HAZELDEN NEW YORK: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HAZELDEN NEW YORK (EIN 13-3673215)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-07-30
- IRS object ID
- 201232129349300638
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-07-30T13:28:08-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Suite 1300 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 554027033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133673215 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hazelden New York | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HAZE | NameControl |
| Phone | 6512134006 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 11 | AddressLine1 |
| City | Center City | City |
| State | MN | State |
| ZIP Code | 55012 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | James Blaha | Name |
| Title | Treasurer | Title |
| Phone | 6512134006 | Phone |
| Date Signed | 2012-07-26 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kim Hunwardsen CPA | Name |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | Phone |
| Date Prepared | 2012-07-26 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Mark Mishek | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 11 | AddressLine1 |
| City | Center City | City |
| State | MN | State |
| ZIP Code | 55012 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1942837 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.hazelden.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | Hazelden helps restore hope, healing, and health to people affected by addiction to alcohol and other drugs. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 32 | TotalNbrEmployees |
| Total Nbr Volunteers | 4 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 155625 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 219728 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1335443 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1717595 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 17556 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5514 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1508624 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1942837 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 951641 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1633232 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 4000 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1304876 | OtherExpensePriorYear |
| Other Expenses Current Year | 2324198 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2256517 | TotalExpensesPriorYear |
| Total Expenses Current Year | 3957430 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -747893 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2014593 | RevenuesLessExpensesCY |
| Total Assets BOY | 7072661 | TotalAssetsBOY |
| Total Assets EOY | 13157219 | TotalAssetsEOY |
| Total Liabilities BOY | 7962055 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16061206 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -889394 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -2903987 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Hazelden New York is a vital affiliated entity of the Hazelden Foundation. Hazelden's mission is to help restore hope, healing and health to people affected by 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 (opened in March 2012), Maple Grove, Plymouth, and St. Paul, Minnesota; Chicago, Illinois; Naples, Florida, and Springbrook, Oregon. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 3055430 | Expense |
| Revenue | 1717595 | Revenue |
| Description | Recovery ServicesCaring experts at Hazelden in New York deliver a wide array of recovery services to men and women needing treatment for alcohol and other drug addiction. Hazelden in 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 2011, the following number of people directly benefited from recovery services at Hazelden in New York: Outpatient Treatment 419 Family Program 19 TOTAL PATIENTS SERVED 438Hazelden 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. | Description |
| Total Program Service Expense | 3055430 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 32 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | James Blaha Chief Financial and Administrative Officer | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6512134006 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15251 Pleasant Valley Road | AddressLine1 |
| City | Center City | City |
| State | MN | State |
| ZIP Code | 55012 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| W Christopher White | ||||||||
| Chair | 5.00 | X | X | 0 | 0 | 0 | ||
| Judy Collins | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Valery Craane | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Paul Gossling | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Margaret Brennan Hassett | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Leonard Holzer | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Robert Manocherian | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Judith Davidson Moyers | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Paul Robert | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Brooke Picotte | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Manfred Altstadt | ||||||||
| Vice-Chair | 5.00 | X | 0 | 0 | 0 | |||
| James Blaha | ||||||||
| Secretary/Treasurer | 3.00 | X | 0 | 253952 | 34829 | |||
| Mark Mishek | ||||||||
| President | 5.00 | X | 0 | 598982 | 83630 | |||
| Barbara Kistenmacher | ||||||||
| Director, Hazelden New York | 50.00 | 155351 | 0 | 12191 | X | |||
| Maureen Borkowski | ||||||||
| Outreach Manager | 45.00 | 115162 | 0 | 1948 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 270513 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 852934 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 132598 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Columbia University | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1051 Riverside Dr Unit 5 | AddressLine1 |
| City | New York | City |
| State | NY | State |
| ZIP Code | 10032 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Psychiatric services | DescriptionOfServices |
| Compensation | 224684 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 219728 | AllOtherContributions |
| Total Contributions | 219728 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Recovery Services | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 1717595 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1717595 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1717595 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5514 | TotalRevenueColumn |
| Exclusion | $5,514 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1942837 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1717595 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $5,514 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168193 | Total |
| Program Services | 168193 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1100948 | Total |
| Program Services | 1100948 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71914 | Total |
| Program Services | 71914 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200596 | Total |
| Program Services | 200596 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91581 | Total |
| Program Services | 91581 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2527 | Total |
| Program Services | 2527 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 329110 | Total |
| Program Services | 329110 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133914 | Total |
| Program Services | 133914 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81192 | Total |
| Program Services | 81192 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 462866 | Total |
| Program Services | 462866 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28325 | Total |
| Program Services | 28325 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1020 | Total |
| Program Services | 1020 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 248397 | Total |
| Program Services | 248397 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | FundraisingFundraising | Program ServicesProgramServices |
|---|---|---|---|---|
| Corporate support mgmt | 902000 | 898000 | 4000 | |
| Provision for bad debt | 98752 | 98752 | ||
| Lab work | 20155 | 20155 | ||
| Program/Client supplies | 7057 | 7057 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8883 | Total |
| Program Services | 8883 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3957430 | Total |
| Program Services | 3055430 | ProgramServices |
| Management And General | 898000 | ManagementAndGeneral |
| Fundraising | 4000 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17791 | BOY |
| EOY | 52280 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2880 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134965 | BOY |
| EOY | 223047 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200000 | BOY |
| EOY | 475 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 14255009 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1373592 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 950514 | BOY |
| EOY | 12881417 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5766511 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7072661 | BOY |
| EOY | 13157219 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 319357 | BOY |
| EOY | 305794 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7642698 | BOY |
| EOY | 15755412 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7962055 | BOY |
| EOY | 16061206 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1115793 | BOY |
| EOY | -3066671 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90186 | BOY |
| EOY | 26471 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 136213 | BOY |
| EOY | 136213 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -889394 | BOY |
| EOY | -2903987 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7072661 | BOY |
| EOY | 13157219 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -2014593 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 0 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4184212 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 770251 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 86554 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 155625 | CurrentTaxYearMinus1Year |
| Current Tax Year | 219728 | CurrentTaxYear |
| Total | 5416370 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4184212 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 770251 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 86554 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 155625 | CurrentTaxYearMinus1Year |
| Current Tax Year | 219728 | CurrentTaxYear |
| Total | 5416370 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 879460 | AmountsSubstContributorsTotal |
| Public Support Total170 | 4536910 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 334310 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 211262 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 52396 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17556 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5514 | CurrentTaxYear |
| Total | 621038 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -10428 | CurrentTaxYearMinus4Years |
| Total | -10428 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 6026980 | TotalSupport |
| Public Support Pertcentage170 | 0.75280 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.74630 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 119030 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -3569 | InvestmentEarningsOrLosses |
| Other Expenditures | 5512 | OtherExpenditures |
| End Of Year Balance | 109949 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 110902 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 14164 | InvestmentEarningsOrLosses |
| Other Expenditures | 6036 | OtherExpenditures |
| End Of Year Balance | 119030 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 136213 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -17499 | InvestmentEarningsOrLosses |
| Other Expenditures | 7812 | OtherExpenditures |
| End Of Year Balance | 110902 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 157629 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -17854 | InvestmentEarningsOrLosses |
| Other Expenditures | 3562 | OtherExpenditures |
| End Of Year Balance | 136213 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13637467 | OtherCostOrOtherBasis |
| Depreciation | 1145900 | Depreciation |
| Book Value | 12491567 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 617542 | OtherCostOrOtherBasis |
| Depreciation | 227692 | Depreciation |
| Book Value | 389850 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 12881417 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Intercompany Payables | Description |
| Amount | $15,755,412 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 15755412 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | Earnings from the endowment funds are used to provide financial aid to qualified patients. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | 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 2011. Open tax years subject to examination by the U.S and the state taxing authorities are for the years 2009 to 2011, which statutes expire in 2012 to 2014, respectively. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James Blaha | |||||||||||||
| 0 | 234278 | 0 | 18135 | 0 | 1539 | 0 | 20062 | 0 | 15955 | 0 | 289969 | 0 | 0 |
| Mark Mishek | |||||||||||||
| 0 | 480865 | 0 | 114553 | 0 | 3564 | 0 | 63004 | 0 | 22966 | 0 | 684952 | 0 | 0 |
| Barbara Kistenmacher | |||||||||||||
| 135152 | 0 | 20000 | 0 | 199 | 0 | 950 | 0 | 11892 | 0 | 168193 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 4b | ReturnReference |
| Explanation | Part 1, Line 4b: Mark Mishek, President and CEO, participated in a nonqualified retirement plan from a related organization in the amount of $36,967. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Officers are employed by Hazelden Foundation, a related exempt organization. Certain members of the board are also board members of the Hazelden Foundation. Therefore, business relationships exist between these individuals. | |
| Form 990, Part VI, Section A, line 6 | Hazelden Foundation is the sole member of Hazelden New York. | |
| Form 990, Part VI, Section A, line 7a | As the sole member, Hazelden 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 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 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 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 Foundation, sole member of Hazelden New York, prior to filing. | |
| Form 990, Part VI, Section B, line 12c | Hazelden 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 himself 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 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 Foundation. Based on this philosophy, the Executive Committee engages the use of an outside independent compensation consultant to identify comparable market data for comparable positions. Generally the market analysis includes competitive data from published survey sources, supplemented with compensation data from custom 990 analyses. Comparable market data are reviewed and discussed by the Executive Committee and minutes record those discussions and any resulting compensation decisions. The President/CEO has the ability to adjust the pay of other officers and key employees if the pay raise or adjustment falls within the market data and compensation philosophy approved prior by the Executive Committee. For the President/CEO, no employment offers or compensation changes are made by the Executive Committee without comparable data and an opinion from the outside compensation consultant. This process was last updated in February, 2010. | |
| Form 990, Part VI, Section C, line 19 | Hazelden 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 VII, Section A: | Officers paid by a related organization served the following hours per week at these related organizations: Mark Mishek 50 hours at Hazelden Foundation and 5 hours at Hazelden Chicago James Blaha 50 hours at Hazelden Foundation and 3 hours at Hazelden Chicago | Average Hours per Week: |
| 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 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
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Hazelden 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 | 0 | Hazelden Foundation | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |