STRATEGY STUDIO / PUBLIC DATA EXPLORER

HAZELDEN NEW YORK: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
HAZELDEN NEW YORK (EIN 13-3673215)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-09-05
IRS object ID
201902489349300310
Schema version
2018v3.1
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)
Return2019-09-05T08:15:00-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Suite 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN133673215EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hazelden New YorkBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHAZEBusinessNameControlTxt
Phone6512134006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 11AddressLine1Txt
CityCenter CityCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55012ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJames BlahaPersonNm
Person TitleTreasurerPersonTitleTxt
Phone6512134006PhoneNum
Signature2019-09-03SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2019-09-03PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address8.39.233.218IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-09-03IPDt
IP Tm11:06:51IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7C38465C21B462EFC398EE6416A8BA5336D54C3FAtSubmissionCreationDeviceId
At Submission Filing Device IdEFC25E59FA7409AE560978A003AFB9E955B778C6AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Hazelden Betty Ford in New YorkBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerMark MishekPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 11AddressLine1Txt
CityCenter CityCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55012ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,457,922GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.hazeldenbettyford.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionHazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee41TotalEmployeeCnt
Total Volunteers2TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$436,296PYContributionsGrantsAmt
CY Contributions Grants$302,466CYContributionsGrantsAmt
PY Program Service Revenue$3,070,401PYProgramServiceRevenueAmt
CY Program Service Revenue$3,164,737CYProgramServiceRevenueAmt
PY Investment Income$6,516PYInvestmentIncomeAmt
CY Investment Income-$9,281CYInvestmentIncomeAmt
PY Other Revenue-$18,991PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$3,494,222PYTotalRevenueAmt
CY Total Revenue$3,457,922CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,065,908PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,815,966CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$107,125CYTotalFundraisingExpenseAmt
PY Other Expenses$3,582,786PYOtherExpensesAmt
CY Other Expenses$3,222,461CYOtherExpensesAmt
PY Total Expenses$5,648,694PYTotalExpensesAmt
CY Total Expenses$5,038,427CYTotalExpensesAmt
PY Revenues Less Expenses-$2,154,472PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,580,505CYRevenuesLessExpensesAmt
Total Assets BOY$33,391,372TotalAssetsBOYAmt
Total Assets EOY$36,675,898TotalAssetsEOYAmt
Total Liabilities BOY$47,420,496TotalLiabilitiesBOYAmt
Total Liabilities EOY$52,255,702TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$14,029,124NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$15,579,804NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHazelden 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; Newton, Massachusetts; Beaverton and Newberg, Oregon; Rancho Mirage, Los Angeles and San Diego, California; and Denver, Colorado. Another affiliated entity-our Children's Program in Irving, Texas-was moved to our Center City location in the fall of 2018.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,672,679ExpenseAmt
Revenue$3,164,737RevenueAmt
DescCaring 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 care services; family programming; sober living; and alumni services. 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 Hazelden Betty Ford Foundation.In 2018, the following number of people directly benefited from recovery services at Hazelden Betty Ford's two facilities in New York:Outpatient Treatment: 658 Mental Health Services: 149Recovery Housing: 10 TOTAL PATIENTS SERVED 817Hazelden Betty Ford also hosted alumni events and related services at its New York locations and made its facilities available for recovery-related 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.Desc
Total Program Service Expenses$3,672,679TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee41EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1James Blaha VP Chief Financial & Administrative OfficerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6512134006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line115251 Pleasant Valley RoadAddressLine1Txt
CityCenter CityCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55012ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
Mark Mishek
President and CEO/Chair5.0055.00Yes (X)Yes (X)$0$755,000$99,089
James Blaha
Treasurer5.0055.00Yes (X)Yes (X)$0$389,470$61,369
Jennifer Lohse
Secretary5.0055.00Yes (X)Yes (X)$0$240,505$52,066
Ramsen Kasha
Regional Director50.000.00$0$166,956$34,068Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,551,931TotReportableCompRltdOrgAmt
Total Other Compensation$246,592TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
All Other Contributions$302,466AllOtherContributionsAmt
Total Contributions$302,466TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRecovery ServicesDesc
Business621400BusinessCd
Total Revenue Column$3,164,737TotalRevenueColumnAmt
Related Or Exempt Func Income$3,164,737RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$3,164,737TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$9,281TotalRevenueColumnAmt
Exclusion-$9,281ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,457,922TotalRevenueColumnAmt
Related Or Exempt Func Income$3,164,737RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$9,281ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,413,203TotalAmt
Program Services$1,413,203ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$71,737TotalAmt
Program Services$71,737ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$230,888TotalAmt
Program Services$230,888ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$100,138TotalAmt
Program Services$100,138ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$474,298TotalAmt
Program Services$474,298ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$75,823TotalAmt
Program Services$75,823ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$437,420TotalAmt
Program Services$437,420ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$24,412TotalAmt
Program Services$24,412ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$523TotalAmt
Program Services$523ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$567,824TotalAmt
Program Services$567,824ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmtProgram ServicesProgramServicesAmt
Corporate Support Manag$1,365,748$1,258,623$107,125
Bad debt$109,115$109,115
Lab work$82,088$82,088
Program/Client supplies$31,607$31,607

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$53,603TotalAmt
Program Services$53,603ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,038,427TotalAmt
Program Services$3,672,679ProgramServicesAmt
Management And General$1,258,623ManagementAndGeneralAmt
Fundraising$107,125FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$95,050BOYAmt
EOY$114,799EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$18,261EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$280,433BOYAmt
EOY$260,963EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$49,747BOYAmt
EOY$46,667EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$13,683,855LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,488,447LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,763,233BOYAmt
EOY$9,195,408EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$23,202,909BOYAmt
EOY$27,039,800EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$33,391,372BOYAmt
EOY$36,675,898EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$387,462BOYAmt
EOY$83,940EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,033,034BOYAmt
EOY$52,171,762EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,420,496BOYAmt
EOY$52,255,702EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$14,439,362BOYAmt
EOY-$16,141,090EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$274,025BOYAmt
EOY$425,073EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$136,213BOYAmt
EOY$136,213EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$14,029,124BOYAmt
EOY-$15,579,804EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,391,372BOYAmt
EOY$36,675,898EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,580,505ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$3,356PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$33,181OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$258,987CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$337,413CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$296,189CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$436,296CurrentTaxYearMinus1YearAmt
Current Tax Year$302,466CurrentTaxYearAmt
Total$1,631,351TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,595,540CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,830,662CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,248,509CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,070,401CurrentTaxYearMinus1YearAmt
Current Tax Year$3,164,737CurrentTaxYearAmt
Total$17,909,849TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,854,527CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,168,075CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,544,698CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,506,697CurrentTaxYearMinus1YearAmt
Current Tax Year$3,467,203CurrentTaxYearAmt
Total$19,541,200TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$40,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$67,713CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$35,000CurrentTaxYearMinus1YearAmt
Current Tax Year$55,000CurrentTaxYearAmt
Total$227,713TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$95,682CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$84,002CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,467CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,566CurrentTaxYearMinus1YearAmt
Current Tax Year$31,034CurrentTaxYearAmt
Total$252,751TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$125,682CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$124,002CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$88,180CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$56,566CurrentTaxYearMinus1YearAmt
Current Tax Year$86,034CurrentTaxYearAmt
Total$480,464TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$19,060,736PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,183CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,410CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,424CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,516CurrentTaxYearMinus1YearAmt
Current Tax Year-$9,281CurrentTaxYearAmt
Total$16,252TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,183CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,410CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,424CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,516CurrentTaxYearMinus1YearAmt
Current Tax Year-$9,281CurrentTaxYearAmt
Total$16,252TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,860,710CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,174,485CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,551,122CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,513,213CurrentTaxYearMinus1YearAmt
Current Tax Year$3,457,922CurrentTaxYearAmt
Total$19,557,452TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97460PublicSupportCY509Pct
Public Support PY5090.96820PublicSupportPY509Pct
Investment Income CY0.00080InvestmentIncomeCYPct
Investment Income PY0.00160InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$132,858BeginningYearBalanceAmt
Investment Earnings Or Losses-$9,281InvestmentEarningsOrLossesAmt
Other Expenditures$6,692OtherExpendituresAmt
End Year Balance$116,885EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$126,435BeginningYearBalanceAmt
Investment Earnings Or Losses$12,943InvestmentEarningsOrLossesAmt
Other Expenditures$6,520OtherExpendituresAmt
End Year Balance$132,858EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$123,692BeginningYearBalanceAmt
Investment Earnings Or Losses$9,167InvestmentEarningsOrLossesAmt
Other Expenditures$6,424OtherExpendituresAmt
End Year Balance$126,435EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$134,597BeginningYearBalanceAmt
Investment Earnings Or Losses-$4,495InvestmentEarningsOrLossesAmt
Other Expenditures$6,410OtherExpendituresAmt
End Year Balance$123,692EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$135,464BeginningYearBalanceAmt
Investment Earnings Or Losses$5,316InvestmentEarningsOrLossesAmt
Other Expenditures$6,183OtherExpendituresAmt
End Year Balance$134,597EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,574,415OtherCostOrOtherBasisAmt
Depreciation$3,539,440DepreciationAmt
Book Value$9,034,975BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,109,440OtherCostOrOtherBasisAmt
Depreciation$949,007DepreciationAmt
Book Value$160,433BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,195,408TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescIntercompany receivablesDesc
Book Value$27,039,800BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$27,039,800TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescIntercompany payablesDesc
Amt$52,171,762Amt
FieldValueIRS element (for citing)
Total Liability$52,171,762TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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, 2018 and 2017.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mark Mishek
President and CEO/Chair$0$648,427$0$101,631$0$4,942$0$73,487$0$25,602$0$854,089$0$0
James Blaha
Treasurer$0$341,386$0$45,825$0$2,259$0$35,000$0$26,369$0$450,839$0$0
Jennifer Lohse
Secretary$0$210,801$0$29,515$0$189$0$15,354$0$36,712$0$292,571$0$0
Ramsen Kasha
Regional Director$0$153,447$0$13,378$0$131$0$6,019$0$28,049$0$201,024$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3Hazelden 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 4bMark Mishek, President and CEO, participated in a nonqualified retirement plan in the amount of $38,487.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 New York board and provides oversight of their activities.
Form 990, Part VI, Section A, line 6Hazelden Betty Ford Foundation is the sole member of Hazelden New York.
Form 990, Part VI, Section A, line 7aAs 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 8bHazelden New York has no committee that has authority to act on behalf of its Board of Trustees.
Form 990, Part VI, Section B, line 11bHazelden 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 12cHazelden 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 15aHazelden 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'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 March of 2018. The compensation review for other officers and key employees was completed in August 2017.
Form 990, Part VI, Section C, line 19Hazelden 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 VIII, Line 3:Investment income losses are related to the market valuation of the endowment portfolio.
Form 990, Part XI, line 9:Net assets released-intercompany transactions 33,181.
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.
Form 990, Part XI, Line 8:In accordance with FASB ASU No. 2016-14, Hazelden New York retrospectively applied to the prior period a reclassification adjustment between net assets without donor restrictions and net assets with donor restrictions representing the cumulative effect of underwater endowments totaling $3,356 as of January 1, 2017, which was previously recognized within unrestricted net assets.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Hazelden Betty Ford Foundation
PO Box 11Center CityMN55012410682405Recovery services, publishing, higher education and trainingMN501(c)33N/A0
Hazelden Chicago
PO Box 11Center CityMN55012364099403Addiction recovery services, including outpatient, sober residenceIL501(c)330Hazelden Betty Ford Foundation
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd