2021-05-17T09:26:14-05:00 2020-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2019-07-01 250965237 ARMSTRONG COUNTY MEMORIAL HOSPITAL % MATTHEW KOCIOLA ARMS 7245483877 ONE NOLTE DRIVE KITTANNING PA 16201 JOHN I LEWIS PRESIDENT AND CEO 7245438181 2021-05-15 true Brian D Todd P00422601 4178658701 2019 2022-09-23 18:48:47Z JOHN I LEWIS ONE NOLTE DRIVE KITTANNING PA 16201 112466052 false X WWW.ACMH.ORG X 1874 PA THE MISSION OF ARMSTRONG MEMORIAL HOSPITAL IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF ARMSTRONG AND NEIGHBORING COUNTIES. 11 8 1105 56 625113 326 448974 2484831 102105402 103717732 243280 550598 1535539 1543616 104333195 108296777 18250 10410 0 0 58224638 57690160 0 0 0 43571049 44438467 101813937 102139037 2519258 6157740 69937618 89833217 31822404 54953341 38115214 34879876 X ACMH IS COMMITTED TO IMPROVING THE EMOTIONAL AND PHYSICAL HEALTH OF ITS PATIENTS THROUGH SUPERIOR CLINICAL CARE AND THE COMPASSIONATE MANAGEMENT OF ILLNESS AND DISABILITY. true false 44961449 64527570 ACMH HOSPITAL PROVIDES OUTPATIENT SERVICES SUCH AS RADIOLOGY, LABORATORY, EMERGENCY VISITS, AMBULATORY SURGERY, AND OTHER VARIOUS SERVICES. DURING THE FISCAL YEAR, TOTAL OUTPATIENT REGISTRATIONS WERE 168,690. 18294325 28543331 ACMH HOSPITAL PROVIDES INPATIENT SERVICES SUCH AS MEDICAL AND SURGICAL, ACUTE REHAB, SKILLED NURSING, OB/GYN, HOSPITALIST, ICU/CCU, PSYCHIATRIC, MEDICAL WITHDRAW AND NURSERY. ACMH HOSPITAL IS A CERTIFIED PRIMARY STROKE CENTER AND ALSO PERFORMS PERCUTANEOUS CORONARY INTERVENTION TO TREAT NARROWED CORONARY ARTERIES. DURING THE FISCAL YEAR, TOTAL ADMISSIONS WERE 4,092 AND PATIENT DAYS WERE 19,645. 4915510 5391945 ACMH HOSPITAL PROVIDES RURAL HEALTH CLINICS AT SEVERAL SURROUNDING COMMUNITY LOCATIONS INCLUDING LEECHBURG, ELDERTON, RURAL VALLEY, KITTANNING, WEST HILLS AND NEW BETHLEHEM. TOTAL VISITS FOR ALL PHYSICIAN CLINICS TOTALED 60,426. THE PHYSICIAN CLINICS ALSO OFFER CHARITY CARE UNDER THE SAME POLICY AS ACMH HOSPITAL. TOTAL CHARITY CARE RELATING TO THE PHYSICIAN CLINICS FOR THE CURRENT FISCAL YEAR WAS 3,286.93. SEE SCHEDULE O FOR MORE INFORMATION. 577486 10410 5254886 68748770 true true false false false false false false false false true true false true true false true true false false false false false false false false true true false false true false false false false false false false false true false false false true true false false false true 71 0 true 1105 true true true false false false false false false false false false true false X 11 8 true false false false true true true true true false false true true true true true true true true false PA X MATTHEW KOCIOLA 7245438618 ONE NOLTE DRIVE KITTANNING PA 16201 X JOHN I LEWIS PRESIDENT & CEO 39.0 1.0 X X 1007210 0 66295 JEFFREY DAVID PHYSICIAN 40.0 0.0 X 252982 0 29493 CHAD SHAFFER MD DIRECTOR 39.0 1.0 X 248651 0 25450 JOSEPH CIPPEL PHYSICIAN 40.0 0.0 X 238250 0 32460 MATTHEW KOCIOLA CFO, VP OF FINANCE 39.0 1.0 X 214568 0 40703 JAMES BACKSTROM MD CHIEF MEDICAL OFFICER 39.0 1.0 X X 229248 0 15167 VICKY M LEO PHYSICIAN 40.0 0.0 X 231367 0 11337 EDWARD BALESTRINO PHYSICIAN 40.0 0.0 X 216273 0 2879 KARLA MCCANN PHYSICIAN 40.0 0.0 X 185176 0 22223 NICHOLE D GERACI CHIEF OPERATING OFFICER 40.0 0.0 X 167661 0 32137 ANNE REMALEY VP OF HUMAN RESOURCES 40.0 0.0 X 160945 0 36040 MONA RUPERT VP OF CLINICAL SERVICES 40.0 0.0 X 146829 0 25237 MEREDITH CHRISTY DIRECTOR 1.0 1.0 X 0 0 0 ELIZABETH WHITE CHAIRMAN 1.0 2.0 X X 0 0 0 VOLKER ZAUN SECRETARY / TREASURER 1.0 1.0 X X 0 0 0 SAMUEL FRIEDE DIRECTOR 1.0 1.0 X 0 0 0 DONALD TYLINSKI EDD DIRECTOR 1.0 1.0 X 0 0 0 SANDY BRADIGAN DIRECTOR 1.0 1.0 X 0 0 0 W STEVEN DAVIS VICE CHAIRMAN 1.0 1.0 X X 0 0 0 MARY A KRAULAND DIRECTOR 1.0 1.0 X 0 0 0 3299160 0 339421 44 false true false CHILDREN'S COMMUNITY PED 11279 PERRY HWY SUITE 450 WEXFORD PA 15090 PEDIATRIC 515911 SIGNET HEALTH 235 W HICKORY ST STE 201 DENTON TX 76201 PSYCHIATRY 312602 BKD LLP 910 E ST LOUIS SUITE 200 SPRINGFIELD MO 65801 AUDIT/TAX/CONSULTING 263560 ADVANCED LITHO CARE LTD 1305 SOUTH MAIN ST MEADVILLE PA 16335 RADIOLOGY 234060 ITXM CLINICAL SERVICE 29668 NETWORK PLACE CHICAGO IL 606731296 LAB SERVICES 192709 12 31481 2166722 286628 138040 2484831 PATIENT SERVICES 621500 98462846 98462846 OTHER REVENUE 900099 3909330 3593094 316236 CAFETERIA 722210 606466 606466 RENT FROM AFFILIATES 623000 431728 431728 UNRELATED LAB SERVICES 621500 307362 307362 103717732 264183 264183 0 0 486675 486675 0 486675 486675 4432631 23059 4149747 19528 282884 3531 286415 286415 0 0 0 0 0 0 0 0 0 GAIN ON EQUITY INVESTEES 800099 1056941 1515 1055426 1056941 108296777 103094134 625113 2092699 X 10410 10410 0 0 0 2189573 890380 1299193 0 41160109 30435655 10724454 1993349 80194 1913155 8245013 837631 7407382 4102116 2603892 1498224 0 396639 396639 159416 159416 0 0 17740 17740 12165473 9102886 3062587 324997 7463 317534 5424029 4353501 1070528 1057983 39444 1018539 0 2191068 864291 1326777 85714 39688 46026 0 88073 27309 60764 117731 75041 42690 0 4232603 2697820 1534783 835882 835882 MEDICAL SUPPLIES & DRUGS 11265165 11265165 BAD DEBT 2199785 2199785 PROVIDER TAX 2175698 2175698 FOOD EXPENSES 671070 80333 590737 1029401 126302 903099 102139037 68748770 33390267 0 964 80019 9860650 33391286 0 0 8173602 10462403 0 0 0 0 0 0 1105832 1158508 1409381 1499725 140476972 117722570 24697409 22754402 7176331 5219615 5707075 6155455 0 0 161083 75916 11645291 9035888 69937618 89833217 11956633 12044202 0 0 139107 17358289 0 0 0 0 0 0 5639793 5091597 0 0 14086871 20459253 31822404 54953341 X 38115214 34879876 0 0 38115214 34879876 69937618 89833217 X 6157740 -332384 -9060694 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 297281 297281 48694377 36879156 11815221 87593566 77818241 9775325 3891748 3025173 866575 22754402 891851 C CHART 4220886 C VANTAGE 1042718 C 6155455 OTHER RECEIVABLES 8258113 DUE FROM 3RD PARTY 206736 DUE FROM AFFILIATES 563830 ACCRUED INTEREST 7209 9035888 0 ACCRUED PENSION LIABILITY 10904396 ESTIMATED INSURANCE LIABILITY 4390029 DUE TO 3RD PARTY 1119864 MEDICARE CONTRACT LIABILITY 4044964 20459253 105620087 -332384 -2199785 -2532169 108152256 144521 144521 108296777 99939252 99939252 2199785 2199785 102139037 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (2,199,785) BAD DEBT EXPENSE SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 144,521 GRANTS FOR PROPERTY AND EQUIPMENT ACQUISITION SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 2,199,785 BAD DEBT EXPENSE true true X true X true X true true false false 480973 480973 0.00480 15702460 12139883 3562577 0.03560 203487 124518 78968 0.00080 16386920 12264401 4122518 0.04120 56211 56211 0.00060 275790 12500 263290 0.00260 6192643 3517029 2675614 0.02670 54749 54749 0.00050 13197 13197 0.00010 6592590 3529529 3063061 0.03050 22979510 15793930 7185579 0.07170 119 119 1553 1553 1672 1672 false 2199785 283772 6904477 8229507 -1325030 X true false 1 1 ARMSTRONG COUNTY MEMORIAL HOSPITAL ONE NOLTE DRIVE KITTANNING PA 16201 WWW.ACMH.ORG 270901 X X X SNU, REHAB, OB, PSYCHIATRIC, NEURO, UROLOGY, WITHDRAWAL ARMSTRONG COUNTY MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 17 true false false true X SEE PART V, SECTION C X true 17 true SEE PART V, SECTION C false true X 100 300. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT: THE COMMUNITY STAKEHOLDERS WHO PARTICIPATED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT REPRESENTED A CROSS-SECTION OF THE HEALTH AND HUMAN SERVICES AGENCIES IN ARMSTRONG COUNTY. SOME PARTICIPANTS WERE SPECIFICALLY CHOSEN BECAUSE OF THEIR PUBLIC HEALTH KNOWLEDGE AND EXPERIENCE. OTHERS WERE CHOSEN BECAUSE OF THEIR EXPERTISE IN: - CHRONIC HEALTH CONDITIONS IN ARMSTRONG COUNTY - BARRIERS TO HEALTHCARE - KNOWLEDGE OF UNDERSERVED GROUPS OF POPULATION IN ARMSTRONG COUNTY - FORMING ORGANIZATIONAL COLLABORATIONS WITH ACMH HOSPITAL TO MEET HEALTH NEEDS - AN AWARENESS OF THE HEALTH CONCERNS OF THE PEOPLE UTILIZING HEALTHCARE SERVICES - WHERE RESIDENTS OF THE COUNTY ARE GOING FOR HEALTH AND WELLNESS SERVICES -RELIABLE SOURCES OF HEALTH INFORMATION INTERVIEWS WITH THESE STAKEHOLDERS REVEALED CERTAIN BARRIERS TO HEALTH SERVICES AND UNDERSERVED GROUPS OF THE POPULATION IN ARMSTRONG COUNTY WHERE PRIORITY COMMUNITY NEEDS. SCHEDULE H, PART V, SECTION B, LINE 7A CHNA URL: HTTPS://WWW.ACMH.ORG/CHNA SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY URL: HTTPS://WWW.ACMH.ORG/CHNA SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING IDENTIFIED NEEDS: ACMH IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENT CHNA AS FOLLOWS: 1. ADDRESS SUBSTANCE ABUSE: ACMH WILL PARTICIPATE IN A COUNTY-WIDE PARTNERSHIP TO DEVELOP A VETERANS COURT, OFFERING HIGHLY STRUCTURED SUBSTANCE ABUSE REHABILITATION PROGRAMS TO VETERANS IN LIEU OF TRADITIONAL INCARCERATION. THE PARTNERSHIP CONSISTS OF THE ARMSTRONG COUNTY COURT OF COMMON PLEAS, THE DISTRICT ATTORNEY, PUBLIC DEFENDER AND CHIEF PROBATION OFFICER, THE ARMSTRONG-INDIANA-CLARION DRUG AND ALCOHOL COMMISSION, ACMH FOUNDATION, THE U.S. DEPARTMENT OF VETERANS AFFAIRS, ARC MANOR, ACMH EMERGENCY MEDICINE AND PSYCHIATRIC PHYSICIANS, AND OTHER STAKEHOLDERS. ACMH WILL OPEN A FOUR-BED MEDICAL DETOXIFICATION UNIT. IT WILL BE CLASSIFIED AS A LEVEL 4A, MEANING THE PATIENT MUST HAVE A SUBSTANCE USE DISORDER AND BE IN ACUTE WITHDRAWAL. ADMISSION IS VOLUNTARY FOR THE PATIENT. PATIENTS WILL BE ADMITTED FOR ALCOHOL, OPIOID, AND BENZO-RELATED WITHDRAWAL. THE AMERICAN SOCIETY OF ADDICTION MEDICINE (ASAM) ASSESSMENT TOOL WILL BE USED AS IT HAS BEEN ADOPTED BY THE COMMONWEALTH OF PENNSYLVANIA. STAFFING WILL CONSIST OF ONE RN, A NURSES AIDE, A THERAPIST AND MAY INCLUDE MEMBERS OF A BEHAVIORAL HEALTH ASSESSMENT TEAM. PHYSICIAN AND MID-LEVEL PRACTITIONERS WILL BE ON SITE AND ON CALL. REFERRALS WILL ORIGINATE PRIMARILY FROM THE EMERGENCY DEPARTMENT. A MEDICAL OVERSIGHT COMMITTEE WILL CONSIST OF AN ACMH HOSPITALIST, AN EMERGENCY DEPARTMENT PHYSICIAN AND AN ANESTHESIOLOGIST. THE COMMONWEALTH OF PENNSYLVANIA HAS PROVIDED $250,000 IN FUNDING FROM REINVESTMENT MONIES TO ASSIST IN THE STARTUP OF THIS PROGRAM. ACMH WILL CONTINUE TO PARTNER WITH AND SUPPORT THE ADDICTION RECOVERY MOBILE OUTREACH TEAM (ARMOT), WHICH IS FUNDED BY THE HRSA FEDERAL OFFICE OF RURAL HEALTH POLICY. ARMOT STAFF PERFORM AN ASSESSMENT WHEN REQUESTED BY A HOSPITAL OR EMERGENCY DEPARTMENT PHYSICIAN, TO DETERMINE THE LIKELIHOOD THAT A PATIENT MAY HAVE A SUBSTANCE ABUSE PROBLEM. ARMOT THEN HELPS DEVELOP A PLAN FOR THE PATIENT WHICH INCLUDES INFORMATION ABOUT AVAILABLE HELP. DESCRIBING THEIR SERVICES AS A "TOUR-GUIDE TO THE CONTINUUM OF RECOVERY SERVICES" ARMOT PERSONNEL ATTEMPT TO TRANSFER PATIENTS INTO TREATMENT AS QUICKLY AS POSSIBLE. ARMOT PERSONNEL INCLUDE CERTIFIED RECOVERY SPECIALISTS, EACH OF WHOM HAS EXPERIENCED LONG-TERM RECOVERY THEMSELVES AND ARE WELL SUITED TO HELP RECOVERING ADDICTS IN ALL RECOVERY NEEDS, SUCH AS FINDING EMPLOYMENT AND HOUSING, AND FINDING THE BEST-SUITED 12-STEP OR FAITH-BASED PROGRAMS AND SPONSORS. ADDITIONALLY, INTENT ON ELIMINATING THE STIGMA ASSOCIATED WITH ADDICTION, THEY PROVIDE COUNSELING TO MEDICAL AND LAW ENFORCEMENT PERSONNEL, HELPING THEM BECOME NON-JUDGMENTAL, ESPECIALLY WHEN DEALING WITH REPEAT OFFENDERS. 2. PROVIDE MEDICALLY SUPPORTED WEIGHT LOSS SERVICES: ACMH WILL PARTNER AS APPROPRIATE WITH SERVICE PROVIDERS TO HELP DEVELOP WEIGHT-LOSS SERVICE PROGRAMS. 3. EDUCATE THE COMMUNITY REGARDING THE IMPORTANCE OF NUTRITION IN IMPROVING HEALTH: ACMH WILL WORK WITH OTHER COMMUNITY ORGANIZATIONS TO IMPLEMENT COMMUNITY KITCHENS FOR NUTRITION EDUCATION WHICH WOULD INCLUDE HEALTHY COOKING, HEALTHY FOOD CHOICES, SUPERMARKET FOOD LABEL READING, RESTAURANT CHOICES AND DIETITIAN COUNSELING. ACMH HOSPITAL WILL PROVIDE THE USE OF ITS EDUCATION CENTER FOR SUCH EDUCATIONAL PROGRAMS. ACMH HAS BEGUN PROVIDING ACCESS TO FARMERS MARKETS ON ACMH CAMPUS AND WILL CONTINUE THAT PROGRAM. ACMH WILL USE EMAIL AND SOCIAL NETWORK NOTIFICATIONS OF THE LOCATIONS AND TIMES FOR FARMERS MARKETS WITHIN THE COUNTY AND NUTRITIONAL EDUCATION CLASSES OFFERED TO THE COMMUNITY. 4. INCREASE COMMUNITY KNOWLEDGE ABOUT THE IMPORTANCE OF LEISURE-TIME PHYSICAL ACTIVITY: ACMH WILL ASSIST WITH PROVIDING EXPOSURE TO THE PUBLIC ABOUT, AND IN PROMOTION OF, THE RAILS TO TRAILS PROGRAM FOR BIKE AND PEDESTRIAN USE IN ARMSTRONG COUNTY. ACMH WILL USE EMAIL AND SOCIAL NETWORK NOTIFICATIONS OF THE LOCATIONS AND TIMES FOR PHYSICAL ACTIVITY PROGRAMS WITHIN THE COUNTY AND TO ENCOURAGE LEISURE-TIME ACTIVITY. ACMH WILL CONTINUE TO PROVIDE ASSISTANCE WITH HEALTHY ARMSTRONG TO ENCOURAGE YOUTH PHYSICAL ACTIVITY AND HEALTHY FOOD CONSUMPTION. ACMH WILL COLLABORATE WITH OTHER LOCAL ORGANIZATIONS TO CREATE COMMUNITY-WIDE PHYSICAL ACTIVITY CAMPAIGNS. 5. PROVIDE EDUCATION REGARDING THE IMPORTANCE OF SMOKING CESSATION: ACMH REGULARLY OFFERS SMOKING CESSATION CLASSES WHICH HAVE RECEIVED POOR ATTENDANCE. ACMH WILL USE EMAIL AND SOCIAL NETWORK NOTIFICATIONS OF THE LOCATIONS AND TIMES FOR THESE CLASSES AND TO ENCOURAGE IMPROVED ATTENDANCE AND PARTICIPATION. 6. INCREASE COMMUNITY KNOWLEDGE ABOUT THE IMPORTANCE OF ADEQUATE SLEEP: ACMH WILL USE EMAIL AND SOCIAL NETWORK SERVICES TO EDUCATE COMMUNITY MEMBERS OF THE IMPORTANCE OF ADEQUATE SLEEP AND THE IMPACT ON HEALTH AND WELLNESS. SCHEDULE H, PART V, SECTION B, LINES 16A-C FAP, APPLICATION, AND PLS URL: HTTP://ACMH.ORG/BILLING-AND-INSURANCE#FINANCIALASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16J THE FINANCIAL ASSISTANCE POLICY INDICATES: INDIVIDUAL NOTICES INFORMING PATIENTS ABOUT FINANCIAL ASSISTANCE/DISCOUNT WILL BE OFFERED AT THE TIME OF REGISTRATION. SIGNS WILL BE POSTED IN REGISTRATION AREAS OF THE HOSPITAL AND ITS AFFILIATED CLINICS AND PHYSICIAN OFFICES. 11 ARMSTRONG PRIMARY CARE CENTER 116 MAIN ST LEECHBURG PA 15656 PRIMARY CARE, LAB DRAW, RADIOLOGY, PHYSICAL THERAPY ACMH HEALTH PAVILION 205 5TH AVE FORD CITY PA 16226 OUTPATIENT PHYSICAL THERAPY, LAB DRAW ARMSTRONG PRIMARY CARE CENTER ELDERTON 116 MAIN ST ELDERTON PA 15736 PRIMARY CARE, LAB DRAW, RADIOLOGY ARMSTRONG PRIMARY CARE CENTER SOUTH BETH 102 SOUTH ST NEW BETHLEHEM PA 16242 PRIMARY CARE, LAB DRAW ARMSTRONG PRIMARY CARE CTR RURAL VALLEY 10261 SR 85 KITTANNING PA 16201 PRIMARY CARE, LAB DRAW ARMSTRONG PRIMARY CARE CENTER KITTANNING 260 S JEFFERSON ST KITTANNING PA 16201 PRIMARY CARE, LAB DRAW ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING PA 16201 OUTPATIENT RADIOLOGY CENTER COWANSVILLE HEALTH CENTER 882 EAST BRADY RD COWANSVILLE PA 16218 LAB DRAW ENDOCRINOLOGY ASSOCIATES 600 MEDICAL ARTS BUILDING SUITE 64 KITTANNING PA 16201 ENDOCRINOLOGY CLINIC WEST HILLS PRIMARY CARE CENTER 300 MEDICAL ARTS BUILDING SUITE 300 KITTANNING PA 16201 PRIMARY CARE, LAB DRAW NEUROLOGIC ASSOCIATES 500 MEDICAL ARTS BUILDING SUITE 51 KITTANNING PA 16201 NEUROLOGIC CLINIC SCHEDULE H, PART I, LINE 7: COSTING METHODOLOGY: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION ON IRS WORKSHEETS 1 AND 3. SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES: ARMSTRONG COUNTY MEMORIAL HOSPITAL REPORTS FIVE RHC FACILITIES AS SUBSIDIZED HEALTH SERVICES. WHEN THESE CLINICS WERE ESTABLISHED, THE AREAS IN WHICH THEY ARE LOCATED WERE IN MEDICALLY UNDERSERVED AREAS OR PHYSICIAN SHORTAGE AREAS. ACMH HOSPITAL ALSO REPORTS INPATIENT PSYCH AND SKILLED NURSING UNITS AS SUBSIDIZED HEALTH SERVICES. THE IRS DEFINITION OF A SUBSIDIZED HEALTH SERVICE MEANS CLINICAL SERVICES PROVIDED DESPITE A FINANCIAL LOSS TO THE ORGANIZATION. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER FORM 990, PART IX, LINE 25, WAS REDUCED BY BAD DEBT EXPENSE OF $2,199,785. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: THE PRIMARY COMMUNITY BUILDING ACTIVITIES ARE STAFF INVOLVEMENT WITH HEALTHY ARMSTRONG WHICH IS A COLLABORATIVE EFFORT TO IMPROVE THE HEALTH OF FAMILIES AND HELP CHILDREN MAINTAIN A HEALTHY WEIGHT THROUGH IMPROVED NUTRITION AND INCREASED PHYSICAL ACTIVITY. HOSPITAL REPRESENTATIVES ALSO ATTEND CAREER DAYS AT LOCAL SCHOOLS AND PROVIDE TOURS OF THE FACILITY TO EDUCATE STUDENTS ABOUT CAREERS IN HEALTH CARE. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THIS IS THE AMOUNT REPORTED AS BAD DEBT ON THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: THIS AMOUNT WAS ESTIMATED BY MULTIPLYING THE TOTAL BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS BY THE POVERTY PERCENTAGE FOR ARMSTRONG COUNTY REPORTED ON WWW.CENSUS.GOV. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE AUDIT FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINES 5 AND 6. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: PATIENTS RECEIVE CORRESPONDENCE GIVING THEM THE OPPORTUNITY TO CONTACT THE ORGANIZATION TO QUESTION THEIR STATEMENTS AND/OR ESTABLISH PAYMENT ARRANGEMENTS. IF A PATIENT CONTACTS THE ORGANIZATION, IT IS FIRST DETERMINED WHETHER OR NOT THEY MAY BE ELIGIBLE FOR ASSISTANCE THROUGH MEDICAID OR FINANCIAL ASSISTANCE. IF THE PATIENT IS NOT ELIGIBLE FOR ANY OF THE ASSISTANCE LISTED, THEN THE ORGANIZATION WORKS WITH THE PATIENT TO ESTABLISH A PAYMENT PLAN, USUALLY FOR UP TO 12 MONTHS BUT EXTENSION IS ALLOWED FOR EXTENUATING CIRCUMSTANCES. IF AN ACCOUNT IS DETERMINED TO BE UNCOLLECTIBLE AND NO REQUEST FOR ASSISTANCE OR PAYMENT ARRANGEMENTS IS RECEIVED, THE ACCOUNT IS REFERRED TO AN OUTSIDE COLLECTION AGENCY. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: ACMH REGULARLY USES RELIABLE DATA AVAILABLE ON THE INTERNET TO DETERMINE THE NEEDS OF OUR COMMUNITY. COUNTY HEALTH RANKINGS PULL FROM VARIOUS RELIABLE DATABASES TO PROVIDE INFORMATION ABOUT OUTCOMES, HEALTH FACTORS, ENVIRONMENTAL FACTORS, AND COMMUNITY HEALTH STATUS INDICATORS. WE USE INFORMATION FROM THE DEPARTMENT OF HEALTH REGARDING HEALTH BEHAVIORS. WE ALSO COLLABORATE WITH THE LOCAL SCHOOL DISTRICT AND OTHER COMMUNITY ORGANIZATIONS AND EMPLOYERS TO DETERMINE OUR ROLE IN THE DEVELOPMENT OF HEALTHY FACILITIES, PROGRAMS, AND BEHAVIORS IN ARMSTRONG COUNTY. IN FY2018 ACMH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AND PUBLISHED THE FINDINGS ON OUR WEBPAGE. THE NEEDS ASSESSMENT TOOK INTO ACCOUNT INFORMATION FROM PRIMARY DATA AS WELL AS SECONDARY DATA. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: EACH PATIENT IS ASKED THE QUESTION, "DO YOU NEED HELP WITH YOUR MEDICAL BILLS?" AT THE POINT OF REGISTRATION. FOR EVERY PATIENT THAT ANSWERS YES, WE SEND THE PATIENT A COVER LETTER EXPLAINING OUR FINANCIAL ASSISTANCE PROGRAM, AN APPLICATION, AND BASIC GUIDELINES IDENTIFYING INFORMATION NEEDED TO PROCESS THE APPLICATION. ONCE THE PATIENT RECEIVES THE APPLICATION AND COMPLETES THE INFORMATION, THE APPLICATION IS REVIEWED FOR ACCURACY AND POTENTIAL APPROVAL. IF THE PATIENT HAS SUPPLIED ALL THE NECESSARY INFORMATION AND A DECISION IS MADE, AN APPROVED OR DENIED LETTER IS SENT TO THE PATIENT. IF THE PATIENT HAS NOT SUPPLIED ENOUGH INFORMATION TO MAKE A PROPER DECISION, A LETTER DETAILING THE MISSING INFORMATION IS SENT TO THE PATIENT ALONG WITH A FOLLOW UP PHONE CALL. THE APPLICATION IS PRINTED ON THE BACK OF EVERY STATEMENT SENT TO PATIENTS CONCERNING THEIR OUT OF POCKET EXPENSE. WE UTILIZE AN EARLY OUT SELF-PAY VENDOR THAT HAS BEEN TRAINED ON OUR FINANCIAL ASSISTANCE POLICY AND WHEN THEY HAVE CONTACT WITH OUR PATIENTS, THEY ADVISE THEM OF THE PROGRAM AND INITIATE THE APPLICATION PROGRAM WHEN THE PATIENT REQUESTS THEIR ASSISTANCE. THIS VENDOR OFFERS THE FINANCIAL ASSISTANCE APPLICATION ON THEIR WEBSITE LISTED UNDER THE OPTIONS FOR RESOLUTION OF THE OUTSTANDING BALANCE(S). THE HOSPITAL HAS FINANCIAL ASSISTANCE POSTERS PLACED IN STRATEGIC LOCATIONS THROUGHOUT THE FACILITY TO INFORM THEM OF THE PROGRAM OFFERED. WE ARE PARTICIPATING IN HEALTH FAIRS THROUGHOUT THE COUNTY BY ATTENDING AND OFFERING ASSISTANCE WITH THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: WE CONSIDER ALL OF ARMSTRONG COUNTY TO BE INCLUDED IN OUR SERVICE AREA AS WE ARE THE ONLY HOSPITAL AND THE ONLY PROVIDER OF EMERGENCY SERVICES. ARMSTRONG COUNTY LIES IN THE RURAL APPALACHIAN REGION AND IS MADE UP OF 45 MINOR CIVIL DIVISIONS. THE MAJORITY OF THESE MUNICIPALITIES ARE DESIGNATED AS EITHER MEDICALLY UNDERSERVED AREAS OR HEALTH PROFESSIONAL SHORTAGE AREAS, OR BOTH, BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. THERE IS NO PUBLIC TRANSPORTATION SYSTEM FOR MOST OF THE AREA. SOCIOECONOMIC DATA FOR THE REGION SHOWS THAT THE PER CAPITA INCOME OF ARMSTRONG COUNTY IS LOWER THAN THE AVERAGE OF THE UNITED STATES, THE COMMONWEALTH OF PENNSYLVANIA AND THE OVERALL APPALACHIAN REGION. ARMSTRONG COUNTY RESIDENTS ARE OLDER THAN THE AVERAGE RESIDENT OF PENNSYLVANIA AS A WHOLE. A DISPROPORTIONATELY LARGER PERCENTAGE OF OUR POPULATION RESIDES IN RURAL AREAS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: ACMH IS A FOUNDING MEMBER OF THE ARMSTRONG COUNTY COALITION FOR HEALTH AND WELLNESS WHICH EXISTS TO PROMOTE PHYSICAL ACTIVITY AND HEALTHIER FAMILIES THROUGH COMMUNITY DESIGN AND SUPPORT. COALITION MEMBERS CURRENTLY INCLUDE, ELECTED ARMSTRONG COUNTY OFFICIALS, ACMH HOSPITAL PERSONNEL, AND OTHER COMMUNITY LEADERS. THE GOAL OF THE COALITION IS TO REVERSE THREATS TO THE HEALTH AND WELL-BEING OF ARMSTRONG COUNTY CITIZENS WHICH INCLUDE POOR NUTRITION, SEDENTARY LIFESTYLES, AND LIMITED PHYSICAL ACTIVITY BY PROVIDING LEADERSHIP, FUNDING AND TECHNICAL ASSISTANCE IN ORDER TO PROMOTE THE USE OF EXISTING TRAILS AND PARKS, TO OPTIMIZE COMMUNITY DESIGN, TO INCREASE ACCESS TO RECREATIONAL RESOURCES, TO ENHANCE EXISTING FITNESS FACILITIES AND TO PROMOTE EDUCATIONAL PROGRAMS THAT FOCUS ON HEALTHIER LIFESTYLES. ACMH ALSO PARTICIPATES IN HEALTHY ARMSTRONG, A COALITION OF A LARGE NUMBER OF STAKEHOLDERS THAT MEETS MONTHLY TO COMBAT CHILDHOOD OBESITY. HEALTHY ARMSTRONG HAS BEEN AWARDED SEVERAL GRANTS AND HAS ACHIEVED NATIONAL RECOGNITION THROUGH ITS PROGRAM OF USING THE SCHOOL SYSTEM TO PROMOTE INCREASED PHYSICAL ACTIVITY AND NUTRITIONAL EDUCATION. ACMH PARTICIPATES IN ECONOMIC DEVELOPMENT MEETINGS. THE MAJORITY OF BOARD MEMBERS ARE ARMSTRONG COUNTY RESIDENTS AND WERE SELECTED TO REPRESENT THE COMMUNITIES SERVED. ACMH MANAGERS ARE ENCOURAGED TO PARTICIPATE ON THE BOARDS OF OTHER NON-PROFIT HEALTH AND HUMAN SERVICES ORGANIZATIONS. ACMH PROVIDES STRATEGIC PLANNING LEADERSHIP AND FACILITATION TO SMALLER ORGANIZATIONS IN THE COMMUNITY. ACMH WIDELY ADVERTISES ITS FINANCIAL ASSISTANCE/FREE CARE PROGRAMS WHICH ARE INCOME BASED. SINCE ACMH OWNS SEVERAL RURAL HEALTH CLINICS LOCATED IN MEDICALLY UNDERSERVED AREAS IT OFFERS FINANCIAL ASSISTANCE TO LOW INCOME INDIVIDUALS AND FAMILIES FOR ALL TYPES OF HEALTHCARE SERVICES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED GROUP, AND THE GROUP'S CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF ARMSTRONG COUNTY MEMORIAL HOSPITAL, ARMSCARE, INC., ARMSTRONG HEALTH AND EDUCATION FOUNDATION, ACMH ANESTHESIA SERVICES, ACMH PHYSICIAN SERVICES, GLADE RUN MEDICAL ASSOCIATES INC., AND ARMSTRONG CENTER FOR MEDICINE AND HEALTH, INC. (ACMH, INC.), COLLECTIVELY REFERRED TO AS THE HEALTH SYSTEM. THE HOSPITAL IS A NOT-FOR-PROFIT ENTITY, WHOLLY OWNED BY ACMH, INC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES IN THE ARMSTRONG COUNTY, PENNSYLVANIA AREA. ACMH, INC. IS A NOT-FOR-PROFIT CORPORATION FORMED TO SUPPORT AND FURTHER THE CHARITABLE ACTIVITIES OF ARMSTRONG COUNTY MEMORIAL HOSPITAL AS WELL AS ANY OTHER SUBSIDIARY ORGANIZATION AND IS THE PARENT ORGANIZATION. ARMSCARE, INC. IS A 95%-OWNED, FOR-PROFIT ENTITY ENGAGED PRINCIPALLY IN THE RENTAL AND SALE OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES. THE FOUNDATION IS A NOT-FOR-PROFIT ENTITY WHOSE PURPOSE IS TO RAISE FUNDS FOR THE BENEFIT OF THE HOSPITAL AND WELLNESS OF THE COMMUNITY. THE HEALTH SYSTEM FORMED ACMH ANESTHESIA SERVICES AND ACMH PHYSICIAN SERVICES IN 2006. THESE ENTITIES WERE ESTABLISHED TO PROVIDE ANESTHESIA AND PHYSICIAN SERVICES TO THE HEALTH SYSTEM. THE HEALTH SYSTEM FORMED GLADE RUN MEDICAL ASSOCIATES, INC. (GLADE RUN) IN 2009, AND IT BEGAN OPERATIONS IN 2010. GLADE RUN IS A NOT-FOR-PROFIT ENTITY ESTABLISHED TO PROVIDE PHYSICIAN SERVICES TO THE HEALTH SYSTEM. X X X X X false true false true false true false false false CHAD SHAFFER MD DIRECTOR 211864 0 36787 0 0 0 1875 0 23575 0 274101 0 0 0 JOHN I LEWIS PRESIDENT & CEO 356225 0 150 0 650835 0 43393 0 22902 0 1073505 0 629094 0 JAMES BACKSTROM MD CHIEF MEDICAL OFFICER 217217 0 0 0 12031 0 1500 0 13667 0 244415 0 0 0 MATTHEW KOCIOLA CFO, VP OF FINANCE 201801 0 0 0 12767 0 39057 0 1646 0 255271 0 0 0 VICKY M LEO PHYSICIAN 224270 0 7097 0 0 0 2625 0 8712 0 242704 0 0 0 JOSEPH CIPPEL PHYSICIAN 174966 0 63284 0 0 0 1875 0 30585 0 270710 0 0 0 KARLA MCCANN PHYSICIAN 166864 0 11480 0 6832 0 1875 0 20348 0 207399 0 0 0 JEFFREY DAVID PHYSICIAN 252819 0 163 0 0 0 2625 0 26868 0 282475 0 0 0 EDWARD BALESTRINO PHYSICIAN 200538 0 15735 0 0 0 1500 0 1379 0 219152 0 0 0 MONA RUPERT VP OF CLINICAL SERVICES 137187 0 0 0 9642 0 14625 0 10612 0 172066 0 0 0 NICHOLE D GERACI CHIEF OPERATING OFFICER 161334 0 0 0 6327 0 13875 0 18262 0 199798 0 0 0 ANNE REMALEY VP OF HUMAN RESOURCES 150200 0 0 0 10745 0 14625 0 21415 0 196985 0 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUAL PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND RECEIVED THE FOLLOWING 457(F) PAYMENT: $629,094 JOHN I. LEWIS THE 457(F) PLAN THAT ARMSTRONG COUNTY MEMORIAL HOSPITAL ESTABLISHED FOR A SELECT GROUP OF MANAGEMENT INCLUDES THE FOLLOWING TERMS: A PARTICIPANT SHALL BECOME FULLY VESTED IN HIS DEFERRED COMPENSATION ACCOUNT AND INCOME, GAINS AND LOSSES ATTRIBUTABLE THERETO, IF HE REMAINS IN SERVICE WITH THE EMPLOYER UNTIL THE FIRST OF THE FOLLOWING EVENTS OCCUR: (A) THE DEATH OF THE PARTICIPANT; (B) THE DISABILITY OF THE PARTICIPANT; (C) THE DATE THE PARTICIPANT ATTAINS AGE 65; 0R (D) THE DATE A PARTICIPANT IS TERMINATED FROM EMPLOYMENT WITH THE EMPLOYER DUE TO A CHANGE OF CONTROL EVENT. (E) THE PARTICIPANT WILL BE VESTED AT 5 YEARS, AT WHICH TIME PAYMENTS WILL BEGIN. UPON VESTING, THE DEFERRED COMPENSATION ACCOUNT WILL BE INCLUDIBLE IN THE GROSS INCOME OF THE PARTICIPANT PURSUANT TO CODE SECTION 457(F). SCHEDULE J, PART I, LINES 5A & 6A CONTINGENT COMPENSATION: MANAGEMENT USES MGMA PUBLISHED STANDARDS TO ESTABLISH A BASE SALARY FOR PROVIDERS. IN ADDITION TO THE BASE SALARY, PROVIDERS HAVE THE ABILITY TO EARN INCENTIVES BASED UPON THEIR PRODUCTIVITY AS REFLECTED IN WORK RVU MEASURES. IN ADDITION, THE CEO PRESENTS GOALS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF WHAT THE ORGANIZATION HOPES TO ACHIEVE DURING EACH FISCAL YEAR. THESE GOALS ARE BASED ON REVENUES, NET EARNINGS, AND OTHER MEASURES. DEPENDING ON THE RESULTS, THE EXECUTIVE COMMITTEE OF THE BOARD, WITH INPUT FROM THE CEO, DETERMINES WHAT AMOUNT OF BONUSES (IF ANY) WILL BE PAID. X 7 138040 FMV false false false SCHEDULE M, PART I, COLUMN (B) NUMBER OF CONTRIBUTIONS: THE NUMBER IN COLUMN B REFLECTS THE NUMBER OF CONTRIBUTIONS. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: THE HOSPITAL WILL: FOCUS ON PATIENT AND FAMILY CENTERED SERVICES; CONTINUE TO DEVELOP THOSE SPECIALTY SERVICES THAT MEET THE CHANGING NEEDS OF THE COMMUNITY; DELIVER HIGH QUALITY, COST-EFFECTIVE CARE; AND PROMOTE HEALTH EDUCATION AND WELLNESS. FORM 990, PART III, LINE 2 SIGNIFICANT PROGRAM SERVICES NOT LISTED ON THE PRIOR FORM 990: ACMH HOSPITALISTS PROFESSIONAL FOCUS IS THE GENERAL MEDICAL CARE OF HOSPITALIZED PATIENTS THROUGH ACTIVITIES SUCH AS PATIENT CARE, TEACHING, RESEARCH, AND LEADERSHIP RELATED TO HOSPITAL MEDICINE. ACMH NEUROLOGY IS THE BRANCH OF MEDICINE CONCERNED WITH THE STUDY AND TREATMENT OF DISORDERS OF THE NERVOUS SYSTEM. THE NERVOUS SYSTEM IS A COMPLEX, SOPHISTICATED SYSTEM THAT REGULATES AND COORDINATES BODY ACTIVITIES. FORM 990, PART III, LINE 4 PROGRAM SERVICES: ARMSTRONG COUNTY MEMORIAL HOSPITAL IS A 160 BED COMMUNITY HOSPITAL WHICH PROVIDES INPATIENT & OUTPATIENT MEDICAL SERVICES TO ALL COUNTY RESIDENTS WITHOUT DISCRIMINATION. THE HOSPITAL HAS CONTRACTS WITH THIRD-PARTY PAYERS TO PROVIDE CARE FOR MEDICARE, MEDICAID, BLUE CROSS AND OTHER COMMERCIAL PAYER PATIENTS. THE HOSPITAL PROVIDES EMERGENCY CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY. PURSUANT TO THE HOSPITAL'S CHARITY CARE POLICY, CHARGES ARE FULLY OR PARTIALLY WRITTEN OFF FOR PATIENTS MEETING THE CRITERIA SPECIFIED IN THE POLICY. CHARGES EXCLUDED UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY $1,505,865 FOR THE FISCAL YEAR. THE AMOUNTS REPORTED AS EXPENSE FOR LINES 4A, 4B AND 4C REPRESENT ONLY THE PORTION OF EXPENSES THAT RELATE TO THE GENERATION OF REVENUE FOR THESE PROGRAMS. ADDITIONALLY, MANAGEMENT AND GENERAL EXPENSE IS ASSOCIATED WITH THESE PROGRAMS AND IS INCLUDED IN PART IX STATEMENT OF FUNCTIONAL EXPENSES COLUMN C. DUE TO FOLLOWING THE IRS INSTRUCTIONS FOR REPORTING EXPENSES UNDER THIS SECTION, THE NET PROFIT (LOSS) OF THESE PROGRAMS IS NOT COMPLETELY DISCLOSED UNDER LINES 4A, 4B AND 4C. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: THESE ARE ITEMS THAT HELP SUPPORT THE MEDICAL SERVICES OUR PATIENTS RECEIVE AT ACMH HOSPITAL. ITEMS INCLUDE CAFETERIA AND VENDING, COMMUNITY BENEFITS, INVESTMENT FEES, PREVENTATIVE HEALTH, XRAY TECHNOLOGY AND THE 340B DRUG PROGRAM. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP: JOHN LEWIS AND MATTHEW KOCIOLA ARE BOARD MEMBERS OF ARMSCARE, INC. A RELATED TAXABLE CORPORATION. SEE SCHEDULE R, PART IV. FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B MEMBERS/STOCKHOLDERS: THE ORGANIZATION IS A SUBSIDIARY OF ARMSTRONG CENTER FOR MEDICINE AND HEALTH, INC. (ACMH), ANOTHER TAX EXEMPT ENTITY. ACCORDING TO THE BYLAWS, ARTICLE II, ACMH, A PENNSYLVANIA NONPROFIT CORPORATION, SHALL HAVE CERTAIN RIGHTS WITH RESPECT TO THE GOVERNANCE OF THIS CORPORATION AS MAY BE SPECIFIED IN THESE BYLAWS IN THE CAPACITY OF ANOTHER BODY AS THAT TERM IS DEFINED IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW, SPECIFICALLY 15 PA C.S. SECTION 7103. THE BYLAWS OF ACMH DESCRIBE SEVEN SITUATIONS IN WHICH APPROVAL IS NEEDED BY THE PARENT CORPORATION. 1) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THIS CORPORATION OR OF THESE BYLAWS; 2) THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THIS CORPORATION; 3) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; 4) DISSOLUTION OF THE CORPORATION AND DISTRIBUTION OF ASSETS PURSUANT THERETO; 5) APPROVAL OF THE ANNUAL BUDGET AND LONG-RANGE PLAN FOR THIS CORPORATION; 6) ANY OTHER MATTER THAT BYLAWS REQUIRE THE APPROVAL OF THE MEMBERS OF THE CORPORATION. ALSO, THE PARENT CORPORATION HAS THE AUTHORITY TO SELECT THE BOARD MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS (ARTICLE 3, SECTION 3(B)). FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A TENTATIVE DRAFT OF THE 990 IS REVIEWED BY THE DIRECTOR OF FINANCE, THE VICE PRESIDENT OF FINANCE, AND THE PRESIDENT/CEO BEFORE BEING PRESENTED TO THE BOARD OF DIRECTORS. THE 990 IS REVIEWED AND APPROVED AT THE BOARD MEETING AND FINAL REPORTS ARE PLACED ON THE BOARD OF DIRECTORS PORTAL ONCE OFFICIALLY FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE ORGANIZATION MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY REQUESTING ON AN ANNUAL BASIS THAT MEMBERS OF THE BOARD OF DIRECTORS, ALL CORPORATE OFFICERS, AND ALL KEY EMPLOYEES COMPLETE A QUESTIONNAIRE LISTING ALL ORGANIZATIONS WITH WHICH THEY HAVE AN AFFILIATION. THE POLICY OF THE ORGANIZATION DESCRIBES HOW ANY CONFLICTS OF INTEREST ARE TO BE ADDRESSED. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH ALL SUCH DISCLOSURE STATEMENTS IN CASE A CONFLICT ARISES. THE VICE-CHAIRMAN OF THE BOARD SHALL BE FAMILIAR WITH THE STATEMENT FILED BY THE CHAIRMAN. IF A CONFLICT OF INTEREST SHOULD ARISE, THE MEMBERS ABSTAIN FROM THE VOTE RELATING TO THAT MATTER. FORM 990 PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW: THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PAID BY ARMSTRONG COUNTY MEMORIAL HOSPITAL (ACMH HOSPITAL). THE PROCESS ACMH HOSPITAL USES TO DETERMINE IF THE OFFICERS OF THE ORGANIZATION ARE TO RECEIVE A WAGE ADJUSTMENT IS AS FOLLOWS: 1) A SALARY COMPARISON PREPARED BY SURVEY DATA OBTAINED FROM A REVIEW OF REGIONAL 990S AND "THE TOTAL COMPENSATION SURVEY 2) THE INFORMATION IS COMPILED BY THE VP OF HUMAN RESOURCES AND GIVEN TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR CONSIDERATION AND INPUT; 3) CHANGES TO EXECUTIVE COMPENSATION REQUIRE A SIGNED DOCUMENT FROM THE CHAIR OF THE HOSPITAL BOARD OF DIRECTORS. EXECUTIVE COMPENSATION IS REVIEWED AS DESCRIBED ABOVE, ON AN AS NEEDED BASIS AND WAS LAST COMPLETED IN JUNE 2019. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION TAKES THE FOLLOWING ACTIONS RELEASING INFORMATION REGARDING ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS: IF A REQUEST IS MADE TO REVIEW THE UNAUDITED FINANCIAL STATEMENTS, IT IS DISCUSSED AND DETERMINED ON A CASE BY CASE BASIS AS TO WHETHER THE INFORMATION WILL BE RELEASED. THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE ORGANIZATIONS THAT REQUEST THEM. A CODE OF CONDUCT FOR THE ORGANIZATION IS AVAILABLE TO THE PUBLIC ON ITS WEBSITE AT WWW.ACMH.ORG. THE CORPORATION'S GOVERNING DOCUMENTS ARE KEPT IN THE ADMINISTRATIVE DEPARTMENT OF THE HOSPITAL. THESE DOCUMENTS CAN BE VIEWED UPON REQUEST, BUT THEY ARE NOT ALLOWED TO BE TAKEN FROM THEIR DESIGNATED AREA OR HAVE COPIES MADE WITHOUT PERMISSION. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: NO BOARD MEMBERS RECEIVE ANY COMPENSATION FOR THEIR DIRECTOR DUTIES. JOHN I. LEWIS IS COMPENSATED AS PRESIDENT/CEO. JAMES BACKSTROM, MD, IS COMPENSATED AS CHIEF MEDICAL OFFICER. CHAD SHAFFER, MD, IS COMPENSATED AS PHYSICIAN. FORM 990, PART VIII, LINE 6A RENTAL INCOME: ACMH HOSPITAL PROVIDES RENTAL LOCATIONS TO AREA PHYSICIANS AND OTHER HEALTHCARE RELATED ENTITIES IN ORDER TO PROMOTE ACCESSIBLE HEALTHCARE OPTIONS CLOSE TO HOME FOR THE LOCAL COMMUNITY. THE RENTAL INCOME CHARGED TO EACH LOCATION IS BASED ON PREVAILING RENTAL RATES PER SQUARE FOOT, THE AMOUNT OF SPACE, THE CONDITION OF THE OFFICE SPACE AND THE AMOUNT OF TIME THE OFFICE SPACE IS USED EACH MONTH. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ (3,355,054) CHANGE IN DEFINED BENEFIT PENSION PLAN (5,705,640) TRANSFER TO AFFILIATES -------------- $ (9,060,694) FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:6023798 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED PHYSICIAN SERVICES TOTAL FEES:2688431 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE & SRVC CONTRACTS TOTAL FEES:2522728 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:442955 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL DIRECTOR FEES TOTAL FEES:413750 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:73811 ARMSTRONG OUTPATIENT IMAGING LLC 87 GLADE PARK EAST KITTANNING PA 16201 030492975 RADIOLOGY PA 0 0 ACMH HOSP ACMH PHYSICIAN SERVICES ONE NOLTE DRIVE KITTANNING PA 16201 204648195 PRIMARY CARE PA 501(C)3 3 ACMH false ARMSTRONG HEALTH & EDUCATION FOUNDATION ONE NOLTE DRIVE KITTANNING PA 16201 251655867 FOUNDATION PA 501(C)3 12A I ACMH false ARMSTRONG CENTER FOR MEDICINE & HEALTH ONE NOLTE DRIVE KITTANNING PA 16201 204648477 PARENT CORP. PA 501(C)3 10 NA false GLADE RUN MEDICAL ASSOCIATES INC ONE NOLTE DRIVE KITTANNING PA 16201 264750523 PHYSICIAN PRA PA 501(C)3 12A I ACMH false ARMSCARE INC ONE NOLTE DRIVE KITTANNING PA 16201 251495691 DURABLE MED EQUIP PA ACMH C CORP 0 0 false false false true true false false false false false true false false true true true true true true true