2020-08-25T15:14:29-05:00 2019-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Suite 1300 Minneapolis MN 554027033 990 2019-01-01 133673215 Hazelden New York HAZE 6512134006 PO Box 11 Center City MN 55012 James Blaha Treasurer 6512134006 2020-08-20 1 Kim Hunwardsen CPA P00484560 6122536500 2020-08-20 209.131.231.188 2020-08-20 15:16:34 CD P DBF4759E62F8FF19F8CA63E0966B25CEDAE47AD3 77B1BAA26CF6A85D2D71573D401B421120EB0C53 2019 2020-11-19 02:30:22Z Hazelden Betty Ford in New York Mark Mishek PO Box 11 Center City MN 55012 4751607 0 X www.hazeldenbettyford.org X 1992 NY Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. 3 0 39 2 0 0 302466 760292 3164737 3974105 -9281 17210 0 0 3457922 4751607 0 0 0 0 1815966 2135667 0 0 203355 3222461 3443121 5038427 5578788 -1580505 -827181 36675898 41222162 52255702 57618042 -15579804 -16395880 X Hazelden Betty Ford in New York (comprising two facilities-one each in the Tribeca and Chelsea neighborhoods) is a vital affiliated entity of the Hazelden Betty Ford Foundation with its mission to help more people sustain lifelong recovery from addiction to alcohol and other drugs. This is accomplished through a commitment to treatment, publishing, education, research, public education, advocacy, and collaboration/shared learnings with other organizations. Hazelden Betty Ford in New York provides a wide array of addiction recovery services and has affiliated entities in Center City, Chaska, Maple Grove, Plymouth and St. Paul, Minnesota; Naples, Florida; Chicago, Illinois; Bellevue, Washington; Beaverton and Newberg, Oregon; Newton, Massachusetts; Rancho Mirage, Los Angeles and San Diego, California; and Denver, Colorado. 0 0 3864449 3974105 Caring experts at Hazelden Betty Ford in New York deliver a wide array of services to men and women seeking recovery from addiction to alcohol and other drugs. Hazelden Betty Ford in New York includes two facilities-one each in the Tribeca and Chelsea neighborhoods of Manhattan-offering outpatient treatment services, including assessment and evaluation; intensive outpatient programs; extended outpatient services; family programming; and sober living. The two facilities are the center for Hazelden Betty Ford's programs and services in the greater New York City area, while also serving as an access point to all of the other resources within the Hazelden Betty Ford Foundation nationwide.In 2019, the following number of people directly benefited from recovery services at Hazelden Betty Ford's two facilities in New York:Outpatient Treatment: 728 Mental Health Services: 145Recovery Housing: 17 TOTAL PATIENTS SERVED 890Hazelden Betty Ford Foundation also hosted alumni events and related services at its New York locations and made its facilities available for an array of recovery-related self-help meetings. 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. 3864449 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 10 0 1 39 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 1 0 0 NY X James Blaha VP Chief Financial & Administrative Officer 6512134006 15251 Pleasant Valley Road Center City MN 55012 X Mark Mishek President and CEO/Chair 5.00 55.00 X X 0 850961 113743 James Blaha Treasurer 5.00 55.00 X X 0 475775 69611 Jennifer Lohse Secretary 5.00 55.00 X X 0 285526 53674 Eliana Leve Director of New York Services 45.00 0.00 X 140231 0 35376 140231 1612262 272404 1 0 1 0 0 760292 760292 Recovery Services 621400 3974105 3974105 3974105 17210 17210 4751607 3974105 0 17210 1668490 1668490 79674 79674 268293 268293 119210 119210 389997 389997 80219 80219 447612 447612 6733 6733 552136 552136 Corporate Support 1714339 1510984 203355 Bad Debt 118390 118390 Purchased Services 38519 38519 Lab Work 34569 34569 60607 60607 5578788 3864449 1510984 203355 114799 126382 18261 279070 260963 238419 46667 46667 13720776 5040582 9195408 8680194 27039800 31851430 36675898 41222162 83940 102638 52171762 57515404 52255702 57618042 X -16141090 -17364069 561286 968189 -15579804 -16395880 36675898 41222162 X -827181 11105 X X 0 1 X 0 0 X 337413 296189 436296 302466 760292 2132656 3830662 4248509 3070401 3164737 3974105 18288414 4168075 4544698 3506697 3467203 4734397 20421070 40000 67713 35000 55000 55000 252713 84002 20467 21566 31034 30893 187962 124002 88180 56566 86034 85893 440675 19980395 6410 6424 6516 -9281 17210 27279 6410 6424 6516 -9281 17210 27279 4174485 4551122 3513213 3457922 4751607 20448349 0.97710 0.97460 0.00130 0.00080 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 116885 17210 6352 127743 132858 -9281 6692 116885 126435 12943 6520 132858 123692 9167 6424 126435 134597 -4495 6410 123692 0.00000 1.00000 0.00000 0 1 1 12583366 4046943 8536423 1109440 993639 115801 27970 27970 8680194 Intercompany receivables 31585017 Operating Lease Right to Use Current 266413 31851430 Intercompany payables 57245883 Operating Lease Liability 269521 57515404 X 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, the Foundation 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 the Foundation and various tax positions related to potential sources of unrelated business taxable income. The Foundation had no uncertain tax positions as of December 31, 2019 and 2018. 0 1 0 0 0 0 0 0 0 Mark Mishek President and CEO/Chair 0 660517 0 185267 0 5177 0 85384 0 28359 0 964704 0 0 James Blaha Treasurer 0 370909 0 102464 0 2402 0 41800 0 27811 0 545386 0 0 Jennifer Lohse Secretary 0 223097 0 62206 0 223 0 16800 0 36874 0 339200 0 0 Eliana Leve Director of New York Services 139531 0 0 0 700 0 6855 0 28521 0 175607 0 0 0 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 and other officers. Part I, Line 4b Mark Mishek, President and CEO, participated in a nonqualified retirement plan in the amount of $49,584. 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 new board members are provided conflict of interest education and periodic training throughout their term. All board members sign an annual conflict of interest disclosure form. Form 990, Part VI, Section B, line 15a Hazelden Betty Ford Foundation 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 develops, reviews, and modifies, as necessary, the compensation philosophy for Hazelden Betty Ford Foundation. Each year the Board members complete a conflict of interest disclosure. The documents are reviewed by Hazelden Betty Ford Foundation's General Counsel and if a Board member has a conflict of interest they are not involved in any compensation decisions. The Executive Committee 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, supplemented with compensation data from custom 990 analyses. Where possible, competitive data are pulled from similarly sized organizations. 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) and total direct compensation (salary plus annual and long-term incentive). In addition, every two to three years 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 August 2019. The compensation review for other officers and key employees was completed in August 2019. 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 11,105. 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. Hazelden Betty Ford Foundation PO Box 11 Center City MN 55012 410682405 Recovery services, publishing, higher education and training MN 501(c)3 3 N/A 0 Hazelden Chicago PO Box 11 Center City MN 55012 364099403 Addiction recovery services, including outpatient, sober residence IL 501(c)3 3 Hazelden Betty Ford Foundation 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0