2025-05-15T12:11:43-05:00 2024-06-30 882730877 CHERRY BEKAERT ADVISORY LLC 1000 VINE CENTER 333 WEST VINE ST LEXINGTON KY 40507 990 2023-07-01 872421892 ARH ADVANCED CARE INC ARHA 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 CHARLES LOVELL CEO 8592262440 2025-05-13 1 1 MELANIE MCPEAK P01346034 8595147800 2023 2025-03-06 01:10:19Z HOLLIE HARRIS 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 3873984 0 X WWW.ARH.ORG X 2021 KY TO PROVIDE TREATMENT FOR SERIOUS MEDICAL CONDITIONS THROUGH ITS LONG-TERM ACUTE CARE HOSPITALS. 4 3 86 4 0 0 0 0 3551718 3873982 0 0 352 2 3552070 3873984 0 0 0 0 5989438 6702165 0 0 0 5857493 6437525 11846931 13139690 -8294861 -9265706 7911129 3573137 16429011 21356725 -8517882 -17783588 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. 0 0 13095454 3873982 ARH ADVANCED CARE INC. OPERATES TWO LONG TERM ACUTE CARE HOSPITALS (LTACHS) IN EASTERN KENTUCKY. LOCATIONS INCLUDE A 25-BED HOSPITAL LOCATED ON THE CAMPUS OF HAZARD ARH REGIONAL MEDICAL CENTER IN PERRY COUNTY AND A 25-BED HOSPITAL LOCATED ON THE CAMPUS OF TUG VALLEY ARH REGIONAL MEDICAL CENTER IN PIKE COUNTY.LONG-TERM ACUTE CARE HOSPITALS (LTACHS) ARE FACILITIES THAT SPECIALIZE IN THE TREATMENT OF PATIENTS WITH SERIOUS MEDICAL CONDITIONS THAT REQUIRE CARE ON AN ONGOING BASIS BUT NO LONGER REQUIRE INTENSIVE CARE. THIS INCLUDES PATIENTS THAT MAY NEED PROLONGED VENTILATOR USE/WEANING OR PATIENTS NEEDING ONGOING DIALYSIS FOR CHRONIC RENAL FAILURE.ARH ADVANCED CARE HAS ADDED 75 NEW HEALTHCARE JOBS TO THE EASTERN KENTUCKY REGION ALONG WITH THE ADDED AVAILABILITY OF THIS MUCH NEEDED SERVICE. CURRENTLY, THERE ARE NO LTACH FACILITIES IN THE EASTERN KENTUCKY REGION OF THE STATE. THE OVERALL GOAL OF ARH ADVANCED CARE IS TO IMPROVE ACCESS TO NEEDED EXTENDED LONG-TERM CARE AND IMPROVE THE OVERALL HEALTH OF THE RESIDENTS THAT LIVE IN THE TARGETED CENTRAL APPALACHIA REGION.DURING FY24, ARH ADVANCED CARE RECEIVED RECLASSIFICATION FROM CMS. THE BIG SANDY LOCATION RECEIVED RECLASSIFICATION NOTIFICATION FROM CGS ON MAY 20, 2024, WITH AN EFFECTIVE RETROACTIVE DATE OF SEPTEMBER 16, 2023. THE KY RIVER LOCATION RECEIVED RECLASSIFICATION NOTIFICATION FROM CGS ON AUGUST 23, 2024, WITH AN EFFECTIVE RETROACTIVE DATE OF APRIL 1, 2024.ARH ADVANCED CARE HAS 117 PROVIDERS CREDENTIALED AT BIG SANDY AND 179 PROVIDERS CREDENTIALED AT KY RIVER. IN SEPTEMBER 2023, IN-PATIENT DIALYSIS SERVICES WERE ADDED TO THE SERVICES OFFERED AT BOTH ARH ADVANCED CARE LOCATIONS.IN KEEPING WITH THE MISSION OF ARH ADVANCED CARE, THESE FACILITIES HAVE BEEN DEVELOPED TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA. ARH ADVANCED CARE FACILITIES WILL PROVIDE A UNIQUE SETTING SPECIALIZING ON THOSE PATIENTS REQUIRING EXTENDED INPATIENT CARE INCLUDING VENTILATOR WEANING AND CARE FOR COMPLEX MEDICAL CONDITIONS.ARH ADVANCED CARE BIG SANDY HAS HAD 24 ADMISSIONS FROM JANUARY 1, 2024 OCTOBER 18, 2024, WITH 106 VENTILATOR DAYS. ARH ADVANCED CARE KY RIVER HAS HAD 40 ADMISSIONS FROM JANUARY 1, 2024 OCTOBER 25, 2024, WITH 451 VENTILATOR DAYS. ALL THESE PATIENTS AND FAMILIES WOULD HAVE HAD TO TRAVEL SOME 2+ HOURS TO RECEIVE THIS CARE PRIOR TO OUR OPENING.ARH ADVANCED CARE WILL WORK COLLABORATIVELY WITH ITS REFERRING FACILITIES TO APPROPRIATELY PLACE THOSE PATIENTS REQUIRING AN EXTENDED ACUTE INPATIENT STAY. IT IS THE VISION OF ARH ADVANCED CARE TO BE THE PREMIER DESTINATION FOR QUALITY LONG TERM ACUTE CARE WHILE ALLOWING PATIENTS TO BE TREATED IN THEIR COMMUNITY WITH THEIR SUPPORT SYSTEM IN CLOSE PROXIMITY. 13095454 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 86 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X THE ORGANIZATION 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 PATRICK DOWNS MD DIRECTOR 12.00 0.00 X 0 0 0 LEON HOLLON CHAIRMAN 5.00 0.00 X X 0 0 0 HOLLIE P HARRIS CORPORATE DIRECTOR/SECRETARY 3.00 37.00 X X 0 1115375 112193 BYRON GABBARD CORPORATE DIRECTOR 5.00 35.00 X 0 505151 52023 DR AARON CRUM DIRECTOR 5.00 0.00 X 0 0 0 JILL MAYNARD DIRECTOR 5.00 0.00 X 0 0 0 RUSSELL BARKER PRESIDENT/CEO 40.00 0.00 X 189323 0 34050 JIM MAYNARD CHIEF OPERATING OFFICER 40.00 0.00 X 115836 0 0 305159 1620526 198266 1 0 1 0 HALLMARK HEALTH CARE SOLUTIONS INC 200 MOTOR PARKWAY SUITE D-26 HAUPPAUGE NY 11788 CONTRACT NURSES 2389889 MURER CONSULTANTS INC (ADVIS) 18670 GRAPHICS DRIVE SUITE 200 TINLEY PARK IL 60477 OPERATIONAL DEVELOPMENT MGMT 576502 MEDICAL SOLUTIONS LLC 1010 N 102ND ST SUITE 300 OMAHA NE 68114 CONTRACT NURSES 197574 QUALIVIS LLC 5930 CORNERSTONE COURT W SUITE 300 SAN DIEGO CA 92121 CONTRACT NURSES 169752 KENTUCKY PRIMARY CARE ASSOCIATION 226 W MAIN STREET FRANKFORT KY 40602 PHYSICIAN SERVICES 130200 5 PATIENT SERVICES 621110 3805833 3805833 HOSPITAL RATE IMPROVEM 621110 68149 68149 3873982 OTHER REVENUE 900099 2 2 2 3873984 3873982 0 2 X 372506 370016 2490 6027964 6003798 24166 73640 69798 3842 228055 217484 10571 2209573 2209573 17262 17262 446884 446884 544 544 500481 500481 8100 8100 43865 40698 3167 BAD DEBT 2957048 2957048 PHARMACEUTICALS 237657 237657 TAXES & LICENSES 14805 14805 RESIDENT/PATIENT ACTIVI 23 23 1283 1283 13139690 13095454 44236 0 130482 1807635 6722133 516605 136147 132226 922367 1116671 7911129 3573137 7800788 2619125 1500000 8628223 17237600 16429011 21356725 X -8517882 -17783588 -8517882 -17783588 7911129 3573137 -9265706 0 X X 0 1 X 1 0 X 0 INTERCOMPANY PAYABLES 17237600 17237600 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. U.S. 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 1 128 128 0.00000 3284357 3284357 0 0 3284485 3284357 128 0.00000 3284485 3284357 128 0.00000 1 2957048 0 485567 2369282 -1883715 X 1 1 2 1 ARH ADVANCED CARE - BIG SANDY 260 HOSPITAL DR 1 SOUTH WILLIAMSON KY 41503 X LONG TERM ACUTE CARE HOSPITAL A 2 ARH ADVANCED CARE - KENTUCKY RIVER 100 MEDICAL CENTER DR SUITE B HAZARD KY 41701 X LONG TERM ACUTE CARE HOSPITAL A FACILITY REPORTING GROUP - A 1 0 0 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 X 0 X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ARH ADVANCED CARE - BIG SANDY, - FACILITY 2: ARH ADVANCED CARE - KENTUCKY RIVER PART V, SECTION B, LINE 13A: FPG FAMILY INCOME IS UNLIMITED FOR ELIGIBILITY FOR FREE CARE. 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 REPORT WAS FILED FOR ALL FACILITIES WITHIN THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM; FILED BY APPALACHIAN REGIONAL HEALTHCARE, INC. (EIN: 52-0795508), THE PARENT ORGANIZATION. PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART I, LINE 3B: FPG FAMILY INCOME IS UNLIMITED FOR ELIGIBILITY FOR FREE CARE. PART III, LINE 2: THE BAD DEBT EXPENSE ON LINE 2 REFLECTS THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. 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 ADQUACY OFTHE 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: A SIGNIFICANT PORTION 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 NEARLY $2 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 $1,883,715 (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, SYSTEM AFFILIATE TO ARH ADVANCED CARE, EVERY THREE YEARS, ARH ALSO CONTINALLY ASSESSES COMMUNITY NEEDS IN OTHER FORMS AS WELL. THE NEEDS OF THE COMMUNITIES THAT ARH ADVANCED CARE SERVES THROUGHOUT EASTERN KENTUCKY 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. PART VI, LINE 3: ARH ADVANCED CARE, INC. DOING BUSINESS AS ARH ADVANCED CARE BIG SANDY AND ARH ADVANCED CARE KY RIVER MAINTAINS A FINANCIAL ASSISTANCE PROGRAM AND POLICY. UNDER THIS PROGRAM AND POLICY, EACH PATIENT WITHOUT MEDICAL COVERAGE FOR RENDERED SERVICES IS OFFERED A 40% DISCOUNT OF GROSS CHARGES AT THE 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 OBLIGATION 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 ARH FINANCIAL COUNSELERS (WHOSE SERVICES ARE PROVIDED UNDER A VENDED SERVICE AGREEMENT) AND/OR ELIGIBILITY AGENCY TO GET THE INDIVIDUAL PLACED IN AN ASSISTANCE 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 MADE 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 ADVANCED CARE, INC. DOING BUSINESS AS ARH ADVANCED CARE BIG SANDY AND ARH ADVANCED CARE KY RIVER IN EASTERN KENTUCKY INCLUDES PERRY, PIKE AND THEIR SURROUNDING 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, ARH ADVANCED CARE BIG SANDY AND ARH ADVANCED CARE KY RIVER 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 UMAN SERVICES. IN ADDITION, THE AREAS SERVED BY ADVANCED CARE BIG SANDY AND ARH ADVANCED CARE KY RIVER 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. PART VI, LINE 5: ARH ADVANCED CARE, INC. DOING BUSINESS AS ARH ADVANCED CARE BIG SANDY AND ARH ADVANCED CARE KY RIVER PROVIDES SERVICES TO PERRY, PIKE AND THEIR SURROUNDING COUNTIES. THE FOCUS OF ARH ADVANCED CARE BIG SANDY AND ARH ADVANCED CARE KY RIVER IS TO PROVIDE AN ACUTE CARE INPATIENT SETTING WHICH FOCUSES ON THE CARE OF PATIENTS REQUIRING AN EXTENDED ACUTE INPATIENT STAY. THE MISSION OF ARH ADVANCED CARE BIG SANDY AND ARH ADVANCED CARE KY RIVER IS TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. ARH ADVANCED CARE, INC. CONSISTS OF TWO ACUTE CARE FACILITIES FOR THE CARE AND TREATMENT OF THOSE PATIENTS REQUIRING AN EXTENDED ACUTE INPATIENT STAY FOR COMPLEX CONDITIONS. AS PART OF THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM, ARH ADVANCED CARE, INC. SERVES AS AN APPROPRIATE SETTING FOR PATIENTS REQUIRING AN EXTENDED STAY, WHILE ALLOWING PATIENTS TO REMAIN CLOSER TO THEIR HOME AND SUPPORT SYSTEMS. UNTIL THE ESTABLISHMENT OF THESE TWO FACILITIES, PATIENTS REQUIRING THIS VENUE OF CARE WERE TRANSFERRED TO FACILITIES A GREAT DISTANCE, MEANING THAT THEY WERE FREQUENLTY AWAY FROM THEIR COMMUNITY AND WITHOUT THEIR SUPPORT SYSTEMS. PART VI, LINE 6: DURING FISCAL YEAR 2024, ARH ADVANCED CARE, INC CONTINUED TO ESTABLISH ITSELF AS A NEW PROVIDER WITHIN THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM. THE MISSION OF THE ARH ADVANCED CARE, INC. FACILITIES IS TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. AS PART OF THE APPALACHIAN HEALTH CARE SYSTEM, ARH ADVANCED CARE, INC. FACILITIES WILL PROVIDE AN APPROPRIATE VENUE OF CARE FOR THOSE PATIENTS REQUIRING AN EXTENDED ACUTE CARE STAY. SPECIFCALLY, ARH ADVANCED CARE, INC. SPECIALIZES IN THE CARE AND TREATMENT OF A COMPLEX PATIENT POPULATION INCLUDING, BUT NOT LIMITED TO, RESPIRATORY AND VENTILATORY CARE AND TREATMENT, COMPLEX POST OPERATIVE INFECTIONS, EXTENSIVE WOUND CARE, AND DIALYSIS TREATMENT. THESE FACILITIES WILL ALLOW THE PEOPLE OF CENTRAL APPALACHIA TO REMAIN CLOSE TO THEIR HOMES AND SUPPORT SYSTEMS INSTEAD OF BEING REQUIRED TO TRAVEL HOURS AWAY TO RECEIVE AN EXTENDED ACUTE INPATIENT STAY. PART VI, LINE 7, REPORTS FILED WITH STATES KY,WV X X X X X 0 1 0 0 0 0 1 0 0 HOLLIE P HARRIS CORPORATE DIRECTOR/SECRETARY 0 938382 0 176400 0 593 0 84230 0 27963 0 1227568 0 0 BYRON GABBARD CORPORATE DIRECTOR 0 424510 0 80000 0 641 0 52023 0 0 0 557174 0 0 RUSSELL BARKER PRESIDENT/CEO 156323 0 33000 0 0 0 34050 0 0 0 223373 0 0 0 PART I, LINE 3 THE RELATED ORGANIZATION USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION FOR ITS CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE RELATED ORGANIZATION, 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; BYRON GABBARD - $7,023. PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE RELATED ORGANIZATION (APPALACHIAN REGIONAL HEALTHCARE, INC. - 52-0795508) ("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. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS APPALACHIAN REGIONAL HEALTHCARE, INC. FORM 990, PART VI, SECTION A, LINE 7A APPALACHIAN REGIONAL HEALTHCARE, INC. APPOINTS THE BOARD OF DIRECTORS OF ARH ADVANCED CARE, INC. FORM 990, PART VI, SECTION A, LINE 7B APPALACHIAN REGIONAL HEALTHCARE, INC. HAS THE POWER TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF ARH ADVANCED CARE, INC. FORM 990, PART VI, SECTION B, LINE 11B APPALACHIAN REGIONAL HEALTHCARE'S (ARH) DIRECTOR OF ACCOUNTING AND CFO BOTH REVIEW THE 990 PRIOR TO THE ARH BOARD REVIEW. THE ARH BOARD THEN REVIEWS THE 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL POLICIES ARE MAINTAINED IN POLICY MANAGEMENT SOFTWARE. A SECURE WEBSITE IS PROVIDED TO OFFICERS AND TRUSTEES FOR ANNUAL DISCLOSURES, AND IS MONITORED REGULARLY BY THE CHIEF LEGAL COUNSEL 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 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 SET THE RANGES AND THE PRESIDENT'S COMPENSATION. THE BOARD REVIEWS AND FINALIZES COMPENSATION AMOUNTS. THE CONSULTING FIRM FOLLOWS UP WITH A LETTER ATTESTING TO THE REASONABLENESS OF COMPENSATION. ARH ADVANCED CARE HAS DEVELOPED A PARTNERSHIP WITH MERCER GROUP TO EVALUATE EXECUTIVE COMPENSATION PLANS. FORM 990, PART VI, SECTION C, LINE 19 WHILE ARH ADVANCED CARE 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 OTHER OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 759,346. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 759,346. VENDED SERVICES: PROGRAM SERVICE EXPENSES 1,450,227. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,450,227. FORM 990, PART XII, LINE 2C: 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. APPALACHIAN REGIONAL HEALTHCARE INC 2260 EXECUTIVE DR LEXINGTON KY 40505 520795508 HEALTH CARE KY 501(C)(3) LINE 3 N/A 0 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 0 ARH TUG VALLEY HEALTH SERVICES INC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 822577178 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 0 ARH MARY BRECKINRIDGE HEALTH SERVICES INC 2260 EXECUTIVE DR LEXINGTON KY 40505 452696517 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1