BLANCHARD VALLEY HEALTH SYSTEM: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- BLANCHARD VALLEY HEALTH SYSTEM (EIN 34-4428206)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-12
- IRS object ID
- 202433179349303318
- Schema version
- 2023v5.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-12T11:31:14+00:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Forvis Mazars LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 E Wayne Street Suite 600 | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344428206 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blanchard Valley Health System | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BLAN | BusinessNameControlTxt |
| Phone | 4194234500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 SOUTH MAIN STREET | AddressLine1Txt |
| City | FINDLAY | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45840 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID CYTLAK | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4194234500 | PhoneNum |
| Signature | 2024-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Aaron Hershberger | PreparerPersonNm |
| PTIN | P00961884 | PTIN |
| Phone | 2604604000 | PhoneNum |
| Preparation | 2023-11-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID CYTLAK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 SOUTH MAIN STREET | AddressLine1Txt |
| City | FINDLAY | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45840 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $67,037,406 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.bvhealthsystem.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | WE PROVIDE MANAGEMENT OVERSIGHT AND GOVERNANCE OF ALL HEALTH SYSTEM ACTIVITIES. WE ALSO OPERATE FAMILY PRACTICES, SPECIALTY PRACTICES, AND EMS AMBULANCE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 413 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $298,508 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $55,269 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $61,734,528 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $61,427,343 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,467,495 | PYInvestmentIncomeAmt |
| CY Investment Income | $835,528 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,598,000 | PYOtherRevenueAmt |
| CY Other Revenue | $3,002,000 | CYOtherRevenueAmt |
| PY Total Revenue | $66,800,023 | PYTotalRevenueAmt |
| CY Total Revenue | $65,264,871 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $105,003,685 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $107,753,169 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,955,193 | PYOtherExpensesAmt |
| CY Other Expenses | $26,217,132 | CYOtherExpensesAmt |
| PY Total Expenses | $132,958,878 | PYTotalExpensesAmt |
| CY Total Expenses | $133,970,301 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$66,158,855 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$68,705,430 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $105,479,151 | TotalAssetsBOYAmt |
| Total Assets EOY | $113,458,151 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $104,932,000 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $112,835,000 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $547,151 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $623,151 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $104,235,297 | ExpenseAmt |
| Revenue | $64,781,301 | RevenueAmt |
| Desc | BLANCHARD VALLEY HEALTH SYSTEM'S PROGRAM SERVICE REVENUE IS GENERATED BY BLANCHARD VALLEY MEDICAL PRACTICES (BVMP) AND HANCO EMERGENCY MEDICAL SERVICES (HANCO), WHICH ARE WHOLLY OWNED, DISREGARDED ENTITIES. BVMP CONSISTS OF FAMILY PRACTICE PHYSICIAN OFFICES, NEUROSURGICAL PHYSICIAN OFFICES, SPECIALTY PHYSICIAN OFFICES, AND AN URGENT CARE CENTER. BVMP IS COMMITTED TO PROVIDING EASILY ACCESSIBLE HEALTH CARE SERVICES TO ALL MEMBERS OF THE SURROUNDING COMMUNITIES THROUGH ITS FAMILY PRACTICES AND URGENT CARE CENTER. SPECIALIZED SERVICES ARE ALSO AVAILABLE, INCLUDING NEUROSURGICAL SERVICES, CANCER CARE, CARDIAC CARE, AND DIAGNOSTIC SERVICES. HANCO PROVIDES PROFESSIONAL AND EXPEDIENT AMBULANCE SERVICES AND PRE-HOSPITAL EMERGENCY MEDICAL CARE. MEDSPA PROVIDES COSMETIC MEDICAL TREATMENT CENTERS. | Desc |
| Total Program Service Expenses | $104,235,297 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 413 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID CYTLAK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4194297669 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 SOUTH MAIN STREET | AddressLine1Txt |
| City | FINDLAY | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45840 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| FRANK COSIANO MD | ||||||||
| VICE CHAIR | 0.5 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GINGER JONES | ||||||||
| CHAIRMAN | 0.5 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAMES DOWLING MD | ||||||||
| SECRETARY | 0.5 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JEFF SCHRADER | ||||||||
| TREASURER | 0.5 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MYRON LEWIS | ||||||||
| CHIEF EXECUTIVE OFFICER | 4.0 | 36.0 | Yes (X) | Yes (X) | $760,659 | $0 | $28,051 | |
| ADELE WEBB PHD | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| ANNETTE EDGINGTON | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| BETH KROETZ | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| DAN KENNARD | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| DONALD MALARKY | ||||||||
| TUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Dr Richard Polder | ||||||||
| TRUSTEE | 38.0 | 2.0 | Yes (X) | $375,991 | $0 | $26,284 | ||
| JOHN REINEKE | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| KIMBERLY STUMPP | ||||||||
| IMMEDIATE PAST CHAIR | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL BROUGH | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD STATES DHSC | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM HOPKINS MD | ||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Barbara J Pasztor | ||||||||
| VP CHIEF NURSING OFFICER | 4.0 | 36.0 | Yes (X) | $283,080 | $0 | $24,157 | ||
| Dave Cytlak | ||||||||
| Chief Financial Officer | 4.0 | 36.0 | Yes (X) | $486,032 | $0 | $28,546 | ||
| DR Andrius Vytautas Giedraitis | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $1,254,524 | $0 | $18,092 | Yes (X) | ||
| DR Douglas W Yoder | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $873,513 | $0 | $21,674 | Yes (X) | ||
| DR Evan R McBeath | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $951,082 | $0 | $21,160 | Yes (X) | ||
| DR James R Bailey | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $880,512 | $0 | $21,364 | Yes (X) | ||
| DR THOMAS KINDL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $1,556,232 | $0 | $27,117 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,421,625 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $216,445 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| TECHNICORE | ||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | MEDICAL EQUIPMENT SERVICES | $2,074,834 | |
| PROLINK HEALTHCARE LLC | ||||||
| 10700 MONTGOMERY ROAD | CINCINNATI | OH | 45242 | CONTRACT WAGES | $1,414,943 | SUITE 226 |
| NW OHIO MEDICINE PHYSICIANS LLC | ||||||
| 400 GALLERIA PKWY | ATLANTA | GA | 30339 | HOSPITALISTS | $822,736 | STE 960 |
| BLANCHARD VALLEY PATHOLOGY AND LAB | ||||||
| 1900 SOUTH MAIN STREE | FINDLAY | OH | 45840 | PATHOLOGY SERVICES | $780,000 | |
| DINSMORE & SHOHL LLP | ||||||
| PO BOX 639038 | CINCINNATI | OH | 45263 | LEGAL SERVICES | $677,703 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 42 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $59,840,000 | $59,840,000 |
| MANAGEMENT ALLOCATIONS TO RELATED ENTITIES | 900099 | $1,587,343 | $1,587,343 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $61,427,343 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $438,566 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $298,508 | UnrelatedBusinessRevenueAmt |
| Exclusion | $140,058 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $134,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $134,000 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $134,000 | TotalRevenueColumnAmt |
| Exclusion | $134,000 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,714,539 | SecuritiesAmt |
| Other | $454,958 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,772,535 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$57,996 | SecuritiesAmt |
| Other | $454,958 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $396,962 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $454,958 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$57,996 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MISCELLANEOUS | 900099 | $2,899,000 | $2,899,000 | |
| EQUITY INVESTMNETS | 621400 | -$31,000 | -$31,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,868,000 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,264,871 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $64,781,301 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $298,508 | UnrelatedBusinessRevenueAmt |
| Exclusion | $185,062 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,598,622 | TotalAmt |
| Program Services | $1,039,449 | ProgramServicesAmt |
| Management And General | $1,559,173 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,757,836 | TotalAmt |
| Program Services | $70,206,269 | ProgramServicesAmt |
| Management And General | $17,551,567 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,266,755 | TotalAmt |
| Management And General | $3,266,755 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,503,521 | TotalAmt |
| Program Services | $6,802,817 | ProgramServicesAmt |
| Management And General | $1,700,704 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,626,435 | TotalAmt |
| Program Services | $4,501,148 | ProgramServicesAmt |
| Management And General | $1,125,287 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,274,784 | TotalAmt |
| Program Services | $637,392 | ProgramServicesAmt |
| Management And General | $637,392 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,089,541 | TotalAmt |
| Program Services | $3,680,587 | ProgramServicesAmt |
| Management And General | $408,954 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,648 | TotalAmt |
| Program Services | $44,683 | ProgramServicesAmt |
| Management And General | $4,965 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,777,149 | TotalAmt |
| Program Services | $2,644,004 | ProgramServicesAmt |
| Management And General | $1,133,145 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,529,861 | TotalAmt |
| Program Services | $1,897,396 | ProgramServicesAmt |
| Management And General | $632,465 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,943,794 | TotalAmt |
| Program Services | $1,555,035 | ProgramServicesAmt |
| Management And General | $388,759 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $689,608 | TotalAmt |
| Program Services | $344,804 | ProgramServicesAmt |
| Management And General | $344,804 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,000 | TotalAmt |
| Management And General | $39,000 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,353,820 | TotalAmt |
| Program Services | $1,883,056 | ProgramServicesAmt |
| Management And General | $470,764 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $818,370 | TotalAmt |
| Program Services | $654,696 | ProgramServicesAmt |
| Management And General | $163,674 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,391,519 | $4,391,519 | |
| PROVISION FOR BAD DEBTS | $2,765,682 | $2,765,682 | |
| DUES & SUBSCRIPTIONS | $832,491 | $624,368 | $208,123 |
| MEDICAL & PROFESSIONAL FEES | $542,752 | $488,476 | $54,276 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,113 | TotalAmt |
| Program Services | $73,916 | ProgramServicesAmt |
| Management And General | $45,197 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,970,301 | TotalAmt |
| Program Services | $104,235,297 | ProgramServicesAmt |
| Management And General | $29,735,004 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,447,151 | BOYAmt |
| EOY | $9,477,151 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,740,000 | BOYAmt |
| EOY | $7,920,000 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,000 | BOYAmt |
| EOY | $31,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,761,000 | BOYAmt |
| EOY | $5,532,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $89,581,000 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,441,000 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,787,000 | BOYAmt |
| EOY | $52,140,000 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,094,000 | BOYAmt |
| EOY | $29,232,000 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,903,000 | BOYAmt |
| EOY | $5,906,000 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,715,000 | BOYAmt |
| EOY | $3,220,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,479,151 | BOYAmt |
| EOY | $113,458,151 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,231,000 | BOYAmt |
| EOY | $46,287,000 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,701,000 | BOYAmt |
| EOY | $66,548,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,932,000 | BOYAmt |
| EOY | $112,835,000 | EOYAmt |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $573,000 | BOYAmt |
| EOY | $635,000 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$25,849 | BOYAmt |
| EOY | -$11,849 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $547,151 | BOYAmt |
| EOY | $623,151 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,479,151 | BOYAmt |
| EOY | $113,458,151 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$68,705,430 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,466,000 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $66,315,430 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 3 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (3 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| BLANCHARD VALLEY REGIONAL HEALTH CENTER | ||||
| 341369963 | 3 | Yes (true) | $1,262,036 | $0 |
| BLANCHARD VALLEY CONTINUING CARE SERVICES | ||||
| 346006904 | 9 | Yes (true) | $318,722 | $0 |
| BLANCHARD VALLEY HEALTH FOUNDATION | ||||
| 341370522 | 7 | Yes (true) | $6,584 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 3 | SupportedOrganizationsTotalCnt |
| Support Sum | $1,587,342 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $0 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $0 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
| Public Support PY170 | 0.0 | PublicSupportPY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Public Support PY509 | 0.0 | PublicSupportPY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
| Investment Income PY | 0.0 | InvestmentIncomePYPct |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (true) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | false | OperateBenefitNonSuprtOrgInd |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Adj Net Income Distributable | $0 | CYAdjNetIncomeDistributableAmt |
| CY Pct85 Adjusted Net Income | $0 | CYPct85AdjustedNetIncomeAmt |
| CY Total Min Ast Distributable | $0 | CYTotalMinAstDistributableAmt |
| CY Greater Adjusted Minimum | $0 | CYGreaterAdjustedMinimumAmt |
| CY Income Tax Imposed PY | $0 | CYIncomeTaxImposedPYAmt |
| CY Distributable As Adjusted | $0 | CYDistributableAsAdjustedAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $554,817 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $60,149 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,063 | OtherExpendituresAmt |
| End Year Balance | $608,903 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $609,350 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$50,657 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,876 | OtherExpendituresAmt |
| End Year Balance | $554,817 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $612,151 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $66,890 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $69,691 | OtherExpendituresAmt |
| End Year Balance | $609,350 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $574,864 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $69,885 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $32,598 | OtherExpendituresAmt |
| End Year Balance | $612,151 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $470,566 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $105,698 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,400 | OtherExpendituresAmt |
| End Year Balance | $574,864 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.6443 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.3557 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,227,499 | OtherCostOrOtherBasisAmt |
| Book Value | $9,227,499 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,590,198 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,051,158 | DepreciationAmt |
| Book Value | $21,539,040 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,035,782 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,791,489 | DepreciationAmt |
| Book Value | $244,293 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,654,481 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,440,993 | DepreciationAmt |
| Book Value | $7,213,488 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,073,040 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,157,360 | DepreciationAmt |
| Book Value | $13,915,680 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $52,140,000 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN EQUITY INTEREST | Desc |
| Book Value | $5,906,000 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $5,906,000 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| ADVANCES FROM AFFILIATES | $51,137,000 |
| LEASE LIABILITY | $1,968,000 |
| DEFERRED REVENUE | $94,000 |
| OTHER LONG-TERM OBLIGATIONS | $12,634,000 |
| CURRENT MATURITIES OF LONG-TER | $75,000 |
| LONG TERM DEBT | $640,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $66,548,000 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $131,280,619 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,466,000 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $66,471,000 | OtherRevenueAmt |
| Revenue Not Reported | $68,937,000 | RevenueNotReportedAmt |
| Revenue Subtotal | $62,343,619 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,921,252 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,921,252 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $65,264,871 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $131,204,619 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $131,204,619 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,765,682 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,765,682 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $133,970,301 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part X, Line 2 ASC 740 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| Schedule D, Part V, Line 4 Intended uses of endowment funds | ENDOWMENT FUNDS ARE UTILIZED FOR DONOR DESIGNATED PURPOSES, INCLUDING CHARITY CARE, CAPITAL PROJECTS AND PURCHASES, AND CONTINUING EDUCATION FOR STAFF AND PHYSICIANS. |
| Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 | TRANSFERS FROM AFFILIATES - 66440000 CHANGE IN BENEFICIAL INTERE IN PERPETUAL TRUST - 31000 |
| Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements | BAD DEBT RECLASS - 2765682 INVESTMENT INCOME TIMING DIFFERENCE - 155570 |
| Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements | BAD DEBT RECLASS - 2765682 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MYRON LEWIS | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $703,010 | $0 | $0 | $0 | $57,649 | $0 | $13,200 | $0 | $14,851 | $0 | $788,710 | $0 | $0 | $0 |
| Dr Richard Polder | ||||||||||||||
| TRUSTEE | $297,210 | $0 | $32,601 | $0 | $46,180 | $0 | $13,200 | $0 | $13,084 | $0 | $402,275 | $0 | $0 | $0 |
| Dave Cytlak | ||||||||||||||
| Chief Financial Officer | $442,673 | $0 | $0 | $0 | $43,359 | $0 | $19,800 | $0 | $8,746 | $0 | $514,578 | $0 | $0 | $0 |
| Barbara J Pasztor | ||||||||||||||
| VP CHIEF NURSING OFFICER | $250,525 | $0 | $0 | $0 | $32,555 | $0 | $17,130 | $0 | $7,027 | $0 | $307,237 | $0 | $0 | $0 |
| DR THOMAS KINDL | ||||||||||||||
| PHYSICIAN | $568,593 | $0 | $961,570 | $0 | $26,069 | $0 | $13,200 | $0 | $13,917 | $0 | $1,583,349 | $0 | $0 | $0 |
| DR Andrius Vytautas Giedraitis | ||||||||||||||
| PHYSICIAN | $422,616 | $0 | $807,244 | $0 | $24,664 | $0 | $13,200 | $0 | $4,892 | $0 | $1,272,616 | $0 | $0 | $0 |
| DR Evan R McBeath | ||||||||||||||
| PHYSICIAN | $577,732 | $0 | $252,425 | $0 | $120,925 | $0 | $13,200 | $0 | $7,960 | $0 | $972,242 | $0 | $0 | $0 |
| DR James R Bailey | ||||||||||||||
| PHYSICIAN | $616,611 | $0 | $261,030 | $0 | $2,871 | $0 | $13,200 | $0 | $8,164 | $0 | $901,876 | $0 | $0 | $0 |
| DR Douglas W Yoder | ||||||||||||||
| PHYSICIAN | $673,068 | $0 | $66,231 | $0 | $134,214 | $0 | $13,200 | $0 | $8,474 | $0 | $895,187 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 4c | FormAndLineReferenceDesc |
| Explanation | IN 2023, BLANCHARD VALLEY HEALTH SYSTEM CALCULATED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) PAYMENTS TO BE CONTRIBUTED IN 2023. $96,553 WILL BE CONTRIBUTED ON BEHALF OF MYRON LEWIS TO A SERP IN 2024. SERP CONTRIBUTIONS IN THE AMOUNT OF $90,461 WERE MADE FOR THE BENEFIT OF MYRON LEWIS IN 2023. 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 2022, BLANCHARD VALLEY HEALTH SYSTEM CACLULATED SERP PAYMENTS TO BE CONTRIBUTED IN 2024. $27,474 WILL BE CONTRIBUTED ON BEHALF OF DAVID CYTLAK TO THE SERP IN 2023. SERP CONTRIBUTIONS IN THE AMOUNT OF $26,713 WERE MADE FOR THE BENEFIT OF DAVID CYTLAK IN 2023. KEY FEATURES OF THE SERP, AS AMENDED AND RESTATED IN 2010/2011, INCLUDE THE FOLLOWING: * ELIGIBILITY IS LIMITED TO CERTAIN MANAGEMENT OR HIGHLY-COMPENSATED EMPLOYEES OF BVHS (I.E., TOP HAT REFERENCE). FUTURE PARTICIPATION IS UPON NOMINATION BY THE CEO AND APPROVAL BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. **EMPLOYEE CONTRIBUTIONS TO THE SERP ACCOUNT ARE NOT ALLOWED. *EACH PARTICIPANT'S 457(B) ACCOUNT WILL BE CREDITED UP TO THE STATUTORY LIMIT ($20,500 IN 2022), 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 0-5 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A DETAILED REVIEW OF THE FORM 990 IS PERFORMED BY 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 FOR REVIEW. ANY QUESTIONS ARISING FROM BOARD MEMBERS ARE ADDRESSED BY THE COMPLIANCE AND AUDIT COMMITTEE, UPPER MANAGEMENT, THE ACCOUNTING DEPARTMENT, AND/OR EXTERNAL ACCOUNTANTS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | ANNUALLY, THE ORGANIZATION ASKS ITS BOARD MEMBERS, CORPORATE OFFICERS, UPPER MANAGEMENT, AND KEY EMPLOYEES TO COMPLETE CONFLICT OF INTEREST SURVEYS. THESE SURVEYS ALSO INCLUDE RELATIONSHIP & ACTIVITY QUESTIONS THAT THESE INDIVIDUALS ARE ASKED TO COMPLETE 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, Line 15a Process to establish compensation of top management official | THE ORGANIZATION REVIEWS EXECUTIVE COMPENSATION, BENEFITS, AND PREREQUISITES ON A PERIODIC BASIS TO ENSURE CONSISTENCY WITH COMPENSATION PHILOSOPHY AND MARKET PRACTICE. A SUBSET OF MEMBERS FROM THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION 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 COMMITTEE ANNUALLY ENGAGES SULLIVAN COTTER AND ASSOCIATES, AN EXTERNAL COMPENSATION CONSULTING FIRM, TO ASSESS THE REASONABLENESS OF THE COMPENSATION PROGRAM USED FOR ITS EXECUTIVES. THE COMMITTEE ALSO PERIODICALLY PERFORMS A FULL BENEFIT ANALYSIS AND REVIEW WITH SULLIVAN COTTER AND ASSOCIATES AS PART OF THIS PROCESS. 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 EXECUTIVE COMPENSATION COMMITTEE'S WORK IS ALSO SHARED/DISCUSSED WITH THE BOARD. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | THE SAME PROCESS APPLIES FOR ALL OTHER EXECUTIVE STEERING COMMITTEE MEMBERS AS DETAILED FOR THE CEO. |
| Form 990, Part VI, Line 19 Required documents available to the public | FINANCIAL STATEMENTS, REQUIRED TAX FORMS (I.E., FORM 990), AS WELL AS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH THE ADMINISTRATIVE AND FINANCE OFFICES. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | INVESTMENT INCOME TIMING DIFFERENCE - -155570; TRANSFERS FROM AFFILIATES - 66440000; CHANGE IN BENEFICIAL INTERE IN PERPETUAL TRUST - 31000; |
| FORM 990, PART VI, LINE 1B Independent voting members | MYRON LEWIS AND DR. RICHARD POLDER ARE BOARD MEMBERS AND ARE PAID EMPLOYEES OF A RELATED ORGANIZATION. DUE TO THEIR EMPLOYMENT, THEY ARE CONSIDERED NON-INDEPENDENT VOTING MEMBERS OF THE BOARD. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| BLANCHARD VALLEY MEDICAL PRACTICES LLC | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 421659766 | PHYS OFFICE | OH | BVHS |
| BLANCHARD VALLEY HOME CARE SERVICES LLC | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 421565629 | HOME HEALTH | OH | BVCCS |
| CRNA OF BLANCHARD VALLEY LLC | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 061748552 | CERT NURSE | OH | BVRHC |
| NEUROSURGICAL ASSOCIATES OF NW OHIO LLC | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 342052585 | PHYS OFFICE | OH | BVMP |
| SPECIALTY PHYSICIANS OF BLANCHARD VALLEY | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 262448601 | PHYS OFFICE | OH | BVMP |
| BLANCHARD VALLEY REGIONAL CANCER CENTER | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 050623393 | PHYS OFFICE | OH | BVMP |
| HANCO EMERGENCY MEDICAL SERVICES LLC | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 463299390 | AMBULANCE SER | OH | BVHS |
| BEYOND MEDSPA LLC | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 814440286 | COSMETIC SPA | OH | BVHS |
| BIRCHAVEN ESTATES AT EASTERN WOODS LTD | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 201494204 | CONDOMINIUMS | OH | BVCCS |
| FINDLAY SURGERY CENTER LTD | |||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 870620245 | SURG CNTR | OH | BVRHC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BLANCHARD VALLEY CONTINUING CARE SERVICE | ||||||||||
| 15100 BIRCHAVEN LANE | FINDLAY | OH | 45840 | 346006904 | CONT. CARE | OH | 501(c)(3) | 10 | BVHS | Yes (true) |
| BLANCHARD VALLEY REGIONAL HEALTH CENTER | ||||||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 341369963 | ACUTE CARE | OH | 501(c)(3) | 3 | BVHS | Yes (true) |
| BLANCHARD VALLEY HEALTH FOUNDATION | ||||||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 341370522 | FUNDRAISING | OH | 501(c)(3) | 7 | BVHS | Yes (true) |
| EC EDWARDS MEMORIAL TRUST FBO FINDLAY | ||||||||||
| 1900 SOUTH MAIN STREET | FINDLAY | OH | 45840 | 346953719 | INVESTMENT | OH | 501(c)(3) | Type I | BVHF | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|
| NORTHWEST OHIO MEDICAL EQUIPMENT | |||||||
| 1900 SOUTH MAIN ST | FINDLAY | OH | 45840 | MED EQUIPMENT | OH | BVCCS | Related |
| BLANCHARD VALLEY PAIN MANAGEMENT | |||||||
| 1900 SOUTH MAIN ST | FINDLAY | OH | 45840 | PAIN MGMT | OH | BVRHC | Related |
| TECHNICORE CLINICAL ENGINEERING | |||||||
| 1900 SOUTH MAIN ST | FINDLAY | OH | 45840 | BIO-MED SUPPO | OH | BVRHC | Related |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITAS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 SOUTH MAIN STREET | AddressLine1Txt |
| City | FINDLAY | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45840 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311369708 | EIN |
| Primary Activities | RECRUITING | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BVHS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C Corporation | EntityTypeTxt |
| Ownership | 1 | OwnershipPct |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLANCHARD VALLEY REGIONAL HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionTypeTxt |
| Involved | $64,440,000 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part I IDENTIFICATION OF DISREGARDED ENTITIES | FormAndLineReferenceDesc |
| Explanation | (A) NAME/ADDRESS/EIN (B) PRIMARY ACTIVITY (C) LEGAL DOMICILE (D) TOTAL INCOME (E)EOY ASSETS (F) DIRECT CONTROL ---------------------------------------------------------------------------------------------------------------------------------- BLANCHARD VALLEY MEDICAL PRACTICES, LLC 42-1659766 1900 SOUTH MAIN STREET FINDLAY, OH 45840 PHYS OFFICE OH 52,662,922. 18,822,318. BVHS BLANCHARD VALLEY HOME CARE SERVICES, LLC 42-1565629 1900 SOUTH MAIN STREET FINDLAY, OH 45840 HOME HEALTH OH BVCCS CRNA OF BLANCHARD VALLEY, LLC 06-1748552 1900 SOUTH MAIN STREET FINDLAY, OH 45840 CERT NURSE OH BVRHC NEUROSURGICAL ASSOCIATES OF NW OHIO, LLC 34-2052585 1900 SOUTH MAIN STREET FINDLAY, OH 45840 PHYS OFFICE OH BVMP SPECIALTY PHYSICIANS OF BLANCHARD VALLEY 26-2448601 1900 SOUTH MAIN STREET FINDLAY, OH 45840 PHYS OFFICE OH BVMP BLANCHARD VALLEY REGIONAL CANCER CENTER 05-0623393 1900 SOUTH MAIN STREET FINDLAY, OH 45840 PHYS OFFICE OH BVMP HANCO EMERGENCY MEDICAL SERVICES, LLC 46-3299390 417 SIXTH STREET FINDLAY, OH 45840 AMBULANCE SER OH 3,718,891. 414,207. BVHS BEYOND MEDSPA LLC 81-4440286 1900 SOUTH MAIN STREET FINDLAY, OH 45840 COSMETIC SPA OH BVHS BIRCHAVEN ESTATES AT EASTERN WOODS, LTD. 20-1494204 1900 SOUTH MAIN STREET FINDLAY, OH 45840 CONDOMINIUMS OH BVCCS FINDLAY SURGERY CENTER, LTD 87-0620245 1900 S MAIN ST FINDLAY, OH 45840 SURG CNTR OH BVRHC | ExplanationTxt |