2025-05-14T13:01:20-05:00 2024-06-30 882730877 CHERRY BEKAERT ADVISORY LLC 101 SOUTH 5TH STREET STE 2100 LOUISVILLE KY 40202 990 2023-07-01 520795508 APPALACHIAN REGIONAL HEALTHCARE APPA 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 BYRON GABBARD CFO/VP FISCAL SERVICES 8592262440 2025-05-13 1 1 MELANIE MCPEAK P01346034 8885871719 2023 2025-03-06 01:10:19Z HOLLIE P HARRIS 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 943917178 0 X WWW.ARH.ORG X 1963 KY TO PROVIDE CENTRAL APPALACHIA AN ABUNDANCE OF HEALTHCARE AND COMMUNITY-ORIENTED SERVICES THROUGH ITS HOSPITAL, CLINICS AND HOME HEALTH OPERATIONS AS WELL AS COMMUNITY OUTREACH SERVICES. 15 15 6175 97 29729077 4974830 2909138 620648 854899897 906150904 8541148 27042785 16575927 10102841 882926110 943917178 119224 781069 0 0 471784797 438098268 0 0 0 430028086 434962133 901932107 873841470 -19005997 70075708 1250085290 1448830338 720139780 745614779 529945510 703215559 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. 0 0 740491952 781069 884010153 APPALACHIAN REGIONAL HEALTHCARE (ARH) CONTINUED ITS MISSION OF PROVIDING ACCESSIBLE, HIGH-QUALITY HEALTHCARE THROUGHOUT CENTRAL APPALACHIA IN 2024. WITH 14 HOSPITALS SPANNING KENTUCKY AND WEST VIRGINIA, AS WELL AS A NETWORK OF MULTI-SPECIALTY PHYSICIAN PRACTICES, HOME HEALTH AGENCIES, HOME MEDICAL EQUIPMENT STORES, AND RETAIL PHARMACIES, ARH ENSURED THAT RESIDENTS ACROSS ITS SERVICE AREAS HAD ACCESS TO ADVANCED MEDICAL CARE CLOSE TO HOME. AS THE LARGEST EMPLOYER IN SOUTHEASTERN KENTUCKY AND THE THIRD-LARGEST PRIVATE EMPLOYER IN SOUTHERN WEST VIRGINIA, ARH RELIES ON ITS MORE THAN 6,000 TEAM MEMBERS AND 1,300 MEDICAL STAFF TO DELIVER EXCEPTIONAL CARE. THEIR DEDICATION FIRMLY ESTABLISHED ARH AS THE REGION'S LARGEST PROVIDER OF CARE.THROUGHOUT FY24, ARH RECEIVED SIGNIFICANT RECOGNITION FOR ITS COMMITMENT TO EXCELLENCE. FORBES NAMED ARH ONE OF AMERICA'S BEST-IN-STATE EMPLOYERS, AND U.S. NEWS & WORLD REPORT RECOGNIZED FOUR HOSPITALS - BECKLEY, HARLAN, HAZARD, AND TUG VALLEY - FOR THEIR HIGH PERFORMANCE IN TREATING COPD AND CONGESTIVE HEART FAILURE. ELEVEN ARH HOSPITALS EARNED GET WITH THE GUIDELINES-STROKE AWARDS FROM THE AMERICAN HEART ASSOCIATION, WITH HAZARD ARH RECEIVING MULTIPLE HONORS. HAZARD ARH ALSO RECEIVED THE 2024 KY PERINATAL QUALITY COLLABORATIVE PLATINUM AWARD, AND SUMMERS COUNTY ARH EARNED A GOLD AWARD FOR QUALITY FROM THE WEST VIRGINIA HOSPITAL ASSOCIATION. ADDITIONALLY, BECKLEY ARH WAS DESIGNATED AS A PRIMARY STROKE CENTER, HARLAN ARH'S WOUND CARE CENTER WAS DESIGNATED A WOUND CENTER OF EXCELLENCE, WHITESBURG ARH WAS RECOGNIZED FOR IMPROVING RURAL CORONARY ARTERY DISEASE CARE, AND MIDDLESBORO ARH WAS CELEBRATED FOR ITS HEPATITIS C TREATMENT PROGRAM. THE ARH CANCER PROGRAM WAS RECOGNIZED AS A LUNG CANCER SCREENING CENTER OF EXCELLENCE, AND BARBOURVILLE ARH WAS NAMED A CERTIFIED AUTISM CENTER. THE ARH SYSTEM ALSO ACHIEVED A LEVEL 8 RANKING IN CHIME'S MOST WIRED HEALTH SYSTEMS FOR BOTH AMBULATORY AND ACUTE CARE, THE FOURTH YEAR IN A ROW THE SYSTEM RECEIVED THE HONOR. 740491952 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 209 0 1 6175 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X BYRON GABBARD 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 GREG COUCH CHAIR 3.00 2.50 X X 0 0 0 JEFFREY B HOLLON VICE CHAIR 3.00 0.00 X X 0 0 0 JOANN ANDERSON SECRETARY/TREASURER 3.00 0.00 X X 0 0 0 JULIE AKEMON TRUSTEE 5.00 0.00 X 0 0 0 KEN ALLMAN TRUSTEE 3.00 0.00 X 0 0 0 DUSTIN SCOTT CAMPBELL MD TRUSTEE 40.00 0.00 X 0 0 0 SAM DUNN TRUSTEE 3.00 0.00 X 0 0 0 RANDY EVANS DVM TRUSTEE 3.00 2.50 X 0 0 0 L BART FRANCIS TRUSTEE 3.00 0.00 X 0 0 0 EDITH KELLEY TRUSTEE 3.00 0.00 X 0 0 0 ANDREA MASSEY TRUSTEE 3.00 3.00 X 0 0 0 KAREN PROFITT NEWMAN TRUSTEE 3.00 0.00 X 0 0 0 MIKE RUST TRUSTEE 3.00 0.00 X 0 0 0 ONZIE SIZEMORE TRUSTEE 3.00 0.00 X 0 0 0 DUANNE THOMPSON TRUSTEE 3.00 0.00 X 0 0 0 HOLLIE P HARRIS PRESIDENT/CEO 25.00 15.00 X 1115375 0 112193 PAUL BETZ CHIEF OPERATING OFFICER 30.00 10.00 X 616925 0 116414 MARIA BRAMAN CHIEF MEDICAL OFFICER 30.00 10.00 X 564584 0 71874 CHRISTI LEE CHIEF LEGAL COUNSEL 25.00 15.00 X 426815 0 83534 SONYA BERGMAN CHIEF PEOPLE OFFICER 30.00 0.00 X 422239 0 90654 BYRON GABBARD CHIEF FINANCIAL OFFICER 25.00 15.00 X 505151 0 52023 DANNY HARRIS CFO/ASST SEC'Y/TREASURER 30.00 10.00 X 437388 0 27315 JAYARAMAKRISHNA DEPA NEPHROLOGIST 40.00 0.00 X 1043813 0 12162 STEPHEN J MULARZ GASTROENTEROLOGIST 40.00 0.00 X 983761 0 5057 RAMZI HADDADIN PULMONOLOGIST 40.00 0.00 X 927661 0 10930 ASHOK PATNAIK CARDIOLOGIST 40.00 0.00 X 882422 0 15617 SAMUEL BAILEY ONCOLOGIST 40.00 0.00 X 818482 0 16650 8744616 0 614423 484 0 1 0 TRIANGLE ANESTHESIA GROUP PSC 3320 TATES CREEK ROAD SUITE 100 LEXINGTON KY 40502 ANESTHESIA MEDICAL GROUP 18764097 LABORATORY CORP OF AMERICA 3320 TATES CREEK ROAD SUITE 100 LEXINGTON KY 40502 LABORATORY SERVICES 13087640 HALLMARK HEALTH CARE SOLUTIONS 200 MOTOR PARKWAY SUITE D-28 HAUPPAUGE NY 11788 CONTRACT NURSES 11749353 HICUITY HEALTH 1 CITY PLACE DRIVE ST LOUIS MO 63141 TELEMEDICINE 4516094 SIEMENS PO BOX 120733 DALLAS TX 75312 LABORATORY SERVICES 4340617 200 620648 620648 PATIENT REVENUES 621110 676385851 676385851 HOSPITAL RATE IMPROVEM 900099 132578864 132578864 PHARMACY & LAB 812300 97082633 74547222 22535411 RECORD TRANSCRIPT FEES 900099 103556 103556 906150904 15153707 15153707 1652381 0 1652381 1652381 1652381 11501355 387723 0 0 11501355 387723 11889078 11889078 DME SALES 900099 5898513 5898513 MISCELLANEOUS 900099 1689813 394660 1295153 CAFETERIA INCOME 900099 862134 862134 8450460 943917178 884010153 29729077 29557300 X 781069 781069 4234224 3282635 951589 331134760 267718001 63416759 6569509 4915464 1654045 75173987 59650666 15523321 20985788 16871251 4114537 1133721 149 1133572 489924 489924 167507 167507 107905770 87892219 20013551 4733075 135381 4597694 28773046 20365075 8407971 21946477 1425383 20521094 31954908 28822931 3131977 2756791 1388725 1368066 328225 1475 326750 2959174 1040612 1918562 18928952 17049468 1879484 18143214 15956087 2187127 MEDICAL SUPPLIES & PHAR 160922792 158194718 2728074 PROVIDER TAX EXPENSE 34097969 25126105 8971864 PROVISION FOR BAD DEBT 19850597 19850597 340B RETAIL CONTRACT FE 4426752 4426752 -24556761 5429682 -29986443 873841470 740491952 133349518 0 9334871 14016474 204127049 163507842 119945324 145913830 21366667 22212234 70538929 65818974 718991715 457055891 251742868 261935824 558197634 760127024 3882054 3986578 2040911 1571815 900000 930000 8008983 8809743 1250085290 1448830338 113384049 134983428 2808539 4936547 67735000 66480000 185095053 174770019 351117139 364444785 720139780 745614779 X 529957376 703227425 -11866 -11866 529945510 703215559 1250085290 1448830338 X 70075708 71716951 31477390 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 1 85673 1 17489 103162 0 PART II-B, LINE 1: ARH IS A MEMBER OF VARIOUS HOSPITAL ASSOCIATIONS. THE APPROPRIATE PERCENTAGE OF DUES PAID TO THE ORGANIZATIONS ALLOCABLE TO LOBBYING ACTIVITIES ARE ALSO INCLUDED. ARH HOLDS ON RETAINER CONSULTANTS TO ASSIST WITH GOVERNMENT AND PUBLIC RELATIONS IN REGARDS TO DEVELOPMENT OF LEGISLATURE, RELATED RESEARCH, AND OTHER RELEVANT ACTIVITIES. 4748137 4748137 320846382 234915220 85931162 2998994 2170373 828621 240705933 178584091 62121842 149692269 41386207 108306062 261935824 MEDICARE & MEDICAID ESTIMATED SETTLEMENTS 70206649 ACCRUED PENSION COST 53997560 RESERVE FOR SELF-INSURANCE 66028768 PHYSICIAN COMMITMENTS 513213 DUE TO PATIENTS 16457513 BOND INTEREST PAYABLE 2426327 SERP PAYABLE 255299 ACCRUED PHYSICIAN SETTLEMENTS 1974016 OPERATING LEASE LIABILITY 8276247 DUE TO AFFILIATE 144309193 364444785 X PART X, LINE 2: THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. HOWEVER, THE CORPORATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. GAAP REQUIRES THE CORPORATION TO EVALUATE ITS TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND HAS CONCLUDED THAT THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 1 X 1 X 0 1 1 0 1 1 38605923 13616495 24989428 0.02860 257175712 257175712 0.00000 0 0 0.00000 295781635 270792207 24989428 0.02860 6209 71799 627207 258 626949 0.00070 1668 1999 4045812 0 4045812 0.00460 0 0 0.00000 0 0 0.00000 204 34750 162076 0 162076 0.00020 8081 108548 4835095 258 4834837 0.00550 8081 108548 300616730 270792465 29824265 0.03410 0 0 0 0 0.00000 4 0 100 0 100 0.00000 100 7703 47246 0 47246 0.00010 4 1070 1347 0 1347 0.00000 4 30 793 0 793 0.00000 86 6841 10010 0 10010 0.00000 533 24641 198119 0 198119 0.00020 2 0 162 0 162 0.00000 0 0 0 0 0.00000 733 40285 257777 257777 0.00030 1 52680303 18506927 83713420 101283011 -17569591 X 1 1 1 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCI CONDO OWNER 0.83840 0.16160 9 1 HAZARD ARH REGIONAL MEDICAL CENTER 100 MEDICAL CENTER DRIVE HAZARD KY 41701 X X X X A 2 BECKLEY ARH HOSPITAL 306 STANAFORD ROAD BECKLEY WV 25801 X X X A 3 HARLAN ARH HOSPITAL 81 BALL PARK ROAD HARLAN KY 40831 X X X A 4 WHITESBURG ARH HOSPITAL 240 HOSPITAL ROAD WHITESBURG KY 41858 X X X A 5 TUG VALLEY ARH REGIONAL MEDICAL CENTER 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 X X X A 6 MIDDLESBORO ARH HOSPITAL 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 X X X A 7 MCDOWELL ARH HOSPITAL ROUTE 122 BOX 247 MCDOWELL KY 41647 X X X X A 8 MORGAN COUNTY ARH HOSPITAL 476 LIBERTY ROAD WEST LIBERTY KY 41472 X X X X A 9 SUMMERS COUNTY ARH HOSPITAL 115 SUMMERS HOSPITAL ROAD HINTON WV 25951 X X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.ARH.ORG/CHNA/ X 1 21 0 1 0 1 X 100.000000000000 X 1 1 X X X X 1 X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ X X X X X 1 X 0 X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: HAZARD ARH REGIONAL MEDICAL CENTER, - FACILITY 3: HARLAN ARH HOSPITAL, - FACILITY 2: BECKLEY ARH HOSPITAL, - FACILITY 5: TUG VALLEY ARH REGIONAL MEDICAL CENTER, - FACILITY 4: WHITESBURG ARH HOSPITAL, - FACILITY 6: MIDDLESBORO ARH HOSPITAL, - FACILITY 8: MORGAN COUNTY ARH HOSPITAL, - FACILITY 7: MCDOWELL ARH HOSPITAL, - FACILITY 9: SUMMERS COUNTY ARH HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: A COMMUNITY STEERING COMMITTEE PROVIDED GUIDANCE OVER THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN EACH OF ARH'S COMMUNITIES. THIS STEERING COMMITTEE WAS MADE UP OF REPRESENTATIVES FROM VARIOUS ORGANIZATIONS AND AGENCIES THROUGHOUT EACH HOSPITAL'S SERVICE AREA. IN PARTICULAR, SOME OF THE COMMITTEE MEMBERS REPRESENTED THE LOCAL HEALTH DEPARTMENT, SENIOR SERVICES, SCHOOL SYSTEM, SOCIAL SERVICE ORGANIZATIONS, AND EMERGENCY MANAGEMENT. THESE INDIVIDUALS ASSISTED WITH DISTRIBUTING SURVEYS AND ORGANIZING FOCUS GROUPS THROUGHOUT THE COMMUNITY ENSURING THAT VARIED COMMUNITY INTERESTS AND EXPERTISE WERE REPRESENTED. SPECIAL ATTENTION WAS PAID TO ENSURING THAT REPRESENTATION FROM THE PUBLIC HEALTH SECTOR WAS INCLUDED IN THIS ASSESSMENT PROCESS AND THAT THE SENIOR CITIZEN AND UNDERSERVED POPULATION WERE REPRESENTED. A COMPLETE LIST OF THE COMMUNITY STEERING COMMITTEE MEMBERS FOR EACH ARH FACILITY IS INCLUDED IN EACH ASSESSMENT'S FINAL REPORT. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED BY ARH IN 2021-2022. THIS OFFERED A GOOD OPPORTUNITY TO EXAMINE PROGRESS MADE SINCE THE PREVIOUS CHNA PROCESS WHILE OUTLINING NEW STRATEGIES TO GUIDE ACTIVITIES, OUTREACH, AND AREAS OF IMPROVEMENT FOR RECENTLY IDENTIFIED NEEDS. ALL OF THE NEEDS IDENTIFIED DURING THIS PROCESS WERE REVIEWED AND PRIORITIZED BY EACH FACILITY. SOME NEEDS MAY NOT HAVE BEEN SELECTED AS A HIGH PRIORITY SINCE ANOTHER COMMUNITY AGENCY MAY ALREADY BE ADDRESSING THAT NEED AND REFERRALS JUST NEED TO BE MADE TO THAT PARTNER AGENCY. MEASURES WERE TAKEN TO ENSURE THAT EACH IDENTIFIED NEED WAS EITHER ADDRESSED TO SOME DEGREE BY ARH OR REFERRED TO OTHER APPROPRIATE COMMUNITY ENTITIES. BELOW ARE THE MAIN SYSTEM-WIDE NEEDS IDENTIFIED DURING ARH'S MOST RECENT CHNA. THESE AREAS ARE THE MAIN FOCUS OF THE HOSPITALS' ACTIVITIES:SUBSTANCE ABUSE (DRUGS, ALCOHOL, TOBACCO, AND VAPING)MENTAL HEALTH (SERVICES AND REDUCING STIGMA)OBESITY/DIABETES/PHYSICAL ACTIVITYCOMMUNICATION AND EDUCATIONTHE RESULTS FROM THE MOST RECENT CHNA IDENTIFIED THE NEED FOR ARH'S FACILITIES TO FOCUS ON PROVIDING MORE PREVENTIVE AND EDUCATIONAL SERVICES. FOR SOME COMMUNITIES, THIS ALSO MEANT FURTHER PUBLICIZING THE PREVENTIVE AND EDUCATIONAL SERVICES THAT THEY WERE ALREADY OFFERING TO FURTHER INCREASE COMMUNITY PARTNERSHIPS AND AWARENESS. CHNA RESPONDENTS ALSO REQUESTED INCREASED EDUCATIONAL TOPICS INCLUDING MORE OF A FOCUS ON TOPICS SUCH AS VAPING AND MENTAL HEALTH ALONG WITH THE CHRONIC DISEASE ISSUES OF DIABETES AND HEART DISEASE. AN INCREASE IN THE AVAILABILITY OF SERVICES AND PROVIDERS TO ADDRESS THESE IDENTIFIED HEALTH ISSUES IS ALSO A PROMINENT NEED IN THE REGION, ESPECIALLY THE NEED TO ADD MORE MENTAL HEALTH PROVIDERS. ANOTHER NEED THAT WAS ALSO APPARENT WITH THE MOST RECENT CHNA RESULTS WAS THE NEED TO IMPROVE COMMUNICATIONS. THIS NEED RANGES FROM ENSURING THAT THERE IS FASTER COMMUNICATION REGARDING TEST RESULTS, IMPROVING COMMUNICATION TO THE PUBLIC ON ARH SERVICES AND ACTIVITIES VIA SOCIAL MEDIA, AND PROVIDING MORE PATIENT NAVIGATORS/ADVOCATES TO ASSIST PATIENTS WITH NEGOTIATING THE HEALTHCARE PROCESS.THE APPALACHIAN REGIONAL HEALTHCARE (ARH) SYSTEM, COMPRISED OF SEVERAL HOSPITALS ACROSS KENTUCKY AND WEST VIRGINIA, HAS MADE SIGNIFICANT EFFORTS SINCE THE RELEASE OF THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO ADDRESS HEALTH DISPARITIES AND ENHANCE COMMUNITY WELLNESS. THIS REPORT DETAILS THE ACTIVITIES AND PROGRESS MADE BY NINE ARH HOSPITALS-BECKLEY ARH HOSPITAL, HAZARD ARH REGIONAL MEDICAL CENTER, HARLAN ARH HOSPITAL, MCDOWELL ARH HOSPITAL, MIDDLESBORO ARH HOSPITAL, MORGAN COUNTY ARH HOSPITAL, SUMMERS COUNTY ARH HOSPITAL, TUG VALLEY ARH REGIONAL MEDICAL CENTER, AND WHITESBURG ARH HOSPITAL-IN RESPONSE TO THEIR COMMUNITIES' MOST PRESSING HEALTH CONCERNS.MENTAL AND BEHAVIORAL HEALTH INITIATIVESTHE VARIOUS ARH HOSPITALS ACROSS KENTUCKY AND WEST VIRGINIA HAVE IMPLEMENTED A RANGE OF INITIATIVES TO EDUCATE THE COMMUNITY ON THE IMPORTANCE OF MENTAL HEALTH AND REDUCE THE STIGMA ASSOCIATED WITH SEEKING CARE.- BECKLEY ARH HAS PROVIDED STAFF WITH MENTAL HEALTH FIRST AID TRAINING, CONDUCTED COMMUNITY EVENTS SUCH AS SIDEWALK CHALK AFFIRMATIONS, AND ORGANIZED PRESENTATIONS TARGETING BOTH YOUTH AND MARGINALIZED POPULATIONS. THEY ALSO MANAGE A STUDENTS AGAINST DESTRUCTIVE DECISIONS (SADD) GROUP, WHICH HAS PARTICIPATED IN 15 EVENTS FOCUSING ON MENTAL HEALTH AND SUICIDE PREVENTION.- HAZARD ARH EXPANDED BEHAVIORAL HEALTH SERVICES BY HIRING A THERAPIST, COMPLETING RENOVATIONS TO THE HAZARD PSYCHIATRIC CENTER, AND CREATING EDUCATIONAL VIDEOS THAT REACHED OVER 3,000 VIEWS. THEIR COMMUNITY EVENTS FOCUSED ON SUICIDE PREVENTION AND SELF-CARE, ESPECIALLY IN RESPONSE TO THE 2022 FLOODING.- MCDOWELL ARH HOSTED MENTAL HEALTH FIRST AID TRAINING, REOPENED ITS SENIOR CARE PROGRAM, AND DELIVERED MENTAL HEALTH EDUCATION IN SCHOOLS. THEY AIM TO PROVIDE QUALITY BEHAVIORAL HEALTHCARE FOR SENIORS AND FOCUS ON SOCIAL INTERACTION AND INDIVIDUALIZED TREATMENT.- MIDDLESBORO ARH HAS WORKED WITH LOCAL ORGANIZATIONS ON HARM REDUCTION PROGRAMS AND COMMUNITY OUTREACH, INCLUDING OVERDOSE SURVIVOR FOLLOW-UPS AND EXPANDING OUTPATIENT BEHAVIORAL HEALTH SERVICES. THEY'VE PARTNERED WITH COMMUNITY ORGANIZATIONS TO INCREASE ACCESS TO MENTAL HEALTH CARE.- MORGAN COUNTY ARH ALSO REOPENED THE SENIOR CARE PROGRAM AND IMPLEMENTED TELEPSYCHIATRY CONSULTATIONS. THEY HAVE BEEN OFFERING MENTAL HEALTH FIRST AID TRAINING AND HAVE PROVIDED MENTAL HEALTH EDUCATION FOR LOCAL STUDENTS, FOCUSING ON HEALTHY RELATIONSHIPS.- SUMMERS COUNTY ARH HAS PROVIDED MENTAL HEALTH FIRST AID TRAINING, HOSTED COMMUNITY EVENTS, AND EXPANDED MENTAL HEALTH SERVICES THROUGH TELEMEDICINE PARTNERSHIPS.- WHITESBURG ARH TRACKED OVER 3,000 BEHAVIORAL HEALTH VISITS AND PARTICIPATED IN CHILD ABUSE AWARENESS EVENTS AND HEALTH FAIRS FOCUSED ON MENTAL HEALTH FOR DIABETIC PATIENTS. THEY'VE ALSO OFFERED STRESS RELIEF CLASSES IN PARTNERSHIP WITH TRAUMA INSTRUCTORS.- HARLAN ARH ENHANCED ITS BEHAVIORAL HEALTH SERVICES BY IMPLEMENTING MID-LEVEL PROVIDERS, INITIATING VIRTUAL VISITS, AND OFFERING EDUCATIONAL EVENTS AT THE COMMUNITY SENIOR CENTER. THESE EFFORTS INCREASED ACCESS TO CARE AND FACILITATED GREATER COMMUNITY ENGAGEMENT.THESE HOSPITALS HAVE ACTIVELY WORKED TO IMPROVE MENTAL HEALTH SERVICES, RAISE AWARENESS, AND INCREASE COMMUNITY PARTICIPATION THROUGH EDUCATIONAL EVENTS, TRAINING, AND PARTNERSHIPSADDRESSING OBESITY AND ITS ROOT CAUSES- BECKLEY ARH: FOCUSED ON OBESITY PREVENTION THROUGH PROGRAMS LIKE RETHINK YOUR DRINK (TARGETING SUGARY DRINKS), MONTHLY DIABETES SUPPORT GROUPS WITH COOKING DEMONSTRATIONS, AND PARTNERSHIPS WITH ACTIVE SOUTHERN WEST VIRGINIA FOR WALKING EVENTS AND 5KS. THEY ALSO REVAMPED THEIR CAFETERIA WITH HEALTHIER OPTIONS AND OFFERED FOOD AS MEDICINE TRAINING TO STAFF. BECKLEY ALSO SUPPORTED THE LOCAL FARMERS MARKET AND PROVIDED RECIPE CARDS TO PROMOTE HEALTHY EATING.- HAZARD ARH: TACKLED FOOD INSECURITY BY OFFERING FREE COOKING CLASSES, COLLABORATING WITH GOD'S PANTRY FOR FOOD DISTRIBUTION, AND HOSTING POP-UP FARMERS MARKETS WITH HEALTHY RECIPE DEMONSTRATIONS. THEY ALSO SPONSORED PHYSICAL ACTIVITY EVENTS LIKE YOGA CLASSES, A BICYCLE RACE, AND MOVEMENT CLASSES FOR STUDENTS WITH DISABILITIES.- MCDOWELL ARH: WORKED ON FOOD INSECURITY BY DISTRIBUTING FOOD BOXES WITH DIETITIAN TIPS, PARTICIPATING IN A STUDY ON MEDICALLY TAILORED MEALS, AND HOSTING DIABETES SUPPORT GROUPS WITH COOKING DEMOS. THEY ALSO PROVIDED FREE GYM MEMBERSHIPS, SPONSORED SENIOR SPORTS EVENTS, AND GAVE FREE SPORTS PHYSICALS TO STUDENTS.- MIDDLESBORO ARH: FOCUSED ON OBESITY PREVENTION BY HOSTING HIKES, OFFERING FREE GYM MEMBERSHIPS, AND PARTNERING WITH LMU-DCOM FOR A COMMUNITY GARDEN. THEY ALSO UPDATED THEIR CAFETERIA MENUS AND VOLUNTEERED AT FOOD GIVEAWAYS TO SUPPORT LOCAL FOOD SECURITY.- TUG VALLEY ARH: HELD MONTHLY DIABETES SUPPORT GROUPS, PROVIDED MEDICALLY-TAILORED FOOD BOXES, AND SPONSORED FITNESS EVENTS. THEY ALSO INCREASED HEALTH EDUCATION IN LOCAL SCHOOLS AND HOSTED COMMUNITY HEALTH FAIRS.- WHITESBURG ARH: ADDRESSED FOOD INSECURITY THROUGH PARTNERSHIPS WITH GOD'S PANTRY FOR FOOD BOX DISTRIBUTION AND IMPLEMENTED PROGRAMS LIKE A FARMERS MARKET SCREENING AND WALKING PROGRAM THAT REWARDED PARTICIPANTS WITH VOUCHERS FOR FRESH PRODUCE.- HARLAN ARH: SUBSIDIZED GYM MEMBERSHIPS, REVAMPED CAFETERIA MENUS WITH HEALTHIER OPTIONS, AND PARTNERED WITH LOCAL FARMS TO PROVIDE FRESH PRODUCE TO EMPLOYEES AND THE KENTUCKY HOMEPLACE PROGRAM. THEY DELIVERED VOUCHERS FOR FRESH PRODUCE TO LOCAL CLIENTS AND EXPANDED THIS INITIATIVE TO SUPPORT FOOD SECURITY.ACROSS THESE HOSPITALS, EFFORTS INCLUDED EDUCATION ON NUTRITION, PROVIDING ACCESS TO HEALTHY FOODS, OFFERING PHYSICAL ACTIVITY OPPORTUNITIES, AND SUPPORTING COMMUNITY-BASED HEALTH PROGRAMS AIMED AT COMBATING OBESITY. PART V, SECTION B, LINE 11 CONTINUED: EDUCATION ON PREVENTATIVE MEDICINE AND HEALTHY LIFESTYLE CHANGE1. BECKLEY ARH:- STROKE EDUCATION: 1165 STROKE RISK ASSESSMENTS, BRAIN PROTECTOR PROGRAMS IN SCHOOLS, AND STROKE SUPPORT GROUPS.- HEART HEALTH: HEART HEALTH EDUCATION, FREE SCREENINGS, AND PAINTING CLASSES FOCUSED ON HEART HEALTH.- CANCER AND DIABETES: CANCER PREVENTION PRESENTATIONS AND DIABETES EDUCATION SESSIONS.- FREE SCREENINGS: OVER 1200 FREE SCREENINGS FOR STROKE, DIABETES, BLOOD PRESSURE, CHOLESTEROL, ETC.- COMMUNITY PARTNERSHIPS: COLLABORATIONS WITH LOCAL ORGANIZATIONS FOR HEALTH FAIRS AND SCREENINGS.2. HAZARD ARH:- CANCER AWARENESS: 20 EVENTS PROMOTING CANCER PREVENTION AND EARLY DETECTION, INCLUDING SCREENINGS AND EDUCATIONAL PRESENTATIONS.- DIABETES MANAGEMENT: MONTHLY SUPPORT GROUPS AND DIABETES-RELATED COMMUNITY EVENTS.- STROKE EDUCATION: STROKE EDUCATION AND RISK ASSESSMENTS, INCLUDING BRAIN PROTECTORS PROGRAMS FOR CHILDREN.- HEALTH FAIRS: MULTIPLE HEALTH FAIRS FOR LOCAL EMPLOYERS AND THE FAITH-BASED COMMUNITY OFFERING SCREENINGS AND EDUCATION.3. MCDOWELL ARH:- FOCUS ON DIABETES EDUCATION AND STROKE RISK ASSESSMENTS AT LOCAL EVENTS AND SENIOR CENTERS.4. MIDDLESBORO ARH:- YOUTH EDUCATION: HEALTH FAIRS AND PROGRAMS IN SCHOOLS, INCLUDING CPR TRAINING AND SMOKING PREVENTION.- COMMUNITY EDUCATION: WALK-N-TALK PROGRAM, SUBSTANCE USE DISORDER EDUCATION, AND CANCER PREVENTION.- PREVENTATIVE SCREENINGS: OFFERING AFFORDABLE MAMMOGRAMS, LUNG CANCER SCREENINGS, AND GENERAL HEALTH FAIRS.5. MORGAN COUNTY ARH:- EMPLOYER ENGAGEMENT: HEALTH FAIRS AND EDUCATION FOR EMPLOYEES OF LOCAL BUSINESSES.- DIABETES EDUCATION: MONTHLY SUPPORT GROUPS AND DIABETES AWARENESS EVENTS.- STROKE EDUCATION: BRAIN PROTECTORS PROGRAM AND STROKE RISK ASSESSMENTS IN LOCAL EVENTS.6. SUMMERS COUNTY ARH:- HEALTH EDUCATION: FREE COMMUNITY HEALTH EVENTS ON HEART HEALTH, DIABETES, STROKE, AND CANCER.- SCHOOL PROGRAMS: BRAIN PROTECTORS FOR SCHOOLCHILDREN AND SMOKING/VAPING PREVENTION PROGRAMS.7. WHITESBURG ARH:- CANCER AWARENESS: COLON, LUNG, AND BREAST CANCER EDUCATION, ALONG WITH SCREENING EVENTS.- DIABETES AND STROKE EDUCATION: MONTHLY SUPPORT GROUPS AND STROKE RISK ASSESSMENTS.- PHYSICAL ACTIVITY: COLLABORATION WITH LOCAL PROGRAMS TO INCREASE PHYSICAL ACTIVITY AND HEALTHY EATING.8. HARLAN ARH:- COMMUNITY LEARNING: "WALK AND TALK" CANCER PROGRAMS, QUARTERLY EDUCATIONAL PROGRAMS ON HEART DISEASE, STROKE, AND DIABETES.- SCHOOL PROGRAMS: FITNESS FAIRS AND MEDICAL SCIENCE EDUCATION FOR STUDENTS.ACROSS ALL FACILITIES, THERE HAS BEEN A STRONG EMPHASIS ON PREVENTATIVE CARE, COMMUNITY OUTREACH, HEALTH SCREENINGS, AND EDUCATION, WITH THOUSANDS OF FREE SCREENINGS, EDUCATIONAL SESSIONS, AND HEALTH FAIRS ORGANIZED TO IMPROVE PUBLIC HEALTH AND AWARENESS.COMBATTING ADDICTIONTHE GOAL OF ADDRESSING DRUG, TOBACCO, AND ALCOHOL ADDICTION THROUGH NEW SERVICES, COMMUNITY PARTNERSHIPS, AND EDUCATION HAS BEEN MET BY VARIOUS ARH HOSPITALS. KEY PROGRAMS AND OUTCOMES INCLUDE:1. BECKLEY ARH LAUNCHED ITS PEER SUPPORT PROGRAM IN 2022, WITH CERTIFIED PEER SUPPORT COACHES AIDING IN RECOVERY, RESPONDING TO OVERDOSES, REFERRING PATIENTS TO TREATMENT, AND EDUCATING THE COMMUNITY. SINCE 2022, THEY ENGAGED 3,801 PATIENTS, REFERRED 651 TO TREATMENT, AND COMPLETED 47,451 SCREENINGS. THEY ALSO HOSTED COMMUNITY EVENTS AND ARE ACTIVE IN LOCAL COALITIONS LIKE THE RALEIGH COUNTY PREVENTION COALITION AND FAMILY RESOURCE NETWORK.2. HAZARD ARH ALSO LAUNCHED A PEER SUPPORT PROGRAM IN 2020. PEER COACHES HAVE ENGAGED 2,157 PATIENTS, REFERRED 491 TO TREATMENT, AND PROVIDED 323 LINKAGES. THEY HAVE HOSTED LOCAL EVENTS LIKE THE "TO GOOD FOR DRUGS" CLASSES AND DISTRIBUTED NALOXONE.3. MCDOWELL ARH FOCUSED ON SMOKING CESSATION AND DRUG PREVENTION, SPONSORING PROGRAMS LIKE "SHOOT HOOPS, NOT DRUGS AND PROVIDING ANTI-VAPING PRESENTATIONS AT LOCAL SCHOOLS. THEY PARTICIPATE IN LOCAL COALITIONS ADDRESSING SUBSTANCE USE DISORDER (SUD).4. MORGAN COUNTY ARH PARTNERED WITH THE KY DEPARTMENT OF PUBLIC HEALTH TO HOST SAFE A LIFE ROADSHOW EVENTS, PROVIDING OVERDOSE AWARENESS EDUCATION AND NARCAN TRAINING. THEY ALSO SPONSORED THE "SHOOT HOOPS, NOT DRUGS" PROGRAM AND CONDUCTED EDUCATIONAL PROGRAMS ON SMOKING AND VAPING.5. SUMMERS COUNTY ARH LAUNCHED ITS PEER SUPPORT PROGRAM IN 2020, WITH COACHES ENGAGING 2,157 PATIENTS AND REFERRING 491 TO TREATMENT. THEY'VE ASSISTED WITH HOUSING AND EMPLOYMENT AND PARTICIPATED IN COMMUNITY EVENTS.6. WHITESBURG ARH STARTED ITS PEER SUPPORT PROGRAM IN 2020, ENGAGING 406 PATIENTS AND REFERRING 49 TO TREATMENT. THEY'VE SPONSORED RECOVERY-RELATED EVENTS AND SERVE ON SEVERAL DRUG-FREE COMMUNITY COALITIONS.7. HARLAN ARH LAUNCHED ITS PEER SUPPORT PROGRAM IN 2022. THEY ENGAGED 763 PATIENTS, REFERRED 151 TO TREATMENT, AND ASSISTED 39 WITH HOUSING OR EMPLOYMENT. THEY'VE HOSTED COMMUNITY EVENTS SUCH AS THE HARLAN KIDS FEST AND OVERDOSE AWARENESS NIGHT AND SUPPORTED NALOXONE DISTRIBUTION EFFORTS.THESE HOSPITALS WORK TOGETHER TO COMBAT ADDICTION THROUGH A VARIETY OF COMMUNITY-DRIVEN INITIATIVES, EDUCATIONAL PROGRAMS, AND PEER RECOVERY SUPPORT.BETTER COMMUNICATION ABOUT SERVICES PROVIDEDTHE GOAL OF IMPROVING COMMUNICATION AND COLLABORATION AMONG COMMUNITY PARTNERS HAS BEEN ACTIVELY PURSUED BY SEVERAL ARH HOSPITALS.1. BECKLEY ARH HAS ENGAGED IN MULTIPLE COUNCILS, COALITIONS, AND BOARDS TO FOSTER PARTNERSHIPS AND BREAK DOWN SILOS BETWEEN HEALTH CARE ORGANIZATIONS. SOME OF THE GROUPS THEY HAVE BEEN INVOLVED IN INCLUDE THE HUMAN RIGHTS COMMISSION, FAMILY RESOURCE NETWORK, AND RALEIGH COUNTY PREVENTION COALITION. BECKLEY ARH ALSO PARTNERS WITH RALEIGH GENERAL HOSPITAL TO HOST THE LARGEST HEALTH FAIR IN SOUTHERN WEST VIRGINIA AND CO-LEADS BLOOD DRIVES.2. HAZARD ARH HAS PARTICIPATED IN 12 COUNCILS, COALITIONS, AND BOARDS IN PERRY COUNTY SINCE 2022, FOCUSING ON HEALTH AND WELLNESS, AS WELL AS COMMUNITY BETTERMENT AND ECONOMIC DEVELOPMENT. THESE INCLUDE THE PERRY COUNTY SENIOR CITIZEN'S BOARD, CASA OF EASTERN KY, AND THE PERRY COUNTY DIABETES COALITION, AMONG OTHERS.3. MCDOWELL ARH HAS WORKED TO INCREASE AWARENESS OF ITS SERVICES BY CREATING SERVICE FLYERS, UPDATING ITS WEBSITE FOR BETTER PROVIDER SEARCHES, AND USING BILLBOARDS FOR PROMOTION. THEY POST REGULARLY ON SOCIAL MEDIA, ORGANIZE PROVIDER VISITS TO MCDOWELL, AND HAVE ADDED INFORMATIONAL MONITORS IN CLINICS AND THE HOSPITAL LOBBY TO SHARE SERVICE INFORMATION.THESE EFFORTS REFLECT ARH'S COMMITMENT TO BETTER COMMUNICATION AND COLLABORATION TO IMPROVE HEALTHCARE ACCESS AND COMMUNITY WELL-BEING.EXPANDED ACCESS TO CARETHE GOAL OF PROVIDING BETTER ACCESS TO CARE HAS BEEN ACHIEVED BY SEVERAL ARH HOSPITALS THROUGH VARIOUS INITIATIVES:1. MCDOWELL ARH INCREASED ACCESS BY RECRUITING TWO PRIMARY CARE PROVIDERS, EXTENDING AFTER HOURS CLINIC HOURS, BECOMING AN ACUTE STROKE READY HOSPITAL, AND EXPANDING THE SWING BED PROGRAM FOR LONG-TERM CARE.2. MIDDLESBORO ARH FOCUSED ON PROVIDER RECRUITMENT AND SERVICE EXPANSION, INCLUDING OPENING A UROLOGY SERVICE, A SPECIALTY PHARMACY, A WOUND CARE CENTER, AND INTRODUCING ROBOTIC SURGERY WITH THE DA VINCI SYSTEM. THEY ALSO CREATED PRE-ADMISSION TESTING, QUICK LAB SITES, AND HOSTED TRAUMA AND PEDIATRIC EMERGENCY NURSE TRAINING.3. MORGAN COUNTY ARH ENHANCED ACCESS BY CONTRACTING NEW EMERGENCY CARE PROVIDERS, HOSTING HEALTHCARE CAREER CAMPS, AND INTRODUCING EMPLOYEE RETENTION INITIATIVES LIKE APPRECIATION PROGRAMS AND GROUP VOLUNTEERING EVENTS.4. SUMMERS COUNTY ARH IMPROVED ACCESS BY ADDING A PRIMARY CARE PHYSICIAN, ORTHOPEDIC SERVICES, TELEPSYCHIATRY FOR MENTAL HEALTH, AND OPENING A SENIOR CARE PROGRAM.5. TUG VALLEY ARH FOCUSED ON RECRUITING SPECIALISTS, ADDING A WOUND CARE CENTER, AND INCREASING SPECIALIST SERVICES THROUGH TELEMEDICINE AND PARTNERSHIPS.6. WHITESBURG ARH ADDED SEVERAL NEW SERVICES, INCLUDING 3D MAMMOGRAPHY, A NEW NUCLEAR SCANNER, A PAIN MANAGEMENT PROGRAM, A SWING BEDS PROGRAM, AND EXPANDED SURGERY OFFERINGS.7. HARLAN ARH LAUNCHED PULMONARY REHABILITATION IN 2022 AND ADDED CARDIAC REHABILITATION IN 2024, BOTH OF WHICH HAVE SEEN GROWING PATIENT PARTICIPATION.THESE EFFORTS REFLECT ARH HOSPITALS' COMMITMENT TO IMPROVING HEALTHCARE ACCESS FOR THEIR COMMUNITIES THROUGH NEW SERVICES, EXPANDED FACILITIES, AND PROVIDER RECRUITMENT. 76 1 - HARLAN ARH HOSPITAL PSYCHIATRIC SERVICE 81 BALL PARK ROAD HARLAN KY 40831 PSYCH 2 - ARH PSYCHIATRIC CENTER-HAZARD 102 MEDICAL CENTER DRIVE HAZARD KY 41701 PSYCH 3 - ARH HAZARD FAMILY HEALTH SERVICES 200 MEDICAL CENTER DRIVE HAZARD KY 417019466 CLINIC 4 - ARH DANIEL BOONE CLINIC - HARLAN 37 BALL PARK ROAD HARLAN KY 408311701 RURAL HEALTH CLINIC 5 - ARH WHITESBURG SURGICAL CLINIC 214 HOSPITAL ROAD STE A WHITESBURG KY 418587627 CLINIC 6 - ARH TUG VALLEY MEDICAL ASSOCIATES 306 HOSPITAL DRIVE SOUTH WILLIAMSON KY 415034095 RURAL HEALTH CLINIC 7 - ARH MIDDLESBORO INTERNAL MEDICINE 3004 CUMBERLAND AVE SUITE 3 MIDDLESBORO KY 409652343 CLINIC 8 - ARH WHITESBURG CLINIC 214 HOSPITAL ROAD WHITESBURG KY 418587627 RURAL HEALTH CLINIC 9 - HAZARD ARH REGIONAL MEDICAL CENTER CLINI 200 MEDICAL CENTER DRIVE HAZARD KY 41701 PHARMACY 10 - HARLAN ARH OUTPATIENT PHARMACY 37 BALL PARK ROAD HARLAN KY 40831 PHARMACY 11 - HAZARD ARH HOME HEALTH AGENCY 100 AIRPORT GARDENS ROAD HAZARD KY 41701 HOME HEALTH 12 - ARH COMMUNITY PHARMACY 210 BLACK GOLD BLVD SUITE 104 HAZARD KY 41701 PHARMACY 13 - ARH HAZARD HOMECARE STORE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 HOME HEALTH CARE 14 - ARH WILLIAMSON HOMECARE STORE 140 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 HOME HEALTH CARE 15 - ARH HARLAN HOMECARE STORE 106 RAILROAD STREET SUITE 5 HARLAN KY 40831 HOME HEALTH CARE 16 - ARH PRESCRIPTION DIVISION 306 HOSPITAL DRIVE SUITE 105 SOUTH WILLIAMSON KY 41503 PHARMACY 17 - WHITESBURG ARH HOME HEALTH AGENCY 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH 18 - BECKLEY ARH HOME HEALTH AGENCY 306 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH 19 - MORGAN COUNTY ARH HOME HEALTH AGENCY 518 MAIN STREET STE 1 WEST LIBERTY KY 41472 HOME HEALTH 20 - ARH WOMEN'S AND FAMILY HEALTH CARE - TUG 26901 US HIGHWAY 119N BELFRY KY 415147520 PRIMARY CARE CLINIC 21 - ARH TRI-CITY MEDICAL CENTER 18880 NORTH US 119 CUMBERLAND KY 408238106 RURAL HEALTH CLINIC 22 - BECKLEY ARH PHARMACY 250 STANAFORD ROAD BECKLEY WV 25801 PHARMACY 23 - HARLAN ARH HOME HEALTH AGENCY 81 BALL PARK ROAD HARLAN KY 40831 HOME HEALTH 24 - ARH SUMMERS COUNTY RURAL HEALTH CLINIC 115 SUMMERS HOSPITAL ROAD HINTON WV 25951 RURAL HEALTH CLINIC 25 - ARH BECKLEY HOMECARE STORE 260 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH CARE 26 - ARH FAMILY HEALTH PHARMACY 1084 HWY 7 STE 3 WEST LIBERTY KY 41472 PHARMACY 27 - PIKEVILLE BRANCH-ARH PIKE CO HOME HEALTH 247 SOUTH MAYO TRAIL PIKEVILLE KY 41502 HOME HEALTH 28 - ARH MCDOWELL PROFESSIONAL CLINIC 9879 KY RT 122 MCDOWELL KY 416476042 RURAL HEALTH CLINIC 29 - WHITESBURG ARH PHARMACY 240 HOSPITAL ROAD WHITESBURG KY 41858 PHARMACY 30 - MIDDLESBORO ARH PHARMACY 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 PHARMACY 31 - MIDDLESBORO ARH HOME HEALTH AGENCY 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH 32 - ARH MIDDLESBORO HOMECARE STORE 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH CARE 33 - ARH SPECIALITY PHARMACY 200 MEDICAL CENTER DR HAZARD KY 41701 PHARMACY 34 - ARH FAMILY CARE WAYLAND 2662 KING KELLY COLEMAN HWY WAYLAND KY 416669998 PRIMARY CARE CLINIC 35 - ARH FAMILY CARE - WHEELWRIGHT 30 KY RT 306 BYPRO KY 416129706 PRIMARY CARE CLINIC 36 - JENKINS ARH FAMILY CARE 9480 HIGHWAY 805 JENKINS KY 415378182 PRIMARY CARE CLINIC 37 - ARH BARIATRIC CENTER 210 BLACK GOLD BOULEVARD SUITE 102 HAZARD KY 417012620 CLINIC 38 - ARH SYSTEM CENTER-HAZARD 100 AIRPORT GARDENS ROAD HAZARD KY 41701 SUPPORT 39 - ARH SYSTEM CENTER-LEXINGTON 2260 EXECUTIVE DR LEXINGTON KY 40505 SUPPORT 40 - ARH SYSTEM CENTER-LEXINGTON JORDAN BUIL 1218 SOUTH BROADWAY LEXINGTON KY 40504 SUPPORT 41 - ARH SYSTEM CENTER-SOUTH WILLIAMSON 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 SUPPORT 42 - ARH REGIONAL DISTRIBUTION CENTER 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 43 - DME WAREHOUSE 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 44 - ARH SOUTHERN WEST VIRGINIA CLINIC 250 STANAFORD ROAD BECKLEY WV 258013140 CLINIC 45 - MIDDLESBORO ARH PHYSICIAN CLINIC 3602 WEST CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 46 - ARH WOMEN'S AND FAMILY HEALTH CARE - MID 2004 W CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 47 - ARH CARDIOLOGY & ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 1J HAZARD KY 417019477 CLINIC 48 - ARH DERMATOLOGY 210 BLACK GOLD BLVD SUITE 211 HAZARD KY 41701 CLINIC 49 - ARH CARDIOLOGY ASSOCIATES - BECKLEY 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 50 - BECKLEY ARH PRIMARY CARE 250 STANFORD ROAD STE 104 BECKLEY WV 258013140 CLINIC 51 - ARH SPECIALTY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 100 SOUTH WILLIAMSON KY 415034095 CLINIC 52 - ARH SPECIALTY ASSOCIATES - WHITESBURG 214 HOSPITAL DR STE B WHITESBURG KY 418587627 CLINIC 53 - ARH CARDIOLOGY ASSOCIATES - WHITESBURG 226 MEDICAL PLAZA LN STE C WHITESBURG KY 418587425 CLINIC 54 - ARH CARDIOLOGY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 203 SOUTH WILLIAMSON KY 415034095 CLINIC 55 - ARH DERMATOLOGY MIDDLESBORO 2145 US HIGHWAY 25E MIDDLESBORO KY 409651874 CLINIC 56 - ARH OAK HILL PRIMARY CARE CENTER 223 MAPLE AVE OAK HILL WV 259013475 CLINIC 57 - ARH SPECIALTY ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 2M HAZARD KY 417019422 CLINIC 58 - ARH PENNINGTON GAP CLINIC 121 STACY DR PENNINGTON GAP VA 242779998 CLINIC 59 - BECKLEY ARH MEDICAL MALL 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 60 - SUMMERS CO ARH FAMILY CARE CLINIC 197 PLEASANT ST HINTON WV 259512540 CLINIC 61 - MIDDLESBORO ARH HEMATOLOGYONCOLOGY CLIN 3602 W CUMBERLAND AVE STE 104 MIDDLESBORO KY 409652614 CLINIC 62 - MORGAN COUNTY ARH FAMILY HEALTH 1084 HWY 7 STE 2 WEST LIBERTY KY 414727146 CLINIC 63 - ARH PRIMARY CARE - BECKLEY 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 64 - ARH BECKLEY GASTROENTEROLOGY 429 CARRIAGE DRIVE BECKLEY WV 25801 CLINIC 65 - ARH BECKLEY ONCOLOGY 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 66 - ARH HAZARD FAMILY CLINIC 181 ROY CAMPBELL DRIVE HAZARD KY 41701 CLINIC 67 - HAZARD MEDICAL MALL 210 BLACK GOLD BLVD STE 102 HAZARD KY 41701 MEDSPA 68 - ARH BECKLEY REJUVENATION CENTER 1256 N EISENHOWER DRIVE BECKLEY WV 25801 MEDSPA 69 - ARH MIDDLESBORO REJUVENATION CENTER 2145 HWY 25E MIDDLESBORO KY 40965 MEDSPA 70 - ARH HAZARD PHARMACY 181 ROY CAMPBELL DRIVE HAZARD KY 41701 PHARMACY 71 - ARH RETAIL PHARMACY 4845 KY RTE 321 PRESTONSBURG KY 41653 PHARMACY 72 - ARH MEDICAL & SPECIALTY ASSOCIATES - PRE 4851 KY ROUTE 321 PRESTONSBURG KY 41653 CLINIC 73 - ARH MED & SPEC ASSOC HAZARD 200 MEDICAL CENTER DRIVE HAZARD KY 41701 CLINIC 74 - ARH MED MALL FAMILY SPEC CLIN 210 BLACK GOLD BLVD HAZARD KY 41701 CLINIC 75 - ARH INTERVENTIONAL PAIN MGMT HEADACHE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 CLINIC 76 - ARH MEDICAL & SPECIALTY ASSOCIATES - PRE 4851 KY RT 321 SUITES 101 AND 102 PRESTONBURG KY 41653 CLINIC PART I, LINE 3C: THE DISCOUNTS ARE BASED ON A SLIDING FEE SCHEDULE STARTING AT 100% OF FPG QUALIFYING FOR FREE CARE, RANGING UP TO UNLIMITED INCOME LEVELS FOR A 40% DISCOUNT ON ALL UNINSURED CARE PROVIDED. PART I, LINE 6A: A COMBINED ANNUAL COMMUNITY BENEFIT WAS FILED BY APPALACHIAN REGIONAL HEALTHCARE, INC. FOR ALL FACILITIES WITHIN THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM. PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART II, COMMUNITY BUILDING ACTIVITIES: ARH MADE A PROFOUND IMPACT ON COMMUNITY HEALTH THROUGH INNOVATIVE OUTREACH AND COMMUNITY DEVELOPMENT PROGRAMS. OVER $5.5 MILLION WAS INVESTED IN COMMUNITY BENEFIT ACTIVITIES, WHICH INCLUDED FREE CLINICAL SCREENINGS AND HEALTH AWARENESS INITIATIVES. FOOD INSECURITY REMAINED A KEY FOCUS, WITH ARH EXPANDING ITS IN-FACILITY FOOD PANTRY PROGRAM TO NINE HOSPITALS AND AMBULATORY CLINICS IN THE BIG SANDY AND KENTUCKY RIVER REGIONS. OVER 1,500 FOOD BOXES WERE DISTRIBUTED TO PATIENTS IDENTIFIED AS FOOD INSECURE. ARH HAS BEEN AT THE FOREFRONT OF FOOD IS MEDICINE IN APPALACHIA, EDUCATING PATIENTS AND COMMUNITIES ABOUT THE BENEFITS OF PROPER NUTRITION. THE FOOD IS MEDICINE MOVEMENT FURTHER INTEGRATED NUTRITION INTO HEALTHCARE, HOSTING EVENTS SUCH AS FARMER'S MARKETS, HEALTHY COOKING DEMONSTRATIONS, AND EDUCATIONAL CAMPAIGNS HIGHLIGHTING THE IMPORTANCE OF PROPER NUTRITION. ADDRESSING MENTAL HEALTH AND SUBSTANCE USE CHALLENGES, ARH EMPLOYED PEER RECOVERY COACHES WHO PROVIDED 80,130 SCREENING BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) SCREENINGS, WITH OVER 6,200 YIELDING POSITIVE RESULTS. NEARLY 900 PATIENTS WERE REFERRED TO TREATMENT, WITH AN IMPRESSIVE 98% REMAINING IN CARE FOR AT LEAST 30 DAYS, DEMONSTRATING A HIGH RATE OF SUCCESSFUL LINKAGE TO CARE. ARH ALSO PARTNERED WITH THE DEPARTMENT OF PUBLIC HEALTH FOR THE SAVE A LIFE ROADSHOW, WHICH TRAINED PARTICIPANTS IN NARCAN ADMINISTRATION AND PROVIDED SCREENINGS FOR HEPATITIS C AND HIV IN HIGH-RISK AREAS. NEARLY 900 DOSES OF NARCAN WERE DISTRIBUTED AT THESE EVENTS, AND 247 CLINICAL TESTS WERE COMPLETED. ADDITIONALLY, ARH EXPANDED ITS WORKFORCE TRAINING INITIATIVES, CERTIFYING STAFF AND COMMUNITY MEMBERS IN MENTAL HEALTH FIRST AID, WHICH TEACHES PARTICIPANTS TO RECOGNIZE AND ASSIST PATIENTS, CAREGIVERS, COWORKERS, OR THEIR FAMILIES WHO MAY BE EXPERIENCING MENTAL DISTRESS OR ADDICTION CHALLENGES. IN FY 24, SIGNIFICANT ADVANCEMENTS WERE MADE IN PATIENT CARE ACCESSIBILITY AND TECHNOLOGY. TUG VALLEY ARH, MIDDLESBORO ARH, AND HIGHLANDS ARH INTRODUCED SPECIALIZED CENTERS, INCLUDING A WOUND CARE CENTER AT TUG VALLEY AND A LEVEL 2 NEONATAL INTENSIVE CARE UNIT AT HIGHLANDS ARH, WHILE MIDDLESBORO ARH ANNOUNCED PLANS FOR A COMPREHENSIVE CANCER CENTER. ARH ALSO LAUNCHED INNOVATIVE PROGRAMS LIKE THE HOME SERVICES RESPIRATORY PROGRAM TO REDUCE COPD AND CHRONIC HEART FAILURE HOSPITALIZATIONS, AND THE LUNG NODULE PROGRAM, WHICH UTILIZES AI FOR EARLY LUNG CANCER DETECTION. NEW IMAGING EQUIPMENT HAS BEEN ADDED, INCLUDING AMYLOID BRAIN PET IMAGING FOR ALZHEIMER'S PATIENTS. MIDDLESBORO ARH LAUNCHED A DA VINCI ROBOTICS PROGRAM, AND THE INTUITIVE ION ROBOTIC BRONCHOSCOPY WAS IMPLEMENTED AT HAZARD ARH, MAKING HAZARD ARH THE SECOND HOSPITAL IN KENTUCKY TO OFFER THIS ADVANCED PROCEDURE. ADDITIONALLY, ARH COMPLETED SIGNIFICANT RENOVATIONS AT THE HAZARD ARH PSYCHIATRIC CENTER'S TREATMENT MALL, GEARED AT PROVIDING RESIDENTS ACCESS TO BOTH RECREATION AND REAL-WORLD SCENARIOS TO ASSIST IN THEIR OVERALL TREATMENT AND RECOVERY, AND OPENED ITS FIRST OUTPATIENT BEHAVIORAL HEALTH CLINIC IN THE ARH BIG SANDY REGION.ADDITIONALLY, ACROSS THE SYSTEM, NEW SERVICES LIKE ENDOSCOPIC ULTRASOUND, 3D MAMMOGRAPHY, AND UPGRADED PATIENT MONITORING SYSTEMS HAVE BEEN INTRODUCED, EMPHASIZING ARH'S COMMITMENT TO DELIVERING COMPREHENSIVE, HIGH-QUALITY HEALTHCARE.AT ARH, WE UNDERSTAND THAT HEALTHCARE IS MORE THAN JUST A DOCTOR'S VISIT. PREVENTIVE CARE SUCH AS SCREENINGS, VACCINATIONS, AND HEALTH EDUCATION PLAY A CRITICAL ROLE IN MAINTAINING GOOD HEALTH AND REDUCING THE RISK OF ILLNESS. THIS ASPECT OF HEALTHCARE HELPS IDENTIFY POTENTIAL HEALTH ISSUES BEFORE THEY BECOME SERIOUS MEDICAL PROBLEMS. TO MAKE OUR COMMUNITIES HEALTHIER, WE MUST MEET THEM WHERE THEY ARE BY BRINGING EDUCATION AND CLINICAL SCREENINGS TO PLACES WHERE PEOPLE WORK, WORSHIP, SHOP, AND PLAY. ARH SECURED SUBSTANTIAL FUNDING TO ENHANCE HEALTHCARE AND EDUCATION IN THE REGION, INCLUDING $12 MILLION FROM THE KENTUCKY GENERAL ASSEMBLY FOR THE MIDDLESBORO CANCER CENTER AND $16 MILLION FOR THE ARH PSYCHIATRY RESIDENCY PROGRAM, AND $6.7 MILLION WAS GRANTED THROUGH THE ECONOMIC DEVELOPMENT ADMINISTRATION' RECOMPETE GRANT FOR THE NEW ARH ALLIED HEALTH TRAINING ACADEMY IN HAZARD WHICH IS ANTICIPATED TO BEGIN IN EARLY 2026 AND WILL TRAIN LICENSED PRACTICAL NURSES, MEDICAL ASSISTANTS AND NURSES' AIDES, ALL CRITICALLY NEEDED POSITIONS AT ARH AND THROUGHOUT THE REGION. ADDITIONAL FUNDING SUPPORTED THE CONSTRUCTION OF A MOBILE CLINIC TO SERVE RURAL COMMUNITIES AND INVESTMENTS IN NEW IMAGING EQUIPMENT. STRATEGIC PARTNERSHIPS FURTHERED WORKFORCE DEVELOPMENT, INCLUDING COLLABORATIONS WITH THE UNIVERSITY OF KENTUCKY AND MOREHEAD STATE UNIVERSITY TO ADDRESS BEHAVIORAL HEALTH SHORTAGES AND SUPPORT EMPLOYEE EDUCATION. ADDITIONALLY, ARH HAS PARTNERED WITH MARSHALL HEALTH TO PROVIDE PEDIATRIC MENTAL TELEHEALTH SERVICES IN SUMMERS COUNTY, WV, OFFERING CRUCIAL SUPPORT FOR CHILDREN DEALING WITH DEPRESSION, ANXIETY, AND ADHD. FURTHERING ITS COMMITMENT TO HEALTHCARE IMPROVEMENT, ARH JOINED THE KENTUCKY HOSPITAL ASSOCIATION (KHA) AND THE KENTUCKY STATEWIDE OPIOID STEWARDSHIP PROGRAM TO IMPLEMENT AN OUTPATIENT OPIOID STEWARDSHIP INITIATIVE IN PRIMARY CARE CLINICS AND HAS JOINED FORCES WITH THE KENTUCKY DEPARTMENT OF AGRICULTURE AND THE KHA TO DEVELOP A "FOOD IS MEDICINE" CAMPAIGN, FOCUSING ON THE POWER OF FOOD AND ITS CONNECTION TO HEALTHIER LIVING.AS ARH CONCLUDES ANOTHER YEAR OF TRANSFORMATIVE GROWTH AND INNOVATION, IT REMAINS DEDICATED TO ADDRESSING THE UNIQUE HEALTHCARE NEEDS OF ITS COMMUNITIES. FROM EXPANDING ACCESS TO CARE TO IMPLEMENTING CUTTING-EDGE TECHNOLOGIES, ARH CONTINUES TO LEAD THE WAY IN IMPROVING HEALTH OUTCOMES AND FOSTERING A HEALTHIER FUTURE FOR CENTRAL APPALACHIA. PART III, LINE 2: COSTING METHODOLOGY: TO DETERMINE THE BAD DEBT EXPENSE ON LINE 2, THE BAD DEBT EXPENSE PER THE FINANCIAL STATEMENTS, WHICH CONSISTS OF GROSS CHARGES LESS DISCOUNTS, WAS CONVERTED TO COST USING THE GLOBAL COST-TO-CHARGE RATIO DEVELOPED IN WORKSHEET 2. PATIENT DISCOUNTS ARE NOT REFLECTED IN BAD DEBT. ANY PAYMENTS ON AN ACCOUNT AFTER IT IS WRITTEN OFF TO BAD DEBT RESULT IN A REVERSAL OF THE ENTIRE ACCOUNT OUT OF BAD DEBT, REINSTATEMENT OF THE PATIENT ACCOUNT RECEIVABLE, AND ANY NEGOTIATED DIFFERENCE IN THE FULL AMOUNT OF THE ACCOUNT AND THE PAYMENT MADE IS WRITTEN OFF TO CONTRACTUAL ALLOWANCE. PATIENTS WHO MAY QUALIFY FOR CHARITY CARE BUT DO NOT APPLY CANNOT BE ESTIMATED. ALL PATIENTS ARE EDUCATED ABOUT AND GIVEN EVERY OPPORTUNITY TO APPLY FOR CHARITY CARE AND, THEREFORE, ARH HAS NO INFORMATION FOR THOSE WHO CHOOSE NOT TO APPLY. PART III, LINE 3: MANAGEMENT CONTINUALLY MONITORS AND ADJUSTS THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ASSOCIATED WITH CREDIT RISK.THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICAL TO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE CORPORATION ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE PRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENT RECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROM INDIVIDUAL PATIENTS.THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE CORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. PART III, LINE 4: THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE CORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. PART III, LINE 8: NEARLY ONE HALF OF THE CORPORATION'S PATIENT REVENUES ARE DERIVED FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES. IN TURN, PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FELL SHORT OF THE COST TO PROVIDE SUCH SERVICES BY MORE THAN $17 MILLION. MEDICARE RECIPIENTS RELY HEAVILY ON ARH FOR CARE. IN MANY OF THE COMMUNITIES IT SERVES, ARH IS THE LONE PROVIDER OF ACUTE HOSPITAL CARE. THE CORPORATION CONSIDERS ITS PARTICIPATION IN THE MEDICARE PROGRAM AND THE ASSOCIATED LOSSES RESULTING THEREOF AS AN ESSENTIAL COMPONENT OF COMMUNITY BENEFIT. ACCORDINGLY, WE DEEM THAT $17,569,591 (OR 100%) OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 7 BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 9B: THE PROVISIONS IN THE WRITTEN DEBT COLLECTION POLICY ARE THAT CHARITY AND FINANCIAL ASSISTANCE APPLICATIONS ARE VALID FOR 6 MONTHS. AFTER THAT TIME, THE PATIENT MUST REAPPLY AND PRESENT CURRENT FINANCIAL DOCUMENTS AS NECESSARY. PART VI, LINE 2: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT IS CONDUCTED BY ARH EVERY THREE YEARS AND REPORTED ELSEWHERE IN THIS DOCUMENT, ARH CONTINUALLY ASSESSES COMMUNITY NEEDS IN OTHER FORMS AS WELL. THE NEEDS OF THE COMMUNITIES THAT ARH SERVES THROUGHOUT EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA ARE ASSESSED BY FOLLOWING EMERGING MEDICAL PRACTICE NEEDS AS A WHOLE ACROSS THE NATION AND SPECIFICALLY IN THE APPALACHIAN REGION. THE HEALTH NEEDS ARE EXAMINED BY LOOKING AT HEALTH STATISTICS AND DISEASE PREVALENCE COMPARED TO SERVICE/PHYSICIAN AVAILABILITY. PATIENT AND COMMUNITY SURVEYS ARE REGULARLY CONDUCTED TO ASSESS CONSUMER PERCEIVED NEEDS. LOCAL ADVISORY COUNCILS (LACS) ALSO EXIST IN EACH OF ARH'S HOSPITAL COMMUNITIES. THE COUNCILS ARE COMPRISED OF LOCAL CITIZENS WHO VOLUNTEER TO HELP ARH IMPROVE THE HEALTH OF ITS COMMUNITIES THROUGH REGULAR MEETINGS THAT DISCUSS COMMUNITY HEALTH ISSUES AND HELP ARH IDENTIFY AND ADDRESS THEM. MEMBERS ALSO ADVISE ARH ABOUT IMPROVEMENTS NEEDED AND COMMUNITY PERCEPTIONS OF ARH FACILITIES AND THESE INDIVIDUALS SERVE AS EXCELLENT AMBASSADORS FOR ARH AND ITS SERVICES. THESE INDIVIDUALS HAVE DEMONSTRATED THEIR LEADERSHIP IN LOCAL CIVIC AFFAIRS AND REFLECT A CROSS SECTION OF THE COMMUNITY. QUARTERLY, ONE REPRESENTATIVE FROM EACH OF THESE LACS MEETS TO DISCUSS COMMON ISSUES ACROSS THE SYSTEM AT A REGIONAL ADVISORY COUNCIL MEETING. FROM THIS GROUP OF REPRESENTATIVES, ONE MEMBER IS SELECTED TO ALSO SERVE ON THE HEALTH SYSTEM'S BOARD OF TRUSTEES. PART VI, LINE 3: UNDER ARH'S FINANCIAL ASSISTANCE PROGRAM AND POLICY, EACH PATIENT WITHOUT MEDICAL COVERAGE FOR RENDERED SERVICES IS OFFERED A 40% DISCOUNT OF GROSS CHARGES AT TIME OF SERVICE. IF THE PATIENT EXTENDS PAYMENT AT TIME OF SERVICE THEY ARE GIVEN ANOTHER 10% DISCOUNT, MAKING THEIR LIABILITY 50% OF GROSS CHARGES. ALL OF THESE DISCOUNTS ARE APPLIED AT TIME OF CHARGE AND BILLED AFTER THE DISCOUNT IS TAKEN. IF SAID PATIENT IS UNABLE TO MEET THE FINANCIAL OBLIGATIONS FOR SERVICE, THEY ARE EDUCATED AND SCREENED FOR POTENTIAL FEDERAL AND/OR STATE ASSISTANCE PROGRAMS. BY DOING THIS, THE PATIENT IS REVIEWED AND EDUCATED BY ON-SITE FINANCIAL COUNSELORS AND/OR ELIGIBILITY AGENCY TO GET THE INDIVIDUAL PLACED IN A PROGRAM. BASED ON INCOME AND FAMILY STATUS, THE PATIENT IS SCREENED IN CONJUNCTION WITH THE FEDERAL AND STATE POVERTY GUIDELINES. AT THIS TIME, ALL APPLICATIONS ARE COMPLETED WITH THE ASSISTANCE OF ARH PERSONNEL AND SUBMITTED FOR APPROVAL. IN THE EVENT AN AGENCY REQUIRES THE PATIENT/GUARANTOR TO APPLY IN PERSON, THE INDIVIDUAL IS ASKED TO MAKE AN APPOINTMENT WITH THAT AGENCY AND FILE THEIR COMPLETED DOCUMENTS. IF THE RESPONSIBLE PARTY IS NOT ELIGIBLE FOR FEDERAL OR STATE ASSISTANCE, THEY ARE ADDITIONALLY SCREENED BY ARH FOR ELIGIBILITY INTO OUR INTERNAL SLIDING FEE SCHEDULE CHARITY PROGRAM FOR ADDITIONAL DISCOUNTS UP TO 100% OF GROSS CHARGES. IF THE PATIENT IS HELD RESPONSIBLE, ADDITIONAL EFFORTS TO ASSIST THE PATIENT ARE OFFERED BY OFFERING REASONABLE PAYMENT PLANS AND DEFERRED PAYMENTS. IN THE EVENT THE PATIENT/GUARANTOR DOES NOT MAKE A REASONABLE EFFORT TO COMPLETE NECESSARY DOCUMENTATION TO APPLY OR BECOME ELIGIBLE FOR A FINANCIAL ASSISTANCE PROGRAM, THEY ARE THEN STILL GIVEN THE INITIAL 40% DISCOUNT AND MOVED THROUGH THE NORMAL COLLECTION PROCESS. PART VI, LINE 4: THE RURAL SERVICE AREA COVERED BY ARH IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA INCLUDES MORE THAN 20 COUNTIES. THIS REGION IS FRAUGHT WITH SOME OF THE HIGHEST CHRONIC HEALTH PREVALENCE RATES IN THE COUNTRY FOR LUNG CANCER, DIABETES, AND HEART DISEASE. TO COMPOUND THESE PROBLEMS, MOST OF ARH'S FACILITIES ARE LOCATED IN AREAS THAT ARE AT LEAST PARTIALLY CLASSIFIED AS MEDICALLY UNDERSERVED AREAS AND HEALTH PROFESSIONAL SHORTAGE AREAS BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. IN ADDITION, THE AREAS SERVED BY ARH ALSO FACE UNEMPLOYMENT RATES THAT ARE SUBSTANTIALLY HIGHER THAN STATE AND NATIONAL AVERAGES AND A HIGHER NUMBER OF CITIZENS IN THESE AREAS RANK BELOW THE NATIONAL POVERTY LEVEL. FOR MORE THAN 60 YEARS, ARH HAS CARRIED A HEAVY LOAD IN CARING FOR THIS POPULATION. IN FISCAL YEAR 2024, APPROXIMATELY 80 PERCENT OF ARH'S INPATIENTS WERE MEDICARE OR MEDICAID BENEFICIARIES. PART VI, LINE 5: TODAY APPALACHIAN REGIONAL HEALTHCARE CONTINUES ITS MISSION IN THE MOUNTAINS BY OFFERING RESIDENTS OF EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA A LOCAL OPTION FOR QUALITY HEALTHCARE SERVICES. ARH HOLDS STEADFAST TO THE MISSION TO, "IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES." ARH HAS EVOLVED INTO AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SERVING MORE THAN 320,000 RESIDENTS AND EMPLOYING OVER 6,000 PEOPLE ACROSS EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA WITH HOSPITALS, CLINICS, HOME HEALTH AGENCIES, PHARMACIES, LONG-TERM ACUTE CARE HOSPITALS, AND HOME DURABLE MEDICAL EQUIPMENT STORES. IN FISCAL YEAR 2024, ARH'S NINE HOSPITALS RANGE IN SIZE FROM CRITICAL-ACCESS FACILITIES TO THE SYSTEM'S FLAGSHIP REGIONAL MEDICAL CENTER WITH 358-LICENSED BEDS IN HAZARD, KENTUCKY. ARH IS THE LARGEST PROVIDER OF CARE AND SINGLE LARGEST EMPLOYER IN SOUTHEASTERN KENTUCKY AND THE THIRD LARGEST PRIVATE EMPLOYER IN SOUTHERN WEST VIRGINIA, AND IS CONSISTENTLY RECOGNIZED FOR ITS MEDICAL EXCELLENCE. WHILE PROVIDING THIS REGION WITH QUALITY HEALTHCARE, ARH REINVESTS ANY EARNINGS BACK INTO OPERATIONS TO FURTHER THE SYSTEM'S EFFORTS IN IMPROVING AND ACCESSING HEALTHCARE SERVICES FOR THE REGION. CREATED TO ADDRESS THE UNMET HEALTH NEEDS OF AN UNDERSERVED REGION, ARH LEADERSHIP AND STAFF MEMBERS REALIZE THAT SERVING THIS POPULATION IS ABOUT MORE THAN JUST ADDRESSING THE HEALTH NEEDS, IT IS ALSO ABOUT PREVENTING CHRONIC DISEASES. THROUGH PARTNERSHIPS WITH AREA SCHOOLS, BUSINESSES, ORGANIZATIONS AND HEALTH DEPARTMENTS, ARH IS ONE OF THE PRIMARY SOURCES FOR HEALTH EDUCATION AND DISEASE PREVENTION IN EACH COMMUNITY AND PARTNERS WITH ALL OF THESE VARIOUS COMMUNITY ENTITIES TO FURTHER THESE EFFORTS. ARH SPONSORS MANY COMMUNITY-WIDE WELLNESS EVENTS THROUGHOUT ITS SERVICE AREAS, INCLUDING HEALTH FAIRS AND VARIOUS SUPPORT GROUPS. EACH YEAR, ARH PROVIDES FREE OR DISCOUNTED HEALTH SCREENINGS FOR COLORECTAL, BREAST, AND PROSTATE CANCERS AS WELL AS ROUTINE BLOOD PRESSURE, CHOLESTEROL, GLUCOSE, AND BODY MASS INDEX (BMI) SCREENINGS IN EFFORTS TO PREVENT THE ONSET OF ILLNESSES OR CATCH MEDICAL CONDITIONS BEFORE THEY BECOME LIFE THREATENING. ARH ALSO ACTIVELY UTILIZES ALL FORMS OF MEDIA TO PROMOTE WELLNESS AND EDUCATE THE PUBLIC ON THE SIGNS AND SYMPTOMS OF MANY COMMON HEALTH CONDITIONS. THIS INCLUDES HEALTH EDUCATION NEWSLETTERS MAILED DIRECTLY TO RESIDENTS' HOMES. PART VI, LINE 6: DURING FISCAL YEAR 2024, ARH'S SERVICES WERE MAINLY ORGANIZED AROUND ITS 9 HOSPITAL SPECIFIC COMMUNITIES ACROSS EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA. IN EACH OF THESE COMMUNITIES, A HOSPITAL EXISTS ALONG WITH A COMPLEMENTARY ARRANGEMENT OF OTHER ARH SERVICES, WHICH MAY INCLUDE CLINICS, HOME HEALTH AGENCIES, PHARMACIES, AND/OR HOME DURABLE MEDICAL EQUIPMENT STORES. AT THE SYSTEM-LEVEL, VARIOUS HEALTH PROMOTION ACTIVITIES ARE ORGANIZED AND PROMOTED ACROSS THE FACILITIES, INCLUDING THE INTRODUCTION OF NEW SERVICE LINES AND NEW TECHNOLOGY. HOWEVER, IN EACH OF ARH'S 9 COMMUNITIES, VARIOUS COMMUNITY OUTREACH PROGRAMS ARE ALSO UNDERWAY AND AGGRESSIVELY ADDRESSING THE HEALTH CONCERNS OF THAT PARTICULAR AREA WHILE STRONG COMMUNITY COLLABORATION IS BEING DEVELOPED. FROM SENIOR CITIZEN WELLNESS PROGRAMS TO PATIENT ASSISTANCE VIA A CANCER NAVIGATOR, ARH'S COMMUNITIES ARE REAPING THE BENEFITS OF SUCCESSFUL COMMUNITY OUTREACH. PART VI, LINE 7, REPORTS FILED WITH STATES KY,WV 0 AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 9500 0 ONGOING SUPPORT BLACK GOLD COMMITTEE INC 221 MEMORIAL DRIVE HAZARD KY 41701 753036575 501(C)(4) 7000 0 ONGOING SUPPORT CITY OF HINTON SANITARY BOARD 322 SUMMERS ST HINTON WV 25951 556000185 GOVT 18000 0 ONGOING SUPPORT FIVCO DEVELOPMENT CORPORATION INC (FKA FIVCO OFFICES INC) 32 FIVCO COURT GRAYSON KY 41143 610874861 25000 0 CONFERENCE SPONSORSHIP GOD'S PANTRY FOOD BANK INC 1685 JAGGIE FOX WAY LEXINGTON KY 40511 310979404 501(C)(3) 5200 0 ONGOING SUPPORT IHEARTMEDIA 20880 STONE OAK PARKWAY SAN ANTONIO TX 78258 742722883 48500 0 CONCERT SPONSORSHIP KENTUCKY CHAMBER OF COMMERCE 464 CHENAULT ROAD FRANKFORT KY 40601 610405718 501(C)(6) 38050 0 ONGOING SUPPORT MATRIX ENTERTAINMENT 3849 LAKE MICHIGAN DR NW GRAND RAPIDS MI 49534 453972742 7000 0 SAVE A LIFE TOUR SPONSORSHIP PERRY COUNTY SCHOOL DISTRICT - BOARD OF EDUCATION 315 PARK AVE HAZARD KY 41701 616001294 GOVT 11300 0 ONGOING SUPPORT PINEVILLE HIGH SCHOOL 401 VIRGINIA AVE PINEVILLE KY 40977 616001431 GOVT 6667 0 ONGOING SUPPORT SHAPING OUR APPALACHIAN REGION INC 137 MAIN STREET SUITE 300 PIKEVILLE KY 41501 371760428 501(C)(3) 32500 0 ONGOING SUPPORT SOUTHEAST KENTUCKY CHAMBER OF COMMERCE 178 COLLEGE STREET PIKEVILLE KY 41501 610544068 501(C)(6) 22000 0 ONGOING SUPPORT THE LEXINGTON CANCER FOUNDATION INC 1504 COLLEGE WAY LEXINGTON KY 40502 562472701 501(C)(3) 15000 0 ONGOING SUPPORT UNIVERSITY OF KENTUCKY STURGILL PHILANTHROPY BUILDING LEXINGTON KY 40506 616001218 GOVT 16500 0 ONGOING SUPPORT 8 6 X X X X X 0 1 0 0 0 1 0 0 0 HOLLIE P HARRIS PRESIDENT/CEO 938382 0 176400 0 593 0 84230 0 27963 0 1227568 0 0 0 JAYARAMAKRISHNA DEPA NEPHROLOGIST 791286 0 252527 0 0 0 11286 0 876 0 1055975 0 0 0 STEPHEN J MULARZ GASTROENTEROLOGIST 953761 0 30000 0 0 0 4787 0 270 0 988818 0 0 0 RAMZI HADDADIN PULMONOLOGIST 699720 0 227941 0 0 0 10044 0 886 0 938591 0 0 0 ASHOK PATNAIK CARDIOLOGIST 590328 0 292094 0 0 0 14997 0 620 0 898039 0 0 0 SAMUEL BAILEY ONCOLOGIST 818482 0 0 0 0 0 15774 0 876 0 835132 0 0 0 PAUL BETZ CHIEF OPERATING OFFICER 527069 0 89077 0 779 0 77510 0 38904 0 733339 0 0 0 MARIA BRAMAN CHIEF MEDICAL OFFICER 469389 0 94200 0 995 0 32970 0 38904 0 636458 0 0 0 BYRON GABBARD CHIEF FINANCIAL OFFICER 424510 0 80000 0 641 0 52023 0 0 0 557174 0 0 0 SONYA BERGMAN CHIEF PEOPLE OFFICER 350164 0 70600 0 1475 0 51750 0 38904 0 512893 0 0 0 CHRISTI LEE CHIEF LEGAL COUNSEL 354644 0 71800 0 371 0 44630 0 38904 0 510349 0 0 0 DANNY HARRIS CFO/ASST SEC'Y/TREASURER 437388 0 0 0 0 0 25074 0 2241 0 464703 0 0 0 PART I, LINE 4B ARH PROVIDES SENIOR EXECUTIVES A CONTRIBUTION 3, 5,OR 7 PERCENT OF PAY (SUBJECT TO DOLLAR CAP), DEPENDING ON JOB TITLE, INTO THE TOP HAT 457(B) RETIREMENT PLAN. THE CONTRIBUTION AND EARNINGS ARE TAX DEFERRED UNTIL ASSETS ARE DISTRIBUTED OR WITHDRAWN. THE MAXIMUM CONTRIBUTION IS SUBJECT TO THE IRS COMPENSATION CAP, WHICH ALLOWS A CONTRIBUTION OF UP TO $22,500 IN 2023. THIS CONTRIBUTION TOTAL IS AN AGGREGATE TOTAL REGARDLESS OF WHETHER ARH OR THE EXECUTIVE MAKES THE CONTRIBUTION. CONTRIBUTION TO THE 457(B) DOES NOT AFFECT THE AMOUNTS THE EXECUTIVE MIGHT CONTRIBUTE TO THE 403(B) THRIFT PLAN. THE EXECUTIVE MAY CONTRIBUTE HIS/HER OWN MONEY TO THE PLAN PRE-TAX, TO THE EXTENT THE IRS CAPS ALLOW ROOM AFTER ARH'S CONTRIBUTION. CATCH UP CONTRIBUTIONS ARE ALLOWED WITHIN IRS LIMITS IN THE LAST THREE YEARS PRIOR TO RETIREMENT (AND, IF THE 3,5 OR 7 PERCENT OF PAY EXCEEDS THE REGULAR DOLLAR CAP, ARH MAY USE THE BALANCE OF THE PERCENTAGE TO FUND UP THE CATCH UP LIMIT). BENEFITS ARE SUBJECT TO SOCIAL SECURITY AND MEDICARE TAXES AS THEY ACCRUE. THE FUNDS ARE INVESTED AS DIRECTED BY THE EXECUTIVE, BUT THE ACCOUNT REMAINS A GENERAL ASSET OF ARH. IF ARH BECOMES INSOLVENT, THE EXECUTIVE WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. IF THE FUNDING OF THE 457(B), INCLUDING ANY CATCH UP PROVISIONS, IS LESS THAN THE 3,5 OR 7 PERCENT OF BASE PAY, THEN ARH WILL CONTRIBUTE THE REMAINDER TO A 457(F) PLAN. INDIVIDUALS PARTICIPATING IN THE 457(F) PLAN AND THE RESPECTIVE EMPLOYER CONTRIBUTIONS FOR EACH INCLUDE: HOLLIE HARRIS - $39,240; MARIA BRAMAN - $10,470; BYRON GABBARD - $7,022.50; CHRISTI LEE - $2,630; SONYA BERGMAN - $2,210; PAUL BETZ- $39,690. PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE ARH BOARD OF TRUSTEES ADOPTED A SHORT-TERM INCENTIVE COMPENSATION PROGRAM FOR EXECUTIVES IN SEPTEMBER 2002. THE PROGRAM ESTABLISHED INCENTIVES FOR ACHIEVING SYSTEM AND COMMUNITY OBJECTIVES FOR EXECUTIVE LEADERSHIP BY INTEGRATING THE PERFORMANCE MANAGEMENT AND EXECUTIVE COMPENSATION SYSTEMS. THE INCENTIVE THRESHOLDS HAVE BEEN MODIFIED ACROSS TIME TO REFLECT INCREASED PERFORMANCE EXPECTATIONS AS IDENTIFIED IN THE SYSTEM'S STRATEGIC, BUDGET AND OPERATIONS PLAN. THE INCENTIVE AWARDS PROVIDE ADDITIONAL CASH COMPENSATION AS A PERCENTAGE OF BASE SALARY IN RELATION TO LEVELS OF ACHIEVEMENT. THESE ACHIEVEMENT LEVELS RANGE FROM THRESHOLD (LOWEST), TO TARGET (10% ABOVE THE THRESHOLD), AND MAXIMUM (HIGHEST AND 20% ABOVE THE THRESHOLD) AND VARY BASED UPON EXECUTIVE LEVEL. THE EXECUTIVE INCENTIVE PLAN WILL BE ADMINISTERED IN ACCORDANCE WITH THE FOLLOWING GUIDELINES: A. OBJECTIVES AND TARGETS ARE SET THROUGH THE STRATEGIC PLANNING, BUDGETING AND PERFORMANCE MANAGEMENT PROCESSES. B. SYSTEM MARGIN AND CASH BUDGET THRESHOLDS MUST BE MET BEFORE INDIVIDUAL AWARDS WILL BE CONSIDERED. C. AWARDS WILL BE CONSIDERED AS HAVING BEEN EARNED UPON AFFIRMATION BASED ON AUDITED FINANCIAL RESULTS AND ACTUAL OPERATING PERFORMANCE. D. THE PRESIDENT AND CEO WILL RECOMMEND PAYMENT OF INDIVIDUAL AWARDS, IF ANY, TO THE COMPENSATION AND CONTRACTS COMMITTEE FOR CONSIDERATION. E. THE COMPENSATION AND CONTRACTS COMMITTEE MAY ACCEPT, REJECT, OR MODIFY THE PRESIDENT AND CEO'S RECOMMENDATION. A CITY OF HAZARD KY 616001839 2021-07-01 70075000 CAPITAL CONSTRUCTION OF FACILITIES IN WV, KY; REFUNDING. 0 0 0 A 3595000 70075000 873823 58638837 10562340 2021 1 0 1 1 A 0 0 0 0 0 0 1 A 1 0 0 0 0 0 A 1 GREG COUCH PRINCIPAL OWNER OF MERIDIAN WEALTH 490672 INVESTMENT COMPANY THAT MANAGES ARH RETIREMENT PORTFOLIO 0 FORM 990, PART VI, SECTION B, LINE 11B THE DIRECTOR OF ACCOUNTING AND CFO BOTH REVIEW THE 990 PRIOR TO THE BOARD REVIEW. THE BOARD THEN REVIEWS THE 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A SECURE WEBSITE IS PROVIDED TO OFFICERS AND TRUSTEES FOR ANNUAL DISCLOSURES, AND IS MONITORED REGULARLY BY THE VICE PRESIDENT OF LEGAL AFFAIRS AND THE CORPORATE COMPLIANCE OFFICERS. POTENTIAL CONFLICTS OF INTEREST ARE REPORTED DIRECTLY TO THE CHAIRMAN OF THE BOARD. TRUSTEES IDENTIFIED AS HAVING A CONFLICT OF INTEREST IN A PARTICULAR MATTER BEFORE THE BOARD MAY NOT PARTICIPATE IN THE BOARD'S DECISION-MAKING PROCESS. FAILURE TO DISCLOSE IS SUBJECT TO DISCIPLINE, INCLUDING CENSURE, AND IN SOME CASES, REMOVAL FROM THE BOARD. EMPLOYEE OFFICERS ARE SUBJECT TO DISCIPLINE IN ACCORDANCE WITH THE CORPORATION'S HUMAN RESOURCE POLICIES AND THE ARH CODE OF BUSINESS AND PROFESSIONAL CONDUCT. FORM 990, PART VI, SECTION B, LINE 15 APPALACHIAN REGIONAL HEALTHCARE, INC.'S (ARH) BOARD SETS COMPENSATION LEVELS FOR PRESIDENT/CEO AND OTHER ARH EXECUTIVES AND KEY EMPLOYEES THROUGH ITS COMPENSATION AND CONTRACTS COMMITTEE. THE BOARD CONTRACTS WITH A CONSULTING FIRM TO REVIEW THE MARKET FOR THE POSITIONS ON THE SYSTEM OPERATING COUNCIL WHO MAKES RECOMMENDATIONS ON THE SALARY RANGES AND ASSESSES THE COMPETITIVENESS OF THE SALARIES. WITH THAT INFORMATION, THE COMPENSATION AND CONTRACTS COMMITTEE SETS THE RANGES AND THE PRESIDENT'S COMPENSATION. THE BOARD REVIEWS AND RATIFIES COMPENSATION AMOUNTS. THE CONSULTING FIRM FOLLOWS UP WITH A LETTER ATTESTING TO THE REASONABLENESS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 WHILE ARH HAS NOT YET ADOPTED A POLICY OF SHARING ITS FINANCIAL STATEMENTS WITH THE PUBLIC, IT DOES PROVIDE FINANCIAL INFORMATION THROUGH THE FORM 990 AND ALSO PROVIDES CERTAIN FINANCIAL INFORMATION IN OTHER PUBLIC DOCUMENTS, INCLUDING ITS PERIODIC REPORTS TO THE COMMUNITIES IT SERVES. FORM 990, PART IX, LINE 11G OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 45,557,454. MANAGEMENT AND GENERAL EXPENSES 19,924,204. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,481,658. PROFESSIONAL FEES PHYSICIANS: PROGRAM SERVICE EXPENSES 42,334,765. MANAGEMENT AND GENERAL EXPENSES 89,347. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,424,112. FORM 990, PART XI, LINE 9: NET PERIODIC PENSION GAIN 4,238,953. CHANGE IN PENSION PLAN ASSET AND OBLIGATION 27,262,097. NET CHANGE IN INVESTMENTS IN AFFILIATE -23,660. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSEEING AND SELECTING INDEPENDENT AUDITORS HAS NOT CHANGED FROM THE PRIOR YEAR. PRIOR TO THE START OF THE AUDIT, THE VICE PRESIDENT OF FINANCE MEETS WITH THE INDEPENDENT AUDITORS. AT THE CONCLUSION OF THE AUDIT, THE FINANCE COMMITTEE MEETS WITH THE INDEPENDENT AUDITORS FOR PRESENTATION OF THE FINANCIAL STATEMENTS. THE INDEPENDENT AUDITORS ARE SELECTED WHEN DEEMED NECESSARY BY MANAGEMENT THROUGH A FORMAL "REQUEST FOR PROPOSAL" (RFP) PROCESS. 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