STRATEGY STUDIO / PUBLIC DATA EXPLORER

HAZELDEN NEW YORK: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
HAZELDEN NEW YORK (EIN 13-3673215)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-06-30
IRS object ID
201421819349300452
Schema version
2013v3.0
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)
Return2014-06-30T07:45:50-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Suite 1300AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN133673215EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hazelden New YorkBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlHAZEBusinessNameControlTxt
Phone6512134006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 11AddressLine1
CityCenter CityCity
StateMNState
ZIP Code55012ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJames BlahaPersonNm
Person TitleTreasurerPersonTitleTxt
Phone6512134006PhoneNum
Signature2014-06-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2014-06-26PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMark MishekPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 11AddressLine1
CityCenter CityCity
StateMNState
ZIP Code55012ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$2,979,162GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.hazelden.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionHazelden helps restore hope, healing, and health to people affected by addiction to alcohol and other drugs.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee43TotalEmployeeCnt
Total Volunteers4TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$71,030PYContributionsGrantsAmt
CY Contributions Grants$76,206CYContributionsGrantsAmt
PY Program Service Revenue$2,559,052PYProgramServiceRevenueAmt
CY Program Service Revenue$2,897,207CYProgramServiceRevenueAmt
PY Investment Income$5,439PYInvestmentIncomeAmt
CY Investment Income$5,749CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,635,521PYTotalRevenueAmt
CY Total Revenue$2,979,162CYTotalRevenueAmt
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$2,107,130PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,045,190CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$15,061CYTotalFundraisingExpenseAmt
PY Other Expenses$3,064,201PYOtherExpensesAmt
CY Other Expenses$2,982,834CYOtherExpensesAmt
PY Total Expenses$5,171,331PYTotalExpensesAmt
CY Total Expenses$5,028,024CYTotalExpensesAmt
PY Revenues Less Expenses-$2,535,810PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,048,862CYRevenuesLessExpensesAmt
Total Assets BOY$16,002,981TotalAssetsBOYAmt
Total Assets EOY$18,273,799TotalAssetsEOYAmt
Total Liabilities BOY$21,442,360TotalLiabilitiesBOYAmt
Total Liabilities EOY$25,762,311TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$5,439,379NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$7,488,512NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHazelden New York is a vital affiliated entity of the Hazelden Betty Ford Foundation. Hazelden's mission is 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 and advocacy, and shared learning with other organizations. Hazelden New York provides addiction recovery services, including outpatient programs and continuing care services for addicted people and their families in New York, New York and has affiliated entities in Center City, Chaska, Maple Grove, Plymouth, and St. Paul, Minnesota; Chicago, Illinois; Naples, Florida; Beaverton and Springbrook, Oregon; and Rancho Mirage, California (starting Feb. 2014).MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,869,007ExpenseAmt
Revenue$2,897,207RevenueAmt
DescRecovery ServicesCaring experts at Hazelden New York deliver a wide array of recovery services to men and women needing treatment for alcohol and other drug addiction. Hazelden New York offers outpatient treatment services including assessment and evaluation, adult nonresidential day treatment, continuing care programs, family programs, sober living facilities and alumni services. The facility is the center for Hazelden's programs and services in the greater New York City area while also serving as an access point to all of Hazelden's resources.University students face one of the biggest obstacles to recovery of any group: finding like-minded peers who are willing to take the clean and sober route through their college careers. To help form the bridge to a new life, Hazelden opened Tribeca Twelve, a collegiate recovery residence in New York City's vibrant Tribeca neighborhood, for 18- to 29-year-olds who attend or plan to enter college. Students find a supportive environment that fosters friendships for life with peers who understand the struggles of recovery and are eager to celebrate their successes. In 2013, the following number of people directly benefited from recovery services at Hazelden New York:Outpatient Treatment Adult: 365Outpatient Treatment Young Adult: 127Room and Board 36Total Patients Served 528Hazelden also hosted alumni events and related services at its New York location and made its facility available for groups to hold recovery-related meetings. The facility is used by other groups for networking and educational opportunities.Desc
Total Program Service Expenses$3,869,007TotalProgramServiceExpensesAmt
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
IRP Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee43EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
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 OtherYes (1)CompensationProcessOtherInd
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 Chief Financial and Administrative OfficerBusinessNameLine1
FieldValueIRS element (for citing)
Phone6512134006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line115251 Pleasant Valley RoadAddressLine1
CityCenter CityCity
StateMNState
ZIP Code55012ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
W Christopher White
Chair5.001.00Yes (X)Yes (X)$0$0$0
Judy Collins
Member1.000.00Yes (X)$0$0$0
Valery Craane
Member1.000.00Yes (X)$0$0$0
Paul Gossling
Member1.003.00Yes (X)$0$0$0
Margaret Brennan Hassett
Member1.000.00Yes (X)$0$0$0
Leonard Holzer
Member1.000.00Yes (X)$0$0$0
Robert Manocherian
Member1.000.00Yes (X)$0$0$0
Judith Davidson Moyers
Member1.000.00Yes (X)$0$0$0
William Paulsen
Member1.000.00Yes (X)$0$0$0
Brooke Picotte
Member1.000.00Yes (X)$0$0$0
Charlie Rubenstein
Member1.000.00Yes (X)$0$0$0
James Blaha
Secretary/Treasurer3.0053.00Yes (X)$0$276,916$45,712
Mark Mishek
President5.0055.00Yes (X)$0$586,923$86,523
Barbara Kistenmacher
Dir. Hazelden New York50.000.00$192,296$0$25,376Yes (X)
Kimberly Hoppes
Dir. Clinical Services45.000.00$111,433$0$4,440Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$303,729TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$863,839TotReportableCompRltdOrgAmt
Total Other Compensation$162,051TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$76,206AllOtherContributionsAmt
Total Contributions$76,206TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRecovery ServicesDesc
Business621400BusinessCd
Total Revenue Column$2,897,207TotalRevenueColumnAmt
Related Or Exempt Func Income$2,897,207RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,897,207TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,749TotalRevenueColumnAmt
Exclusion$5,749ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,979,162TotalRevenueColumnAmt
Related Or Exempt Func Income$2,897,207RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$5,749ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$218,513TotalAmt
Program Services$218,513ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,380,959TotalAmt
Program Services$1,380,959ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$81,180TotalAmt
Program Services$81,180ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$246,668TotalAmt
Program Services$246,668ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$117,870TotalAmt
Program Services$117,870ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$235,507TotalAmt
Program Services$235,507ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$106,752TotalAmt
Program Services$106,752ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$108,960TotalAmt
Program Services$108,960ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$371,516TotalAmt
Program Services$371,516ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$67,041TotalAmt
Program Services$67,041ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,990TotalAmt
Program Services$1,990ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$751,122TotalAmt
Program Services$751,122ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmtProgram ServicesProgramServicesAmt
Corporate support mgmt$1,159,017$1,143,956$15,061
Provision for bad debt$82,492$82,492
Lab work$53,640$53,640
Purchased services$23,750$23,750

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$21,047TotalAmt
Program Services$21,047ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,028,024TotalAmt
Program Services$3,869,007ProgramServicesAmt
Management And General$1,143,956ManagementAndGeneralAmt
Fundraising$15,061FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$178,688BOYAmt
EOY$263,951EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$40,075BOYAmt
EOY$26,506EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$327,330BOYAmt
EOY$277,723EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$95,653BOYAmt
EOY$86,969EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$14,747,256LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,844,455LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,539,124BOYAmt
EOY$11,902,801EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,822,111BOYAmt
EOY$5,715,849EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,002,981BOYAmt
EOY$18,273,799EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$369,444BOYAmt
EOY$196,641EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,072,916BOYAmt
EOY$25,565,670EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,442,360BOYAmt
EOY$25,762,311EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$5,615,667BOYAmt
EOY-$7,655,831EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$40,075BOYAmt
EOY$31,106EOYAmt

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-$5,439,379BOYAmt
EOY-$7,488,512EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,002,981BOYAmt
EOY$18,273,799EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$2,048,862ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$271OtherChangesInNetAssetsAmt
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)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$86,554CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$155,625CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$219,728CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$71,030CurrentTaxYearMinus1YearAmt
Current Tax Year$76,206CurrentTaxYearAmt
Total$609,143TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$86,554CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$155,625CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$219,728CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$71,030CurrentTaxYearMinus1YearAmt
Current Tax Year$76,206CurrentTaxYearAmt
Total$609,143TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$357,424SubstantialContributorsTotAmt
Public Support Total170$251,719PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$52,396CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$17,556CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,514CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,439CurrentTaxYearMinus1YearAmt
Current Tax Year$5,749CurrentTaxYearAmt
Total$86,654TotalAmt
FieldValueIRS element (for citing)
Total Support$695,797TotalSupportAmt
Gross Receipts Rltd Activities$9,352,373GrossReceiptsRltdActivitiesAmt
Public Support CY1700.36180PublicSupportCY170Pct
Public Support PY1700.61300PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$120,641BeginningYearBalanceAmt
Investment Earnings Or Losses$20,572InvestmentEarningsOrLossesAmt
Other Expenditures$5,749OtherExpendituresAmt
End Year Balance$135,464EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$109,949BeginningYearBalanceAmt
Investment Earnings Or Losses$16,131InvestmentEarningsOrLossesAmt
Other Expenditures$5,439OtherExpendituresAmt
End Year Balance$120,641EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$119,030BeginningYearBalanceAmt
Investment Earnings Or Losses-$3,569InvestmentEarningsOrLossesAmt
Other Expenditures$5,512OtherExpendituresAmt
End Year Balance$109,949EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$110,902BeginningYearBalanceAmt
Investment Earnings Or Losses$14,164InvestmentEarningsOrLossesAmt
Other Expenditures$6,036OtherExpendituresAmt
End Year Balance$119,030EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$136,213BeginningYearBalanceAmt
Investment Earnings Or Losses-$17,499InvestmentEarningsOrLossesAmt
Other Expenditures$7,812OtherExpendituresAmt
End Year Balance$110,902EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
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$14,148,222OtherCostOrOtherBasisAmt
Depreciation$2,443,189DepreciationAmt
Book Value$11,705,033BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$571,080OtherCostOrOtherBasisAmt
Depreciation$401,266DepreciationAmt
Book Value$169,814BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,954OtherCostOrOtherBasisAmt
Book Value$27,954BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,902,801TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescIntercompany ReceivableDesc
Book Value$5,715,849BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$5,715,849TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescIntercompany PayablesDesc
Amt$25,565,670Amt
FieldValueIRS element (for citing)
Total Liability$25,565,670TotalLiabilityAmt
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 accordance with the accounting standard on Accounting for Uncertainty in Income Taxes, the Foundation addresses the determination of whether tax benefits claimed on a tax return should be recorded in the financial statements. Under this guidance, the Foundation may recognize 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 positions related to the potential sources of unrelated business taxable income. There were no unrecognized tax benefits identified or recorded as liabilities during fiscal year 2013. Open tax years subject to examination by the U.S and state taxing authorities are for the years 2011 to 2013, which statutes expire in 2014 to 2016, respectively.

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 (3 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
James Blaha
Secretary/Treasurer$0$240,932$0$34,339$0$1,645$0$27,910$0$18,821$0$323,647$0$0
Mark Mishek
President$0$488,088$0$93,976$0$4,859$0$65,171$0$23,032$0$675,126$0$0
Barbara Kistenmacher
Dir. Hazelden New York$183,409$0$8,626$0$261$0$11,505$0$14,712$0$218,513$0$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 for the CEO.
Part I, Line 4bMark Mishek, President and CEO, participated in a nonqualified retirement plan from a related organization in the amount of $29,821

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Officers are employed by Hazelden Betty Ford Foundation, a related exempt organization. Certain members of the board are also board members of the Hazelden Betty Ford Foundation. Therefore, business relationships exist between these individuals.
Form 990, Part VI, Section A, line 4The Bylaws were amended as follows: The Bylaws may be amended without a meeting with the consent of the members.
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 has the right to elect one or more members of the governing body of Hazelden New York. As a regional board, Hazelden New York, can submit candidates to the Hazelden Betty Ford Foundation Board for approval.
Form 990, Part VI, Section A, line 7bSome decisions made by the regional Board of Hazelden New York are subject to approval by the Hazelden Betty Ford Foundation Board of Trustees, sole member 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 11Hazelden New York sent its Form 990, with Schedule B suppressed, via email to Board members for review and questions prior to filing. It was also reviewed by the CFO and the General Counsel of Hazelden Betty Ford Foundation, sole member of Hazelden New York, 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 15Hazelden has an established process for determining the compensation of the CEO, other officers and key employees that starts with the Board of Trustees. The Hazelden Betty Ford Foundation by-laws delegate responsibility for determining compensation for the 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'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 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 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 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 CEO was most recently done in February 2014. The compensation review for other officers and key employees was completed in May 2013.
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.hazelden.org. The governing documents and conflict of interest policy are not available for public inspection.
Form 990, Part XI, line 9:Rounding -271.
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/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
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