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← BLUESTONE CHILD AND ADOLESCENT PSYCHIATRIC HOSPITAL

Form 990 for tax year 2022

Filed by BLUESTONE CHILD AND ADOLESCENT PSYCHIATRIC HOSPITAL.

Totals

Total revenue
$2,409,902
Total expenses
$3,828,856
Contributions and grants received
$1,856,502
Grants paid
$0
Program service revenue
$553,400
Investment income
$0
Other revenue
$0
Total assets, end of year
$551,752
Total liabilities, end of year
$2,190,455
Net assets or fund balances, end of year
-$1,638,703
Program services expenses (Part IX)
$3,722,600
Management and general expenses
$106,256
Fundraising expenses
$0
Program service expenses (Part III)
$3,722,600

Program services were 97.2% 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.

  • 1d · Related organizations

    $575,469

  • 1e · Government grants (contributions)

    $1,281,033

  • 2a · Program service revenue: THERAPEUTIC SERVICES

    total $553,400 · related or exempt $553,400

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $2,306,654 · program services $2,306,654

  • 8 · Pension plan contributions

    total $2,090 · program services $2,090

  • 9 · Other employee benefits

    total $97,413 · program services $97,413

  • 10 · Payroll taxes

    total $189,746 · program services $189,746

  • 11b · Fees: legal

    total $6,124 · management and general $6,124

  • 11c · Fees: accounting

    total $35,228 · management and general $35,228

  • 11g · Fees: other

    total $647,198 · program services $647,198

  • 12 · Advertising and promotion

    total $11,600 · program services $11,600

  • 13 · Office expenses

    total $13,755 · program services $13,755

  • 14 · Information technology

    total $19,546 · program services $19,546

  • 16 · Occupancy

    total $265,076 · program services $265,076

  • 17 · Travel

    total $835 · program services $835

  • 22 · Depreciation, depletion and amortization

    total $56,448 · program services $56,448

  • 23 · Insurance

    total $64,904 · management and general $64,904

  • 24a · Other expenses: FOOD AND SUPPLIES

    total $42,080 · program services $42,080

  • 24b · Other expenses: EQUIP./FURNITURE PURCH.

    total $25,452 · program services $25,452

  • 24c · Other expenses: STAFF DEVELOPMENT FEES

    total $18,319 · program services $18,319

  • 24d · Other expenses: LICENSES AND FEES

    total $11,938 · program services $11,938

  • 24e · All other expenses

    total $14,450 · program services $14,450

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $51,861 · end of year $2,548

  • 4 · Accounts receivable

    beginning of year $190,461 · end of year $203,417

  • 9 · Prepaid expenses and deferred charges

    beginning of year $21,989 · end of year $20,441

  • 15 · Other assets

    beginning of year $376,321 · end of year $325,346

  • 17 · Accounts payable and accrued expenses

    beginning of year $498,204 · end of year $1,983,699

  • 19 · Deferred revenue

    beginning of year $226,663 · end of year $0

  • 25 · Other liabilities

    beginning of year $135,514 · end of year $206,756

  • 27 · Net assets without donor restrictions

    beginning of year -$219,749 · end of year -$1,638,703

Mission and programs · 2022

Mission

THE SOLE MISSION OF BLUESTONE IS TO PROVIDE CRITICAL MENTAL HEALTH SERVICES TO YOUTH IN CRISIS. ALL STAFF AND PROGRAMS ARE DESIGNED TO SUPPORT THAT MISSION. SERVICES WILL BE REIMBURSED, PRIMARILY, THROUGH BILLING PRIVATE INSURANCE AND MEDICAID, BUT BLUESTONE IS COMMITTED TO PROVIDING SERVICES TO PERSONS REGARDLESS OF THEIR ABILITY TO PAY OR TO SATISFY RELATED FINANCIAL OBLIGATIONS. CHARITY CARE WILL BE AVAILABLE, PER BLUESTONE'S FINANCIAL ASSISTANCE POLICY, FOR THOSE WHO ARE AT OR NEAR THE FEDERAL POVERTY LEVEL.

  • BLUESTONE CHILD AND ADOLESCENT PSYCHIATRIC HOSPITAL, UNIVERSITY HEIGHTS, OHIO, IS A 12-BED PSYCHIATRIC HOSPITAL DESIGNED TO CREATE CUTTING-EDGE CLINICAL CARE AND POSITIVE PATIENT EXPERIENCES FOR YOUTH IN CRISIS. BLUESTONE WAS DEVELOPED TO FILL A WIDENING GAP IN SERVICES FOR CHILDREN'S ACUTE MENTAL HEALTH NEEDS. THE 12-BED FACILITY, BUILT WITH A WIDE RANGE OF SAFETY FEATURES, IS SUPPORTED BY AN EQUALLY IMPRESSIVE TEAM OF PROFESSIONALS WHO UNDERSTAND THAT LONG-TERM SUCCESS OF THE YOUTH SERVED IS THE NUMBER ONE PRIORITY. THE MULTIDISCIPLINARY STAFF INCLUDES BOARD CERTIFIED CHILD AND ADOLESCENT PSYCHIATRISTS, PEDIATRICIANS, NURSING, SOCIAL WORKERS, RECREATIONAL THERAPISTS AND BEHAVIORAL HEALTH TECHNICIANS. BLUESTONE IS LOCATED IN UNIVERSITY HEIGHTS, OHIO ON A PARK-LIKE, 32-ACRE CAMPUS.AS A PEDIATRIC PSYCHIATRIC HOSPITAL, BLUESTONE HAS THE EXPERTISE TO SERVE CHILDREN AND YOUTH, AGES 6-17, WITH SOME OF THE MOST COMPLEX CHALLENGES SUCH AS TRAUMA AND SIGNIFICANT MENTAL HEALTH, EMOTIONAL AND BEHAVIORAL DISORDERS, INCLUDING CLIENTS WHO ARE DUALLY DIAGNOSED WITH AUTISM SPECTRUM DISORDER OR A SUBSTANCE USE DISORDER. ADMISSION IS AVAILABLE 24 HOURS A DAY, SEVEN (7) DAYS A WEEK, 365 DAYS PER YEAR DEPENDING ON BED AVAILABILITY AND A PSYCHIATRIST'S ORDER TO ADMISSION.

    Expenses $3,722,600 · Revenue $553,400

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

Listed in Part VII

  • Adam Jacobs

    CHAIR/PRESIDENT

    Total calculated
    $959,272
    From this org
    $0
    From related orgs
    $779,282
    Other
    $179,990
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $533,421 related
    Bonus
    $0
    Other
    $0 + $245,861 related
    Deferred
    $0 + $174,780 related
    Nontaxable benefits
    $0 + $5,210 related
    Filer's total
    $0 + $959,272 related

  • Scott Moore

    TREASURER/CFO/DIRECTOR-AT-LARGE

    Total calculated
    $248,312
    From this org
    $0
    From related orgs
    $227,205
    Other
    $21,107
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $226,746 related
    Bonus
    $0
    Other
    $0 + $459 related
    Deferred
    $0 + $21,107 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $248,312 related

  • Shannon Seifreit

    SECRETARY/DIR.-AT-LARGE UNTIL 2/2023

    Total calculated
    $84,650
    From this org
    $0
    From related orgs
    $84,650
    Other
    $0
    Hours/week
    1 + 39 related

  • Andrew Hertz

    DIRECTOR-AT-LARGE

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Marcy Schwartz

    DIRECTOR-AT-LARGE

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Sandra Wuliger

    DIRECTOR-AT-LARGE

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Kelli Michaud

    EXECUTIVE DIRECTOR UNTIL 7/22/22

    Total calculated
    $180,191
    From this org
    $0
    From related orgs
    $149,079
    Other
    $31,112
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $149,079 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $12,587 related
    Nontaxable benefits
    $0 + $18,525 related
    Filer's total
    $0 + $180,191 related

  • Jeff Lox

    COO - BELLEFAIRE

    Total calculated
    $326,503
    From this org
    $0
    From related orgs
    $218,835
    Other
    $107,668
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $217,578 related
    Bonus
    $0
    Other
    $0 + $1,257 related
    Deferred
    $0 + $87,109 related
    Nontaxable benefits
    $0 + $20,559 related
    Filer's total
    $0 + $326,503 related

  • Leigh Hall

    DIRECTOR OF RISK MANAGEMENT

    Total calculated
    $318,330
    From this org
    $0
    From related orgs
    $203,739
    Other
    $114,591
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $202,842 related
    Bonus
    $0
    Other
    $0 + $897 related
    Deferred
    $0 + $87,138 related
    Nontaxable benefits
    $0 + $27,453 related
    Filer's total
    $0 + $318,330 related

  • Peter Corpus

    PSYCHIATRIST

    Total calculated
    $286,822
    From this org
    $286,762
    From related orgs
    $0
    Other
    $60
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $286,762
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $60
    Filer's total
    $286,822

  • Christopher Clancy

    CIO

    Total calculated
    $280,869
    From this org
    $0
    From related orgs
    $226,885
    Other
    $53,984
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $225,988 related
    Bonus
    $0
    Other
    $0 + $897 related
    Deferred
    $0 + $23,481 related
    Nontaxable benefits
    $0 + $30,503 related
    Filer's total
    $0 + $280,869 related

  • Beth Cohen Pollack

    DIRECTOR ORGANIZATIONAL ADVANCEMENT

    Total calculated
    $259,908
    From this org
    $0
    From related orgs
    $190,648
    Other
    $69,260
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $188,971 related
    Bonus
    $0
    Other
    $0 + $1,677 related
    Deferred
    $0 + $39,909 related
    Nontaxable benefits
    $0 + $29,351 related
    Filer's total
    $0 + $259,908 related

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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE CHAIR/PRESIDENT AND TREASURER/CFO/DIRECTOR-AT-LARGE OF BLUESTONE CHILD AND ADOLESCENT PSYCHIATRIC HOSPITAL ARE PAID THROUGH WINGSPAN CARE GROUP, THE PARENT COMPANY. THE CHAIR'S COMPENSATION IS ESTABLISHED AND APPROVED BY THE BOARD OF WINGSPAN CARE GROUP AS PART OF THE OVERALL BUDGET APPROVAL PROCESS, WITH THE PROPORTIONAL SHARE CHARGED TO BLUESTONE CHILD AND ADOLESCENT PSYCHIATRIC HOSPITAL.
PART I, LINE 4B
ADAM JACOBS ACCRUED DEFERRED COMPENSATION OF $56,406 FOR SUPPLEMENTAL NON-QUALIFIED 457 PLANS.

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.

Provenance

Return type
form_990
Tax year
2022
Filed
13 May 2024
IRS schema version
2022v5.0
Source object
202421359349304587

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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