FURP.ORG / PUBLIC DATA EXPLORER

BLANCHARD VALLEY HEALTH SYSTEM: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
BLANCHARD VALLEY HEALTH SYSTEM (EIN 34-4428206)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-12
IRS object ID
201533169349304558
Schema version
2014v5.0
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)
Return2015-11-12T14:36:48-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

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 Begin2014-01-01TaxPeriodBeginDt

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
Phone4194235497PhoneNum

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
Phone4194235497PhoneNum
Signature2015-11-16SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJoyce A DulworthPreparerPersonNm
PTINP00151125PTIN
Phone2604604000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

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$33,674,017GrossReceiptsAmt
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, AN URGENT CARE CENTER, AND A CANCER CENTER.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee515TotalEmployeeCnt
Total Volunteers165TotalVolunteersCnt
Total Gross UBI$26,633TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$9,240NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$19,074,699PYProgramServiceRevenueAmt
CY Program Service Revenue$28,475,535CYProgramServiceRevenueAmt
PY Investment Income$333,799PYInvestmentIncomeAmt
CY Investment Income$1,988,717CYInvestmentIncomeAmt
PY Other Revenue$1,081,218PYOtherRevenueAmt
CY Other Revenue$650,798CYOtherRevenueAmt
PY Total Revenue$20,489,716PYTotalRevenueAmt
CY Total Revenue$31,115,050CYTotalRevenueAmt
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$16,307,754PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$22,275,801CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,637,345PYOtherExpensesAmt
CY Other Expenses$10,745,462CYOtherExpensesAmt
PY Total Expenses$24,945,099PYTotalExpensesAmt
CY Total Expenses$33,021,263CYTotalExpensesAmt
PY Revenues Less Expenses-$4,455,383PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,906,213CYRevenuesLessExpensesAmt
Total Assets BOY$80,822,187TotalAssetsBOYAmt
Total Assets EOY$88,909,940TotalAssetsEOYAmt
Total Liabilities BOY$54,918,624TotalLiabilitiesBOYAmt
Total Liabilities EOY$67,329,193TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,903,563NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,580,747NetAssetsOrFundBalancesEOYAmt
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$25,161,713ExpenseAmt
Revenue$28,475,535RevenueAmt
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 OFFICES, SPECIALTY PHYSICIAN OFFICES, RADIATION THERAPY SERVICES, AND AN URGENT CARE CENTER. BVMP IS COMMITTED TO PROVIDING EASILY ACCESSIBLE HEALTH CARE SERVICES TO ALL MEMBERS OF THE SURROUNDING COMMUNITIES THROUGH THEIR FAMILY PRACTICES AND URGENT CARE CENTER. SPECIALIZED SERVICES ARE ALSO AVAILABLE, INCLUDING NEUROLOGICAL SERVICES, CANCER TREATMENT, CARDIAC CARE, AND DIAGNOSTIC SERVICES. HANCO PROVIDES PROFESSIONAL AND EXPEDIENT AMBULANCE SERVICES AND PRE-HOSPITAL EMERGENCY MEDICAL CARE.Desc
Total Program Service Expenses$25,161,713TotalProgramServiceExpensesAmt
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
Employee515EmployeeCnt
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
Phone4194235497PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
SCOTT MALANEY
CHIEF EXECUTIVE OFFICER2.038.0Yes (X)Yes (X)$856,896$0$24,088
DUANE JEBBETT
CHAIR0.51.0Yes (X)$0$0$0
PAUL WORSTELL
VICE CHAIR0.51.0Yes (X)$0$0$0
CHERYL BUCKLAND
TRUSTEE0.51.0Yes (X)$0$0$0
KAREN CLINE
TRUSTEE0.51.0Yes (X)$0$0$0
DAVID EUBANKS
TRUSTEE0.51.0Yes (X)$0$0$0
RANDALL MYERS
TRUSTEE0.51.0Yes (X)$0$0$0
ROD NICHOLS
TRUSTEE0.51.0Yes (X)$0$0$0
GARRY PEIFFER
TRUSTEE0.51.0Yes (X)$0$0$0
ANDREA KOEPKE
TRUSTEE0.51.0Yes (X)$0$0$0
WILLIAM REIST DMIN
TRUSTEE0.51.0Yes (X)$0$0$0
LEROY SCHROEDER MD
TRUSTEE0.51.0Yes (X)$0$0$0
BRADLEY HUGHES
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)$0$0$0
ERIC BOSTICK MD
TRUSTEE0.51.0Yes (X)$0$0$0
RICHARD POLDER MD
TRUSTEE0.51.0Yes (X)$0$0$0
DAVE CYTLAK
CHIEF FINANCIAL OFFICER2.038.0Yes (X)$392,875$0$21,888
WILLIAM KOSE
CHIEF QUALITY OFFICER4.036.0Yes (X)$406,724$0$25,200
WILLIAM WATKINS
CHIEF ADMINISTRATIVE OFFICER36.04.0$204,004$0$13,735Yes (X)
CHRISTOPHER PRESS
PRESIDENT BVRHC2.038.0$484,768$0$2,055Yes (X)
DR MICHAEL DENIKE
PHYSICIAN40.00.0$498,386$0$21,588Yes (X)
DR GARY PARENTEAU
PHYSICIAN40.00.0$449,919$0$19,013Yes (X)
DR SEAN LOGAN
PHYSICIAN40.00.0$923,168$0$9,180Yes (X)
DR ROBERT HOLLIS
PHYSICIAN40.00.0$703,347$0$13,323Yes (X)
DR MOHAMMAD MOBAYED
PHYSICIAN40.00.0$505,507$0$20,674Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,425,594TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$170,744TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K52IndivRcvdGreaterThan100KCnt
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
CARETECH SOLUTIONS INC
PO BOX 674271DETROITMI48267HEALTHCARE IT$633,808
BKD LLP
200 EAST MAIN STREET SUITE 700FT WAYNEIN46802AUDIT & TAX SERVICES$220,377
SCHNEIDER AND WUEST INC
26302 THOMPSON RDPERRYSBURGOH43351PHYSICIST SERVICES$162,720
RCM ARCHITECTS INC
322 SOUTH MAIN STFINDLAYOH45840ARCHITECTS$188,916
SEI INVESTMENTS COMPANY
PO BOX 945794ATLANTAGA30394INVESTMENT SERVICES$1,083,781
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$22,574,675$22,574,675
MANAGEMENT ALLOCATIONS TO RELATED ENTITIES900099$5,900,860$5,900,860
FieldValueIRS element (for citing)
Total Program Service Revenue$28,475,535TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,051,758TotalRevenueColumnAmt
Unrelated Business Revenue$26,633UnrelatedBusinessRevenueAmt
Exclusion$1,025,125ExclusionAmt

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$332,107RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$332,107RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$332,107TotalRevenueColumnAmt
Exclusion$332,107ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$3,495,926SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,558,967SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$936,959SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$936,959TotalRevenueColumnAmt
Exclusion$936,959ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business900099BusinessCd
Total Revenue Column$318,691TotalRevenueColumnAmt
Exclusion$318,691ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$318,691OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,115,050TotalRevenueColumnAmt
Related Or Exempt Func Income$28,475,535RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$26,633UnrelatedBusinessRevenueAmt
Exclusion$2,612,882ExclusionAmt

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$5,103,527TotalAmt
Program Services$4,082,822ProgramServicesAmt
Management And General$1,020,705ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,015,038TotalAmt
Program Services$11,212,030ProgramServicesAmt
Management And General$2,803,008ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$545,121TotalAmt
Program Services$436,097ProgramServicesAmt
Management And General$109,024ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,583,156TotalAmt
Program Services$1,266,525ProgramServicesAmt
Management And General$316,631ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,028,959TotalAmt
Program Services$823,167ProgramServicesAmt
Management And General$205,792ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$444,811TotalAmt
Management And General$444,811ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,109,982TotalAmt
Program Services$554,991ProgramServicesAmt
Management And General$554,991ManagementAndGeneralAmt

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$1,089,781TotalAmt
Management And General$1,089,781ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$880,071TotalAmt
Program Services$792,064ProgramServicesAmt
Management And General$88,007ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$16,297TotalAmt
Program Services$1,630ProgramServicesAmt
Management And General$14,667ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,926,876TotalAmt
Program Services$1,926,876ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$372,309TotalAmt
Program Services$279,232ProgramServicesAmt
Management And General$93,077ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$804,360TotalAmt
Program Services$643,488ProgramServicesAmt
Management And General$160,872ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$165,546TotalAmt
Program Services$82,773ProgramServicesAmt
Management And General$82,773ManagementAndGeneralAmt

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$77,186TotalAmt
Management And General$77,186ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,095,102TotalAmt
Program Services$985,592ProgramServicesAmt
Management And General$109,510ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$96,650TotalAmt
Program Services$77,320ProgramServicesAmt
Management And General$19,330ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBTS$1,443,252$1,443,252
MEDICAL & PRO. FEES$311,470$280,323$31,147
OTHER$911,769$273,531$638,238

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$33,021,263TotalAmt
Program Services$25,161,713ProgramServicesAmt
Management And General$7,859,550ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$375BOYAmt
EOY$3,105EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$9,175BOYAmt
EOY$31,072EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,361,571BOYAmt
EOY$2,611,942EOYAmt

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$300BOYAmt
EOY$36,136EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$338,567BOYAmt
EOY$1,380,491EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$49,427,091LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$24,398,310LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,987,083BOYAmt
EOY$25,028,781EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$51,807,745BOYAmt
EOY$53,595,267EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$6,071,098BOYAmt
EOY$6,080,374EOYAmt

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$246,273BOYAmt
EOY$142,772EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$80,822,187BOYAmt
EOY$88,909,940EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,935,190BOYAmt
EOY$5,070,771EOYAmt

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$147,454EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,983,434BOYAmt
EOY$62,110,968EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$54,918,624BOYAmt
EOY$67,329,193EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,739,469BOYAmt
EOY$7,192,665EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$436,522BOYAmt
EOY$454,158EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,727,572BOYAmt
EOY$13,933,924EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,903,563BOYAmt
EOY$21,580,747EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$80,822,187BOYAmt
EOY$88,909,940EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,906,213ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,224,431NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,192,172OtherChangesInNetAssetsAmt
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 TypeOrganizationTypeDescGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
BLANCHARD VALLEY REGIONAL HEALTH CENTER
34136996303false$5,330,355$0
BLANCHARD VALLEY CONTINUING CARE SERVICES
34600690409false$628,983$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Support Sum$5,959,338SupportSumAmt

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$14,152,532BeginningYearBalanceAmt
Investment Earnings Or Losses-$420,329InvestmentEarningsOrLossesAmt
End Year Balance$13,732,203EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,058,307BeginningYearBalanceAmt
Investment Earnings Or Losses-$1,125InvestmentEarningsOrLossesAmt
Other Expenditures$23,037OtherExpendituresAmt
End Year Balance$13,034,145EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,801,268BeginningYearBalanceAmt
Investment Earnings Or Losses-$1,731,242InvestmentEarningsOrLossesAmt
Other Expenditures$11,719OtherExpendituresAmt
End Year Balance$13,058,307EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.96690PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.03310TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$6,701,247OtherCostOrOtherBasisAmt
Book Value$6,701,247BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$9,725,318OtherCostOrOtherBasisAmt
Depreciation$5,378,836DepreciationAmt
Book Value$4,346,482BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,893,294OtherCostOrOtherBasisAmt
Depreciation$1,492,973DepreciationAmt
Book Value$400,321BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$23,193,050OtherCostOrOtherBasisAmt
Depreciation$15,708,708DepreciationAmt
Book Value$7,484,342BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$7,914,183OtherCostOrOtherBasisAmt
Depreciation$1,817,794DepreciationAmt
Book Value$6,096,389BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$25,028,781TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
VENTURES AND PARTNERSHIPS$264,251C
CARE SERVICES$5,816,123C
FieldValueIRS element (for citing)
Total Book Value Securities$6,080,374TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescADVANCES FROM AFFILIATESDesc
Amt$62,110,968Amt
FieldValueIRS element (for citing)
Total Liability$62,110,968TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$28,974,486TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$1,224,431NetUnrealizedGainsInvstAmt
Other Revenue$537,234OtherRevenueAmt
Revenue Not Reported-$687,197RevenueNotReportedAmt
Revenue Subtotal$29,661,683RevenueSubtotalAmt
Other Revenues Not Included$1,453,367OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,453,367RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$31,115,050TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$31,578,011TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$31,578,011ExpensesSubtotalAmt
Other Expenses Not Included$1,443,252OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,443,252ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$33,021,263TotalExpensesPerForm990Amt

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 $318,234 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS $219,000 TOTAL $537,234
PART XI, LINE 4BBAD DEBT RECLASS $1,443,252 INVESTMENT INCOME TIMING DIFFERENCE $10,115 TOTAL $1,453,367
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
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
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 (10 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 OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SCOTT MALANEY
CHIEF EXECUTIVE OFFICER$515,637$0$180,132$0$161,127$0$15,600$0$8,488$0$880,984$0$0$0
DAVE CYTLAK
CHIEF FINANCIAL OFFICER$297,010$0$70,281$0$25,584$0$15,600$0$6,288$0$414,763$0$0$0
WILLIAM KOSE
CHIEF QUALITY OFFICER$298,539$0$75,943$0$32,242$0$15,600$0$9,600$0$431,924$0$0$0
DR MICHAEL DENIKE
PHYSICIAN$495,946$0$1,900$0$540$0$15,600$0$5,988$0$519,974$0$0$0
DR GARY PARENTEAU
PHYSICIAN$429,919$0$20,000$0$0$0$15,600$0$3,413$0$468,932$0$0$0
DR SEAN LOGAN
PHYSICIAN$895,893$0$0$0$27,275$0$692$0$8,488$0$932,348$0$0$0
DR ROBERT HOLLIS
PHYSICIAN$703,347$0$0$0$0$0$7,695$0$5,628$0$716,670$0$0$0
DR MOHAMMAD MOBAYED
PHYSICIAN$491,806$0$0$0$13,701$0$10,095$0$10,579$0$526,181$0$0$0
WILLIAM WATKINS
CHIEF ADMINISTRATIVE OFFICER$162,350$0$37,507$0$4,147$0$10,114$0$3,621$0$217,739$0$0$0
CHRISTOPHER PRESS
PRESIDENT BVRHC$251,730$0$89,436$0$143,602$0$1,769$0$286$0$486,823$0$117,744$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4AFormAndLineReferenceDesc
ExplanationCONSISTENT WITH HIS CONTRACT TERMS, SEVERANCE PAY OF $275,000 WAS GIVEN TO CHRISTOPHER PRESS. PART I, LINE 4B In 2014, Blanchard Valley Health System contributed on behalf of Scott Malaney $146,184 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 2014, Blanchard Valley Health System contributed on behalf of David Cytlak $21,149 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 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 President (Christopher Press) Provide 50% target income replacement for CFO (David Cytlak) **Employee contributions to the 457(f) account are not allowed. * Each participants 457(b) account will be credited up to the statutory limit ($17,500 in 2014), 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 feasible.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, QUESTION 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, QUESTION 11BDETAIL 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, QUESTION 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, QUESTION 15ATHE ORGANIZATION REVIEWS EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES ON A BI-ANNUAL 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 EARLY 2014 BY SULLIVAN COTTER AND ASSOCIATES (AN EXTERNAL CONSULTANT) AND SHARED/DISCUSSED WITH THE BOARD IN APRIL 2014.
FORM 990, PART VI, QUESTION 15BTHE SAME PROCESS APPLIES FOR ALL OTHER EXECUTIVE STEERING COMMITTEE MEMBERS AS DETAILED FOR THE CEO.
FORM 990, PART VI, QUESTION 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). FORM 990, PART XI, LINE 9 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS: $219,000 INVESTMENT INCOME TIMING DIFFERENCE: ($10,115) TRANSFERS FROM AFFILIATES: $318,234 CHANGE IN UNRESTRICTED NET ASSETS ($1,719,292) TOTAL: $1,192,173

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 STFINDLAYOH45840421659766PHYS OFCSOH$19,922,819$6,343,577BVHS
BLANCHARD VALLEY HOME CARE SERVICES LLC
1900 SOUTH MAIN STFINDLAYOH45840421565629HOME HEALTHOHBVCCS
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STFINDLAYOH45840061748552CERT NURSEOHBVHS
NEUROSURGICAL ASSOCIATES OF NW OHIO LLC
1900 SOUTH MAIN STFINDLAYOH45840342052585PHYS OFFICEOHBVMP
SPECIALTY PHYSICIANS OF BLANCHARD VALLEY
1900 SOUTH MAIN STFINDLAYOH45840262448601PHYS OFFICEOHBVMP
BLANCHARD VALLEY REGIONAL CANCER CENTER
1900 SOUTH MAIN STFINDLAYOH45840050623393PHYS OFFICEOHBVMP
HANCO EMERGENCY MEDICAL SERVICES LLC
417 SIXTH STFINDLAYOH45840463299390AMBULANCE SEROH$3,286,065$1,303,208BVHS

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 LNFINDLAYOH45840346006904CONT. CAREOH501(C)(3)9BVHSYes (true)
BLANCHARD VALLEY REGIONAL HEALTH CENTER
1900 SOUTH MAIN STFINDLAYOH45840341369963ACUTE CAREOH501(C)(3)3BVHSYes (true)
BLANCHARD VALLEY HEALTH FOUNDATION
1900 SOUTH MAIN STFINDLAYOH45840341370522FUNDRAISINGOH501(C)(3)7BVHSYes (true)
EC EDWARDS MEMORIAL TRUST FBO FINDLAY
1900 SOUTH MAIN STFINDLAYOH45840346953719INVESTMENTOH501(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 LLC
1900 SOUTH MAIN STFINDLAYOH45840341882390MED EQUIPMENTOHBVCCSRELATED
BLANCHARD VALLEY PAIN MANAGEMENT LLC
1900 SOUTH MAIN STFINDLAYOH45840270095470PAIN MGMTOHBVRHCRELATED
TECHNICORE CLINICAL ENGINEERING SERVICES
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 CORP1.00000false
CITAS INC
1900 SOUTH MAIN STFINDLAYOH45840311369708RECRUITINGOHBVHSC 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$104,550,000FMV
BLANCHARD VALLEY CONTINUING CARE SERVICES
J$60,000FMV
BLANCHARD VALLEY REGIONAL HEALTH CENTER
J$56,004FMV