2018-05-14T14:23:06-05:00 2017-06-30 860133881 HENRY & HORNE LLP 2055 E WARNER RD STE 101 TEMPE AZ 85284 990 2016-07-01 860253158 HACIENDA INC HACI 6022434231 1402 E SOUTH MOUNTAIN AVENUE PHOENIX AZ 85040 WILLIAM TIMMONS CEO 6022434231 2018-05-09 1 COLETTE KAMPS CPA P00367616 4808394900 2018-05-08 70.166.220.114 2018-05-09 08:23:04 US P AF2378FD9713AE9D9202BF6EA5223FAD57B118DA 3FF46F59D2D650A0AED771B6D7230A78E60916E9 2016 2021-01-29 14:40:06Z WILLIAM TIMMONS 1402 E SOUTH MOUNTAIN AVENUE PHOENIX AZ 85040 24683531 0 X WWW.HACIENDAHEALTHCARE.ORG X 1970 AZ PROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN 9 9 671 9 0 0 267606 684047 21269538 23894872 6388 6870 3406 20550 21546938 24606339 0 0 0 0 17151920 18700339 0 0 0 5172711 4863657 22324631 23563996 -777693 1042343 6899131 7296507 2907522 2933991 3991609 4362516 X PROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN 0 0 12852936 16319486 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 PATIENTS 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 PROVIDES 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. 5650975 6607905 GROUP HOMES, MEDICAL GROUP HOMES AND AUTISM GROUP HOME: THE ORGANIZATION OPERATES EIGHT GROUP HOMES IN THE COMMUNITY; FIVE THAT ARE MEDICAL FACILITIES AND TWO TRADITIONAL GROUP HOMES AND ONE AUTISM GROUP 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 (CONTINUED ON SCHEDULE O) 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 THESE 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. 915736 1042028 THE ORGANIZATION OPERATES A DAY TREATMENT AND TRAINING PROGRAM IN PHOENIX, ARIZONA FOR ADULTS AND TEENAGERS WITH DEVELOPMENTAL DISABILITIES. 19419647 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 20 0 671 0 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 AZ X THE ORGANIZATION 6022434231 1402 E SOUTH MOUNTAIN AVENUE PHOENIX AZ 85040 KEVIN BERGER BOARD MEMBER 0.50 1.00 X 0 0 0 JIM GERDES BOARD MEMBER 0.50 1.00 X 0 0 0 PATRICK WHITE BOARD MEMBER 0.50 1.00 X 0 0 0 THOM NIEMIEC BOARD MEMBER 0.50 1.00 X 0 0 0 GARY ORMAN EXECUTIVE VICE PRESIDENT 0.50 1.00 X 0 0 0 MIKE WADE SECRETARY 1.00 2.00 X X 0 0 0 RALPH WALLWORK TREASURER 1.00 2.00 X X 0 0 0 KATHRYN L DEL REAL VICE PRESIDENT 1.00 2.00 X X 0 0 0 TOM POMEROY PRESIDENT 1.00 2.00 X X 0 0 0 WILLIAM TIMMONS CHIEF EXECUTIVE OFFICER 20.00 20.00 X 628432 0 45780 JOSEPH O'MALLEY CHIEF FINANCIAL OFFICER 20.00 20.00 X 209110 0 12849 KEVIN PAYNE CHIEF OPERATING OFFICER OP 20.00 20.00 X 170725 0 35313 JANET LOVELADY DIRECTOR OF NURSING 40.00 0.00 X 140710 0 13668 HEATHER TEAFORD ICF RN 40.00 0.00 X 128444 0 15689 LISA LECOMTE ICF-ID ADMINISTRATOR 40.00 0.00 X 152720 0 9386 NANCY SALMON VP - CORPORATE COMMUNICATIONS 20.00 20.00 X 108232 0 3022 DEBRA KULKAY DIRECTOR OF REVENUE CYCLE 20.00 20.00 X 106750 0 6220 1645123 0 141927 9 0 1 0 0 26726 148660 508661 81334 684047 GOVERNMENT PATIENT SERVICE REVENU 623990 22558002 22558002 MANAGEMENT FEE 561000 1041435 1041435 PRIVATE PATIENT SERVICE REVENUE 623990 295435 295435 23894872 6870 6870 23195 148660 77192 -53997 -53997 MEALS AND MISCELLANEOUS 623990 74547 74547 74547 24606339 23969419 0 -47127 1154552 1154552 14375151 11764931 2610220 387848 387848 1433543 1406826 26717 1349245 1266797 82448 12413 12413 43700 43700 149808 135314 14494 132841 108379 24462 28937 22122 6815 761144 746984 14160 14775 11453 3322 417092 408871 8221 496541 475717 20824 SUPPLIES 1624757 1605413 19344 OTHER OPERATING EXPENSE 367199 310719 56480 EQUIPMENT EXPENSE 279299 250376 28923 FLEET EXPENSE 206682 206682 328469 311215 17254 23563996 19419647 4144349 0 4860 4500 120775 8829 2018783 2554872 195587 169025 490565 294767 8575781 5283283 3218429 3292498 660564 755978 176943 192920 12625 23118 6899131 7296507 2102602 2061225 149219 122957 655701 749809 2907522 2933991 X 3975667 4258440 12742 100876 3200 3200 3991609 4362516 6899131 7296507 X 1042343 15597 -687033 X 0 1 X 1 0 X 230153 775806 297094 267606 684047 2254706 15013476 19991096 20244933 21269538 23894872 100413915 15243629 20766902 20542027 21537144 24578919 102668621 0 0 0 102668621 5810 6912 10593 6388 6870 36573 5810 6912 10593 6388 6870 36573 3406 74547 77953 15249439 20773814 20552620 21546938 24660336 102783147 0.99890 0.99970 0.00040 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 74000 74000 5288076 3066527 2221549 3213705 2216756 996949 3292498 DEFERRED COMPENSATION LIABILITY 749809 749809 X 24651448 15597 15597 24635851 -29512 -29512 24606339 23593508 29512 29512 23563996 0 23563996 PART X, LINE 2: THE ORGANIZATION RECOGNIZES UNCERTAIN TAX POSITIONS IN THE FINANCIAL STATEMENTS WHEN IT IS MORE LIKELY THAN NOT THE POSITIONS WILL NOT BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES. AS OF JUNE 30, 2017, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES -29,512. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 29,512. SALMON ROAST 171855 148660 23195 8031 39428 29733 171855 148660 23195 8031 39428 29733 77192 -53997 X X X 0 0 0 0 0 0 0 0 0 WILLIAM TIMMONS CHIEF EXECUTIVE OFFICER 548432 0 80000 0 0 0 40000 0 5780 0 674212 0 0 0 JOSEPH O'MALLEY CHIEF FINANCIAL OFFICER 186891 0 22219 0 0 0 8732 0 4117 0 221959 0 0 0 KEVIN PAYNE CHIEF OPERATING OFFICER OP 156685 0 14040 0 0 0 26520 0 8793 0 206038 0 0 0 JANET LOVELADY DIRECTOR OF NURSING 129990 0 10720 0 0 0 6928 0 6740 0 154378 0 0 0 LISA LECOMTE ICF-ID ADMINISTRATOR 148220 0 4500 0 0 0 3166 0 6220 0 162106 0 0 0 PART I, LINE 3 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 STUDIES IS BECAUSE THE ALREADY COMPLEX AND MULTI-FACETED SERVICE DELIVERY SYSTEM CONTINUES TO GROW. FOR EXAMPLE, OVER THE LAST 25 YEARS A NEW PROGRAM WAS ADDED TO THE SERVICE DELIVERY SYSTEM APPROXIMATELY EVERY 11 MONTHS. HACIENDA HEALTHCARE IS A COMPLEX, MULTI-FACETED HEALTH CARE AND SOCIAL SERVICE DELIVERY SYSTEM THAT PROVIDES 43 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 APPROPRIATE EXECUTIVE COMPENSATION. WE DETERMINED THAT A COMPARABLE ORGANIZATION WOULD HAVE TO BE SIMILIAR 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 BEFORE THE CHANGES TAKE PLACE. THE ANNUAL EXECUTIVE COMPENSATION COMPARABILITY DATA STUDY AND THE BOARD OF DIRECTORS' APPROVAL OF EXECUTIVE COMPENSATION ARE DOCUMENTED. SOUTH MOUNTAIN HEALTH SUPPLY INC (SMHS) OFFICERS OF SMHS ARE BOARD MEMBERS OF FILING ORGANIZATION 1906300 THE FILING ORGANIZATION PURCHASES HEALTH CARE SUPPLIES FROM SMHS. 0 X TICKETS 2 28959 FAIR MARKET VALUE X TABLES, CHAIRS, CABINETS 1 26000 FAIR MARKET VALUE X TOYS AND CLOTHING 1 7960 FAIR MARKET VALUE X AUCTION ITEMS 1 7795 FAIR MARKET VALUE X MEDICAL SUPPLIES 1 5500 FAIR MARKET VALUE X PROM INVITATIONS 1 5120 FAIR MARKET VALUE 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CEO, TREASURER AND CFO 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. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATE -687,033. 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 LOS NINOS HOSPITAL INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 860892673 NON-PROFIT CHILDREN'S HOSPITAL 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 10 N/A 0 SOUTH MOUNTAIN HEALTH SUPPLY 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 860858893 MEDICAL SUPPLY COMPANY AZ HACIENDA HEALTHCARE C 0 INNOVATIVE HOME HEALTH INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 262398755 HOME HEALTH NURSING SERVICES AZ HACIENDA HEALTHCARE C 0 HACIENDA HEALTHCARE 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 272988610 BRAND NAME FOR RELATED AFFILIATES AZ N/A C 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 0 1