FURP.ORG / PUBLIC DATA EXPLORER

BLANCHARD VALLEY HEALTH SYSTEM: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
BLANCHARD VALLEY HEALTH SYSTEM (EIN 34-4428206)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-10-12
IRS object ID
201422879349300862
Schema version
2013v3.1
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)
Return2014-10-12T08:53:36-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 E Main St Suite 700AddressLine1
CityFort WayneCity
StateINState
ZIP Code46802ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN344428206EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BLANCHARD VALLEY HEALTH SYSTEMBusinessNameLine1
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 STREETAddressLine1
Address Line2SuiteAddressLine2
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID M CYTLAKPersonNm
Person TitleCFOPersonTitleTxt
Phone4194235497PhoneNum
Signature2014-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJoyce A DulworthPreparerPersonNm
PTINP00151125PTIN
Phone4194235497PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSCOTT MALANEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$64,701,866GrossReceiptsAmt
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 Body21VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee514TotalEmployeeCnt
Total Volunteers88TotalVolunteersCnt
Total Gross UBI$38,157TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$17,541NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$16,351,862PYProgramServiceRevenueAmt
CY Program Service Revenue$19,074,699CYProgramServiceRevenueAmt
PY Investment Income$962,492PYInvestmentIncomeAmt
CY Investment Income$333,799CYInvestmentIncomeAmt
PY Other Revenue$671,535PYOtherRevenueAmt
CY Other Revenue$1,081,218CYOtherRevenueAmt
PY Total Revenue$17,985,889PYTotalRevenueAmt
CY Total Revenue$20,489,716CYTotalRevenueAmt
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$12,172,201PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,307,754CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,747,426PYOtherExpensesAmt
CY Other Expenses$8,637,345CYOtherExpensesAmt
PY Total Expenses$17,919,627PYTotalExpensesAmt
CY Total Expenses$24,945,099CYTotalExpensesAmt
PY Revenues Less Expenses$66,262PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,455,383CYRevenuesLessExpensesAmt
Total Assets BOY$72,566,126TotalAssetsBOYAmt
Total Assets EOY$80,822,187TotalAssetsEOYAmt
Total Liabilities BOY$45,342,547TotalLiabilitiesBOYAmt
Total Liabilities EOY$54,918,624TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$27,223,579NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$25,903,563NetAssetsOrFundBalancesEOYAmt
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$16,908,019ExpenseAmt
Revenue$19,011,577RevenueAmt
DescBLANCHARD VALLEY HEALTH SYSTEM'S PROGRAM SERVICE REVENUE IS GENERATED BY BLANCHARD VALLEY MEDICAL PRACTICES (BVMP), A WHOLLY OWNED, DISREGARDED ENTITY. 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.Desc
Total Program Service Expenses$16,908,019TotalProgramServiceExpensesAmt
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 MemYes (true)BusinessRlnWithFamMemInd
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
Employee514EmployeeCnt
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
Excess Business HoldingsfalseExcessBusinessHoldingsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
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 STREETAddressLine1
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (30 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)$691,547$0$41,028
Dr Eric Bostick
Trustee0.51.0Yes (X)$0$0$0
Cheryl Buckland
Trustee0.51.0Yes (X)$0$0$0
Karen Cline
Trustee0.51.0Yes (X)$0$0$0
Kurt Geisheimer
Treasurer0.51.0Yes (X)$0$0$0
Duane Jebbett
Chairman0.51.0Yes (X)$0$0$0
Karen Klassen Harder
Secretary0.51.0Yes (X)$0$0$0
Andrea Koepke
Trustee0.51.0Yes (X)$0$0$0
Joe Longo
Trustee0.51.0Yes (X)$0$0$0
Dr Steve McCullough
Trustee0.51.0Yes (X)$0$0$0
Dr Randall Myers
Trustee0.51.0Yes (X)$0$0$0
Rod Nichols
Trustee0.51.0Yes (X)$0$0$0
Dr Nancy Orel
Trustee0.51.0Yes (X)$0$0$0
Dr Richard Polder
Trustee0.51.0Yes (X)$0$0$0
Dr LeRoy Schroeder
Trustee0.51.0Yes (X)$0$0$0
Kimberly Stump
Trustee0.51.0Yes (X)$0$0$0
David Eubanks
Trustee0.51.0Yes (X)$0$0$0
Garry Peiffer
Trustee0.51.0Yes (X)$0$0$0
Paul Worstell
Vice Chairman0.51.0Yes (X)$0$0$0
William Reist Dmin
Trustee0.51.0Yes (X)$0$0$0
Bradley Hughes
Trustee0.51.0Yes (X)$0$0$0
DAVE CYTLAK
Chief Financial Officer2.038.0Yes (X)$380,705$0$37,235
WILLIAM KOSE
Chief Quality Officer4.036.0Yes (X)$400,326$0$32,692
WILLIAM WATKINS
President BVMP36.04.0$18,208$174,044$28,741Yes (X)
CHRISTOPHER PRESS
President BVRHC2.038.0$351,526$0$16,989Yes (X)
Dr Michael Denike
Physician40.0$502,318$0$38,528Yes (X)
Dr Gary Parenteau
Physician40.0$450,124$0$28,686Yes (X)
Dr Robert Hollis
Physician40.0$697,184$0$21,806Yes (X)
Dr Sean Logan
Physician40.0$931,261$0$25,728Yes (X)
Dr Martin Valdivia
Physician40.0$373,268$0$39,829Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,796,467TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$174,044TotReportableCompRltdOrgAmt
Total Other Compensation$311,262TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K50IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
BKD LLP
200 EAST MAIN STREET SUITE 700FORT WAYNEIN46802AUDIT & TAX SERVICES$228,988
COMPREHENSIVE REIMBURSEMENT INC
947 EAST JOHNSTOWN ROAD SUITE 234GAHANNAOH43230COST REPORT PREP$242,525
SEI INVESTMENTS COMPANY
1 FREEDOM VALLEY DRIVEOAKSPA19456INVESTMENT CONSULTNG$432,262
CARETECH SOLUTIONS INC
PO BOX 674271DETROITMI48267HEALTHCARE IT$415,111
ALTA PARTNERS
902 WESTPOINT PARKWAY SUITE 320WESTLAKEOH44145PHYSICIAN BILLING$718,282
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$14,464,407$14,464,407
MANAGEMENT ALLOCATIONS TO RELATED ENTITIES900099$4,610,292$4,610,292
FieldValueIRS element (for citing)
Total Program Service Revenue$19,074,699TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,585,154TotalRevenueColumnAmt
Unrelated Business Revenue$38,113UnrelatedBusinessRevenueAmt
Exclusion-$1,623,267ExclusionAmt

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$351,107RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$351,107RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$351,107TotalRevenueColumnAmt
Exclusion$351,107ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$46,131,103SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$44,149,028SecuritiesAmt
Other$63,122OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,982,075SecuritiesAmt
Other-$63,122OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,918,953TotalRevenueColumnAmt
Related Or Exempt Func Income-$63,122RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$44UnrelatedBusinessRevenueAmt
Exclusion$1,982,031ExclusionAmt

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 (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
AFFILIATE EARNINGS621400$334,673$334,673
MISCELLANEOUS REVENUE900099$395,438$395,438
FieldValueIRS element (for citing)
Other Revenue Total$730,111OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,489,716TotalRevenueColumnAmt
Related Or Exempt Func Income$19,011,577RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$38,157UnrelatedBusinessRevenueAmt
Exclusion$1,439,982ExclusionAmt

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$2,892,832TotalAmt
Program Services$867,850ProgramServicesAmt
Management And General$2,024,982ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,431,500TotalAmt
Program Services$9,145,200ProgramServicesAmt
Management And General$2,286,300ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$398,039TotalAmt
Management And General$398,039ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$810,309TotalAmt
Program Services$648,247ProgramServicesAmt
Management And General$162,062ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$775,074TotalAmt
Program Services$620,059ProgramServicesAmt
Management And General$155,015ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$868,379TotalAmt
Management And General$868,379ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$289,279TotalAmt
Program Services$144,640ProgramServicesAmt
Management And General$144,639ManagementAndGeneralAmt

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$676,608TotalAmt
Management And General$676,608ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$665,926TotalAmt
Program Services$599,333ProgramServicesAmt
Management And General$66,593ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$11,137TotalAmt
Program Services$1,114ProgramServicesAmt
Management And General$10,023ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,162,484TotalAmt
Program Services$1,162,484ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$316,152TotalAmt
Program Services$237,114ProgramServicesAmt
Management And General$79,038ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$719,992TotalAmt
Program Services$575,994ProgramServicesAmt
Management And General$143,998ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$165,450TotalAmt
Program Services$82,725ProgramServicesAmt
Management And General$82,725ManagementAndGeneralAmt

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$679,721TotalAmt
Program Services$611,749ProgramServicesAmt
Management And General$67,972ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$830,901TotalAmt
Program Services$664,721ProgramServicesAmt
Management And General$166,180ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBTS$1,025,032$1,025,032
MEDICAL & PRO. FEES$256,453$230,808$25,645
OTHER$969,831$290,949$678,882

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$24,945,099TotalAmt
Program Services$16,908,019ProgramServicesAmt
Management And General$8,037,080ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,357,954BOYAmt
EOY$9,175EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,841,604BOYAmt
EOY$2,361,571EOYAmt

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$300EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$249,404BOYAmt
EOY$338,567EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$41,850,212LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$21,863,129LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,114,266BOYAmt
EOY$19,987,083EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$45,587,734BOYAmt
EOY$51,807,745EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$6,120,516BOYAmt
EOY$6,071,098EOYAmt

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$293,973BOYAmt
EOY$246,273EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$72,566,126BOYAmt
EOY$80,822,187EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,848,033BOYAmt
EOY$6,935,190EOYAmt

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$40,494,514BOYAmt
EOY$47,983,434EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$45,342,547BOYAmt
EOY$54,918,624EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,798,754BOYAmt
EOY$12,739,469EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$386,749BOYAmt
EOY$436,522EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,038,076BOYAmt
EOY$12,727,572EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,223,579BOYAmt
EOY$25,903,563EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$72,566,126BOYAmt
EOY$80,822,187EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$4,455,383ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,000NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$3,134,367OtherChangesInNetAssetsAmt
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
CertificationYes (X)CertificationInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeDescGoverning Document ListedGoverningDocumentListedIndSupported Org NotifiedSupportedOrgNotifiedIndUS OrganizedUSOrganizedIndSupportSupportAmt
BVRHC
34136996303falsefalseYes (true)$4,706,256
BVCCS
34600690409falsefalseYes (true)$300,078
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Support Sum$5,006,334SupportSumAmt

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$14,424,824BeginningYearBalanceAmt
Investment Earnings Or Losses$113,872InvestmentEarningsOrLossesAmt
Other Expenditures$386,164OtherExpendituresAmt
End Year Balance$14,152,532EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,540,550BeginningYearBalanceAmt
Investment Earnings Or Losses$1,260,718InvestmentEarningsOrLossesAmt
End Year Balance$14,801,268EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.96920PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.03080TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,427,222OtherCostOrOtherBasisAmt
Depreciation$4,107,607DepreciationAmt
Book Value$5,319,615BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,477,794OtherCostOrOtherBasisAmt
Depreciation$1,234,373DepreciationAmt
Book Value$243,421BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,688,331OtherCostOrOtherBasisAmt
Depreciation$14,816,634DepreciationAmt
Book Value$5,871,697BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,561,618OtherCostOrOtherBasisAmt
Depreciation$1,704,515DepreciationAmt
Book Value$1,851,103BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$19,987,083TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
VENTURES AND PARTNERSHIPS$254,875C
CARE SERVICES$5,816,223C
FieldValueIRS element (for citing)
Total Book Value Securities$6,071,098TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescADVANCES FROM AFFILIATESDesc
Amt$47,983,434Amt
FieldValueIRS element (for citing)
Total Liability$47,983,434TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$22,600,051TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,000NetUnrealizedGainsInvstAmt
Other Revenue$3,624,857OtherRevenueAmt
Revenue Not Reported$3,625,857RevenueNotReportedAmt
Revenue Subtotal$18,974,194RevenueSubtotalAmt
Other Revenues Not Included$1,515,522OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,515,522RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$20,489,716TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$23,920,067TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$23,920,067ExpensesSubtotalAmt
Other Expenses Not Included$1,025,032OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,025,032ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$24,945,099TotalExpensesPerForm990Amt

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: $3,624,857
PART XI, LINE 4BCHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS: $322,119 INVESTMENT INCOME TIMING DIFFERENCE: $168,371 BAD DEBT RECLASS $1,025,032 TOTAL: $1,515,522 PART XII, LINE 4B BAD DEBT RECLASS $1,025,032
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)
Travel For CompanionsYes (X)TravelForCompanionsInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
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 (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$482,069$0$165,208$0$44,271$0$15,300$0$25,728$0$732,575$0$0$0
DAVE CYTLAK
Chief Financial Officer$273,441$0$64,986$0$42,278$0$15,300$0$21,935$0$417,940$0$0$0
WILLIAM KOSE
Chief Quality Officer$282,316$0$70,494$0$47,517$0$15,300$0$17,392$0$433,018$0$0$0
WILLIAM WATKINS
President BVMP$18,108$136,555$0$33,914$100$3,575$1,107$8,501$348$18,784$19,663$201,329$0$0
CHRISTOPHER PRESS
President BVRHC$232,108$0$82,837$0$36,581$0$14,981$0$2,008$0$368,515$0$0$0
Dr Michael Denike
Physician$497,219$0$4,600$0$498$0$15,300$0$23,228$0$540,846$0$0$0
Dr Gary Parenteau
Physician$429,076$0$20,000$0$1,049$0$15,300$0$13,386$0$478,810$0$0$0
Dr Robert Hollis
Physician$686,144$0$0$0$11,040$0$0$0$21,806$0$718,990$0$0$0
Dr Sean Logan
Physician$892,781$0$0$0$38,480$0$0$0$25,728$0$956,989$0$0$0
Dr Martin Valdivia
Physician$322,317$0$37,500$0$13,451$0$15,300$0$24,529$0$413,097$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1BSCOTT MALANEY'S WIFE SERVED A BONA FIDE BUSINESS FUNCTION ON THE TRIP AND CLAIMED EXPENSES ARE PROPERLY SUBSTANTIATED UNDER THE RULES OF SECTION 274.
PART I, LINE 4BIn 2013, Blanchard Valley Health System contributed on behalf of Scott Malaney $140,807 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 Christopher Press and David Cytlak. In 2013, Blanchard Valley Health System contributed on behalf of Christopher Press $44,943 and contributed on behalf of David Cytlak $20,602 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 2013), 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.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonBUCKMAN LTDPersonNm
FieldValueIRS element (for citing)
Relationship Description>35% OWNED BOARDRelationshipDescriptionTxt
TransactionSEE STATEMENTTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, LINE 3FormAndLineReferenceDesc
ExplanationCHERYL BUCKLAND IS A TRUSTEE ON THE ORGANIZATION'S BOARD. SHE IS A 50% OWNER IN BUCKMAN LTD. BLANCHARD VALLEY CONTINUING CARE SERVICES, A RELATED ENTITY, HAS AN OUSTANDING LOAN TO BUCKMAN LTD FOR THE 2008 PURCHASE OF INDEPENDENCE HOUSE.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, QUESTION 1bCHERYL BUCKLAND IS A 50% OWNER OF A COMPANY THAT HAS AN OUTSTANDING LOAN TO BLANCHARD VALLEY CONTINUING CARE SERVICES, A RELATED ORGANIZATION. DUE TO THIS RELATIONSHIP, SHE IS CONSIDERED A NON INDEPENDENT VOTING MEMBER OF THE BOARD. SCOTT 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 2013 BY SULLIVAN COTTER AND ASSOCIATES (AN EXTERNAL CONSULTANT) AND SHARED/DISCUSSED WITH THE BOARD IN APRIL 2013.
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: ($322,119) INVESTMENT INCOME TIMING DIFFERENCE: ($168,371) TRANSFERS FROM AFFILIATES: 3,624,857 Total: $3,134,367

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (6 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
BLANCHARD VALLEY MEDICAL PRACTICES
1900 SOUTH MAIN STFINDLAYOH45840421659766PHYS OFCSOH$13,892,000$6,855,240BVHS
BLANCHARD VALLEY HOME CARE SERVICES
1900 SOUTH MAIN STFINDLAYOH45840421565629HOME HEALTHOHBVCCS
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STFINDLAYOH45840061748552CERT NURSEOHBVHS
NEUROSURGICAL ASSOCIATION NORTHWEST OHIO
1900 SOUTH MAIN STFINDLAYOH45840421659766PHYS OFFICEOHBVMP
SPECIALTY PHYSICIANS OF BLANCHARD VALLEY
1900 SOUTH MAIN STFINDLAYOH45840421659766PHYS OFFICEOHBVMP
BLANCHARD VALLEY REGIONAL CANCER CENTER
1900 SOUTH MAIN STFINDLAYOH45840421659766PHYS OFFICEOHBVMP

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
BLANCHARD VALLEY CONTINUING CARE SVCS
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/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeTxt
NORTHWEST OHIO MEDICAL EQUIPMENT
1900 SOUTH MAIN STFINDLAYOH45840341882390MED EQUIPMENTOHBVCCSN/A
BLANCHARD VALLEY PAIN MANAGEMENT
1900 SOUTH MAIN STFINDLAYOH45840270095470PAIN MGMTOHBVRHCN/A
TECHNICORE
PO BOX 1210FINDLAYOH45839421702910BIO-MED SUPPOOHBVRHCN/A
CREIGHTON DIALYSIS
1900 SOUTH MAIN STFINDLAYOH45840274527592DIALYSIS SVCSOHBVRHCN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmt
BIRCHAVEN ESTATES AT EASTERN WOODS LTD
15100 BRIRCHAVEN LANEFINDLAYOH45840201494204CONDOMINIUMSOHBVCCSC CORP1.00000false
CITAS INC
1900 SOUTH MAIN STFINDLAYOH45840311369708RECRUITINGOHBVHSC CORP1.00000Yes (true)
HANCO AMBULANCE INC
417 SIXTH STREETFINDLAYOH45840382048755HEALTHCAREOHBVHSC CORP1.00000Yes (true)$2,975,000$1,232,000
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$105,625,000FMV
BLANCHARD VALLEY REGIONAL HEALTH CENTER
I$56,004FMV
BLANCHARD VALLEY CONTINUING CARE SERVICES
I$60,000FMV