BLANCHARD VALLEY HEALTH SYSTEM: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
BLANCHARD VALLEY HEALTH SYSTEM (EIN 34-4428206)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201933189349310638
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-14T14:57:24-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 E Main St Suite 700AddressLine1Txt
CityFort WayneCityNm
State AbbreviationINStateAbbreviationCd
ZIP46802ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN344428206EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BLANCHARD VALLEY HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% DAVID M CYTLAKInCareOfNm
Business Name ControlBLANBusinessNameControlTxt
Phone4194234500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1Txt
CityFINDLAYCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45840ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID M CYTLAKPersonNm
Person TitleCFOPersonTitleTxt
Phone4194234500PhoneNum
Signature2019-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAARON D HERSHBERGERPreparerPersonNm
PTINP00961884PTIN
Phone2604604000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id35027420193185000004FederalOriginalSubmissionId
Federal Original Submission Id2019-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdCA4D4D82627664C21956C83B295B0094B3C05049AtSubmissionCreationDeviceId
At Submission Filing Device IdF560D4A486E1B6265A73BA7576EDA83A4C287CC2AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID M CYTLAKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1Txt
CityFINDLAYCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45840ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$51,274,230GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BVHEALTHSYSTEM.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1951FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionWE PROVIDE MANAGEMENT OVERSIGHT AND GOVERNANCE OF ALL HEALTH SYSTEM ACTIVITIES. WE ALSO OPERATE FAMILY PRACTICES, SPECIALTY PRACTICES, AND EMS AMBULANCE SERVICES.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee363TotalEmployeeCnt
Total Volunteers155TotalVolunteersCnt
Total Gross UBI$83,910TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$112,472NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$41,566,444PYProgramServiceRevenueAmt
CY Program Service Revenue$48,169,268CYProgramServiceRevenueAmt
PY Investment Income$3,206,421PYInvestmentIncomeAmt
CY Investment Income$2,422,593CYInvestmentIncomeAmt
PY Other Revenue$152,104PYOtherRevenueAmt
CY Other Revenue$146,373CYOtherRevenueAmt
PY Total Revenue$44,924,969PYTotalRevenueAmt
CY Total Revenue$50,738,234CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$64,332,935PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$71,301,229CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$25,184,131PYOtherExpensesAmt
CY Other Expenses$26,797,273CYOtherExpensesAmt
PY Total Expenses$89,517,066PYTotalExpensesAmt
CY Total Expenses$98,098,502CYTotalExpensesAmt
PY Revenues Less Expenses-$44,592,097PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$47,360,268CYRevenuesLessExpensesAmt
Total Assets BOY$117,881,948TotalAssetsBOYAmt
Total Assets EOY$116,113,518TotalAssetsEOYAmt
Total Liabilities BOY$180,767,859TotalLiabilitiesBOYAmt
Total Liabilities EOY$115,643,224TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$62,885,911NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$470,294NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION: OUR EXTRAORDINARY PEOPLE PROVIDE CARING FOR A LIFETIME THROUGH A BROAD CONTINUUM OF EXCEPTIONAL HEALTH-RELATED SERVICES IN NORTHWEST OHIO.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$76,033,957ExpenseAmt
Revenue$48,179,569RevenueAmt
DescBLANCHARD VALLEY HEALTH SYSTEM'S PROGRAM SERVICE REVENUE IS GENERATED BY BLANCHARD VALLEY MEDICAL PRACTICES (BVMP), HANCO EMERGENCY MEDICAL SERVICES (HANCO), AND BEYOND MEDSPA (MEDSPA), WHICH ARE WHOLLY OWNED, DISREGARDED ENTITIES. BVMP CONSISTS OF FAMILY PRACTICE PHYSICIAN OFFICES, NEUROSURGICAL PHYSICIAN OFFICES, SPECIALTY PHYSICIAN OFFICES, AND AN URGENT CARE CENTER. BVMP IS COMMITTED TO PROVIDING EASILY ACCESSIBLE HEALTH CARE SERVICES TO ALL MEMBERS OF THE SURROUNDING COMMUNITIES THROUGH ITS FAMILY PRACTICES AND URGENT CARE CENTER. SPECIALIZED SERVICES ARE ALSO AVAILABLE, INCLUDING NEUROSURGICAL SERVICES, CANCER CARE, CARDIAC CARE, AND DIAGNOSTIC SERVICES. HANCO PROVIDES PROFESSIONAL AND EXPEDIENT AMBULANCE SERVICES AND PRE-HOSPITAL EMERGENCY MEDICAL CARE. MEDSPA PROVIDES COSMETIC MEDICAL TREATMENT CENTERS.Desc
Total Program Service Expenses$76,033,957TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee363EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID M CYTLAKPersonNm
Phone4194234500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1Txt
CityFINDLAYCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45840ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DUANE JEBBETT
CHAIR0.51.0Yes (X)Yes (X)$0$0$0
PAUL WORSTELL
VICE CHAIR0.51.0Yes (X)Yes (X)$0$0$0
KAREN CLINE
TRUSTEE0.51.0Yes (X)$0$0$0
FRANK A COSIANO MD
TRUSTEE0.51.0Yes (X)$0$0$0
GINGER JONES
TRUSTEE0.51.0Yes (X)$0$0$0
DAVID EUBANKS
TRUSTEE0.51.0Yes (X)$0$0$0
RANDAL MYERS RPH
TRUSTEE0.51.0Yes (X)$0$0$0
JAMES DOWLING MD
TRUSTEE0.51.0Yes (X)$0$0$0
DEBRA PARKER
TRUSTEE0.51.0Yes (X)$0$0$0
GARRY PEIFFER
TREASURER0.51.0Yes (X)Yes (X)$0$0$0
WILLIAM REIST DMIN
TRUSTEE0.51.0Yes (X)$0$0$0
KIMBERLY STUMPP
TRUSTEE0.51.0Yes (X)$0$0$0
JOSEPH LONGO
TRUSTEE0.51.0Yes (X)$0$0$0
KAREN KLASSEN HARDER
SECRETARY0.51.0Yes (X)Yes (X)$0$0$0
SCOTT MALANEY
CEO2.038.0Yes (X)Yes (X)$941,156$0$24,223
RICHARD POLDER MD
TRUSTEE0.51.0Yes (X)$0$0$0
ADELE WEBB PHD
TRUSTEE0.51.0Yes (X)$0$0$0
JOHN REINEKE
TRUSTEE0.51.0Yes (X)$0$0$0
DAVE CYTLAK
CFO2.038.0Yes (X)$396,349$0$20,650
WILLIAM KOSE
CHIEF MEDICAL OFFICER4.036.0Yes (X)$151,180$0$20,245
ROBERT WESTPHAL
PRESIDENT OF BVCCS0.040.0Yes (X)$226,244$0$24,825
MICHAEL DENIKE MD
VP OF MEDICAL AFFAIRS40.00.0$519,863$0$24,459Yes (X)
KELLEY SHROLL
PRESIDENT OF BVMP40.00.0$206,345$0$20,312Yes (X)
DR ANAS BALAA
PHYSICIAN40.00.0$1,112,070$0$34,518Yes (X)
DR PANAGIOTIS BAKOS
PHYSICIAN40.00.0$984,455$0$21,190Yes (X)
DR THOMAS KINDL
PHYSICIAN40.00.0$1,272,601$0$22,555Yes (X)
DR AMBER PATTERSON
PHYSICIAN40.00.0$840,204$0$15,728Yes (X)
DR WILLIAM HOGAN
PHYSICIAN40.00.0$806,771$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,457,238TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$228,705TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K101IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
STEVEN P HAMAN MD
2950 MILLS ROADLIMAOH45806MEDICAL FEES$360,000
BLANCHARD VALLEY MEDICAL ASSOCIATES
200 W PEARL STREETFINDLAYOH45840OUTSIDE REF LABS$390,491
BLANCHARD VALLEY PATHOLOGY AND LAB
1900 SOUTH MAIN STREETFINDLAYOH45840PATHOLOGY SERVICES$845,046
JDP VENTURES LLC
301 S MAIN STREETFINDLAYOH45840REAL ESTATE RENT$414,681
TECHNICORE
PO BOX 1210FINDLAYOH45839MED EQUIP SERVICES$1,605,768
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$46,777,751$46,777,751
MANAGEMENT ALLOCATIONS TO RELATED ENTITIES900099$1,391,517$1,391,517
FieldValueIRS element (for citing)
Total Program Service Revenue$48,169,268TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,422,517TotalRevenueColumnAmt
Unrelated Business Revenue$83,910UnrelatedBusinessRevenueAmt
Exclusion$2,338,607ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$146,373RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$146,373RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$146,373TotalRevenueColumnAmt
Exclusion$146,373ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$525,771SecuritiesAmt
Other$10,301OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$535,996SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$10,225SecuritiesAmt
Other$10,301OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$76TotalRevenueColumnAmt
Related Or Exempt Func Income$10,301RelatedOrExemptFuncIncomeAmt
Exclusion-$10,225ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,738,234TotalRevenueColumnAmt
Related Or Exempt Func Income$48,179,569RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$83,910UnrelatedBusinessRevenueAmt
Exclusion$2,474,755ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,804,874TotalAmt
Program Services$721,950ProgramServicesAmt
Management And General$1,082,924ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$62,264,564TotalAmt
Program Services$49,811,651ProgramServicesAmt
Management And General$12,452,913ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$856,367TotalAmt
Management And General$856,367ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,213,828TotalAmt
Program Services$2,571,062ProgramServicesAmt
Management And General$642,766ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,161,596TotalAmt
Program Services$2,529,277ProgramServicesAmt
Management And General$632,319ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,279,252TotalAmt
Program Services$639,626ProgramServicesAmt
Management And General$639,626ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$798,456TotalAmt
Management And General$798,456ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,013,978TotalAmt
Program Services$912,580ProgramServicesAmt
Management And General$101,398ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$169,352TotalAmt
Program Services$152,417ProgramServicesAmt
Management And General$16,935ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,294,263TotalAmt
Program Services$2,305,984ProgramServicesAmt
Management And General$988,279ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,372,291TotalAmt
Program Services$1,029,218ProgramServicesAmt
Management And General$343,073ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,837,124TotalAmt
Program Services$1,469,699ProgramServicesAmt
Management And General$367,425ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$682,214TotalAmt
Program Services$341,107ProgramServicesAmt
Management And General$341,107ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,710,174TotalAmt
Program Services$6,168,139ProgramServicesAmt
Management And General$1,542,035ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$840,867TotalAmt
Program Services$672,694ProgramServicesAmt
Management And General$168,173ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBTS$2,247,759$2,247,759
MEDICAL SUPPLIES$3,108,744$3,108,744
DUES & SUBSCRIPTIONS$818,432$613,824$204,608
OTHER$1,624,367$738,226$886,141

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$98,098,502TotalAmt
Program Services$76,033,957ProgramServicesAmt
Management And General$22,064,545ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$16,742,900BOYAmt
EOY$11,001,795EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,042,843BOYAmt
EOY$15,476,000EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$37,116BOYAmt
EOY$37,116EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,982,801BOYAmt
EOY$3,809,557EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$53,622,579LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$26,228,013LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$22,783,285BOYAmt
EOY$27,394,566EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$41,300,337BOYAmt
EOY$38,273,479EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$6,013,953BOYAmt
EOY$6,014,000EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$17,978,713BOYAmt
EOY$14,107,005EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$117,881,948BOYAmt
EOY$116,113,518EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$36,656,190BOYAmt
EOY$32,480,150EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$144,111,669BOYAmt
EOY$83,163,074EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$180,767,859BOYAmt
EOY$115,643,224EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$63,378,268BOYAmt
EOY-$272EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$492,357BOYAmt
EOY$470,566EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$62,885,911BOYAmt
EOY$470,294EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$117,881,948BOYAmt
EOY$116,113,518EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$47,360,268ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$4,898,000NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$115,614,473OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations3SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (3 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
BLANCHARD VALLEY REGIONAL HEALTH CENTER
3413699633Yes (true)$878,921$0
BLANCHARD VALLEY CONTINUING CARE SERVICES
34600690410Yes (true)$293,907$0
BLANCHARD VALLEY HEALTH FOUNDATION
3413705227Yes (true)$5,766$0
FieldValueIRS element (for citing)
Supported Organizations Total3SupportedOrganizationsTotalCnt
Support Sum$1,178,594SupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$492,357BeginningYearBalanceAmt
Investment Earnings Or Losses-$9,147InvestmentEarningsOrLossesAmt
Other Expenditures$12,644OtherExpendituresAmt
End Year Balance$470,566EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$449,878BeginningYearBalanceAmt
Investment Earnings Or Losses$61,967InvestmentEarningsOrLossesAmt
Other Expenditures$19,488OtherExpendituresAmt
End Year Balance$492,357EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,031,190BeginningYearBalanceAmt
Investment Earnings Or Losses$28,650InvestmentEarningsOrLossesAmt
Other Expenditures$12,609,962OtherExpendituresAmt
End Year Balance$449,878EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,732,203BeginningYearBalanceAmt
Investment Earnings Or Losses-$381,512InvestmentEarningsOrLossesAmt
Other Expenditures$319,501OtherExpendituresAmt
End Year Balance$13,031,190EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,152,532BeginningYearBalanceAmt
Investment Earnings Or Losses-$420,329InvestmentEarningsOrLossesAmt
End Year Balance$13,732,203EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.84700PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.15300TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,950,074OtherCostOrOtherBasisAmt
Book Value$6,950,074BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,801,604OtherCostOrOtherBasisAmt
Depreciation$5,323,164DepreciationAmt
Book Value$6,478,440BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,493,817OtherCostOrOtherBasisAmt
Depreciation$1,473,054DepreciationAmt
Book Value$20,763BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,795,055OtherCostOrOtherBasisAmt
Depreciation$17,761,770DepreciationAmt
Book Value$7,033,285BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,582,029OtherCostOrOtherBasisAmt
Depreciation$1,670,025DepreciationAmt
Book Value$6,912,004BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$27,394,566TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
VENTURES AND PARTNERSHIPS$244,000F
CARE SERVICES$5,770,000F
FieldValueIRS element (for citing)
Total Book Value Securities$6,014,000TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ADVANCES FROM AFFILIATES$72,820,058
OTHER LONG-TERM OBLIGATIONS$10,318,133
DEFERRED REVENUE$24,883
FieldValueIRS element (for citing)
Total Liability$83,163,074TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$159,206,948TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$4,898,000NetUnrealizedGainsInvstAmt
Other Revenue$115,614,473OtherRevenueAmt
Revenue Not Reported$110,716,473RevenueNotReportedAmt
Revenue Subtotal$48,490,475RevenueSubtotalAmt
Other Revenues Not Included$2,247,759OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,247,759RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$50,738,234TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$95,850,743TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$95,850,743ExpensesSubtotalAmt
Other Expenses Not Included$2,247,759OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,247,759ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$98,098,502TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS ARE UTILIZED FOR DONOR DESIGNATED PURPOSES, INCLUDING CHARITY CARE, CAPITAL PROJECTS AND PURCHASES, AND CONTINUING EDUCATION FOR STAFF AND PHYSICIANS.
PART XI, LINE 2DINVESTMENT INCOME TIMING DIFFERENCE $ 52,473 TRANSFERS FROM AFFILIATES $115,562,000 TOTAL $115,614,473
PART XI & PART XII, LINE 4BBAD DEBT RECLASS $2,247,759 ASC 740 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
SCOTT MALANEY
CEO$598,347$0$0$0$342,809$0$16,500$0$7,723$0$965,379$0$153,739
DAVE CYTLAK
CFO$364,486$0$0$0$31,863$0$16,500$0$4,150$0$416,999$0$3,501
WILLIAM KOSE
CHIEF MEDICAL OFFICER$126,375$0$0$0$24,805$0$9,581$0$10,664$0$171,425$0
ROBERT WESTPHAL
PRESIDENT OF BVCCS$212,756$0$0$0$13,488$0$13,643$0$11,182$0$251,069$0
DR ANAS BALAA
PHYSICIAN$569,476$0$524,590$0$18,004$0$16,500$0$18,018$0$1,146,588$0
DR PANAGIOTIS BAKOS
PHYSICIAN$473,935$0$491,017$0$19,503$0$11,000$0$10,190$0$1,005,645$0
DR THOMAS KINDL
PHYSICIAN$579,610$0$673,682$0$19,309$0$11,000$0$11,555$0$1,295,156$0
DR AMBER PATTERSON
PHYSICIAN$367,274$0$454,106$0$18,824$0$1,500$0$14,228$0$855,932$0
DR WILLIAM HOGAN
PHYSICIAN$453,745$0$326,851$0$26,175$0$0$0$0$0$806,771$0
MICHAEL DENIKE MD
VP OF MEDICAL AFFAIRS$519,053$0$0$0$810$0$16,500$0$7,959$0$544,322$0
KELLEY SHROLL
PRESIDENT OF BVMP$201,042$0$0$0$5,303$0$12,761$0$7,551$0$226,657$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 4CFormAndLineReferenceDesc
ExplanationIN 2018, BLANCHARD VALLEY HEALTH SYSTEM CONTRIBUTED ON BEHALF OF SCOTT MALANEY $18,500 TO A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT CONSISTING OF TWO PLANS: AN ELIGIBLE PLAN SUBJECT TO INTERNAL REVENUE CODE SECTION 457(B) AND AN INELIGIBLE PLAN SUBJECT TO SECTION 457(F). THE 457(B) PLAN WAS ORIGINALLY IMPLEMENTED EFFECTIVE JANUARY 1, 2002. THE 457(F) PLAN WAS ORIGINALLY EFFECTIVE SEPTEMBER 1, 2000 AND WAS RESTATED ON JANUARY 1, 2002 FOR COORDINATION WITH THE 457(B) PLAN. IN 2010 AND 2011, THE 457(F) PLAN WAS FURTHER AMENDED AND RESTATED TO COMPLY WITH THE LATEST REGULATORY GUIDANCE AND PROVIDE FOR A NEW CONTRIBUTION MODEL AND VESTING SCHEDULE. ADDITIONAL EXECUTIVES WERE ALSO ADDED AND DEEMED ELIGIBLE FOR PLAN BENEFITS IN 2010, INCLUDING DAVID CYTLAK. IN 2018, BLANCHARD VALLEY HEALTH SYSTEM CONTRIBUTED ON BEHALF OF DAVID CYTLAK $25,011 TO THE SERP. KEY FEATURES OF THE SERP, AS AMENDED AND RESTATED IN 2010/2011, INCLUDE THE FOLLOWING: * ELIGIBILITY IS LIMITED TO CERTAIN MANAGEMENT OR HIGHLY-COMPENSATED EMPLOYEES OF BVHS (I.E., TOP HAT REFERENCE). FUTURE PARTICIPATION IS UPON NOMINATION BY THE CEO AND APPROVAL BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. * EMPLOYER CONTRIBUTIONS ARE COMPRISED OF: ** DEFINED CONTRIBUTION TARGET INCOME REPLACEMENT PERCENTAGE CONTRIBUTION: - PROVIDE 60% TARGET INCOME REPLACEMENT FOR CEO (SCOTT MALANEY) - PROVIDE 50% TARGET INCOME REPLACEMENT FOR CFO (DAVID CYTLAK) **EMPLOYEE CONTRIBUTIONS TO THE SERP ACCOUNT ARE NOT ALLOWED. *EACH PARTICIPANT'S 457(B) ACCOUNT WILL BE CREDITED UP TO THE STATUTORY LIMIT ($18,500 IN 2018), WITH THE REMAINING AMOUNT BEING DEPOSITED INTO THE 457(F) ACCOUNT. *EMPLOYER CONTRIBUTIONS TO THE 457(F) PLAN ARE SUBJECT TO A CLASS YEAR VESTING SCHEDULE, WITH A WAITING PERIOD SET AT 2-5 YEARS, DEPENDING ON THE AGE OF THE PARTICIPANT AT THE TIME OF CONTRIBUTION. UPON VESTING, THE FULL VESTED BALANCE WILL BE DISTRIBUTED TO THE PARTICIPANT AND CONSIDERED TAXABLE INCOME. IN ADDITION TO THE VESTING SCHEDULE ABOVE, 100% AND IMMEDIATE VESTING OF THE BENEFIT ACCRUED UPON ATTAINMENT OF NORMAL RETIREMENT AGE, DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, PLAN TERMINATION, OR CHANGE OF CONTROL. *DISTRIBUTION OF THE VESTED PORTION OF THE 457(F) BENEFIT IS PAID AS A LUMP SUM AS SOON AS ADMINISTRATIVELY FEASIBLEExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1BSCOTT MALANEY IS A BOARD MEMBER AND IS ALSO A PAID EMPLOYEE OF BLANCHARD VALLEY HEALTH SYSTEM. DUE TO HIS EMPLOYMENT, HE IS CONSIDERED A NON INDEPENDENT VOTING MEMBER OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B A DETAIL REVIEW OF THE FORM 990 IS PERFORMED BY THE ORGANIZATION'S COMPLIANCE & AUDIT COMMITTEE. THIS COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, MEMBERS OF THE COMMUNITY, AND MEMBERS OF UPPER MANAGEMENT. THE COMPLIANCE & AUDIT COMMITTEE REPORTS TO THE BOARD OF TRUSTEES ANY AREAS OF CONCERN REGARDING THE FORM 990'S. ONCE THE FORM 990'S HAVE BEEN FINALIZED, REVIEWED AND APPROVED, THE MEMBERS OF BOARD OF TRUSTEES RECEIVE ELECTRONIC COMMUNICATION THAT THE FORM 990'S ARE COMPLETE AND AVAILABLE FOR REVIEW. ANY QUESTIONS ARISING FROM BOARD MEMBERS ARE ADDRESSED BY THE COMPLIANCE & AUDIT COMMITTEE, UPPER MANAGEMENT, THE ACCOUNTING DEPARTMENT, AND/OR EXTERNAL ACCOUNTANTS.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE ORGANIZATION ASKS ITS BOARD MEMBERS, ITS CORPORATE OFFICERS, AND ITS KEY EMPLOYEES TO SIGN CONFLICT OF INTEREST LETTERS. THE ORGANIZATION ALSO ASKS THESE INDIVIDUALS TO REVIEW THEIR ACTIVITIES AND COMPLETE RELATIONSHIP QUESTIONNAIRES FOR THE FORM 990 FILING YEAR. BOARD MEMBERS ARE REQUIRED TO BRING TO THE ATTENTION OF EXECUTIVE MANAGEMENT ANY CONFLICTS AS THEY ARISE. THESE CONFLICTS ARE DOCUMENTED IN THE BOARD MINUTES. BOARD MEMBERS THAT HAVE CONFLICTS ARE TO EXCUSE THEMSELVES FROM DISCUSSIONS AND/OR VOTING ON ISSUES WITH WHICH CONFLICTS EXIST.
FORM 990, PART VI, SECTION B, LINE 15ATHE ORGANIZATION REVIEWS EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES ON A PERIODIC BASIS TO ENSURE CONSISTENCY WITH COMPENSATION PHILOSOPHY AND MARKET PRACTICE. A SUBSET OF MEMBERS FROM THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION REVIEW COMMITTEE, AND THIS COMMITTEE MEETS TO APPROVE WAGE INCREASES AS WELL AS REVIEWS THE ORGANIZATION'S POSITION IN THE MARKET WHEN IT COMES TO EXECUTIVE COMPENSATION. IN ADDITION, THE EXECUTIVE COMPENSATION REVIEW COMMITTEE REGULARLY ENGAGES A HUMAN RESOURCES CONSULTING FIRM TO ASSESS THE REASONABLENESS OF THE COMPENSATION PROGRAM USED FOR ITS EXECUTIVES. THE ORGANIZATION IS COMMITTED TO A DECISION-MAKING PROCESS FOR EXECUTIVE COMPENSATION THAT IS CONSISTENT WITH INTERNAL REVENUE CODE SECTION 4958 REQUIREMENTS FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS". THE MEMBERS OF THE COMMITTEE APPROVING EXECUTIVE COMPENSATION DECISIONS ARE INDIVIDUALS WHO ARE DISINTERESTED (I.E., DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE ARRANGEMENTS). THE COMMITTEE REVIEWS OBJECTIVE DATA, INCLUDING SURVEY DATA PREPARED BY INDEPENDENT FIRMS, AS PART OF THE DECISION-MAKING PROCESS. THE MARKET DATA PROVIDED IN THE COMPENSATION REPORT FROM THE CONSULTING FIRM ASSISTS THE ORGANIZATION IN ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS. THE ORGANIZATION CONSULTS WITH SULLIVAN COTTER AND ASSOCIATES (AN EXTERNAL CONSULTANT) ON AN ANNUAL BASIS TO REVIEW COMPENSATION MATTERS. ON A BIENNIAL BASIS, THE ORGANIZATION PERFORMS A FULL COMPENSATION AND BENEFIT ANALYSIS AND REVIEW. THE RESULTS OF THE REVIEW BY SULLIVAN COTTER AND ASSOCIATES ARE SHARED/DISCUSSED WITH THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15BTHE SAME PROCESS APPLIES FOR ALL OTHER EXECUTIVE STEERING COMMITTEE MEMBERS AS DETAILED FOR THE CEO.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS, REQUIRED TAX FORMS (I.E., FORM 990), AS WELL AS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH THE ADMINISTRATIVE AND FINANCE OFFICES.
FORM 990, PART XI, LINE 9INVESTMENT INCOME TIMING DIFFERENCE $ 52,473 TRANSFER FROM AFFILIATES $115,562,000 TOTAL $115,614,473

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
BLANCHARD VALLEY MEDICAL PRACTICES LLC
1900 SOUTH MAIN STREETFINDLAYOH45840421659766PHYS OFFICEOH$38,549,000$10,844,000BVHS
BLANCHARD VALLEY HOME CARE SERVICES LLC
1900 SOUTH MAIN STREETFINDLAYOH45840421565629HOME HEALTHOHBVCCS
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STREETFINDLAYOH45840061748552CERT NURSEOHBVRHC
NEUROSURGICAL ASSOCIATES OF NW OHIO LLC
1900 SOUTH MAIN STREETFINDLAYOH45840342052585PHYS OFFICEOHBVMP
SPECIALTY PHYSICIANS OF BLANCHARD VALLEY
1900 SOUTH MAIN STREETFINDLAYOH45840262448601PHYS OFFICEOHBVMP
BLANCHARD VALLEY REGIONAL CANCER CENTER
1900 SOUTH MAIN STREETFINDLAYOH45840050623393PHYS OFFICEOHBVMP
HANCO EMERGENCY MEDICAL SERVICES LLC
417 SIXTH STREETFINDLAYOH45840463299390AMBULANCE SEROH$9,491,912$746,505BVHS
BEYOND MEDSPA LLC
1900 SOUTH MAIN STREETFINDLAYOH45840814440286COSMETIC SPAOH$740,266$437,905BVHS
BIRCHAVEN ESTATES AT EASTERN WOODS LTD
15100 BIRCHAVEN LANEFINDLAYOH45840201494204CONDOMINIUMSOHBVCCS

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
BLANCHARD VALLEY CONTINUING CARE SERVICE
15100 BIRCHAVEN LANEFINDLAYOH45840346006904CONT. CAREOH501(C)(3)10BVHSYes (true)
BLANCHARD VALLEY REGIONAL HEALTH CENTER
1900 SOUTH MAIN STREETFINDLAYOH45840341369963ACUTE CAREOH501(C)(3)3BVHSYes (true)
BLANCHARD VALLEY HEALTH FOUNDATION
1900 SOUTH MAIN STREETFINDLAYOH45840341370522FUNDRAISINGOH501(C)(3)7BVHSYes (true)
EC EDWARDS MEMORIAL TRUST FBO FINDLAY
1900 SOUTH MAIN STREETFINDLAYOH45840346953719INVESTMENTOH501(C)(3)PFBVHFYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
NORTHWEST OHIO MEDICAL EQUIPMENT
1900 SOUTH MAIN STFINDLAYOH45840341882390MED EQUIPMENTOHBVCCSRELATED
BLANCHARD VALLEY PAIN MANAGEMENT
1900 SOUTH MAIN STFINDLAYOH45840270095470PAIN MGMTOHBVRHCRELATED
TECHNICORE CLINICAL ENGINEERING
1900 SOUTH MAIN STFINDLAYOH45840421702910BIO-MED SUPPORTOHBVRHCRELATED
CREIGHTON DIALYSIS LLC
1900 SOUTH MAIN STFINDLAYOH45840274527592DIALYSIS SERVICESOHBVRHCRELATED

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CITAS INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1Txt
CityFINDLAYCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45840ZIPCd
FieldValueIRS element (for citing)
EIN311369708EIN
Primary ActivitiesRECRUITINGPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1BVHSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CORPEntityTypeTxt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BLANCHARD VALLEY REGIONAL HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeDTransactionTypeTxt
Involved$93,700,000InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.