2014-06-30T07:45:50-05:00 2013-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Suite 1300 Minneapolis MN 554027033 990 2013-01-01 133673215 Hazelden New York HAZE 6512134006 PO Box 11 Center City MN 55012 James Blaha Treasurer 6512134006 2014-06-26 1 Kim Hunwardsen CPA P00484560 6122536500 2014-06-26 2013 2015-11-30 17:44:51Z Mark Mishek PO Box 11 Center City MN 55012 2979162 0 X www.hazelden.org X 1992 NY Hazelden helps restore hope, healing, and health to people affected by addiction to alcohol and other drugs. 10 10 43 4 0 0 71030 76206 2559052 2897207 5439 5749 0 0 2635521 2979162 0 0 0 0 2107130 2045190 0 0 15061 3064201 2982834 5171331 5028024 -2535810 -2048862 16002981 18273799 21442360 25762311 -5439379 -7488512 X Hazelden 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). 0 0 3869007 2897207 Recovery 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. 3869007 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 6 0 1 43 1 0 0 0 0 0 0 0 0 0 0 X 10 10 1 0 1 0 1 1 1 1 0 0 0 0 1 1 1 1 1 1 1 0 NY X James Blaha Chief Financial and Administrative Officer 6512134006 15251 Pleasant Valley Road Center City MN 55012 W Christopher White Chair 5.00 1.00 X X 0 0 0 Judy Collins Member 1.00 0.00 X 0 0 0 Valery Craane Member 1.00 0.00 X 0 0 0 Paul Gossling Member 1.00 3.00 X 0 0 0 Margaret Brennan Hassett Member 1.00 0.00 X 0 0 0 Leonard Holzer Member 1.00 0.00 X 0 0 0 Robert Manocherian Member 1.00 0.00 X 0 0 0 Judith Davidson Moyers Member 1.00 0.00 X 0 0 0 William Paulsen Member 1.00 0.00 X 0 0 0 Brooke Picotte Member 1.00 0.00 X 0 0 0 Charlie Rubenstein Member 1.00 0.00 X 0 0 0 James Blaha Secretary/Treasurer 3.00 53.00 X 0 276916 45712 Mark Mishek President 5.00 55.00 X 0 586923 86523 Barbara Kistenmacher Dir. Hazelden New York 50.00 0.00 X 192296 0 25376 Kimberly Hoppes Dir. Clinical Services 45.00 0.00 X 111433 0 4440 303729 863839 162051 2 0 1 0 0 76206 76206 Recovery Services 621400 2897207 2897207 2897207 5749 5749 2979162 2897207 0 5749 218513 218513 1380959 1380959 81180 81180 246668 246668 117870 117870 235507 235507 106752 106752 108960 108960 371516 371516 67041 67041 1990 1990 751122 751122 Corporate support mgmt 1159017 1143956 15061 Provision for bad debt 82492 82492 Lab work 53640 53640 Purchased services 23750 23750 21047 21047 5028024 3869007 1143956 15061 178688 263951 40075 26506 327330 277723 95653 86969 14747256 2844455 12539124 11902801 2822111 5715849 16002981 18273799 369444 196641 21072916 25565670 21442360 25762311 X -5615667 -7655831 40075 31106 136213 136213 -5439379 -7488512 16002981 18273799 X -2048862 -271 X X 0 1 X 0 0 X 86554 155625 219728 71030 76206 609143 86554 155625 219728 71030 76206 609143 357424 251719 52396 17556 5514 5439 5749 86654 695797 9352373 0.36180 0.61300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 120641 20572 5749 135464 109949 16131 5439 120641 119030 -3569 5512 109949 110902 14164 6036 119030 136213 -17499 7812 110902 1.00000 0 1 1 14148222 2443189 11705033 571080 401266 169814 27954 27954 11902801 Intercompany Receivable 5715849 5715849 Intercompany Payables 25565670 25565670 X 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. 0 1 0 0 0 0 0 0 0 James Blaha Secretary/Treasurer 0 240932 0 34339 0 1645 0 27910 0 18821 0 323647 0 0 Mark Mishek President 0 488088 0 93976 0 4859 0 65171 0 23032 0 675126 0 0 Barbara Kistenmacher Dir. Hazelden New York 183409 0 8626 0 261 0 11505 0 14712 0 218513 0 0 0 Part I, Line 3 Hazelden New York relies on a related entity, Hazelden Betty Ford Foundation, to determine the compensation for the CEO. Part I, Line 4b Mark Mishek, President and CEO, participated in a nonqualified retirement plan from a related organization in the amount of $29,821 Form 990, Part VI, Section A, line 2 Officers 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 4 The 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 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 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 7b Some 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 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 11 Hazelden 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 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 15 Hazelden 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 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.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. 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