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Nonprofiteer
← BLACKSTONE HEALTH INC

Form 990 for tax year 2022

Filed by BLACKSTONE HEALTH INC.

Totals

Total revenue
$1,700,264
Total expenses
$1,484,357
Contributions and grants received
$985,214
Grants paid
$0
Program service revenue
$715,050
Investment income
$0
Other revenue
$0
Total assets, end of year
$1,581,350
Total liabilities, end of year
$127,226
Net assets or fund balances, end of year
$1,454,124
Program services expenses (Part IX)
$1,335,923
Management and general expenses
$148,434
Fundraising expenses
$0
Program service expenses (Part III)
$1,335,923

Program services were 90.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $923,464

  • 1f · All other contributions, gifts and grants

    $61,750

  • 2a · Program service revenue: MEDICAID RECEIPTS

    total $113,385 · related or exempt $113,385

  • 2b · Program service revenue: ADULT DAY SERVICES

    total $593,152 · related or exempt $593,152

  • 2c · Program service revenue: OTHER HEALTHCARE RELATED REVENUE

    total $8,513 · related or exempt $8,513

  • 3 · Investment income

    total $0 · unrelated business $0

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 6d · Net rental income or loss

    total $0

  • 7d · Net gain or loss

    total $0

  • 8a · Fundraising events: gross income

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $0

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $427,887 · program services $385,098 · management and general $42,789 · fundraising $0

  • 8 · Pension plan contributions

    total $11,610 · program services $10,449 · management and general $1,161

  • 9 · Other employee benefits

    total $136,386 · program services $122,747 · management and general $13,639

  • 10 · Payroll taxes

    total $30,799 · program services $27,720 · management and general $3,079

  • 11a · Fees: management

    total $0

  • 11b · Fees: legal

    total $0

  • 11c · Fees: accounting

    total $0

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $0

  • 12 · Advertising and promotion

    total $0

  • 13 · Office expenses

    total $796,919 · program services $717,228 · management and general $79,691

  • 14 · Information technology

    total $0

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $1,855 · program services $1,670 · management and general $185

  • 17 · Travel

    total $2,222 · program services $2,000 · management and general $222

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $0

  • 20 · Interest

    total $0

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $8,091 · program services $7,282 · management and general $809

  • 23 · Insurance

    total $12,845 · program services $11,560 · management and general $1,285

  • 24a · Other expenses: CONTRACTED SERVICES

    total $36,952 · program services $33,257 · management and general $3,695

  • 24b · Other expenses: OTHER EXPENSES

    total $18,791 · program services $16,912 · management and general $1,879

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $500 · end of year $500

  • 2 · Savings and temporary cash investments

    beginning of year $1,126,412 · end of year $1,323,747

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $224,669 · end of year $236,395

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $8,274 · end of year $9,142

  • 10a · Land, buildings and equipment: cost or other basis

    $222,908

  • 10b · Land, buildings and equipment: accumulated depreciation

    $211,342

  • 10c · Land, buildings and equipment, net

    beginning of year $19,657 · end of year $11,566

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0 · end of year $0

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $123,688 · end of year $107,996

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $17,607 · end of year $19,230

  • 27 · Net assets without donor restrictions

    beginning of year $1,238,217 · end of year $1,392,374

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $61,750

Mission and programs · 2022

Mission

A NON-PROFIT ORGANIZATION DEDICATED TO PROVIDING SERVICES TO SENIOR CITIZENS AND DISABLED INDIVIDUALS THROUGHOUT RHODE ISLAND. THE SERVICES PROVIDED INCLUDE ADULT DAY CARE AND MEAL PROGRAMS. FUNDING FOR PROGRAMS SPONSORED BY THE ORGANIZATION IS DERIVED PRINCIPALLY FROM GOVERNMENT AGENCIES, PROGRAM FEES, THIRD PARTY REIMBURSEMENTS AND CONTRIBUTIONS.

Activities or mission (Part I)

TO BE A COMMUNITY-BASED ORGANIZATION DELIVERING AN APPROPRIATE AND RESPONSIVE MIX OF HEALTHCARE AND RELATED SERVICES AS PART OF THE CARE NEW ENGLAND HEALTH SYSTEM.

  • EXPENSES INCURRED IN PROVIDING NUTRITIONAL MEALS TO THE ELDERLY AND HANDICAPPED AT 16 CONGREGATE MEAL SITES AND EXPENSES INCURRED IN THE OPERATION OF AN ADULT DAY CARE CENTER FOR THE ELDERLY AND HANDICAPPED. NURSING SERVICES, CASE MANAGEMENT, THERAPEUTIC RECREATION AND DAILY LIVING SERVICES ARE PROVIDED TO SENIOR CITIZENS IN A SAFE AND SECURE ENVIRONMENT.

    Expenses $1,335,923 · Revenue $715,050

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • JAMES E FANALE MD

    DIR-PRES/CEO/CNE(TERM 12/1/22)

    Total calculated
    $2,227,535
    From this org
    $0
    From related orgs
    $2,193,741
    Other
    $33,794
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $1,158,814 related
    Bonus
    $0 + $750,000 related
    Other
    $0 + $284,927 related
    Deferred
    $0 + $14,400 related
    Nontaxable benefits
    $0 + $19,394 related
    Filer's total
    $0 + $2,227,535 related

  • KATHLEEN TOPOR

    TREASURER - DIRECTOR

    Total calculated
    $232,780
    From this org
    $0
    From related orgs
    $206,135
    Other
    $26,645
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $133,605 related
    Bonus
    $0 + $50,000 related
    Other
    $0 + $22,530 related
    Deferred
    $0 + $13,041 related
    Nontaxable benefits
    $0 + $13,604 related
    Filer's total
    $0 + $232,780 related

  • KATHLEEN PEIRCE RN BSN MS

    FORMER OFFICER

    Total calculated
    $222,088
    From this org
    $0
    From related orgs
    $207,912
    Other
    $14,176
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $142,925 related
    Bonus
    $0 + $50,000 related
    Other
    $0 + $14,987 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $14,176 related
    Filer's total
    $0 + $222,088 related

  • JENNIFER LEE

    DIRECTOR - ED VNA

    Total calculated
    $150,644
    From this org
    $0
    From related orgs
    $136,472
    Other
    $14,172
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $136,295 related
    Bonus
    $0
    Other
    $0 + $177 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $14,172 related
    Filer's total
    $0 + $150,644 related

  • MICHAEL E WAGNER MD

    DIR-PRES/CEO/CNE(EFF 12/1/22)

    Total calculated
    $81,655
    From this org
    $0
    From related orgs
    $79,999
    Other
    $1,656
    Hours/week
    55

  • KARL SHERRY

    CHAIRMAN - DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JAMES BRIDEN ESQ

    SECRETARY - DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • PAUL MOONEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART VII AND SCHEDULE J
IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 RULES, REGULATIONS AND INSTRUCTIONS, THE COMPENSATION REPORTED IN CORE FORM, PART VII AND SCHEDULE J, PART II OF THIS FORM 990 IS DERIVED FROM 2022 FORMS W-2 AND FORMS 1099 (IF APPLICABLE).
SCHEDULE J, PART I; QUESTION 4A
THE FOLLOWING INDIVIDUAL INCLUDED IN SCHEDULE J, PART II RECEIVED SEVERANCE DURING CALENDAR YEAR 2022 WHICH WAS INCLUDED IN HIS 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES E. FANALE, M.D., $96,539.
SCHEDULE J, PART I; QUESTION 4B
THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL INCLUDES VESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN HIS 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES E. FANALE, M.D., $125,501.
SCHEDULE J, PART I; QUESTION 6A & 6B
THE EXECUTIVE COMPENSATION PACKAGE FOR VARIOUS INDIVIDUALS REPORTED ON THIS FORM 990 CONSISTS OF BOTH A FIXED SALARY AND ADDITIONAL AT-RISK COMPENSATION THAT IS BASED ON SEVERAL QUALITATIVE AND QUANTITATIVE COMPONENTS. THE AT-RISK COMPENSATION IS COMPRISED OF BOTH SHORT-TERM AND LONG-TERM FACTORS AS FOLLOWS. THE SHORT-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACHIEVEMENT OF CRITICAL STRETCH GOALS THAT RECOGNIZE PERFORMANCE ABOVE EXPECTATIONS. THESE GOALS ARE MEASURED FOR EACH FISCAL PERIOD IN THE FOLLOWING CRITICAL AREAS: QUALITY, FINANCIAL AND PATIENT SATISFACTION. THE LONG-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACCOMPLISHMENT OF CRITICAL MULTI-YEAR SYSTEM PERFORMANCE OBJECTIVES. AWARDS ARE EARNED BY MEASURING SYSTEM PERFORMANCE OVER THREE-YEAR OVERLAPPING PERFORMANCE PERIODS AND ARE MEASURED IN REFERENCE TO GOALS IN THE FOLLOWING CRITICAL AREAS: NET INCOME FROM OPERATIONS, MARKET SHARE, PATIENT SATISFACTION AND STRATEGIC OBJECTIVE.
SCHEDULE J, PART I, COLUMN 7
CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2022 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II HEREIN AND IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
13 August 2024
IRS schema version
2022v5.0
Source object
202442279349303909

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