LOS NINOS HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- LOS NINOS HOSPITAL INC (EIN 86-0892673)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-11
- IRS object ID
- 201121319349302627
- Schema version
- 2009v1.7
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-11T17:15:38-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | 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 | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860892673 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOS NINOS HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LOSN | NameControl |
| Phone | 6022434231 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E 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 | 2011-05-02 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Colette Kamps CPA | Name |
| Phone | 4804831170 | Phone |
| Date Prepared | 2011-05-02 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | 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 E SOUTH MOUNTAIN AVENUE | AddressLine1 |
| City | PHOENIX | City |
| State | AZ | State |
| ZIP Code | 85042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17352891 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.haciendahealthcare.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | NON-PROFIT CHILDREN'S HOSPITAL | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 180 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 160496 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1957 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17102257 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17295035 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 91250 | InvestmentIncomePriorYear |
| Investment Income Current Year | 53657 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 2242 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17354003 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17352891 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 50000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6138446 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6533693 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8428668 | OtherExpensePriorYear |
| Other Expenses Current Year | 8579693 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14567114 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15163386 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2786889 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2189505 | RevenuesLessExpensesCY |
| Total Assets BOY | 19722985 | TotalAssetsBOY |
| Total Assets EOY | 21918043 | TotalAssetsEOY |
| Total Liabilities BOY | 1193929 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1188593 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18529056 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 20729450 | NetAssetsOrFundBalancesEOY |
| Mission Description | NON-PROFIT CHILDREN'S HOSPITAL | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2777478 | Expense |
| Revenue | 2852482 | Revenue |
| Description | INPATIENT - A 15 BED FAMILY ORIENTED HOSPITAL SPECIALIZING IN HIGH QUALITY ACUTE AND SUB-ACUTE CARE FOR INFANTS, CHILDREN, AND TEENS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2810956 | Expense |
| Revenue | 3810538 | Revenue |
| Description | HOME HEALTHCARE - PROVIDES HOME HEALTH CARE NEEDS TO INFANTS, CHILDREN, AND YOUNG ADULTS WITH SPECIAL HOME HEALTH CARE NEEDS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5065749 | Expense |
| Revenue | 5695873 | Revenue |
| Description | OUTPATIENT - HOME TO THE ONLY SYNAGIS OUTPATIENT CLINIC IN ARIZONA PROVIDING IMMUNIZATION AGAINST RESPIRATORY SYNCYTIAL VIRUS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3794451 | Expense |
| Revenue | 4938384 | Revenue |
| Description | THERAPY SERVICES - PROVIDES A BROAD RANGE OF PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY SERVICCES. SERVICES ARE PROVIDED THROUGH INPATIENT, OUTPATIENT AND HOME HEALTH CARE. THERAPY CLINIC- AN EXTENSION OF THE HOME BASE THERAPY SERVICES PROGRAM.REGISTRY SERVICES - PROVIDES STAFFING NEEDS TO FILL VACANT POSITIONS AND OPEN SHIFTS WITHIN THE PROFESSIONAL SETTING INCLUDING RN'S, LPN'S, CNA'S, CAREGIVERS, AND RESPIRATORY THERAPISTS. VENTILATOR - THIS PROGRAM ENABLES VENTILATOR DEPENDENT INDIVIDUALS TO FUNCTION IN SOCIETY AT THE OPTIMAL LEVEL OF THEIR CAPABILITIES BY COMBINING TECHNOLOGY, SERVICES, AND MEDICAL SUPPLIES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 3794451 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 4938384 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 14448634 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | 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 |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | Hospital |
| Grants To Organizations | 1 | 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 | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | 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 |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 180 | 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 |
| 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 | 0 | 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 E SOUTH MOUNTAIN AVENUE | AddressLine1 |
| City | PHOENIX | City |
| State | AZ | State |
| ZIP Code | 85042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Carl Munding | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Thom Niemiec | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Gary Orman | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Ralph Wallwork | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Patrick Walsh | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Bruce Samuels | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Wanda O'Malley | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Patricia Shaw | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Dick Kaupie | ||||||||
| President | 5.00 | X | 0 | 0 | 0 | X | ||
| Tom Pomeroy | ||||||||
| Executive Vice President | 5.00 | X | 0 | 0 | 0 | X | ||
| Michael Stone | ||||||||
| Vice President | 5.00 | X | 0 | 0 | 0 | X | ||
| Peter Ranke | ||||||||
| Treasurer | 5.00 | X | 0 | 0 | 0 | X | ||
| Barry Goldstin | ||||||||
| Secretary | 5.00 | X | 0 | 0 | 0 | X | ||
| William Timmons | ||||||||
| Chief Executive Officer | 50.00 | 0 | 360868 | 21188 | X | |||
| Dale Skurdahl | ||||||||
| Chief Operations Officer Medical Se | 50.00 | 0 | 220240 | 38679 | X | |||
| Robert Miller | ||||||||
| Chief Operations Officer | 50.00 | 0 | 149760 | 7596 | X | |||
| Jim Smith | ||||||||
| Chief Financial Officer | 50.00 | 0 | 0 | 0 | X | |||
| RICHARD HART | ||||||||
| CHIEF Financial Officer | 40.00 | 0 | 35432 | 0 | X | |||
| Davena Ballard | ||||||||
| Director Synagis | 50.00 | 155190 | 0 | 21085 | X | |||
| Joseph O'Malley | ||||||||
| Controller/Financial Analyst | 50.00 | 0 | 121388 | 12935 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 155190 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 887688 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 101483 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hacienda Inc | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1402 E South Mountain Ave | AddressLine1 |
| City | Phoenix | City |
| State | AZ | State |
| ZIP Code | 85042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | management fees | DescriptionOfServices |
| Compensation | 636000 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 1957 | AllOtherContributions |
| Noncash Contributions | 1957 | NoncashContributions |
| Total Contributions | 1957 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PRIVATE SECTOR REVENUE | 623000 | 10362872 | 10362872 |
| GOVERNMENT REVENUE | 623000 | 5949832 | 5949832 |
| THERAPY INCOME FROM RE | 623000 | 982331 | 982331 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17295035 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 53657 | TotalRevenueColumn |
| Exclusion | $53,657 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | miscellaneous | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 2242 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2242 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2242 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17352891 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17297277 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $53,657 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50000 | Total |
| Program Services | 50000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155190 | Total |
| Program Services | 155190 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5392344 | Total |
| Program Services | 5392344 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101363 | Total |
| Program Services | 101363 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 505593 | Total |
| Program Services | 501797 | ProgramServices |
| Management And General | 3796 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 379203 | Total |
| Program Services | 379203 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 636000 | Total |
| Management And General | 636000 | 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 | 540440 | Total |
| Program Services | 495971 | ProgramServices |
| Management And General | 44469 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31639 | Total |
| Program Services | 31639 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19221 | Total |
| Program Services | 17555 | ProgramServices |
| Management And General | 1666 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 545047 | Total |
| Program Services | 534047 | ProgramServices |
| Management And General | 11000 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22309 | Total |
| Program Services | 22309 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 123 | Total |
| Program Services | 123 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 283514 | Total |
| Program Services | 283514 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 144309 | Total |
| Program Services | 144309 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 5977933 | 5962372 | 15561 |
| EQUIPMENT EXPENSE | 187892 | 187892 | |
| MISCELLANEOUS | 87980 | 87970 | 10 |
| BAD DEBT | 69741 | 69741 | |
| FLEET EXPENSES | 31295 | 31295 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15163386 | Total |
| Program Services | 14448634 | ProgramServices |
| Management And General | 714752 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5291373 | BOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3963827 | BOY |
| EOY | 6138789 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50000 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1365224 | BOY |
| EOY | 1545158 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 301257 | BOY |
| EOY | 309976 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20230 | BOY |
| EOY | 23188 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4675750 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2839141 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2052463 | BOY |
| EOY | 1836609 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 107077 | BOY |
| EOY | 117966 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6571534 | BOY |
| EOY | 11946357 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19722985 | BOY |
| EOY | 21918043 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1192400 | BOY |
| EOY | 1133215 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1529 | BOY |
| EOY | 55378 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1193929 | BOY |
| EOY | 1188593 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18438344 | BOY |
| EOY | 20722161 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90712 | BOY |
| EOY | 7289 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18529056 | BOY |
| EOY | 20729450 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19722985 | BOY |
| EOY | 21918043 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 77150 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 47113 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5228 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 160496 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1957 | CurrentTaxYear |
| Total | 291944 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 13367474 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14446794 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 16118706 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17102257 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17295035 | CurrentTaxYear |
| Total | 78330266 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 13444624 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14493907 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 16123934 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17262753 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17296992 | CurrentTaxYear |
| Total | 78622210 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | 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) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 78622210 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 120942 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 225632 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 77303 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 91250 | CurrentTaxYearMinus1Year |
| Current Tax Year | 53657 | CurrentTaxYear |
| Total | 568784 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 120942 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 225632 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 77303 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 91250 | CurrentTaxYearMinus1Year |
| Current Tax Year | 53657 | CurrentTaxYear |
| Total | 568784 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 2242 | CurrentTaxYear |
| Total | 2242 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 13565566 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14719539 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 16201237 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17354003 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17352891 | CurrentTaxYear |
| Total | 79193236 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99280 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.98470 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00720 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00650 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 795024 | OtherCostOrOtherBasis |
| Book Value | 795024 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 263146 | OtherCostOrOtherBasis |
| Depreciation | 118569 | Depreciation |
| Book Value | 144577 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3338985 | OtherCostOrOtherBasis |
| Depreciation | 2500430 | Depreciation |
| Book Value | 838555 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 278595 | OtherCostOrOtherBasis |
| Depreciation | 220142 | Depreciation |
| Book Value | 58453 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1836609 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM RELATED AFFILIATES | 11934221 |
| EMPLOYEE RECEIVABLES | 12136 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 11946357 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAPITAL LEASE | Description |
| Amount | $55,378 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 55378 | TotalOfAmounts |
| Total Revenue | 17352891 | TotalRevenue |
| Total Expenses | 15163386 | TotalExpenses |
| Excess Or Deficit For Year | 2189505 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 10889 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 10889 | TotalAdjustments |
| Excess Or Deficit Per FS | 2200394 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 17363780 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 10889 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 10889 | RevenueNotRptdF990 |
| Revenue Subtotal | 17352891 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17352891 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15163386 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15163386 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15163386 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | The Organization recognizes tax positions in the financial statements when it is more likely than not that the positions will not be sustained upon examination by the tax authorities. As of June 30, 2010, the Organization had no uncertain tax positions that qualify for either recognition or disclosure in the financial statements. The Organization's federal and state exempt returns (Form 990 and 99) for fiscal years ended June 30, 2007, 2008, 2009 and 2010 are subject to examination by the IRS and the State of Arizona, generally for three years after they were filed. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2552 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2552 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 270274 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 270274 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01800 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 272826 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 272826 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01800 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 272826 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 272826 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01800 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $69,741 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 152539 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 123967 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 28572 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOS NINOS HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2303 E THOMAS RD | AddressLine1 |
| City | PHOENIX | City |
| State | AZ | State |
| ZIP Code | 85016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Childrens Hospital | X | ChildrensHospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | 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. | BadDebtFootnote |
| Debt Collection Policy | 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. | DebtCollectionPolicy |
| Community Information | Part VI, Line 4: AS DESCRIBED IN FORM 990, PART III, SUPPLEMENTED IN SCHEDULE O, LOS NINOS HOSPITAL PROVIDES A VARIETY OF CLINICAL PROGRAMS THAT ARE CRITICAL TO THE HEALTH OF INFANTS, CHILDREN AND YOUNG ADULTS WHO ARE CHRONICALLY ILL AND MEDICALLY FRAGILE. NEARLY ALL PATIENTS ARE COVERED BY GOVERNMENTAL HEALTH PROGRAMS DUE TO THE NATURE OF THEIR MEDICAL CONDITIONS, SUCH AS THE STATE OF ARIZONA'S DIVISION OF DEVELOPMENTAL DISABILITIES, THE ARIZONA MEDICAID PROGRAM (KNOWN AS AHCCCS), OR MEDICAID MANAGED CARE PLANS. AS A RESULT, FEW PATIENTS HAVE A NEED FOR CHARITY DISCOUNTS.THE LOS NINOS HOSPITAL INPATIENT UNIT PROVIDES ACUTE AND SUB-ACUTE HOSPITAL CARE TO INFANTS AND CHILDREN LESS EXPENSIVELY THAN LARGER ACUTE CARE HOSPITALS. MEDICAL SERVICES PAYORS OFTEN REQUIRE THE TRANSFER OF PATIENTS TO LOS NINOS FROM MORE EXPENSIVE SETTINGS WHEN THEY'RE CLINICALLY APPROPRIATE, THEREBY SAVING SCARCE GOVERNMENT FUNDS.LOS NINOS HOSPITAL'S SIX SYNAGIS CLINICS PROTECT HIGH RISK INFANTS FROM CONTRACTING RESPIRATORY SYNCYTIAL VIRUS, THEREBY SAVING LIVES AND MINIMIZING THE POTENTIAL FOR EXPENSIVE LIFELONG RESPIRATORY TREATMENT. LOS NINOS HOSPITAL'S HOME VENTILATOR PROGRAM AND HOME HEALTH SERVICES PROVIDE PATIENTS WITH EFFECTIVE HEALTH CARE IN THEIR HOMES, A FAR LESS EXPENSIVE SETTING THAN HOSPITALS, THEREBY FURTHER SAVING INCREASINGLY SCARCE GOVERNMENT FUNDS. | CommunityInformation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HACIENDA SKILLED NURSING FACILITY INC | BusinessNameLine1 |
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) |
|---|---|---|
| EIN Of Recipient | 141906233 | EINOfRecipient |
| IRC Section | 3 | IRCSection |
| Amount Of Cash Grant | 50000 | AmountOfCashGrant |
| Purpose Of Grant | Capital campaign | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The contribution given during fiscal year 2010 was to an affiliated organization, as determined by the board of directors. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | 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 | 310868 | 0 | 50000 | 0 | 0 | 0 | 13719 | 0 | 7469 | 0 | 382056 | 0 | 0 |
| Dale Skurdahl | |||||||||||||
| 0 | 203377 | 0 | 16863 | 0 | 0 | 0 | 11437 | 0 | 27242 | 0 | 258919 | 0 | 0 |
| Robert Miller | |||||||||||||
| 0 | 127794 | 0 | 21966 | 0 | 0 | 0 | 6589 | 0 | 1007 | 0 | 157356 | 0 | 0 |
| Davena Ballard | |||||||||||||
| 137407 | 0 | 17783 | 0 | 0 | 0 | 5331 | 0 | 15754 | 0 | 176275 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Pomeroy & Pomeroy | |||
| Entity more than 35% owned by T.Pomeroy, board member | 0 | Insurance Brokerage services | 0 |
| South Mountain Health Supply Inc (SMHS) | |||
| OFFICERS OF SMHS ARE BOARD MEMBERS OF FILING ORGANIZATION | 5562352 | The organization purchases health care supplies from SMHS. | 0 |
| Hacienda Inc | |||
| same board of directors | 636000 | Hacienda provides management services to the filing organization. | 0 |
| Hacienda Inc | |||
| Same board of directors | 38465 | The filing organization provides nurse registry services and therapy services to Hacienda. | 0 |
| Hacienda Skilled Nursing Facility Inc (SNF) | |||
| same board of directors | 897516 | The filing organization provides nurse registry services and therapy services to SNF. | 0 |
| Hacienda Skilled Nursing Facility Inc (SNF) | |||
| same board of directors | 11423 | SNF charges rent to the filing organization for use of its facility. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section B, line 11 | The Organization's CEO, CFO, 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 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 officers and KEY EMPLOYEES OF THE ORGANIZATION. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, and FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| SCHEDULE R- PART II AND PART IV THE FILING ORGANIZATION IS PART OF A GROUP OF ENTITIES WHICH ARE ALL AFFILIATED UNDER THE NAME HACIENDA HEALTHCARE. THIS GROUP OF ENTITIES ALSO INCLUDES HACIENDA SKILLED NURSING FACILITY, INC.(SNF)(A TAX EXEMPT ENTITY); HACIENDA, INC. (HACIENDA) (A TAX EXEMPT ENTITY); CHILDREN'S ANGEL FOUNDATION (A TAX EXEMPT ENTITY); AND SOUTH MOUNTAIN HEALTH SUPPLY, INC. (SMHS)(A TAXABLE ENTITY). SOUTH MOUNTAIN HEALTH SUPPLY is WHOLLY OWNED BY HACIENDA HEALTHCARE AND FILEs AS a SEPARATE TAXABLE ENTITY. HACIENDA EMPLOYS THE FOUR EMPLOYEES WHO SERVE AS THE TOP MANAGEMENT OFFICIALS OF ALL OF THESE ENTITIES. THE FILING ORGANIZATION, SNF, SMHS, AND CAF ALL PAY MANAGEMENT FEES TO HACIENDA FOR AN ALLOCATED PORTION OF THESE SERVICES AS WELL AS FOR OTHER SHARED SERVICES. THE SALARIES LISTED FOR THESE INDIVIDUALS ON PART 7 REPRESENT 100% OF THEIR SALARIES PER THEIR FORMS W-2. |
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 |
|---|---|---|---|---|---|---|---|---|
| HACIENDA HEALTHCARE INC | ||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 272988610 | BRAND NAME FOR RELATED ORGANIZATIONS | AZ | 3 | 7 |
| HACIENDA SKILLED NURSING FACILITY INC | ||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 141906233 | NURSING CARE & RESPIRATORY INTERVENTION | AZ | 3 | 7 |
| HACIENDA Inc | ||||||||
| 1402 E SOUTH MOUNTAIN AVE | PHOENIX | AZ | 85042 | 860253158 | PROVIDE SERVICES FOR HANDICAPPED & CHRONICALLY ILL CHILDREN | AZ | 3 | 7 |
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 INC | C |
| INNOVATIVE HOME HEALTH INC | ||||||||
| 1402 E SOUTH MOUNTAIN AVE | pHOENIX | AZ | 85042 | 262398755 | HOME HEALTH NURSING SERVICES | AZ | HACIENDA HEALTHCARE INC | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | 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 | 0 | 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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