Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 07-01-2014 , and ending 01-01-2015
BCheck if applicable:
CName of organization
THE BETTY FORD CENTER
 
Doing business as
BETTY FORD CENTER
 
Number and street (or P.O. box if mail is not delivered to street address)
39000 BOB HOPE DRIVE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
RANCHO MIRAGE, CA92270
D Employer identification number

95-3863994
E Telephone number

G Gross receipts $ 17,836,880
F Name and address of principal officer:
MARK MISHEK
15251 PLEASANT VALLEY ROAD
CENTER CITY,MN55012
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HAZELDENBETTYFORD.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1983
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE EFFECTIVE ALCOHOL AND OTHER DRUG DEPENDENCY TREATMENT SERVICES, INCLUDING PROGRAMS OF EDUCATION AND RESEARCH, TO HELP WOMEN, MEN AND FAMILIES BEGIN THE PROCESS OF RECOVERY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 30
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 29
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 342
6 Total number of volunteers (estimate if necessary) ............. 6 65
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,415,925 2,494,996
9 Program service revenue (Part VIII, line 2g) ......... 33,014,375 14,889,982
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,130,622 113
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 622,895 451,163
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 37,183,817 17,836,254
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 3,500,000 42,780,375
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 21,889,042 9,791,602
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet738,227    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 17,203,307 15,968,451
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 42,592,349 68,540,428
19 Revenue less expenses. Subtract line 18 from line 12....... -5,408,532 -50,704,174
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 65,050,946 0
21 Total liabilities (Part X, line 26)............. 13,266,720 0
22 Net assets or fund balances. Subtract line 21 from line 20..... 51,784,226 0
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO PROVIDE EFFECTIVE ALCOHOL AND OTHER DRUG DEPENDENCY TREATMENT SERVICES, INCLUDING PROGRAMS OF EDUCATION AND RESEARCH, TO HELP WOMEN, MEN AND FAMILIES BEGIN THE PROCESS OF RECOVERY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 50,108,927 including grants of $ 41,433,989 ) (Revenue $   )
ON JANUARY 1, 2015, THE BETTY FORD CENTER MERGED WITH THE HAZELDEN BETTY FORD FOUNDATION, A SECTION 501(C)(3) PUBLIC CHARITY, AND DISCONTINUED ITS OPERATIONS AS A SEPARATE LEGAL ENTITY. ALL ASSETS AND LIABILITIES WERE TRANSFERRED TO THE HAZELDEN BETTY FORD FOUNDATION AND THE ORGANIZATION WILL CONTINUE AS AN OPERATING DIVISION OF THE FOUNDATION. SEE SCHEDULE N FOR ADDITIONAL INFORMATION.
4b (Code:   ) (Expenses $ 12,776,705 including grants of $ 580,663 ) (Revenue $ 15,172,363 )
PATIENT SERVICES: DURING THE PARTIAL FISCAL YEAR (7/1/14 -1/1/15)APPROXIMATELY 482 PATIENTS RECEIVED TREATMENT AT THE BETTY FORD CENTER'S INPATIENT PROGRAM. IN ADDITION, 131 PATIENTS CONTINUED TREATMENT AT THE CENTER'S RESIDENTIAL DAY TREATMENT PROGRAM AND 36 PATIENTS WERE TREATED IN ONE OF THE CENTER'S TWO OUTPATIENT PROGRAMS. 440 FAMILY MEMBERS PARTICIPATED IN THE CENTER'S FAMILY PROGRAM. $580,663 WAS PROVIDED IN FINANCIAL ASSISTANCE FOR PATIENTS IN TREATMENT.
4c (Code:   ) (Expenses $ 1,003,300 including grants of $ 765,723 ) (Revenue $ 49,838 )
OUTREACH PROGRAMS: 1,198 CHILDREN AND PARENTS PARTICIPATED IN ONE OF THE THREE BETTY FORD CENTER'S CHILDREN'S PROGRAMS LOCATED IN TEXAS, COLORADO AND CALIFORNIA. OVER 95% OF THE PARTICIPANTS RECEIVED FINANCIAL ASSISTANCE TO ATTEND THESE PROGRAMS TOTALING $600,873 IN THE PERIOD COVERING JULY 2014 - DECEMBER 2014. THE CHILDREN'S PROGRAM TRAINING ACADEMY CONTINUES TO WORK WITH TWO PARTNERS IN THE DEVELOPMENT OF THEIR PROGRAMS. THERE WAS A WOMEN SYMPOSIUM SPONSORED BY THE CENTER WHERE PEOPLE CELEBRATED RECOVERY BY LEARNING ABOUT THE LATEST IN TREATMENT PRACTICES DESIGNED TO BENEFIT WOMEN. THE CENTER'S ALUMNI DEPARTMENT OFFERED ITS NETWORK OF RECOVERY SUPPORT THROUGH 35 REGULARLY SCHEDULED CHAPTER MEETINGS ACROSS THE UNITED STATES AND CANADA. THERE ARE OVER 5,000 ALUMNI CONTACTS TO SERVE AS SUPPORT FOR PATIENTS LEAVING TREATMENT.
(Code:   ) (Expenses $ 341,390 including grants of $   ) (Revenue $ 77,800 )
TRAINING PROGRAMS: THE SUMMER INSTITUTE FOR MEDICAL STUDENTS PROGRAM HOSTED 104 STUDENTS FOR MEDICAL SCHOOLS IN THE UNITED STATES AND OUTSIDE THE US. THE BETTY FORD CENTER CONTINUES TO PROVIDE CULTURALLY-SENSITIVE EDUCATION PROGRAMS ABOUT FAMILY RECOVERY FROM ADDICTION IN AMERICAN INDIAN, CANADIAN FIRST NATIONS AND SPANISH SPEAKING CULTURES.
4d Other program services (Describe in Schedule O.)
(Expenses $ 341,390 including grants of $   ) (Revenue $ 77,800 )
4e Total program service expensesMediumBullet64,230,322
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I........................... Click to see attachment
31
Yes
 
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...................... Click to see attachment
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
76
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
342
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
30
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
29
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AK , AZ , CA , CO , FL , GA , KY , MA , ME , NJ , NM , NY
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJAMES BLAHA
15251 PLEASANT VALLEY ROAD
CENTER CITY,MN55012 (651) 213-4006
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MARK G MISHEK........................................................................
PRESIDENT & CEO
 2.00
.......................40.00 		X   X       0 741,769 101,222
(2) PAUL GOSSLING........................................................................
VICE CHAIR
 2.00
.......................2.00 		X   X       0 0 0
(3) MARY TURNER PATTIZ PHD........................................................................
VICE CHAIR
 2.00
.......................2.00 		X   X       0 0 0
(4) HON SUSAN FOX GILLIS........................................................................
CHAIR
 2.00
.......................2.00 		X   X       0 0 0
(5) TERRY M RUBENSTEIN........................................................................
SECRETARY
 2.00
.......................2.00 		X   X       0 0 0
(6) VADEN F BALES........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(7) JOHN K BUTLER........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(8) WILLIAM CIRONE........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(9) CAROLINE COCHENER........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(10) MARINA FORSTMANN DAY........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(11) SUSAN S ENGELEITER........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(12) HARVE FERRILL........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(13) JAMES R GREENBAUM........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(14) A JOHN HUSS JR........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(15) DR ANDREW JEON MD........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(16) WILLIAM J LAMMERS........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(17) ERIC LUND........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) CHERYL S MCKINLEY........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(19) A THOMAS MCLELLAN PHD........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(20) LESTER MUNSON........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(21) AUSTIN P PIERRE OLNEY........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(22) GLORIA PEREZ........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(23) MADELINE M REDSTONE........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(24) CINI GANNON ROBB........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(25) G AUBREY SERFLING........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(26) MICHAEL SIME........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(27) CATHERINE LANE WEYERHAEUSER........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(28) W CHRISTOPHER WHITE........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(29) MARY FARNHAM WHITNEY........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(30) DR FRANK B WILDERSON JR PHD........................................................................
BOARD MEMBER
 2.00
.......................2.00 		X           0 0 0
(31) JOHN T SCHWARZLOSE........................................................................
FORMER CEO
 40.00
.......................   		    X       1,291,224 0 21,302
(32) JAMES A BLAHA........................................................................
TREASURER
 2.00
.......................40.00 		    X       0 352,289 54,292
(33) JAMES GREEN........................................................................
FORMER CFO
 40.00
.......................   		    X       177,583 0 4,749
(34) JERRY J MOE........................................................................
VP CHILDREN'S SERVICE
 40.00
.......................   		      X     260,652 0 38,789
(35) PETER PRZEKOP........................................................................
PHYSICIAN
 40.00
.......................   		      X     250,875 0 12,544
(36) JOHN M BOOP........................................................................
PRESIDENT FOUNDATION
 40.00
.......................   		      X     238,466 0 37,191
(37) CHARLENE G MONTGOMERY........................................................................
SR VP HR
 40.00
.......................   		      X     180,500 0 22,278
(38) BRIAR L GERACI........................................................................
VP COMPLIANCE DIRECTOR
 40.00
.......................   		        X   146,958 0 8,152
(39) MICHELA A SANDS........................................................................
REGIONAL DIRECTOR
 40.00
.......................   		        X   132,490 0 34,594
(40) ELIZABETH R FARVER-SMITH........................................................................
EXECUTIVE DIRECTOR
 40.00
.......................   		        X   135,956 0 18,800
(41) JOHN C PUSTAVER........................................................................
PTP PROGRAM DIRECTOR
 40.00
.......................   		        X   117,013 0 0
(42) RICHARD D SHELLEY........................................................................
DIRECTOR IMS
 40.00
.......................   		        X   118,204 0 6,102
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,049,921 1,094,058 360,015
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet19
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SODEXO INC & AFFILIATES

DEPT 880328
LOS ANGELES,CA900880328 		FOOD SERVICES 431,482
KAZOO MARKETING

821 WEST 17TH
KANSAS CITY,KS64108 		ADVERTISING 317,258
STEVEN J EICKELBERG

54 SAN FERNANDO
RANCHO MIRAGE,CA92270 		MEDICAL DIRECTOR 214,888
MOUNTAIN SPORTS MEDICINE INC

PO BOX 207
WEST DOVER,VT05356 		PHYSICIAN 187,950
HORT TECH LANDSCAPE MANAGEMENT

POBOX 3284
PALM DESERT,CA92261 		LANDSCAPING 169,890
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet10
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 5,000
f All other contributions, gifts, grants, and
similar amounts not included above1f 		2,489,996
g Noncash contributions included in lines
1a-1f:$ 		12,124
h Total. Add lines 1a-1f.......MediumBullet 2,494,996
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICES 624100 14,889,982 14,889,982    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 14,889,982
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 739     739
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses   626
c Gain or (loss)   -626
d Net gain or (loss)..........MediumBullet -626     -626
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a OTHER 624100 394,522 394,522    
b CAFETERIA FOOD SALES 624100 41,144     41,144
c MEDICAL RECORDS 621400 15,497 15,497    
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 451,163
12 Total revenue. See Instructions......MediumBullet 17,836,254 15,300,001 0 41,257
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 41,433,989 41,433,989
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 1,346,386 1,346,386
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 744,921 559,383 142,316 43,222
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages .... 6,541,778 4,935,978 1,227,322 378,478
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 40,294 28,823 9,067 2,404
9 Other employee benefits ....... 1,963,809 1,404,746 441,884 117,179
10 Payroll taxes ........... 500,800 392,009 82,609 26,182
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 105,902   105,902  
c Accounting ........... 11,000   11,000  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 1,360   1,360  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 2,378,822 2,118,996 219,904 39,922
12 Advertising and promotion .... 641,585   641,488 97
13 Office expenses ....... 629,482 432,928 166,462 30,092
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 571,056 435,238 94,980 40,838
17 Travel ............ 134,494 31,517 75,864 27,113
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 71,991 71,991    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 1,116,926 1,077,115 29,279 10,532
23 Insurance .............. 76,834 76,834    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a CORPORATE SUPPORT ALLOC 8,674,938 8,674,938    
b UTILITIES 466,228 466,228    
c PATIENT MEALS 271,480 253,659 17,596 225
d REPAIRS & MAINTENANCE 193,019 77,865 106,378 8,776
e All other expenses 623,334 411,699 198,468 13,167
25 Total functional expenses. Add lines 1 through 24e 68,540,428 64,230,322 3,571,879 738,227
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 2,388,441 1 0
2 Savings and temporary cash investments .........   2 0
3 Pledges and grants receivable, net ........... 6,571,753 3 0
4 Accounts receivable, net ............. 355,164 4 0
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6 0
7 Notes and loans receivable, net .............   7 0
8 Inventories for sale or use ..............   8 0
9 Prepaid expenses and deferred charges .......... 204,731 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 0
b Less: accumulated depreciation ..... 10b 0 36,191,994 10c 0
11 Investments—publicly traded securities .......... 17,433,188 11 0
12 Investments—other securities. See Part IV, line 11 .....   12 0
13 Investments—program-related. See Part IV, line 11 .....   13 0
14 Intangible assets ............... 57,419 14 0
15 Other assets. See Part IV, line 11 ........... 1,848,256 15 0
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 65,050,946 16 0
Liabilities 17 Accounts payable and accrued expenses ......... 5,071,218 17 0
18 Grants payable .................   18  
19 Deferred revenue ................ 1,164,040 19 0
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 541,542 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 6,489,920 23 0
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................   25  
26 Total liabilities. Add lines 17 through 25......... 13,266,720 26 0
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 32,640,214 27 0
28 Temporarily restricted net assets ........... 8,842,253 28 0
29 Permanently restricted net assets ........... 10,301,759 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 51,784,226 33 0
34 Total liabilities and net assets/fund balances ........ 65,050,946 34 0
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
17,836,254
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
68,540,428
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-50,704,174
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
51,784,226
5
Net unrealized gains (losses) on investments ...............
5
-229,167
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-850,885
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
0
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
 
No
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number

95-3863994
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2014 		(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number

95-3863994
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
THE BETTY FORD CENTER
  		Employer identification number

95-3863994
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
THE BETTY FORD CENTER
  		Employer identification number

95-3863994
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
THE BETTY FORD CENTER
  		Employer identification number

95-3863994
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number

95-3863994
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 10,168,231 9,986,792 9,970,125 10,000,138 9,581,174
b Contributions ........ 229,170 12,312 23,662 305,770 418,964
c Net investment earnings, gains, and losses 104,968 626,304 446,559 -335,783  
d Grants or scholarships ..... 10,502,369        
e Other expenditures for facilities
and programs ........ 		  457,177 453,554    
f Administrative expenses ....          
g End of year balance ......   10,168,231 9,986,792 9,970,125 10,000,138
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet0 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................        
e Other .................        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 0
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet  
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART V, LINE 4: THE ENDOWMENT INCOME HAD TWO INTENDED USES: 1. TO PROVIDE FINANCIAL SUPPORT FOR MEN, WOMEN AND FAMILIES TO PARTICIPATE IN TREATMENT OR THE RELATED EDUCATION SESSIONS; 2. TO ASSIST STUDENTS IN ATTENDING ADDICTION TREATMENT TRAINING PROGRAMS AT THE CENTER. AT 1/1/2015, THE ENDOWMENT WAS TRANSFERED TO THE HAZELDEN BETTY FORD FOUNDATION AS A RESULT OF THE MERGER BETWEEN THE BETTY FORD CENTER AND THE HAZELDEN BETTY FORD FOUNDATION.
PART X, LINE 2: THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABLITIES DURING FISCAL YEAR 2014. OPEN TAX YEARS SUBJECT TO EXAMINATION BY THE U.S. AND STATE TAXING AUTHORITIES ARE FOR THE YEARS 2012 TO 2014, WHICH STATUTES EXPIRE IN 2015 TO 2017, RESPECTIVELY.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number

95-3863994
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
 
No
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
 
No
b
If "Yes," did the organization make it available to the public? ..............
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    580,663   580,663 3.170 %
b Medicaid (from Worksheet 3,
column a) .... 		           
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    580,663   580,663 3.170 %
Other Benefits
     1,041,903 105,315 936,588 5.110 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		           
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits ..     1,041,903 105,315 936,588 5.110 %
k Total. Add lines 7d and 7j .     1,622,566 105,315 1,517,251 8.280 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
97,991
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
 
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
 
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
 
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
 
No
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

 

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 BETTY FORD CENTER
39000 BOB HOPE DRIVE
RANCHO MIRAGE,CA92270
WWW.BETTYFORDCENTER.ORG
106330120 		X                  
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
BETTY FORD CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

BETTY FORD CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

BETTY FORD CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19 Yes  
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21   No
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
BETTY FORD CENTER PART V, SECTION B, LINE 15E: POLICY:THE CENTER RECOGNIZES THAT PATIENTS SEEKING CHEMICAL DEPENDENCY TREATMENT AND FAMILY MEMBERS PARTICIPATING IN THE FAMILY PROGRAM MAY NOT BE ABLE TO AFFORD THE FULL COST OF SERVICES. THE CENTER FURTHER RECOGNIZES ITS OBLIGATION TO PROVIDE FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS IN NEED. THEREFORE, THIS FINANCIAL ASSISTANCE PROGRAM (FAP) HAS BEEN ESTABLISHED TO GOVERN FINANCIAL AID TO QUALIFYING PERSONS. FOR FINANCIAL AND CLINICAL REASONS, APPLICANTS ARE ASKED TO CONTRIBUTE A CO-PAYMENT TOWARDS THE COST OF SERVICES. THIS AMOUNT IS DETERMINED BY THE CFO AT THE BEGINNING OF EACH FISCAL YEAR.NOTE: UNDER NO CIRCUMSTANCES ARE CLINICAL DECISIONS BASED ON THE APPLICANT'S ABILITY TO PAY.PROCEDURE:1. INDIVIDUALS WHO REQUEST FINANCIAL ASSISTANCE WILL BE PROVIDED WITH AN APPLICATION. HE OR SHE WILL BE INSTRUCTED TO PROVIDE CERTAIN PERSONAL AND FINANCIAL INFORMATION WITH THE ADVISEMENT THAT THE APPLICATION WILL NOT BE PROCESSED UNLESS IT IS FULLY COMPLETE INCLUDING ANY REQUIRED DOCUMENTATION.2. THE APPLICATION WILL BE REVIEWED AND APPROVED OR DENIED BY THE DIRECTOR, PATIENT ACCOUNTS SERVICES UTILIZING BETTY FORD CENTER FINANCIAL ASSISTANCE CRITERIA WORKSHEET. IF DENIED, THE INDIVIDUAL WILL BE ADVISED OF THE REASON(S) FOR DENIAL.APPROVAL IS HIGHLY CONTINGENT UPON THE FOLLOWING CRITERIA: NEED - AS DETERMINED BY A REVIEW OF FINANCIAL STATUS, INCOME AND EXPENSES, CREDIT WORTHINESS, AND OTHER FINANCIAL CRITERIA. APPLICATION CAN BE MADE SUBSEQUENT TO ADMISSION IN THE EVENT INSURANCE COVERAGE IS DENIED AFTER TREATMENT HAS STARTED. COMMITMENT - THE INDIVIDUAL'S WILLINGNESS TO SATISFACTORILY PARTICIPATE IN AND FULLY COMPLETE ALL PROGRAM REQUIREMENTS. 3. IN MOST CASES, THE CENTER WILL PROVIDE PARTIAL, NOT FULL, FINANCIAL ASSISTANCE (INDIVIDUALS RECEIVING DISCOUNTS WILL NOT BE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE). ALSO, FINANCIAL ASSISTANCE CARRIES MAXIMUM LIMITS, UNLESS EXTENUATING CIRCUMSTANCES WARRANT A HIGHER AMOUNT THAT IS SPECIFICALLY AUTHORIZED BY THE PRESIDENT/CEO.4. APPROVED APPLICANTS WILL BE ADVISED THEIR PORTION OF THE COST OF TREATMENT MUST BE PAID IN FULL ON THE DAY OF ADMISSION UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE AND APPROVED IN ADVANCE. 5. IN MOST CASES, THE CENTER WILL PROVIDE FULL FINANCIAL ASSISTANCE FOR PARTICIPATION IN ITS CHILDREN'S PROGRAMS.
BETTY FORD CENTER PART V, SECTION B, LINE 18D: THOSE PATIENT ACCOUNTS ARE SENT TO A COLLECTION AGENCY.
BETTY FORD CENTER PART V, SECTION B, LINE 21C: THE CENTER DOES NOT ADMIT PATIENTS NEEDING EMERGENCY CARE. THOSE PATIENTS ARE REFERRED TO AN ACUTE CARE FACILITY FOR TREATMENT.
BETTY FORD CENTER PART V, SECTION B, LINE 22D: THE CENTER DOES NOT ADMIT PATIENTS NEEDING EMERGENCY CARE. THOSE PATIENTS ARE REFERRED TO AN ACUTE CARE FACILITY FOR TREATMENT.
PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
BETTY FORD CENTER PART V, SECTION B, LINE 16A WEBSITE: WWW.HAZELDENBETTYFORD.ORG
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LN 7 COL(F): PAST DUE BALANCES THAT ARE DELINQUENT BEYOND THE ACCEPTABLE TERMS OF CREDIT FOR EACH PATIENT ARE REVIEWED INDIVIDUALLY FOR COLLECTABILITY. THE CENTER PROVIDES FOR PROBABLE UNCOLLECTIBLE ACCOUNTS THROUGH A CHARGE TO EARNINGS AND A CREDIT TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON ITS ASSESSMENT OF THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS THAT ARE STILL OUTSTANDING AFTER THE CENTER HAS USED REASONABLE COLLECTION EFFORTS. AT THIS POINT THE ACCOUNTS ARE WRITTEN OFF THROUGH A CHARGE TO THE ALLOWANCE ACCOUNT AND A CREDIT TO PATIENTS ACCOUNTS RECEIVABLE.
PART VI, LINE 2: ALCOHOL AND CHEMICAL ADDICTION ARE WELL DOCUMENTED HEALTH CARE PROBLEMS WITHIN THE UNITED STATES. THE CENTER SEEKS TO PROVIDE EFFECTIVE ALCOHOL AND OTHER DRUG DEPENDANCY TREATMENT SERVICES ON A NATIONAL (AND INTERNATIONAL) BASIS, INCLUDING PROGRAMS OF EDUCATION AND RESEARCH TO HELP WOMEN, MEN AND FAMILIES IN THE PROCESS OF RECOVERY.
PART VI, LINE 3: THE CENTER PUBLISHES THE AVAILABILITY OF FINANCIAL ASSISTANCE ON ITS WEBSITE, WITHIN PUBLISHED MATERIALS AND DURING THE PROCESS OF ADMISSION INTO THE CENTER.
PART VI, LINE 4: THE CENTER IS A SPECIALTY HEALTH CARE FACILITY, NOT A COMMUNITY BASED HOSPITAL. ACCORDINGLY, GEOGRAPHIC AND DEMOGRAPHIC CONSTITUENTS ARE NATIONAL AND INTERNATIONAL. APPROXIMATELY, 50% OF THE PATIENTS ADMITTED TO THE CENTER ARE FROM THE STATE OF CALIFORNIA.
Schedule H (Form 990) 2014
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number
95-3863994
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) HAZELDEN BETTY FORD FOUNDATION
PO BOX 11
CENTER CITY,MN55012 		41-0682405 501(C)(3) 1,756,862 39,677,127 BOOK VALUE SEE SCHEDULE N MERGER; TRANSFER OF ASSETS






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) FINANCIAL ASSISTANCE 71   1,346,386 BOOK FINANCIAL ASSISTANCE FOR TREATMENT AND CHILDREN'S PROGRAMS












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: THE ORGANIZATION VERIFIES THE RECIPIENT HAS QUALIFIED FOR FINANCIAL ASSISTANCE AND MAINTAINS THE APPROPRIATE SUPPORTING DOCUMENTATION.
SCHEDULE I, PART I, LINE 2: ON JANUARY 1, 2015, THE ORGANIZATION MERGED WITH THE HAZELDEN BETTY FORD FOUNDATION A SECTION 501(C)(3) PUBLIC CHARITY AND DISCONTINUED ITS OPERATIONS. SEE SCHEDULE N FOR ADDITIONAL INFORMATION.
Schedule I (Form 990) 2014


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number

95-3863994
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1MARK G MISHEKPRESIDENT & CEO (i)
(ii)		 0
...............................
503,336 		0
...............................
232,889 		0
...............................
5,544 		0
...............................
78,096 		0
...............................
24,807 		0
...............................
844,672 		0
...............................
0
2JOHN T SCHWARZLOSEFORMER CEO (i)
(ii)		 1,291,224
...............................
0 		0
...............................
0 		0
...............................
0 		0
...............................
0 		21,302
...............................
0 		1,312,526
...............................
0 		791,225
...............................
0
3JAMES A BLAHATREASURER (i)
(ii)		 0
...............................
260,370 		0
...............................
90,119 		0
...............................
1,800 		0
...............................
34,815 		0
...............................
20,555 		0
...............................
407,659 		0
...............................
0
4JAMES GREENFORMER CFO (i)
(ii)		 177,583
...............................
0 		0
...............................
0 		0
...............................
0 		0
...............................
0 		4,749
...............................
0 		182,332
...............................
0 		0
...............................
0
5JERRY J MOEVP CHILDREN'S SERVICE (i)
(ii)		 260,652
...............................
0 		0
...............................
0 		0
...............................
0 		18,701
...............................
0 		20,088
...............................
0 		299,441
...............................
0 		0
...............................
0
6PETER PRZEKOPPHYSICIAN (i)
(ii)		 250,875
...............................
0 		0
...............................
0 		0
...............................
0 		12,544
...............................
0 		0
...............................
0 		263,419
...............................
0 		0
...............................
0
7JOHN M BOOPPRESIDENT FOUNDATION (i)
(ii)		 238,466
...............................
0 		0
...............................
0 		0
...............................
0 		17,155
...............................
0 		20,036
...............................
0 		275,657
...............................
0 		0
...............................
0
8CHARLENE G MONTGOMERYSR VP HR (i)
(ii)		 180,500
...............................
0 		0
...............................
0 		0
...............................
0 		12,833
...............................
0 		9,445
...............................
0 		202,778
...............................
0 		0
...............................
0
9BRIAR L GERACIVP COMPLIANCE DIRECTOR (i)
(ii)		 146,958
...............................
0 		0
...............................
0 		0
...............................
0 		7,476
...............................
0 		676
...............................
0 		155,110
...............................
0 		0
...............................
0
10MICHELA A SANDSREGIONAL DIRECTOR (i)
(ii)		 132,490
...............................
0 		0
...............................
0 		0
...............................
0 		7,071
...............................
0 		27,523
...............................
0 		167,084
...............................
0 		0
...............................
0
11ELIZABETH R FARVER-SMITHEXECUTIVE DIRECTOR (i)
(ii)		 135,956
...............................
0 		0
...............................
0 		0
...............................
0 		9,741
...............................
0 		9,059
...............................
0 		154,756
...............................
0 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINES 4A-B EXECUTIVES PARTICIPATE IN A NON-QUALIFIED RETIREMENT PLAN AS PART OF THEIR COMPENSATION ARRANGEMENTS. THE BETTY FORD CENTER ESTABLISHED A FUTURE SERVICE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"), A DEFINED CONTRIBUTION BASED PLAN, WHICH PROVIDES SUPPLEMENTAL POSTEMPLOYMENT AND POSTRETIREMENT BENEFITS TO THE CHIEF EXECUTIVE OFFICER. THE CONTRIBUTIONS ARE BASED ON A PERCENTAGE OF THE ELIGIBLE EXECUTIVES' SALARIES AND ARE INCLUDED AS PART OF THE BENEFIT EXPENDITURE ALLOWANCES.
PART I, LINE 7 PROCESS FOR APPROVING BONUSES IS THE SAME AS THAT FOR APPROVING EXECUTIVE COMPENSATION. SEE SCHEDULE O FOR PROCESS OF APPROVING EXECUTIVE COMPENSATION.
Schedule J (Form 990) 2014

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SCHEDULE N
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution, or Significant Disposition of Assets
bullet Complete if the organization answered "Yes" to Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
bullet Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet Attach to Form 990 or 990-EZ.
bulletInformation about Schedule N (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number
95-3863994
Part I
Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated if additional space is needed.
1(a)Description of asset(s)
distributed or transaction
expenses paid		 (b)Date of
distribution		 (c)Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d)Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e)EIN of recipient (f)Name and address of recipient (g)IRC section
of recipient(s) (if
tax-exempt) or type
of entity
CASH 01-01-2015 1,756,862 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
ACCOUNTS RECEIVABLE, NET 01-01-2015 508,511 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
PLEDGES RECEIVABLE 01-01-2015 7,005,604 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
PREPAID EXPENSES 01-01-2015 402,354 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
LAND 01-01-2015 5,542,979 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
BUILDINGS AND EQUIPMENT, NET 01-01-2015 29,901,857 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
INTANGIBLE ASSETS 01-01-2015 55,253 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
INVESTMENTS 01-01-2015 14,599,871 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
OTHER ASSETS 01-01-2015 794,040 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
ACCOUNTS PAYABLE 01-01-2015 4,993,170 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
DEFERRED REVENUE 01-01-2015 539,333 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
RELATED PARTY LOAN PAYABLE 01-01-2015 10,073,774 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
SECURED MORTGAGES AND NOTES PAYABLE 01-01-2015 3,527,065 BOOK VALUE 41-0682405 HAZELDEN BETTY FORD FOUNDATION
 
PO BOX 11
CENTER CITY,MN55012 		501(C)(3)
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
Yes
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . .
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? . . . . .
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) (2014)

Schedule N (Form 990 or 990-EZ) (2014)
Page 2
Part I
Liquidation, Termination, or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III . . . . . . . . . . .
3
Yes
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? . . . . . .
4a
Yes
 
b
If "Yes," did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .
4b
Yes
 
5
Did the organization discharge or pay all of its liabilities in accordance with state laws? . . . . . . . . . . . . . . . . .
5
Yes
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? . . . . . . . . . . . . . . . . . . . .
6a
 
No
b
If "Yes" to line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?
6b
 
 
c
If "Yes" to line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" to line 6b, explain in Part III.

Part II
Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid		 (b) Date of
distribution		 (c) Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d) Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
















Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
Yes
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? . . . . . . .
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
Schedule N(Form 990 or 990-EZ) (2014)

Schedule N (Form 990 or 990-EZ) (2014)
Page 3
Part III
Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.
Return Reference Explanation
PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: MARK MISHEK WAS THE PRESIDENT & CEO FOR BOTH THE BETTY FORD CENTER AND THE HAZELDEN BETTY FORD FOUNDATION PRIOR TO THE DISSOLUTION AND WILL REMAIN THE PRESIDENT & CEO OF HAZELDEN BETTY FORD FOUNDATION.JAMES BLAHA WAS THE TREASURER FOR THE BETTY FORD CENTER AND THE CFO FOR HAZELDEN BETTY FORD FOUNDATION PRIOR TO THE DISSOLUTION AND WILL REMAIN THE CFO OF HAZELDEN BETTY FORD FOUNDATION.THE FOLLOWING INDIVIDUALS SERVED AS BOARD MEMBERS ON BOTH THE BETTY FORD CENTER AND THE HAZELDEN BETTY FORD FOUNDATION PRIOR TO THE DISSOLUTION AND WILL REMAIN BOARD MEMBERS OF HAZELDEN BETTY FORD FOUNDATION:WILLIAM CIRONECAROLINE COCHENERMARINA FORSTMANN DAYHARVE FERRILLHON. SUSAN FOX GILLISPAUL GOSSLINGJAMES GREENBAUMERIC LUNDCHERYL MCKINLEYA. THOMAS MCLELLANLESTER MUNSONAUSTIN "PIERRE" OLNEYMADELINE REDSTONECINI GANNON ROBBG AUBREY SERFLINGCHRISTOPHER WHITEDR. FRANK WILDERSON
SCHEDULE N - SUPPLEMENTAL INFORMATION ON FEBRUARY 7, 2014, THE BOARD OF TRUSTEES FOR THE HAZELDEN FOUNDATION AND THE BOARD OF TRUSTEES FOR BETTY FORD CENTER AT EISENHOWER COMBINED THEIR OPERATIONS TO BETTER FULFILL THEIR RESPECTIVE MISSIONS AND TO ENHANCE THEIR ABILITY TO SERVE PATIENTS AND OTHER STAKEHOLDERS. UNDER THE LEGAL PLAN OF MERGER, BETTY FORD CENTER WAS MERGED WITH AND INTO THE FOUNDATION AS A WHOLLY OWNED SUBSIDIARY AND THE LEGAL NAME FOR THE FOUNDATION WAS CHANGED TO HAZELDEN BETTY FORD FOUNDATION.THE FOUNDATION DID NOT TRANSFER ANY CONSIDERATION AS PART OF THE ACQUISITION AND RECOGNIZED AN INHERENT CONTRIBUTION RECEIVED OF $62,272,927 INCLUDING $8,020,822 TEMPORARILY RESTRICTED BY DONORS AND $10,299,990 PERMANENTLY RESTRICTED BY DONORS IN THE STATEMENT OF ACTIVITIES FOR THE 12 MONTHS ENDED DECEMBER 31, 2014. THE ACQUISITION OF ASSETS AND LIABILITIES DOES NOT INCLUDE THE BALANCE FROM THE RELATED PARTY TRANSACTIONS AS THESE WERE ELIMINATED WITH THE TRANSFER. EFFECTIVE JANUARY 1, 2015, THE BETTY FORD CENTER WAS LEGALLY DISSOLVED AS A CORPORATION AND BECAME AN OPERATING DIVISION OF THE FOUNDATION. SEE ATTACHED ARTICLES OF MERGER FOR ADDITIONAL INFORMATION.
Schedule N (Form 990 or 990-EZ) (2014)


Additional Data


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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number

95-3863994
Return Reference Explanation
FORM 990, PART III, LINE 3 THE ORGANIZATION MERGED WITH HAZELDEN BETTY FORD FOUNDATION AND BECAME AN OPERATING DIVISION OF THE FOUNDATION. FOR ADDITIONAL INFORMATION, PLEASE SEE SCHEDULE N.
FORM 990, PART VI, SECTION A, LINE 2 THE BETTY FORD CENTER BUYS OPERATING SUPPORT SERVICES FROM EISENHOWER MEDICAL CENTER (EMC). AUBRY SERFLING IS A MEMBER OF THE BETTY FORD CENTER'S BOARD OF DIRECTORS, THE CHIEF EXECUTIVE OFFICER OF EMC AND A MEMBER OF THE EMC BOARD OF TRUSTEES. MADELINE REDSTONE IS A MEMBER OF THE BETTY FORD CENTER'S BOARD OF DIRECTORS AND HER SPOUSE IS A MEMBER OF THE EMC BOARD OF TRUSTEES. ONE BETTY FORD CENTER BOARD MEMBER IS THE PERSONAL PHYSICIAN TO ANOTHER BOARD MEMBER. A BETTY FORD CENTER BOARD MEMBER SERVES ON THE BOARD OF AN ORGANIZATION THAT HAS A PRICING AGREEMENT WITH THE BETTY FORD CENTER. A BETTY FORD CENTER BOARD MEMBER SERVES AS PERSONAL LEGAL COUNSEL TO THREE OF THE CENTER'S EXECUTIVES AND HAS PREVIOUSLY REPRESENTED OVER 150 STAFF MEMBERS IN VARIOUS LEGAL MATTERS.
FORM 990, PART VI, SECTION A, LINE 4 AN AGREEMENT OF MERGER WAS FILED BETWEEN HAZELDEN BETTY FORD FOUNDATION AND THE BETTY FORD CENTER, IN WHICH, THE BETTY FORD CENTER LEGALLY DISSOLVED AND BECAME A SEPARATE OPERATING DIVISION OF THE HAZELDEN BETTY FORD FOUNDATION. SEE ATTACHED ARTICLES OF MERGER
FORM 990, PART VI, SECTION A, LINE 6 EFFECTIVE FEBRUARY 7, 2014, THE HAZELDEN FOUNDATION ("HAZELDEN") WAS SUBSTITUTED AS THE SOLE CORPORATE MEMBER OF THE BETTY FORD CENTER AT EISENHOWER TO FACILITATE THE PLANNED STATUTORY MERGER OF THE TWO ORGANIZATIONS AT JANUARY 1, 2015. HAZELDEN, A 501(C)(3) TAX-EXEMPT ORGANIZATION, IS CONSIDERED TO BE A LEADER IN CHEMICAL DEPENDENCY TREATMENT HEADQUARTERED IN MINNESOTA. HAZELDEN AND ITS SUBSIDIARIES OWN AND OPERATE SUBSTANCE ABUSE TREATMENT FACILITIES AND OTHER PROGRAMS AND SERVICES IN VARIOUS SITES ACROSS THE COUNTRY. BOTH PARTIES DETERMINED THAT A COMPLETE INTEGRATION AND MERGER OF THEIR PROGRAMS AND SERVICES WOULD FURTHER THE MISSION OF BOTH ORGANIZATIONS DUE TO IDENTICAL MISSIONS, CLINICAL MODEL ROOTED IN THE TWELVE STEPS OF ALCOHOLICS ANONYMOUS, AND COMMITMENT TO PROVIDING THE HIGHEST QUALITY OF CARE. THE BENEFITS OF THE MERGER INCLUDED OPERATING EFFICIENCIES, EXPANDING GEOGRAPHIC REACH TO HELP MORE PEOPLE, COMBINING RESOURCES TO RESPOND TO THE NEEDS OF HEALTH REFORM AND STRENGTHENING AND ENHANCING THE CONTINUUM OF PROGRAM OFFERINGS IN THE COMMUNITIES SERVED BY EACH ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A IT IS THE INTENT OF BOTH THE BOARD OF TRUSTEES OF HAZELDEN BETTY FORD FOUNDATION AND THE BOARD OF DIRECTORS OF THE BETTY FORD CENTER THAT THEIR BOARDS FULLY MELD TOGETHER TO CREATE ONE UNIFIED BOARD OVER THE COMBINED ORGANIZATIONS AND AFFILIATED SUBSIDIARIES. UPON THE EFFECTIVE DATE OF JANUARY 1, 2015, IN ACCORDANCE WITH THE REVISED HAZELDEN FOUNDATION BYLAWS, THE INITIAL BOARD OF TRUSTEES OF HAZELDEN BETTY FORD FOUNDATION AND THE INITIAL BOARD OF DIRECTORS OF BETTY FORD CENTER SHALL BE COMPRISED OF ALL HAZELDEN FOUNDATION AND BETTY FORD CENTER DIRECTORS INTERESTED AND ELIGIBLE TO SERVE AS BOARD MEMBERS OF HAZELDEN BETTY FORD FOUNDATION AND BETTY FORD CENTER, AS DETERMINED PURSUANT TO SECTION 2.2.9 OF THE BYLAWS. THEREAFTER, THE HAZELDEN BETTY FORD FOUNDATION BOARD MEMBERSHIP SHALL BE SELF PERPETUATING, AND THE BETTY FORD CENTER BOARD MEMBERSHIP SHALL BE IDENTICAL TO THE HAZELDEN BETTY FORD FOUNDATION BOARD MEMBERSHIP. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF HAZELDEN BETTY FORD FOUNDATION SHALL SERVE ON THE BOARD OF TRUSTEES OF HAZELDEN BETTY FORD FOUNDATION AND THE BOARD OF DIRECTORS OF BETTY FORD CENTER AS AN EX-OFFICIO MEMBER WITH A VOTE.
FORM 990, PART VI, SECTION B, LINE 11 EACH BOARD MEMBER IS SENT A COPY OF FORM 990 FOR REVIEW BEFORE THE FORM IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, FOUNDATION TRUSTEES AND MEMBERS OF SENIOR MANAGEMENT ARE REQUIRED TO COMPLETE ANNUAL CONFLICT OF INTEREST STATEMENTS WHICH ARE REVIEWED BY THE BETTY FORD CENTER'S LEGAL COUNSEL. CONFLICT OF INTEREST POLICY: BETTY FORD CENTER EMPLOYEES AND TRUSTEES MUST AVOID CONFLICTS OF INTEREST BY APPROPRIATELY ARRANGING OUTSIDE OBLIGATIONS, FINANCIAL INTERESTS, CONSULTATION AND OTHER ACTIVITIES THAT RELATE TO OR CONFLICT WITH THEIR EMPLOYMENT OR RELATIONSHIP WITH THE BETTY FORD CENTER. ACCORDINGLY, EMPLOYEES MAY NOT UNDERTAKE ANY ACTIVITY, WITH OR WITHOUT COMPENSATION, WHICH MIGHT: A. INTERFERE WITH THE PROPER PERFORMANCE OF HIS/HER DUTIES; B. CAUSE LOSS OR CAUSE UNFAVORABLE PUBLICITY OR EMBARRASSMENT TO THE BETTY FORD CENTER IF DISCLOSED OR POSTED ON ANY SOCIAL MEDIA SITE/BLOG; C. BE UNETHICAL OR UNLAWFUL IN THEIR RELATIONSHIPS WITH PATIENTS AND THEIR FAMILIES, HEALTH CARE PRACTITIONERS, SUPPLIERS, SUBCONTRACTORS AND COMPETITORS. TO ENSURE COMPLIANCE WITH THIS POLICY, ALL EMPLOYEES/TRUSTEES MUST DISCLOSE ANY KNOWN OR POTENTIAL CONFLICT OF INTEREST AS DEFINED IN THIS POLICY AND RECEIVE APPROVAL PRIOR TO UNDERTAKING THE "QUESTIONABLE" ACTIVITY. IN ADDITION, ALL MANAGEMENT EMPLOYEES SHALL COMPLETE A CONFLICT OF INTEREST CERTIFICATION WHEN AN EXTERNAL ACTIVITY MAY BE CONSTRUED AS A CONFLICT OF INTEREST. THE CHIEF EXECUTIVE OFFICER (CEO) MUST APPROVE ALL POTENTIAL CONFLICT TRANSACTIONS OR ACTIVITIES INVOLVING EMPLOYEES OF BETTY FORD CENTER. THE CEO AND THE CHAIRMAN, BOARD OF DIRECTORS MUST APPROVE ALL POTENTIAL CONFLICT TRANSACTIONS OR ACTIVITIES INVOLVING TRUSTEES. IT IS THE RESPONSIBILITY OF MANAGEMENT TO ENSURE THAT ALL EMPLOYEES ARE INFORMED OF THIS POLICY STATEMENT AND PROCEDURE. A. DEFINITIONS 1. CONFLICT OF INTEREST: A CONFLICT OF INTEREST IS DEFINED AS A SITUATION IN WHICH AN EMPLOYEE, EITHER DIRECTLY OR INDIRECTLY THROUGH A SPOUSE, PARENTS, CHILDREN OR OTHER FAMILY MEMBERS, HAS THE OPPORTUNITY, OR APPEARS TO HAVE THE OPPORTUNITY TO INFLUENCE BETTY FORD CENTER DECISIONS OR TO USE ANY RESOURCES OR INFORMATION WHICH IS CONFIDENTIAL WITH RESPECT TO THE CENTER IN WAYS THAT COULD LEAD TO PROFESSIONAL, PERSONAL OR ECONOMIC GAIN OR GIVE IMPROPER ADVANTAGE TO SELF OR ASSOCIATES OUTSIDE OF THE CENTER. 2. SIGNIFICANT FINANCIAL INTEREST: A SIGNIFICANT FINANCIAL INTEREST SHALL BE ANY INTEREST, FEE, SALARY, DIVIDEND, RENT OR ANY OTHER FORM OF COMPENSATION IN EXCESS OF $7,500 PER ANNUM, OR A 1% OR GREATER EQUITY OR OTHER FINANCIAL POSITION (INCLUDING STOCK, STOCK OPTIONS, WARRANTS, DEBT, OR OTHER SECURITIES OR OWNERSHIP INTEREST) IN ANY COMPANY OR OTHER INVESTMENT ENTITY WHICH CONDUCTS BUSINESS WITH BFC, BUT EXCLUDING ANY INTEREST ARISING SOLELY BY REASON OF AN INVESTMENT IN WHICH THE EMPLOYEE OWNS LESS THAN A 1% INTEREST. 3. PROFESSIONAL ACTIVITY: AN OUTSIDE PROFESSIONAL ACTIVITY SHALL MEAN ANY CONSULTATION, EMPLOYMENT, SCIENTIFIC ADVISORY ROLE, AND PARTICIPATION IN ANY CORPORATION, PARTNERSHIP AGREEMENT, BUSINESS, HEALTH CARE ENTERPRISE OR ANY OTHER LEGAL ENTITY. B. EXAMPLES OF PROHIBITED ACTIVITIES THE FOLLOWING ACTIVITIES ARE CONSIDERED "PROHIBITED" UNLESS WRITTEN PERMISSION IS GRANTED BY THE CEO OR THE CHAIRMAN, BOARD OF DIRECTORS. 1. ANY PARTICIPATION IN OR ACCEPTANCE OF ANY PLAN, TRANSACTION, OR ARRANGEMENT, WHICH THE EMPLOYEE KNOWS OR SUSPECTS, IS UNETHICAL OR UNLAWFUL. 2. ANY DIRECT OR INDIRECT SIGNIFICANT FINANCIAL INTEREST IN ANY BUSINESS OR HEALTH CARE ENTERPRISE THAT PRODUCES SERVICES OR PRODUCTS WHICH COMPETE OR COULD POTENTIALLY COMPETE WITH THOSE OF THE BETTY FORD CENTER. 3. DISCLOSURE OF CONFIDENTIAL PATIENT INFORMATION, FINANCIAL, OPERATING, MEDICAL OR OTHER INFORMATION RELATED TO BFC INTENDED TO BE PRIVILEGED OR CONFIDENTIAL TO ANY PERSON OR ORGANIZATION. 4. ACCEPTANCE FOR HIS OR HER PROFESSIONAL ACTIVITY HONORARIA, CONSULTING FEES OR OTHER REMUNERATION IN ANY AMOUNT FROM AN INDIVIDUAL OR COMPANY WHICH CONDUCTS BUSINESS WITH BFC AND FOR WHICH THE EMPLOYEE IS IN A POSITION TO MAKE OR INFLUENCE DECISIONS. 5. SERVICE AS AN OFFICER, DIRECTOR, EMPLOYEE, COMMITTEE MEMBER, ADVISOR, AGENT, REPRESENTATIVE OR CONSULTANT OR IN ANY OTHER PROFESSIONAL ACTIVITY CAPACITY FOR ANY COMPANY, FIRM OR BUSINESS OTHER THAN THE BETTY FORD CENTER WHEN, IN THE JUDGMENT OF THE EMPLOYEE'S CEO, SUCH SERVICE CONFLICTS WITH THE CENTER'S INTERESTS OR DETRACTS FROM OR INFRINGES IN A SIGNIFICANT WAY ON THE EMPLOYEE'S RESPONSIBILITIES TO THE BETTY FORD CENTER. 6. DIRECTLY OR INDIRECTLY OWN, TRADE, OR DEAL IN REAL ESTATE, MATERIALS, SUPPLIES, EQUIPMENT OR OTHER PROPERTY WITH THE INTENT OF SELLING, RENTING OR CONTRACTING TO BETTY FORD CENTER, OR ITS EMPLOYEES. 7. CASH GIFTS OF ANY AMOUNT, OR A GIFT, GRATUITY, ENTERTAINMENT OR FAVORS ARE NOT ACCEPTED. INCLUDED IN THIS PROHIBITION ARE GIFTS FROM PATIENTS, BETTY FORD CENTER EMPLOYEES, AFFILIATED PROVIDERS, AND ANY BUSINESS ENTERPRISE THAT IS A CURRENT OR PROSPECTIVE SUPPLIER, LESSOR OR LESSEE. GIFTS ARE PRESUMED TO BE OF "SUCH SIGNIFICANCE" IF THE VALUE EXCEEDS $50 PER EVENT FROM A SINGLE PERSON OR ENTITY. SUCH GIFTS ARE REPORTED TO THE SUPERVISOR, WHO MAKES A DETERMINATION: 1. THE GIFT IS ONE THAT CAN BE SHARED BY THE DEPARTMENT OR 2. THE INDIVIDUAL MAY KEEP THE GIFT. C. DISCLOSURE PROCEDURE 1. AT HIRE AND PERIODIC DISCLOSURE: ALL EMPLOYEES AT THE MANAGER LEVEL OR ABOVE ARE REQUIRED TO PROVIDE FULL DISCLOSURE OF ALL SIGNIFICANT FINANCIAL INTERESTS, POTENTIAL CONFLICT OF INTEREST SITUATIONS, AND RELATIONSHIPS WHICH MAY BE PROHIBITED ACTIVITIES. SUCH DISCLOSURES AND AGREEMENTS ARE REQUIRED AS A CONDITION OF EMPLOYMENT AT THE BETTY FORD CENTER. ALL DISCLOSURES WILL BE MADE AT THE TIME THE EMPLOYEE BEGINS EMPLOYMENT AND WHEN A NEW SITUATION DEVELOPS. 2. SITUATIONAL DISCLOSURE: IT IS THE AFFIRMATIVE RESPONSIBILITY OF ANY MANAGEMENT EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THE CEO AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION. IN ADDITION, ANY NON-MANAGEMENT EMPLOYEE WHO HAS THE POTENTIAL FOR INFLUENCING BUSINESS DECISIONS AS DESCRIBED IN THIS POLICY SHALL ALSO DISCLOSE TO HIS/HER RESPECTIVE DIRECTOR AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL CONFLICT. 3. APPROVAL PROCESS: THE CEO IS CHARGED WITH REVIEWING, IN CONFIDENCE, ALL DISCLOSURES IN A TIMELY AND OBJECTIVE MANNER TO DETERMINE IF A PROHIBITED ACTIVITY OR CONFLICT OF INTEREST EXISTS. THE APPROVING AUTHORITY MAY GRANT WAIVERS IN SITUATIONS WHEN IT CAN BE DEMONSTRATED THAT THE INTEREST OR RELATIONSHIP AT ISSUE WOULD NOT COMPROMISE THE OBJECTIVITY OF DECISIONS AND ACTIONS TAKEN. IF A PROHIBITED ACTIVITY OR CONFLICT OF INTEREST IS IDENTIFIED, THE APPROVING AUTHORITY MAY TAKE STEPS TO ELIMINATE ANY CONFLICT, OR APPROPRIATELY MANAGE THE SITUATION, INCLUDING A RECOMMENDATION OF CORRECTIVE ACTIVE AND/OR TERMINATION OF EMPLOYMENT.
FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION LEVELS FOR THE CEO AND CFO/TREASURER ARE REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE REVIEW IS ASSISTED BY THE SENIOR VICE PRESIDENT FOR HUMAN RELATIONS AND RELIES ON COMPARATIVE DATA OBTAINED FROM A NUMBER OF OUTSIDE SOURCES AS WELL AS THE PERIODIC ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT. OTHER KEY EMPLOYEES' COMPENSATION IS PERIODICALLY REVIEWED BY HR THROUGH SURVEYS AND 990 INFORMATION AND MARKET ADJUSTMENTS ARE APPROVED BY THE CEO WHERE REQUIRED.
FORM 990, PART VI, SECTION C, LINE 19 THE BETTY FORD CENTER DOES NOT ROUTINELY MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, BUT WILL CONSIDER WRITTEN REQUESTS FOR THIS INFORMATION. AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9: PROVISION FOR UNCOLLECTIBLE PLEDGES -1,080,055. CHANGES IN ENDOWMENT DRAWS 229,170.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE BETTY FORD CENTER
 
Employer identification number

95-3863994
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) HAZELDEN BETTY FORD FOUNDATION
PO BOX 11

CENTER CITY,MN55012
41-0682405 		RECOVERY SERVICES, PUBLISHING, HIGHER EDUCATION AND TRAINING MN 501(C)(3) 501(C)(3) N/A
 
No












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) HARDY 6 CHARITABLE REMAINDER UNITRUST

PO BOX 45174
SAN FRANCISCO,CA414500174
33-6155740 		CHARITABLE TRUST CA N/A
 T     100.000 %   No
(2) REIFSCHNEIDER ANNUITY

PO BOX 2999
HARTFORD,CT061042999
 GIFT ANNUITY FUND CA N/A
 T     100.000 %   No
(3) AMY FAMILY 2007 REMAINDER TRUST

1190 W MARION AVE
PUNTA GORDA,FL33950
 CHARITABLE TRUST FL N/A
 T     100.000 %   No
(4) ERIC J LUND TRUST

1901 AVE OF THE STARS 2ND FLOOR
LOS ANGELES,CA90067
 CHARITABLE TRUST CA N/A
 T     100.000 %   No






Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HAZELDEN BETTY FORD FOUNDATION

 B 41,433,989 BOOK VALUE
(2) HAZELDEN BETTY FORD FOUNDATION

 P 8,674,938 BOOK VALUE




Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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