HACIENDA SKILLED NURSING FACILITY INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- HACIENDA SKILLED NURSING FACILITY INC (EIN 14-1906233)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201201369349302810
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T10:46:31-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY & HORNE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7098 E COCHISE SUITE 100 | AddressLine1 |
| City | SCOTTSDALE | City |
| State | AZ | State |
| ZIP Code | 852534517 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141906233 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA SKILLED NURSING FACILITY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HACI | NameControl |
| Phone | 6022434231 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 EAST SOUTH MOUNTAIN AVENUE | AddressLine1 |
| City | PHOENIX | City |
| State | AZ | State |
| ZIP Code | 85042 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM TIMMONS | Name |
| Title | CEO | Title |
| Phone | 6022434231 | Phone |
| Date Signed | 2012-05-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | COLETTE KAMPS CPA | Name |
| Phone | 4804831170 | Phone |
| Date Prepared | 2012-05-08 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WILLIAM TIMMONS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 EAST SOUTH MOUNTAIN AVENUE | AddressLine1 |
| City | PHOENIX | City |
| State | AZ | State |
| ZIP Code | 85042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 8104910 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HACIENDAHEALTHCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2004 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | SKILLED NURSING AND RESPIRATORY INTERVENTION | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 179 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 520732 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 204464 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 7048292 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 7586675 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3213 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2003 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 11715 | OtherRevenuePriorYear |
| Other Revenue Current Year | 11531 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7583952 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7804673 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3758195 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5046339 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3032749 | OtherExpensePriorYear |
| Other Expenses Current Year | 2696318 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6790944 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7742657 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 793008 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 62016 | RevenuesLessExpensesCY |
| Total Assets BOY | 12618840 | TotalAssetsBOY |
| Total Assets EOY | 13626916 | TotalAssetsEOY |
| Total Liabilities BOY | 9131309 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9918887 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3487531 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3708029 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE NURSING AND RESPIRATORY CARE TO THOSE WHO REQUIRE FREQUENT SKILLED NURSING AND RESPIRATORY INTERVENTION. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7577779 | Expense |
| Revenue | 7586675 | Revenue |
| Description | ARIZONA'S FIRST SKILLED NURSING FACILITY FOR INFANTS, CHILDREN, TEENS, AND YOUNG ADULTS. CARE FOR MEDICALLY FRAGILE PATIENTS WHO REQUIRE FREQUENT SKILLED NURSING AND RESPIRATORY INTERVENTIONS. | Description |
| Total Program Service Expense | 7577779 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 179 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6022434231 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 EAST SOUTH MOUNTAIN AVENUE | AddressLine1 |
| City | PHOENIX | City |
| State | AZ | State |
| ZIP Code | 85042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| CARL MUNDING | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| THOM NIEMIEC | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| GARY ORMAN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RALPH WALLWORK | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| PATRICK WALSH | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| WANDA O'MALLEY | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| PATRICIA SHAW | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DICK KAUPIE | |||||||
| PRESIDENT | 2.00 | X | 0 | 0 | 0 | X | |
| TOM POMEROY | |||||||
| EXECUTIVE VICE PRESIDENT | 2.00 | X | 0 | 0 | 0 | X | |
| MICHAEL STONE | |||||||
| VICE PRESIDENT | 2.00 | X | 0 | 0 | 0 | X | |
| PETER RANKE | |||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | X | |
| BARRY GOLDSTIN | |||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X | |
| WILLIAM TIMMONS | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | 0 | 378315 | 22964 | X | ||
| DALE SKURDAHL | |||||||
| CHIEF OPERATIONS OFFICER MEDICAL SERVICES | 40.00 | 0 | 193366 | 41354 | X | ||
| JAMES SMITH | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 0 | 161691 | 14379 | X | ||
| ROBERT MILLER | |||||||
| CHIEF OPERATIONS OFFICER | 40.00 | 0 | 137009 | 7989 | X | ||
| STACI GLASS | |||||||
| DIRECTOR OF MARKETING | 40.00 | 0 | 142085 | 36590 | X | ||
| JOSEPH O'MALLEY | |||||||
| CONTROLLER/FINANCIAL ANALYST | 40.00 | 0 | 116029 | 15719 | X | ||
| MELINDA MORALES | |||||||
| DIRECTOR OF HUMAN RESOURCES | 40.00 | 0 | 110161 | 11300 | X | ||
| JANET LOVELADY | |||||||
| DIRECTOR OF NURSING | 40.00 | 0 | 110126 | 7086 | X | ||
| ANN CRISLER | |||||||
| HEALTH CARE LIASON | 40.00 | 0 | 109276 | 13527 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1458058 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 170908 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| LOS NINOS HOSPITAL INC | |||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | NURSING REGISTRY AND THERAPY SERVICES | 649500 |
| HACIENDA INC | |||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | MANAGEMENT SERVICES | 159300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| All Other Contributions | 204464 | AllOtherContributions |
| Noncash Contributions | 68250 | NoncashContributions |
| Total Contributions | 204464 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PRIVATE SECTOR REVENUE | 623000 | 7150284 | 7150284 |
| GOVERNMENT REVENUES | 623000 | 436391 | 436391 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 7586675 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2003 | TotalRevenueColumn |
| Exclusion | $2,003 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 311768 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 300237 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 11531 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11531 | TotalRevenueColumn |
| Exclusion | $11,531 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7804673 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7586675 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $13,534 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4321000 | Total |
| Program Services | 4321000 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32202 | Total |
| Program Services | 32202 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431917 | Total |
| Program Services | 431917 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 261220 | Total |
| Program Services | 261220 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 159300 | Total |
| Management And General | 159300 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2250 | Total |
| Management And General | 2250 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 762560 | Total |
| Program Services | 759232 | ProgramServices |
| Management And General | 3328 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9319 | Total |
| Program Services | 9319 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4397 | Total |
| Program Services | 4397 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 248079 | Total |
| Program Services | 248079 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1110 | Total |
| Program Services | 1110 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 192122 | Total |
| Program Services | 192122 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 243983 | Total |
| Program Services | 243983 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 188203 | Total |
| Program Services | 188203 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| SUPPLIES | 397492 | 397492 |
| FOOD | 282445 | 282445 |
| MISCELLANEOUS | 83084 | 83084 |
| MEDICAL EQUIPMENT | 69608 | 69608 |
| BAD DEBT EXPENSE | 52366 | 52366 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7742657 | Total |
| Program Services | 7577779 | ProgramServices |
| Management And General | 164878 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 379611 | BOY |
| EOY | 700 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 411536 | BOY |
| EOY | 1160895 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25000 | BOY |
| EOY | 72373 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 853286 | BOY |
| EOY | 1196784 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8584 | BOY |
| EOY | 26186 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5011 | BOY |
| EOY | 13227 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 11296473 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1253022 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9251016 | BOY |
| EOY | 10043451 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 140000 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1544796 | BOY |
| EOY | 1113300 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12618840 | BOY |
| EOY | 13626916 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 672755 | BOY |
| EOY | 814372 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6000000 | BOY |
| EOY | 6000000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2458554 | BOY |
| EOY | 3104515 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9131309 | BOY |
| EOY | 9918887 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3079915 | BOY |
| EOY | 3636823 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 407616 | BOY |
| EOY | 71206 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3487531 | BOY |
| EOY | 3708029 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12618840 | BOY |
| EOY | 13626916 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 62016 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 158482 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 517920 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 278143 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 59509 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 520732 | CurrentTaxYearMinus1Year |
| Current Tax Year | 204464 | CurrentTaxYear |
| Total | 1580768 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3369235 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4335915 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6833526 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7060007 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7598206 | CurrentTaxYear |
| Total | 29196889 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3887155 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4614058 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6893035 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7580739 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7802670 | CurrentTaxYear |
| Total | 30777657 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 37224 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 300000 | CurrentTaxYearMinus1Year |
| Total | 337224 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 37224 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 300000 | CurrentTaxYearMinus1Year |
| Total | 337224 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 30440433 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 184224 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7893 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8843 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3213 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2003 | CurrentTaxYear |
| Total | 206176 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 184224 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7893 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8843 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3213 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2003 | CurrentTaxYear |
| Total | 206176 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 8366 | CurrentTaxYearMinus3Years |
| Total | 8366 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4071379 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4630317 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6901878 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7583952 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7804673 | CurrentTaxYear |
| Total | 30992199 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.98220 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.97740 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00670 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01000 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9204689 | OtherCostOrOtherBasis |
| Depreciation | 845730 | Depreciation |
| Book Value | 8358959 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 87006 | OtherCostOrOtherBasis |
| Depreciation | 9875 | Depreciation |
| Book Value | 77131 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 454342 | OtherCostOrOtherBasis |
| Depreciation | 202127 | Depreciation |
| Book Value | 252215 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1550436 | OtherCostOrOtherBasis |
| Depreciation | 195290 | Depreciation |
| Book Value | 1355146 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10043451 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM RELATED AFFILIATE | 1100233 |
| SCHOOL LOANS RECEIVABLE | 13067 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1113300 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED AFFILIATE | $2,615,641 |
| INTEREST RATE SWAP AGREEMENT | $488,874 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3104515 | TotalOfAmounts |
| Total Revenue | 7804673 | TotalRevenue |
| Total Expenses | 7742657 | TotalExpenses |
| Excess Or Deficit For Year | 62016 | ExcessOrDeficitForYear |
| Donated Services And Facilities | 50000 | DonatedServicesAndFacilities |
| Other | $108,482 | OtherAmount |
| Total Adjustments | 158482 | TotalAdjustments |
| Excess Or Deficit Per FS | 220498 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 8154910 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 50000 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 50000 | RevenueNotRptdF990 |
| Revenue Subtotal | 8104910 | RevenueSubtotal |
| Other Revenues Not Included | -300237 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -300237 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7804673 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8151376 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 408719 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 408719 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7742657 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7742657 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | 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, 2011, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | LOSS ON INTEREST RATE SWAP AGREEMENT 108,482. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INTEREST EXPENSE NETTED WITH RENTAL INCOME ON FORM 990 -184,588. DEPRECIATION EXPENSE NETTED WITH RENTAL INCOME ON FORM 990 -115,649. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | INTEREST EXPENSE NETTED WITH RENTAL INCOME ON FORM 990 184,588. DEPRECIATION EXPENSE NETTED WITH RENTAL INCOME ON FORM 990 115,649. LOSS ON INTEREST RATE SWAP AGREEMENT 108,482. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM TIMMONS | |||||||||||||
| 0 | 333315 | 0 | 45000 | 0 | 0 | 0 | 14512 | 0 | 8452 | 0 | 401279 | 0 | 0 |
| DALE SKURDAHL | |||||||||||||
| 0 | 183904 | 0 | 9462 | 0 | 0 | 0 | 10210 | 0 | 31144 | 0 | 234720 | 0 | 0 |
| JAMES SMITH | |||||||||||||
| 0 | 156741 | 0 | 4950 | 0 | 0 | 0 | 0 | 0 | 14379 | 0 | 176070 | 0 | 0 |
| STACI GLASS | |||||||||||||
| 0 | 104918 | 0 | 37167 | 0 | 0 | 0 | 6206 | 0 | 30384 | 0 | 178675 | 0 | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | PATIO REMODEL | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 60554 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| 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. | |
| 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 12C | |
| THE BOARD OF DIRECTORS DETERMINES REASONABLE AND APPROPRIATE SALARIES FOR KEY EMPLOYEES OF THE ORGANIZATION. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION GENERALLY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| COMPENSATION FROM RELATED ORGANIZATION | HACIENDA SKILLED NURSING FACILITY, INC. IS RELATED TO TWO TAX EXEMPT AFFILIATES, HACIENDA, INC. AND LOS NINOS HOSPITAL, INC. THESE THREE ORGANIZATIONS SHARE A COMMON MANAGEMENT TEAM. THE INDIVIDUALS ON THE MANAGEMENT TEAM ARE COMPENSATED AS EMPLOYEES THROUGH HACIENDA, INC. HACIENDA, INC. CHARGES A MANAGEMENT FEE FOR THESE SERVICES TO BOTH LOS NINOS HOSPITAL, INC. AND TO HACIENDA SKILLED NURSING FACILITY, INC. THE COMPENSATION AMOUNTS LISTED IN PART VII ARE THE TOTAL GROSS WAGES AND OTHER COMPENSATION PAID TO THESE INDIVIDUALS FOR THEIR SERVICES TO ALL THREE ORGANIZATIONS. | FORM 990, PART VII, LINE 1A |
| CHANGES IN NET ASSETS OR FUND BALANCES: | DONATED SERVICES AND USE OF FACILITIES: 50,000. LOSS ON INTEREST RATE SWAP AGREEMENT 108,482. TOTAL TO FORM 990, PART XI, LINE 5: 158,482. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HACIENDA HEALTHCARE | ||||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 272988610 | BRAND NAME FOR RELATED ORGAIZATIONS | AZ | 501(C)(3) | LINE 9 | N/A | 0 |
| HACIENDA INC | ||||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 860253158 | NURSING CARE & RESPIRATORY INTERVENTION | 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 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| SOUTH MOUNTAIN HEALTH SUPPLY | ||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 860858893 | MEDICAL SUPPLY COMPANY | AZ | HACIENDA HEALTHCARE | C |
| INNOVATIVE HOME HEALTH INC | ||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 262398755 | HOME HEALTH NURSING SERVICES | AZ | HACIENDA HEALTHCARE | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 1 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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