXECUTIVE COMPENSATION ANALYSIS EVERY 3-5 YEARS WITH EVERY 3 YEARS BEING THE AUDITORS' RECOMMENDATION AND EVERY 5 YEARS BEING ACCEPTABLE. THE REASON THAT HACIENDA HEALTHCARE DOES ANNUAL EXECUTIVE COMPENSATION COMPARABILITY DATA STUDIES IS BECAUSE THE ALREADY COMPLEX AND MULTI-FACETED SERVICE DELIVERY SYSTEM CONTINUES TO GROW. HACIENDA HEALTHCARE IS A COMPLEX, MULTI-FACETED HEALTH CARE AND SOCIAL SERVICE DELIVERY SYSTEM THAT PROVIDES 4 PROGRAMS THROUGHOUT THE STATE OF ARIZONA, MANY OF WHICH ARE ONE-OF-A-KIND. THUS, A THREE COMPONENT EXECUTIVE COMPENSATION COMPARABILITY DATA STUDY IS USED. IT INCLUDES TWO SALARY/PAYROLL WEBSITES AND A THOROUGH COMPENSATION COMPARABILITY STUDY USING 990'S FROM APPROXIMATELY 50 NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS THAT SHARE A NUMBER OF COMMON VARIABLES WITH HACIENDA HEALTHCARE. WE CONSIDERED THE UTILIZATION OF REBUTTABLE PRESUMPTION STUDIES AS ANOTHER WAY TO DETERMINE APPROPRITAE EXECUTIVE COMPENSATION. WE DETERMINED THAT A COMPARABLE ORGANIZATION WOULD HAVE TO BE SIMILAR TO HACIENDA HEALTHCARE IN 12 WAYS IN ORDER TO BE VALID. WE REQUESTED THE NAMES OF SEVERAL COMPANIES THAT PERFORM REBUTTABLE PRESUMPTION STUDIES. WE WERE PROVIDED FOUR NAMES. NONE OF THE COMPANIES WE CONTACTED WERE WILLING TO CONTRACT WITH HACIENDA HEALTHCARE SINCE THEY DID NOT FEEL THEY COULD MEET THE 12 CATEGORIES REQUIREMENT. THE HACIENDA HEALTHCARE BOARD OF DIRECTORS APPROVES CHANGES IN EXECUTIVE COMPENSATION ANNUALLY BEFORE THE CHANGES TAKE PLACE. THE ANNUAL EXECUTIVE COMPENSATION COMPARABILITY DATA STUDY AND THE BOARD OF DIRECTORS' APPROVAL OF EXECUTIVE COMPENSATION ARE THOROUGHLY DOCUMENTED. | ExplanationTxt |
Schedule M IRS990ScheduleM
Cars And Other Vehicles CarsAndOtherVehiclesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 4 | ContributionCnt |
| Noncash Contributions Rpt F990 | $249,900 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 30060 | ContributionCnt |
| Noncash Contributions Rpt F990 | $257,635 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | 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 EQIPMENT, ADMITTANCE OF OUTSIDE PERSONS, DAILY TEMPURTURE 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 | 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 | 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 15 | THE BOARD OF DIRECTORS DETERMINES REASONABLE AND APPROPRIATE SALARIES FOR KEY EMPLOYEES OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION GENERALLY DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| LOS NINOS HOSPITAL INC | ||||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 860892673 | NON-PROFIT CHILDREN'S HOSPITAL | AZ | 501(C)(3) | LINE 3 | N/A | 0 |
| HACIENDA SKILLED NURSING FACILITY INC | ||||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 141906233 | NURSING CARE & RESPIRATORY INTERVENTION | AZ | 501(C)(3) | LINE 10 | N/A | 0 |
| HACIENDA CHILDRENS HOSPITAL INC | ||||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 473035370 | NON-PROFIT CHILDREN'S HOSPITAL | AZ | 501(C)(3) | LINE 3 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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