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BLANCHARD VALLEY HEALTH SYSTEM: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
BLANCHARD VALLEY HEALTH SYSTEM (EIN 34-4428206)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-14
IRS object ID
202343189349302744
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-14T08:47:23-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FORVIS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 E Wayne St Suite 600AddressLine1Txt
CityFort WayneCityNm
State AbbreviationINStateAbbreviationCd
ZIP46802ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN344428206EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID CYTLAKPersonNm
Person TitleCFOPersonTitleTxt
Phone4194234500PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDAVIDPersonFirstNm
Person LastCYTLAKPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAARON D HERSHBERGERPreparerPersonNm
PTINP00961884PTIN
Phone2604604000PhoneNum
Preparation2023-11-15PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID CYTLAKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1Txt
CityFINDLAYCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45840ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$69,535,143GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BVHEALTHSYSTEM.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1951FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionWE PROVIDE MANAGEMENT OVERSIGHT AND GOVERNANCE OF ALL HEALTH SYSTEM ACTIVITIES. WE ALSO OPERATE FAMILY PRACTICES, SPECIALTY PRACTICES, AND EMS AMBULANCE SERVICES.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee415TotalEmployeeCnt
Total Volunteers21TotalVolunteersCnt
Total Gross UBI$262,731TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$48,126NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$58,770,624PYProgramServiceRevenueAmt
CY Program Service Revenue$61,734,528CYProgramServiceRevenueAmt
PY Investment Income$3,463,420PYInvestmentIncomeAmt
CY Investment Income$1,467,495CYInvestmentIncomeAmt
PY Other Revenue$10,750,000PYOtherRevenueAmt
CY Other Revenue$3,598,000CYOtherRevenueAmt
PY Total Revenue$72,984,044PYTotalRevenueAmt
CY Total Revenue$66,800,023CYTotalRevenueAmt
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$98,518,805PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$105,003,685CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$34,992,699PYOtherExpensesAmt
CY Other Expenses$27,955,193CYOtherExpensesAmt
PY Total Expenses$133,511,504PYTotalExpensesAmt
CY Total Expenses$132,958,878CYTotalExpensesAmt
PY Revenues Less Expenses-$60,527,460PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$66,158,855CYRevenuesLessExpensesAmt
Total Assets BOY$134,673,501TotalAssetsBOYAmt
Total Assets EOY$105,479,151TotalAssetsEOYAmt
Total Liabilities BOY$132,603,000TotalLiabilitiesBOYAmt
Total Liabilities EOY$104,932,000TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,070,501NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$547,151NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION: OUR EXTRAORDINARY PEOPLE PROVIDE CARING FOR A LIFETIME THROUGH A BROAD CONTINUUM OF EXCEPTIONAL HEALTH-RELATED SERVICES IN NORTHWEST OHIO.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$102,700,289ExpenseAmt
Revenue$65,224,528RevenueAmt
DescBLANCHARD 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$102,700,289TotalProgramServiceExpensesAmt
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
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
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
Employee415EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID CYTLAKPersonNm
Phone4194234500PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndKey EmployeeKeyEmployeeInd
DR THOMAS KINDL
PHYSICIAN40.00.0Yes (X)$1,525,182$0$25,900
DR ANDRIUS GIEDRAITIS
PHYSICIAN40.00.0Yes (X)$1,291,502$0$16,879
DR DOUGLAS YODER
PHYSICIAN40.00.0Yes (X)$960,031$0$20,385
DR JAMES BAILEY
PHYSICIAN40.00.0Yes (X)$804,425$0$20,997
DR TOM ZHOU
PHYSICIAN40.00.0Yes (X)$795,411$0$17,029
MYRON LEWIS
CHIEF EXECUTIVE OFFICER2.038.0$779,794$0$26,386Yes (X)Yes (X)
DAVE CYTLAK
CHIEF FINANCIAL OFFICER2.038.0$491,422$0$24,620Yes (X)
DR RENEE SMITH
CHIEF MEDICAL OFFICER40.00.0$407,213$0$13,871Yes (X)
DR RICHARD POLDER
TRUSTEE38.02.0$381,109$0$24,491Yes (X)
BARBARA PASZTOR
VP OF NURSING40.00.0$301,471$0$31,096Yes (X)
JAMES WELLMAN
CHIEF INFORMATION OFFICER4.036.0$313,160$0$0Yes (X)
KELLY SHROLL
PRESIDENT OF BVMP40.00.0$285,100$0$19,406Yes (X)
DR WILLIAM KOSE
VP OF SPECIAL PROJECTS4.036.0$194,230$0$15,100Yes (X)
KIMBERLY STUMPP
CHAIRMAN0.51.0$0$0$0Yes (X)
GINGER JONES
VICE CHAIR0.51.0$0$0$0Yes (X)Yes (X)
JOSEPH LONGO
TREASURER0.51.0$0$0$0Yes (X)Yes (X)
JAMES PF DOWLING
SECRETARY0.51.0$0$0$0Yes (X)Yes (X)
FRANK A COSIANO
TRUSTEE0.51.0$0$0$0Yes (X)
CHERYL BUCKLAND
TRUSTEE0.51.0$0$0$0Yes (X)
MICHAEL BROUGH
TRUSTEE0.51.0$0$0$0Yes (X)
DAN KENNARD
TRUSTEE0.51.0$0$0$0Yes (X)
BETH KROETZ
TRUSTEE0.51.0$0$0$0Yes (X)
RICHARD STATES
TRUSTEE0.51.0$0$0$0Yes (X)
ADELE WEBB
TRUSTEE0.51.0$0$0$0Yes (X)
JOHN REINEKE
TRUSTEE0.51.0$0$0$0Yes (X)
JEFF SHRADER
TRUSTEE0.51.0$0$0$0Yes (X)
JAMIE STALL
TRUSTEE0.51.0$0$0$0Yes (X)
WILLIAM HOPKINS MD
TRUSTEE0.51.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,530,050TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$256,160TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K43IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PROLINK HEALTHCARE LLC
10700 MONTGOMERY ROAD SUITE 226CINCINNATIOH45242CONTRACT WAGES$2,619,655
BLANCHARD VALLEY PATHOLOGY AND LAB
1900 SOUTH MAIN STREETFINDLAYOH45840PATHOLOGY SERVICES$780,000
JDP VENTURES LLC
301 S MAIN STREETFINDLAYOH45840REAL ESTATE RENT$584,740
IRB MEDICAL EQUIPMENT LLC
5445 ALU DR STE CGRAND BLANCMI48439MEDICAL EQUIP. SERV.$591,381
TECHNICORE
1900 SOUTH MAIN STREETFINDLAYOH45840MED EQUIP. SERVICES$1,901,490
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K39CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$60,222,000$60,222,000
MANAGEMENT ALLOCATIONS TO RELATED ENTITIES900099$1,512,528$1,512,528
FieldValueIRS element (for citing)
Total Program Service Revenue$61,734,528TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,328,725TotalRevenueColumnAmt
Unrelated Business Revenue$262,731UnrelatedBusinessRevenueAmt
Exclusion$1,065,994ExclusionAmt

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$154,000RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$154,000RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$154,000TotalRevenueColumnAmt
Exclusion$154,000ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,873,891SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,735,120SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$138,771SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$138,770TotalRevenueColumnAmt
Exclusion$138,770ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
MISCELLANEOUS900099$3,490,000$3,490,000
EQUITY INVESTMNETS621400-$46,000-$46,000
FieldValueIRS element (for citing)
Other Revenue Total$3,444,000OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$66,800,023TotalRevenueColumnAmt
Related Or Exempt Func Income$65,224,528RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$262,731UnrelatedBusinessRevenueAmt
Exclusion$1,312,764ExclusionAmt

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$2,772,390TotalAmt
Program Services$1,108,956ProgramServicesAmt
Management And General$1,663,434ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$86,176,426TotalAmt
Program Services$68,941,141ProgramServicesAmt
Management And General$17,235,285ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,913,406TotalAmt
Management And General$2,913,406ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,693,251TotalAmt
Program Services$6,154,601ProgramServicesAmt
Management And General$1,538,650ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,448,212TotalAmt
Program Services$4,358,570ProgramServicesAmt
Management And General$1,089,642ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,897,014TotalAmt
Program Services$948,507ProgramServicesAmt
Management And General$948,507ManagementAndGeneralAmt

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$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,497,884TotalAmt
Program Services$3,148,096ProgramServicesAmt
Management And General$349,788ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$68,229TotalAmt
Program Services$61,406ProgramServicesAmt
Management And General$6,823ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,520,081TotalAmt
Program Services$2,464,057ProgramServicesAmt
Management And General$1,056,024ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,685,395TotalAmt
Program Services$1,264,046ProgramServicesAmt
Management And General$421,349ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,068,217TotalAmt
Program Services$1,654,574ProgramServicesAmt
Management And General$413,643ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$768,296TotalAmt
Program Services$384,148ProgramServicesAmt
Management And General$384,148ManagementAndGeneralAmt

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$42,500TotalAmt
Management And General$42,500ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,304,974TotalAmt
Program Services$2,643,979ProgramServicesAmt
Management And General$660,995ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$657,193TotalAmt
Program Services$525,754ProgramServicesAmt
Management And General$131,439ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBTS$2,826,772$2,826,772
MEDICAL SUPPLIES$4,689,584$4,689,584
DUES & SUBSCRIPTIONS$757,877$568,408$189,469
MEDICAL & PROFESSIONAL FEES$487,961$439,165$48,796

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,683,216TotalAmt
Program Services$518,525ProgramServicesAmt
Management And General$1,164,691ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$132,958,878TotalAmt
Program Services$102,700,289ProgramServicesAmt
Management And General$30,258,589ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$14,796,501BOYAmt
EOY$2,447,151EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,671,000BOYAmt
EOY$10,740,000EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$37,000BOYAmt
EOY$32,000EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,753,000BOYAmt
EOY$3,761,000EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$75,517,000LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$34,730,000LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$40,330,000BOYAmt
EOY$40,787,000EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$57,279,000BOYAmt
EOY$40,094,000EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$5,942,000BOYAmt
EOY$5,903,000EOYAmt

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$2,865,000BOYAmt
EOY$1,715,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$134,673,501BOYAmt
EOY$105,479,151EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$50,223,000BOYAmt
EOY$41,231,000EOYAmt

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$82,380,000BOYAmt
EOY$63,701,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$132,603,000BOYAmt
EOY$104,932,000EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,445,501BOYAmt
EOY$573,000EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$625,000BOYAmt
EOY-$25,849EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,070,501BOYAmt
EOY$547,151EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$134,673,501BOYAmt
EOY$105,479,151EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$66,158,855ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$10,372,000NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$75,007,505OtherChangesInNetAssetsAmt
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 RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

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

Supported Org Information SupportedOrgInformationGrp (3 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
BLANCHARD VALLEY REGIONAL HEALTH CENTER
3413699633Yes (true)$966,834$0
BLANCHARD VALLEY CONTINUING CARE SERVICES
34600690410Yes (true)$272,562$0
BLANCHARD VALLEY HEALTH FOUNDATION
3413705227Yes (true)$4,954$0
FieldValueIRS element (for citing)
Supported Organizations Total3SupportedOrganizationsTotalCnt
Support Sum$1,244,350SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

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

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

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

Schedule D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$609,350BeginningYearBalanceAmt
Investment Earnings Or Losses-$50,657InvestmentEarningsOrLossesAmt
Other Expenditures$3,876OtherExpendituresAmt
End Year Balance$554,817EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$612,151BeginningYearBalanceAmt
Investment Earnings Or Losses$66,890InvestmentEarningsOrLossesAmt
Other Expenditures$69,691OtherExpendituresAmt
End Year Balance$609,350EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$574,864BeginningYearBalanceAmt
Investment Earnings Or Losses$69,885InvestmentEarningsOrLossesAmt
Other Expenditures$32,598OtherExpendituresAmt
End Year Balance$612,151EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$470,566BeginningYearBalanceAmt
Investment Earnings Or Losses$105,698InvestmentEarningsOrLossesAmt
Other Expenditures$1,400OtherExpendituresAmt
End Year Balance$574,864EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$492,357BeginningYearBalanceAmt
Investment Earnings Or Losses-$9,147InvestmentEarningsOrLossesAmt
Other Expenditures$12,644OtherExpendituresAmt
End Year Balance$470,566EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.70710PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.29290TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,262,499OtherCostOrOtherBasisAmt
Book Value$9,262,499BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$31,180,291OtherCostOrOtherBasisAmt
Depreciation$9,563,849DepreciationAmt
Book Value$21,616,442BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,968,671OtherCostOrOtherBasisAmt
Depreciation$1,762,513DepreciationAmt
Book Value$206,158BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,588,120OtherCostOrOtherBasisAmt
Depreciation$21,344,859DepreciationAmt
Book Value$7,243,261BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,517,419OtherCostOrOtherBasisAmt
Depreciation$2,058,779DepreciationAmt
Book Value$2,458,640BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$40,787,000TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN EQUITY INTERESTDesc
Book Value$5,903,000BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$5,903,000TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
ADVANCES FROM AFFILIATES$48,886,000
LEASE LIABILITY$671,000
DEFERRED REVENUE$113,000
OTHER LONG-TERM OBLIGATIONS$13,246,000
CURRENT MATURITIES OF LONG-TER$70,000
LONG TERM DEBT$715,000
FieldValueIRS element (for citing)
Total Liability$63,701,000TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$128,608,756TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$10,372,000NetUnrealizedGainsInvstAmt
Other Revenue$75,260,000OtherRevenueAmt
Revenue Not Reported$64,888,000RevenueNotReportedAmt
Revenue Subtotal$63,720,756RevenueSubtotalAmt
Other Revenues Not Included$3,079,267OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$3,079,267RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$66,800,023TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$130,132,106TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$130,132,106ExpensesSubtotalAmt
Other Expenses Not Included$2,826,772OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,826,772ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$132,958,878TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS ARE UTILIZED FOR DONOR DESIGNATED PURPOSES, INCLUDING CHARITY CARE, CAPITAL PROJECTS AND PURCHASES, AND CONTINUING EDUCATION FOR STAFF AND PHYSICIANS.
PART XI, LINE 2DTRANSFERS FROM AFFILIATES $75,260,000
PART XI LINE 4BBAD DEBT RECLASS $2,826,772 INVESTMENT INCOME TIMING DIFFERENCE $ 252,495 TOTAL $3,079,267
PART XII LINE 4BBAD DEBT RECLASS $2,826,772
ASC 740MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
MYRON LEWIS
CHIEF EXECUTIVE OFFICER$608,452$149,600$21,742$12,200$14,186$806,180
DAVE CYTLAK
CHIEF FINANCIAL OFFICER$387,651$67,316$36,455$18,300$6,320$516,042
JAMES WELLMAN
CHIEF INFORMATION OFFICER$266,610$45,541$1,009$313,160
DR WILLIAM KOSE
VP OF SPECIAL PROJECTS$164,780$29,049$401$10,158$4,942$209,330
BARBARA PASZTOR
VP OF NURSING$254,077$46,376$1,018$15,955$15,141$332,567
KELLY SHROLL
PRESIDENT OF BVMP$242,940$41,240$920$14,794$4,612$304,506
DR RENEE SMITH
CHIEF MEDICAL OFFICER$398,682$6,954$1,577$13,871$421,084
DR THOMAS KINDL
PHYSICIAN$532,551$990,304$2,327$12,200$13,700$1,551,082
DR ANDRIUS GIEDRAITIS
PHYSICIAN$445,762$844,010$1,730$12,200$4,679$1,308,381
DR DOUGLAS YODER
PHYSICIAN$692,141$162,748$105,142$12,200$8,185$980,416
DR JAMES BAILEY
PHYSICIAN$618,850$183,190$2,385$12,200$8,797$825,422
DR TOM ZHOU
PHYSICIAN$512,714$230,774$51,923$12,200$4,829$812,440
DR RICHARD POLDER
TRUSTEE$358,047$19,084$3,978$12,200$12,291$405,600

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 4CFormAndLineReferenceDesc
ExplanationIN 2022, BLANCHARD VALLEY HEALTH SYSTEM CALCULATED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) PAYMENTS TO BE CONTRIBUTED IN 2022. $96,553 WILL BE CONTRIBUTED ON BEHALF OF MYRON LEWIS TO A SERP IN 2023. SERP CONTRIBUTIONS IN THE AMOUNT OF $90,461 WERE MADE FOR THE BENEFIT OF MYRON LEWIS IN 2022. 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 2023. $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 2022. 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1BMYRON 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.
FORM 990, PART VI, SECTION B, LINE 11BA 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, SECTION B, LINE 12CANNUALLY, 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, SECTION B, LINE 15ATHE ORGANIZATION REVIEWS EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES ON A PERIODIC BASIS TO ENSURE CONSISTENCY WITH COMPENSATION PHILOSOPHY AND MARKET PRACTICE. A SUBSET OF MEMBERS FROM THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION 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, SECTION B, LINE 15BTHE SAME PROCESS APPLIES FOR ALL OTHER EXECUTIVE STEERING COMMITTEE MEMBERS AS DETAILED FOR THE CEO.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS, REQUIRED TAX FORMS (I.E., FORM 990), AS WELL AS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH THE ADMINISTRATIVE AND FINANCE OFFICES.
FORM 990, PART XI, LINE 9INVESTMENT INCOME TIMING DIFFERENCE $ -252,495 TRANSFERS FROM AFFILIATES $75,260,000 TOTAL $75,007,505

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
BLANCHARD VALLEY MEDICAL PRACTICES LLC
1900 SOUTH MAIN STREETFINDLAYOH45840421659766PHYS OFFICEOH$52,662,922$18,822,318BVHS
BLANCHARD VALLEY HOME CARE SERVICES LLC
1900 SOUTH MAIN STREETFINDLAYOH45840421565629HOME HEALTHOHBVCCS
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STREETFINDLAYOH45840061748552CERT NURSEOHBVRHC
NEUROSURGICAL ASSOCIATES OF NW OHIO LLC
1900 SOUTH MAIN STREETFINDLAYOH45840342052585PHYS OFFICEOHBVMP
SPECIALTY PHYSICIANS OF BLANCHARD VALLEY
1900 SOUTH MAIN STREETFINDLAYOH45840262448601PHYS OFFICEOHBVMP
BLANCHARD VALLEY REGIONAL CANCER CENTER
1900 SOUTH MAIN STREETFINDLAYOH45840050623393PHYS OFFICEOHBVMP
HANCO EMERGENCY MEDICAL SERVICES LLC
417 SIXTH STREETFINDLAYOH45840463299390AMBULANCE SEROH$3,718,891$414,207BVHS
BEYOND MEDSPA LLC
1900 SOUTH MAIN STREETFINDLAYOH45840814440286COSMETIC SPAOHBVHS
BIRCHAVEN ESTATES AT EASTERN WOODS LTD
1900 SOUTH MAIN STREETFINDLAYOH45840201494204CONDOMINIUMSOHBVCCS
FINDLAY SURGERY CENTER LTD
1900 S MAIN STFINDLAYOH45840870620245SURG CNTROHBVRHC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
BLANCHARD VALLEY CONTINUING CARE SERVICE
15100 BIRCHAVEN LANEFINDLAYOH45840346006904CONT. CAREOH501(C)(3)10BVHSYes (true)
BLANCHARD VALLEY REGIONAL HEALTH CENTER
1900 SOUTH MAIN STREETFINDLAYOH45840341369963ACUTE CAREOH501(C)(3)3BVHSYes (true)
BLANCHARD VALLEY HEALTH FOUNDATION
1900 SOUTH MAIN STREETFINDLAYOH45840341370522FUNDRAISINGOH501(C)(3)7BVHSYes (true)
EC EDWARDS MEMORIAL TRUST FBO FINDLAY
1900 SOUTH MAIN STREETFINDLAYOH45840346953719INVESTMENTOH501(C)(3)12ABVHFYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CITAS INCBusinessNameLine1Txt

US Address USAddress

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

Direct Controlling Entity Name DirectControllingEntityName

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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BLANCHARD VALLEY REGIONAL HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeDTransactionTypeTxt
Involved$75,110,000InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt