FURP.ORG / PUBLIC DATA EXPLORER

BLANCHARD VALLEY HEALTH SYSTEM: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
BLANCHARD VALLEY HEALTH SYSTEM (EIN 34-4428206)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-09
IRS object ID
201733139349302873
Schema version
2016v3.1
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)
Return2017-11-09T14:43:37-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

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 Begin2016-01-01TaxPeriodBeginDt

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
Signature2017-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJoyce A DulworthPreparerPersonNm
PTINP00151125PTIN
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 Id35027420173135000009FederalOriginalSubmissionId
Federal Original Submission Id2017-11-09FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id384BDF3ACA8E49551A5231C8C81D96B0BE015756AtSubmissionCreationDeviceId
At Submission Filing Device Id1466242D98572CF50F8DAFF8C03C944EFBA58CF0AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

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$48,104,342GrossReceiptsAmt
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 Employee353TotalEmployeeCnt
Total Volunteers141TotalVolunteersCnt
Total Gross UBI-$155,603TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$15,280NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$31,651,495PYProgramServiceRevenueAmt
CY Program Service Revenue$39,418,288CYProgramServiceRevenueAmt
PY Investment Income$616,292PYInvestmentIncomeAmt
CY Investment Income$2,637,640CYInvestmentIncomeAmt
PY Other Revenue$308,725PYOtherRevenueAmt
CY Other Revenue$122,059CYOtherRevenueAmt
PY Total Revenue$32,576,512PYTotalRevenueAmt
CY Total Revenue$42,177,987CYTotalRevenueAmt
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$26,266,610PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$57,887,539CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,124,406PYOtherExpensesAmt
CY Other Expenses$29,706,442CYOtherExpensesAmt
PY Total Expenses$38,391,016PYTotalExpensesAmt
CY Total Expenses$87,593,981CYTotalExpensesAmt
PY Revenues Less Expenses-$5,814,504PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$45,415,994CYRevenuesLessExpensesAmt
Total Assets BOY$99,291,697TotalAssetsBOYAmt
Total Assets EOY$114,427,650TotalAssetsEOYAmt
Total Liabilities BOY$84,039,815TotalLiabilitiesBOYAmt
Total Liabilities EOY$135,123,159TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,251,882NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$20,695,509NetAssetsOrFundBalancesEOYAmt
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$67,785,968ExpenseAmt
Revenue$39,484,467RevenueAmt
DescBLANCHARD VALLEY HEALTH SYSTEM'S PROGRAM SERVICE REVENUE IS GENERATED BY BLANCHARD VALLEY MEDICAL PRACTICES (BVMP) AND HANCO EMERGENCY MEDICAL SERVICES (HANCO), 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.Desc
Total Program Service Expenses$67,785,968TotalProgramServiceExpensesAmt
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
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee353EmployeeCnt
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
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
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
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 (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
SCOTT MALANEY
CHIEF EXECUTIVE OFFICER2.038.0Yes (X)Yes (X)$781,714$0$177,689
CHERYL BUCKLAND
TRUSTEE0.51.0Yes (X)$0$0$0
KAREN CLINE
TRUSTEE0.51.0Yes (X)$0$0$0
FRANK A COSIANO MD
TRUSTEE0.51.0Yes (X)$0$0$0
DAVID EUBANKS
TRUSTEE0.51.0Yes (X)$0$0$0
DUANE JEBBETT
CHAIRMAN0.51.0Yes (X)Yes (X)$0$0$0
KAREN KLASSEN HARDER
SECRETARY0.51.0Yes (X)Yes (X)$0$0$0
ANDREA KOEPKE
TRUSTEE0.51.0Yes (X)$0$0$0
RANDALL MYERS
TRUSTEE0.51.0Yes (X)$0$0$0
RODNEY NICHOLS
TRUSTEE0.51.0Yes (X)$0$0$0
GARY PEIFFER
TREASURER0.51.0Yes (X)Yes (X)$0$0$0
RICHARD POLDER MD
TRUSTEE0.51.0Yes (X)$0$0$0
WILLIAM REIST
TRUSTEE0.51.0Yes (X)$0$0$0
LEROY SCHROEDER MD
TRUSTEE0.51.0Yes (X)$0$0$0
KIMBERLY STUMPP
TRUSTEE0.51.0Yes (X)$0$0$0
PAUL WORSTELL
VICE CHAIRMAN0.51.0Yes (X)Yes (X)$0$0$0
GINGER JONES
TRUSTEE0.51.0Yes (X)$0$0$0
JOSEPH LONGO
TRUSTEE0.51.0Yes (X)$0$0$0
DAVE CYTLAK
CHIEF FINANCIAL OFFICER2.038.0Yes (X)$385,790$0$39,278
WILLIAM KOSE
CHIEF QUALITY OFFICER4.036.0Yes (X)$387,739$0$29,302
DR ANAS BALAA
PHYSICIAN40.00.0$858,184$0$31,745Yes (X)
DR SEAN LOGAN
PHYSICIAN40.00.0$753,583$0$5,160Yes (X)
DR ROBERT HOLLIS III
PHYSICIAN40.00.0$749,183$0$23,042Yes (X)
DR THOMAS KINDL
PHYSICIAN40.00.0$971,650$0$9,930Yes (X)
DR PANAGIOTIS BAKOS
PHYSICIAN40.00.0$847,227$0$3,611Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,735,070TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$319,757TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K23IndivRcvdGreaterThan100KCnt
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
CONCORDANCE HEALTHCARE SOLUTIONS L
85 SHAFFER PARK DRTIFFINOH44883MEDICAL SUPPLIES$123,763
DINSMORE SHOHL LLP
255 E 5TH ST STE 1900CINCINNATIOH45202LEGAL SERVICES$140,253
MD HOGAN LTD
615 MEADOWVIEW DRFINDLAYOH45840PHYSICIAN SERVICES$145,517
BKD LLP
200 EAST MAIN STREET SUITE 700FORT WAYNEIN46802AUDIT & TAX SERVICES$149,060
SHUMAKER LOOP KENDRICK LLP
41 SOUTH HIGH STCOLUMBUSOH43215LEGAL SERVICES$181,019
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$34,964,828$34,964,828
MANAGEMENT ALLOCATIONS TO RELATED ENTITIES900099$4,453,460$4,453,460
FieldValueIRS element (for citing)
Total Program Service Revenue$39,418,288TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,837,442TotalRevenueColumnAmt
Unrelated Business Revenue-$155,603UnrelatedBusinessRevenueAmt
Exclusion$2,993,045ExclusionAmt

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$122,059RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$122,059RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$122,059TotalRevenueColumnAmt
Exclusion$122,059ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,660,374SecuritiesAmt
Other$66,179OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$5,926,355SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$265,981SecuritiesAmt
Other$66,179OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$199,802TotalRevenueColumnAmt
Related Or Exempt Func Income$66,179RelatedOrExemptFuncIncomeAmt
Exclusion-$265,981ExclusionAmt
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$42,177,987TotalRevenueColumnAmt
Related Or Exempt Func Income$39,484,467RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$155,603UnrelatedBusinessRevenueAmt
Exclusion$2,849,123ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

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$1,801,512TotalAmt
Program Services$1,170,983ProgramServicesAmt
Management And General$630,529ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$49,732,822TotalAmt
Program Services$39,786,258ProgramServicesAmt
Management And General$9,946,564ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,609,979TotalAmt
Program Services$1,287,983ProgramServicesAmt
Management And General$321,996ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,135,705TotalAmt
Program Services$1,708,564ProgramServicesAmt
Management And General$427,141ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,607,521TotalAmt
Program Services$2,086,017ProgramServicesAmt
Management And General$521,504ManagementAndGeneralAmt

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$1,809,164TotalAmt
Program Services$904,582ProgramServicesAmt
Management And General$904,582ManagementAndGeneralAmt

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$1,277,920TotalAmt
Management And General$1,277,920ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,874,489TotalAmt
Program Services$3,487,040ProgramServicesAmt
Management And General$387,449ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$382,813TotalAmt
Program Services$38,281ProgramServicesAmt
Management And General$344,532ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,857,640TotalAmt
Program Services$4,857,640ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,683,273TotalAmt
Program Services$4,262,455ProgramServicesAmt
Management And General$1,420,818ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,541,224TotalAmt
Program Services$1,232,979ProgramServicesAmt
Management And General$308,245ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$406,208TotalAmt
Program Services$203,104ProgramServicesAmt
Management And General$203,104ManagementAndGeneralAmt

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$2,894,562TotalAmt
Program Services$2,315,650ProgramServicesAmt
Management And General$578,912ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,800,540TotalAmt
Program Services$1,440,432ProgramServicesAmt
Management And General$360,108ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBTS$2,350,332$2,350,332
MEDICAL & PRO. FEES$179,370$161,433$17,937
DUES & SUBSCRIPTIONS$974,535$974,535
OTHER$1,674,372$492,235$1,182,137

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$87,593,981TotalAmt
Program Services$67,785,968ProgramServicesAmt
Management And General$19,808,013ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY-$788BOYAmt
EOY$5,223,603EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$29,530BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,591,429BOYAmt
EOY$13,345,671EOYAmt

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$36,136BOYAmt
EOY$36,902EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,214,581BOYAmt
EOY$1,677,360EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$69,497,484LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$22,031,790LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$38,405,756BOYAmt
EOY$47,465,694EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$50,934,679BOYAmt
EOY$40,644,136EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$6,080,374BOYAmt
EOY$6,034,284EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$99,291,697BOYAmt
EOY$114,427,650EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,420,032BOYAmt
EOY$35,972,503EOYAmt

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$80,619,783BOYAmt
EOY$99,150,656EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$84,039,815BOYAmt
EOY$135,123,159EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,220,692BOYAmt
EOY-$21,145,387EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$433,443BOYAmt
EOY$449,878EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,597,747BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,251,882BOYAmt
EOY-$20,695,509EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$99,291,697BOYAmt
EOY$114,427,650EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$45,415,994ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,000NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$9,464,603OtherChangesInNetAssetsAmt
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
Supported Organizations2SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
BLANCHARD VALLEY REGIONAL HEALTH CENTER
3413699633false$4,312,678$0
BLANCHARD VALLEY CONTINUING CARE SERVICES
34600690410false$409,080$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Support Sum$4,721,758SupportSumAmt

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$13,031,190BeginningYearBalanceAmt
Investment Earnings Or Losses$28,650InvestmentEarningsOrLossesAmt
Other Expenditures$12,609,962OtherExpendituresAmt
End Year Balance$449,878EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,152,532BeginningYearBalanceAmt
Investment Earnings Or Losses-$420,329InvestmentEarningsOrLossesAmt
End Year Balance$13,732,203EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,424,824BeginningYearBalanceAmt
Investment Earnings Or Losses$113,872InvestmentEarningsOrLossesAmt
Other Expenditures$386,164OtherExpendituresAmt
End Year Balance$14,152,532EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,034,145BeginningYearBalanceAmt
Investment Earnings Or Losses$1,720,414InvestmentEarningsOrLossesAmt
Other Expenditures$329,735OtherExpendituresAmt
End Year Balance$14,424,824EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
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$6,717,407OtherCostOrOtherBasisAmt
Book Value$6,717,407BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,902,439OtherCostOrOtherBasisAmt
Depreciation$4,529,556DepreciationAmt
Book Value$4,372,883BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,480,576OtherCostOrOtherBasisAmt
Depreciation$1,411,911DepreciationAmt
Book Value$68,665BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,838,504OtherCostOrOtherBasisAmt
Depreciation$13,644,043DepreciationAmt
Book Value$4,194,461BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,558,558OtherCostOrOtherBasisAmt
Depreciation$2,446,280DepreciationAmt
Book Value$32,112,278BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$47,465,694TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
VENTURES AND PARTNERSHIPS$264,284F
CARE SERVICES$5,770,000F
FieldValueIRS element (for citing)
Total Book Value Securities$6,034,284TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ADVANCES FROM AFFILIATES$90,036,803
OTHER LONG-TERM OBLIGATIONS$9,113,853
FieldValueIRS element (for citing)
Total Liability$99,150,656TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$49,296,258TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$4,000NetUnrealizedGainsInvstAmt
Other Revenue$9,464,603OtherRevenueAmt
Revenue Not Reported$9,468,603RevenueNotReportedAmt
Revenue Subtotal$39,827,655RevenueSubtotalAmt
Other Revenues Not Included$2,350,332OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,350,332RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$42,177,987TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$85,243,649TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$85,243,649ExpensesSubtotalAmt
Other Expenses Not Included$2,350,332OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,350,332ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$87,593,981TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 2DTRANSFERS TO AFFILIATES $9,309,000 INVESTMENT INCOME TIMING DIFFERENCE $ 155,603 TOTAL $9,464,603
PART XI & PART XII, LINE 4BBAD DEBT RECLASS $2,350,332
ASC 740MANAGEMENT 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 (8 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
CHIEF EXECUTIVE OFFICER$561,502$0$44,903$0$175,309$0$170,638$0$7,051$0$959,403$0$138,650
DAVE CYTLAK
CHIEF FINANCIAL OFFICER$320,659$0$35,548$0$29,583$0$38,177$0$1,101$0$425,068$0$2,281
WILLIAM KOSE
CHIEF QUALITY OFFICER$311,142$0$37,966$0$38,631$0$15,900$0$13,402$0$417,041$0
DR ANAS BALAA
PHYSICIAN$482,033$0$358,363$0$17,788$0$15,900$0$15,845$0$889,929$0
DR SEAN LOGAN
PHYSICIAN$722,192$0$0$0$31,391$0$0$0$5,160$0$758,743$0
DR ROBERT HOLLIS III
PHYSICIAN$747,665$0$0$0$1,518$0$15,900$0$7,142$0$772,225$0
DR THOMAS KINDL
PHYSICIAN$567,771$0$384,880$0$18,999$0$0$0$9,930$0$981,580$0
DR PANAGIOTIS BAKOS
PHYSICIAN$565,340$0$262,355$0$19,532$0$0$0$3,611$0$850,838$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 4CFormAndLineReferenceDesc
ExplanationIN 2016, BLANCHARD VALLEY HEALTH SYSTEM CONTRIBUTED ON BEHALF OF SCOTT MALANEY $154,738 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 2016, BLANCHARD VALLEY HEALTH SYSTEM CONTRIBUTED ON BEHALF OF DAVID CYTLAK $22,277 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 ($18,000 IN 2016), 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, 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, LINE 11B DETAIL REVIEWS OF THE FORM 990'S ARE PERFORMED BY AN INDEPENDENT CPA FIRM AND THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE. THIS COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, MEMBERS OF THE COMMUNITY, AND MEMBERS OF UPPER MANAGEMENT. THE COMPLIANCE AND 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 ON BOARDNET. 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, 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 A CONFLICT EXISTS.
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 MOST RECENT FULL COMPENSATION AND BENEFIT ANALYSIS AND REVEIW WAS COMPLETED IN 2015 BY SULLIVAN COTTER AND ASSOCIATES (AN EXTERNAL CONSULTANT) AND THE RESULTS WERE 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 IXThe amounts reported on 990 Part VIII Line 11a columns (b) and (d) represent management fee allocations out to other related organizations for management related services performed by individuals employed by Blanchard Valley Health System. The compensation, benefits, and other related costs for such individuals are recorded on 990 Part IX columns (b) and (c). In 2016, the organization implemented a new HCIS system (Cerner/PeopleSoft). During this implementation, the organization changed how it categorized its general ledger income statement accounts to present a clearer picture of the operating results of the organizations divisions. As a result, various departmental expense accounts from the BVRHC division were reclassified to the parent organization, BVHS. Most of these departmental expense accounts related to business office administrative costs that had historically been recorded under BVRHC (e.g. administration, accounting, purchasing, legal, etc.). These administrative costs are now reported under BVHS, as these departments perform duties for the entire organization and not just the BVRHC division. Thus, due to this change in categorization of administrative costs, divisional expenses recorded on Part IX - Statement of Functional Expenses will look significantly different on the BVRHC Form 990 (reduction to Functional Expenses) and the BVHS Form 990 (increase to Functional Expenses). Similarly, changes to the categories per the general ledger affected how the balance sheets are presented for the various divisions of BVHS. FORM 990, PART XI, LINE 9 INVESTMENT INCOME TIMING DIFFERENCE: $ 155,603 TRANSFERS FROM AFFILIATES: $9,309,000 TOTAL: $9,464,603

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (7 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$29,594,828$10,476,232BVHS
BLANCHARD VALLEY HOME CARE SERVICES LLC
1900 SOUTH MAIN STREETFINDLAYOH45840421565629HOME HEALTHOHBVCCS
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STREETFINDLAYOH45840061748552CERT NURSEOHBVHS
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 SEROHBVHS

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 (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
BIRCHAVEN ESTATES AT EASTERN WOODS LTD
15100 BIRCHAVEN LANEFINDLAYOH45840201494204CONDOMINIUMSOHBVCCSC CORP1.00000Yes (true)
CITAS INC
1900 SOUTH MAIN STREETFINDLAYOH45840311369708RECRUITINGOHBVHSC CORP1.00000Yes (true)
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 OrgYes (true)RentalOfFcltsFromOthOrgInd
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 OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
BLANCHARD VALLEY REGIONAL HEALTH CENTER
D$99,700,000FMV
BLANCHARD VALLEY CONTINUING CARE SERVICES
JFMV
BLANCHARD VALLEY REGIONAL HEALTH CENTER
JFMV