HAZELDEN NEW YORK: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HAZELDEN NEW YORK (EIN 13-3673215)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-08-26
- IRS object ID
- 202202389349301015
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-26T11:07:22-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Suite 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133673215 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hazelden New York | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAZE | BusinessNameControlTxt |
| Phone | 6512134006 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 11 | AddressLine1Txt |
| City | Center City | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55012 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | James Blaha | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 6512134729 | PhoneNum |
| Signature | 2022-08-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | James | PersonFirstNm |
| Person Last | Blaha | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2022-08-18 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hazelden Betty Ford in New York | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Dr Joseph Lee | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 11 | AddressLine1Txt |
| City | Center City | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55012 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,556,408 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.hazeldenbettyford.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | Substance use and mental health services are provided to individuals and families. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 30 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $226,613 | PYContributionsGrantsAmt |
| CY Contributions Grants | $541,315 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,767,412 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,999,440 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,321 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,653 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,998,346 | PYTotalRevenueAmt |
| CY Total Revenue | $3,556,408 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,698,344 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,081,481 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $13,329 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,236,396 | PYOtherExpensesAmt |
| CY Other Expenses | $1,948,426 | CYOtherExpensesAmt |
| PY Total Expenses | $3,934,740 | PYTotalExpensesAmt |
| CY Total Expenses | $4,029,907 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$936,394 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$473,499 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $44,750,812 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,675,971 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $62,322,571 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $70,127,007 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$17,571,759 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$18,451,036 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,241,129 | ExpenseAmt |
| Revenue | $2,999,440 | RevenueAmt |
| Desc | Caring experts at Hazelden Betty Ford in New York deliver a wide array of services to individuals and families seeking recovery from substance use and mental health conditions. Hazelden Betty Ford in New York included two facilities in 2021-one each in the Tribeca and Chelsea neighborhoods of New York City's Manhattan borough. The organization moved out of the Chelsea site at the end of the year, with plans to consolidate and expand at the Tribeca site in 2022. Hazelden Betty Ford's team in New York offers outpatient treatment services, including assessment and evaluation; intensive outpatient programs and extended outpatient services during morning, afternoon and evening hours; medication assisted treatment options; family programming; and mental health services. Continued on Schedule O.In 2021, due to the COVID-19 pandemic, all services were offered virtually to ensure the safety of staff and patients. On-site services will begin to resume in 2022, pending the pandemic status, while virtual offerings will continue as well. Our Tribeca location is the center for Hazelden Betty Ford's programs and services in the New York City and surrounding area, while also serving as an access point to all of the other resources within the Hazelden Betty Ford Foundation nationwide. In 2021, the following number of people directly benefited from recovery services provided by the team at Hazelden Betty Ford in New York:Intensive Outpatient Treatment 411Mental Health 263 Outpatient Treatment 222 TOTAL PATIENTS SERVED 896In 2021, due to the pandemic, Hazelden Betty Ford did not host alumni events and related services at its New York locations or make its facilities available for recovery-related self-help meetings, as well as networking and educational opportunities. However, several virtual alternatives were provided, and the plan is to resume hosting those kinds of on-site activities in 2022.A non-governance "council" was organized in 2016, named Hazelden Betty Ford New York Council, comprised of former board members and other community members to advise on recovery events, community needs, alumni relations, and philanthropic opportunities in the community served by Hazelden New York. | Desc |
| Total Program Service Expenses | $3,241,129 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 30 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | James Blaha VP Chief Financial A | PersonNm |
| Phone | 6512134729 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15251 Pleasant Valley Road | AddressLine1Txt |
| City | Center City | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55012 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Dr Joseph Lee President | ||||||||
| CEO/Chair as of June 2021 | 5.00 | 55.00 | Yes (X) | Yes (X) | $0 | $544,823 | $43,905 | |
| James Blaha | ||||||||
| Treasurer | 5.00 | 55.00 | Yes (X) | Yes (X) | $0 | $482,225 | $66,990 | |
| Jennifer Lohse | ||||||||
| Secretary | 5.00 | 55.00 | Yes (X) | Yes (X) | $0 | $296,392 | $54,625 | |
| Mark Mishek President | ||||||||
| CEO/Chair until June 2021 | 5.00 | 55.00 | Yes (X) | Yes (X) | $0 | $534,167 | $32,218 | |
| Eliana Leve | ||||||||
| Director of New York Services | 45.00 | 0.00 | $132,998 | $0 | $45,556 | Yes (X) | ||
| Stanislav Vorel | ||||||||
| Medical Director | 45.00 | 0.00 | $144,413 | $0 | $36,393 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $277,411 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,857,607 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $279,687 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $27,815 | GovernmentGrantsAmt |
| All Other Contributions | $513,500 | AllOtherContributionsAmt |
| Total Contributions | $541,315 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Recovery Services | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $2,999,440 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,999,440 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,999,440 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,653 | TotalRevenueColumnAmt |
| Exclusion | $15,653 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,556,408 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,999,440 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $15,653 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,601,139 | TotalAmt |
| Program Services | $1,601,139 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,384 | TotalAmt |
| Program Services | $95,384 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,767 | TotalAmt |
| Program Services | $254,767 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,191 | TotalAmt |
| Program Services | $130,191 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,188 | TotalAmt |
| Program Services | $50,188 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,821 | TotalAmt |
| Program Services | $32,821 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,791 | TotalAmt |
| Program Services | $20,791 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,062 | TotalAmt |
| Program Services | $451,062 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99 | TotalAmt |
| Program Services | $99 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,425 | TotalAmt |
| Program Services | $2,425 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$75,687 | TotalAmt |
| Program Services | -$75,687 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $520,911 | TotalAmt |
| Program Services | $520,911 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|---|
| Corporate support | $788,778 | $775,449 | $13,329 | |
| Purchased services | $129,075 | $129,075 | ||
| Program/client supplies | $9,424 | $9,424 | ||
| License, dues, subscrip | $7,348 | $7,348 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,191 | TotalAmt |
| Program Services | $11,191 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,029,907 | TotalAmt |
| Program Services | $3,241,129 | ProgramServicesAmt |
| Management And General | $775,449 | ManagementAndGeneralAmt |
| Fundraising | $13,329 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,191 | BOYAmt |
| EOY | $144,972 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,570 | BOYAmt |
| EOY | $259,079 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $278,581 | BOYAmt |
| EOY | $379,598 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,469 | BOYAmt |
| EOY | $42,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,508,819 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,082,404 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,216,266 | BOYAmt |
| EOY | $11,426,415 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,865,735 | BOYAmt |
| EOY | $39,423,540 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,750,812 | BOYAmt |
| EOY | $51,675,971 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $637,773 | BOYAmt |
| EOY | $160,262 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,684,798 | BOYAmt |
| EOY | $69,966,745 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,322,571 | BOYAmt |
| EOY | $70,127,007 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$18,320,740 | BOYAmt |
| EOY | -$18,998,228 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $748,981 | BOYAmt |
| EOY | $547,192 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$17,571,759 | BOYAmt |
| EOY | -$18,451,036 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,750,812 | BOYAmt |
| EOY | $51,675,971 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$473,499 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$405,778 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $436,296 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $302,466 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $760,292 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $226,613 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $541,315 | CurrentTaxYearAmt |
| Total | $2,266,982 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,070,401 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,164,737 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,974,105 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,767,412 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,999,440 | CurrentTaxYearAmt |
| Total | $15,976,095 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,506,697 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,467,203 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,734,397 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,994,025 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,540,755 | CurrentTaxYearAmt |
| Total | $18,243,077 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $55,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $80,000 | CurrentTaxYearAmt |
| Total | $270,000 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,566 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,034 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30,893 | CurrentTaxYearMinus2YearsAmt |
| Total | $83,493 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $56,566 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $86,034 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $85,893 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $80,000 | CurrentTaxYearAmt |
| Total | $353,493 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $17,889,584 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,516 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$9,281 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,210 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,321 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,653 | CurrentTaxYearAmt |
| Total | $34,419 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,516 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$9,281 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,210 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,321 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,653 | CurrentTaxYearAmt |
| Total | $34,419 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,513,213 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,457,922 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,751,607 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,998,346 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,556,408 | CurrentTaxYearAmt |
| Total | $18,277,496 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97880 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97990 | PublicSupportPY509Pct |
| Investment Income CY | 0.00190 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00130 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $126,154 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $15,653 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,888 | OtherExpendituresAmt |
| End Year Balance | $135,919 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $127,743 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,319 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,908 | OtherExpendituresAmt |
| End Year Balance | $126,154 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $116,885 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $17,210 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,352 | OtherExpendituresAmt |
| End Year Balance | $127,743 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,858 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$9,281 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,692 | OtherExpendituresAmt |
| End Year Balance | $116,885 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $126,435 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $12,943 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,520 | OtherExpendituresAmt |
| End Year Balance | $132,858 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,583,366 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,009,353 | DepreciationAmt |
| Book Value | $7,574,013 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,109,440 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,073,051 | DepreciationAmt |
| Book Value | $36,389 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,816,013 | OtherCostOrOtherBasisAmt |
| Book Value | $3,816,013 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,426,415 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Intercompany receivables | Desc |
| Book Value | $39,423,540 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $39,423,540 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Intercompany payables | Desc |
| Amt | $69,966,745 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $69,966,745 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Earnings from the endowment funds are used to provide financial aid to qualified patients. |
| Part X, Line 2: | In accounting for uncertain tax positions, Hazelden New York recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities, based on the technical merit of the position. Examples of tax positions include the tax-exempt status of Hazelden New York and various tax positions related to potential sources of unrelated business taxable income. Hazelden New York had no uncertain tax positions as of December 31, 2021 and 2020. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Joseph Lee President | ||||||||||||||
| CEO/Chair as of June 2021 | $0 | $500,955 | $0 | $43,104 | $0 | $764 | $0 | $36,150 | $0 | $7,755 | $0 | $588,728 | $0 | $0 |
| Mark Mishek President | ||||||||||||||
| CEO/Chair until June 2021 | $0 | $328,601 | $0 | $143,821 | $0 | $61,745 | $0 | $16,650 | $0 | $15,568 | $0 | $566,385 | $0 | $0 |
| James Blaha | ||||||||||||||
| Treasurer | $0 | $411,490 | $0 | $67,570 | $0 | $3,165 | $0 | $36,150 | $0 | $30,840 | $0 | $549,215 | $0 | $0 |
| Jennifer Lohse | ||||||||||||||
| Secretary | $0 | $250,564 | $0 | $45,571 | $0 | $257 | $0 | $14,368 | $0 | $40,257 | $0 | $351,017 | $0 | $0 |
| Stanislav Vorel | ||||||||||||||
| Medical Director | $144,115 | $0 | $0 | $0 | $298 | $0 | $789 | $0 | $35,604 | $0 | $180,806 | $0 | $0 | $0 |
| Eliana Leve | ||||||||||||||
| Director of New York Services | $132,247 | $0 | $0 | $0 | $751 | $0 | $8,419 | $0 | $37,137 | $0 | $178,554 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Hazelden New York relies on a related entity, Hazelden Betty Ford Foundation, to determine the compensation of the CEO. Hazelden Betty Ford Foundation uses one or more of the methods on Part I, Line 3 to determine compensation for the CEO. |
| Part I, Line 4b | Mark Mishek, President and CEO, participated in a nonqualified retirement plan. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 1b: | Board members are employees of Hazelden Betty Ford Foundation and therefore are not independent. However, the Hazelden Betty Ford Foundation Board of Trustees is comprised of only independent board members and the board appoints the members of the Hazelden New York board and provides oversight of their activities. |
| Form 990, Part VI, Section A, line 6 | Hazelden Betty Ford Foundation is the sole member of Hazelden New York. |
| Form 990, Part VI, Section A, line 7a | As the sole member, Hazelden Betty Ford Foundation will elect all members of the governing body of Hazelden New York. |
| Form 990, Part VI, Section A, line 8b | Hazelden New York has no committee that has authority to act on behalf of its Board of Trustees. |
| Form 990, Part VI, Section B, line 11b | Hazelden New York sent its Form 990 via email to Board members for review and questions prior to filing. |
| Form 990, Part VI, Section B, line 12c | Hazelden Betty Ford Foundation, the sole member of Hazelden New York, monitors and enforces compliance with the conflict of interest policy. If a board member does disclose a potential conflict, that person excuses him or herself from voting on a particular issue. All board members sign an annual conflict of interest disclosure form. |
| Form 990, Part VI, Section B, line 15a | Hazelden Betty Ford has an established process for determining the compensation of the President and CEO, other officers and key employees. The Hazelden Betty Ford Foundation by-laws delegate responsibility for determining compensation for the President and CEO, other officers and key employees to the Executive Committee of the Board of Trustees. The Executive Committee approves, as necessary, the compensation philosophy for Hazelden Betty Ford Foundation. Hazelden Betty Ford has established a compensation process for executives that provides Hazelden Betty Ford with a rebuttable presumption of reasonableness as defined under Intermediate Sanction Regulations--Excess Benefit Transactions, IRS Section 4958. Each year the Board members complete a conflict of interest disclosure. The documents are reviewed by Hazelden Betty Ford's general counsel and if a Board member has a conflict of interest they are not involved in any compensation decisions. The Executive Committee in partnership with Human Resources, engages the use of an outside independent compensation consultant to identify comparable market data for comparable positions for the President and CEO and other disqualified individuals consistent with the approved compensation philosophy. Generally, the market analysis includes competitive data from published survey sources, and may be supplemented with compensation data from custom 990 analyses. Where possible, competitive data is pulled from organizations similar in size, revenue and industry. The compensation consultant analyzes the pay packages of the President and CEO and other disqualified individuals by reviewing base salary, total cash compensation (salary plus annual incentive at both target and actual levels). In addition, the Executive Committee reviews the total compensation package of the President and CEO and other disqualified individuals. The total compensation package includes total direct compensation plus severance, employee benefits, perquisites and any other pay. Comparable market data are reviewed and discussed by the Executive Committee and minutes record those discussions and any resulting compensation decisions. A compensation review for the President and CEO was most recently done in March 2021. The compensation review for other officers and key employees was completed in March 2021. |
| Form 990, Part VI, Section C, line 19 | Hazelden Betty Ford Foundation, the sole member of Hazelden New York, makes its annual report available to the public via its website at www.hazeldenbettyford.org. The governing documents and conflict of interest policy are not available for public inspection. |
| Form 990, Part VII, Section A: | The organization does not have any person with ultimate responsibility for implementing decisions of the board other than the board members in their capacity as officers of Hazelden Betty Ford Foundation. |
| Form 990, Part XI, line 9: | Net assets released-intercompany transactions -405,778. |
| Form 990, Part XII, Line 2c: | Hazelden New York does not have a committee that assumes responsibility for oversight of the audit. However, as the sole member, Hazelden Betty Ford Foundation's audit committee assumes the oversight responsibility for the consolidated audit of the Foundation and its related entities and the selection of the independent accounting firm. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Hazelden Betty Ford Foundation | |||||||||||
| PO Box 11 | Center City | MN | 55012 | 410682405 | Inpatient and outpatient addiction and mental health care | MN | 501(c)3 | 3 | N/A | 0 | |
| Hazelden Chicago | |||||||||||
| PO Box 11 | Center City | MN | 55012 | 364099403 | Substance use and mental health services | IL | 501(c)3 | 3 | 0 | Hazelden Betty Ford Foundation | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |