2022-04-05T13:16:16-05:00 2021-06-30 271235638 MCM CPAS & ADVISORS LLP 462 SOUTH 4TH STREET SUITE 2600 LOUISVILLE KY 40202 990 2020-07-01 520795508 APPALACHIAN REGIONAL HEALTHCARE APPA 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 DANNY HARRIS CFO/VP FISCAL SERVICES 8592262440 2022-03-24 1 DANNY HARRIS 999009999 THERESA BATLINER CPA P00543162 5027491900 2022-03-24 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z HOLLIE HARRIS 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 817692172 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. 19 19 6091 312 14781425 0 34328570 3359358 736665433 781510902 12841022 23563335 9793902 8853884 793628927 817287479 750417 875347 0 0 374448378 384029047 0 0 268097 382454789 320828655 757653584 705733049 35975343 111554430 1013172338 1267201787 765469185 782229304 247703153 484972483 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. 0 0 591361158 875347 744686661 APPALACHIAN REGIONAL HEALTHCARE INC. (ARH), IS A NOT-FOR-PROFIT HEALTH SYSTEM OPERATING 13 HOSPITALS (NINE OF WHICH ARE INCLUDED IN THIS RETURN) IN BARBOURVILLE, HAZARD, HARLAN, HYDEN, MARTIN, MCDOWELL, MIDDLESBORO, PRESTONSBURG, WEST LIBERTY, WHITESBURG, AND SOUTH WILLIAMSON IN KENTUCKY AS WELL AS BECKLEY AND HINTON IN WEST VIRGINIA. ARH ALSO OPERATES MULTI-SPECIALTY AND FAMILY PRACTICE CLINICS, HOME HEALTH AGENCIES, HOME MEDICAL EQUIPMENT STORES, AND RETAIL AND SPECIALTY PHARMACIES IN THESE AND SURROUNDING AREAS. ARH EMPLOYS MORE THAN 6,000 PEOPLE WITH MOST RECENT ANNUAL PAYROLL AND BENEFITS OF MORE THAN $350 MILLION GENERATED INTO OUR LOCAL ECONOMIES. THE MAJORITY OF THESE EMPLOYEES RESIDE IN THE SAME COMMUNITIES THAT ARH SERVES. ARH ALSO HAS A NETWORK OF 600 ACTIVE AND COURTESY MEDICAL STAFF MEMBERS. ARH IS THE LARGEST PROVIDER OF CARE AND SINGLE LARGEST EMPLOYER IN SOUTHEASTERN KENTUCKY AND THE THIRD LARGEST IN SOUTHERN WEST VIRGINIA. THE COMPANY HAS BEEN RANKED AS ONE OF THE TOP TEN EMPLOYERS IN KENTUCKY BY FORBES MAGAZINE, AND IS CONSISTENTLY RECOGNIZED FOR ITS MEDICAL EXCELLENCE.ARH HAS PUT A MAJOR FOCUS INVESTING IN SIGNIFICANT NEUROSCIENCE GROWTH, INCLUDING CUTTING-EDGE TELEHEALTH EMERGENCY ROOM SERVICE AS WELL AS TELENEUROLOGY CLINICS AND INPATIENT SERVICES ACROSS THE ARH SYSTEM.ARH COMMUNITIES CAN COUNT ON ARH HOSPITALS TO PROVIDE THE BEST IN STROKE CARE WHETHER AT THE BEDSIDE OR VIA ITS NEW TELESTROKE AND TELENEUROLOGY PATIENT CARE AND MONITORING PROGRAM. WITH A SHORTAGE OF NEUROLOGISTS IN THE UNITED STATES, ESPECIALLY IN RURAL AREAS, TELESTROKE AND TELENEUROLOGY PROGRAMS ALLOW EXPERT-LEVEL CARE FROM A NEUROLOGIST IN OUR LOCAL COMMUNITY. SEVERAL ARH LOCATIONS ADDED THE NEW TELESTROKE AND TELENEUROLOGY PATIENT CARE AND MONITORING PROGRAM. THE TELESTROKE PROGRAM ALLOWS ARH TO PROVIDE TIME-CRITICAL DIAGNOSIS TREATMENT SUCH AS THE CLOT DISSOLVING DRUGS (THROMBOLYTICS) USED TO TREAT THE MOST COMMON TYPE OF STROKE. PROVIDING TELESTROKE AND TELENEUROLOGY SERVICES GIVE ALL PATIENTS IN APPALACHIA A BETTER CHANCE OF STROKE SURVIVAL AND RECOVERY.IT IS PART OF ARH'S MISSION TO IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS IT SERVES THROUGH PARTNERSHIPS WITH OUR COMMUNITIES. ONE SUCH EXAMPLE WAS THE BARBOURVILLE ARH HOSPITAL PARTNERSHIP WITH UNION COLLEGE TO OPEN THE ARH CAMPUS HEALTH CENTER-UNION COLLEGE OFFERING ACUTE AND CHRONIC CARE, INCLUDING ANNUAL WELLNESS EXAMS, COLD AND FLU TREATMENT, DIABETES MANAGEMENT, WOMEN'S HEALTH AND SCHOOL, SPORTS AND WORK PHYSICALS FOR MEN, WOMEN AND CHILDREN OF ALL AGES.ARH STRIVES NOT ONLY TO PROVIDE ITS COMMUNITIES EXCEPTIONAL MEDICAL CARE, BUT ALSO TO BUILD PUBLIC AWARENESS OF WARNING SIGNS AND TIPS FOR PREVENTION OF COMMON HEALTH CONDITIONS IN OUR AREA THROUGH FREE EDUCATIONAL SESSIONS. DURING MANY OF THESE EDUCATIONAL EVENTS, FREE HEALTH SCREENINGS ARE OFFERED TO FURTHER IMPROVE THE HEALTH OF THE RESIDENTS ARH SERVES. ARH STRONGLY PROMOTES THE IMPORTANCE OF PREVENTATIVE HEALTH SCREENINGS AND EACH YEAR ARH FACILITIES PROVIDE A NUMBER OF FREE ROUTINE HEALTH SCREENINGS. TO ENCOURAGE WOMEN TO GET ANNUAL SCREENING MAMMOGRAMS, EACH YEAR ARH ALSO OFFERS DISCOUNTED MAMMOGRAM SCREENINGS DURING OCTOBER'S BREAST CANCER AWARENESS MONTH, WHICH COINCIDE WITH AWARENESS EVENTS HELD THROUGHOUT THE MONTH. THE NORTON HEALTHCARE/UK HEALTHCARE STROKE CARE NETWORK RECOGNIZED TUG VALLEY ARH REGIONAL MEDICAL CENTER FOR ITS WORK IN PUBLIC AWARENESS AND COMMUNITY EDUCATION WITH THE "SERVICE AWARD" FOR STROKE AWARENESS.ARH ALSO IS A STRONG ADVOCATE OF GOOD NUTRITION IN OUR COMMUNITIES AND HELD FARMER'S MARKETS AT SOME HOSPITAL LOCATIONS BRINGING LOCALLY SOURCED FRESH FRUITS AND VEGETABLES TO VISITORS, PATIENTS AND EMPLOYEES, WHICH IN TURN SUPPORTED LOCAL GROWERS.IN EFFORTS TO PREVENT THE SPREAD OF THE VIRUS THE COVID-19 PANDEMIC AND IN ADHERING TO GUIDANCE FROM PUBLIC HEALTH OFFICIALS THAT CAUTIONED AGAINST LARGE MASS GATHERINGS, THE MAJORITY OF THE IN-PERSON EDUCATION AND OUTREACH ACTIVITIES NORMALLY HELD IN THESE COMMUNITIES HAD TO BE HALTED DURING THIS TIME. HOWEVER, THE SYSTEM WAS STILL ABLE TO PROVIDE MORE THAN $3 MILLION IN COMMUNITY BENEFIT ACTIVITIES TO MORE THAN 47,000 PEOPLE. WHILE THE MAJORITY OF IN PERSON EVENTS CEASED, ARH EMBRACED TECHNOLOGY TO CONTINUE OUR OUTREACH ENDEAVORS BY OFFERING HEALTH EDUCATION AND OUTREACH ACTIVITIES THROUGH ONLINE HEALTH WEBINARS.ARH VALUES OUR RELATIONSHIP WITH THE SCHOOL SYSTEMS IN EACH OF OUR COMMUNITIES. WE HAVE WORKED TO PROVIDE COVID-19 INFORMATION AND EDUCATION TO SCHOOL STAFF AS WELL AS WORKED TO PROTECT THEM BY PROVIDING NEEDED SUPPLIES SUCH AS HAND SANITIZER AND REUSABLE FACE MASKS FOR STUDENTS IN EACH ARH COMMUNITY.THROUGHOUT THE PANDEMIC, ARH HAS BEEN AT THE FOREFRONT OF RESPONSE, TREATMENT, AND PREVENTION. WE HAVE RELIED ON THE COLLECTIVE STABILITY, RESOURCES, AND STRENGTH THAT A MULTI-HOSPITAL SYSTEM SUCH AS ARH CAN OFFER TO PROVIDE THE 23 COUNTIES WE SERVE IN KENTUCKY AND WEST VIRGINIA COVID-19 EDUCATION, TESTING, TREATMENT, AND NOW VACCINATIONS.ARH HAS PUT CDC-RECOMMENDED MEASURES IN PLACE TO PROVIDE THE SAFEST POSSIBLE CARE DURING THE COVID-19 PANDEMIC. DURING THIS TIME, ARH HAS EMBRACED TECHNOLOGY TO PROVIDE OUR COMMUNITIES WITH ROBUST VIRTUAL CARE OPTIONS DESIGNED TO ENSURE OUR PATIENTS RECEIVE THE SAFEST MANNER OF CARE FOR THEIR HEALTH CONDITIONS AND COMFORT LEVELS. SOME OPTIONS INCLUDE VIRTUAL OFFICE AND SPECIALIST VISITS IN ADDITION TO A CURBSIDE CARE OPTION WHERE STAFF BRINGS THE ELECTRONIC DEVICE OUT TO THE PATIENT'S VEHICLE FOR THE VISIT. THIS OPTION HAS PROVED HELPFUL FOR PATIENTS WITHOUT ACCESS TO SMARTPHONES AND OTHER DEVICES OR LIMITED INTERNET ACCESS.ARH ALSO LOOKED TO TECHNOLOGY AS IT PREPARED FOR THE ROLLOUT OF THE COVID-19 VACCINE. TO STREAMLINE THE VACCINATION PROCESS THROUGHOUT THE COMMUNITIES WE SERVE, ARH LAUNCHED A CENTRALIZED ONLINE VACCINE SCHEDULING SYSTEM TO ALLOW OUR COMMUNITY MEMBERS TO GET ON THE LIST FOR THE VACCINE. JOINING IN EFFORTS TO BOOST VACCINATION NUMBERS IN THE STATES WE SERVE, ARH HAS WORKED TO MAKE GETTING A COVID-19 VACCINE AS EASY AS POSSIBLE FOR OUR COMMUNITIES WITH SOME LOCATIONS OFFERING A DRIVE-THRU OPTION THAT ALLOWS THE PATIENT TO REMAIN IN THE SAFETY OF THEIR VEHICLE WHEN GETTING THE VACCINE. OTHER LOCATIONS HAVE OFFERED A TRADITIONAL VACCINATION SYSTEM OR A HYBRID VACCINATION MODEL THAT ALLOWS A PATIENT WHO NEEDS TO RECEIVE THE VACCINE FROM THEIR VEHICLES, TO RECEIVE THE VACCINATION THERE, WHILE OTHERS GO INSIDE TO A DESIGNATED AREA INSIDE THE BUILDING FOR THEIR VACCINATIONS. OUTREACH EFFORTS HAVE ALSO INCLUDED PROVIDING VACCINATIONS FOR LOCAL SCHOOL SYSTEMS AND STUDENTS. VACCINATION IS ALSO A SIMPLE PROCESS FOR ARH EMPLOYEES WHO ARE REQUIRED TO BE VACCINATED. 591361158 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 1 0 0 1 304 0 1 6091 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X DANNY HARRIS 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 JOSEPH L GROSSMAN PRESIDENT/CEO (TERM ENDED 5/21) 35.00 5.00 X 934080 0 63601 TODD JAROSZ ORTHOPEDIC SURGEON 40.00 X 902291 0 49180 DONNIE R STACY ONCOLOGIST 40.00 X 775984 0 34445 ADNAN M BHOPALWALA CARDIOLOGIST 40.00 X 771783 0 29680 CHAD E BRASHEAR GENERAL SURGEON 40.00 X 766708 0 28775 JAMEEL BUTT GENERAL SURGEON 40.00 X 717721 0 28775 MARIA BRAMAN CMO/VP MEDICAL AFFAIRS 40.00 X 349042 0 49180 DANNY M HARRIS TREASURER 35.00 5.00 X 331680 0 18186 HOLLIE P HARRIS PRESIDENT/CEO 40.00 X 272466 0 51999 BESSIE ELLEN WRIGHT VP AND CHIEF NURSING OFFIC 40.00 X 189386 0 36245 PAUL V MILES COO/VP OPERATIONS 40.00 X 335573 0 71483 JEFFREY B HOLLON TRUSTEE 3.00 X 0 0 0 RANDALL EVANS DVM TRUSTEE 5.00 X 0 0 0 TAD MYRE TRUSTEE 3.00 X 0 0 0 JIM HART TRUSTEE 3.00 X 0 0 0 BART FRANCIS TRUSTEE 3.00 X 0 0 0 BROCK LITTERAL TRUSTEE 3.00 X 0 0 0 ONZIE SIZEMORE TRUSTEE 3.00 X 0 0 0 JOANN ANDERSON TRUSTEE 3.00 X 0 0 0 KEN ALLMAN TRUSTEE 5.00 X 0 0 0 BONITA COMPTON TRUSTEE 3.00 X 0 0 0 ANDREA MASSEY TRUSTEE 3.00 X 0 0 0 MIKE RUST TRUSTEE 3.00 X 0 0 0 JOANNA SANTIESTEBAN MD TRUSTEE 3.00 X 0 0 0 GREG WILSON TRUSTEE 4.00 X 0 0 0 CRYSTAL SHEAVES TRUSTEE 3.00 X 0 0 0 GREG PAULEY TRUSTEE 3.00 X 0 0 0 GREG COUCH SEC'Y/TREAS 3.00 X 0 0 0 JULIE ROSE AKEMON VICE CHAIR 3.00 X 0 0 0 DUANNE THOMPSON CHAIR 3.00 X 0 0 0 6346714 0 461549 273 0 1 0 LABORATORY CORP OF AMERICA 1477 YORK COURT BURLINGTON NC 27215 LABORATORY SERVICES 16488087 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA ST OMAHA NE 68154 CONTRACT NURSES 15235339 CONEXUS MEDSTAFF LLC 12141 WICKCHESTER LANE HOUSTON TX 77079 CONTRACT NURSES 14351204 TRIANGLE ANESTHESIA GROUP PSC 3320 TATES CREEK ROAD STE 100 LEXINGTON KY 40502 ANESTHESIA MEDICAL GROUP 11578000 MEDICAL SOLUTIONS PO BOX 850737 MINNEAPOLIS MN 554850737 CONTRACT EMPLOYEE 5700582 139 1988683 1370675 3359358 PATIENT REVENUES 621110 675980677 675980677 PHARMACY/LAB/LAUNDRY 812300 54828271 46640662 8187609 HOSPITAL RATE IMPROVEM 900099 50623674 50623674 RECORD TRANSCRIPT FEES 900099 78280 78280 781510902 10530471 10530471 1101350 0 1101350 1101350 1101350 13437557 0 404693 13437557 -404693 13032864 13032864 DME SALES 900099 3971823 5131344 -1159521 MISC. INCOME 900099 1505996 1462472 43524 CAFETERIA INCOME 900099 906511 906511 1368204 1363368 4836 7752534 817287479 774686661 14781425 24460035 X 875347 875347 2705921 2705921 299101842 266161654 32794457 145731 12063384 10372248 1683313 7823 53849391 46106973 7709072 33346 16308509 13871639 2427095 9775 1563990 16271 1547719 215156 2239 212917 77231982 59637307 17594675 1788765 1657569 118651 12545 24495321 4525452 19963693 6176 7780327 7437363 342689 275 11238857 10380908 855364 2585 315065 169806 145232 27 316694 274691 42003 4511187 1193673 3317514 24388987 21014281 3374706 8473178 7734449 738729 MEDICAL SUPPLIES 121689375 121689375 TAXES & LICENSES 15452116 4881891 10570225 EQUIPMENT RENTAL AND MA 10626113 3427580 7198282 251 MISCELLANEOUS 6597609 6548046 49563 4143933 3382396 761537 705733049 591361158 114103794 268097 0 0 159489153 308896158 73285380 118875442 2565568 0 18803813 19325995 45139090 48856053 688167322 445114409 241638108 243052913 418655666 516884480 666536 621536 900000 900000 52029024 9789210 1013172338 1267201787 119158853 138004705 2597343 2620661 11472557 70075000 188031913 194803743 444208519 376725195 765469185 782229304 X 247704617 484973947 -1464 -1464 247703153 484972483 1013172338 1267201787 X 111554430 72034973 53679927 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 100345 1 18938 119283 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 291881250 211490097 80391153 232852977 190585821 42267156 158684958 43038491 115646467 243052913 MEDICARE & MEDICAID ESTIMATED SETTLEMENTS 196898354 ACCRUED PENSION COST 114390765 RESERVE FOR SELF-INSURANCE 41234605 PHYSICIAN COMMITMENTS 513213 DUE TO PATIENTS 9653134 BOND INTEREST PAYABLE 1394933 SERP PAYABLE 328938 ACCRUED PHYSICIAN SETTLEMENTS 2674664 OPERATING LEASE LIABILITY 9636589 376725195 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 1 X 1 1 0 1 1 20756445 18953123 1803322 0.00260 219363833 203510901 15852932 0.02250 240120278 222464024 17656254 0.02510 5671 46043 266362 266362 0.00040 1105 869 3145519 3145519 0.00450 3 225 1916 1916 0.00000 6779 47137 3413797 3413797 0.00490 6779 47137 243534075 222464024 21070051 0.03000 62 5915 29637 29637 0.00000 13 190 827 827 0.00000 17 236 2890 2890 0.00000 2756 5246 27344 27344 0.00000 1 15 53 53 0.00000 2849 11602 60751 60751 0.00000 1 4161827 13316276 129893962 131207269 -1313307 X 1 1 1 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCI CONDO OWNER 0.68710 0.31290 2 WHITESBURG PHYSICIAN OFFICE BUILDING LLC CONDO OWNER 0.75000 0.25000 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 18 1 0 0 1 X HTTPS://WWW.ARH.ORG/CHNA/ X 1 18 1 HTTPS://WWW.ARH.ORG/CHNA/ 0 1 X 100.000000000000 200.000000000000 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 X 0 X 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 2018-2019. 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. 83 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 WOMEN'S AND FAMILY HEALTH CARE HARLA 37 BALL PARK ROAD SUITE 201 HARLAN KY 408311701 CLINIC 13 - ARH COMMUNITY PHARMACY 210 BLACK GOLD BLVD SUITE 104 HAZARD KY 41701 PHARMACY 14 - ARH HAZARD HOMECARE STORE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 HOME HEALTH CARE 15 - ARH WILLIAMSON HOMECARE STORE 140 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 HOME HEALTH CARE 16 - ARH MAN HOMECARE STORE ROUTE 99 BUFFALO CREEK ROAD KISTLER WV 25628 HOME HEALTH CARE 17 - ARH HARLAN HOMECARE STORE 106 RAILROAD STREET SUITE 5 HARLAN KY 40831 HOME HEALTH CARE 18 - ARH PRESCRIPTION DIVISION 306 HOSPITAL DRIVE SUITE 105 SOUTH WILLIAMSON KY 41503 PHARMACY 19 - WHITESBURG ARH HOME HEALTH AGENCY 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH 20 - ARH MORGAN COUNTY CLINIC 476 LIBERTY ROAD WEST LIBERTY KY 414720579 RURAL HEALTH CLINIC 21 - BECKLEY ARH HOME HEALTH AGENCY 306 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH 22 - MORGAN COUNTY ARH HOME HEALTH AGENCY 518 MAIN STREET WEST LIBERTY KY 41472 HOME HEALTH 23 - ARH WOMEN'S AND FAMILY HEALTH CARE - TUG 26901 US HIGHWAY 119N BELFRY KY 415147520 RURAL HEALTH CLINIC 24 - ARH TRI-CITY MEDICAL CENTER 18880 NORTH US 119 CUMBERLAND KY 408238106 RURAL HEALTH CLINIC 25 - BECKLEY ARH PHARMACY 250 STANAFORD ROAD BECKLEY WV 25801 PHARMACY 26 - MCDOWELL ARH HOME HEALTH AGENCY 8535 KY RT 122 MINNE KY 41651 HOME HEALTH 27 - HARLAN ARH HOME HEALTH AGENCY 81 BALL PARK ROAD HARLAN KY 40831 HOME HEALTH 28 - ARH SUMMERS COUNTY RURAL HEALTH CLINIC 115 SUMMERS HOSPITAL RD HINTON WV 259510940 RURAL HEALTH CLINIC 29 - ARH BECKLEY HOMECARE STORE 260 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH CARE 30 - WILLIAMSON ARH HOME HEALTH AGENCY 160 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 HOME HEALTH 31 - PIKEVILLE BRANCH-ARH PIKE CO HOME HEALT 247 SOUTH MAYO TRAIL PIKEVILLE KY 41502 HOME HEALTH 32 - ARH MCDOWELL PROFESSIONAL CLINIC 9879 KY RT 122 MCDOWELL KY 416476042 RURAL HEALTH CLINIC 33 - ARH WEST LIBERTY HOMECARE STORE 522 PRESTONSBURG STREET WEST LIBERTY KY 41472 HOME HEALTH CARE 34 - WHITESBURG ARH PHARMACY 240 HOSPITAL ROAD WHITESBURG KY 41858 PHARMACY 35 - ARH MAYKING HOMECARE STORE 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH CARE 36 - ARH MCDOWELL HOMECARE STORE 8535 KY RT 122 MINNE KY 41651 HOME HEALTH CARE 37 - MIDDLESBORO ARH PHARMACY 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 PHARMACY 38 - MIDDLESBORO ARH HOME HEALTH AGENCY 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH 39 - ARH MIDDLESBORO HOMECARE STORE 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH CARE 40 - ARH SPECIALTY PHARMACY 200 MEDICAL CENTER DR HAZARD KY 41701 PHARMACY 41 - ARH HINTON HOMECARE STORE 1500 TERRACE STREET HINTON WV 25951 HOME HEALTH CARE 42 - ARH FAMILY CARE WAYLAND 2662 KING COLEMAN HWY WAYLAND KY 416669998 PRIMARY CARE CLINIC 43 - ARH FAMILY CARE - WHEELWRIGHT 30 KY RT 306 BYPRO KY 416129706 PRIMARY CARE CLINIC 44 - JENKINS ARH FAMILY CARE 9480 HIGHWAY 805 JENKINS KY 415378182 PRIMARY CARE CLINIC 45 - ARH BARIATRIC CENTER 210 BLACK GOLD BOULEVARD SUITE 102 HAZARD KY 417012620 CLINIC 46 - ARH SYSTEM CENTER-HAZARD 100 AIRPORT GARDENS ROAD HAZARD KY 41701 SUPPORT 47 - ARH SYSTEM CENTER-LEXINGTON 2260 EXECUTIVE DR SUITE 400 LEXINGTON KY 40505 SUPPORT 48 - ARH SYSTEM CENTER-LEXINGTON JORDAN BUIL 1218 SOUTH BROADWAY LEXINGTON KY 40504 SUPPORT 49 - ARH SYSTEM CENTER-SOUTH WILLIAMSON 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 SUPPORT 50 - ARH REGIONAL DISTRIBUTION CENTER 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 51 - DME WAREHOUSE 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 52 - ARH SOUTHERN WEST VIRGINIA CLINIC 250 STANAFORD ROAD BECKLEY WV 258013140 CLINIC 53 - MIDDLESBORO ARH PHYSICIAN CLINIC 3602 WEST CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 54 - ARH WOMEN'S AND FAMILY HEALTH CARE - MID 2004 CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 55 - ARH CARDIOLOGY & ASSOC - HAZARD 200 MEDICAL CENTER DR STE 1J HAZARD KY 417019477 CLINIC 56 - ARH DERMATOLOGY 210 BLACK GOLD BLVD SUITE 211 HAZARD KY 41701 CLINIC 57 - ARH CARDIOLOGY ASSOCIATES - BECKLEY 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 58 - BECKLEY ARH PRIMARY CARE 250 STANAFORD ROAD STE 104 BECKLEY WV 258013140 CLINIC 59 - BECKLEY ARH UROLOGY CLINIC 407 CARRIAGE DR BECKLEY WV 258013120 CLINIC 60 - ARH SPECIALTY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 100 SOUTH WILLIAMSON KY 415034095 CLINIC 61 - ARH SPECIALTY ASSOCIATES - WHITESBURG 214 HOSPITAL DR STE B WHITESBURG KY 418587627 CLINIC 62 - ARH CARDIOLOGY ASSOCIATES - WHITESBURG 226 MEDICAL PLAZA LN STE C WHITESBURG KY 418587425 CLINIC 63 - ARH CARDIOLOGY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 202 SOUTH WILLIAMSON KY 415034095 CLINIC 64 - ARH DERMATOLOGY MIDDLESBORO 2145 US HIGHWAY 25E MIDDLESBORO KY 409651874 CLINIC 65 - ARH OAK HILL PRIMARY CARE CENTER 223 MAPLE AVE OAK HILL WV 259013475 CLINIC 66 - ARH SPECIALTY ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE MULTIPLE SUIT HAZARD KY 417019422 CLINIC 67 - ARH PENNINGTON GAP CLINIC 121 STACY DR PENNINGTON GAP VA 242779998 CLINIC 68 - BECKLEY ARH MEDICAL MALL 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 69 - SUMMERS CO ARH FAMILY CARE CLINIC 197 PLEASANT ST HINTON WV 259512540 CLINIC 70 - MIDDLESBORO ARH HEMATOLOYONCOLOGY CLINI 3602 W CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 71 - MORGAN COUNTY ARH FAMILY HEALTH 1084 HWY 7 WEST LIBERTY KY 414727146 CLINIC 72 - ARH PRIMARY CARE - BECKLEY 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 73 - HAZARD MEDICAL MALL 210 BLACK GOLD BLVD STE 102 HAZARD KY 41701 MEDSPA 74 - ARH BECKLEY REJUVENATION CENTER 1256 N EISENHOWER DRIVE BECKLEY WV 25801 MEDSPA 75 - ARH MIDDLESBORO REJUVENATION CENTER 2145 US HIGHWAY 25E MIDDLESBORO KY 40965 MEDSPA 76 - ARH BECKLEY GASTROENTEROLOGY 429 CARRIAGE DRIVE BECKLEY WV 25801 CLINIC 77 - ARH BECKLEY ONCOLOGY 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 78 - ARH HAZARD FAMILY CLINIC 181 ROY CAMPBELL DRIVE HAZARD KY 41701 CLINIC 79 - ARH FAMILY HEALTH LACKEY 77 MILLARD ALLEN DR LACKEY KY 41643 CLINIC 80 - ARH FAMILY HEALTH PHARMACY 1084 HWY 7 SUITE 3 WEST LIBERTY KY 41472 PHARMACY 81 - ARH HAZARD PHARMACY 181 ROY CAMPBELL DRIVE HAZARD KY 41701 PHARMACY 82 - ARH PAIN AND HEADACHE MEDICINE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 CLINIC 83 - ARH RETAIL PHARMACY 4845 KY RTE 321 PRESTONSBURG KY 41653 PHARMACY 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 7: THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART II, COMMUNITY BUILDING ACTIVITIES: 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 AND HOME DURABLE MEDICAL EQUIPMENT STORES. IN FISCAL YEAR 2021, 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 THAT ARE MAILED DIRECTLY TO RESIDENTS' HOMES. PART III, LINE 2: COSTING METHODOLOGY: TO DETERMINE THE BAD DEBT EXPENSE ON LINE 2, THE BADDEBT EXPENSE PER THE FINANCIAL STATEMENTS, WHICH CONSISTS OF GROSS CHARGESLESS DISCOUNTS, WAS CONVERTED TO COST USING THE GLOBAL COST-TO-CHARGERATIO DEVELOPED IN WORKSHEET 2. PATIENT DISCOUNTS ARE NOT REFLECTED INBAD DEBT. ANY PAYMENTS ON AN ACCOUNT AFTER IT IS WRITTEN OFF TO BAD DEBTRESULT IN A REVERSAL OF THE ENTIRE ACCOUNT OUT OF BAD DEBT, REINSTATEMENTOF THE PATIENT ACCOUNT RECEIVABLE, AND ANY NEGOTIATED DIFFERENCE IN THEFULL AMOUNT OF THE ACCOUNT AND THE PAYMENT MADE IS WRITTEN OFF TOCONTRACTUAL ALLOWANCE. PATIENTS WHO MAY QUALIFY FOR CHARITY CARE BUT DONOT APPLY CANNOT BE ESTIMATES. ALL PATIENTS ARE EDUCATED ABOUT AND GIVENEVERY OPPORTUNITY TO APPLY FOR CHARITY CARE AND, THEREFORE, ARH HAS NOINFORMATION FOR THOSE WHO CHOOSE NOT TO APPLY. PART III, LINE 3: EXPLANATION: MANAGEMENT CONTINUALLY MONITORS AND ADJUSTS THEALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ASSOCIATED WITH CREDIT RISK.THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICALTO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTSRECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE CORPORATIONESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYINGVALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THEPRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENTRECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROMINDIVIDUAL PATIENTS.THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OFTHE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OFANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NOSINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCEFOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THECORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASHCOLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION ANDAGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE AREWRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITHTHE 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 $1 MILLION. MEDICARE RECIPIENTS RELY HEAVILY ON ARH FOR CARE, AND 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 $1,313,307 (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 ALSO 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 ALSO 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 2021, ARH PROVIDED CLOSE TO $6 MILLION IN UNCOMPENSATED CARE AND DURING THAT SAME FISCAL YEAR, 80 PERCENT OF THE CHARGES THAT OCCURRED WERE FOR MEDICARE AND MEDICAID PATIENTS. 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 AND HOME DURABLE MEDICAL EQUIPMENT STORES. IN FISCAL YEAR 2020, 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 THAT ARE MAILED DIRECTLY TO RESIDENTS' HOMES. PART VI, LINE 6: DURING FISCAL YEAR 2021, 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 COMPLIMENTARY 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. 0 PERRY CO ECONOMIC DEVELOPMENT PO BOX 1059 HAZARD KY 41702 473338245 GOVT 20000 SUPPORT ONGOING OPERATIONS ONE HARLAN COUNTY 81 BALL PARK RD HARLAN KY 40831 811027395 GOVT 40000 SUPPORT ONGOING OPERATIONS UNIVERSITY OF KENTUCKY STURGILL PHILANTHROPY BUILDING LEXINGTON KY 40506 616001218 501(C)(3) 98477 SUPPORT ONGOING OPERATIONS LEXINGTON CANCER FOUNDATION 15014 COLLEGE WAY LEXINGTON KY 40502 562472701 501(C)(3) 15000 SUPPORT ONGOING OPERATIONS WV CHAMBER OF COMMERCE PO BOX 2789 CHARLESTON WV 25330 550306990 GOVT 5000 SUPPORT ONGOING OPERATIONS COWAN COMMUNITY ACTION 81 STURGILL BR PO BOX 268 WHITESBURG KY 41858 611396831 501(C)(3) 10000 SUPPORT ONGOING OPERATIONS FLOYD COUNTY BOARD OF EDUCATION 442 KY ROUTE 550 EASTERN KY 41622 616001347 501(C)(3) 20000 SUPPORT ONGOING OPERATIONS 6 X X X X 0 1 0 0 0 1 0 0 0 JOSEPH L GROSSMAN PRESIDENT/CEO (TERM ENDED 5/21) 744684 0 186900 0 2496 0 42500 0 21101 0 997681 0 0 0 TODD JAROSZ ORTHOPEDIC SURGEON 902291 0 0 0 0 0 19500 0 29680 0 951471 0 0 0 DONNIE R STACY ONCOLOGIST 775984 0 0 0 0 0 4765 0 29680 0 810429 0 0 0 ADNAN M BHOPALWALA CARDIOLOGIST 771783 0 0 0 0 0 0 0 29680 0 801463 0 0 0 CHAD E BRASHEAR GENERAL SURGEON 766708 0 0 0 0 0 19500 0 9275 0 795483 0 0 0 JAMEEL BUTT GENERAL SURGEON 717721 0 0 0 0 0 19500 0 9275 0 746496 0 0 0 MARIA BRAMAN CMO/VP MEDICAL AFFAIRS 281760 0 66195 0 1087 0 19500 0 29680 0 398222 0 0 0 DANNY M HARRIS TREASURER 267822 0 61404 0 2454 0 18186 0 0 0 349866 0 0 0 HOLLIE P HARRIS PRESIDENT/CEO 220137 0 51752 0 577 0 32521 0 19478 0 324465 0 0 0 BESSIE ELLEN WRIGHT VP AND CHIEF NURSING OFFIC 151548 0 36106 0 1732 0 16767 0 19478 0 225631 0 0 0 PAUL V MILES COO/VP OPERATIONS 268439 0 63463 0 3671 0 41803 0 29680 0 407056 0 0 0 PART I, LINE 4B ARH PROVIDES SENIOR EXECUTIVES A CONTRIBUTION OF SEVEN (7) PERCENT OF PAY (SUBJECT TO DOLLAR CAP) INTO THE TOP HAT 457(B) RETIREMENT PLAN, IF THE EXECUTIVE SIGNS A NON-COMPETE AGREEMENT. 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 $19,500 IN 2020. 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 7% OF PAY EXCEEDS THE REGULAR DOLLAR CAP, ARH MAY USE THE BALANCE OF THE 7% 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. TO RECEIVE THE ARH CREDIT TO THE 457(B) PLAN, THE EXECUTIVE MUST SIGN A NON-COMPETE, CONFIDENTIALITY, ETC. AGREEMENT RESTRICTING WORK FOR A COMPETING ORGANIZATION FOR TWO (2) YEARS POST TERMINATION. IF THE FUNDING OF THE 457(B), INCLUDING ANY CATCH UP PROVISIONS, IS LESS THAN 7% 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: JOE GROSSMAN $22,500 AND MARIA BRAMAN $112. PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE RELATED ORGANIZATION (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 HEALTHCARE REVENUE BOND 0 0 0 A 70075000 873823 58638837 10562340 0 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 289757 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 PROFESSIONAL FEES - PHYSICIANS: PROGRAM SERVICE EXPENSES 28,772,140. MANAGEMENT AND GENERAL EXPENSES 1,053,405. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,825,545. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 28,495,729. MANAGEMENT AND GENERAL EXPENSES 16,536,161. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,031,890. SECURITY SERVICES: PROGRAM SERVICE EXPENSES 2,369,438. MANAGEMENT AND GENERAL EXPENSES 5,109. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,374,547. FORM 990, PART XI, LINE 9: NET PERIODIC PENSION GAIN 737,984. HIGHLANDS ACQUISITION -590,331. CHANGE IN PENSION PLAN ASSET AND OBLIGATION 53,532,274. 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 DEEM NECESSARY BY MANAGEMENT THROUGH A FORMAL "REQUEST FOR PROPOSAL" (RFP) PROCESS. HAZARD ARH IMAGING CENTER LLC 210 BLACK GOLD BLVD HAZARD KY 41701 270755457 MEDICAL IMAGING SERVICES KY 896 8093943 APPALACHIAN REGIONAL HEALTHCARE INC CUMBERLAND VALLEY ARH CANCER CENTER LLC 2260 EXECUTIVE DRIVE LEXINGTON KY 40606 HEALTH CARE KY APPALACHIAN REGIONAL HEALTHCARE INC THE ARH FOUNDATION FOR HEALTHIER COMMUNITIES INC 100 AIRPORT GARDENS RD HAZARD KY 41701 204840007 CARRYING OUT FUNDRAISING AND CHARITABLE ACTIVITIES FOR ARH KY 501(C)(3) LINE 7 APPALACHIAN REGIONAL HEALTHCARE INC 1 ARH MARY BRECKINRIDGE 2260 EXECUTIVE DR LEXINGTON KY 40505 452696517 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 ARH TUG VALLEY HEALTH SERVICES INC 2260 EXECUTIVE DR LEXINGTON KY 40505 822577178 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 WHITESBURG PHYSICIAN OFFICE BLDG LLC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 753022080 PHYSICIAN OFFICE BUILDING KY EXCLUDED 69420 456610 0 1 0.28130 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCIL 2260 EXECUTIVE DRIVE LEXINGTON KY 40504 201796044 OFFICE BUILDING MANAGEMENT KY N/A C 0.39600 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 ARH FOUNDATION FOR HEALTHIER COMMUNITIES Q 525240 ALLOCATED COSTS