Hacienda Childrens Hospital Inc: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- Hacienda Childrens Hospital Inc (EIN 47-3035370)
- Tax period
- 2015-08-01 to 2016-07-31
- Filed
- 2017-06-15
- IRS object ID
- 201721669349301087
- Schema version
- 2015v3.0
- 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 H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-06-15T14:39:08-05:00 | ReturnTs |
| Tax Period End | 2016-07-31 | 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 RD STE 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 | 2015-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473035370 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA CHILDRENS HOSPITAL 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 AVE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM TIMMONS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6022434231 | PhoneNum |
| Signature | 2017-06-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | COLETTE KAMPS CPA | PreparerPersonNm |
| PTIN | P00367616 | PTIN |
| Phone | 4808394900 | PhoneNum |
| Preparation | 2017-06-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | WILLIAM TIMMONS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E SOUTH MOUNTAIN AVE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $595,005 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HACIENDAHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2015 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HIGH QUALITY ACUTE AND SUB-ACUTE CARE FOR INFANTS, CHILDREN AND TEENS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 22 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $154,664 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $439,027 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $1,314 | CYOtherRevenueAmt |
| CY Total Revenue | $595,005 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $1,500,132 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $1,363,518 | CYOtherExpensesAmt |
| CY Total Expenses | $2,863,650 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | -$2,268,645 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $11,322,554 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $175,061 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $11,147,493 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE HIGH QUALITY ACUTE AND SUB-ACUTE CARE FOR INFANTS, CHILDREN AND TEENS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,703,650 | ExpenseAmt |
| Revenue | $440,341 | RevenueAmt |
| Desc | HACIENDA CHILDREN'S HOSPITAL (HCH) SERVES THE NEEDS OF ACUTE AND CHRONICALLY ILL PATIENTS. THE 24-BED HOSPITAL PROVIDES NON-EMERGENCY, NON-SURGICAL, STEP-DOWN MEDICAL CARE TO CHILDREN AND HANDS-ON TRAINING TO EACH PARENT, ALL IN A TRANQUIL, FAMILY-CENTERED ATMOSPHERE. | Desc |
| Total Program Service Expenses | $2,703,650 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| 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 | 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 | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 22 | 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 | Yes (1) | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | Yes (1) | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 |
| States Where Copy Of Return Is Fld | AZ | StatesWhereCopyOfReturnIsFldCd |
| 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 AVE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PATRICK WALSH | ||||||||
| PRESIDENT OF THE BOARD | 0.50 | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TOM POMEROY | ||||||||
| EXECUTIVE VICE PRESIDENT OF THE BOARD | 0.50 | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KATHRYN L DEL REAL | ||||||||
| VICE PRESIDENT OF THE BOARD | 0.50 | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RALPH WALLWORK | ||||||||
| TREASURER OF THE BOARD | 0.50 | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MIKE WADE | ||||||||
| SECRETARY OF THE BOARD | 0.50 | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GARY ORMAN | ||||||||
| BOARD MEMBER | 0.25 | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN BERGER | ||||||||
| BOARD MEMBER | 0.25 | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| THOM NIEMIEC | ||||||||
| BOARD MEMBER | 0.25 | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| PATRICK WHITE | ||||||||
| BOARD MEMBER | 0.25 | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM TIMMONS | ||||||||
| CHIEF EXECUTIVE OFFICER | 5.00 | 40.00 | Yes (X) | $0 | $578,397 | $30,519 | ||
| JOSEPH O'MALLEY | ||||||||
| CHIEF FINANCIAL OFFICER | 5.00 | 40.00 | Yes (X) | $0 | $200,114 | $16,629 | ||
| DANI AALFS | ||||||||
| CHIEF OPERATIONS OFFICER ADMIN SERVICES | 5.00 | 40.00 | Yes (X) | $0 | $113,419 | $13,574 | ||
| KEVIN PAYNE | ||||||||
| CHIEF OPERATING OFFICER OPERATIONS | 5.00 | 40.00 | Yes (X) | $0 | $132,703 | $13,010 | ||
| PERRY PETRILLI | ||||||||
| VP- RESIDENTIAL SERVICES | 5.00 | 40.00 | $0 | $108,794 | $4,082 | Yes (X) | ||
| MARIANNE COPPOLA | ||||||||
| DIRECTOR OF CORPORATE COMPLIANCE | 5.00 | 40.00 | $0 | $102,496 | $4,186 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,235,923 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $82,000 | 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 |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E SOUTH MOUNTAIN AVE | AddressLine1Txt |
| City | PHOENIX | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MANAGEMENT SERVICES | ServicesDesc |
| Compensation | $160,000 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $154,664 | AllOtherContributionsAmt |
| Noncash Contributions | $14,833 | NoncashContributionsAmt |
| Total Contributions | $154,664 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PRIVATE SECTR REVENUE | 623990 | $431,842 | $431,842 |
| GOVERNMENT FEES FOR SE | 623990 | $7,185 | $7,185 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $439,027 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,314 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,314 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,314 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $595,005 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $440,341 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,310,380 | TotalAmt |
| Program Services | $1,310,380 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,763 | TotalAmt |
| Program Services | $28,763 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,989 | TotalAmt |
| Program Services | $160,989 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,000 | TotalAmt |
| Management And General | $160,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,205 | TotalAmt |
| Program Services | $100,205 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,471 | TotalAmt |
| Program Services | $25,471 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,499 | TotalAmt |
| Program Services | $4,499 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,616 | TotalAmt |
| Program Services | $289,616 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,906 | TotalAmt |
| Program Services | $438,906 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,700 | TotalAmt |
| Program Services | $56,700 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| SUPPLIES | $246,455 | $246,455 |
| FOOD | $18,441 | $18,441 |
| OTHER OPERATING EXPENSE | $15,477 | $15,477 |
| DUES, LICESNES, AND PER | $7,748 | $7,748 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,863,650 | TotalAmt |
| Program Services | $2,703,650 | ProgramServicesAmt |
| Management And General | $160,000 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $400 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $28,069 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $204,093 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $32,074 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $9,621 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,487,203 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $438,906 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $11,048,297 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $11,322,554 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $175,061 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $175,061 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $11,114,924 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $32,569 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $11,147,493 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $11,322,554 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,268,645 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $13,416,138 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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 | $154,664 | CurrentTaxYearAmt |
| Total | $154,664 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $439,027 | CurrentTaxYearAmt |
| Total | $439,027 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $593,691 | CurrentTaxYearAmt |
| Total | $593,691 | 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 | $593,691 | PublicSupportTotal509Amt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $1,314 | CurrentTaxYearAmt |
| Total | $1,314 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $595,005 | CurrentTaxYearAmt |
| Total | $595,005 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $795,024 | OtherCostOrOtherBasisAmt |
| Book Value | $795,024 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,566,723 | OtherCostOrOtherBasisAmt |
| Depreciation | $305,863 | DepreciationAmt |
| Book Value | $9,260,860 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,773 | OtherCostOrOtherBasisAmt |
| Depreciation | $955 | DepreciationAmt |
| Book Value | $16,818 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $881,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $118,238 | DepreciationAmt |
| Book Value | $762,816 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $226,629 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,850 | DepreciationAmt |
| Book Value | $212,779 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,048,297 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $595,005 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $595,005 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $595,005 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,863,650 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,863,650 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,863,650 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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 JULY 31, 2016, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCAL STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,388,514 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,388,514 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.83410 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,388,514 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,388,514 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.83410 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,388,514 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,388,514 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.83410 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $170,739 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $0 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $0 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA CHILDREN'S HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 W JEROME AVE | AddressLine1Txt |
| City | MESA | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85210 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Childrens Hospital | Yes (X) | ChildrensHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA CHILDREN'S HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://HACIENDAINC.ORG/WP-CONTENT/UPLOADS/HCH_CHNA_2016-2018_REV.PDF | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://HACIENDAINC.ORG/WP-CONTENT/UPLOADS/HCH_CHNA_2016-2018_REV.PDF | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HACIENDA CHILDREN'S HOSPITAL, INC. | PART V, SECTION B, LINE 5: THE ARIZONA STATE HEALTH ASSESSMENT AND THE MARICOPA COUNTY COORDINATED COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED INPUT FROM COMMUNITY MEMBERS AND ORGANIZATIONS AS WELL AS SURVEYS DONE BY UNDERSERVED AND MINORITY MEMBERS OF THE COMMUNITY. HACIENDA CHILDREN'S HOSPITAL SOLICITS INPUT FROMPERSONS REPRESENTING THE COMMUNITY'S INTEREST VIA EMAIL AND THROUGH OUR MARKETING AND PHILANTHROPY DEPARTMENT MEETINGS WITH VARIOUS ORGANIZATIONS AND AGENCIES. HACIENDA CHILDREN'S HOSPITAL ALSO CONTINUES TO RECEIVE FEEDBACK FROM FAMILY MEMBERS VIA SURVEYS CONDUCTED PRIOR TO DISCHARGE REGARDING PERCEIVED COMMUNITY HEALTH NEEDS, AND INCORPORATE THEM INTO OUR ASSESSMENTS. |
| HACIENDA CHILDREN'S HOSPITAL, INC. | PART V, SECTION B, LINE 11: THE MAJORITY OF OUR FAMILIES ARE ON MEDICAID AND RECEIVE FINANCIAL ASSISTANCE. THEY FEEL THAT EATING HEALTHY IS NOT AN OPTION BECAUSE OF THE COSTS INVOLVED. WE PROVIDE RESOURCES AND LITERATURE FOR THE FAMILIES TO HELP THEM FIND LOWER COST FOODS THAT ARE ALSO NUTRITIONALLY DENSE. |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, COMMUNITY BUILDING ACTIVITIES: | WE COMPLETE NUTRITION SURVEYS WITH EACH FAMILY IN ORDER TO IDENTIFY BARRIERS THEY HAVE TO HEALTHY EATING. |
| PART III, LINE 4: | THE CARRYING AMOUNT OF ACCOUNTS RECEIVABLE MAY BE REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S BEST ESTIMATE OF UNCOLLECTIBLE AMOUNTS. MANAGEMENT REVIEWS ALL ACCOUNTS RECEIVABLE BALANCES PERIODICALLY, AND BASED ON AN ASSESSMENT OF CREDITWORTHINESS AND AN ANALYSIS OF THE AGING OF INVOICES, ESTIMATES THE PORTION, IF ANY, OF THE BALANCES THAT WILL NOT BE COLLECTED. BECAUSE OF THE INHERENT UNCERTAINTIES IN ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS, IT IS AT LEAST REASONABLY POSSIBLE THAT THE ESTIMATES USED WILL CHANGE WITHIN THE NEAR TERM. |
| PART III, LINE 8: | THE COSTING METHODOLOGY WAS BASED ON A COST TO CHARGE RATIO FORMULA, INFORMATION WAS OBTAINED FORM THE DSH REPORT. |
| PART III, LINE 9B: | ALL GUARANTORS WITH SELF-PAY BALANCES ARE PROVIDED WITH A CHARITY CARE FINANCIAL ASSISTANCE APPLICATION TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. HOSPITAL BILLING STAFF REVIEWS EACH RETURNED APPLICATION, FOLLOWS UP WITH THE GUARANTOR FOR ANY QUESTIONS AND MISSING INFORMATION, AND COMMUNICATES ELIGIBILITY STATUS TO THE GUARANTOR. |
| PART VI, LINE 2: | A FOCUSED APPROACH TO UNDERSTANDING THE NEEDS WITHIN THE UNDERSERVED AND MINORITY POPULATION IN WHICH HCH SERVES INCLUDED AN ANALYSIS OF THE INPUT PROVIDED BY THE MARICOPA COUNTY COORDINATED COMMUNITY HEALTH NEEDS ASSESSMENT AS WELL AS THE ARIZONA STATE HEALTH ASSESSMENT. |
| PART VI, LINE 4: | THE COMMUNITY HACIENDA CHILDREN'S HOSPITAL SERVES, CONSISTS MAINLY OF MEDICALLY UNDERSERVED,LOW INCOME AND MINORITY POPULATIONS. HACIENDA CHILDREN'S HOSPITAL SERVES PEDIATRIC PATIENTS ONLY. THE AVERAGE AGE OF OUR ADMISSIONS IS 20.3 MONTHS OLD. THE OVERWHELMING MAJORITY OF OUR PATIENTS ARE MEDICAID RECIPIENTS. WE SERVICE THE HIGHEST NUMBER OF MEDICAID PATIENTS OF ANY HOSPITAL PROVIDER INTHE STATE, 96% IN OUR FIRST YEAR. MOST FAMILIES OF OUR PATIENTS HAVE MULTIPLE CHILDREN AND FACE ADDITIONAL BARRIERS TO HEALTH ACCESS AND HAVE MULTIPLE SOCIAL SUPPORT NEEDS. WITHIN OUR FIRST YEAR, 57% OF THE PATIENTS ADMITTED TO HACIENDA CHILDREN'S HOSPITAL WERE OF HISPANIC OR NATIVE AMERICAN ETHNICITY,AND 41% WERE CAUCASIAN. HACIENDA CHILDREN'S HOSPITAL'S GEOGRAPHIC COMMUNITY CONSISTS OF MARICOPA COUNTY. THE MAJORITY OF HACIENDA CHILDREN'S HOSPITAL'S ADMISSIONS COME FROM CARDON CHILDREN'S MEDICAL CENTER, PHOENIX CHILDREN'S HOSPITAL AND THE MARICOPA INTEGRATED HEALTH SYSTEM. |
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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM TIMMONS | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $0 | $503,397 | $0 | $75,000 | $0 | $0 | $0 | $18,777 | $0 | $11,742 | $0 | $608,916 | $0 | $0 |
| JOSEPH O'MALLEY | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $184,434 | $0 | $15,680 | $0 | $0 | $0 | $7,748 | $0 | $8,881 | $0 | $216,743 | $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. 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. 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. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH MOUNTAIN HEALTH SUPPLY INC (SMHS) | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | OFFICERS OF SMHS ARE BOARD MEMBERS OF FILING ORGANIZATION. | RelationshipDescriptionTxt |
| Transaction | $105,000 | TransactionAmt |
| Transaction | THE FILING ORGANIZATION PURCHASES HEALTH CARE SUPPLIES FROM SMHS. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S BOARD TREASURER, CEO AND CONTROLLER WILL REVIEW AND APPROVE THE FORM 990 PRIOR TO FILING. THEY WILL THEN REVIEW THE FINAL FORM 990 WITH THE ENTIRE BOARD. |
| 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 MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF LAND, PROPERTY AND EQUIPMENT FROM AFFILIATE 10,930,906. OTHER TRANSFERS FROM AFFILIATES 2,485,232. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| HACIENDA INC | ||||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 860253158 | CARE FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN | AZ | 501(C)(3) | LINE 9 | 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 9 | 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 9 | N/A | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 AFFILIATED ORGANIZATIONS | AZ | C | 0 | N/A | |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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