HACIENDA INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HACIENDA INC (EIN 86-0253158)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-11
IRS object ID
201141319349302684
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-11T17:15:38-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Henry & Horne LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line17098 E Cochise Suite 100AddressLine1
CityScottsdaleCity
StateAZState
ZIP Code852534517ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

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 Code85042ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWILLIAM TimmonsName
TitleCEOTitle
Phone6022434231Phone
Date Signed2011-05-02DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameColette Kamps CPAName
Phone4804831170Phone
Date Prepared2011-05-02DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

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 Code85042ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17593979GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
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 Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees414TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI70664TotalGrossUBI
Net Unrelated Business Txbl Income-20054NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year452387ContributionsGrantsPriorYear
Contributions Grants Current Year256374ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15149597ProgramServiceRevenuePriorYear
Program Service Revenue CY14574467ProgramServiceRevenueCY
Investment Income Prior Year145879InvestmentIncomePriorYear
Investment Income Current Year182117InvestmentIncomeCurrentYear
Other Revenue Prior Year871653OtherRevenuePriorYear
Other Revenue Current Year980910OtherRevenueCurrentYear
Total Revenue Prior Year16619516TotalRevenuePriorYear
Total Revenue Current Year15993868TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year12301821SalariesEtcPriorYear
Salaries Etc Current Year13253351SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4102758OtherExpensePriorYear
Other Expenses Current Year4071223OtherExpensesCurrentYear
Total Expenses Prior Year16404579TotalExpensesPriorYear
Total Expenses Current Year17324574TotalExpensesCurrentYear
Revenues Less Expenses Prior Year214937RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1330706RevenuesLessExpensesCY
Total Assets BOY6594909TotalAssetsBOY
Total Assets EOY12438044TotalAssetsEOY
Total Liabilities BOY6004178TotalLiabilitiesBOY
Total Liabilities EOY12995267TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY590731NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-557223NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE SERVICES FOR HANDICAPPED AND CHRONICALLY ILL CHILDRENMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense10961649Expense
Revenue11518805Revenue
DescriptionIntermediate Care Facility - PROVIDES MEDICAL, EDUCATIONAL, SOCIAL, AND RECREATIONAL NEEDS TO THOSE WHO ARE DISABLED.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense308713Expense
Revenue305684Revenue
DescriptionDAY TREATMENT AND TRAINING - A PROGRAM FOR YOUNG ADULTS AND TEENAGERS WITH DEVELOPMENTAL DISABILITIES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3192050Expense
Revenue3282904Revenue
DescriptionGROUP HOMES AND MEDICAL GROUP HOMES - PROVIDES AROUND-THE- CLOCK SUPERVISION TO CHRONICALLY ILL CHILDREN WHO DO NOT REQUIRE ON SITE DOCTORS, NURSES, AND THERAPISTS.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense356365Expense
Revenue377320Revenue
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.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp356365TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev377320TotalOfOtherProgramServiceRev
Total Program Service Expense14818777TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
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 Organization0BsnssRltnshpWithOrganization
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 With109619NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees414NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
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 Body0Form990ProvidedToGoverningBody
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 Code85042ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Carl Munding
Director5.00X000
Thom Niemiec
Director5.00X000
Gary Orman
Director5.00X000
Ralph Wallwork
Director5.00X000
Patrick Walsh
Director5.00X000
Bruce Samuels
Director5.00X000
Wanda O'Malley
Director5.00X000
Patricia Shaw
Director5.00X000
Dick Kaupie
President5.00X000X
Tom Pomeroy
Executive Vice President5.00X000X
Michael Stone
Vice President5.00X000X
Peter Ranke
Treasurer5.00X000X
Barry Goldstin
Secretary5.00X000X
William Timmons
Chief Executive Officer50.00360868021188X
Dale Skurdahl
Chief Operations Officer Medical Se50.00220240038679X
Robert Miller
Chief Operations Officer50.0014976007596X
Jim Smith
Chief Financial Officer50.00000X
RICHARD HART
CHIEF FINANCIAL OFFICER40.003543200X
Staci Glass
Director Marketing50.00130753032694X
Joseph O'Malley
Controller/Financial Analyst50.00121388012935X
Janet Lovelady
Director of Nursing50.00117582021330X
Anne Crisler
Health Care Liason50.00114576012428X
Lysa Garcia
Assistant Chief Operating Officer50.0011578606469X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1366385TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation153319TotalOtherCompensation
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 Code85042ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesRentDescriptionOfServices
Compensation300233Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions256374AllOtherContributions
Noncash Contributions51816NoncashContributions
Total Contributions256374TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
GOVERNMENT FEES FOR SE6230001429788614297886
PRIVATE SECTOR FEES FO623000276581276581
FieldValueIRS element (for citing)
Total Program Service Revenue14574467TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column109176TotalRevenueColumn
Exclusion$109,176ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1673052Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1600111Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities72941Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column72941TotalRevenueColumn
Exclusion$72,941ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MANAGEMENT FEES623000885307885307
Catering income6230007066470664
Miscellaneous income6230002493924939
FieldValueIRS element (for citing)
Total Other Revenue980910TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15993868TotalRevenueColumn
Related Or Exempt Function Income15484713RelatedOrExemptFunctionIncome
Unrelated Business Revenue70664UnrelatedBusinessRevenue
Exclusion$182,117ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total730868Total
Program Services370000ProgramServices
Management And General360868ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10414473Total
Program Services8586487ProgramServices
Management And General1827986ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total260375Total
Program Services242149ProgramServices
Management And General18226ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1076218Total
Program Services1005233ProgramServices
Management And General70985ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total771417Total
Program Services717418ProgramServices
Management And General53999ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total44411Total
Program Services34245ProgramServices
Management And General10166ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total24201Total
Management And General24201ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total188878Total
Program Services188878ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total44566Total
Program Services37828ProgramServices
Management And General6738ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total63105Total
Program Services49277ProgramServices
Management And General13828ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total675044Total
Program Services663910ProgramServices
Management And General11134ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total4134Total
Program Services3768ProgramServices
Management And General366ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total279540Total
Program Services273878ProgramServices
Management And General5662ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total417425Total
Program Services399906ProgramServices
Management And General17519ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies1335693131817717516
Food359709359709
Equipment expense25236822219130177
Other operating expense20053817800622532
Fleet expenses101655101655

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total79956Total
Program Services66062ProgramServices
Management And General13894ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17324574Total
Program Services14818777ProgramServices
Management And General2505797ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY18516BOY
EOY3160EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1344191BOY
EOY1262022EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY152969BOY
EOY175197EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY227275BOY
EOY233812EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5626187LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3133156LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2364208BOY
EOY2493031EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2337363BOY
EOY8197646EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY150387BOY
EOY73176EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6594909BOY
EOY12438044EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1198039BOY
EOY1020608EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY128764BOY
EOY223319EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4677375BOY
EOY11751340EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6004178BOY
EOY12995267EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY373943BOY
EOY-738037EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY213588BOY
EOY177614EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3200BOY
EOY3200EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY590731BOY
EOY-557223EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6594909BOY
EOY12438044EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 Years67080CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years487255CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years199002CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year452287CurrentTaxYearMinus1Year
Current Tax Year256374CurrentTaxYear
Total1461998Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9542487CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11826723CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13675375CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15149597CurrentTaxYearMinus1Year
Current Tax Year14574467CurrentTaxYear
Total64768649Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9609567CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12313978CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13874377CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15601884CurrentTaxYearMinus1Year
Current Tax Year14830841CurrentTaxYear
Total66230647Total

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 Total50966230647PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years43842CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years78156CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years144505CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year145879CurrentTaxYearMinus1Year
Current Tax Year182117CurrentTaxYear
Total594499Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years43842CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years78156CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years144505CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year145879CurrentTaxYearMinus1Year
Current Tax Year182117CurrentTaxYear
Total594499Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year-1203CurrentTaxYearMinus1Year
Current Tax Year-20054CurrentTaxYear
Total-21257Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years529458CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years798515CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years809104CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year871653CurrentTaxYearMinus1Year
Current Tax Year885307CurrentTaxYear
Total3894037Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10182867CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13190649CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14827986CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year16618213CurrentTaxYearMinus1Year
Current Tax Year15878211CurrentTaxYear
Total70697926Total
FieldValueIRS element (for citing)
Public Support Percentage5090.93680PublicSupportPercentage509
Prior Year Support Percentage0.93860PriorYearSupportPercentage
Investment Income Percentage0.00840InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00850PriorYrInvestIncomePercentage
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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis34000OtherCostOrOtherBasis
Book Value34000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2591787OtherCostOrOtherBasis
Depreciation1245632Depreciation
Book Value1346155BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1145778OtherCostOrOtherBasis
Depreciation542668Depreciation
Book Value603110BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1180977OtherCostOrOtherBasis
Depreciation877286Depreciation
Book Value303691BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis673645OtherCostOrOtherBasis
Depreciation467570Depreciation
Book Value206075BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2493031TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED AFFILIATE$11,600,083
Line of Credit$151,257
FieldValueIRS element (for citing)
Total Of Amounts11751340TotalOfAmounts
Total Revenue15993868TotalRevenue
Total Expenses17324574TotalExpenses
Excess Or Deficit For Year-1330706ExcessOrDeficitForYear
Net Unrealized GL On Investments182752NetUnrealizedGLOnInvestments
Total Adjustments182752TotalAdjustments
Excess Or Deficit Per FS-1147954ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt16176620TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments182752NetUnrealizedGainsInvestments
Revenue Not Rptd F990182752RevenueNotRptdF990
Revenue Subtotal15993868RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99015993868TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt17324574TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal17324574ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99017324574TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationEffective January 1, 2009, the Organization follows Accounting Standards for uncertainty in income taxes, which require that tax positions initially need to be recognized 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 J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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)

Base 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 Timmons
31086805000000013719074690382056000
Dale Skurdahl
203377016863000114370272420258919000
Robert Miller
1277940219660006589010070157356000
Staci Glass
10759402315900061160265780163447000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Pomeroy & Pomeroy
Entity more than 35% owned by T.Pomeroy, board member0Insurance brokerage services0
South Mountain Health Supply Inc (SMHS)
4 officers of SMHS are board members of organization1280301The Organization purchases health care supplies from SMHS0
South Mountain Health Supply Inc (SMHS)
4 officers of SMHS are board members of organization78000The filing organization provides management services to SMHS.0
Hacienda Skilled Nursing Facility Inc (SNF)
same board of directors159300The filing organization provides management services to SNF.0
Los Ninos Hospital Inc (LNH)
same board of directors636000The filing organization provides management services to LNH.0
Los Ninos Hospital Inc (LNH)
same board of directors38465LNH provides nursing registry services and therapy services to the filing organization0
hacienda Skilled Nursing Facility Inc (SNF)
same board of directors300233SNF charges rent to the filing organization for use of its facility.0

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable (3 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XPlaying cards120122FMV
XLandscape15230
XMiscellaneous kids supplies1026464
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11The 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 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 officers and KEY EMPLOYEES OF THE ORGANIZATION.
Form 990, Part VI, Section C, line 19THE ORGANIZATION Does not MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
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 LOS NINOS HOSPITAL, INC. (LNH)(A TAX EXEMPT ENTITY); HACIENDA SKILLED NURSING FACILITY, INC. (SNF) (A TAX EXEMPT ENTITY); CHILDREN'S ANGEL FOUNDATION (A TAX EXEMPT ENTITY); AND SOUTH MOUNTAIN HEALTH SUPPLY, INC. (SMHS)(A TAXABLE ENTITY). SMHS 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. SNF, LNH, SMHS, AND CAF ALL PAY MANAGEMENT FEES TO THE FILING ORGANIZATION FOR AN ALLOCATED PORTION OF THESE SERVICES AS WELL AS FOR OTHER SHARED SERVICES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatus
HACIENDA HEALTHCARE INC
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042272988610BRAND NAME FOR RELATED ORGANIZATIONSAZ37
HACIENDA SKILLED NURSING FACILITY INC
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042141906233NURSING CARE & RESPIRATORY INTERVENTIONAZ39
LOS NINOS HOSPITAL INC
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042860892673NON-PROFIT CHILDREN'S HOSPITALAZ39

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
SOUTH MOUNTAIN HEALTH SUPPLY
1402 E SOUTH MOUNTAIN AVEPHOENIXAZ85042860858893MEDICAL SUPPLY COMPANYAZHACIENDA HEALTHCARE INCC
INNOVATIVE HOME HEALTH INC
1402 E SOUTH MOUNTAIN AVEpHOENIXAZ85042262398755HOME HEALTH NURSING SERVICESAZHACIENDA HEALTHCARE INCC
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 Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org1PurchaseOfAssetsFromOtherOrg
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 Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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