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ARMSTRONG COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
ARMSTRONG COUNTY MEMORIAL HOSPITAL (EIN 25-0965237)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-11
IRS object ID
202221319349301617
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-11T08:49:45-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN250965237EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ARMSTRONG COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MATTHEW KOCIOLAInCareOfNm
Business Name ControlARMSBusinessNameControlTxt
Phone7245438618PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE NOLTE DRIVEAddressLine1Txt
CityKITTANNINGCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16201ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN I LEWISPersonNm
Person TitlePRESIDENT AND CEOPersonTitleTxt
Phone7245438181PhoneNum
Signature2022-03-01SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHN IPersonFirstNm
Person LastLEWISPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrian D ToddPreparerPersonNm
PTINP00422601PTIN
Phone4178658701PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN I LEWISPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE NOLTE DRIVEAddressLine1Txt
CityKITTANNINGCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16201ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$121,872,848GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ACMH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1874FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionTHE MISSION OF ARMSTRONG MEMORIAL HOSPITAL IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF ARMSTRONG AND NEIGHBORING COUNTIES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee1148TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$720,481TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$55,819NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,484,831PYContributionsGrantsAmt
CY Contributions Grants$6,178,688CYContributionsGrantsAmt
PY Program Service Revenue$103,717,732PYProgramServiceRevenueAmt
CY Program Service Revenue$112,646,989CYProgramServiceRevenueAmt
PY Investment Income$550,598PYInvestmentIncomeAmt
CY Investment Income$434,587CYInvestmentIncomeAmt
PY Other Revenue$1,543,616PYOtherRevenueAmt
CY Other Revenue$1,590,059CYOtherRevenueAmt
PY Total Revenue$108,296,777PYTotalRevenueAmt
CY Total Revenue$120,850,323CYTotalRevenueAmt
PY Grants And Similar Paid$10,410PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,301CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$57,690,160PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$62,471,997CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$44,438,467PYOtherExpensesAmt
CY Other Expenses$46,103,543CYOtherExpensesAmt
PY Total Expenses$102,139,037PYTotalExpensesAmt
CY Total Expenses$108,588,841CYTotalExpensesAmt
PY Revenues Less Expenses$6,157,740PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$12,261,482CYRevenuesLessExpensesAmt
Total Assets BOY$89,833,217TotalAssetsBOYAmt
Total Assets EOY$80,272,359TotalAssetsEOYAmt
Total Liabilities BOY$54,953,341TotalLiabilitiesBOYAmt
Total Liabilities EOY$33,250,839TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$34,879,876NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$47,021,520NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionACMH IS COMMITTED TO IMPROVING THE EMOTIONAL AND PHYSICAL HEALTH OF ITS PATIENTS THROUGH SUPERIOR CLINICAL CARE AND THE COMPASSIONATE MANAGEMENT OF ILLNESS AND DISABILITY.MissionDesc
Significant New Program SrvcYes (true)SignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$51,833,548ExpenseAmt
Revenue$73,647,945RevenueAmt
DescACMH HOSPITAL PROVIDES OUTPATIENT SERVICES SUCH AS RADIOLOGY, LABORATORY, EMERGENCY VISITS, AMBULATORY SURGERY, AND OTHER VARIOUS SERVICES. DURING THE FISCAL YEAR, TOTAL OUTPATIENT REGISTRATIONS WERE 200,897.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$16,502,925ExpenseAmt
Revenue$25,802,345RevenueAmt
DescACMH 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 3,719 AND PATIENT DAYS WERE 19,699.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$5,086,366ExpenseAmt
Revenue$5,429,312RevenueAmt
DescACMH 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 59,136. 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 583.59. SEE SCHEDULE O FOR MORE INFORMATION.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$621,905TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$13,301TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$7,767,387TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$74,044,744TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document75IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1148EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMATTHEW KOCIOLAPersonNm
Phone7245438618PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE NOLTE DRIVEAddressLine1Txt
CityKITTANNINGCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16201ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndKey EmployeeKeyEmployeeInd
JOHN I LEWIS
PRESIDENT AND CEO39.01.0Yes (X)Yes (X)$477,069$0$50,294
JAMES BACKSTROM MD
CHIEF MEDICAL OFFICER39.01.0Yes (X)Yes (X)$358,039$0$41,760
MATTHEW KOCIOLA
CFO, VP OF FINANCE39.01.0Yes (X)$265,137$0$46,690
JEFFREY DAVID
PHYSICIAN40.00.0$262,775$0$30,353Yes (X)
CHAD SHAFFER MD
DIRECTOR39.01.0Yes (X)$242,159$0$26,075
THOMAS LITZ
PHYSICIAN40.00.0$241,636$0$25,960Yes (X)
VICKY M LEO
PHYSICIAN40.00.0$244,622$0$11,543Yes (X)
JON R BELASCO
PHYSICIAN40.00.0$226,986$0$15,615Yes (X)
NICHOLE D GERACI
CHIEF OPERATING OFFICER40.00.0$205,566$0$26,723Yes (X)
ADAM AKERS
PHYSICIAN40.00.0$227,961$0$2,075Yes (X)
ANNE REMALEY
VP OF HUMAN RESOURCES40.00.0$181,831$0$31,804Yes (X)
MONA RUPERT
VP OF CLINICAL SERVICES40.00.0$182,294$0$8,295Yes (X)
DONALD TYLINSKI
DIRECTOR1.01.0Yes (X)$0$0$0
ELIZABETH WHITE
CHAIRMAN1.01.0Yes (X)Yes (X)$0$0$0
MARY A KRAULAND
DIRECTOR1.01.0Yes (X)$0$0$0
MEREDITH CHRISTY
DIRECTOR1.01.0Yes (X)$0$0$0
SAMUEL FRIEDE
DIRECTOR1.01.0Yes (X)$0$0$0
VOLKER ZAUN
SECRETARY / TREASURER1.01.0Yes (X)Yes (X)$0$0$0
W STEVEN DAVIS
VICE CHAIR1.01.0Yes (X)Yes (X)$0$0$0
SANDY BRADIGAN
DIRECTOR1.01.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,116,075TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$317,187TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K51IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CHILDREN'S COMMUNITY PED
11279 PERRY HWY ST 450WEXFORDPA15090PEDIATRIC$607,820
CONSILUM STAFFING LLC
6225 NORTH STATE HWY 161 ST 400IRVINGTX75038STAFFING$605,209
COMPHEALTH
PO BOX 972651DALLASTX75397PROF. SERVICES$448,544
BKD LLP
910 E ST LOUIS ST SUITE 200SPRINGFIELDMO65801AUDIT/TAX/CONSULTING$322,954
ARMSTRONG SECURITY INVESTIGATIONS
104 S WATER STKITTANNINGPA16201SECURITY$282,958
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
Related Organizations$175,000RelatedOrganizationsAmt
Government Grants$5,586,997GovernmentGrantsAmt
All Other Contributions$416,691AllOtherContributionsAmt
Noncash Contributions$69,087NoncashContributionsAmt
Total Contributions$6,178,688TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES621500$104,879,602$104,879,602
OTHER REVENUE900099$6,369,363$6,043,737$325,626
CAFETERIA722210$561,518$561,518
RENT FROM AFFILIATES623000$441,651$441,651
UNRELATED LAB SERVICES621500$394,855$394,855
FieldValueIRS element (for citing)
Total Program Service Revenue$112,646,989TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$232,091TotalRevenueColumnAmt
Exclusion$232,091ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$431,146RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$431,146RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$431,146TotalRevenueColumnAmt
Exclusion$431,146ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,166,348SecuritiesAmt
Other$58,673OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,015,797SecuritiesAmt
Other$6,728OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$150,551SecuritiesAmt
Other$51,945OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$202,496TotalRevenueColumnAmt
Exclusion$202,496ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescGAIN ON EQUITY INVESTEESDesc
Business800099BusinessCd
Total Revenue Column$1,158,913TotalRevenueColumnAmt
Exclusion$1,158,913ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,158,913OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$120,850,323TotalRevenueColumnAmt
Related Or Exempt Func Income$111,926,508RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$720,481UnrelatedBusinessRevenueAmt
Exclusion$2,024,646ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,301TotalAmt
Program Services$13,301ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,067,985TotalAmt
Program Services$1,062,762ProgramServicesAmt
Management And General$1,005,223ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$44,315,867TotalAmt
Program Services$33,092,316ProgramServicesAmt
Management And General$11,223,551ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,116,308TotalAmt
Program Services$88,898ProgramServicesAmt
Management And General$2,027,410ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,285,245TotalAmt
Program Services$1,119,847ProgramServicesAmt
Management And General$9,165,398ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,686,592TotalAmt
Program Services$2,789,105ProgramServicesAmt
Management And General$897,487ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$238,744TotalAmt
Management And General$238,744ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$164,709TotalAmt
Management And General$164,709ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$15,287TotalAmt
Management And General$15,287ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$12,871,819TotalAmt
Program Services$9,546,493ProgramServicesAmt
Management And General$3,325,326ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$281,261TotalAmt
Program Services$9,557ProgramServicesAmt
Management And General$271,704ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,625,669TotalAmt
Program Services$4,281,804ProgramServicesAmt
Management And General$1,343,865ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,085,678TotalAmt
Program Services$27,966ProgramServicesAmt
Management And General$1,057,712ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,232,257TotalAmt
Program Services$896,845ProgramServicesAmt
Management And General$1,335,412ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$59,902TotalAmt
Program Services$22,943ProgramServicesAmt
Management And General$36,959ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$68,897TotalAmt
Program Services$25,925ProgramServicesAmt
Management And General$42,972ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$118,329TotalAmt
Program Services$75,986ProgramServicesAmt
Management And General$42,343ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,215,549TotalAmt
Program Services$2,707,045ProgramServicesAmt
Management And General$1,508,504ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$916,364TotalAmt
Program Services$916,364ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$13,612,536$13,612,536
PROVIDER TAX$1,999,189$1,999,189
FOOD EXPENSES$664,104$89,114$574,990
LICENSES, DUES, SUBSCRIPTIONS$339,060$90,233$248,827

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,594,189TotalAmt
Program Services$1,576,515ProgramServicesAmt
Management And General$17,674ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$108,588,841TotalAmt
Program Services$74,044,744ProgramServicesAmt
Management And General$34,544,097ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$80,019BOYAmt
EOY$16,137EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$33,391,286BOYAmt
EOY$18,958,602EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,462,403BOYAmt
EOY$11,037,033EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,158,508BOYAmt
EOY$1,490,673EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,499,725BOYAmt
EOY$1,570,883EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$145,753,458LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$121,410,672LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$22,754,402BOYAmt
EOY$24,342,786EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,219,615BOYAmt
EOY$6,484,862EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$6,155,455BOYAmt
EOY$6,799,861EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$75,916BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$9,035,888BOYAmt
EOY$9,571,522EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$89,833,217BOYAmt
EOY$80,272,359EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,044,202BOYAmt
EOY$12,865,460EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$17,358,289BOYAmt
EOY$600,000EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,091,597BOYAmt
EOY$4,808,603EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,459,253BOYAmt
EOY$14,976,776EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$54,953,341BOYAmt
EOY$33,250,839EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$34,879,876BOYAmt
EOY$47,021,520EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$34,879,876BOYAmt
EOY$47,021,520EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$89,833,217BOYAmt
EOY$80,272,359EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$12,261,482ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$693,899NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$813,737OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$297,281OtherCostOrOtherBasisAmt
Book Value$297,281BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$49,238,465OtherCostOrOtherBasisAmt
Depreciation$38,126,073DepreciationAmt
Book Value$11,112,392BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$91,659,599OtherCostOrOtherBasisAmt
Depreciation$80,211,609DepreciationAmt
Book Value$11,447,990BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,558,113OtherCostOrOtherBasisAmt
Depreciation$3,072,990DepreciationAmt
Book Value$1,485,123BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$24,342,786TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

FieldValueIRS element (for citing)
Book Value$1,150,047BookValueAmt
Method ValuationCMethodValuationCd

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
CHART$4,331,141C
VANTAGE$1,318,673C
FieldValueIRS element (for citing)
Total Book Value Securities$6,799,861TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$8,446,502
DUE FROM 3RD PARTY$826,219
DUE FROM AFFILIATES$297,140
ACCRUED INTEREST$1,661
FieldValueIRS element (for citing)
Total Book Value Other Assets$9,571,522TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED PENSION LIABILITY$5,159,877
ESTIMATED INSURANCE LIABILITY$4,817,467
DUE TO 3RD PARTY$1,664,644
MEDICARE CONTRACT LIAB$3,334,788
FieldValueIRS element (for citing)
Total Liability$14,976,776TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$121,143,054TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$693,899NetUnrealizedGainsInvstAmt
Revenue Not Reported$693,899RevenueNotReportedAmt
Revenue Subtotal$120,449,155RevenueSubtotalAmt
Other Revenues Not Included$401,168OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$401,168RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$120,850,323TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$108,588,841TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$108,588,841ExpensesSubtotalAmt
Total Expenses Per Form990$108,588,841TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2UNCERTAIN 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 4BAMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 401,168 GRANTS FOR PROPERTY AND EQUIPMENT ACQUISITION

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$334,326TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$334,326NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,349,726TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,977,647DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,372,079NetCommunityBenefitExpnsAmt
Total Expense0.04030TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$204,208TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$132,741DirectOffsettingRevenueAmt
Net Community Benefit Expns$71,467NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,888,260TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,110,388DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,777,872NetCommunityBenefitExpnsAmt
Total Expense0.04410TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$40,253TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$40,253NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$139,478TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$139,478NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,152,155TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,622,241DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,529,914NetCommunityBenefitExpnsAmt
Total Expense0.02330TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$96,619TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$96,619NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,301TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,301NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,441,806TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,622,241DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,819,565NetCommunityBenefitExpnsAmt
Total Expense0.02600TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,330,066TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,732,629DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,597,437NetCommunityBenefitExpnsAmt
Total Expense0.07010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$2,692,522BadDebtExpenseAmt
Bad Debt Expense Attributable$298,062BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,350,268ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$12,168,683CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,818,415MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnfalseFinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ARMSTRONG COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE NOLTE DRIVEAddressLine1Txt
CityKITTANNINGCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16201ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.ACMH.ORGWebsiteAddressTxt
State License270901StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherSNU, REHAB, OB, PSYCHIATRIC, NEURO, UROLOGY, WITHDRAWALOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ARMSTRONG COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted20CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt20ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5COMMUNITY 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 7ACHNA URL: HTTPS://WWW.ACMH.ORG/CHNA
SCHEDULE H, PART V, SECTION B, LINE 10AIMPLEMENTATION STRATEGY URL: HTTPS://WWW.ACMH.ORG/CHNA
SCHEDULE H, PART V, SECTION B, LINE 11ADDRESSING IDENTIFIED NEEDS: ACMH IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENT CHNA AS FOLLOWS: 1. NEEDS RELATED TO THE HIGH RATE OF OBESITY IN ARMSTRONG COUNTY. ACMH HAS ALREADY BEGUN TO ADDRESS THIS NEED BY CONTRACTING WITH WILLIAM WHITE, PHD, TO ASSIST IN THE DEVELOPMENT OF A "CHOOSE HEALTH" PROGRAM. THE PROGRAM INCLUDES TRAINING "TRAINERS" TO HELP MOTIVATE MEMBERS OF THE COMMUNITY TO LOSE WEIGHT, BECOME STRONGER, AND ACHIEVE THEIR LIFE GOALS REGARDLESS OF THEIR AGE AND CO-MORBID CONDITIONS. 2. NEEDS RELATED TO SUBSTANCE ABUSE. ACMH HAS ALREADY BEGUN TO ADDRESS THIS NEED BY A. CO-DEVELOPING THE ARMOT PROGRAM TO IDENTIFY SUBSTANCE ABUSE AND GET PATIENTS INTO TREATMENT QUICKLY. (A COLLABORATION WITH THE ARMSTRONG/INDIANA/CLARION DRUG AND ALCOHOL COUNCIL.) B. THE DEVELOPMENT AND CONTINUING SUPPORT FOR THE ARMSTRONG COUNTY VETERANS' TREATMENT COURT. C. THE OPENING OF A FOUR-BED MEDICAL DETOXIFICATION UNIT. D. ACMH'S CONTINUING SUPPORT OF THE DRUGS KILL DREAMS PROGRAM. E. ACMH'S PARTNERSHIP WITH CHILDREN'S HOSPITAL OF PITTSBURGH FOUNDATION TO PARTICIPATE IN THE SMART CHOICES PROGRAM WHICH ADDRESSES SUBSTANCE ABUSE IN CHILDREN AND TEENS. F. A CONTINUATION OF THE DEVELOPMENT OF A PROGRAM FOR DRUG-ADDICTED PREGNANT WOMEN. (THIS WAS STARTED PRE-PANDEMIC, THEN TABLED.) 3. NEEDS RELATED TO MENTAL HEALTH, ACMH HAS BEGUN PLANS TO PROVIDE OUTPATIENT PROVIDER-BASED MENTAL HEALTH SERVICES. 4. NEEDS RELATED TO CHRONIC DISEASE MANAGEMENT AND PREVENTION - ACMH HAS ALREADY BEGUN TO ADDRESS THESE NEEDS THROUGH ACMH'S PARTICIPATION IN THE PENNSYLVANIA RURAL HEALTH MODEL, AND THE DEVELOPMENT OF COMPREHENSIVE TRANSFORMATION PLANS AS WELL IDENTIFIED ACTIONS INCLUSIVE BUT NOT LIMITED TO: A. COLLABORATIVE EFFORTS WITH LOCAL NURSING FACILITIES, B. THE IMPLEMENTATION OF REMOTE-MONITORING SYSTEMS IN PATIENTS' HOMES, C. THE ACMH PARTNERSHIP - "LIFE ARMSTRONG" D. THE PROVISION OF DIABETIC PATIENTS TEST KITS TO IDENTIFY FOOT ULCERS BEFORE THEY BECOME BAD ENOUGH TO REQUIRE HOSPITALIZATION. 5. NEEDS RELATED TO UNHEALTHY BEHAVIORS. ACMH WILL LOOK TO ADDRESS THESE NEEDS THROUGH THE "CHOOSE HEALTH" PROGRAM. 6. NEEDS RELATED TO PRIMARY CARE PROVIDER SHORTAGES. A. ACMH PLANS TO WORK WITH DUQUESNE UNIVERSITY MEDICAL SCHOOL TO PROVIDE PHYSICIAN ROTATIONS DURING 3RD AND 4TH YEAR MEDICAL SCHOOL AND FUTURE RESIDENCIES IN FAMILY PRACTICE. B. ACMH CONTINUES TO HIRE PHYSICIAN EXTENDERS WHO PROVIDE MANY PRIMARY CARE SERVICES. C. ACMH PLANS TO CONTACT HRSA TO DETERMINE IF ADDITIONAL AREAS IN ARMSTRONG COUNTY ARE NOW ELIGIBLE TO BE CLASSIFIED AS HEALTH PROFESSIONAL SHORTAGE AREAS. 7. NEEDS RELATED TO NURSE AND SOCIAL WORKER SHORTAGES. ACMH IS LOOKING INTO TRAINING "COMMUNITY EXTENDERS" --PEOPLE WHO CAN BE TRAINED TO PROVIDE CERTAIN CARE IN LIEU OF A NURSE OR SOCIAL WORKER. 8. NEEDS RELATED TO TRANSPORTATION TO/FROM HEALTHCARE AND WELLNESS SERVICE. ACMH IS WORKING WITH VANTAGE TO MITIGATE THIS NEED. NEEDS NOT BEING ADDRESSED: THE FOLLOWING NEEDS WERE NOT ADDRESSED, DUE TO A LACK OF ABILITY OF ACMH TO AFFECT CHANGE AND A DETERMINATION BY ACMH THAT OTHER COMMUNITY ORGANIZATIONS ARE WORKING TO ALREADY ADDRESS A NEED. 1. DRIVING DEATHS THAT HAD ALCOHOL INVOLVEMENT. THIS IS BEING ADDRESS BY THE STATE POLICE AND BY THE COUNTY THROUGH ITS DUI TASK FORCE. 2. LOW POST-SECONDARY EDUCATION RATE. ACMH DOES NOT HAVE THE ABILITY TO AFFECT CHANGE. 3. LOW FLU VACCINATION RATE AMONG MEDICARE FFS ENROLLEES. ACMH BELIEVES THAT THIS IS AN ABERRATION AS MOST MEDICARE ENROLLEES IN ARMSTRONG COUNTY HAVE MANAGED CARE PLANS SO THE FFS POPULATION IS SMALL AND THOUGHT TO BE TEMPORARY, AS PATIENTS WILL LIKELY MOVE TO A MANAGED CARE PLAN. 4. PREVENTION OF DRUG RELATED DEATHS. THIS IS BEING ADDRESSED BY THE ARMSTRONG/INDIANA/CLARION DRUG AND ALCOHOL COUNCIL, ARC MANOR AND OTHER COUNTY GOVERNMENTAL ORGANIZATIONS. 5. UNEMPLOYMENT. ACMH DOES NOT HAVE THE ABILITY TO AFFECT CHANGE. 6. NEEDS RELATED TO LOW RATES OF COLONOSCOPY AND PROSTATE SCREENINGS. ACMH BELIEVES THAT THIS RATE DECLINE WAS CAUSED BY THE FACT THAT THE AREA LOST ITS GASTROENTEROLOGY PROVIDERS AND WAS EXPERIENCING A SHORTAGE OF UROLOGY PROVIDERS, WHICH HAVE BEEN RESOLVED THROUGH RECENTLY ADDED MEDICAL STAFF.
SCHEDULE H, PART V, SECTION B, LINES 16A-CFAP, APPLICATION, AND PLS URL: HTTP://ACMH.ORG/BILLING-AND-INSURANCE#FINANCIALASSISTANCE
SCHEDULE H, PART V, SECTION B, LINE 16JTHE 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.
FieldValueIRS element (for citing)
Facility11FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
ARMSTRONG PRIMARY CARE CENTER
116 MAIN STLEECHBURGPA15656PRIMARY CARE, LAB DRAW, RADIOLOGY, PHYSICAL THERAPY
ACMH HEALTH PAVILION
205 5TH AVEFORD CITYPA16226OUTPATIENT PHYSICAL THERAPY, LAB DRAW
ARMSTRONG PRIMARY CARE CENTER ELDERTON
116 MAIN STELDERTONPA15736PRIMARY CARE, LAB DRAW, RADIOLOGY
ARMSTRONG PRIMARY CARE CENTER SOUTH BETH
102 SOUTH STNEW BETHLEHEMPA16242PRIMARY CARE, LAB DRAW
ARMSTRONG PRIMARY CARE CENTER RURAL VALL
10261 SR 85KITTANNINGPA16201PRIMARY CARE, LAB DRAW
ARMSTRONG PRIMARY CARE CENTER KITTANNING
260 S JEFFERSON STKITTANNINGPA16201PRIMARY CARE, LAB DRAW
ARMSTRONG OUTPATIENT IMAGING CENTER
87 GLADE PARK EASTKITTANNINGPA16201OUTPATIENT RADIOLOGY CENTER
COWANSVILLE HEALTH CENTER
882 EAST BRADY RDCOWANSVILLEPA16218LAB DRAW
ENDOCRINOLOGY ASSOCIATES
600 MEDICAL ARTS BUILDING SUITE 64KITTANNINGPA16201ENDOCRINOLOGY CLINIC
WEST HILLS PRIMARY CARE CENTER
300 MEDICAL ARTS BUILDING SUITE 300KITTANNINGPA16201PRIMARY CARE, LAB DRAW
NEUROLOGIC ASSOCIATES
500 MEDICAL ARTS BUILDING SUITE 51KITTANNINGPA16201NEUROLOGIC CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7COSTING 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 7GSUBSIDIZED 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 FPERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER FORM 990, PART IX, LINE 25.
SCHEDULE H, PART IICOMMUNITY 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 2BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 014-09 (TOPIC 606). UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2021. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
SCHEDULE H, PART III, SECTION A, LINE 3BAD 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 4BAD 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: PATIENT ACCOUNTS RECEIVABLE REFLECTS THE OUTSTANDING AMOUNT OF CONSIDERATION TO WHICH THE HOSPITAL EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS) AND OTHERS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S RESPONSIBILITY FOR CO-PAYS, COINSURANCE AND DEDUCTIBLES IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED.
SCHEDULE H, PART III, SECTION B, LINE 8COMMUNITY 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 9BCOLLECTION 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 2NEEDS 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 FY2021 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 3PATIENT 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 4COMMUNITY 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 5PROMOTION 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 6AFFILIATED 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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (true)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CHAD SHAFFER MD
DIRECTOR$219,851$0$22,308$0$0$0$1,875$0$24,200$0$268,234$0$0$0
JAMES BACKSTROM MD
CHIEF MEDICAL OFFICER$357,789$0$250$0$0$0$20,263$0$21,497$0$399,799$0$0$0
JOHN I LEWIS
PRESIDENT AND CEO$400,457$0$12,712$0$63,900$0$27,113$0$23,181$0$527,363$0$0$0
MATTHEW KOCIOLA
CFO, VP OF FINANCE$250,928$0$12,712$0$1,497$0$44,996$0$1,694$0$311,827$0$0$0
JEFFREY DAVID
PHYSICIAN$262,525$0$250$0$0$0$2,625$0$27,728$0$293,128$0$0$0
VICKY M LEO
PHYSICIAN$243,405$0$1,217$0$0$0$2,625$0$8,918$0$256,165$0$0$0
THOMAS LITZ
PHYSICIAN$241,386$0$250$0$0$0$1,500$0$24,460$0$267,596$0$0$0
JON R BELASCO
PHYSICIAN$226,736$0$250$0$0$0$1,500$0$14,115$0$242,601$0$0$0
ADAM AKERS
PHYSICIAN$227,711$0$250$0$0$0$1,500$0$575$0$230,036$0$0$0
NICHOLE D GERACI
CHIEF OPERATING OFFICER$191,696$0$12,712$0$1,158$0$7,832$0$18,891$0$232,289$0$0$0
ANNE REMALEY
VP OF HUMAN RESOURCES$167,295$0$12,712$0$1,824$0$9,777$0$22,027$0$213,635$0$0$0
MONA RUPERT
VP OF CLINICAL SERVICES$27,340$0$4,519$0$150,435$0$6,054$0$2,241$0$190,589$0$125,012$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4BSUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND RECEIVED THE FOLLOWING 457(F) CONTRIBUTIONS OR DISTRIBUTIONS: $54,300 JOHN I. LEWIS $29,826 MATTHEW KOCIOLA 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 & 6ACONTINGENT 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.

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution6ContributionCnt
Noncash Contributions Rpt F990$69,087NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART I, COLUMN (B)FormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTIONS: THE NUMBER IN COLUMN B REFLECTS THE NUMBER OF CONTRIBUTIONS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (20 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1ORGANIZATION'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 2SIGNIFICANT PROGRAM SERVICES NOT LISTED ON THE PRIOR FORM 990: ACMH PULMONARY OFFERS A WIDE RANGE OF CRITICAL CARE & PULMONARY SERVICES TO PATIENTS SUFFERING FROM LUNG CONDITIONS. ACMH ACUTE REHAB OFFERS A COMPREHENSIVE, MULTIDISCIPLINARY THERAPY PROGRAM. ALSO INFECTIOUS DISEASE SERVICES AND RURAL HEALTH SERVICES HAVE BEEN ADDED.
FORM 990, PART III, LINE 4PROGRAM 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 $1,050,348 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 4DOTHER 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 2BUSINESS 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, LINE 4SIGNIFICANT CHANGES MADE TO BYLAWS: THE BOARD MAY NOW APPOINT TO THE MEDICAL STAFF PHYSICIANS OR OTHER PRACTITIONERS MEETING THE MINIMUM QUALIFICATIONS SET OUT IN THE MEDICAL STAFF GOVERNING DOCUMENTS AND MAY ASSIGN CLINICAL PRIVILEGES TO THEM. APPOINTMENTS SHALL BE RENEWABLE IN ACCORDANCE WITH THE REAPPOINTMENT PROCEDURES SET OUT IN THE MEDICAL STAFF GOVERNING DOCUMENTS. THE BOARD RETAINS THE DISCRETION TO TAKE ANY ACTION IT DEEMS IN THE BEST INTEREST OF THE HOSPITAL WITH RESPECT TO RECOMMENDATIONS FROM THE MEDICAL STAFF CONCERNING THE APPOINTMENT, REAPPOINTMENT, CLINICAL PRIVILEGES OR PROFESSIONAL REVIEW ACTIONS RELATING TO ANY INDIVIDUAL, WHETHER RECOMMENDED BY THE MEDICAL STAFF OR TAKEN BY THE BOARD ON ITS OWN INITIATIVE. IF THE BOARD DISAGREES WITH A RECOMMENDATION OF THE MEDICAL BOARD, THE BOARD WILL DESIGNATE AN INDIVIDUAL TO DISCUSS THE MATTER WITH THE PRESIDENT OF THE MEDICAL STAFF. WHENEVER THE BOARD MAKES A DETERMINATION THAT WOULD ENTITLE AN INDIVIDUAL TO A HEARING UNDER THE MEDICAL STAFF GOVERNING DOCUMENTS THE BOARD WILL PROMPTLY SEND SPECIAL NOTICE TO THE AFFECTED INDIVIDUAL. HEARINGS WILL BE CONDUCTED UNDER THE PROCEDURES AS MAY BE ADOPTED BY THE BOARD WHICH ARE CONSISTENT WITH THE DUE PROCESS PROCEDURES SET FORTH IN THE HEALTH CARE QUALITY IMPROVEMENT ACT. NO OTHER PERSON EXCEPT THOSE SO AUTHORIZED MAY BE ELIGIBLE FOR MEDICAL STAFF APPOINTMENT OR CLINICAL PRIVILEGES AND/OR EXERCISE CLINICAL PRIVILEGES TO PERFORM THE SPECIFIED SERVICES AT THE HOSPITAL. IF ANY CONTRACT WOULD HAVE THE EFFECT OF RENDERING AN INDIVIDUAL CURRENTLY APPOINTED TO THE MEDICAL STAFF OR GRANTED CLINICAL PRIVILEGES INELIGIBLE FOR THE EXERCISE OF CLINICAL PRIVILEGES OR REAPPOINTMENT, THAT INDIVIDUAL SHALL RECEIVE WRITTEN NOTICE OF SUCH ACTION AND SHALL BE PROVIDED AN OPPORTUNITY TO MEET WITH A COMMITTEE DESIGNATED BY THE BOARD AT A TIME AND PURSUANT TO SUCH PROCEDURES AS THE BOARD SHALL ADOPT. THE INDIVIDUAL SHALL NOT BE ENTITLED TO ANY OTHER PROCEDURAL RIGHTS WITH RESPECT TO THE DECISION OR THE EFFECT OF THE CONTRACT ON HIS OR HER ELIGIBILTY FOR REAPPOINTMENT. THE HOSPITAL MAY LIMIT PHYSICIANS ELIGIBLE TO PROVIDE EMERGENCY DEPARTMENT CALL COVERAGE TO EMPLOYEES OF THE HOSPITAL OR ITS AFFILIATES OR PHYSICIANS UNDER CONTRACT TO PROVIDE CALL COVERAGE. SUCH DECISIONS MAY BE MADE BY THE CEO AT HIS OR HER DISCRETION AND SHALL BE FINAL AND NOT SUBJECT TO APPEAL. THE EXCLUSIVE ARRANGEMENTS DO NOT CONSTITUTE PEER REVIEW AND DO NOT ADVERSELY AFFECT THE CLINICAL PRIVILEGES OR MEDICAL STAFF APPOINTMENT OF PRACTITIONERS WHO ARE NOT PARTY TO EXCLUSIVE ARRANGEMENTS. THE BOARD MAY IMPOSE A MORATORIUM ON ACCEPTING NEW APPLICATIONS OR PRE-APPLICATIONS FOR MEDICAL STAFF APPOINTMENT OR CLINICAL PRIVILEGES FOR A LIMITED PERIOD OF TIME IN ANY SPECIALTY WHERE SUCH EXCLUSIVE ARRANGEMENTS MAY BE UNDER CONSIDERATION.
FORM 990, PART VI, SECTION A, LINES 6, 7A & 7BMEMBERS/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 11BREVIEW 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 12CCONFLICT 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 & 15BCOMPENSATION 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 MARCH 2021.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT 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 ABOARD 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 6ARENTAL 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 9OTHER CHANGES IN NET ASSETS: $ 4,923,195 CHANGE IN DEFINED BENEFIT PENSION PLAN (5,736,932) TRANSFER TO AFFILIATES -------------- $ ( 813,737)
FORM 990 PART IX LINE 11GDESCRIPTION:OUTSIDE SERVICES TOTAL FEES:7504442
FORM 990 PART IX LINE 11GDESCRIPTION:MAINTENANCE & SRVC CONTRACTS TOTAL FEES:2562908
FORM 990 PART IX LINE 11GDESCRIPTION:PURCHASED PHYSICIAN SERVICES TOTAL FEES:2006546
FORM 990 PART IX LINE 11GDESCRIPTION:COLLECTION FEES TOTAL FEES:390052
FORM 990 PART IX LINE 11GDESCRIPTION:MEDICAL DIRECTOR FEES TOTAL FEES:335000
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING FEES TOTAL FEES:72871

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1ARMSTRONG OUTPATIENT IMAGING LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line187 GLADE PARK EASTAddressLine1Txt
CityKITTANNINGCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16201ZIPCd
FieldValueIRS element (for citing)
EIN030492975EIN
Primary ActivitiesRADIOLOGYPrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ACMH HOSPBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ACMH PHYSICIAN SERVICES
ONE NOLTE DRIVEKITTANNINGPA16201204648195PRIMARY CAREPA501(C)33ACMHfalse
ARMSTRONG HEALTH & EDUCATION FOUNDATION
ONE NOLTE DRIVEKITTANNINGPA16201251655867FOUNDATIONPA501(C)312A IACMHfalse
ARMSTRONG CENTER FOR MEDICINE & HEALTH
ONE NOLTE DRIVEKITTANNINGPA16201204648477PARENT CORP.PA501(C)310NAfalse
GLADE RUN MEDICAL ASSOCIATES INC
ONE NOLTE DRIVEKITTANNINGPA16201264750523PHYSICIAN PRAPA501(C)312A IACMHfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ARMSCARE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE NOLTE DRAddressLine1Txt
CityKITTANNINGCityNm
State AbbreviationPAStateAbbreviationCd
ZIP16201ZIPCd
FieldValueIRS element (for citing)
EIN251495691EIN
Primary ActivitiesDURABLE MED EQUIPPrimaryActivitiesTxt
Legal Domicile StatePALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ACMHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CORPEntityTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd