HOMEASSIST HEALTH INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HOMEASSIST HEALTH INC (EIN 46-4337829)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-02-28
- IRS object ID
- 202240599349301314
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-02-28T20:56:58-06:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 860133881 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY & HORNE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 E WARNER ROAD SUITE 101 | AddressLine1Txt |
| City | TEMPE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85284 | 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 | 464337829 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOME ASSIST HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOME | BusinessNameControlTxt |
| Phone | 6027957620 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3737 N 7TH ST NO 203 | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85014 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SARA WILSON | PersonNm |
| Person Title | PRESIDENT/ CEO | PersonTitleTxt |
| Phone | 6027957620 | PhoneNum |
| Signature | 2022-02-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SARA | PersonFirstNm |
| Person Last | WILSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | COLETTE KAMPS CPA | PreparerPersonNm |
| PTIN | P00367616 | PTIN |
| Phone | 4808394900 | PhoneNum |
| Preparation | 2022-02-21 | PreparationDt |
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 | SARA WILSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3737 N 7TH ST NO 203 | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85014 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,547,462 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://HOMEASSISTHEALTH.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | PROVIDING NON-SKILLED PERSONAL CARE SERVICES TO MEDICALLY UNDERSERVED (CONTINUED ON SCHEDULE O) PERSONS WHO RESIDE PRIMARILY IN MARICOPA COUNTY BUT ALSO OTHER STATE OF ARIZONA RESIDENTS. THE ORGANIZATION ALSO PROVIDES TRAINING TO THE PUBLIC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 726 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $848,139 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,484,210 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,697,662 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,614 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,661 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,164 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $10,495,988 | PYTotalRevenueAmt |
| CY Total Revenue | $10,547,462 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,287,475 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,914,999 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $853,287 | PYOtherExpensesAmt |
| CY Other Expenses | $812,161 | CYOtherExpensesAmt |
| PY Total Expenses | $10,140,762 | PYTotalExpensesAmt |
| CY Total Expenses | $10,727,160 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $355,226 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$179,698 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,112,029 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,783,537 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,703,038 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,554,244 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,408,991 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,229,293 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING NON-SKILLED PERSONAL CARE SERVICES TO MEDICALLY UNDERSERVED PERSONS LIVING IN A HOME ENVIRONMENT PREDOMINANTLY IN MARICOPA COUNTY BUT ALSO THOSE RESIDING IN OTHER COUNTIES IN ARIZONA. THE ORGANIZATION ALSO PROVIDES TRAINING TO THE PUBLIC. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,209,194 | ExpenseAmt |
| Revenue | $9,697,662 | RevenueAmt |
| Desc | PROVIDING NON-SKILLED PERSONAL CARE SERVICES TO MEDICALLY UNDERSERVED PERSONS LIVING IN A HOME ENVIRONMENT PREDOMINANTLY IN MARICOPA COUNTY BUT ALSO THOSE RESIDING IN OTHER COUNTIES IN ARIZONA. | Desc |
| Total Program Service Expenses | $9,209,194 | 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 | 0 | 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 | 0 | 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | 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 | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 726 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | 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 | 6027957620 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3737 N 7TH ST NO 203 | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85014 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| BARBARA HARDING | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| RENEE CLARK | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| MARTIN DEMOS | ||||||
| SECRETARY | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CLAIRE AGNEW | ||||||
| TREASURER | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SHERRY STOTLER | ||||||
| BOARD PRESIDENT | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SARA N WILSON | ||||||
| PRESIDENT/ CEO | 40.00 | Yes (X) | $178,039 | $0 | $240 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $178,039 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $240 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $196,848 | GovernmentGrantsAmt |
| All Other Contributions | $651,291 | AllOtherContributionsAmt |
| Total Contributions | $848,139 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HOME HEALTHCARE SERVICES | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $9,697,662 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,697,662 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,697,662 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,661 | TotalRevenueColumnAmt |
| Exclusion | $1,661 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,547,462 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,697,662 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,661 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,168 | TotalAmt |
| Management And General | $180,168 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,803,367 | TotalAmt |
| Program Services | $8,066,799 | ProgramServicesAmt |
| Management And General | $736,568 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,227 | TotalAmt |
| Program Services | $107,539 | ProgramServicesAmt |
| Management And General | $106,688 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $717,237 | TotalAmt |
| Program Services | $651,871 | ProgramServicesAmt |
| Management And General | $65,366 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,000 | TotalAmt |
| Management And General | $21,000 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,250 | TotalAmt |
| Management And General | $16,250 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,150 | TotalAmt |
| Program Services | $3,150 | ProgramServicesAmt |
| Management And General | $9,000 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,326 | TotalAmt |
| Program Services | $8,014 | ProgramServicesAmt |
| Management And General | $41,312 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,947 | TotalAmt |
| Program Services | $16,509 | ProgramServicesAmt |
| Management And General | $9,438 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,740 | TotalAmt |
| Program Services | $21,269 | ProgramServicesAmt |
| Management And General | $24,471 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,213 | TotalAmt |
| Program Services | $112,629 | ProgramServicesAmt |
| Management And General | $129,584 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,580 | TotalAmt |
| Program Services | $10,004 | ProgramServicesAmt |
| Management And General | $2,576 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,000 | TotalAmt |
| Management And General | $27,000 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,938 | TotalAmt |
| Management And General | $32,938 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,555 | TotalAmt |
| Program Services | $99,904 | ProgramServicesAmt |
| Management And General | $38,651 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| ELECTRONIC MEDICAL RECO | $69,583 | $32,356 | $37,227 |
| PAYROLL PROCESSING FEES | $29,568 | $13,749 | $15,819 |
| EMPLOYEE TRAINING | $24,871 | $24,871 | |
| EQUIPMENT LEASE | $22,674 | $10,544 | $12,130 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,766 | TotalAmt |
| Program Services | $29,986 | ProgramServicesAmt |
| Management And General | $11,780 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,727,160 | TotalAmt |
| Program Services | $9,209,194 | ProgramServicesAmt |
| Management And General | $1,517,966 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,333,148 | BOYAmt |
| EOY | $4,034,424 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $617,606 | BOYAmt |
| EOY | $619,906 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,260 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,857 | BOYAmt |
| EOY | $79,468 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $249,119 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $221,126 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,932 | BOYAmt |
| EOY | $27,993 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,486 | BOYAmt |
| EOY | $18,486 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,112,029 | BOYAmt |
| EOY | $4,783,537 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $763,670 | BOYAmt |
| EOY | $818,652 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $900,000 | BOYAmt |
| EOY | $2,711,860 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,368 | BOYAmt |
| EOY | $23,732 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,703,038 | BOYAmt |
| EOY | $3,554,244 | 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 | $1,198,820 | BOYAmt |
| EOY | $1,120,961 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $210,171 | BOYAmt |
| EOY | $108,332 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,408,991 | BOYAmt |
| EOY | $1,229,293 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,112,029 | BOYAmt |
| EOY | $4,783,537 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$179,698 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | Yes (1) | 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 Minus2 Years | $250,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $848,139 | CurrentTaxYearAmt |
| Total | $1,098,139 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,624,570 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,228,986 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,470,636 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,484,210 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,697,662 | CurrentTaxYearAmt |
| Total | $52,506,064 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,624,570 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,228,986 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,720,636 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,484,210 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,545,801 | CurrentTaxYearAmt |
| Total | $53,604,203 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $53,604,203 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $16,849 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,614 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,661 | CurrentTaxYearAmt |
| Total | $26,124 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $16,849 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,614 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,661 | CurrentTaxYearAmt |
| Total | $26,124 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $375 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,164 | CurrentTaxYearMinus1YearAmt |
| Total | $4,539 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,624,570 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,228,986 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,737,860 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,495,988 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,547,462 | CurrentTaxYearAmt |
| Total | $53,634,866 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99940 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99950 | PublicSupportPY509Pct |
| Investment Income CY | 0.00050 | 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,984 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,035 | DepreciationAmt |
| Book Value | $5,949 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $214,135 | OtherCostOrOtherBasisAmt |
| Depreciation | $192,091 | DepreciationAmt |
| Book Value | $22,044 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $27,993 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER LIABILITIES | $400 |
| DEFERRED RENT | $23,332 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $23,732 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,547,462 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,547,462 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,547,462 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,727,160 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,727,160 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,727,160 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION FOLLOWS ACCOUNTING STANDARD FOR UNCERTAINTY IN INCOME TAXES, WHICH REQUIRE THAT TAX POSITIONS INITIALLY NEED TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS WHEN IT IS MORE LIKELY-THAN-NOT THAT THE POSITIONS WILL NOT BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES. AS OF JUNE 30, 2021, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SARA N WILSON | PersonNm |
| Title | PRESIDENT/ CEO | TitleTxt |
| Base Compensation Filing Org | $147,799 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $30,240 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $240 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $178,279 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | EXCEPT FOR THE CEO, ALL OF THE DIRECTORS OF THE ORGANIZATION WORK FOR MARICOPA INTEGRATED HEALTH SYSTEM, THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS ONE MEMBER WHICH IS MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT D/B/A MARICOPA INTEGRATED HEALTH SYSTEM, A POLITICAL SUBDIVISION OF THE STATE OF ARIZONA. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT DBA MARICOPA INTEGRATED HEALTH SYSTEM APPROVES THE ELECTION AND REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS CANNOT BE TAKEN BY THE ORGANIZATION WITHOUT THE APPROVAL OF THE SOLE MEMBER OF THE ORGANIZATION: (1) ELECTION AND REMOVAL OF DIRECTORS (2) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE ORGANIZATION (3) AMENDEMENT OF THE BYLAWS OF THE ORGANIZATION, AND (4) MERGER, CONSOLIDATION OR DISSOLUTION OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING FOR THEIR REVIEW AND APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A FORMAL CONFLICT OF INTEREST POLICY THAT ALL EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO READ AND SIGN ANNUALLY. EACH DIRECTOR, OFFICER, KEY EMPLOYEE, AND MEMBER OF A COMMITTEE OF THE BOARD IS REQUIRED TO ANNUALLY SIGN THE ORGANIZATION'S CONFLICT OF INTEREST ACKNOWLEDGEMENT STATEMENT, DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION COMPARES ITS WAGES TO THE WAGES OF OTHER CHARITABLE ORGANIZATIONS, OF ENTITIES IN THE MEDICAL INDUSTRY, AND OF MARICOPA COUNTY TO ENSURE WAGES ARE AT MARKET RATES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THERE WAS NO CHANGE FROM THE PRIOR YEAR. |
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