BLANCHARD VALLEY REGIONAL HEALTH CENTER: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: BLANCHARD VALLEY REGIONAL HEALTH CENTER (EIN 34-1369963)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-09
IRS object ID: 201713139349302466
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-09T12:22:55-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	200 E Main St Suite 700	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	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	341369963	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BLANCHARD VALLEY REGIONAL HEALTH CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DAVID M CYTLAK	InCareOfNm
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 M CYTLAK	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4194235497	PhoneNum
Signature	2017-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Joyce A Dulworth	PreparerPersonNm
PTIN	P00151125	PTIN
Phone	2604604000	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	35027420173135000006	FederalOriginalSubmissionId
Federal Original Submission Id	2017-11-09	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	87E0E0BD69ECE6C5CC4B848586F9054C7DE5B5AF	AtSubmissionCreationDeviceId
At Submission Filing Device Id	FD17B16453602DE2B5C268902672A980DDBA3821	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2018-03-14 21:41:22Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DAVID M CYTLAK	PrincipalOfficerNm

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	$316,227,651	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BVHEALTHSYSTEM.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1982	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	BLANCHARD VALLEY REGIONAL HEALTH CENTER OPERATES TWO HOSPITALS OFFERING INPATIENT, EMERGENCY, MATERNITY AND OUTPATIENT SERVICES; OUTPATIENT CENTERS, AND A PRIMARY CARE CLINIC.	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	17	VotingMembersIndependentCnt
Total Employee	2184	TotalEmployeeCnt
Total Volunteers	397	TotalVolunteersCnt
Total Gross UBI	$1,841,481	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$936,215	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$251,330,036	PYProgramServiceRevenueAmt
CY Program Service Revenue	$255,859,450	CYProgramServiceRevenueAmt
PY Investment Income	$14,151,326	PYInvestmentIncomeAmt
CY Investment Income	$1,054,004	CYInvestmentIncomeAmt
PY Other Revenue	$5,816,147	PYOtherRevenueAmt
CY Other Revenue	$3,785,733	CYOtherRevenueAmt
PY Total Revenue	$271,297,509	PYTotalRevenueAmt
CY Total Revenue	$260,699,187	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	$104,647,697	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$91,841,370	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$115,989,418	PYOtherExpensesAmt
CY Other Expenses	$102,510,766	CYOtherExpensesAmt
PY Total Expenses	$220,637,115	PYTotalExpensesAmt
CY Total Expenses	$194,352,136	CYTotalExpensesAmt
PY Revenues Less Expenses	$50,660,394	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$66,347,051	CYRevenuesLessExpensesAmt
Total Assets BOY	$494,791,464	TotalAssetsBOYAmt
Total Assets EOY	$525,812,412	TotalAssetsEOYAmt
Total Liabilities BOY	$206,226,740	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$169,664,623	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$288,564,724	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$356,147,789	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
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	$18,254,826	ExpenseAmt
Revenue	$26,079,474	RevenueAmt
Desc	NEUROSCIENCES SERVICES: NEUROSCIENCES SERVICES AT BLANCHARD VALLEY REGIONAL HEALTH CENTER (BVRHC) INCLUDE: SPINAL SURGERY, CRANIAL SURGERY, PERIPHERAL NERVE SURGERY, PAIN MANAGEMENT SURGERY, AND MANY OTHER PROCEDURES. ALSO, BVRHC PROVIDES SERVICES THAT DIAGNOSE, TREAT, AND MANAGE DISORDERS OF THE BRAIN AND NERVOUS SYSTEM. WE WORK DIRECTLY WITH OUR PATIENTS TO CREATE A HEALTH CARE PLAN TO FITTHEIR NEEDS. OUR CONTINUING GOAL IS TO PROVIDE SUPERIOR OUTCOMES BY UTILIZING THE LATEST SURGICAL TECHNIQUES AND EVIDENCE-BASED MEDICINE GUIDELINES TO ACHIEVE CLINICAL EXCELLENCE. IN 2012, HEALTHGRADES - THE LEADING INDEPENDENT HEALTHCARE RATINGS COMPANY - AWARDED SEVERAL HONORS TO THE BVH TOTAL JOINT REPLACEMENT PROGRAM INCLUDING: 2012 HEALTHGRADES ORTHOPEDIC SURGERY EXCELLENCE AWARD #1 IN OHIO FOR OVERALL ORTHOPEDICS; 5-STARRATING FOR OVERALL ORTHOPEDICS; 5-STAR RATING FOR TOTAL JOINT REPLACEMENT; 5-STAR RATING FOR TOTAL KNEE REPLACEMENT; 5-STAR RAITING FOR TOTAL HIP REPLACEMENT.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$20,346,650	ExpenseAmt
Revenue	$29,067,926	RevenueAmt
Desc	CARDIOVASCULAR SERVICES: BLANCHARD VALLEY HEARTCARE CENTER OFFERS A COMPLETE RANGE OF SERVICES FOR COMPREHENSIVE CARDIAC CARE. SERVICESFOR DIAGNOSIS AND TREATMENT INCLUDE CORONARY ARTERY BYPASS SURGERY, VALVE REPLACEMENTS, CARDIAC AND PULMONARY REHABILITATION, AND DIAGNOSTIC TESTING INCLUDING EKGS, STRESS TESTS, HOLTER MONITORING,AND ECHOCARDIOGRAMS. THE CARDIAC AND PULMONARY REHAB PROGRAMS ARE NATIONALLY CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACPR). IN ADDITION, EDUCATION IS PROVIDED TO PATIENTS AND THEIR FAMILY, AS WELL AS COMMUNITY MEMBERS, ON A VARIETY OF HEART-RELATED TOPICS THROUGHOUT THE YEAR. THE EMERGENCY DEPARTMENTS AT BLANCHARD VALLEY HOSPITAL AND BLUFFTON HOSPITAL ADHERE TO THE NATIONAL GOLD STANDARD OF HEART CARE THAT INCLUDES THE ADMINISTRATION OF CLOT BUSTERS AND OTHER DRUG THERAPY.ALL EMERGENCY DEPARTMENT PHYSICIANS AND NURSES HAVE RECEVIED EXTENSIVE EDUCATION IN CRITICAL CARDIAC CARE, WHICH INCLUDES ADVANCED CARDIAC LIFE SUPPORT. THANKS TO TEAMWORK, THE BVH EMERGENCY DEPARTMENT AND THE BLANCHARD VALLEY HEARTCARE CENTER CONSISTENTLY BEAT THE 90-MINUTE NATIONAL BENCHMARK FOR DOOR TO BALLOON TIME, ESTABLISHED BY THE AMERICAN COLLEGE OF CARDIOLOGY (ACC). IN 2016, OUR MEDIAN DOOR TO BALLOON TIME WAS 53 MINUTES. ALSO, BLANCHARD VALLEY HOSPITAL'S CARDIOVASCULAR PROGRAM, PART OF THE JANE AND GARY HEMINGER HEARTCARE CENTER, WAS NAMED ONE OF THE NATION'S 50 TOP CARDIOVASCULAR HOSPITALS FOR 2013 BY TRUVEN HEALTH ANALYTICS, FORMERLY THOMSON REUTERS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$21,735,043	ExpenseAmt
Revenue	$31,051,432	RevenueAmt
Desc	GENERAL SURGERY: BLANCHARD VALLEY HOSPITAL'S GENERAL SURGERY GROUP IS RESPONSIBLE FOR A FULL SPECTRUM OF CARE, FROM SCHEDULED, ELECTIVE PROCEDURES TO THE TREATMENT OF ADVANCED STAGES OF CANCER. PROCEDURES PERFORMED BY THIS GROUP INCLUDE BUT ARE NOT LIMITED TO APPENDECTOMY (REMOVAL OF THE APPENDIX), CHOLECYSTECOMY (REMOVAL OF THE GALLBLADDER), NON-COSMETIC BREAST SURGERY (FROM LUMPECTOMY TO MASTECTOMY), ORTHOPEDIC PROCEDURES (JOINT REPLACEMENT), AND LUNG AND VASCULAR PROCEDURES. BLANCHARD VALLEY HOSPITAL IS A LEVEL 3 TRAUMA CENTER, SO OUR SURGEONS ARE TRAINED AND AVAILABLE TO RESPOND TO A WIDE RANGE OF TRAUMA NEEDS AND MOST SURGICAL EMERGENCIES THAT COME INTO OUR EMERGENCY DEPARTMENT.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (7 entries)

ExpenseExpenseAmt	RevenueRevenueAmt	DescDesc
$113,257,294	$168,853,823	OTHER SERVICES PROVIDED AT BVRHC INCLUDE:
		WOMAN'S AND CHILDREN'S SERVICES (GYNECOLOGY,
		OBSTETRICS, BREAST HEALTH, PEDIATRIC
		HOSPITALISTS, LEVEL 2 SPECIAL CARE NURSERY),
		ONCOLOGY/HEMATOLOGY SERVICES, UROLOGY/
		NEPHROLOGY SERVICES, SLEEP DISORDERS, PAIN
		MANAGEMENT, WOUND CARE, AND DIALYSIS.

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$113,257,294	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$168,853,823	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$173,593,813	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	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	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
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 With Officer Ent	false	BusinessRlnWithOfficerEntInd
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	352	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	2184	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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	18	GoverningBodyVotingMembersCnt
Independent Voting Member	17	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
States Where Copy Of Return Is Fld	OH	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DAVID M CYTLAK	PersonNm
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

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
CHERYL BUCKLAND
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
KAREN CLINE
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
FRANK A COSIANO MD
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
DAVID EUBANKS
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
DUANE JEBBETT
CHAIRMAN	0.5	1.0	Yes (X)	$0	$0	$0	Yes (X)
KAREN KLASSEN HARDER
SECRETARY	0.5	1.0	Yes (X)	$0	$0	$0	Yes (X)
ANDREA KOEPKE
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
RANDALL MYERS
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
RODNEY NICHOLS
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
GARRY PEIFFER
TREASURER	0.5	1.0	Yes (X)	$0	$0	$0
RICHARD POLDER MD
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
WILLIAM REIST
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
LEROY SCHROEDER MD
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
KIMBERLY STUMPP
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
PAUL WORSTELL
VICE CHAIRMAN	0.5	1.0	Yes (X)	$0	$0	$0	Yes (X)
GINGER JONES
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
JOSEPH LONGO
TRUSTEE	0.5	1.0	Yes (X)	$0	$0	$0
SCOTT MALANEY
CHIEF EXECUTIVE OFFICER	32.0	8.0	Yes (X)	$0	$781,714	$177,689	Yes (X)
DAVE CYTLAK
CHIEF FINANCIAL OFFICER	32.0	8.0		$0	$385,790	$39,278	Yes (X)
WILLIAM KOSE
CHIEF QUALITY OFFICER	36.0	4.0		$0	$387,739	$29,302	Yes (X)
BARBARA PASZTOR
VP OF NURSING	40.0	0.0		$252,365	$0	$21,702		Yes (X)
CHRISTINE KELLER
VP OF CLINICAL SERVICES	40.0	0.0		$217,236	$0	$19,892		Yes (X)
ANGELA HOLT
PHYSICIAN	40.0	0.0		$467,524	$0	$21,073			Yes (X)
MICHAEL MANUAL
PHYSICIAN	40.0	0.0		$399,412	$0	$27,884			Yes (X)
DANIEL SAK
PHYSICIAN	40.0	0.0		$393,483	$0	$7,822			Yes (X)
REBECCA DOEDE
PHYSICIAN	40.0	0.0		$340,105	$0	$11,166			Yes (X)
SCOTT SPIRIDIGLIOZZI
CRNA	40.0	0.0		$327,031	$0	$14,274			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,397,156	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,555,243	TotReportableCompRltdOrgAmt
Total Other Compensation	$370,082	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	125	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
HCTEC PARTNERS LLC
7105 S SPRINGS DR SUITE 208	FRANKLIN	IN	37067	PHYSICIAN SERVICES	$1,220,050
TECHNICORE
PO BOX 1210	FINDLAY	OH	45840	PHYSICIAN SERVICES	$1,254,679
PROLINK HEALTHCARE LLC
10700 MONTGOMERY ROAD	CINCINNATI	OH	45242	LOCUM SERVICES	$2,808,935
BLANCHARD VALLEY PATHOLOGY AND LAB
1900 S MAIN STREET	FINDLAY	OH	45840	PATHOLOGY	$650,000
DELTA LOCUM TENENS LLC
1755 WITTINGTON PLACE SUITE 800	DALLAS	TX	75234	LOCUM SERVICES	$710,513

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	28	CntrctRcvdGreaterThan100KCnt
Total Contributions	$0	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE	900099	$251,708,702	$251,708,702
OUTPATIENT PHARMACY	446110	$1,794,504	$959,073	$835,431
INVESTMENT IN TECHNICORE	541900	$2,356,244	$2,376,120	-$19,876

Field	Value	IRS element (for citing)
Total Program Service Revenue	$255,859,450	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,093,767	TotalRevenueColumnAmt
Exclusion	$4,093,767	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$77,525	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$77,525	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$77,525	TotalRevenueColumnAmt
Exclusion	$77,525	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$52,066,264	SecuritiesAmt
Other	$8,760	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$55,114,787	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$3,048,523	SecuritiesAmt
Other	$8,760	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$3,039,763	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,760	RelatedOrExemptFuncIncomeAmt
Exclusion	-$3,048,523	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$424,422	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$413,677	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,745	TotalRevenueColumnAmt
Exclusion	$10,745	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
INVESTMENT IN PARTNERSHIP	621300	$1,025,926	$1,025,926
MISCELLANEOUS	900099	$2,051,820		$2,051,820
FINDLAY SURGICAL PROPERTIES	900099	$160,238		$160,238

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$459,479	TotalRevenueColumnAmt
Exclusion	$459,479	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$3,697,463	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$260,699,187	TotalRevenueColumnAmt
Related Or Exempt Func Income	$255,052,655	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,841,481	UnrelatedBusinessRevenueAmt
Exclusion	$3,805,051	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$511,195	TotalAmt
Program Services	$434,516	ProgramServicesAmt
Management And General	$76,679	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$72,485,760	TotalAmt
Program Services	$61,612,894	ProgramServicesAmt
Management And General	$10,872,866	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,710,590	TotalAmt
Program Services	$2,304,002	ProgramServicesAmt
Management And General	$406,588	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$11,378,182	TotalAmt
Program Services	$9,671,455	ProgramServicesAmt
Management And General	$1,706,727	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,755,643	TotalAmt
Program Services	$4,042,296	ProgramServicesAmt
Management And General	$713,347	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$16,629	TotalAmt
Program Services	$14,135	ProgramServicesAmt
Management And General	$2,494	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$7,704,919	TotalAmt
Program Services	$6,549,181	ProgramServicesAmt
Management And General	$1,155,738	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$769,479	TotalAmt
Program Services	$654,057	ProgramServicesAmt
Management And General	$115,422	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,072,788	TotalAmt
Program Services	$4,311,870	ProgramServicesAmt
Management And General	$760,918	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$2,734,580	TotalAmt
Program Services	$2,324,393	ProgramServicesAmt
Management And General	$410,187	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,104,341	TotalAmt
Program Services	$2,638,690	ProgramServicesAmt
Management And General	$465,651	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$518,462	TotalAmt
Program Services	$440,693	ProgramServicesAmt
Management And General	$77,769	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,899,077	TotalAmt
Program Services	$5,864,215	ProgramServicesAmt
Management And General	$1,034,862	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$10,706,999	TotalAmt
Program Services	$9,100,949	ProgramServicesAmt
Management And General	$1,606,050	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$322,482	TotalAmt
Program Services	$274,110	ProgramServicesAmt
Management And General	$48,372	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBTS	$10,795,043	$10,795,043
MEDICAL & PROFESSIONAL FEES	$3,950,735	$3,358,125	$592,610
MEDICAL SUPPLIES	$45,168,283	$45,168,283
DUES & SUBSCRIPTIONS	$167,067	$142,007	$25,060

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,579,882	TotalAmt
Program Services	$3,892,899	ProgramServicesAmt
Management And General	$686,983	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$194,352,136	TotalAmt
Program Services	$173,593,813	ProgramServicesAmt
Management And General	$20,758,323	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$14,116,829	BOYAmt
EOY	$3,904,740	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$33,433,734	BOYAmt
EOY	$37,080,545	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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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	$6,072,016	BOYAmt
EOY	$7,452,588	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$526,350	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$256,884,028	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$140,297,597	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$120,797,099	BOYAmt
EOY	$116,586,431	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$224,760,751	BOYAmt
EOY	$250,244,048	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$298,760	BOYAmt
EOY	$754,218	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$94,785,925	BOYAmt
EOY	$109,789,842	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$494,791,464	BOYAmt
EOY	$525,812,412	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$26,225,748	BOYAmt
EOY	$3,276,199	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$122,524	BOYAmt
EOY	$39,670	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$111,600,000	BOYAmt
EOY	$107,575,000	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$7,738,294	BOYAmt
EOY	$277,570	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$60,540,174	BOYAmt
EOY	$58,496,184	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$206,226,740	BOYAmt
EOY	$169,664,623	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$281,422,656	BOYAmt
EOY	$337,000,883	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$928,562	BOYAmt
EOY	$897,129	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,213,506	BOYAmt
EOY	$18,249,777	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$288,564,724	BOYAmt
EOY	$356,147,789	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$494,791,464	BOYAmt
EOY	$525,812,412	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$66,347,051	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$14,871,000	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$13,634,986	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$10,681	OtherActivitiesAmt
Total Lobbying Expenditures	$10,681	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	BLANCHARD VALLEY REGIONAL HEALTH CENTER PAID MEMBERSHIP DUES TO TWO ORGANIZATIONS FOR WHICH A VARYING PERCENTAGE WAS ATTRIBUTED TO LOBBYING EXPENSES. THESE ORGANIZATIONS INCLUDE THE OHIO HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,142,069	BeginningYearBalanceAmt
Contributions	$12,609,392	ContributionsAmt
Investment Earnings Or Losses	$852,205	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,444,699	OtherExpendituresAmt
End Year Balance	$19,158,967	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,573,876	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$48,989	InvestmentEarningsOrLossesAmt
Other Expenditures	$382,818	OtherExpendituresAmt
End Year Balance	$7,142,069	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,583,720	BeginningYearBalanceAmt
Investment Earnings Or Losses	$291,783	InvestmentEarningsOrLossesAmt
Other Expenditures	$301,627	OtherExpendituresAmt
End Year Balance	$7,573,876	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,814,938	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,051,432	InvestmentEarningsOrLossesAmt
Other Expenditures	$282,650	OtherExpendituresAmt
End Year Balance	$7,583,720	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,334,186	BeginningYearBalanceAmt
Investment Earnings Or Losses	$752,562	InvestmentEarningsOrLossesAmt
Other Expenditures	$271,810	OtherExpendituresAmt
End Year Balance	$6,814,938	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.95300	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.04700	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (true)	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	$3,193,307	OtherCostOrOtherBasisAmt
Book Value	$3,193,307	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$136,679,405	OtherCostOrOtherBasisAmt
Depreciation	$54,242,766	DepreciationAmt
Book Value	$82,436,639	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,101,000	OtherCostOrOtherBasisAmt
Depreciation	$1,099,391	DepreciationAmt
Book Value	$1,609	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$98,867,025	OtherCostOrOtherBasisAmt
Depreciation	$78,523,864	DepreciationAmt
Book Value	$20,343,161	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$17,043,291	OtherCostOrOtherBasisAmt
Depreciation	$6,431,576	DepreciationAmt
Book Value	$10,611,715	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$116,586,431	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
ADVANCES TO AFFILIATES	$108,533,239
DEFERRED BOND ISSUANCE COSTS	$1,256,603

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$109,789,842	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
PENSION LIABILITY	$38,084,556
THIRD PARTY SETTLEMENTS	$1,527,552
INTEREST RATE SWAP OBLIGATION	$22,336,543
MINORITY INTEREST IN PAIN MANA	-$3,452,467

Field	Value	IRS element (for citing)
Total Liability	$58,496,184	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$251,375,832	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$14,871,000	NetUnrealizedGainsInvstAmt
Other Revenue	$1,178,207	OtherRevenueAmt
Revenue Not Reported	$16,049,207	RevenueNotReportedAmt
Revenue Subtotal	$235,326,625	RevenueSubtotalAmt
Other Revenues Not Included	$25,372,562	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$25,372,562	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$260,699,187	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$183,557,093	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$183,557,093	ExpensesSubtotalAmt
Other Expenses Not Included	$10,795,043	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$10,795,043	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$194,352,136	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	ENDOWMENT FUNDS ARE UTILIZED FOR DONOR DESIGNATED PURPOSES, INCLUDING CHARITY CARE, CAPITAL PROJECTS AND PURCHASES, AND CONTINUING EDUCATION FOR STAFF AND PHYSICIANS.
PART XI, LINE 2D	CHANGE IN INTEREST RATE SWAP AGREEMENT 1,178,207 TOTAL $ 1,178,207 PART XI, LINE 4B DEFINED BENEFIT PENSION PLAN 2,486,071 BAD DEBT RECLASS 10,795,043 OTHER CHANGES IN NONCONTROLLING INTEREST 1,037,326 TRANSFERS FROM AFFILIATES 11,054,122 TOTAL $25,372,562 PART XII, LINE 4D BAD DEBT RECLASS 10,795,043 TOTAL $10,795,043
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 H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent250	Yes (X)	Percent250Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,950,166	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,950,166	NetCommunityBenefitExpnsAmt
Total Expense	0.01060	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,758,862	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,064,072	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,694,790	NetCommunityBenefitExpnsAmt
Total Expense	0.05280	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$29,709,028	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,064,072	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,644,956	NetCommunityBenefitExpnsAmt
Total Expense	0.06340	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$141,648	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$141,648	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$74,047	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$74,047	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$102,054	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$102,054	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$317,749	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$317,749	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,026,777	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,064,072	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,962,705	NetCommunityBenefitExpnsAmt
Total Expense	0.06520	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$137	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$137	NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$102,771	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$102,771	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$80,763	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$80,763	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,279	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$35,279	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$218,950	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$218,950	NetCommunityBenefitExpnsAmt
Total Expense	0.00120	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$4,362,277	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,454,092	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$50,711,275	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$55,834,733	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$5,123,458	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	false	FinancialAssistancePrvsnInd
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Critical Access HospitalCriticalAccessHospitalInd
BLANCHARD VALLEY HOSPITAL
1	1900 SOUTH MAIN STREET	FINDLAY	OH	45840	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	Yes (X)	Yes (X)
BLUFFTON HOSPITAL
2	139 GARAU STREET	BLUFFTON	OH	45817	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	Yes (X)	Yes (X)	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Strategy AttachedStrategyAttachedInd	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Income Level CriteriaIncomeLevelCriteriaInd	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd	Residency CriteriaResidencyCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Provided Nonprofit ContactProvidedNonprofitContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Collection ActivitiesCollectionActivitiesInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Look Back Medicare PrivateLookBackMedicarePrivateInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd	Look Back MedicareLookBackMedicareInd
BLANCHARD VALLEY HOSPITAL
1	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (X)	www.bvhealthsystem.org	Yes (X)	Yes (X)	Yes (true)	16	Yes (true)	www.bvhealthsystem.org	false	false	Yes (true)	Yes (X)	150.	250.	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	false	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
BLUFFTON HOSPITAL
2	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	16	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (X)	www.bvhealthsystem.org	Yes (X)	Yes (X)	Yes (true)	16	Yes (true)	www.bvhealthsystem.org	false	false	Yes (true)	Yes (X)	150.	250.	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	WWW.BVHEALTHSYSTEM.ORG	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	false	Yes (X)	Yes (X)	Yes (X)	Yes (true)		false	false	Yes (X)

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 3

a.) The definition of the community for the community health assessment was Hancock County, Ohio. The community that is served by the hospital facility is defined as residents and community members that live within Hancock County as well as residents and community members that utilize services provided by Blanchard Valley Hospital and Bluffton Hospital. b.) Hancock County, Ohio is home to 74,782 residents. Three-fourths (75%) of residents were adults over the age of 19, 10% were youth ages 12-18 years, and 15% were adolescents under the age of 11 (Source: Census, 2010). The majority (93%) of the population were Caucasian. Hispanics (5%), African Americans (2%), Asian (2%) and two or more races (2%) comprise the rest of the population (Source: Census, 2010). The median household income in Hancock County (in 2014 inflation-adjusted dollars) is $50,166. Fifteen percent of all Hancock County residents and ten percent of Hancock County families had an income below the poverty level in 2014 (Source: Census, 2010-2014 American Community Survey 5-year estimates). Three percent of Hancock County residents were uninsured. c.) These are the organizations who participated in the health assessment and strategic planning process: Findlay-Hancock County Community Foundation, United Way of Hancock County, Blanchard Valley Health System, Blanchard Valley Health Foundation, Findlay City Health Department, Hancock County Health Department, Hancock County Schools/ESC, Hancock County Family First Council, Hancock County ADAMHS Board, Hancock County Community Partnership, Findlay City Schools, Hancock County Family and Children First Council, Hancock County Help Me Grow, 50 North, University of Findlay, St. Andrews United Methodist Church, HHWP Community Action Commission, Alzheimers Association, Findlay City Council, Hancock County Job and Family Services, Senior Insurance Services, Lutheran Social Services, Caretakers.

d) Adult Survey

Adults ages 19 and over living in Hancock County were used as the sampling frame for the adult survey. There were 56,041 persons ages 18 and over living in Hancock County. The investigators conducted a power analysis to determine what sample size was needed to ensure a 95% confidence level with a corresponding margin of error of 5%. A sample size of at least 382 adults was needed to ensure this level of confidence. The random sample of mailing addresses of adults from Hancock County was obtained from Allegra Marketing Services in Louisville, KY. Prior to mailing the survey to adults, an advance letter was mailed to 1,200 adults in Hancock County. This advance letter was personalized, printed on Be Healthy Now Hancock County stationery and was signed by William Kose, M.D., Chief Quality Officer, Blanchard Valley Regional Health Center, Stephen Mills, D.O., Health Commissioner, Findlay City Health Department, Katherine Kreuchauf, President, Findlay-Hancock County Community Foundation, and John Urbanski, President & CEO, United Way of Hancock County. The letter introduced the county health assessment project and informed the readers that they may be randomly selected to receive the survey. The letter also explained that the respondents confidentiality would be protected and encouraged the readers to complete and return the survey promptly if they were selected. Three weeks following the advance letter, a three-wave mailing procedure was implemented to maximize the survey return rate. The initial mailing included a personalized hand signed cover letter (on Be Healthy Now Hancock County stationery) describing the purpose of the study; a questionnaire printed on colored paper; a self-addressed stamped return envelope; and a $2 incentive. Approximately three weeks after the first mailing, a second wave mailing included another personalized cover letter encouraging them to reply, another copy of the questionnaire on colored paper, and another reply envelope. A third wave postcard was sent three weeks after the second wave mailing. Surveys returned as undeliverable were not replaced with another potential respondent. The response rate for the mailing was 48% (n=501: CI= 4.36). This return rate and sample size means that the responses in the health assessment should be representative of the entire county. Adolescent Survey There were 7,295 persons ages 12 to 18 years old living in Hancock County. A sample size of 365 adolescents was needed to ensure a 95% confidence interval with a corresponding 5% margin of error. Students were randomly selected and surveyed in the schools. The survey was approved by all superintendents. Schools and grades were randomly selected. Each student in that grade had to have an equal chance of being in the class that was selected, such as a general English or health class. Classrooms were chosen by the school principal. Passive permission slips were mailed home to parents of any student whose class was selected to participate. The response rate was 87% (n=381: CI= 4.89). Child Survey Children ages 0-11 residing in Hancock County were used as the sampling frames for the surveys. Using U.S. Census Bureau data, it was determined that 11,446 children ages 0-11 reside in Hancock County. The investigators conducted a power analysis based on a post-hoc distribution of variation in responses (70/30 split) to determine what sample size was needed to ensure a 95% confidence level with corresponding confidence interval of 5% (i.e., we can be 95% sure that the "true" population responses are within a 5% margin of error). Because many of the items were identical between the 0-5 and 6-11 surveys, the responses were combined to analyze data for children 0-11. The sample size required to generalize to children ages 0-11 was 372. The random sample of mailing addresses of parents of children 0-11 from Hancock County was obtained from Allegra Marketing Services in Louisville, KY. Prior to mailing the survey to parents of 0-11 year olds, an advance letter was mailed to 2,400 parents in Hancock County. This advance letter was personalized, printed on Be Healthy Now Hancock County stationery and was signed by William Kose, M.D., Chief Quality Officer, Blanchard Valley Regional Health Center, Stephen Mills, D.O., Health Commissioner, Findlay City Health Department, Katherine Kreuchauf, President, Findlay-Hancock County Community Foundation, and John Urbanski, President & CEO, United Way of Hancock County. The letter introduced the county health assessment project and informed the readers that they may be randomly selected to receive the survey. The letter also explained that the respondents confidentiality would be protected and encouraged the readers to complete and return the survey promptly if they were selected. Three weeks following the advance letter, a three-wave mailing procedure was implemented to maximize the survey return rate. The initial mailing included a personalized hand signed cover letter (on Be Healthy Now Hancock County stationery) describing the purpose of the study; a questionnaire printed on colored paper; a self-addressed stamped return envelope; and a $2 incentive. Approximately three weeks after the first mailing, a second wave mailing included another personalized cover letter encouraging them to reply, another copy of the questionnaire on colored paper, and another reply envelope. A third wave postcard was sent three weeks after the second wave mailing. Surveys returned as undeliverable were not replaced with another potential respondent. The response rate was 24% (n=429: CI= 4.64). E.) The health needs of Hancock County that were examined by the needs assessment include but are not limited to: health status perceptions, health care coverage, health care access and utilization, cardiovascular health, cancer, diabetes, asthma and other respiratory disease, weight status, tobacco use, alcohol consumption, drug use, womens health, mens health, preventive medicine and environmental health, sexual behavior and pregnancy outcomes, quality of life, social context and safety, mental health and suicide, oral health, youth weight control, youth tobacco use, youth alcohol consumption, youth drug use, youth sexual behavior and teen pregnancy outcomes, youth mental health and suicide, youth safety, youth violence issues, child health and functional status, child health insurance, access, and medical home, early childhood, middle childhood, family functioning, neighborhood and community context, and parent health. There were 26 key leaders from the community that represented public health, law enforcement, churches, local officials, social service agencies and other various community members in attendance at the public release of the community health needs assessment. At the event, participants participated in focus groups and priorities were chosen for Hancock County to focus on. F.) Lack of health care coverage, tobacco use, drug use (including marijuana and prescription drug abuse), lack of female health screenings, and lack of routine dental care were all prevalent issues among those Hancock County adults with incomes less than $25,000. The chronic disease prevalence among Hancock County adults with incomes less than $25,000 were: high blood pressure (35%), high blood cholesterol (32%), asthma (13%), and diabetes (12%). High blood pressure, diabetes, and asthma had a higher prevalence among those adults with incomes less than $25,000. Three percent of Hancock County adults were uninsured at the time of the survey. Hancock County adults who were uninsured reported that the reason they were without health care coverage was that they lost or changed employers, they could not afford to pay the insurance premiums, or their employer does not/stopped offering coverage. The majority (93%) of the population were Caucasian. Hispanics (5%), African Americans (2%), Asian (2%) and two or more races (2%) comprise the rest of the population (Source: Census, 2010). G.) There were 26 key leaders from the community that represented public health, law enforcement, churches, local officials, social service agencies and other various community members in attendance at the public release of the community health needs assessment. At the event, participants participated in focus groups and priorities were chosen for Hancock County to focus on. H.) Local community agencies were invited to participate in the health assessment process, including choosing questions for the surveys, providing local data, reviewing draft reports and planning the community event, release of the data and setting priorities. The needs of the population, especially those who are medically underserved, low-income, minority populations and populations with chronic disease needs, were taken into account through the sample methodology that surveyed these populations. In addition, the organizations that serve these populations participated in the health assessment and co

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CREIGHTON DIALYSIS LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 EAST MAIN CROSS STREET	AddressLine1Txt
City	FINDLAY	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45840	ZIPCd

Field	Value	IRS element (for citing)
Facility	DIALYSIS CENTER	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART III, SECTION A, LINE 2	OUR BAD DEBT EXPENSE IS COMPRISED OF FOUR COMPONENTS. FIRST, ACCOUNTS THAT HAVE BEEN TRANSFERRED TO COLLECTION AGENCIES ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. SECOND, CHANGES IN OUR ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON CHANGES IN OUR ACCOUNTS RECEIVABLE AGING BUCKETS ARE RECORDED AS AN INCREASE OR DECREASE TO BAD DEBT EXPENSE. THIRD, ANY ACCOUNTS NOT COLLECTIBLE DUE TO BANKRUPTCIES OR DEATHS (ESTATES NOT SUFFICIENT) ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. FINALLY, ANY RECOVERIES THAT ARE RECEIVED FROM COLLECTION AGENCIES ARE RECORDED AS A DECREASE TO BAD DEBT EXPENSE. THESE FOUR COMPONENTS ARE THE NET BAD DEBT EXPENSE AMOUNTS THAT ARE PRESENTED IN OUR FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION A, LINE 3	ASSUMPTION IS THAT OUR CHARITY CARE PROGRAM CAPTURES A LARGE PERCENTAGE OF THOSE WHO QUALIFY. HOWEVER, THERE IS A SUBSECTION OF PATIENTS WHO ARE PROVIDED THE INFORMATION FOR CHARITY CARE BUT CHOOSE NOT TO PROVIDE THE NECESSARY DOCUMENTS. THERE IS A LARGE PORTION OF BAD DEBT THAT IS ATTRIBUTABLE TO INDIVIDUALS THAT HAVE INSURANCE AND WORK IN WHITE COLLAR JOBS, THUS THE ASSUMPTION IS THAT 2 OUT OF EVERY THREE BAD DEBT ACCOUNTS ARE FOR SUCH INDIVIDUALS. THUS, THE REMAINING 1/3 RELATE TO THOSE WHO COULD QUALIFY FOR CHARITY CARE.
SCHEDULE H, PART III, SECTION A, LINE 4	WE DO NOT HAVE A BAD DEBT FOOTNOTE. OUR BAD DEBT EXPENSE IS COMPRISED OF FOUR COMPONENTS. FIRST, ACCOUNTS THAT HAVE BEEN TRANSFERRED TO COLLECTION AGENCIES ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. SECOND, CHANGES IN OUR ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON CHANGES IN OUR ACCOUNTS RECEIVABLE AGING BUCKETS ARE RECORDED AS AN INCREASE OR DECREASE TO BAD DEBT EXPENSE. THIRD, ANY ACCOUNTS NOT COLLECTIBLE DUE TO BANKRUPTCIES OR DEATHS (ESTATES NOT SUFFICIENT) ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. FINALLY, ANY RECOVERIES THAT ARE RECEIVED FROM COLLECTION AGENCIES ARE RECORDED AS A DECREASE TO BAD DEBT EXPENSE. THESE FOUR COMPONENTS ARE THE NET BAD DEBT EXPENSE AMOUNTS THAT ARE PRESENTED IN OUR FINANCIAL STATEMENTS. Bad Debt at Cost (Part III line 2) is calculated by multiplying total bad debt expense for the year by the average cost-to-charge ratio per the Medicare Cost Report. The amount of that number attributable to patients eligible under charity care policies (Part III line 3) is estimated based upon past experiences. Bad debt should be treated as community benefit. We perform services to all patients, regardless of ability to pay. We consciously know that some of these individuals will not be able to pay some or all of the costs associated with providing services to these individuals. Thus, this is a benefit to the community as they know that they will always be treated and will not be turned away.
SCHEDULE H, PART III, SECTION B, LINE 8	ALL OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. WE PERFORM SERVICES TO MEDICARE PATIENTS AND CONSCIOUSLY KNOW THAT THE COSTS TO PERFORM SUCH SERVICES ARE HIGHER THAN THE REIMBURSEMENT WE RECEIVE. THUS, WE FEEL THAT THIS IS A BENEFIT TO THE COMMUNITY BY BEING A CONVENIENT AND REPUTABLE SOURCE WITHIN THE COMMUNITY TO RECEIVE SUCH SERVICES. THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS OUR 2015 MEDICARE COST REPORTS AND OUR 2014 PSR REPORTS. SCHEDULE H, PART III, SECTION B, LINE 9B BLANCHARD VALLEY HEALTH SYSTEM EDUCATES PATIENTS WITH FINANCIAL ASSISTANCE IN SEVERAL WAYS. THE FINANCIAL ASSISTANCE GUIDELINES ARE ON THE BACK OF EACH STATEMENT. WHEN PATIENTS ARE CALLED OR CALL THE BUSINESS OFFICE, ASSOCIATES IN THE CREDIT AND COLLECTION DEPARTMENT PRE-SCREEN PATIENTS TO DETERMINE IF THEY MAY BE ELIGIBLE FOR ANY TYPE OF FINANCIAL ASSISTANCE. IF THE PATIENT IS DETERMINED TO POTENTIALLY BE ELIGIBLE, WE DISCUSS WITH THE PATIENT THEIR OPTIONS AND WHAT FINANCIAL ASSISTANCE CONSISTS OF. WE THEN SEND AN APPLICATION TO THE PATIENTS VIA MAIL. OUR APPLICATIONS AND PROCESS IS ALSO ON OUR WEBSITE. IN ADDITION, IF WE HAVE AN OUTPATIENT OR INPATIENT THAT MAY QUALIFY, WE TALK TO THOSE PATIENTS AND EVEN ASSIST WITH THE APPLICATION. APPLICATIONS ARE THEN PROCESSED AND A LETTER OF AWARD OR DENIAL IS SENT TO THE PATIENT. THEY ARE INSTRUCTED TO CALL THE FINANCIAL ADVOCATES IF THEY HAVE FURTHER QUESTIONS OR CONCERNS. NOTE: ALL POINTS OF SERVICE ARE EQUIPPED TO DISCUSS THE FINANCIAL APPLICATION AS WELL AS DISTRIBUTE.
NEEDS ASSESSMENT	THE HEALTH NEEDS OF HANCOCK COUNTY THAT WERE EXAMINED BY THE NEEDS ASSESSMENT INCLUDE BUT ARE NOT LIMITED TO: HEALTH STATUS PERCEPTIONS, HEALTH CARE COVERAGE, HEALTH CARE ACCESS AND UTILIZATION, CARDIOVASCULAR HEALTH, CANCER, DIABETES, ASTHMA AND OTHER RESPIRATORY DISEASE, WEIGHT STATUS, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, WOMEN'S HEALTH, MEN'S HEALTH, PREVENTIVE MEDICINE AND ENVIRONMENTAL HEALTH, SEXUAL BEHAVIOR AND PREGNANCY OUTCOMES, QUALITY OF LIFE, SOCIAL CONTEXT AND SAFETY, MENTAL HEALTH AND SUICIDE, ORAL HEALTH, YOUTH WEIGHT CONTROL, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH DRUG USE, YOUTH SEXUAL BEHAVIOR AND TEEN PREGNANCY OUTCOMES, YOUTH MENTAL HEALTH AND SUICIDE, YOUTH SAFETY, YOUTH VIOLENCE ISSUES, CHILD HEALTH AND FUNCTIONAL STATUS, CHILD HEALTH INSURANCE, ACCESS, AND MEDICAL HOME, EARLY CHILDHOOD, MIDDLE CHILDHOOD, FAMILY FUNCTIONING, NEIGHBORHOOD AND COMMUNITY CONTEXT, AND PARENT HEALTH. THERE WERE 26 KEY LEADERS FROM THE COMMUNITY THAT REPRESENTED PUBLIC HEALTH, LAW ENFORCEMENT, CHURCHES, LOCAL OFFICIALS, SOCIAL SERVICE AGENCIES AND OTHER VARIOUS COMMUNITY MEMBERS IN ATTENDANCE AT THE PUBLIC RELEASE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. AT THE EVENT, PARTICIPANTS PARTICIPATED IN FOCUS GROUPS AND PRIORITIES WERE CHOSEN FOR HANCOCK COUNTY TO FOCUS ON.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OR ELIGIBILITY FOR ASSISTANCE BLANCHARD VALLEY REGIONAL HEALTH CENTER EDUCATES PATIENTS ABOUT OUR OPTIONS FOR FINANCIAL ASSISTANCE IN SEVERAL WAYS. THE FINANCIAL ASSISTANCE GUIDELINES ARE ON THE BACK OF EACH STATEMENT. WHEN PATIENTS ARE CALLED OR CALL THE BUSINESS OFFICE, ASSOCIATES IN THE CREDIT AND COLLECTION DEPARTMENT PRE-SCREEN PATIENTS TO DETERMINE IF THEY MAY BE ELIGIBLE FOR ANY TYPE OF FINANCIAL ASSISTANCE. IF THE PATIENT IS DETERMINED TO POTENTIALLY BE ELIGIBLE, WE DISCUSS WITH THE PATIENT THEIR OPTIONS FOR OBTAINING FINANCIAL ASSISTANCE. WE THEN SEND AN APPLICATION TO THE PATIENTS VIA MAIL. THE PROCESS IS ALSO DEFINED AND OUR APPLICATION IS AVAILABLE ON OUR WEBSITE. IN ADDITION, IF WE HAVE AN OUTPATIENT OR INPATIENT THAT MAY QUALIFY, WE TALK TO THOSE PATIENTS AND EVEN ASSIST WITH COMPLETING THE APPLICATION. APPLICATIONS ARE THEN PROCESSED AND A LETTER OR AWARD OR DENIAL IS SENT TO THE PATIENT. THEY ARE INSTRUCTED TO CALL THE FINANCIAL ADVOCATES IF THEY HAVE FURTHER QUESTIONS OR CONCERNS. NOTE: ALL POINTS OF SERVICE ARE EQUIPPED TO DISCUSS AND DISTRIBUTE THE FINANCIAL ASSISTANCE APPLICATION.
COMMUNITY INFORMATION	BLANCHARD VALLEY HEALTH SYSTEM SERVES AN EIGHT-COUNTY AREA THAT INCLUDES HANCOCK, ALLEN, PUTNAM, HENRY, WOOD, SENECA, WYANDOT, AND HARDIN COUNTIES. HANCOCK (OUR PRIMARY SERVICE AREA) AND SENECA COUNTIES CAN BE DESCRIBED AS MICROPOLITAN; ALLEN AND WOOD COUNTIES AS METROPOLITAN; AND THE SURROUNDING FOUR COUNTIES AS RURAL. THE FINDLAY/HANCOCK COUNTY AREA HAS PLACED IN THE TOP 20 FOR THE PAST 11 CONSECUTIVE YEARS OF SITE SELECTION MAGAZINE'S LISTING OF BEST MICROPOLITON COMMUNITIES IN THE U.S. THE POPULATION OF HANCOCK COUNTY IS APPROXIMATELY 75,000, WITH FINDLAY COMPRISING ABOUT HALF OF THAT TOTAL. MEDIAN INCOME IS MODERATE; RANGING FROM $40,000 TO $60,000 DEPENDING ON LOCATION. FINDLAY SUPPORTS A UNIVERSITY, AS WELL AS SEVERAL LARGE CORPORATIONS INCLUDING COOPER TIRE & RUBBER COMPANY, MARATHON PETROLEUM COMPANY, AND WHIRLPOOL CORPORATION. THE SURROUNDING AREAS ARE HEAVILY AGRICULTURAL.
PROMOTION OF COMMUNITY HEALTH	BY REACHING OUT TO THE COMMUNITY THOUGH HEALTH FAIRS, SERVING ON THE BOARDS OF LOCAL ORGANIZATIONS, AND PROVIDING HEALTH EDUCATION, WE ARE GIVEN THE OPPORTUNITY TO FURTHER THE KNOWLEDGE OF THE COMMUNITY ABOUT THE IMPORTANCE OF WELLNESS. WE ARE ALSO PRESENTED WITH THE OPPORTUNITY TO INTERACT WITH OUR COMMUNITY AND LISTEN TO AND IDENTIFY THEIR NEEDS. OUR HOSPITALS ARE MAJOR SPONSORS OF AND PARTICIPATE IN MANY COMMUNITY HEALTH FAIRS THAT PROVIDE FREE OR LOW-COST HEALTH SCREENS, EDUCATIONAL MATERIALS ON VARIOUS HEALTH TOPICS, AND OVERALL HELP TO INCREASE AWARENESS THROUGHOUT THE COMMUNITY OF HEALTHIER LIFESTYLES AND OF LOCAL RESOURCES FOR HEALTH AND HEALTHCARE SERVICES AND PRODUCTS. THE ORGANIZATION ALSO CONTRIBUTES MONETARILY TO LOCAL CHARITIES SUCH AS UNITED WAY, MARCH OF DIMES, THE AMERICAN CANCER SOCIETY, SUSAN G. KOMEN, AND THE AMERICAN HEART ASSOCIATION.
AFFILIATED HEALTH CARE SYSTEM	CAUGHMAN HEALTH CENTER (CAUGHMAN) AND WOMENS & CHILDRENS CENTER (W&C) PROVIDES HEALTH CARE TO HANCOCK COUNTY FAMILIES, REGARDLESS OF THEIR ABILITY TO PAY. FAMILY PRACTICE, PEDIATRIC, OB/GYN, AND PREVENTATIVE SERVICES ARE OFFERED AT CAUGHMAN. CAUGHMAN AND W&C ALSO PARTICIPATES IN A PROGRAM THAT CONNECTS PATIENTS WITH PHARMACEUTICAL COMPANIES' INDIGENT CARE PROGRAMS TO PROVIDE MEDICATIONS AT NO CHARGE TO PATIENTS. A LICENSED INDEPENDENT SOCIAL WORKER IS EMPLOYED AT CAUGHMAN, AND SHE FACILITATES CLASSES FOR TEEN MOMS, PROVIDES COUNSELING TO PATIENTS, MAKES HOME VISITS FOR PATIENTS, AND PROVIDES ADDITIONAL SUPPORT FOR PATIENTS. BLANCHARD VALLEY REGIONAL HEALTH CENTER, ALONG WITH ITS AFFILIATES, PROVIDES UNRESTRICTED ACCESS TO CARE THROUGH THE ABOVE MENTIONED CAUGHMAN HEALTH CENTER, WOMENS & CHILDRENS CENTER, PHYSICIAN'S PLUS URGENT CARE FACILITY, AND ALL OF THEIR RELATED MEDICAL PRACTICES.
STATE FILING OF COMMUNITY BENEFIT REPORT	OHIO

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
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 (10 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 Rltd OrgsCompReportPrior990RltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
SCOTT MALANEY
CHIEF EXECUTIVE OFFICER	$0	$561,502	$0	$44,903	$0	$175,309	$0	$170,638	$0	$7,051	$0	$959,403	$138,650
DAVE CYTLAK
CHIEF FINANCIAL OFFICER	$0	$320,659	$0	$35,548	$0	$29,583	$0	$38,177	$0	$1,101	$0	$425,068	$2,281
WILLIAM KOSE
CHIEF QUALITY OFFICER	$0	$311,142	$0	$37,966	$0	$38,631	$0	$15,900	$0	$13,402	$0	$417,041	$0
ANGELA HOLT
PHYSICIAN	$447,976	$0	$0	$0	$19,548	$0	$15,900	$0	$5,173	$0	$488,597	$0		$0
MICHAEL MANUAL
PHYSICIAN	$179,162	$0	$201,989	$0	$18,261	$0	$15,900	$0	$11,984	$0	$427,296	$0
DANIEL SAK
PHYSICIAN	$393,483	$0	$0	$0	$0	$0	$0	$0	$7,822	$0	$401,305	$0
REBECCA DOEDE
PHYSICIAN	$224,330	$0	$93,631	$0	$22,144	$0	$9,786	$0	$1,380	$0	$351,271	$0		$0
SCOTT SPIRIDIGLIOZZI
CRNA	$308,283	$0	$0	$0	$18,748	$0	$2,843	$0	$11,431	$0	$341,305	$0
BARBARA PASZTOR
VP OF NURSING	$224,914		$12,028	$0	$15,423	$0	$14,651	$0	$7,051	$0	$274,067	$0		$0
CHRISTINE KELLER
VP OF CLINICAL SERVICES	$206,212		$10,778	$0	$246	$0	$12,750	$0	$7,142	$0	$237,128	$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 2016, BLANCHARD VALLEY HEALTH SYSTEM CONTRIBUTED ON BEHALF OF SCOTT MALANEY $154,738 TO A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT CONSISTING OF TWO PLANS: AN ELIGIBLE PLAN SUBJECT TO INTERNAL REVENUE CODE SECTION 457(B) AND AN INELIGIBLE PLAN SUBJECT TO SECTION 457(F). THE 457(B) PLAN WAS ORIGINALLY IMPLEMENTED EFFECTIVE JANUARY 1, 2002. THE 457(F) PLAN WAS ORIGINALLY EFFECTIVE SEPTEMBER 1, 2000 AND WAS RESTATED ON JANUARY 1, 2002 FOR COORDINATION WITH THE 457(B) PLAN. IN 2010 AND 2011, THE 457(F) PLAN WAS FURTHER AMENDED AND RESTATED TO COMPLY WITH THE LATEST REGULATORY GUIDANCE AND PROVIDE FOR A NEW CONTRIBUTION MODEL AND VESTING SCHEDULE. ADDITIONAL EXECUTIVES WERE ALSO ADDED AND DEEMED ELIGIBLE FOR PLAN BENEFITS IN 2010, INCLUDING DAVID CYTLAK. IN 2016, BLANCHARD VALLEY HEALTH SYSTEM CONTRIBUTED ON BEHALF OF DAVID CYTLAK $22,277 TO THE SERP. KEY FEATURES OF THE SERP, AS AMENDED AND RESTATED IN 2010/2011, INCLUDE THE FOLLOWING: * ELIGIBILITY IS LIMITED TO CERTAIN MANAGEMENT OR HIGHLY-COMPENSATED EMPLOYEES OF BVHS (I.E., TOP HAT REFERENCE). FUTURE PARTICIPATION IS UPON NOMINATION BY THE CEO AND APPROVAL BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. EMPLOYER CONTRIBUTIONS ARE COMPRISED OF: DEFINED CONTRIBUTION TARGET INCOME REPLACEMENT PERCENTAGE CONTRIBUTION: - PROVIDE 60% TARGET INCOME REPLACEMENT FOR CEO (SCOTT MALANEY) - PROVIDE 50% TARGET INCOME REPLACEMENT FOR CFO (DAVID CYTLAK) EMPLOYEE CONTRIBUTIONS TO THE SERP ACCOUNT ARE NOT ALLOWED. EACH PARTICIPANT'S 457(B) ACCOUNT WILL BE CREDITED UP TO THE STATUTORY LIMIT ($18,000 IN 2016), WITH THE REMAINING AMOUNT BEING DEPOSITED INTO THE 457(F) ACCOUNT. EMPLOYER CONTRIBUTIONS TO THE 457(F) PLAN ARE SUBJECT TO A CLASS YEAR VESTING SCHEDULE, WITH A WAITING PERIOD SET AT 2-5 YEARS, DEPENDING ON THE AGE OF THE PARTICIPANT AT THE TIME OF CONTRIBUTION. UPON VESTING, THE FULL VESTED BALANCE WILL BE DISTRIBUTED TO THE PARTICIPANT AND CONSIDERED TAXABLE INCOME. IN ADDITION TO THE VESTING SCHEDULE ABOVE, 100% AND IMMEDIATE VESTING OF THE BENEFIT ACCRUED UPON ATTAINMENT OF NORMAL RETIREMENT AGE, DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, PLAN TERMINATION, OR CHANGE OF CONTROL. DISTRIBUTION OF THE VESTED PORTION OF THE 457(F) BENEFIT IS PAID AS A LUMP SUM AS SOON AS ADMINISTRATIVELY FEASIBLE.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd	CUSIPCUSIPNum
VILLAGE OF BLUFFTON OH
A	346400139	2010-12-31	$11,293,759	REFUNDED PRIOR OBLIGATION, SEE PAR	false	false	false
COUNTY OF HANCOCK OHIO
B	346400608	2011-04-14	$108,706,899	REFUND ISSUE DATED 11/4/2004	false	false	false	410040BY4
VILLAGE OF ANNA OHIO
C	340894539	2012-06-13	$9,700,000	BUILDING & EQUIPMENT FINANCING	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$11,293,759	$0	$11,293,759	$0	$0	$0	$0	$0	$0	$0	$11,293,759	$0	Yes (true)	false	Yes (true)	Yes (true)
B	$8,975,000	$0	$108,706,899	$0	$0	$0	$1,874,847	$0	$0	$0	$106,832,052	$0	Yes (true)	false	Yes (true)	Yes (true)
C	$1,825,000	$0	$9,700,000	$0	$0	$0	$0	$0	$0	$9,700,000	$0	$0	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	Yes (true)	Yes (true)	false	false	false	false	Yes (true)
B	false	false	Yes (true)	Yes (true)	false	false	false	false	Yes (true)
C	false	false	Yes (true)	Yes (true)	false	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	Yes (true)	false	Yes (true)	false	false	0	false	Yes (true)
0
B	false	Yes (true)	false	false	false	false	false	0	false	Yes (true)
0
C	false	Yes (true)	false	false	Yes (true)	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, COL. B, F:	THE ISSUE REFUNDED LEASE OBLIGATIONS DATED 11/15/2002, 12/21/2005, 12/20/2006, AND 10/23/2009.
PART 2, COL. A & B, LINE 11:	THE PROCEEDS LISTED WERE USED TO CURRENTLY REFUND THE PRIOR OBLIGATIONS LISTED IN PART I.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 1B	SCOTT MALANEY IS A BOARD MEMBER AND PAID EMPLOYEE OF A RELATED ORGANIZATION. DUE TO HIS EMPLOYMENT, HE IS CONSIDERED A NON INDEPENDENT VOTING MEMBER OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B A DETAILED REVIEW OF THE FORM 990 IS PERFORMED BY THE ORGANIZATION'S COMPLIANCE & AUDIT COMMITTEE. THIS COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, MEMBERS OF THE COMMUNITY, AND MEMBERS OF UPPER MANAGEMENT. THE COMPLIANCE & AUDIT COMMITTEE REPORTS TO THE BOARD OF TRUSTEES ANY AREAS OF CONCERN REGARDING THE FORM 990. ONCE THE FORM 990 HAS BEEN FINALIZED, REVIEWED AND APPROVED, THE MEMBERS OF BOARD OF TRUSTEES RECEIVE ELECTRONIC COMMUNICATION THAT THE FORM 990 IS COMPLETE AND AVAILABLE FOR REVIEW. ANY QUESTIONS ARISING FROM BOARD MEMBERS ARE ADDRESSED BY THE COMPLIANCE & AUDIT COMMITTEE, UPPER MANAGEMENT, THE ACCOUNTING DEPARTMENT, AND/OR EXTERNAL ACCOUNTANTS.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY, THE ORGANIZATION ASKS ITS BOARD MEMBERS, ITS CORPORATE OFFICERS, AND ITS KEY EMPLOYEES TO SIGN CONFLICT OF INTEREST LETTERS. THE ORGANIZATION ALSO ASKS THESE INDIVIDUALS TO REVIEW THEIR ACTIVITIES AND COMPLETE RELATIONSHIP QUESTIONNAIRES FOR THE FORM 990 FILING YEAR. BOARD MEMBERS ARE REQUIRED TO BRING TO THE ATTENTION OF EXECUTIVE MANAGEMENT ANY CONFLICTS AS THEY ARISE. THESE CONFLICTS ARE DOCUMENTED IN THE BOARD MINUTES. BOARD MEMBERS THAT HAVE CONFLICTS ARE TO EXCUSE THEMSELVES FROM DISCUSSIONS AND/OR VOTING ON ISSUES WITH WHICH CONFLICTS EXIST.
FORM 990, PART VI, SECTION B, LINE 15A	THE ORGANIZATION REVIEWS EXECUTIVE COMPENSATION, BENEFITS, AND PREREQUESITES ON A PERIODIC BASIS TO ENSURE CONSISTENCY WITH COMPENSATION PHILOSOPHY AND MARKET PRACTICE. A SUBSET OF MEMBERS FROM THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION REVIEW COMMITTEE, AND THIS COMMITTEE MEETS TO APPROVE WAGE INCREASES AS WELL AS REVIEWS THE ORGANIZATION'S POSITION IN THE MARKET WHEN IT COMES TO EXECUTIVE COMPENSATION. IN ADDITION, THE EXECUTIVE COMPENSATION REVIEW COMMITTEE REGULARLY ENGAGES A HUMAN RESOURCES CONSULTING FIRM TO ASSESS THE REASONABLENESS OF THE COMPENSATION PROGRAM USED FOR ITS EXECUTIVES. THE ORGANIZATION IS COMMITTED TO A DECISION-MAKING PROCESS FOR EXECUTIVE COMPENSATION THAT IS CONSISTENT WITH INTERNAL REVENUE CODE SECTION 4958 REQUIREMENTS FOR OBTAINING A REBUTTABLE PRESUMPTION OF REASONABLENESS. THE MEMBERS OF THE COMMITTEE APPROVING EXECUTIVE COMPENSATION DECISIONS ARE INDIVIDUALS WHO ARE DISINTERESTED (I.E., DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE ARRANGEMENTS). THE COMMITTEE REVIEWS OBJECTIVE DATA, INCLUDING SURVEY DATA PREPARED BY INDEPENDENT FIRMS, AS PART OF THE DECISION-MAKING PROCESS. *THE MARKET DATA PROVIDED IN THE COMPENSATION REPORT FROM THE CONSULTING FIRM ASSISTS THE ORGANIZATION IN ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS. THE ORGANIZATION CONSULTS WITH SULLIVAN COTTER AND ASSOCIATES (AN EXTERNAL CONSULTANT) ON AN ANNUAL BASIS TO REVIEW COMPENSATION MATTERS. ON A BIENNIAL BASIS, THE ORGANIZATION PERFORMS A FULL COMPENSATION & BENEFIT ANALYSIS & REVIEW. THE RESULTS OF THE REVIEW BY SULLIVAN COTTER AND ASSOCIATES ARE SHARED/DISCUSSED WITH THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15B	THE SAME PROCESS APPLIES FOR ALL OTHER EXECUTIVE STEERING COMMITTEE MEMBERS AS DETAILED FOR THE CEO.
FORM 990, PART VI, SECTION C, LINE 19	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.
PART IX	In 2016, the organization implemented a new HCIS system (Cerner/PeopleSoft). During this implementation, the organization changed how it categorized its general ledger income statement accounts to present a clearer picture of the operating results of the organizations divisions. As a result, various departmental expense accounts from the BVRHC division were reclassified to the parent organization, BVHS. Most of these departmental expense accounts related to business office administrative costs that had historically been recorded under BVRHC (e.g. administration, accounting, purchasing, legal, etc.). These administrative costs are now reported under BVHS, as these departments perform duties for the entire organization and not just the BVRHC division. Thus, due to this change in categorization of administrative costs, divisional expenses recorded on Part IX - Statement of Functional Expenses will look significantly different on the BVRHC Form 990 (reduction to Functional Expenses) and the BVHS Form 990 (increase to Functional Expenses). Similarly, changes to the categories per the general ledger affected how the balance sheets are presented for the various divisions of BVHS. PART XI, LINE 9 CHANGE IN INTEREST RATE SWAP AGREEMENT 942,533 DEFINED BENEFIT PENSION PLAN -2,486,071 OTHER CHANGES IN NONCONTROLLING INTEREST -1,037,326 TRANSFERS FROM AFFILIATES -11,054,122 TOTAL $13,634,986

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	061748552	CERT NURSE	OH	$1,992,431	BVRHC
BLANCHARD VALLEY MEDICAL PRACTICES LLC
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	421659766	PHYS OFFICES	OH		BVHS
BLANCHARD VALLEY HOME CARE SERVICES
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	421565629	HOME HEALTH	OH		BVCCS
NEUROSURGICAL ASSOCIATES OF NW OHIO
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	342052585	PHYS OFFICES	OH		BVMP
SPECIALTY PHYSICIANS OF BLANCHARD VALLEY
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	262448601	PHYS OFFICES	OH		BVMP
BLANCHARD VALLEY REGIONAL CANCER CENTER
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	050623393	CANCER CARE	OH		BVMP
HANCO EMERGENCY MEDICAL SERVICES LLC
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	463299390	AMBULANCE	OH		BVHS

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 HEALTH SYSTEM
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	344428206	HEALTH CARE	OH	501(C)3	12A	NA	Yes (true)
BLANCHARD VALLEY CONTINUING CARE SERVICE
15100 BIRCHAVEN LANE	FINDLAY	OH	45840	346006904	CONTINUING CA	OH	501(C)3	10	BVHS	Yes (true)
BLANCHARD VALLEY HEALTH FOUNDATION
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	341370522	FUNDRAISING	OH	501(C)3	7	BVHS	false
EC EDWARDS MEMORIAL TRUST
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	346953719	INVESTMENT	OH	501(C)3	PF	BVHF	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	UBI Code VUBICodeVAmt
BLANCHARD VALLEY PAIN MANAGEMENT
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	270095470	PAIN MGMT	OH	BVRHC	RELATED	$4,402,293	$1,226,388	false	false	0.51000
TECHNICORE CLINICAL ENGINEERING SERVICES
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	421702910	BIO-MED SUPPORT	OH	BVRHC	RELATED	$549,750	$726,844	false	false	0.66660	-$19,876
CREIGHTON DIALYSIS LLC
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	274527592	DIALYSIS SERVICES	OH	BVRHC	RELATED	$2,632,792	-$3,781	false	false	0.60000
NORTHWEST OHIO MEDICAL EQUIPMENT
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	341882390	MEDICAL EQUIP	OH	BVCCS	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
CITAS INC
1900 SOUTH MAIN STREET	FINDLAY	OH	45840	341369708	RECRUITING	OH	BVHS	C CORP	false
BIRCHAVEN ESTATES AT EASTERN WOODS LTD
15100 BIRCHAVEN LANE	FINDLAY	OH	45840	201494204	CONDOMINIUMS	OH	BVCCS	C CORP	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	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	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	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	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	TECHNICORE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	L	TransactionTypeTxt
Involved	$189,739	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt