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BLANCHARD VALLEY REGIONAL HEALTH CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BLANCHARD VALLEY REGIONAL HEALTH CENTER (EIN 34-1369963)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-08
IRS object ID
201243139349301729
Schema version
2011v1.3
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)
Timestamp2012-11-08T15:02:33-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Date2011-01-01TaxPeriodBeginDate

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
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAVID M CYTLAKName
TitleCFOTitle
Date Signed2012-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoyce A DulworthName
Phone2604604000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

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 Receipts245767234GrossReceipts
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 Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1634TotalNbrEmployees
Total Nbr Volunteers340TotalNbrVolunteers
Total Gross UBI1528620TotalGrossUBI
Net Unrelated Business Txbl Income1022049NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year188651594ProgramServiceRevenuePriorYear
Program Service Revenue CY201649018ProgramServiceRevenueCY
Investment Income Prior Year4283584InvestmentIncomePriorYear
Investment Income Current Year6893753InvestmentIncomeCurrentYear
Other Revenue Prior Year3713456OtherRevenuePriorYear
Other Revenue Current Year5912853OtherRevenueCurrentYear
Total Revenue Prior Year196648634TotalRevenuePriorYear
Total Revenue Current Year214455624TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year10000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY10000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year85445958SalariesEtcPriorYear
Salaries Etc Current Year93062061SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year93116587OtherExpensePriorYear
Other Expenses Current Year95160072OtherExpensesCurrentYear
Total Expenses Prior Year178572545TotalExpensesPriorYear
Total Expenses Current Year188232133TotalExpensesCurrentYear
Revenues Less Expenses Prior Year18076089RevenuesLessExpensesPriorYear
Revenues Less Expenses CY26223491RevenuesLessExpensesCY
Total Assets BOY357376493TotalAssetsBOY
Total Assets EOY365224455TotalAssetsEOY
Total Liabilities BOY188820476TotalLiabilitiesBOY
Total Liabilities EOY231143785TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY168556017NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY134080670NetAssetsOrFundBalancesEOY
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
Expense31204338Expense
Revenue39905605Revenue
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 (AACPVR). 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 2011, OUR MEDIAN "DOOR TO BALLOON TIME" WAS 51.5 MINUTES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense24340644Expense
Revenue31127985Revenue
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)
Expense19136080Expense
Revenue24472138Revenue
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 2010, HEALTHGRADES - THE LEADING INDEPENDENT HEALTH CARE RATINGS COMPANY - AWARDED SEVERAL HONORS TO THE BVH TOTAL JOINT REPLACEMENT PROGRAM INCLUDING: 2010 JOINT REPLACEMENT EXCELLENCE AWARD TM; 5-STAR RATING FOR TOTAL JOINT REPLACEMENT; 5-STAR RATING FOR TOTAL KNEE REPLACEMENT; 5-STAR RATING FOR TOTAL HIP REPLACEMENT; AND 5-STAR RATING FOR BACK AND NECK SURGERY (SPINAL FUSION). IN 2011, BLANCHARD VALLEY HOSPITAL ALSO RECEIVED THE ORTHOPEDIC SURGERY EXCELLENCE AWARD FROM HEALTHGRADES.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp84361800TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev107944190TotalOfOtherProgramServiceRev
Total Program Service Expense159042862TotalProgramServiceExpense
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 IndividualstrueGrantsToIndividuals
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 With1096340NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1634NumberOfEmployees
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 Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
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
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
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
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CHRISTOPHER PRESS
PRESIDENT BVRHC40.0XX031884429750
KURT GEISHEIMER
VICE CHAIR1.0X000
STEVE DANDURAND
TRUSTEE1.0X000
STEVEN MCCULLOUGH DO
TRUSTEE1.0X000
PAUL WORSTELL
CHAIR1.0X000
DUANE JEBBETT
TRUSTEE1.0X000
MARK FOX MD
MEDICAL STAFF PRESIDENT1.0X0160000
CHERYL BUCKLAND
TRUSTEE1.0X000
KAREN CLINE
TREASURER1.0X000
KATHLEEN CRATES PHD
SECRETARY1.0X000
RANDALL MYERS
TRUSTEE1.0X000
ROBERT HEACOCK MD
TRUSTEE1.0X7799000
KAREN EUBANKS
TRUSTEE1.0X000
ROBERT SUTER
TRUSTEE1.0X000
RODNEY WINKLE
TRUSTEE1.0X000
SCOTT MALANEY
PRESIDENT BVHS32.0X057199346322
DAVE CYTLAK
CFO32.0X031892540073
BARBARA PASZTOR
VP OF NURSING40.0197596016567X
CHRISTINE SWANSON
VP OF CLINICAL SERVICES40.0192151022300X
WILLIAM WATKINS
CHIEF ADMINISTRATIVE OFFICER40.0173889030634X
DR CHIRANJI AGRAWAL
PHYSICIAN40.0479015018847X
DR ANGELA HOLT
PHYSICIAN40.0390711023639X
DR MIGUEL JORDAN
PHYSICIAN40.0385675021957X
DR JEFFREY SCHULTZ
PHYSICIAN40.0345113041860X
DR MICHAEL MANUEL
PHYSICIAN40.0306179039973X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2548319TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1225762TotalReportableCompFrmRltdOrgs
Total Other Compensation331922TotalOtherCompensation
Number Individuals GT100 K64NumberIndividualsGT100K
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
901 Wilshire Dr Ste 250TROYMI48084IT & COMMUNICATION6213722
Charles Construction Services Inc
811 East Bigelow AveFINDLAYOH45839CONTRACTORS4010693
Hylant GroupInc
811 MADISON AVETOLEDOOH43604CONSULTING SERVICES1111540
Sodexo Inc
9001 WASHINGTON BLVDGAITHERSBURGMD20878DIETARY SERVICES1233185
Technicore
PO Box 1210FINDLAYOH45839BIO-MED SUPPORT1010497
FieldValueIRS element (for citing)
Number Of Contractors GT100 K38NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE900099200486892200486892
OUTPATIENT PHARMACY4461101162126745991416135
FieldValueIRS element (for citing)
Total Program Service Revenue201649018TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6551161TotalRevenueColumn
Exclusion$6,551,161ExclusionAmount

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)
Real305434Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real305434Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column305434TotalRevenueColumn
Exclusion$305,434ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities31495886Securities
Other4051Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities31080023Securities
Other77322Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities415863Securities
Other-73271Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column342592TotalRevenueColumn
Related Or Exempt Function Income-73271RelatedOrExemptFunctionIncome
Exclusion$415,863ExclusionAmount

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 Inventory257565GrossSalesOfInventory
Cost Of Goods Sold154265CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column103300TotalRevenueColumn
Exclusion$103,300ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
FINDLAY SURGERY CENTER62130011298171129817
CAFETERIA900099170784$170,784
MEAL TICKETS900099785136$785,136

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column3418382TotalRevenueColumn
Related Or Exempt Function Income2290306RelatedOrExemptFunctionIncome
Unrelated Business Revenue-17332UnrelatedBusinessRevenue
Exclusion$1,145,409ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue5504119TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column214455624TotalRevenueColumn
Related Or Exempt Function Income203449918RelatedOrExemptFunctionIncome
Unrelated Business Revenue1528620UnrelatedBusinessRevenue
Exclusion$9,477,087ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total10000Total
Program Services10000ProgramServices

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)
Total590687Total
Program Services404600ProgramServices
Management And General186087ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total20070Total
Program Services20070ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total73933132Total
Program Services58835737ProgramServices
Management And General15097395ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2417465Total
Program Services1923944ProgramServices
Management And General493521ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11088190Total
Program Services8824559ProgramServices
Management And General2263631ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5012517Total
Program Services3989222ProgramServices
Management And General1023295ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total62195Total
Management And General62195ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total213741Total
Management And General213741ManagementAndGeneral

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)
Total8000223Total
Program Services6366994ProgramServices
Management And General1633229ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total760430Total
Program Services605190ProgramServices
Management And General155240ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total39089771Total
Program Services37993333ProgramServices
Management And General1096438ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2856258Total
Program Services1922286ProgramServices
Management And General933972ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3664369Total
Program Services2916296ProgramServices
Management And General748073ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total633039Total
Program Services503805ProgramServices
Management And General129234ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total8364774Total
Program Services6657123ProgramServices
Management And General1707651ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11312534Total
Program Services9003103ProgramServices
Management And General2309431ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total-685950Total
Management And General-685950ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBTS1194814411948144
MEDICAL & PROFESSIONAL FEES35551642829384725780
DUES & SUBSCRIPTIONS546817435185111632
OTHER EXPENSES48385633853887984676

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total188232133Total
Program Services159042862ProgramServices
Management And General29189271ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY22002052BOY
EOY26832431EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY22551614BOY
EOY23017139EOY

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)
BOY3567127BOY
EOY5227897EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY838966BOY
EOY833193EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis218824430LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec86210597LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY134781574BOY
EOY132613833EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY130006555BOY
EOY134440337EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY583783BOY
EOY46968EOY

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)
BOY43044822BOY
EOY42212657EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY357376493BOY
EOY365224455EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY16575795BOY
EOY16216567EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY678128BOY
EOY183287EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY121971600BOY
EOY118879980EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY8241008BOY
EOY6878336EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY41353945BOY
EOY88985615EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY188820476BOY
EOY231143785EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY162037058BOY
EOY127746483EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY647711BOY
EOY628340EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5871248BOY
EOY5705847EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY168556017BOY
EOY134080670EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY357376493BOY
EOY365224455EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses26223491ReconcilationRevenueExpenses
Reconcilation Other Changes-60698838ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 Balance6518959BeginningOfYearBalance
Investment Earnings Or Losses-168872InvestmentEarningsOrLosses
Other Expenditures15901OtherExpenditures
End Of Year Balance6334186EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

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

Current Year Minus3 Years CurrentYearMinus3Years

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 Balance0.90080PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.09920TermEndowmentEOYBalance
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 Basis3189752OtherCostOrOtherBasis
Book Value3189752BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis132743308OtherCostOrOtherBasis
Depreciation31572924Depreciation
Book Value101170384BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1513718OtherCostOrOtherBasis
Depreciation1218724Depreciation
Book Value294994BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis71720461OtherCostOrOtherBasis
Depreciation50297344Depreciation
Book Value21423117BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9657191OtherCostOrOtherBasis
Depreciation3121605Depreciation
Book Value6535586BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings132613833TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
ADVANCES TO AFFILIATES40161408
DEFERRED BOND ISSUANCE COSTS2051249
FieldValueIRS element (for citing)
Total Book Value Other Assets42212657TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
PENSION LIABILITY$49,920,349
THIRD PARTY SETTLEMENTS$4,425,728
INTEREST RATE SWAP OBLIGATION$33,948,599
MINORITY INTEREST IN PAIN MANA$690,939
FieldValueIRS element (for citing)
Total Of Amounts88985615TotalOfAmounts
Total Revenue214455624TotalRevenue
Total Expenses188232133TotalExpenses
Excess Or Deficit For Year26223491ExcessOrDeficitForYear
Net Unrealized GL On Investments-11090527NetUnrealizedGLOnInvestments
Other-$49,608,311OtherAmount
Total Adjustments-60698838TotalAdjustments
Excess Or Deficit Per FS-34475347ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt153756786TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-11090527NetUnrealizedGainsInvestments
Other Revenues-49608311OtherRevenues
Revenue Not Rptd F990-60698838RevenueNotRptdF990
Revenue Subtotal214455624RevenueSubtotal
Total Revenue Per Form990214455624TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt188232133TotExpensesEtcAuditedFinclStmt
Expenses Subtotal188232133ExpensesSubtotal
Total Expenses Per Form990188232133TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (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 $(13,977,414) DEFINED BENEFIT PENSION PLAN (30,495,101) DEBT EXTINGUISHMENT (8,709,179) OTHER CHANGES IN NONCONTROLLING INTEREST 229,426 BUILDING IMPAIRMENT (1,590,080) CHANGE IN PERPETUAL TRUST (165,401) OTHER CHANGES IN NET ASSETS 4,581,000 FSC TAX DIFFERENCE (366,767) NET ASSETS RELEASED 885,205 TOTAL ($49,608,311)
FIN 48 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 ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5366853TotalCommunityBenefitExpense
Net Community Benefit Expense5366853NetCommunityBenefitExpense
Percent Of Total Expense0.03040PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense18097052TotalCommunityBenefitExpense
Direct Offsetting Revenue11713418DirectOffsettingRevenue
Net Community Benefit Expense6383634NetCommunityBenefitExpense
Percent Of Total Expense0.03620PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense3895262TotalCommunityBenefitExpense
Direct Offsetting Revenue3381416DirectOffsettingRevenue
Net Community Benefit Expense513846NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense27359167TotalCommunityBenefitExpense
Direct Offsetting Revenue15094834DirectOffsettingRevenue
Net Community Benefit Expense12264333NetCommunityBenefitExpense
Percent Of Total Expense0.06950PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense218925TotalCommunityBenefitExpense
Direct Offsetting Revenue300DirectOffsettingRevenue
Net Community Benefit Expense218625NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense61038TotalCommunityBenefitExpense
Net Community Benefit Expense61038NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense81833TotalCommunityBenefitExpense
Net Community Benefit Expense81833NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense361796TotalCommunityBenefitExpense
Direct Offsetting Revenue300DirectOffsettingRevenue
Net Community Benefit Expense361496NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense27720963TotalCommunityBenefitExpense
Direct Offsetting Revenue15095134DirectOffsettingRevenue
Net Community Benefit Expense12625829NetCommunityBenefitExpense
Percent Of Total Expense0.07150PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense3589TotalCommunityBuildingExpense
Net Community Building Expense3589NetCommunityBuildingExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense63187TotalCommunityBuildingExpense
Net Community Building Expense63187NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense9215TotalCommunityBuildingExpense
Net Community Building Expense9215NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense75991TotalCommunityBuildingExpense
Net Community Building Expense75991NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$5,589,178BadDebtExpenseAmount
Amount Attributable To1863059AmountAttributableTo
Amount Reimbursed By Medicare40586543AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare48570244CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-7983701MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
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 ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyLowest Negotiated RatesLowestNegotiatedRatesAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
BLANCHARD VALLEY HOSPITAL
1truetrue150.true250.trueXXXXXXtruetrueXXXtruefalsetrueXfalsefalse
BLUFFTON HOSPITAL
2truetrue150.true250.trueXXXXXXtruetrueXXXtruefalsetrueXfalsefalse

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAUGHMAN HEALTH CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11800 NORTH BLANCHARD STREET STE 121AddressLine1
CityFINDLAYCity
StateOHState
ZIP Code45840ZIPCode
FieldValueIRS element (for citing)
Facility TypeOUTPATIENT CLINICFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 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 2011 Medicaid Cost Reports. We pull information from Schedule F and Schedule H for costs, payments, and charges as they are presented in the 2011 Medicaid Cost Report.
PART I, LINE 7F$11,948,144 of bad debt expense was removed from total expenses prior to calculating the percentage of total expense.
PART III, LINE 4AWE DO NOT HAVE A BAD DEBT FOOTNOTE. PART III, LINE 4B We record bad debt expense based on three components. First, we record accounts that have been transferred to collection agencies to bad debt expense. Second, we record changes in our allowance for uncollectible accounts based on changes in our accounts receivable aging buckets to bad debt expense. Finally, we record any recoveries that are received from collection agencies as a reduction 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 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 because members of the community will 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, 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 2011 Medicare Cost Reports and our 2011 Provider statistical and reimbursement reports provided by Medicare.
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. brochure, packets, etc.) is available, and Financial Counselors are available and make room visits.
PART VI, LINE 2Blanchard 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, form 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 hospitals 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.NEEDS ASSESSMENT
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 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 micropolitAn 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, Marathon Petroleum Corporation and Whirlpool. The surrounding areas are heavily agricultural.COMMUNITY INFORMATION
PART VI, LINE 5By reaching out to the community through 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. $1.7 million in medications were provided at no charge to patients in 2011, thanks to a program that connects patients with pharmaceutical companies' indigent care programs. A Licensed Independent Social Worker was also hired in 2009. She has facilitated classes for teen moms and does counseling, home visits 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. Blanchard Valley Hospital and Bluffton Hospital are part of Spirit of Women, a network of hospitals and health care providers across the United States that ascribe to the highest standards of excellence in women's health, education, and community outreach. This network affiliation allows Blanchard Valley Hospital and Bluffton Hospital to reach women and their families in our community through innovative and inspiring educational events, e-mail newsletters, and other health information venues. In its first two years of membership, more than 750 women in Findlay and the surrounding communities have become local BVHS Spirit of Women Members.AFFILIATED HEALTH CARE SYSTEM

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEDUCATIONAL SCHOLARSHIPSTypeOfGrant
Number Of Recipients10NumberOfRecipients
Amount Of Cash Grant10000AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE IIdentifier
Return ReferencePART I, LINE 2ReturnReference
ExplanationSCHOLARSHIP RECIPIENTS MUST MEET ELIGIBILITY CRITERIA PRIOR TO BEING AWARDED THE SCHOLARSHIP. THE SCHOLARSHIP IS EITHER PAID DIRECTLY TO THE RECEIPIENT'S SCHOOL OR IS PAID TO THE RECIPIENT AFTER PROOF OF PAYMENT OF ELIGIBLE EXPENSES (I.E. BOOK AND/OR TUITION INVOICE FROM THE SCHOOL) IS PROVIDED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (11 entries)

Base 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
16694100030655000165670214163000
CHRISTINE SWANSON
1630480289730130098600124400214451000
WILLIAM WATKINS
14377902619903911089900216440204523000
DR CHIRANJI AGRAWAL
476894000212104890183580497862000
DR ANGELA HOLT
37345200017259084620151770414350000
DR MIGUEL JORDAN
316180025758043737014700072570407632000
DR JEFFREY SCHULTZ
25893608601301640147000271600386973000
DR MICHAEL MANUEL
2151930743120166740147000252730346152000
SCOTT MALANEY
04296870100628041678014700031622061831500
DAVE CYTLAK
0256705038924023296014352025373035865000
CHRISTOPHER PRESS
0237929063439017476014352015398034859400

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPART I, LINE 4BIdentifier
ExplanationIn 2011, Blanchard Valley Health System contributed on behalf of Scott Malaney $123,519 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 2011, Blanchard Valley Health System contributed on behalf of David Cytlak $18,385 to the SERP. In 2011, Blanchard Valley Health System contributed on behalf of Christopher Press $43,056 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 President, BVRHC and CFO (Christopher Press and David Cytlak, respectively) **Employee contributions to the SERP are not allowed. * Each participants 457(b) account will be credited up to the statutory limit ($16,500 in 2011), 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 (2 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancingCUSIP NumberCUSIPNumber
VILLAGE OF BLUFFTON OHIO
3464001392010-12-3011293759SEE PART VIfalsefalsefalse
COUNTY OF HANCOCK OHIO
3464006082011-04-14108706899REFUND ISSUE DATED 11/4/2004falsefalsefalse410040BY4

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount 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 MaintaindAdequateBooksAndRecdsMaintaindYear Of Subst CompletionYearOfSubstCompletion
10265250112937590000000112937590truefalsetruetrue
1000000010870689900018748470001068320530truefalsetruetrue2007

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsetruetruefalse0.000000.000000.00000true
falsefalsetruetruefalse0true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
0
falsetruefalsefalse0falsefalse
0
falsetruefalsefalse0falsefalse

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, 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 (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
BUCKMAN LTD
>35% OWNED0SEE SUPPLEMENTAL INFORMATIONfalse
LOUISE WATKINS
WIFE OF WILLIAM WATKINS20070COMPENSATIONfalse

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, LLC. BLANCHARD VALLEY CONTINUING CARE SERVICES, A RELATED ENTITY, HAS AN OUTSTANDING LOAN TO BUCKMAN LIMITED, LLC FOR THE 2008 PURCHASE OF INDEPENDENCE HOUSE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART IIIQUESTION 4DOTHER SERVICES PROVIDED AT BVRHC INCLUDE WOMEN'S AND CHILDRENS 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 CHRISTOPHER PRESS, DR. ROBERT HEACOCK, AND DR. MARK FOX ARE BOARD MEMBERS AND PAID EMPLOYEES OF A RELATED ORGANIZATION. DUE TO THEIR EMPLOYMENT, THEY ARE CONSIDERED NON INDEPENDENT VOTING MEMBERS 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 WHICH IS COMPRISED OF MEMBERS OF THE GOVERNING BODIES OF THE SYSTEM. THE BOARD CHAIR OF THE HEALTH FOUNDATION ALSO ATTENDS THIS REVIEW. THE COMPLIANCE COMMITTEE REPORTS TO THE PARENT BOARD ANY AREAS OF CONCERN REGARDING THE 990'S. THE PARENT BOARD HAS GRANTED AUTHORITY TO THE COMPLIANCE COMMITTEE TO REVIEW AND APPROVE THE 990'S. ONCE THE 990'S HAVE BEEN FINALIZED, REVIEWED AND APPROVED, THE MEMBERS OF THE PARENT AND HEALTH FOUNDATION BOARDS RECEIVE ELECTRONIC COMMUNICATION THAT THE 990S ARE COMPLETE AND AVAILABLE FOR THEIR REVIEW ON THE ELECTRONIC REPOSITORY. ANY QUESTIONS ARISING FROM BOARD MEMBERS ARE ADDRESSED BY THE COMPLIANCE AND AUDIT COMMITTEE, UPPER MANAGEMENT, THE ACCOUNTING DEPARTMENT, AND 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 PERFORMS AN INDEPTH REVIEW OF EXECUTIVE AND PHYSICIAN COMPENSATION, BENEFITS, AND PERQUISITES ON A BIENNIAL BASIS TO ENSURE CONSISTENCY WITH COMPENSATION PHILOSOPHY AND MARKET PRACTICE. AN ANNUAL REVIEW FOR COMPETITIVENESS IS ALSO PERFORMED. THE EXECUTIVE COMMITTEE FROM THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION COMMITTEE, AND AS SUCH MAINTAINS SEPARATE MEETING MINUTES IN THEIR ROLE AS COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE MEETS TO APPROVE WAGE INCREASES AS WELL AS REVIEW THE ORGANIZATION'S POSITION IN THE MARKET WHEN IT COMES TO EXECUTIVE AND PHYSICIAN COMPENSATION. IN ADDITION, THE COMMITTEE REGULARLY ENGAGES A HUMAN RESOURCES CONSULTING FIRM TO ASSESS THE REASONABLENESS OF THE COMPENSATION PROGRAM USED FOR ITS EXECUTIVES. THE ORGANIZATION IS COMMITTED TO A DECISION-MAKING PROCESS FOR EXECUTIVE COMPENSATION THAT IS CONSISTENT WITH INTERNAL REVENUE CODE SECTION 4958 REQUIREMENTS FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS": THE MEMBERS OF THE COMMITTEE APPROVING EXECUTIVE COMPENSATION DECISIONS ARE INDIVIDUALS WHO ARE DISINTERESTED (I.E., DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE ARRANGEMENTS). THE COMMITTEE REVIEWS OBJECTIVE DATA, INCLUDING SURVEY DATA PREPARED BY INDEPENDENT FIRMS, AS PART OF THE DECISION-MAKING PROCESS. THE MARKET DATA PROVIDED IN THE COMPENSATION REPORT FROM THE CONSULTING FIRM ASSISTS THE ORGANIZATION IN ESTABLISHING THE "REBUTTABLE PRESUMPTION OF REASONABLENESS". THE MOST RECENT FULL REVIEW OF COMPENSATION, BENEFITS, AND PERQUISITES WAS COMPLETED IN EARLY 2011 BY SULLIVAN COTTER AND ASSOCIATES (AN EXTERNAL CONSULTANT) AND SHARED/DISCUSSED WITH THE BOARD IN APRIL 2011. PRIOR TO AWARDING WAGE INCREASES IN 2012, ANOTHER LESS EXTENSIVE REVIEW WAS COMPLETED OF EXECUTIVE COMPENSATION TO REFRESH MARKET DATA PROVIDED IN THE 2011 REPORT. THIS LESS EXTENSIVE REVIEW WAS ALSO SHARED WITH THE EXECUTIVE COMPENSATION COMMITTEE IN APRIL 2012, AND THEN WITH THE FULL BOARD IN JUNE 2012. 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.
RECONCILIATION OF NET ASSETSPART XILINE 5 CHANGE IN INTEREST RATE SWAP AGREEMENT $(13,977,414) DEFINED BENEFIT PENSION PLAN (30,495,101) DEBT EXTINGUISHMENT (8,709,179) OTHER CHANGES IN NONCONTROLLING INTEREST 229,426 UNREALIZED LOSS (11,090,527) BUILDING IMPAIRMENT (1,590,080) CHANGE IN PERPETUAL TRUST (165,401) OTHER CHANGES IN NET ASSETS 4,581,000 FSC TAX DIFFERENCE (366,767) NET ASSETS RELEASED 885,205 TOTAL (60,698,838)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:SCOTT MALANEY TITLE:PRESIDENT BVHS HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DAVE CYTLAK TITLE:CFO HOURS:8

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeBusiness Name Line1DirectControllingEntityName/BusinessNameLine1EOY AssetsEOYAssets
CRNA OF BLANCHARD VALLEY LLC
1900 SOUTH MAIN STFINDLAYOH45840061748552CERT NURSEOH3055757NA
BLANCHARD VALLEY MEDICAL PRACTICES
1900 SOUTH MAIN STFINDLAYOH45840421659766PHYS OFCSOHBVHS
BLANCHARD VALLEY HOME CARE SERVICES
1900 SOUTH MAIN STFINDLAYOH45840421565629HOME HEALTHOH0BVCCS0

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)11ANAfalse
BLANCHARD VALLEY CONTINUING CARE SVCS
15100 BIRCHAVEN LNFINDLAYOH45840346006904CONT. CAREOH501(C)(3)9BVHSfalse
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 MGMTOHBVRHCRELATED61718902671530falsefalse0.51000
TECHNICORE
PO BOX 1210FINDLAYOH45839421702910BIO-MED SUPPORTOHBVRHCRELATED-110714329419falsetrue0.67000
CREIGHTON DIALYSIS
1900 SOUTH MAIN STFINDLAYOH45840274527592DIALYSIS SERVICESOHNARELATED914391369655falsetrue0.99000
NORTHWEST OHIO MEDICAL EQUIPMENT
1900 SOUTH MAIN STFINDLAYOH45840341882390MEDICAL EQUIPMENTOHBVCCSRELATED00false

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssets
CITAS INC
1900 SOUTH MAIN STREETFINDLAYOH45840341369708RECRUITINGOHBVHSC CORP
HANCO AMBULANCE INC
417 SIXTH STREETFINDLAYOH45840382048755HEALTHCAREOHBVHSC CORP
BIRCHAVEN ESTATES AT EASTERN WOODS LTD
15100 BIRCHAVEN LANEFINDLAYOH45870346006904CONDOMINIUMOHBVCCSC CORP00
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
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
A260611FMV
TECHNICORE
L1010497FMV