SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Hazelden Betty Ford Foundation
 
Employer identification number

41-0682405
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

 

No
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
 
No
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
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
No
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) . . . 		    4,304,986 0 4,304,986 1.990 %
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 . . . . .     4,304,986   4,304,986 1.990 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     3,987,334 1,901,593 2,085,741 0.960 %
f Health professions education (from Worksheet 5) . . .     1,243,489 0 1,243,489 0.570 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .     795,476 89,939 705,537 0.330 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     6,026,299 1,991,532 4,034,767 1.860 %
k Total. Add lines 7d and 7j .     10,331,285 1,991,532 8,339,753 3.850 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 Healthcare 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
5,121,050
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
0
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
0
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
Yes
 
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

Yes

 
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) 2021
Schedule H (Form 990) 2021
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?1Name, 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 and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Betty Ford Center
39000 Bob Hope Drive
Rancho Mirage,CA92270
see supplemental info for website
106330120 		X                  
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
Page 4
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 Yes  
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 21
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 Yes  
6 a 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   No
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   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
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 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Part V, Page 8
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2021
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Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Betty Ford Center
Name of hospital facility or letter of facility reporting group  
Yes No
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 Was widely publicized 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
www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage
b
www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
Betty Ford Center
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
19 Did the hospital facility or other authorized 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   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
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 19. (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 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Betty Ford Center
Name of hospital facility or letter of facility reporting group  
Yes No
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) 2021
Page 8
Schedule H (Form 990) 2021
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
Part V, Section A: www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage
Betty Ford Center Part V, Section B, Line 5: The method of soliciting input from people representing the broad interests of the community was an online survey that targeted leaders of local organizations in the health and human services fields. The survey for local leaders assessed who these organizations served, what types of services they provided, and what their perspective was on substance use and/or mental health issues that their clients struggled with. The survey included questions regarding barriers to treatment, and the urgency of the need to address substance use and/or mental health issues in the region. The recruit participant list was produced by obtaining active provider information from the Substance Abuse and Mental Health Services Administration (SAMHSA) as well as California Office of Statewide Health Planning and Development (OSHPD). The list included a variety of health and human services organizations such as health clinics, hospitals, federally qualified health centers (FQHCs), nonprofits including homeless shelters, LGBT centers, senior centers, and county health departments including Department of Health, Department of Behavioral Health, and Department of Public Health. A total of 147 organizations (two of these were not originally on the recruitment list but received information about the survey) were reached. Among these 147 organizations, 51% participated in the survey. After the launch date, the organizations were sent an email reminder encouraging them to participate. Despite the email invitation and reminder emails, the response rate was subpar. To increase response rates, personal email reminders were sent. These recruitment efforts resulted in a total of 120 respondents, representing 80 organizations.All participants were asked to specify the County service area in which they work. Participation was acquired from each county, and some respondents indicated that they serve clients outside of these counties. Respondents were also asked to specify the populations they serve and to check all that apply. A total of 119 participants responded to this question. A range of populations are served, including various demographic races (Hispanic/Latino (93.3%), White/Caucasian (87.4%), African American (86.6%), American Indian/Alaska Native (80.7%), as well as LGBTQIA+ (84.9%), low-income (89.9%), homeless (72.3%), uninsured (67.2%), and medically underserved (68.1%). Participants were also asked to specify the types of services that their organization provides and were encouraged to select all of the response options that apply. The most common services provided, as expected, are mental healthcare (58.3%) and substance use treatment (57.5%); however, there were other selections such as advocacy (35.8%), homeless intervention services (33.3%), and primary healthcare (26.7%). The survey was designed to measure perceptions of local organizations providing substance use and mental health services in some capacity. However, some organizations may exclusively provide one type of service such as only substance use or only mental health services, while others provide a combination of these two services. For example, if an organization provided only mental health services, they received questions pertaining only to mental health. Nearly three-quarters (73.7%) of participants stated their organization provides both mental health and substance use services.
Betty Ford Center Part V, Section B, Line 11: To assemble the list of significant health needs for the overall service area of Los Angeles County, Riverside County, and San Diego County, both the secondary data as well as the primary data collected from local community leaders were utilized. Health needs were rated with respect to their magnitude, severity, disparity, and feasibility. In other words, each health need was evaluated in terms of how many people are affected, the consequences of the need, the disproportionate impact, and then the potential to meaningfully address the need. The top health needs that had a high need priority as well as a high feasibility rating were retained.Thus, the health needs identified through this CHNA are as follows: 1. Substance Use - Education and Awareness 2. Mental Health - Education and Awareness 3. Substance Use - Improved Access to Care 4. Mental Health - Improved Access to Care Note that Betty Ford Center (BFC) is actively engaged in each of these above bullets at all times. Thus, based on community input, these areas will remain as primary focus areas for Betty Ford Center over the next three years.Substance Use Education and Awareness: The strategies being worked on are: 1. Continuing to provide education for community members focused on prevention and treatment of substance use disorders and the long-term recovery process.2. Continuing to establish Motivational Interviewing skills as key competencies for the care that is provided. 3. Continue providing support and education for children and families affected by substance use disorder. The following progress was made on these strategies:-Betty Ford Center contracted with Palo Verde College in Blythe, CA to offer nursing students collaboration and training at BFC starting in 2022. This allows BFC to provide education to nursing students on addiction treatment during their rotation. Betty Ford Center outreach had an informational booth at the 35th annual Palm Springs Pride Festival. -Multiple staff members applied for Motivational Interviewing training.-Alumni Services held the 39th annual Alumni Anniversary event (virtual due to the pandemic). The Children's Program offered Alumni Curbside participation. The children were given goodie bags with candy, toys, masks and Beamer t-shirts. Beamer is the mascot and ambassador that helps reinforce all the skills taught to children relative to addiction. Mental Health Education and Awareness: The strategies being worked on are: 1. Integrated care for mental health substance use disorders for patients.2. Providing training on integrated treatment of mental health and substance use disorders. 3. Continue providing education for community members focused on integrated treatment of mental health and substance use disorders.The following progress was made on these strategies:-A monthly meeting for Men's Association for Addition Treatment (MAAT) were held. The meeting is a networking meeting for men and women in the field of addiction, behavioral and mental health fields. Substance Use Improved Access to Care: The strategies being worked on are: 1. Continuing to expand virtual treatment options and services. 2. Continuing to improve care coordination and collaboration between Betty Ford Center and community providers, removing barriers to community accessing treatment and non-treatment resources related to substance use disorder. 3. Expanding Betty Ford Center services delivered in Spanish.The following progress was made on these strategies:-Intensive Outpatient, Family and Children's programs are being offered virtually.-Hazelden Betty Ford Foundation website has extensive informational resources.-The BFC Executive Director presented at Patient Care Network on our COVID response and continuing to provide access to care during the pandemic.-Recovery Trek is an alcohol and drug screening program for those needing screenings to attend virtual programs.-The Manger of Children's Programming and an addiction counselor gave a two-part presentation at the Labor Assistance Professionals Conference addressing cultural barriers to treatment and recovery and addressing family dynamics in treatment and recovery.-Leaders at Betty Ford Center and Eisenhower Health Behavioral Services meet periodically regarding services that are offered.-The Family Program and Children's Program are offered virtually in Spanish.-A Spanish speaking Children's Program counselor and a Family Program counselor created a Spanish speaking PSA along with a 30 second radio PSA to be run on Univision TV and radio in California.-A Spanish speaking Family Program counselor did a Let's Talk podcast regarding the program.-A Spanish speaking Family Program counselor and a patient did an interview with Together Magazine regarding the positive impact of the program.Mental Health Improved Access to Care:The strategies being worked on are: 1. Continuing to expand virtual treatment services for mental health disorders. 2. Continue to improve care coordination and collaboration between Betty ford Center and community mental health and psychiatric providers.The following progress has been made on these strategies:-The Hazelden Betty Ford Foundation website has extensive informational resources on mental health services provided.Secondary data collection and primary data collection focused on themes related to substance use and mental health, as Betty Ford Center is a chemical dependency hospital, unlike a traditional acute care hospital. Thus, general health conditions (heart disease, diabetes, immunodeficiency, etc.) are not included anywhere in the prioritization process. Although general health conditions were not included, the demographic findings did provide some insight to the community being served by Betty Ford Center. For example, it appears economic opportunity, as it pertains to educational attainment, employment status, and poverty status certainly are significant health needs and deserve special focus. For example, less than a third (29.6%) of adults have a bachelor's degree or higher, about a tenth (9.9%) of the labor force is unemployed, and about 14.0% are living below the poverty line (a line barely sufficient for suitable living standards). However, the need of economic opportunity is better suited for other employment development and educational institutions to pursue. When looking at Betty Ford Center's service area, those who are ages 65 and older (1.4%), or under the age of 19 (3.9%) are far less likely to be uninsured compared to working age adults (19-64) (12.8%). That said, about 14.9% of residents in the service area have delayed or didn't get needed healthcare. Thus, there is certainly a need to improve access to general healthcare. However, improving access to this type of care is better suited for other acute care hospitals, clinics, and federally qualified health centers.
Betty Ford Center Part V, Section B, Line 13h: Factors other than the Federal Poverty Guidelines that are used by Hazelden Betty Ford Foundation for determining eligibility for financial assistance include proof of household income, evaluation of assets, number of dependents living in the household, debt associated with major assets to determine net worth, major monthly debt payments to calculate debt to income ratio, and trust documents, if any.The application process may be waived or suspended due to medical necessity, including timing and urgency of care.To the fullest extent possible, financial assistance can be estimated prior to services based on verbal information provided but must be verified by submission of the financial assistance application within ten (10) days before financial assistance is awarded.
Part V, Section B, Line 7a www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage
Part V, Section B, Line 10a www.hazeldenbettyford.org/locations/betty-ford-center-rancho-mirage
Part V, Section B, Line 22b The maximum amount that can be charged for FAP-eligible individuals for medically necessary care was calculated using the look-back method with private health insurers only as Hazelden Betty Ford Foundation does not receive Medicare or Medicaid funding.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
Page 9
Schedule H (Form 990) 2021
Page 9
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?13
Name and address Type of Facility (describe)
1 1 - Hazelden Betty Ford in Center City
15251 Pleasant Valley Road
Center City,MN55012 		Inpatient addiction treatment center for adults
2 2 - Hazelden Betty Ford in Plymouth
11505 36th Avenue North
Plymouth,MN55441 		Inpatient/outpatient addiction treatment center for adolescents/young adults
3 3 - Hazelden Betty Ford in Newberg
1901 Esther Street
Newberg,OR97132 		Inpatient addiction treatment center for adults
4 4 - Hazelden Betty Ford in St Paul
680 Stewart Avenue
St Paul,MN55102 		Outpatient addiction treatment center for adults & recovery housing
5 5 - Hazelden Betty Ford in Naples
950 6th Ave N Suite 101
Naples,FL34102 		In/outpatient addiction treatment center for adults & recovery housing
6 6 - Hazelden Chicago
867 North Dearborn Street
Chicago,IL60610 		Outpatient addiction treatment center for adults, adolescents & young adults
7 7 - Hazelden New York in Tribeca
283 West Broadway
New York,NY10013 		Outpatient addiction treatment center for adults
8 8 - Hazelden Betty Ford in Maple Grove
7001 E Fish Lake Road Suite 120
Maple Grove,MN55311 		Outpatient addiction treatment center for adults
9 9 - Hazelden Betty Ford in Beaverton
6600 SW 105th Ave Suite 120
Beaverton,OR97008 		Outpatient addiction treatment center for adults
10 10 - Hazelden Betty Ford in Chaska
1107 Hazeltine Blvd Ste 300
Chaska,MN55318 		Outpatient addiction treatment center for adults, adolescents & young adults
11 11 - Hazelden Betty Ford in Bellevue
1231 116th Ave Ste 410
Bellevue,WA98004 		Outpatient addiction treatment center for adults
12 12 - Betty Ford Center in San Diego
11720 El Camino Real Suite 200
San Diego,CA92130 		Outpatient addiction treatment center for adults
13 13 - Betty Ford Center in Los Angeles
10700 Santa Monica Blvd Suite 310
Los Angeles,CA90025 		Outpatient addiction treatment center for adults
Schedule H (Form 990) 2021
Page 10
Schedule H (Form 990) 2021
Page 10
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, Line 3c: Factors other than the Federal Poverty Guidelines that are used by Hazelden Betty Ford Foundation for determining eligibility for financial assistance include proof of household income, evaluation of assets, number of dependents living in the household, debt associated with major assets to determine net worth, major monthly debt payments to calculate debt to income ratio, and trust documents, if any.
Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Community health improvement services, health professions education, and research are reported based on actual expenses recorded in the organization's general ledger.
Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Foundation determines its estimate of implicit price concessions based on its historical collection experience with this class of patients.
Part III, Line 4: The footnote to the Foundation's financial statements addressing implicit price concessions may be found on page 12 of the attached audited financial statements.
Part III, Line 9b: The Betty Ford Center will not engage in extraordinary collection actions before it makes a reasonable effort to determine whether a patient is eligible for financial assistance under the financial aid policy which is up to a total of 240 days from the first post-discharge bill for the most recent episode of care. Actions that may be taken against a patient for nonpayment include utilizing a collection agency for debts older than 120 days. If a collection agency identifies a patient as meeting the Betty Ford Center's financial assistance eligibility criteria, the patient's account may be considered for patient aid. Collection activity will be suspended on these accounts and the Betty Ford Center will review the financial assistance application. If the entire account is adjusted, the account will be returned to the Betty Ford Center. If a partial adjustment occurs, the patient fails to cooperate with the financial assistance process, or if the patient is not eligible for patient aid, collection activity will resume.
Part VI, Line 2: A community health needs assessment was completed for Betty Ford Center in 2021 which allows the organization to understand the needs of the community.
Part VI, Line 3: Hazelden Betty Ford Foundation includes notices regarding the availability of patient aid on its website, and in marketing and program-related materials, and in locations where there is a high volume of admission and or registration related activity.
Part VI, Line 4: Betty Ford Center serves people from all around the world, however the majority of the clients come from California. For calendar year 2020, most clients are coming from the counties of Los Angeles (27.7%), Riverside (24.5%), and San Diego (12.3%). Therefore, Betty Ford Center's community is defined as these counties, and is frequently referred to as the "overall service area". "Other counties" include all counties in which less than 1% of Betty Ford Center's California clients originate from.Across Betty Ford Center's service area, there are about 15.8 million people. About half are male while the other half are female. About 60.2% are white, and nearly half (45.5%) report being Hispanic/Latino. More than half (60.1%) of the adults in the overall service area have obtained either some college degree/associate's degree or bachelor's/higher degree. As of December of 2020, the unemployment rate of the overall service area was 9.9%. About 63.4% of households in the overall service area have a household income of $50,000 or more; however, about 14% of the service area lives in poverty. About half of the population ages 5 and older speak English in their home (49.8%); another third speak Spanish at home (35.4%). Rates of healthcare coverage vary by age group. The vast majority of seniors age 65 and older and youth younger than age 19 are insured. About 12.8% of working-age adults (ages 19 to 64) are uninsured. More than half (60.5%) of residents have private health insurance coverage whereas only 38.2% of residents have public health insurance. In 2020, about 12.5% of adults in the overall service area have likely had serious psychological distress. About 13.8% of adults have seriously thought about committing suicide at some point in their lives. There are about 1,636 emergency room (ER) visits and 344 ER admissions per 100,000 people in the overall service area. About a fifth (20.1%) of adults who have experienced psychological distress in the past year have been unable to work for more than 3 months due to mental problems. Riverside County's rate (34.4%) is noticeably higher. Across Betty Ford Center's service area, approximately 11.8% of the total population received opioid prescriptions in 2019. Approximately 3.0% of the adults in Betty Ford Center's service area have misused prescription pain killers in the past 12 months. While this number seems small, that 3.0% equates to more than 364,000 adults misusing prescription pain killers. Among adults who report having at least a single drink in the past month across Betty Ford Center's service area, about 17.4% report binge drinking, putting nearly a fifth of drinking adults at an increased risk for poor health outcomes. Among those aged 12 and older, between 11% and 14% have engaged in illicit drug use in the past month. However, when looking at those who engaged in illicit drug usage in past month other than marijuana, the rates drop by more than half (between 2% and 4%). For every 100,000 residents, between 101 and 124 residents visit the emergency department for all drug-related overdoses. The rate for drug-related hospitalizations is between 42 and 53 per 100,000 population. San Diego County has a slightly higher rate of hospitalizations per 100,000 compared to Los Angeles County, and to a lesser extent, Riverside County. The death rate due to drug overdoses ranges from 11 to 19 deaths per 100,000 population each year. Riverside County (18.1) is slightly higher than Los Angeles County (11.8) and San Diego County (13.6).
Part VI, Line 5 The Betty Ford Center (BFC) promotes the health of the community outside of the CHNA needs. During 2021, the Betty Ford Center staff distributed thank you notes to local first responders that provide services to BFC. The Children's Program partnered with Hope Collaborative to provide holiday gifts for foster kids, infants and teens across Coachella Valley. BFC also held a food drive to support the local community for those who find themselves food insecure during the holiday season. The Betty Ford Center partnered with Coachella Valley Pharmacy to provide COVID vaccinations to the patients, staff, family and friends at no cost.Currently, the campus is undergoing a renovation which includes tearing down the patient unit buildings and building new ones so the patients can have a more comfortable and modern living and recovery environment. Along with the campus renovation, there are many smaller projects that take place to replace furniture, to improve the HVAC systems, etc. for the comfort and safety of the employees and patients.The Betty Ford Center recovery experts offer an intervention education seminar for adults. This seminar is free to the public and includes educational materials about the signs and symptoms of substance abuse as well as what's involved in planning and conducting a successful intervention.The Professionals in Residence (PIR) program and the Summer Institute for Medical Students (SIMS) give medical students, residents, health care and legal professionals an in-depth experience with the dynamics of the disease of addiction. Intensive one-week programs blend classes presented by Betty Ford Center physicians and expert clinicians with time spent interacting with patients and staff on treatment units or family programs. Participants learn about the latest research and evidence-based methods from our multidisciplinary faculty. A rotation on addiction for psychiatry, family medicine and internal medicine residents also is available in California. In addition, a one-year accredited Addiction Medicine Fellowship is available at the Betty Ford Center and an online Course on Addiction and Recovery Education (CARE) is available worldwide. The Hazelden Betty Ford Foundation's (HBFF) website, www.hazeldenbettyford.org, provides a wealth of knowledge on substance use disorders and mental health that is available to all, including health care professionals. There are free webinars presented by HBFF experts and authors. Online courses are available through the Hazelden Betty Ford Graduate School of Addiction Studies. There are also research updates, books, videos and curricula along with continuing education events and workshops.
Schedule H (Form 990) 2021
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