Form 990 for tax year 2023

Revenue

Part VIII, the statement of revenue.

• 1c · Fundraising events

  $225,885

• 1d · Related organizations

  $6,584

• 1f · All other contributions, gifts and grants

  $1,345,429

• 2f · All other program service revenue

  total $0 · related or exempt $0 · unrelated business $0 · excluded $0

• 3 · Investment income

  total $1,071,944 · excluded $1,071,944

• 6c · Rental income or loss

  real property $0 · personal property $0

• 7a · Gross sales of assets other than inventory

  securities $2,878,752

• 7b · Less cost or other basis and sales expenses

  securities $2,983,696

• 7c · Gain or loss

  securities -$104,944 · other assets $0

• 7d · Net gain or loss

  total -$104,944 · excluded -$104,944

• 8a · Fundraising events: gross income

  $90,624

• 8a · Fundraising events: contributions included on line 1c

  $225,885

• 8b · Fundraising events: direct expenses

  $128,007

• 8c · Net income from fundraising events

  total -$37,383 · excluded -$37,383

• 11d · All other revenue

  total $0 · related or exempt $0 · unrelated business $0 · excluded $0

• 11e · Other revenue, total

  $0

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $1,327,000 · program services $1,327,000

• 5 · Compensation of officers, directors and key employees

  total $252,405 · management and general $63,101 · fundraising $189,304

• 7 · Other salaries and wages

  total $173,479 · management and general $43,370 · fundraising $130,109

• 8 · Pension plan contributions

  total $11,673 · management and general $2,918 · fundraising $8,755

• 9 · Other employee benefits

  total $78,383 · management and general $19,596 · fundraising $58,787

• 11c · Fees: accounting

  total $1,507 · management and general $377 · fundraising $1,130

• 11g · Fees: other

  total $18,615 · program services $0 · management and general $4,654 · fundraising $13,961

• 12 · Advertising and promotion

  total $23,705 · management and general $5,926 · fundraising $17,779

• 13 · Office expenses

  total $6,805 · management and general $1,701 · fundraising $5,104

• 14 · Information technology

  total $16,588 · management and general $4,147 · fundraising $12,441

• 17 · Travel

  total $639 · fundraising $639

• 22 · Depreciation, depletion and amortization

  total $17 · management and general $4 · fundraising $13

• 23 · Insurance

  total $2,712 · management and general $678 · fundraising $2,034

• 24a · Other expenses: PROVISION FOR BAD DEBTS

  total $120,140 · fundraising $120,140

• 24b · Other expenses: MEDICAL & PROFESSIONAL FEES

  total $7,680 · management and general $1,920 · fundraising $5,760

• 24c · Other expenses: OTHER EXPENSES

  total $358,923 · management and general $89,731 · fundraising $269,192

• 24e · All other expenses

  total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

• 2 · Savings and temporary cash investments

  beginning of year $367,375 · end of year $506,040

• 3 · Pledges and grants receivable

  beginning of year $2,033,000 · end of year $1,628,000

• 5 · Loans and receivables from officers and key people

  beginning of year $0 · end of year $0

• 6 · Loans and receivables from disqualified persons

  end of year $0

• 10a · Land, buildings and equipment: cost or other basis

  $40,268

• 10b · Land, buildings and equipment: accumulated depreciation

  $40,268

• 10c · Land, buildings and equipment, net

  beginning of year $17 · end of year $0

• 11 · Investments: publicly traded securities

  beginning of year $23,614,937 · end of year $25,637,157

• 12 · Investments: other securities

  beginning of year $0

• 13 · Investments: program-related

  beginning of year $0

• 15 · Other assets

  beginning of year $0 · end of year $0

• 22 · Loans and payables to officers and key people

  end of year $0

• 25 · Other liabilities

  beginning of year $11,944,000 · end of year $12,237,000

• 27 · Net assets without donor restrictions

  beginning of year -$471,671 · end of year $490,197

• 28 · Net assets with donor restrictions

  beginning of year $14,543,000 · end of year $15,044,000

The filer's explanations (Part III)

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

IN 2023, BLANCHARD VALLEY HEALTH SYSTEM CALCULATED SERP PAYMENTS TO BE CONTRIBUTED IN 2024. $114,858 WILL BE CONTRIBUTED ON BEHALF OF MYRON LEWIS TO A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2024. SERP CONTRIBUTIONS IN THE AMOUNT OF $96,553 WERE MADE FOR THE BENEFIT OF MYRON LEWIS IN 2023. THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT CONSISTING OF TWO PLANS: AN ELIGIBLE PLAN SUBJECT TO INTERNAL REVENUE CODE SECTION 457(B) AND AN INELIGIBLE PLAN SUBJECT TO SECTION 457(F). THE 457(B) PLAN WAS ORIGINALLY IMPLEMENTED EFFECTIVE JANUARY 1, 2002. THE 457(F) PLAN WAS ORIGINALLY EFFECTIVE SEPTEMBER 1, 2000 AND WAS RESTATED ON JANUARY 1, 2002 FOR COORDINATION WITH THE 457(B) PLAN. IN 2010 AND 2011, THE 457(F) PLAN WAS FURTHER AMENDED AND RESTATED TO COMPLY WITH THE LATEST REGULATORY GUIDANCE AND PROVIDE FOR A NEW CONTRIBUTION MODEL AND VESTING SCHEDULE. ADDITIONAL EXECUTIVES WERE ALSO ADDED AND DEEMED ELIGIBLE FOR PLAN BENEFITS IN 2010, INCLUDING DAVID CYTLAK. IN 2023, BLANCHARD VALLEY HEALTH SYSTEM CACLULATED SERP PAYMENTS TO BE CONTRIBUTED IN 2024. $31,599 WILL BE CONTRIBUTED ON BEHALF OF DAVID CYTLAK TO THE SERP IN 2024. SERP CONTRIBUTIONS IN THE AMOUNT OF $27,474 WERE MADE FOR THE BENEFIT OF DAVID CYTLAK IN 2023. KEY FEATURES OF THE SERP, AS AMENDED AND RESTATED IN 2010/2011, INCLUDE THE FOLLOWING: * ELIGIBILITY IS LIMITED TO CERTAIN MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES OF BVHS (I.E., TOP HAT REFERENCE). FUTURE PARTICIPATION IS UPON NOMINATION BY THE CEO AND APPROVAL BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. **EMPLOYEE CONTRIBUTIONS TO THE SERP ACCOUNT ARE NOT ALLOWED. *EACH PARTICIPANT'S 457(B) ACCOUNT WILL BE CREDITED UP TO THE STATUTORY LIMIT ($20,500 IN 2022), WITH THE REMAINING AMOUNT BEING DEPOSITED INTO THE 457(F) ACCOUNT. *EMPLOYER CONTRIBUTIONS TO THE 457(F) PLAN ARE SUBJECT TO A CLASS YEAR VESTING SCHEDULE, WITH A WAITING PERIOD SET AT 0-5 YEARS, DEPENDING ON THE AGE OF THE PARTICIPANT AT THE TIME OF CONTRIBUTION. UPON VESTING, THE FULL VESTED BALANCE WILL BE DISTRIBUTED TO THE PARTICIPANT AND CONSIDERED TAXABLE INCOME. IN ADDITION TO THE VESTING SCHEDULE ABOVE, 100% AND IMMEDIATE VESTING OF THE BENEFIT ACCRUED UPON ATTAINMENT OF NORMAL RETIREMENT AGE, DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, PLAN TERMINATION, OR CHANGE OF CONTROL. *DISTRIBUTION OF THE VESTED PORTION OF THE 457(F) BENEFIT IS PAID AS A LUMP SUM AS SOON AS ADMINISTRATIVELY FEASIBLE.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

• BLANCHARD VALLEY MEDICAL PRACTICES

  PHYS OFFICE · OH

  Directly controlled by BVHS

• BLANCHARD VALLEY HOME CARE SERVICES

  HOME HEALTH · OH

  Directly controlled by BVCCS

• CRNA OF BLANCHARD VALLEY LLC

  CERT NURSE · OH

  Directly controlled by BVRHC

• SPECIALTY PHYSICIANS OF BLANCHARD VALLEY

  PHYS OFFICE · OH

  Directly controlled by BVMP

• NEUROSURGICAL ASSOCIATES OF NORTHWEST OH

  PHYS OFFICE · OH

  Directly controlled by BVMP

• BLANCHARD VALLEY REGIONAL CANCER CENTER

  CANCER CARE · OH

  Directly controlled by BVMP

• HANCO EMERGENCY MEDICAL SERVICES

  AMBULANCE · OH

  Directly controlled by BVHS

• BIRCHAVEN ESTATES AT EASTERN WOODS LTD

  CONDOMINIUMS · OH

  Directly controlled by BVCCS

• BEYOND MEDSPA LLC

  COSMETIC SPA · OH

  Directly controlled by BVHS

• FINDLAY SURGERY CENTER LTD

  SURGERY CENT · OH

  Directly controlled by BVRHC

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

• NORTHWEST OHIO MEDICAL EQUIPMENT

  N/A · MED EQUIPMENT · OH

  Directly controlled by BVCCS

• BLANCHARD VALLEY PAIN MANAGEMENT

  N/A · PAIN MGMT · OH

  Directly controlled by BVRHC

• TECHNICORE CLINICAL ENGINEERING

  N/A · BIO-MED SUPPO · OH

  Directly controlled by BVRHC

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• CITAS INC

  C Corporation · RECRUITING · OH

  Directly controlled by BVHS