2022-01-10T18:52:23-06:00 2020-06-30 860271207 SCHMIDT WESTERGARD & COMPANY PLLC 77 WEST UNIVERSITY DRIVE MESA AZ 852015830 990 2019-07-01 860892673 LOS NINOS HOSPITAL INC LOSN 6022434231 1402 E SOUTH MOUNTAIN AVENUE PHOENIX AZ 85042 PERRY PETRILLI CEO 6022434231 2022-01-10 1 JEFFREY A BITHER P01428424 4808346030 2019 2022-09-23 18:48:47Z PERRY PETRILLI 1402 E SOUTH MOUNTAIN AVENUE PHOENIX AZ 85042 18383350 0 X HTTPS://HACIENDAINC.ORG/ X 1997 AZ TO CARE FOR MEDICALLY FRAGILE INFANTS, CHILDREN, TEENS AND ADULTS AT THEIR HOME. 1 1 58 1 0 0 1213522 1400627 6780723 6512431 -208079 432060 0 0 7786166 8345118 2895199 4304807 0 0 4120387 3798007 0 0 0 2013713 3168682 9029299 11271496 -1243133 -2926378 13198391 11275295 1146900 2266409 12051491 9008886 X TO CARE FOR MEDICALLY FRAGILE INFANTS, CHILDREN, TEENS AND ADULTS AT THEIR HOME. 0 1 6911786 4304807 2379844 HOME HEALTH CARE: HOME HEALTH CARE SPECIALIZES IN THE CARE OF INFANTS, CHILDREN AND ADULTS WITH SPECIAL HEALTH CARE NEEDS REQUIRING HOME HEALTH CARE FROM NURSES AND THERAPISTS WITH SPECIAL TRAINING. 3345305 3398248 VENTILATOR PROGRAM: THE VENTILATOR PROGRAM ENABLES VENTILATOR DEPENDENT INDIVIDUALS TO FUNCTION IN SOCIETY AT THE OPTIMAL LEVEL OF THEIR CAPABILITIES AND POTENTIAL BY COMBINING TECHNOLOGY, SERVICES AND MEDICAL SUPPLIES. THIS IS ACHIEVED BY PROVIDING PRODUCTS, EDUCATION, TRAINING AND ON-GOING MONITORING OF EQUIPMENT. THE VENTILATOR PROGRAM PROVIDES SERVICE ON VENTILATORS AND OTHER MEDICAL EQUIPMENT IN PATIENTS' HOMES, AS WELL AS A HOME ENTERAL FEEDING SERVICE THAT SERVES THE NUTRITIONAL NEEDS OF MEDICALLY FRAGILE PATEINTS BY PROVIDING FORMULA AND SUPPLIES. 533222 227625 SYNAGIS CLINICS: THE ORGANIZATION OPERATES 6 OUTPATIENT SYNAGIS CLINICS LOCATED IN ARIZONA AND COLORADO. SYNAGIS IS AN INJECTIBLE USED TO IMMUNIZE INFANTS AND YOUNG CHILDREN AGAINST RESPIRATORY SYNCYTIAL VIRUS (RSV). THE CLINICS ARE OPEN FROM NOVEMBER TO APRIL EACH YEAR, WHICH IS THE HIGH SEASON FOR RSV. 506714 ENTERAL SERVICES: THE ENTERAL PROGRAM SERVES THE NUTRITIONAL NEEDS OF MEDICALLY FRAGILE PATIENTS BY PROVIDING FORMULA AND SUPPLIES. 506714 10790313 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 58 1 0 0 0 0 0 0 0 0 0 0 X 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 6022434231 1402 E SOUTH MOUNTAIN AVENUE PHOENIX AZ 85040 X GARY ORMAN PRESIDENT 1.00 3.00 X X 0 0 0 THOM NIEMIEC FORMER BOARD MEMBER 0.50 1.50 X 0 0 0 MIKE WADE FORMER SECRETARY 1.00 3.00 X X 0 0 0 PERRY PETRILLI CEO 20.00 20.00 X 0 251885 0 JOHN WIDDER DIRECTOR HOME MEDICAL SERV 40.00 X 136324 0 0 JANET ORCUTT HOME VENT RT 40.00 X 104150 0 0 240474 251885 0 2 0 1 0 MCKESSON MEDICAL SURGICAL PO BOX 630693 CINCINNATIE OH 452630693 MEDICAL SUPPLIES SUPPLIER 1082695 RESPIRONICS PO BOX 405740 ATLANTA GA 303845740 MEDICAL SUPPLIES SUPPLIER 156961 SPECIALIED MEDICAL SERVICES 3112 SOLUTION CENTER CHICAGO IL 606773001 OXYGEN & OXYGEN SUPPLIES SUPPLIER 153925 SMITHS MEDICAL PO BOX 7247-7784 PHILADELPHIA PA 191707784 MEDICAL SUPPLIES SUPPLIER 129302 4 1396650 3977 1400627 GOVERNMENT PATIENT REVENUE 623990 5137137 5137137 PRIVATE PATIENT REVENUE 623990 1248903 1248903 VENT EQUIPMENT RENTAL INCOME 623990 64114 64114 OTHER INCOME 623990 62277 62277 6512431 45145 45145 10425147 10038232 386915 386915 386915 8345118 6512431 0 432060 4304807 4304807 3041541 2724367 317174 572093 506982 65111 184373 184373 31364 11884 19480 10000 10000 7055 7055 21736 21736 1991 1991 11507 11507 70331 52331 18000 195381 191513 3868 666 666 4698 4698 196523 196523 179800 155761 24039 SUPPLIES 2185438 2185438 EQUIPMENT EXPENSE 140694 140694 OTHER EXPENSES 59648 43192 16456 FLEET EXPENSES 21918 21918 29932 29932 11271496 10790313 481183 0 1176 0 6017079 7008186 824746 749851 47346 71196 5727 5727 4581262 3951290 820432 629972 5481885 2810363 13198391 11275295 446900 922362 700000 1344047 1146900 2266409 X 12050106 9008886 1385 0 12051491 9008886 13198391 11275295 -2926378 -116227 0 X X 0 1 X 1 0 X 9164 38362 115315 1213522 1400627 2776990 11815697 11511576 7267633 6780723 6512431 43888060 11824861 11549938 7382948 7994245 7913058 46665050 0 1150422 1317068 2467490 1150422 1317068 2467490 44197560 421434 87208 180139 94188 45145 828114 421434 87208 180139 94188 45145 828114 45909 385266 431175 12292204 12022412 7563087 8088433 7958203 47924339 0.92220 0.96500 0.01730 0.02480 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4581262 3951290 629972 629972 X 6825186 -116227 -116227 6941413 7055 1396650 1403705 8345118 6959634 0 6959634 7055 4304807 4311862 11271496 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "IRC") AND SIMILAR STATE PROVISIONS. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE ORGANIZATION'S TAX-EXEMPT PURPOSE MAY BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(III) OF THE IRC AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(1) OF THE IRC. THE ORGANIZATION HAS PROVIDED FOR INCOME TAXES ON ITS UNRELATED BUSINESS INCOME, WHICH HAVE NOT BEEN SIGNIFICANT, AS REQUIRED BY SECTION 512 OF THE CODE. THE ORGANIZATION ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON WHETHER IT IS "MORE-LIKELY-THAN-NOT" THAT THE POSITION WILL BE SUSTAINED BY THE TAXING AUTHORITY UPON EXAMINATION. THE ORGANIZATION ROUTINELY EVALUATES POTENTIAL UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAS IDENTIFIED ITS STATUS AS AN EXEMPT ORGANIZATION AS A TAX POSITION; HOWEVER, THE ORGANIZATION HAS DETERMINED THAT SUCH TAX POSITION DOES NOT RESULT IN AN UNCERTAINTY THAT REQUIRES RECOGNITION. THE ORGANIZATION FILES INFORMATIONAL AND INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF ARIZONA. AS OF JUNE 30, 2020, U.S. FEDERAL INFORMATIONAL AND INCOME TAX RETURNS FOR YEARS ENDED PRIOR TO JUNE 30, 2017 AND STATE RETURNS FOR YEARS ENDED PRIOR TO JUNE 30, 2016 ARE CLOSED TO ASSESSMENT. INTEREST AND PENALTIES, IF ANY, ARE ACCRUED AS A COMPONENT OF MANAGEMENT AND GENERAL EXPENSES WHEN ASSESSED. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS RECEIVED FROM RELATED PARTIES 1,396,650. PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS TO RELATED PARTIES 4,304,807. PARTS XI AND XII, LINE 4B THE RECONCILING ITEMS INCLUDED IN PARTS XI AND XII FOR CONTRIBUTIONS TO AND FROM RELATED PARTIES WERE REPORTED AS A NET AMOUNT ON THE FINANCIAL STATEMENTS. THIS NET LOSS WAS NOT INCLUDED AS REVENUE OR EXPENDITURES ON THE FINANCIAL STATEMENTS BUT WAS INSTEAD INCLUDED AS A SEPARATE ITEM UNDER GAINS AND LOSSES. 1 HACIENDA INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 860253158 4298045 TO FULFILL THE ORGANIZATION'S CHARITABLE PURPOSE HACIENDA CHILDREN'S HOSPITAL INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 473035370 6762 TO FULFILL THE ORGANIZATION'S CHARITABLE PURPOSE PART I, LINE 2: THE RELATED ORGANIZATIONS' GOVERNING BOARDS MONITOR THE USE OF GRANTS BETWEEN RELATED ENTITIES X X X 0 0 0 0 0 0 0 0 0 PERRY PETRILLI CEO 0 251885 0 0 0 0 0 0 0 0 0 251885 0 0 PART I, LINE 3 HACIENDA HEALTHCARE COMPLETES AN ANNUAL EXECUTIVE COMPENSATION COMPARABILITY DATA STUDY TO ENSURE THAT THE VALUE OF THE SERVICES PROVIDED BY ITS EXECUTIVES IS COMMENSURATE WITH THEIR COMPENSATION. THIS ANNUAL PROCESS DOCUMENTS HOW IMPORTANT THIS MATTER IS TO HACIENDA HEALTHCARE. IN ARIZONA MOST NON-PROFIT ORGANIZATIONS ONLY DO AN EXECUTIVE COMPENSATION ANALYSIS EVERY 3-5 YEARS WITH EVERY 3 YEARS BEING THE AUDITORS' RECOMMENDATION AND EVERY 5 YEARS BEING ACCEPTABLE. THE REASON THAT HACIENDA HEALTHCARE DOES ANNUAL EXECUTIVE COMPENSATION COMPARABILITY DATA STUDIES IS BECAUSE THE ALREADY COMPLEX AND MULTI-FACETED SERVICE DELIVERY SYSTEM CONTINUES TO GROW. FOR EXAMPLE, OVER THE LAST 25 YEARS A NEW PROGRAM WAS ADDED TO THE SERVICE DELIVERY SYSTEM APPROXIMATELY EVERY 11 MONTHS. HACIENDA HEALTHCARE IS A COMPLEX, MULTI-FACETED HEALTH CARE AND SOCIAL SERVICE DELIVERY SYSTEM THAT PROVIDES 43 PROGRAMS THROUGHOUT THE STATE OF ARIZONA, MANY OF WHICH ARE ONE-OF-A-KIND. THUS, A THREE COMPONENT EXECUTIVE COMPENSATION COMPARABILITY DATA STUDY IS USED. IT INCLUDES TWO SALARY/PAYROLL WEBSITES AND A THOROUGH COMPENSATION COMPARABILITY STUDY USING 990'S FROM APPROXIMATELY 50 NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS THAT SHARE A NUMBER OF COMMON VARIABLES WITH HACIENDA HEALTHCARE. WE CONSIDERED THE UTILIZATION OF REBUTTABLE PRESUMPTION STUDIES AS ANOTHER WAY TO DETERMINE APPROPRITAE EXECUTIVE COMPENSATION. WE DETERMINED THAT A COMPARABLE ORGANIZATION WOULD HAVE TO BE SIMILAR TO HACIENDA HEALTHCARE IN 12 WAYS IN ORDER TO BE VALID. WE REQUESTED THE NAMES OF SEVERAL COMPANIES THAT PERFORM REBUTTABLE PRESUMPTION STUDIES. WE WERE PROVIDED FOUR NAMES. NONE OF THE COMPANIES WE CONTACTED WERE WILLING TO CONTRACT WITH HACIENDA HEALTHCARE SINCE THEY DID NOT FEEL THEY COULD MEET THE 12 CATEGORIES REQUIREMENT. THE HACIENDA HEALTHCARE BOARD OF DIRECTORS APPROVES CHANGES IN EXECUTIVE COMPENSATION ANNUALLY BEFORE THE CHANGES TAKE PLACE. THE ANNUAL EXECUTIVE COMPENSATION COMPARABILITY DATA STUDY AND THE BOARD OF DIRECTORS' APPROVAL OF EXECUTIVE COMPENSATION ARE THOROUGHLY DOCUMENTED. FORM 990, PART III, LINE 3 THE ORGANIZATION CLOSED THE SYNAGIS CLINICS IN NOVEMBER 2019. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S BOARD TREASURER, CEO AND CONTROLLER WILL REVIEW AND APPROVE THE FORM 990 PRIOR TO FILING. THEY WILL THEN REVIEW THE FINAL FORM 990 WITH THE ENTIRE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT ADDRESSES THE CONSIDERATION OF POTENTIAL CONFLICTS OF INTEREST BY THE BOARD OF DIRECTORS, COMMITTEE MEMBERS, KEY EMPLOYEES, AND THEIR RELATIVES. AS PER THE POLICY, SUCH PERSONS MUST MAKE DISCLOSURE OF ANY POTENTIAL CONFLICTS OF INTEREST AND MUST ABSTAIN FROM VOTING ON ANY ACTION IN WHICH THEY MAY HAVE AN INTEREST. ON AN ANNUAL BASIS, ALL BOARD MEMBERS ARE REQUIRED TO SIGN OFF ON AN ANNUAL CONFLICT OF INTEREST FORM, EITHER STATING ANY KNOWN CONFLICTS, OR STATING THAT THERE ARE NONE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS DETERMINES REASONABLE AND APPROPRIATE SALARIES FOR KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION GENERALLY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII LOS NINOS HOSPITAL, INC. IS RELATED TO THREE TAX EXEMPT AFFILIATES: HACIENDA, INC., HACIENDA CHILDRENS HOSPITAL, INC. AND HACIENDA SKILLED NURSING FACILITY, INC. THESE ORGANIZATIONS SHARE A COMMON MANAGMENT TEAM. THE INDIVIDUALS ON THE MANAGEMENT TEAM ARE COMPENSATED AS EMPLOYEES BY HACIENDA, 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 AFFILIATED ORGANIZATIONS. FORM 990, PART XII, LINE 2C: THERE WERE NO CHANGES IN THE PROCESS FOR THE CURRENT YEAR HACIENDA INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 860253158 NURSING CARE & RESPIRATORY INTERVENTION AZ 501(C)(3) LINE 10 N/A 0 HACIENDA SKILLED NURSING FACILITY INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 141906233 NURSING CARE & RESPIRATORY INTERVENTION AZ 501(C)(3) LINE 10 N/A 0 HACIENDA CHILDRENS HOSPITAL INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 473035370 NON-PROFIT CHILDREN'S HOSPITAL AZ 501(C)(3) LINE 3 N/A 0 CHILDREN'S ANGEL FOUNDATION 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 860751640 FUNDRAISING FOR ALL HACIENDA ORGANIZATIONS AZ 501(C)(3) LINE 10 N/A 0 INNOVATIVE HOME HEALTH INC 1402 E SOUTH MOUNTAIN AVE PHOENIX AZ 85042 262398755 HOME HEALTH NURSING SERVICES AZ HACIENDA HEALTHCARE C 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1 0