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BLANCHARD VALLEY REGIONAL HEALTH CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BLANCHARD VALLEY REGIONAL HEALTH CENTER (EIN 34-1369963)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-10-29
IRS object ID
201313029349300401
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-10-29T06:18:38-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1200 E Main St Suite 700AddressLine1
CityFort WayneCity
StateINState
ZIP Code46802ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN341369963EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BLANCHARD VALLEY REGIONAL HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% DAVID M CYTLAKInCareOfName
Name ControlBLANNameControl
Phone4194235497Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1
Address Line2SuiteAddressLine2
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAVID M CYTLAKName
TitleCFOTitle
Phone4194235497Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoyce A DulworthName
Phone2604604000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAVID M CYTLAKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode
FieldValueIRS element (for citing)
Gross Receipts238425735GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BVHEALTHSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionBLANCHARD VALLEY REGIONAL HEALTH CENTER OPERATES TWO HOSPITALS OFFERING INPATIENT, EMERGENCY, MATERNITY AND OUTPATIENT SERVICES; OUTPATIENT CENTERS, AND A HOSPITAL-SUBSIDIZED PRIMARY CARE CLINIC.ActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees1654TotalNbrEmployees
Total Nbr Volunteers459TotalNbrVolunteers
Total Gross UBI1653556TotalGrossUBI
Net Unrelated Business Txbl Income1068824NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year201649018ProgramServiceRevenuePriorYear
Program Service Revenue CY214115860ProgramServiceRevenueCY
Investment Income Prior Year6893753InvestmentIncomePriorYear
Investment Income Current Year7392278InvestmentIncomeCurrentYear
Other Revenue Prior Year5912853OtherRevenuePriorYear
Other Revenue Current Year6408953OtherRevenueCurrentYear
Total Revenue Prior Year214455624TotalRevenuePriorYear
Total Revenue Current Year227917091TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year10000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year93062061SalariesEtcPriorYear
Salaries Etc Current Year98794796SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year95160072OtherExpensePriorYear
Other Expenses Current Year100273844OtherExpensesCurrentYear
Total Expenses Prior Year188232133TotalExpensesPriorYear
Total Expenses Current Year199068640TotalExpensesCurrentYear
Revenues Less Expenses Prior Year26223491RevenuesLessExpensesPriorYear
Revenues Less Expenses CY28848451RevenuesLessExpensesCY
Total Assets BOY365224455TotalAssetsBOY
Total Assets EOY396025373TotalAssetsEOY
Total Liabilities BOY231143785TotalLiabilitiesBOY
Total Liabilities EOY227053543TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY134080670NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY168971830NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR MISSION: OUR EXTRAORDINARY PEOPLE PROVIDE CARING FOR A LIFETIME THROUGH A BROAD CONTINUUM OF EXCEPTIONAL HEALTH-RELATED SERVICES IN NORTHWEST OHIO.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense32697262Expense
Revenue41902180Revenue
DescriptionCardiovascular Services: Blanchard Valley Heartcare Center offers a complete range of services for comprehensive cardiac care. Services for 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 (AAC[VR). 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 received 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 2012, our median "door to balloon time" was 49.5 minutes. Also, Blanchard Valley Hospitals Cardiovascular Program, part of the Jane & Gary Heminger HeartCare Center, was named one of the nations 50 Top Cardiovascular Hospitals for 2013 by Truven Health Analytics, formerly Thomson Reuters.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense25505185Expense
Revenue32685394Revenue
DescriptionGeneral 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.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense20051617Expense
Revenue25696539Revenue
DescriptionORTHOPEDIC SERVICES: ORTHOPEDIC SERVICES AT BLANCHARD VALLEY HOSPITAL INCLUDE: HIP FRACTURE REPAIR AND REPLACEMENT, KNEE SURGERY, JOINT REPLACEMENT, TOTAL KNEE REPLACEMENT, AND MANY OTHER PROCEDURES. WE HAVE PERFORMED MORE THAN 1,000 JOINT REPLACEMENTS SINCE 2008 WITH SOME OF THE MOST ADVANCED TECHNOLOGY IN THE U.S., INCLUDING MINIMALLY INVASIVE AND GENDER-SPECIFIC PROCEDURES. OUR ORTHOPEDIC PROGRAM WAS DEVELOPED THROUGH THE COLLABORATION OF OUR SPECIALTY ORTHOPEDIC SURGEONS AND HOSPITAL ASSOCIATES. WE WORK DIRECTLY WITH OUR PATIENTS TO CREATE A HEALTH CARE PLAN TO FIT THEIR NEEDS. IN 2012, HEALTHGRADES - THE LEADING INDEPENDENT HEALTH CARE 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-STAR RATING FOR OVERALL ORTHOPEDICS, 5-STAR RATING FOR TOTAL JOINT REPLACEMENT; 5-STAR RATING FOR TOTAL KNEE REPLACEMENT; 5-STAR RATING FOR TOTAL HIP REPLACEMENT.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp88397963TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev113344902TotalOfOtherProgramServiceRev
Total Program Service Expense166652027TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096420NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1654NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAVID M CYTLAKNamePerson
Telephone Number4194235497TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11900 SOUTH MAIN STREETAddressLine1
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
SCOTT MALANEY
CHIEF EXECUTIVE OFFICER2.038.0XX060937344760
DR ERIC BOSTICK
TRUSTEE0.51.0X000
CHERYL BUCKLAND RN
TRUSTEE0.51.0X000
KAREN CLINE
TRUSTEE0.51.0X000
KURT GEISHEIMER
TREASURER0.51.0X000
DUANE JEBBETT
CHAIRMAN0.51.0X000
KAREN KLASSEN HARDER PHD
SECRETARY0.51.0X000
ANDREA KOEPKE DNS
TRUSTEE0.51.0X000
JOE LONGO
TRUSTEE0.51.0X000
DR STEVE MCCULLOUGH
TRUSTEE0.51.0X000
DR RANDALL MYERS
TRUSTEE0.51.0X000
ROD NICHOLS
TRUSTEE0.51.0X000
DR NANCY OREL
TRUSTEE0.51.0X000
DR RICHARD POLDER
TRUSTEE0.51.0X000
REV WILLIAM REIST
TRUSTEE0.51.0X000
DR LEROY SCHROEDER
TRUSTEE0.51.0X000
KIMBERLY STUMP
TRUSTEE0.51.0X000
DAVID EUBANKS
TRUSTEE0.51.0X000
ERIC KURJAN
TRUSTEE0.51.0X000
GARRY PEIFFER
TRUSTEE0.51.0X000
PAUL WORSTELL
VICE CHAIRMAN0.51.0X000
DAVE CYTLAK
CHIEF FINANCIAL OFFICER2.038.0X035430340264
CHRISTOPHER PRESS
PRESIDENT BVRHC38.02.0X310390030815
DR WILLIAM KOSE
CHIEF QUALITY OFFICER4.036.0X035844431813
ROBERT WESTPHAL
PRESIDENT BVCCS2.038.0X022159638361
BARBARA PASZTOR RN
VP OF NURSING40.0233017034345X
CHRISTINE KELLER
VP OF CLINICAL SERVICES40.0188938024403X
WILLIAM WATKINS
CHIEF ADMINISTRATIVE OFFICER4.036.0017066426854X
DR CHIRANJI AGRAWAL
PHYSICIAN40.0485684029700X
DR ANGELA HOLT
PHYSICIAN40.0429789028588X
DR MIGUEL JORDAN
PHYSICIAN40.0382702022565X
DR GEORGE ABATE
PHYSICIAN40.0353426027480X
DR MICHAEL MANUAL
PHYSICIAN40.0317364038760X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2701310TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1714380TotalReportableCompFrmRltdOrgs
Total Other Compensation418708TotalOtherCompensation
Number Individuals GT100 K54NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Caretech Solutions Inc
901 Wilshire Dr Suite 250TROYMI48084IT & COMMUNICATION5851061
Sodexo Inc
9001 Washington BlvdGAITHERSBURGMD20878Dietary Services1451179
Hylant Group Inc
811 MADISON AVETOLEDOOH43604INSURANCE1146746
Technicore
PO Box 1210FINDLAYOH45839Bio-Med Support1095835
Delta Dental Plan Of Ohio
PO Box 633198CINCINNATIOH45263Dental Plan889562
FieldValueIRS element (for citing)
Number Of Contractors GT100 K45NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE900099209815119209815119
OUTPATIENT PHARMACY4461101423309869041554268
INVESTMENT IN TECHNICORE54190018720011918836-46835
MEDICAL SERVICES900099119033119033
CHARITY SERVICES900099236669236669

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column649729TotalRevenueColumn
Related Or Exempt Function Income649729RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue214115860TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7281774TotalRevenueColumn
Exclusion$7,281,774ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real310364Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real310364Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column310364TotalRevenueColumn
Exclusion$310,364ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities10407762Securities
Other20588Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities10317846Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities89916Securities
Other20588Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column110504TotalRevenueColumn
Related Or Exempt Function Income20588RelatedOrExemptFunctionIncome
Exclusion$89,916ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory203866GrossSalesOfInventory
Cost Of Goods Sold190798CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column13068TotalRevenueColumn
Exclusion$13,068ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
FINDLAY SURGERY CENTER62130011461231146123
CAFETERIA900099164340$164,340
MEAL TICKETS900099811899$811,899

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column3963159TotalRevenueColumn
Exclusion$3,963,159ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue6085521TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column227917091TotalRevenueColumn
Related Or Exempt Function Income213629015RelatedOrExemptFunctionIncome
Unrelated Business Revenue1653556UnrelatedBusinessRevenue
Exclusion$12,634,520ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3006652Total
Program Services2059450ProgramServices
Management And General947202ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total74081366Total
Program Services58953701ProgramServices
Management And General15127665ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3130550Total
Program Services2491455ProgramServices
Management And General639095ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13476579Total
Program Services10725363ProgramServices
Management And General2751216ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5099649Total
Program Services4058566ProgramServices
Management And General1041083ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total72287Total
Program Services0ProgramServices
Management And General72287ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total984598Total
Program Services0ProgramServices
Management And General984598ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total8861053Total
Program Services7052087ProgramServices
Management And General1808966ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total689992Total
Program Services549132ProgramServices
Management And General140860ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5980838Total
Program Services5813081ProgramServices
Management And General167757ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3331709Total
Program Services2242268ProgramServices
Management And General1089441ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3941118Total
Program Services3136547ProgramServices
Management And General804571ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total698105Total
Program Services555588ProgramServices
Management And General142517ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total8254130Total
Program Services6587241ProgramServices
Management And General1666889ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11487588Total
Program Services9142420ProgramServices
Management And General2345168ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total662037Total
Program Services0ProgramServices
Management And General662037ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PROVISION FOR BAD DEBTS9319402931940200
MEDICAL & PROFESSIONAL FEES415595333075248484290
DUES & SUBSCRIPTIONS5849294655171194120
MEDICAL SUPPLIES360540893605408900

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5196016Total
Program Services4138596ProgramServices
Management And General1057420ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total199068640Total
Program Services166652027ProgramServices
Management And General32416613ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY26832431BOY
EOY28334610EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY23017139BOY
EOY23346014EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5227897BOY
EOY5086555EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY833193BOY
EOY1161349EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis226461222LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec95244489LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY132613833BOY
EOY131216733EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY134440337BOY
EOY158100470EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY46968BOY
EOY377806EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY42212657BOY
EOY48401836EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY365224455BOY
EOY396025373EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY16216567BOY
EOY17154597EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY183287BOY
EOY161044EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY118879980BOY
EOY125004414EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
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Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6878336BOY
EOY6349826EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY88985615BOY
EOY78383662EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY231143785BOY
EOY227053543EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY127746483BOY
EOY162156891EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY628340BOY
EOY722525EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5705847BOY
EOY6092414EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY134080670BOY
EOY168971830EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY365224455BOY
EOY396025373EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses28848451ReconcilationRevenueExpenses
Reconciliation Unrealized Invest14717930ReconciliationUnrealizedInvest
Reconcilation Other Changes-8675221ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance6334186BeginningOfYearBalance
Investment Earnings Or Losses752562InvestmentEarningsOrLosses
Other Expenditures271810OtherExpenditures
End Of Year Balance6814938EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6518959BeginningOfYearBalance
Investment Earnings Or Losses-168872InvestmentEarningsOrLosses
Other Expenditures15901OtherExpenditures
End Of Year Balance6334186EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance6136329BeginningOfYearBalance
Investment Earnings Or Losses389430InvestmentEarningsOrLosses
Other Expenditures6800OtherExpenditures
End Of Year Balance6518959EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5459960BeginningOfYearBalance
Investment Earnings Or Losses677759InvestmentEarningsOrLosses
Other Expenditures1390OtherExpenditures
End Of Year Balance6136329EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7587291BeginningOfYearBalance
Investment Earnings Or Losses-2022743InvestmentEarningsOrLosses
Other Expenditures104588OtherExpenditures
End Of Year Balance5459960EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.89400PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.10600TermEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3084517OtherCostOrOtherBasis
Book Value3084517BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis132072631OtherCostOrOtherBasis
Depreciation35850354Depreciation
Book Value96222277BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1526998OtherCostOrOtherBasis
Depreciation1246186Depreciation
Book Value280812BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis78183445OtherCostOrOtherBasis
Depreciation54637138Depreciation
Book Value23546307BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11592103OtherCostOrOtherBasis
Depreciation3510811Depreciation
Book Value8081292BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings131215205TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
ADVANCES TO AFFILIATES46451035
DEFERRED BOND ISSUANCE COSTS1950801
FieldValueIRS element (for citing)
Total Book Value Other Assets48401836TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
PENSION LIABILITY$47,275,798
THIRD PARTY SETTLEMENTS$2,301,238
INTEREST RATE SWAP OBLIGATION$28,265,661
MINORITY INTEREST IN PAIN MANA$540,965
FieldValueIRS element (for citing)
Total Of Amounts78383662TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt233959800TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments14717930NetUnrealizedGainsInvestments
Other Revenues-8675221OtherRevenues
Revenue Not Rptd F9906042709RevenueNotRptdF990
Revenue Subtotal227917091RevenueSubtotal
Total Revenue Per Form990227917091TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt199068640TotExpensesEtcAuditedFinclStmt
Expenses Subtotal199068640ExpensesSubtotal
Total Expenses Per Form990199068640TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE DPART VQUESTION 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 8 & PART XII, LINE 2D CHANGE IN INTEREST RATE SWAP AGREEMENT $(129,062) DEFINED BENEFIT PENSION PLAN (1,603,834) OTHER CHANGES IN NONCONTROLLING INTEREST (6,830,892) CHANGE IN PERPETUAL TRUST 387,567 TRANSFERS TO AFFILIATES (499,000) TOTAL (8,675,221)
ASC 740 FOOTNOTEManagement 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

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7023137TotalCommunityBenefitExpense
Net Community Benefit Expense7023137NetCommunityBenefitExpense
Percent Of Total Expense0.03700PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense17919706TotalCommunityBenefitExpense
Direct Offsetting Revenue12056308DirectOffsettingRevenue
Net Community Benefit Expense5863398NetCommunityBenefitExpense
Percent Of Total Expense0.03090PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense4073710TotalCommunityBenefitExpense
Direct Offsetting Revenue2845975DirectOffsettingRevenue
Net Community Benefit Expense1227735NetCommunityBenefitExpense
Percent Of Total Expense0.00650PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense29016553TotalCommunityBenefitExpense
Direct Offsetting Revenue14902283DirectOffsettingRevenue
Net Community Benefit Expense14114270NetCommunityBenefitExpense
Percent Of Total Expense0.07440PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense248173TotalCommunityBenefitExpense
Direct Offsetting Revenue4418DirectOffsettingRevenue
Net Community Benefit Expense243755NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense97780TotalCommunityBenefitExpense
Net Community Benefit Expense97780NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense69582TotalCommunityBenefitExpense
Net Community Benefit Expense69582NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense415535TotalCommunityBenefitExpense
Direct Offsetting Revenue4418DirectOffsettingRevenue
Net Community Benefit Expense411117NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense29432088TotalCommunityBenefitExpense
Direct Offsetting Revenue14906701DirectOffsettingRevenue
Net Community Benefit Expense14525387NetCommunityBenefitExpense
Percent Of Total Expense0.07660PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense5945TotalCommunityBuildingExpense
Net Community Building Expense5945NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense75307TotalCommunityBuildingExpense
Direct Offsetting Revenue3000DirectOffsettingRevenue
Net Community Building Expense72307NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense38455TotalCommunityBuildingExpense
Net Community Building Expense38455NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense9297TotalCommunityBuildingExpense
Net Community Building Expense9297NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense129004TotalCommunityBuildingExpense
Direct Offsetting Revenue3000DirectOffsettingRevenue
Net Community Building Expense126004NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$9,319,402BadDebtExpenseAmount
Amount Attributable To3075403AmountAttributableTo
Amount Reimbursed By Medicare39927365AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare49513168CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-9585803MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursCritical Access HospitalCriticalAccessHospital
BLANCHARD VALLEY HOSPITAL
11900 SOUTH MAIN STREETFINDLAYOH45840XXX
BLUFFTON HOSPITAL
2139 GARAU STREETBLUFFTONOH45817XXXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesReport To Credit AgencyReportToCreditAgencyLawsuitLawsuitNotify Before DischargeNotifyBeforeDischargeNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyLowest Negotiated RatesLowestNegotiatedRatesAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
BLANCHARD VALLEY HOSPITAL
1truetrue150.true250.trueXXXXXXtruetrueXXXtruetrueXXXXXtrueXfalsefalse
BLUFFTON HOSPITAL
2truetrue150.true250.trueXXXXXXtruetrueXXXtruetrueXXXXXtrueXfalsefalse

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
CAUGHMAN HEALTH CENTER
1800 NORTH BLANCHARD STREET SUITEFINDLAYOH45840OUTPATIENT CLINIC
CREIGHTON DIALYSIS LLC
100 EAST MAIN CROSS STREETFINDLAYOH45840DIALYSIS CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 7The costing methodology that is used to calculate the amounts in 7a through 7d is the same methodology that is used to prepare our 2012 Medicaid AND MEDICARE Cost Reports. We pull information from Schedule F and Schedule H for costs, payments, and charges as they are presented in the 2012 MedicaID Cost Report.
PART I, LINE 7FBad debt expense of $9,319,402 was removed from total expenses prior to calculating the percentage of total expense.
PART III, LINE 4WE DO NOT HAVE A BAD DEBT FOOTNOTE. Our bad debt expense is comprised of three 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. Finally, any recoveries that are received from collection agencies are recorded as a decrease to bad debt expense. These three 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 the 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 always be treated and will not be turned away.
PART III, LINE 8AALL 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 2012 MEDICARE COST REPORTS AND OUR 2012 PSR REPORTS.
PART III, LINE 9BBlanchard 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. PART V, LINE 13G The Ohio Revised Code is posted throughout the hospital facility, finanical assistance information is included on the back of a patient's monthly statement, literature (i.e. brochures, packets, etc.) is available, and Financial Couselors are available and make room visits. available, and Financial Couselors are available and make room visits. Part vi, line 2 needs assessment Blanchard Valley Regional Health Center (BVRHC) has a long-standing commitment to the health care needs of the communities it serves. Through participation in and sponsorship of health fairs, health screenings, awareness campaigns, and educational events; as well as active and ongoing dialogue with the Findlay City and Hancock County Health Departments, BVRHC seeks not only to assess the needs of local communities, but also to encourage community members of all ages to take charge of their health care needs. We confer with the local city and county schools, and cooperate with agencies in the community that may, from time to time, conduct health assessments. The Bluffton Hospital collaborates with the local schools to provide a school nurse program that not only evaluates the population for health issues, but provides education as well. BVRHC periodically conducts physician needs assessments. Our multiple boards and committees are formed with members and physicians who live within the community. We also monitor diseases and conditions that present in our emergency department at Caughman Health Center. BVRHC HELPED LEAD THE DEVELOPMENT OF THE 2011 HANCOCK COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL'S CONTRIBUTIONS INCLUDED SENIOR EXECUTIVE TIME AND FINANCIAL SUPPORT. BVRHC SUCCESSFULLY SOUGHT EXECUTIVE AND FINANCIAL SUPPORT FROM OTHER HANCOCK COUNTY PRIVATE AND PUBLIC AGENCIES WHO ARE STAKEHOLDERS IN ANY HEALTH NEEDS ASSESSMENT. DURING 2011, THE HOSPITAL HELPED A STEERING COMMITTEE ADMINISTER ASSESSMENTS OF ADULTS, YOUTH, AND CHILDREN. THE REPORT WAS COMPLETED IN LATE 2011. THE HOSPITAL REMAINS INVOLVED WITH THE COMMITTEE AS IT CONTINUES FORWARD TO devise action plans to address selected health problems.
PART VI, LINE 3Blanchard 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.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
PART VI, LINE 4Blanchard 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 large university, as well as several large corporations including Cooper Tire & RUBBER COMPANY, Marathon PETROLEUM COMPANY, and Whirlpool CORPORATION. The surrounding areas are heavily agricultural.COMMUNITY INFORMATION
PART VI, LINE 5By 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 and the American Cancer Society.PROMOTION OF COMMUNITY HEALTH
PART VI, LINE 6CAUGHMAN HEALTH CENTER 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 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, PHYSICIAN'S PLUS URGENT CARE FACILITY, AND ALL OF THEIR RELATED MEDICAL PRACTICES. WE ARE A SPONSORING AND PARTICIPATING MEMBER OF THE NORTHWEST OHIO FLOOD MITIGATION PARTNERSHIP WHICH IS WORKING TOWARDS RESOLVING THE FLOODING ISSUES IN OUR COMMUNITY. IN 2010 WE JOINED WITH OUR COMMUNITY IN THE HABITAT FOR HUMANITY BUILDING PROJECTS.AFFILIATED HEALTH CARE SYSTEM

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BARBARA PASZTOR RN
VP OF NURSING18579302941701780801054702379802673620
CHRISTINE KELLER
VP OF CLINICAL SERVICES168475020320014401140801299502133410
WILLIAM WATKINS
CHIEF ADMINISTRATIVE OFFICER01484770181710401601032001653401975180
SCOTT MALANEY
CHIEF EXECUTIVE OFFICER0479574010514502465401346970297600773830
DAVE CYTLAK
CHIEF FINANCIAL OFFICER02831400471180240450181640252640397731
CHRISTOPHER PRESS
PRESIDENT BVRHC24370804865601802604174901612803682670
DR WILLIAM KOSE
CHIEF QUALITY OFFICER02926620358470299350150000168130390257
DR CHIRANJI AGRAWAL
PHYSICIAN483290000239401272201697805153840
DR ANGELA HOLT
PHYSICIAN4111020001868701500001358804583770
DR MIGUEL JORDAN
PHYSICIAN3003030586620237370150000756504052670
DR GEORGE ABATE
PHYSICIAN2773480573910186870408902339103809060
DR MICHAEL MANUAL
PHYSICIAN20451709567301717401500002376003561240
ROBERT WESTPHAL
PRESIDENT BVCCS018020803315208236013561024800025995700

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPART I, LINE 4BIdentifier
ExplanationIn 2012, Blanchard Valley Health System contributed on behalf of Scott Malaney $136,697 to a Supplemental Executive Retirement Plan (SERP). The SERP is an unfunded, nonqualified deferred compensation arrangement consisting of two plans: an "eligible" plan subject to Internal Revenue Code Section 457(b) and an "ineligible" plan subject to Section 457(f). The 457(b) plan was originally implemented effective January 1, 2002. The 457(f) plan was originally effective September 1, 2000 and was restated on January 1, 2002 for coordination with the 457(b) plan. In 2010 and 2011, the 457(f) plan was further amended and restated to comply with the latest regulatory guidance and provide for a new contribution model and vesting schedule. Additional executives were also added and deemed eligible for plan benefits in 2010, including Christopher Press and David Cytlak. In 2012, Blanchard Valley Health System contributed on behalf of Christopher Press $44,062 and contributed on behalf of David Cytlak $20,164 to the SERP. Key features of the SERP, as amended and restated in 2010/2011, include the following: * Eligibility is limited to certain management or highly-compensated employees of BVHS (i.e., "top hat" reference). Future participation is upon nomination by the CEO and approval by the Committee of the Board. * Employer contributions are comprised of: ** Defined Contribution Target Income Replacement Percentage Contribution: Provide 60% target income replacement for CEO (Scott Malaney) Provide 50% target income replacement for President (Christopher Press) Provide 50% target income replacement for CFO (David Cytlak) **Employee contributions to the SERP are not allowed. * Each participants 457(b) account will be credited up to the statutory limit ($17,000 in 2012), 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.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancingCUSIP NumberCUSIPNumber
VILLAGE OF BLUFFTON OHIO
A3464001392010-12-3111293759SEE PART VIfalsefalsefalse
COUNTY OF HANCOCK OHIO
B3464006082011-04-14108706899REFUND ISSUE DATED 11/4/2004falsefalsefalse410040BY4
VILLAGE OF ANNA OHIO
C3408945392012-06-139700000BUILDING & EQUIPMENT FINANCINGfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A42131420112937590000000112937590truefalsetruetrue
B2000000010870689900018748470001068320520truefalsetruetrue
C35000009700000000000097000000falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsetruetruefalse0truefalsefalsefalse
Bfalsefalsetruetruefalse0truefalsefalsefalse
Cfalsefalsetruetruefalse0truefalsefalsefalse

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
0
Afalsefalsefalsefalsetruefalsefalse0falsefalse
0
Bfalsefalsefalsefalsefalsefalsefalse0falsefalse
0
Cfalsefalsefalsefalsetruefalsefalse0falsefalse

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Afalse
Bfalse
Cfalse

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART I, COL. B, F:0THE ISSUE REFUNDED LEASE OBLIGATIONS DATED 11/15/2002, 12/21/2005, 12/20/2006, AND 10/23/2009.
PART 2, COL. A, B, & C, LINE 11:0THE PROCEEDS LISTED WERE USED TO CURRENTLY REFUND THE PRIOR OBLIGATIONS LISTED IN PART I.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
LOUISE WATKINS
WIFE OF WILLIAM WATKINS19952COMPENSATIONfalse
BUCKMAN LTD
>35% OWNEDSEE SUPPLEMENTAL INFORMATIONfalse
DR JASON SCHROEDER
SON OF DR. LEROY589827COMPENSATIONfalse
TERESA SCHROEDER
WIFE OF DR. LEROY25128COMPENSATIONfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierPART IVIdentifier
ExplanationCHERYL BUCKLAND IS A TRUSTEE ON THE ORGANIZATION'S BOARD. SHE IS A 50% OWNER IN BUCKMAN LIMITED. BLANCHARD VALLEY CONTINUING CARE SERVICES, A RELATED ENTITY, HAS AN OUTSTANDING LOAN TO BUCKMAN LIMITED FOR THE 2008 PURCHASE OF INDEPENDENCE HOUSE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART IIIQUESTION 4DOther services provided at BVRHC include: Women'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 Dialysis PART VI QUESTION 1B CHERYL BUCKLAND IS A 50% OWNER OF A COMPANY THAT HAS AN OUTSTANDING LOAN TO BLANCHARD VALLEY CONTINUING CARE SERVICES, A RELATED ORGANIZATION. DUE TO THIS RELATIONSHIP, SHE IS CONSIDERED A NON INDEPENDENT VOTING MEMBER OF THE BOARD. SCOTT MALANEY IS A BOARD MEMBER AND PAID EMPLOYEE OF A RELATED ORGANIZATION. DUE TO HIS EMPLOYMENT, HE IS CONSIDERED A NON INDEPENDENT VOTING MEMBER OF THE BOARD. DR. LEROY SCHROEDER IS RELATED TO TWO PAID EMPLOYEES OF BVRHC. DUE TO THESE RELATIONSHIPS, HE IS CONSIDERED A NON INDEPENDENT VOTING MEMBER OF THE BOARD. QUESTION 11B DETAIL REVIEWS OF THE FORM 990'S ARE PERFORMED BY AN INDEPENDENT CPA FIRM AND THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE. THIS COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, MEMBERS OF THE COMMUNITY, AND MEMBERS OF UPPER MANAGEMENT. THE COMPLIANCE & AUDIT COMMITTEE REPORTS TO THE BOARD OF TRUSTEES ANY AREAS OF CONCERN REGARDING THE FORM 990'S. ONCE THE FORM 990'S HAVE BEEN FINALIZED, REVIEWED AND APPROVED, THE MEMBERS OF BOARD OF TRUSTEES RECEIVE ELECTRONIC COMMUNICATION THAT THE FORM 990'S ARE COMPLETE AND AVAILABLE ON BOARDNET. ANY QUESTIONS ARISING FROM BOARD MEMBERS ARE ADDRESSED BY THE COMPLIANCE & AUDIT COMMITTEE, UPPER MANAGEMENT, THE ACCOUNTING DEPARTMENT, AND/OR EXTERNAL ACCOUNTANTS. QUESTION 12C ANNUALLY, THE ORGANIZATION ASKS THEIR BOARD AND EXECUTIVES TO SIGN CONFLICT OF INTEREST POLICIES. THE ORGANIZATION ALSO ASKS THEM TO REVIEW THEIR ACTIVITY AND COMPLETE RELATIONSHIP QUESTIONNAIRES FOR THE FORM 990 FILING YEAR. TRUSTEES ARE REQUIRED TO BRING TO THE ATTENTION OF MANAGEMENT ANY CONFLICTS AS THEY ARISE. THESE CONFLICTS ARE DOCUMENTED IN THE BOARD MINUTES. MEMBERS WITH CONFLICTS ARE TO EXCUSE THEMSELVES FROM DISCUSSION AND/OR VOTING ON ISSUES WITH WHICH A CONFLICT EXISTS. QUESTION 15A & 15B THE ORGANIZATION REVIEWS EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES ON A BI-ANNUAL BASIS TO ENSURE CONSISTENCY WITH COMPENSATION PHILOSOPHY AND MARKET PRACTICE. A SUBSET OF MEMBERS FROM THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION REVIEW COMMITTEE, AND THIS COMMITTEE MEETS TO APPROVE WAGE INCREASES AS WELL AS REVIEWS THE ORGANIZATION'S POSITION IN THE MARKET WHEN IT COMES TO EXECUTIVE COMPENSATION. IN ADDITION, THE EXECUTIVE COMPENSATION REVIEW COMMITTEE REGULARLY ENGAGES A HUMAN RESOURCES CONSULTING FIRM TO ASSESS THE REASONABLENESS OF THE COMPENSATION PROGRAM USED FOR ITS EXECUTIVES. THE ORGANIZATION IS COMMITTED TO A DECISION-MAKING PROCESS FOR EXECUTIVE COMPENSATION THAT IS CONSISTENT WITH INTERNAL REVENUE CODE SECTION 4958 REQUIREMENTS FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS". *THE MEMBERS OF THE COMMITTEE APPROVING EXECUTIVE COMPENSATION DECISIONS ARE INDIVIDUALS WHO ARE DISINTERESTED (I.E., DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE ARRANGEMENTS). *THE COMMITTEE REVIEWS OBJECTIVE DATA, INCLUDING SURVEY DATA PREPARED BY INDEPENDENT FIRMS, AS PART OF THE DECISION-MAKING PROCESS. *THE MARKET DATA PROVIDED IN THE COMPENSATION REPORT FROM THE CONSULTING FIRM ASSISTS THE ORGANIZATION IN ESTABLISHING THE "REBUTTABLE PRESUMPTION OF REASONABLENESS". THE MOST RECENT REVEIW WAS COMPLETED IN EARLY 2011 BY SULLIVAN COTTER AND ASSOCIATES (AN EXTERNAL CONSULTANT) AND SHARED/DISCUSSED WITH THE BOARD IN APRIL 2011. QUESTION 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 XII QUESTION 2 During 2012, the organization changed its governance structure so that it could address health system needs over the entire continuum of care provided by the organization. Prior to 2012, the organization had a separate compliance committee and a separate audit committee. Also, the form 990's were reviewed by a subcommittee of the audit committee. In 2012, these two separate committees and one subcommittee were combined into one Compliance & Audit Committee. All of the duties of these prior committees were transferred to the new committee. Thus, the Compliance & Audit Committee is responsible for reviews of compliance, reviews of the audited financial statements, reviews of the form 990's, and reviews of other areas as described in the committee's charter.
RECONCILIATION OF NET ASSETSPART XILINE 9 CHANGE IN INTEREST RATE SWAP AGREEMENT $(129,062) DEFINED BENEFIT PENSION PLAN (1,603,834) OTHER CHANGES IN NONCONTROLLING INTEREST (6,830,892) TRANSFERS TO AFFILIATES (499,000) CHANGE IN PERPETUAL TRUST 387,567 TOTAL (8,675,221)

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STFINDLAYOH45840061748552CERT NURSEOH3054550NA
BLANCHARD VALLEY MEDICAL PRACTICES
1900 SOUTH MAIN STFINDLAYOH45840421659766PHYS OFCSOHBVHS
BLANCHARD VALLEY HOME CARE SERVICES
1900 SOUTH MAIN STFINDLAYOH45840421565629HOME HEALTHOHBVCCS

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
BLANCHARD VALLEY HEALTH SYSTEM
1900 SOUTH MAIN STFINDLAYOH45840344428206HEALTHCAREOH501(C)(3)11ANAtrue
BLANCHARD VALLEY CONTINUING CARE SVCS
15100 BIRCHAVEN LNFINDLAYOH45840346006904CONT. CAREOH501(C)(3)9BVHStrue
BLANCHARD VALLEY HEALTH FOUNDATION
1900 SOUTH MAIN STFINDLAYOH45840341369963FUNDRAISINGOH501(C)(3)7BVHSfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
BLANCHARD VALLEY PAIN MANAGEMENT
1900 SOUTH MAIN STFINDLAYOH45840270095470PAIN MGMTOHBVRHCRELATED98419802996760falsefalse0.51000
TECHNICORE
PO BOX 1210FINDLAYOH45839421702910BIO-MED SUPPOOHBVRHCRELATED1248000288667falsetrue0.67000
CREIGHTON DIALYSIS
1900 SOUTH MAIN STFINDLAYOH45840274527592DIALYSIS SERVOHNARELATED23890003270000falsetrue1.00000
NORTHWEST OHIO MEDICAL EQUIPMENT
1900 SOUTH MAIN STFINDLAYOH45840341882390MEDICAL EQUIPOHBVCCSRELATEDfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
CITAS INC
1900 SOUTH MAIN STREETFINDLAYOH45840341369708RECRUITINGOHBVHSC CORPfalse
HANCO AMBULANCE INC
417 SIXTH STREETFINDLAYOH45840382048755HEALTHCAREOHBVHSC CORPfalse
BIRCHAVEN ESTATES AT EASTERN WOODS LTD
15100 BIRCHAVEN LANEFINDLAYOH45870346006904CONDOMINIUMOHBVCCSC CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
BLANCHARD VALLEY PAIN MANAGEMENT
A290010FMV
TECHNICORE
M1095835FMV