HACIENDA INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HACIENDA INC (EIN 86-0253158)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-13
IRS object ID
201411339349305706
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-05-13T17:31:23-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN860133881EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1HENRY & HORNE LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12055 E WARNER RD STE 101AddressLine1
CityTEMPECity
StateAZState
ZIP Code85284ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860253158EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HACIENDA INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHACINameControl
Phone6022434231Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11402 E SOUTH MOUNTAIN AVENUEAddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85040ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWILLIAM TIMMONSName
TitleCEOTitle
Phone6022434231Phone
Date Signed2014-05-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCOLETTE KAMPSName
PTINP00367616PTIN
Phone4808394900Phone
Date Prepared2014-05-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWILLIAM TIMMONSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11402 E SOUTH MOUNTAIN AVENUEAddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85040ZIPCode
FieldValueIRS element (for citing)
Gross Receipts15249439GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HACIENDAHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionPROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDRENActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees419TotalNbrEmployees
Total Nbr Volunteers19TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year70656ContributionsGrantsPriorYear
Contributions Grants Current Year230153ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15228068ProgramServiceRevenuePriorYear
Program Service Revenue CY14894467ProgramServiceRevenueCY
Investment Income Prior Year1880InvestmentIncomePriorYear
Investment Income Current Year5810InvestmentIncomeCurrentYear
Other Revenue Prior Year923267OtherRevenuePriorYear
Other Revenue Current Year119009OtherRevenueCurrentYear
Total Revenue Prior Year16223871TotalRevenuePriorYear
Total Revenue Current Year15249439TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year12181623SalariesEtcPriorYear
Salaries Etc Current Year11940640SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4192274OtherExpensePriorYear
Other Expenses Current Year4387734OtherExpensesCurrentYear
Total Expenses Prior Year16373897TotalExpensesPriorYear
Total Expenses Current Year16328374TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-150026RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1078935RevenuesLessExpensesCY
Total Assets BOY4664067TotalAssetsBOY
Total Assets EOY4943675TotalAssetsEOY
Total Liabilities BOY6158648TotalLiabilitiesBOY
Total Liabilities EOY7504761TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1494581NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-2561086NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDREN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11197020Expense
Revenue11201325Revenue
DescriptionINTERMEDIATE 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.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense241608Expense
Revenue191208Revenue
DescriptionEARLY INTERVENTION: THE EARLY INTERVENTION PROGRAM WORKS WITH INFANTS AND TODDLERS AGES 0-3 WHO HAVE BEEN DIAGNOSED WITH A DEVELOPMENTAL DELAY OR DISABILITY OR HAVE BEEN IDENTIFIED AS BEING AT RISK FOR A DELAY OR DISABILITY IN THE FUTURE. DEVELOPMENTAL SPECIALISTS SERVE CHILDREN OF ALL LEVELS OF FUNCTIONING WITHIN AN EDUCATIONAL FRAMEWORK THAT HELPS CHILDREN ACHIEVE THEIR POTENTIALS, AS WELL AS MINIMIZE THE NEED FOR REMEDIAL SERVICES IN THE FUTURE.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3176228Expense
Revenue3325296Revenue
DescriptionGROUP HOMES AND MEDICAL GROUP HOMES: THE ORGANIZATION OPERATES FIVE GROUP HOMES IN THE COMMUNITY; THREE THAT ARE MEDICAL FACILITIES AND TWO TRADITIONAL GROUP HOMES. THE TWO TRADITIONAL GROUP HOMES OFFER 24-HOUR SUPERVISION, THE TEACHING OF HABILITATION SKILLS, DAILY LIVING SKILLS AND INTEGRATION INTO THE COMMUNITY.IN ADDITION TO THE OPPORTUNITIES PROVIDED IN THE TRADITIONAL GROUP HOME SETTING, THE MEDICAL GROUP HOME FACILITIES OFFER AROUND-THE-CLOCK MEDICAL SUPERVISION BY LICENSED PRACTICAL NURSES AND SUPERVISION BY A REGISTERED NURSE. THE INDIVIDUALS IN THESE HOMES REQUIRE SPECIFIC MEDICAL SUPERVISION BY TRAINED PERSONNEL.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense354163Expense
Revenue295647Revenue
DescriptionTHE ORGANIZATION OPERATES A DAY TREATMENT AND TRAINING PROGRAM IN PHOENIX, ARIZONA FOR ADULTS AND TEENAGERS WITH DEVELOPMENTAL DISABILITIES.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp354163TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev295647TotalOfOtherProgramServiceRev
Total Program Service Expense14969019TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109616NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees419NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6022434231TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11402 E SOUTH MOUNTAIN AVENUEAddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85040ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
THOM NIEMIEC
BOARD MEMBER1.00X000
PATRICK WALSH
BOARD MEMBER1.00X000
KEVIN BERGER
BOARD MEMBER1.00X000
PATRICIA SHAW
BOARD MEMBER1.00X000
KATHRYN L DEL REAL
BOARD MEMBER1.00X000
MIKE WADE
BOARD MEMBER1.00X000
DICK KAUPIE
PRESIDENT2.00X000X
TOM POMEROY
EXECUTIVE VICE PRESIDENT/SECRETARY2.00X000X
GARY ORMAN
VICE PRESIDENT2.00X000X
RALPH WALLWORK
TREASURER2.00X000X
WILLIAM J TIMMONS
CHIEF EXECUTIVE OFFICER40.00417717021473X
DALE SKURDAHL
CHIEF OPERATIONS OFFICER M40.00207885031787X
PERRY F PETRILLI
VP-RESIDENTAL SERVICES40.0014298406030X
MICHAEL STONE
VP OF ADMINISTRATIVE SUPPORT SERVICES40.0021072906944X
JOSEPH O'MALLEY
CONTROLLER40.00152796015915X
JANET LOVELADY
DIRECTOR OF NURSING40.0012144204856X
HEATHER J TEAFORD
ICF-MR RN40.00113112011750X
LEAH SHALER
VP-HEALTHCARE SUPPORT SERVICES40.00126816017421X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1493481TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation116176TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HACIENDA SKILLED NURSING FACILITY INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11402 E SOUTH MOUNTAIN AVEAddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85040ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesRENTDescriptionOfServices
Compensation300237Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Federated Campaigns31355FederatedCampaigns
All Other Contributions198798AllOtherContributions
Noncash Contributions145169NoncashContributions
Total Contributions230153TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT FEES-GOVERNMENT6239901451784214517842
NET PATIENT FEES- PRIVATE623990376625376625
FieldValueIRS element (for citing)
Total Program Service Revenue14894467TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5810TotalRevenueColumn
Exclusion$5,810ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMEALS AND MISCELLANEOUSDescription
Business Code623990BusinessCode
Total Revenue Column119009TotalRevenueColumn
Related Or Exempt Function Income119009RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue119009TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15249439TotalRevenueColumn
Related Or Exempt Function Income15013476RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,810ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total720000Total
Management And General720000ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total9230058Total
Program Services8711046ProgramServices
Management And General519012ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total261170Total
Program Services261170ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1013054Total
Program Services1012497ProgramServices
Management And General557ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total716358Total
Program Services627155ProgramServices
Management And General89203ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total57667Total
Program Services57603ProgramServices
Management And General64ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total29953Total
Management And General29953ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total138025Total
Program Services138025ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total172785Total
Program Services172754ProgramServices
Management And General31ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total53759Total
Program Services53717ProgramServices
Management And General42ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total25611Total
Program Services25585ProgramServices
Management And General26ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total778005Total
Program Services777977ProgramServices
Management And General28ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total36601Total
Program Services36565ProgramServices
Management And General36ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total296416Total
Program Services296403ProgramServices
Management And General13ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total565315Total
Program Services565223ProgramServices
Management And General92ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES1468547146850839
EQUIPMENT EXPENSE280155280021134
OTHER OPERATING EXPENSE16384016374793
FLEET EXPENSE142863142863

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total178192Total
Program Services178160ProgramServices
Management And General32ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16328374Total
Program Services14969019ProgramServices
Management And General1359355ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY27998BOY
EOY27142EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY70968EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1270524BOY
EOY1214345EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY146292BOY
EOY149193EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY270927BOY
EOY365024EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6318533LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3975475LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2375295BOY
EOY2343058EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY524265BOY
EOY738765EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY48766BOY
EOY35180EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4664067BOY
EOY4943675EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY971158BOY
EOY1062083EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY212539BOY
EOY206757EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4974951BOY
EOY6235921EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6158648BOY
EOY7504761EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-1569243BOY
EOY-2683768EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY71462BOY
EOY119482EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3200BOY
EOY3200EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1494581BOY
EOY-2561086EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4664067BOY
EOY4943675EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1078935ReconcilationRevenueExpenses
Reconciliation Unrealized Invest12430ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years452287CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years256374CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years147380CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year70656CurrentTaxYearMinus1Year
Current Tax Year230153CurrentTaxYear
Total1156850Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15149597CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14574467CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16004859CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year16151219CurrentTaxYearMinus1Year
Current Tax Year15013476CurrentTaxYear
Total76893618Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15601884CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14830841CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16152239CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year16221875CurrentTaxYearMinus1Year
Current Tax Year15243629CurrentTaxYear
Total78050468Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50978050468PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years145879CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years182117CurrentTaxYearMinus3Years
Current Tax Year5810CurrentTaxYear
Total333806Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-1203CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years-20054CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years-39534CurrentTaxYearMinus2Years
Total-60791Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years144676CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years162063CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years-39534CurrentTaxYearMinus2Years
Current Tax Year5810CurrentTaxYear
Total273015Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15746560CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14992904CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16112705CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year16221875CurrentTaxYearMinus1Year
Current Tax Year15249439CurrentTaxYear
Total78323483Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99650PublicSupportPercentage509
Prior Year Support Percentage0.99470PriorYearSupportPercentage
Investment Income Percentage0.00350InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00530PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$138,025OtherActivitiesAmount
Total Lobbying Expenditures IIB138025TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationTHIRD PARTY LOBBYISTExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis74000OtherCostOrOtherBasis
Book Value74000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4056774OtherCostOrOtherBasis
Depreciation2200446Depreciation
Book Value1856328BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2187759OtherCostOrOtherBasis
Depreciation1775029Depreciation
Book Value412730BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2343058TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED AFFILIATE$5,656,519
DEFERRED COMPENSATION LIABILITY$579,402
FieldValueIRS element (for citing)
Total Of Amounts6235921TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt15261869TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments12430NetUnrealizedGainsInvestments
Revenue Not Rptd F99012430RevenueNotRptdF990
Revenue Subtotal15249439RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99015249439TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16328374TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal16328374ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99016328374TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE 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, 2013, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
WILLIAM J TIMMONS
CHIEF EXECUTIVE OFFICER38271703500000014303071700439190000
DALE SKURDAHL
CHIEF OPERATIONS OFFICER M1998850800000089710228160239672000
MICHAEL STONE
VP OF ADMINISTRATIVE SUPPORT SERVICE1971290136000000069440217673000
JOSEPH O'MALLEY
CONTROLLER13991001288600000159150168711000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationCERTAIN EMPLOYEES PARTICIPATE IN A SECTION 457B PLAN. THE AMOUNTS CONTRIBUTED BY THESE EMPLOYEES ARE LISTED BELOW. THE ORGANIZATION DOES NOT MAKE EMPLOYER CONTRIBUTIONS TO THE ACCOUNTS IN THIS PLAN. WILLIAM TIMMONS - $22,500 DALE SKURDAHL - $20,075Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
SOUTH MOUNTAIN HEALTH SUPPLY INC (SMHS)
OFFICERS OF SMHS ARE BOARD MEMBERS OF FILING ORGANIZATION1422189THE FILING ORGANIZATION PURCHASES HEALTH CARE SUPPLIES FROM SMHS.0
PETER RANKE
FORMER BOARD MEMBER69750FINANCIAL CONSULTING SERVICES0

Schedule M IRS990ScheduleM

Books And Publications BooksAndPublications

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99046432NoncashContribsRptdF990
Method Of Determining RevenuesTHRIFT STORE VALUEMethodOfDeterminingRevenues

Cars And Other Vehicles CarsAndOtherVehicles

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions2NumberOfContributions
Noncash Contribs Rptd F99070968NoncashContribsRptdF990
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XCHRISTMAS GIFTS1620081FAIR MARKET VALUE
XEVENT TICKETS27688FAIR MARKET VALUE
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierMETHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS:Identifier
Return ReferencePART I, COLUMN (B):ReturnReference
ExplanationPART I, COLUMN B REPRESENTS THE NUMBER OF SEPARATE INSTANCES OF DONATIONS RECEIVED.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S CEO, TREASURER AND CONTROLLER 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 12CTHE 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 15THE BOARD OF DIRECTORS DETERMINES REASONABLE AND APPROPRIATE SALARIES FOR KEY EMPLOYEES OF THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION GENERALLY DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
HACIENDA HEALTHCARE
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042272988610BRAND NAME FOR RELATED ORGANIZATIONSAZ501(C)(3)LINE 9N/A0
HACIENDA SKILLED NURSING FACILITY INC
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042141906233NURSING CARE & RESPIRATORY INTERVENTIONAZ501(C)(3)LINE 9N/A0
LOS NINOS HOSPITAL INC
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042860892673NON-PROFIT CHILDREN'S HOSPITALAZ501(C)(3)LINE 9N/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
SOUTH MOUNTAIN HEALTH SUPPLY
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042860858893MEDICAL SUPPLY COMPANYAZHACIENDA HEALTHCAREC0
INNOVATIVE HOME HEALTH INC
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042262398755HOME HEALTH NURSING SERVICESAZHACIENDA HEALTHCAREC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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