2021-05-12T14:30:16-05:00 2020-06-30 271235638 MCM CPAS & ADVISORS LLP 462 S FOURTH ST SUITE 2600 LOUISVILLE KY 402023445 990 2019-07-01 520795508 APPALACHIAN REGIONAL HEALTHCARE APPA 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 DANNY HARRIS CFO/VP FISCAL SERVICES 8592262440 2021-04-26 1 ELEANOR A LIVINGSTON CPA MST P00226461 5027491900 2021-04-26 2019 2022-09-23 18:48:47Z JOSEPH GROSSMAN 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 794025984 0 X WWW.ARH.ORG X 1963 KY TO PROVIDE CENTRAL APPALACHIA AN ABUNDANCE OF HEALTHCARE AND COMMUNITY-ORIENTED SERVICES THROUGH ITS HOSPITAL, CLINICS AND HOME HEALTH OPERATIONS AS WELL AS COMMUNITY OUTREACH SERVICES. 17 17 6291 200 11523819 0 1700290 34328570 751019497 736665433 12200393 12841022 13243378 9793902 778163558 793628927 696417 750417 0 0 376923792 374448378 0 0 288188 374107099 382454789 751727308 757653584 26436250 35975343 874022382 1013172338 618721464 765469185 255300918 247703153 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. 0 0 663114608 750417 732348581 APPALACHIAN REGIONAL HEALTHCARE (ARH), THE HEALTHCARE SYSTEM OF APPALACHIA, AND RANKED AS ONE OF THE TOP 10 EMPLOYERS IN KENTUCKY BY FORBES MAGAZINE, IS A NOT-FOR-PROFIT HEALTH SYSTEM OPERATING 13 HOSPITALS (9 OF WHICH ARE INCLUDED ON THIS RETURN) IN BARBOURVILLE, HAZARD, HARLAN, HYDEN, MARTIN, MCDOWELL, MIDDLESBORO, PRESTONSBURG, WEST LIBERTY, WHITESBURG AND SOUTH WILLIAMSON IN KENTUCKY AND BECKLEY AND HINTON IN WEST VIRGINIA, AS WELL AS MULTI-SPECIALTY PHYSICIAN PRACTICES, HOME HEALTH AGENCIES, HOME MEDICAL EQUIPMENT STORES AND RETAIL PHARMACIES. ARH EMPLOYS MORE THAN 6,000 PEOPLE WITH AN ANNUAL PAYROLL AND BENEFITS OF $330 MILLION GENERATED INTO OUR LOCAL ECONOMIES. ARH ALSO HAS A NETWORK OF MORE THAN 600 ACTIVE AND COURTESY MEDICAL STAFF MEMBERS. ARH IS THE LARGEST PROVIDER OF CARE AND SINGLE LARGEST EMPLOYER IN SOUTHEASTERN KENTUCKY AND THE THIRD LARGEST PRIVATE EMPLOYER IN SOUTHERN WEST VIRGINIA, AND IS CONSISTENTLY RECOGNIZED FOR ITS MEDICAL EXCELLENCE.IN THE PAST YEAR, ARH KEPT PATIENT CARE AND SAFETY AT THE FOREFRONT BY COMPLETING THE LAUNCH OF THE MEDITECH ELECTRONIC MEDICAL RECORDS SYSTEM AT ALL LOCATIONS THROUGHOUT KENTUCKY AND WEST VIRGINIA. TWO OF ARH'S HOME HEALTH SERVICES AGENCIES WERE RECOGNIZED BY HOMECARE ELITE, AN ANNUAL COMPILATION OF THE MOST SUCCESSFUL HOME CARE PROVIDERS IN THE UNITED STATES. THIS MARKET-LEADING REVIEW FROM ABILITY NETWORK AND DECISIONHEALTH BASED ON QUALITY OUTCOME AND PROCESS MEASURES, DECIDED BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES.SEVERAL ARH HOSPITALS WERE AMONG THOSE IN ACEP HONORS FOR EMERGENCY DEPARTMENTS FOR IMPROVING OUTCOMES OF OPIOIDS, SEPSIS, AND CHEST PAIN. BARBOURVILLE ARH HOSPITAL, HAZARD ARH REGIONAL MEDICAL CENTER, MARY BRECKINRIDGE ARH HOSPITAL, TUG VALLEY ARH REGIONAL MEDICAL CENTER AND WHITESBURG ARH HOSPITAL WERE THE ONLY HOSPITAL EMERGENCY DEPARTMENTS IN KENTUCKY TO BE NAMED TO THE EMERGENCY QUALITY NETWORK (E-QUAL) HONOR ROLL FOR LEADING THE WAY FOR THE QUALITY OF CARE THEY PROVIDE TO EMERGENCY PATIENTS.IN SEPTEMBER, THE WEST VIRGINIA HEALTH CARE AUTHORITY ISSUED A DECISION APPROVING BECKLEY ARH HOSPITAL'S CERTIFICATE OF NEED APPLICATION TO EXPAND ADVANCED CARDIAC SERVICES GIVING HEART ATTACK PATIENTS MORE ACCESS TO LIFE-SAVING INTERVENTIONAL PROCEDURES LOCALLY. THE NEW MEDICAL PROCEDURE--PERCUTANEOUS CORONARY INTERVENTION OR PCI--IS A NON-SURGICAL, THERAPEUTIC PROCEDURE THAT OPENS A BLOCKED OR NARROW ARTERY TO RESTORE BLOOD FLOW. THE PROCEDURE USES A CATHETER (A THIN FLEXIBLE TUBE) TO PLACE A STENT TO OPEN UP BLOOD VESSELS IN THE HEART THAT HAVE BEEN NARROWED BY PLAQUE BUILDUP, A CONDITION KNOWN AS ATHEROSCLEROSIS.IN THE FALL, THE NORTON HEALTHCARE/UK HEALTHCARE - STROKE CARE NETWORK RECOGNIZED MIDDLESBORO ARH HOSPITAL AS A "RISING STAR" FOR ITS WORK IN IMPROVING STROKE CARE FOR ITS PATIENTS. AT THE NETWORK'S ANNUAL SUMMIT IN LEXINGTON, DR. LARRY GOLDSTEIN, INTERIM DIRECTOR OF THE STROKE CARE NETWORK, PRESENTED MIDDLESBORO ARH HOSPITAL WITH THEIR AWARD, AND CONGRATULATED THEM FOR THEIR ACCOMPLISHMENTS. THE "RISING STAR" AWARD IS GIVEN TO THOSE WHO DEMONSTRATE REMARKABLE PROGRAM DEVELOPMENT, EVIDENCE-BASED COMPONENTS IMPLEMENTED, AND DISEASE SPECIFIC CERTIFICATION. IT WAS NOTED THAT MIDDLESBORO ARH HOSPITAL "MADE REMARKABLE PROGRESS IN THEIR WORK TO ENHANCE STROKE CARE FOR ITS PATIENTS AND ACHIEVED CERTIFICATION THROUGH DET NORSKE VERITAS (DNV) AS AN ACUTE STROKE READY HOSPITAL. IN NOVEMBER, THE COMMISSION ON CANCER (COC), A QUALITY PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS (ACS) GRANTED THREE-YEAR ACCREDITATION TO THE CANCER PROGRAM AT HARLAN ARH HOSPITAL. TO EARN VOLUNTARY COC ACCREDITATION, A CANCER PROGRAM MUST MEET 34 COC QUALITY CARE STANDARDS, BE EVALUATED EVERY THREE YEARS THROUGH A SURVEY PROCESS AND MAINTAIN LEVELS OF EXCELLENCE IN THE DELIVERY OF COMPREHENSIVE PATIENT-CENTERED CARE. THE COC ACCREDITATION PROGRAM PROVIDES THE FRAMEWORK FOR HARLAN ARH HOSPITAL TO IMPROVE ITS QUALITY OF PATIENT CARE THROUGH VARIOUS CANCER-RELATED PROGRAMS THAT FOCUS ON THE FULL SPECTRUM OF CANCER CARE INCLUDING PREVENTION, EARLY DIAGNOSIS, CANCER STAGING, OPTIMAL TREATMENT, REHABILITATION, LIFE-LONG FOLLOW-UP FOR RECURRENT DISEASE, AND END-OF-LIFE CARE. REPORTS. THESE REPORTS HELP COC FACILITIES WITH THEIR QUALITY IMPROVEMENT EFFORTS.ARH STRIVES NOT ONLY TO PROVIDE ITS COMMUNITIES EXCEPTIONAL MEDICAL CARE, BUT ALSO TO BUILD PUBLIC AWARENESS OF WARNING SIGNS AND TIPS FOR PREVENTION OF COMMON HEALTH CONDITIONS IN OUR AREA THROUGH FREE EDUCATIONAL SESSIONS. DURING MANY OF THESE EDUCATIONAL EVENTS, FREE HEALTH SCREENINGS ARE OFFERED TO FURTHER IMPROVE THE HEALTH OF THE RESIDENTS ARH SERVES. ARH STRONGLY PROMOTES THE IMPORTANCE OF PREVENTATIVE HEALTH SCREENINGS AND EACH YEAR ARH FACILITIES PROVIDE A NUMBER OF FREE ROUTINE HEALTH SCREENINGS. TO ENCOURAGE WOMEN TO GET ANNUAL SCREENING MAMMOGRAMS, EACH YEAR ARH ALSO OFFERS DISCOUNTED MAMMOGRAM SCREENINGS DURING OCTOBER'S BREAST CANCER AWARENESS MONTH, WHICH COINCIDE WITH AWARENESS EVENTS HELD THROUGHOUT THE MONTH. ARH HAS CONTINUED ITS WORK TO EDUCATE THE REGION'S YOUTH ABOUT THE IMPORTANCE OF PHYSICAL FITNESS TO GOOD HEALTH AND KEEPS OUR SENIORS HEALTHY THROUGH A SENIOR WELLNESS PROGRAM. ADDITIONALLY, ARH HEADED UP SEVERAL OTHER YOUTH-RELATED OUTREACH INITIATIVES INCLUDING CONDUCTING SPECIAL AWARENESS EVENTS AT SEVEN HIGH SCHOOLS AND IMPACTING MORE THAN 10,000 STUDENTS IN OUR COMMUNITIES RELATED TO THE OPIOID EPIDEMIC AND MAKING HEALTHIER LIFE CHOICES. IN ABUNDANCE OF CAUTION TO PROTECT ARH PATIENTS, EMPLOYEES, AND COMMUNITIES FROM THE POTENTIAL SPREAD OF COVID-19, ARH CANCELLED IN-PERSON COMMUNITY EVENTS STARTING IN FEBRUARY 2020 THROUGH THE REST OF THE YEAR. ARH FOCUSED ON PROVIDING COVID-19 EDUCATION TO ITS PATIENTS, EMPLOYEES, AND COMMUNITIES VIA ITS WEBSITE, SOCIAL MEDIA PAGES, ONLINE ZOOM MEETINGS, AND A TOLL-FREE NUMBER. ARH ALSO PROVIDED COVID-19 SCREENINGS AT ITS HOSPITALS AND CLINICS SYSTEM-WIDE.DURING THE COVID-19 PANDEMIC, ARH HAS BEEN AT THE FOREFRONT OF RESPONSE, TREATMENT, AND PREVENTION IN KENTUCKY. WE HAVE:-CREATED AND MAINTAINED A LONG TERM ARCHER CLINIC TESTING SITE LOCATION, INCLUDING THE ESTABLISHMENT OF DRIVE-THRU CLINICS-BEEN CHOSEN AS EMERGENCY MANAGEMENT'S REGION 8 LAB TESTING HUB SITE FOR THE STATE'S GRAVITY LAB PROJECT, OFTEN PROCESSING AS MANY AS 200 TESTS PER DAY-UTILIZED TELEHEALTH AND CURB-SIDE SERVICES FOR THE SAFETY OF OUR PATIENTS-ENFORCED NEW POLICIES FOR ALL VISITORS AND EMPLOYEES, INCLUDING DAILY SCREENING BEFORE ENTRY, MASK ENFORCEMENT, QUARANTINE AFTER TRAVEL, AND COVID-19 TESTING FOR ALL NEW AND RETURNING STAFF-UTILIZED A VAST FOLLOWING ON SOCIAL MEDIA TO EDUCATE AND SPREAD COVID-19 MESSAGING DAILY 663114608 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 417 0 1 6291 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X DANNY HARRIS 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 JAMEEL A BUTT GENERAL SURGEON 40.00 X 1009709 0 7456 JOSEPH L GROSSMAN PRESIDENT/CEO 30.00 10.00 X 792333 0 65652 DONNIE R STACY RADIATION ONCOLOGIST 40.00 X 786008 0 23652 JAMES H SHOPTAW CARDIOVASCULAR SURGEON 40.00 X 686506 0 42652 ZOUHAIR KABBARA FAMILY PHYSICIAN 40.00 X 693161 0 14794 ASHOK PATNAIK CARDIOLOGIST 40.00 X 665108 0 23652 PAUL V MILES COO/VP OPERATIONS 40.00 X 326613 0 65384 MARIA BRAMAN CMO/VP MEDICAL AFFAIRS 40.00 X 338675 0 42652 BOBBY RICK KING SECRETARY 35.00 5.00 X 301041 0 57997 DANNY M HARRIS TREASURER 30.00 10.00 X 316259 0 33793 HOLLIE P HARRIS VP CORPORATE STRATEGY 40.00 X 264263 0 48828 BESSIE ELLEN WRIGHT VP AND CHIEF NURSING OFFIC 40.00 X 181791 0 32517 JEFFREY B HOLLON TRUSTEE 3.00 X 0 0 0 GREG COUCH SEC'Y/TREAS 3.00 X 0 0 0 RANDALL EVANS DVM TRUSTEE 5.00 X 0 0 0 TAD MYRE TRUSTEE 3.00 X 0 0 0 JIM HART TRUSTEE 3.00 X 0 0 0 BART FRANCIS TRUSTEE 3.00 X 0 0 0 BROCK LITTERAL TRUSTEE 3.00 X 0 0 0 DUANNE THOMPSON CHAIR 3.00 X 0 0 0 JULIE ROSE AKEMON VICE CHAIR 3.00 X 0 0 0 ONZIE SIZEMORE TRUSTEE 3.00 X 0 0 0 JOANN ANDERSON TRUSTEE 3.00 X 0 0 0 KEN ALLMAN TRUSTEE 5.00 X 0 0 0 BONITA COMPTON TRUSTEE 3.00 X 0 0 0 ANDREA MASSEY TRUSTEE 3.00 X 0 0 0 MIKE RUST TRUSTEE 3.00 X 0 0 0 JOANNA SANTIESTEBAN MD TRUSTEE 3.00 X 0 0 0 GREG WILSON TRUSTEE 4.00 X 0 0 0 6361467 0 459029 254 0 1 0 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA ST OMAHA NE 68154 CONTRACT NURSES 24620449 LABORATORY CORP OF AMERICA 1477 YORK COURT BURLINGTON NC 27215 LABORATORY SERVICES 15203603 CONEXUS MEDSTAFF LLC 12141 WICKCHESTER LANE HOUSTON TX 77079 CONTRACT NURSES 13586728 TRIANGLE ANESTHESIA GROUP PSC 3320 TATES CREEK ROAD STE 100 LEXINGTON KY 40502 ANESTHESIA MEDICAL GROUP 11427423 CARDIOSOLUTION LLC 4675 CORNELL ROAD CINCINNATI OH 45241 CARDIOVASCULAR STAFFING 6735523 136 33030257 1298313 34328570 PATIENT REVENUES 621110 683601651 683601651 PHARMACY/LAB/LAUNDRY 812300 46875752 40990959 5884793 HOSPITAL RATE IMPROVEM 900099 6075108 6075108 RECORD TRANSCRIPT FEES 900099 112922 112922 736665433 10224873 10224873 988410 0 988410 988410 988410 3013206 0 397057 3013206 -397057 2616149 2616149 DME SALES 900099 4662941 4401036 261905 MISC. INCOME 900099 1395273 1237990 157283 CAFETERIA INCOME 900099 1174904 1174904 1572374 1567941 4433 8805492 793628927 732348581 11523819 15427957 750417 750417 2540319 2540319 285346461 252072852 33107818 165791 11596924 10188522 1400718 7684 59109310 51277749 7794475 37086 15855364 13570550 2275251 9563 1921888 107111 1814777 259778 14478 245300 73560152 61607023 11953129 1712450 1586851 113589 12010 11258786 4394228 6858348 6210 8395253 8025182 369774 297 11080013 10215488 862041 2484 568257 230602 337619 36 457428 331992 125436 6192120 1082260 5109860 25178210 21745875 3432335 12432910 12198741 234169 MEDICAL SUPPLIES 120878367 120878367 BAD DEBT 80009915 79987540 22375 TAXES & LICENSES 10628919 1643813 8985106 EQUIPMENT RENTAL AND MA 9897222 1693674 8203424 124 8023121 9511293 -1535075 46903 757653584 663114608 94250788 288188 20681714 0 84728916 159489153 94845924 73285380 6983366 2565568 14620327 18803813 10688447 45139090 662508209 420870101 239979656 241638108 397220909 418655666 752036 666536 900000 900000 2621087 52029024 874022382 1013172338 118433425 119158853 2657217 2597343 17162829 11472557 193158241 188031913 287309752 444208519 618721464 765469185 X 255302382 247704617 -1464 -1464 255300918 247703153 874022382 1013172338 X 35975343 14448077 -58021185 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 99645 1 23713 123358 0 PART II-B, LINE 1: ARH IS A MEMBER OF VARIOUS HOSPITAL ASSOCIATIONS. THE APPROPRIATE PERCENTAGE OF DUES PAID TO THE ORGANIZATIONS ALLOCABLE TO LOBBYING ACTIVITIES ARE ALSO INCLUDED. ARH HOLDS ON RETAINER CONSULTANTS TO ASSIST WITH GOVERNMENT AND PUBLIC RELATIONS IN REGARDS TO DEVELOPMENT OF LEGISLATURE, RELATED RESEARCH, AND OTHER RELEVANT ACTIVITIES. 4748137 4748137 291593202 201599699 89993503 222119516 180916524 41202992 144047354 38353878 105693476 241638108 LIFE INSURANCE CONTRACTS 252450 PREPAID RECRUITING EXPENSE 2230129 INTERCOMPANY RECEIVABLE 49546445 52029024 MEDICARE & MEDICAID ESTIMATED SETTLEMENTS 201838632 ACCRUED PENSION COST 168778816 RESERVE FOR SELF-INSURANCE 48144811 PHYSICIAN COMMITMENTS 567283 DUE TO PATIENTS 19220027 BOND INTEREST PAYABLE 1652050 CAPITAL LEASE OBLIGATIONS 3644765 SERP PAYABLE 362135 444208519 X PART X, LINE 2: THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. HOWEVER, THE CORPORATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. GAAP REQUIRES THE CORPORATION TO EVALUATE ITS TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND HAS CONCLUDED THAT THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 1 X 1 X 1 X 100.000000000000 1 1 0 1 1 13371829 9210045 4161784 0.00550 201009431 155996761 45012670 0.05940 214381260 165206806 49174454 0.06490 2121 31905 1869104 1869104 0.00250 1327999 1327999 0.00180 2121 31905 3197103 3197103 0.00430 2121 31905 217578363 165206806 52371557 0.06920 1 24 84 6522 6522 0.00000 248 46012 211255 211255 0.00030 44 691 2587 2587 0.00000 46 1261 1720 1720 0.00000 767 24418 247962 247962 0.00030 40 3768 14013 14013 0.00000 1170 76234 484059 484059 0.00060 1 97473129 17287061 136712923 154528061 -17815138 X 1 1 1 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCI CONDO OWNER 0.61490 0.38510 2 WHITESBURG PHYSICIAN OFFICE BUILDING LLC CONDO OWNER 0.28130 0.71870 9 1 HAZARD ARH REGIONAL MEDICAL CENTER 100 MEDICAL CENTER DRIVE HAZARD KY 41701 X X X X A 2 BECKLEY ARH HOSPITAL 306 STANAFORD ROAD BECKLEY WV 25801 X X X A 3 HARLAN ARH HOSPITAL 81 BALL PARK ROAD HARLAN KY 40831 X X X A 4 WHITESBURG ARH HOSPITAL 240 HOSPITAL ROAD WHITESBURG KY 41858 X X X A 5 TUG VALLEY ARH REGIONAL MEDICAL CENTER 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 X X X A 6 MIDDLESBORO ARH HOSPITAL 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 X X X A 7 MCDOWELL ARH HOSPITAL ROUTE 122 BOX 247 MCDOWELL KY 41647 X X X X A 8 MORGAN COUNTY ARH HOSPITAL 476 LIBERTY ROAD WEST LIBERTY KY 41472 X X X X A 9 SUMMERS COUNTY ARH HOSPITAL 115 SUMMERS HOSPITAL ROAD HINTON WV 25951 X X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTPS://WWW.ARH.ORG/CHNA/ X 1 18 1 HTTPS://WWW.ARH.ORG/CHNA/ 0 1 X 100.000000000000 200.000000000000 X 1 1 X X X X 1 X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ X X X X X 1 X X 0 X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: HAZARD ARH REGIONAL MEDICAL CENTER, - FACILITY 3: HARLAN ARH HOSPITAL, - FACILITY 2: BECKLEY ARH HOSPITAL, - FACILITY 5: TUG VALLEY ARH REGIONAL MEDICAL CENTER, - FACILITY 4: WHITESBURG ARH HOSPITAL, - FACILITY 6: MIDDLESBORO ARH HOSPITAL, - FACILITY 8: MORGAN COUNTY ARH HOSPITAL, - FACILITY 7: MCDOWELL ARH HOSPITAL, - FACILITY 9: SUMMERS COUNTY ARH HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: A COMMUNITY STEERING COMMITTEE PROVIDED GUIDANCE OVER THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN EACH OF ARH'S COMMUNITIES. THIS STEERING COMMITTEE WAS MADE UP OF REPRESENTATIVES FROM VARIOUS ORGANIZATIONS AND AGENCIES THROUGHOUT EACH HOSPITAL'S SERVICE AREA. IN PARTICULAR, SOME OF THE COMMITTEE MEMBERS REPRESENTED THE LOCAL HEALTH DEPARTMENT, SENIOR SERVICES, SCHOOL SYSTEM, SOCIAL SERVICE ORGANIZATIONS, AND EMERGENCY MANAGEMENT. THESE INDIVIDUALS ASSISTED WITH DISTRIBUTING SURVEYS AND ORGANIZING FOCUS GROUPS THROUGHOUT THE COMMUNITY ENSURING THAT VARIED COMMUNITY INTERESTS AND EXPERTISE WERE REPRESENTED. SPECIAL ATTENTION WAS PAID TO ENSURING THAT REPRESENTATION FROM THE PUBLIC HEALTH SECTOR WAS INCLUDED IN THIS ASSESSMENT PROCESS AND THAT THE SENIOR CITIZEN AND UNDERSERVED POPULATION WERE REPRESENTED. A COMPLETE LIST OF THE COMMUNITY STEERING COMMITTEE MEMBERS FOR EACH ARH FACILITY IS INCLUDED IN EACH ASSESSMENT'S FINAL REPORT. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED BY ARH IN 2018-2019. THIS OFFERED A GOOD OPPORTUNITY TO EXAMINE PROGRESS MADE SINCE THE PREVIOUS CHNA PROCESS WHILE OUTLINING NEW STRATEGIES TO GUIDE ACTIVITIES, OUTREACH, AND AREAS OF IMPROVEMENT FOR RECENTLY IDENTIFIED NEEDS. ALL OF THE NEEDS IDENTIFIED DURING THIS PROCESS WERE REVIEWED AND PRIORITIZED BY EACH FACILITY. SOME NEEDS MAY NOT HAVE BEEN SELECTED AS A HIGH PRIORITY SINCE ANOTHER COMMUNITY AGENCY MAY ALREADY BE ADDRESSING THAT NEED AND REFERRALS JUST NEED TO BE MADE TO THAT PARTNER AGENCY. MEASURES WERE TAKEN TO ENSURE THAT EACH IDENTIFIED NEED WAS EITHER ADDRESSED TO SOME DEGREE BY ARH OR REFERRED TO OTHER APPROPRIATE COMMUNITY ENTITIES. BELOW ARE THE MAIN SYSTEM-WIDE NEEDS IDENTIFIED DURING ARH'S MOST RECENT CHNA. THESE AREAS ARE THE MAIN FOCUS OF THE HOSPITALS' ACTIVITIES:SUBSTANCE ABUSE (DRUGS, ALCOHOL, TOBACCO, AND VAPING)MENTAL HEALTH (SERVICES AND REDUCING STIGMA)OBESITY/DIABETES/PHYSICAL ACTIVITYCOMMUNICATION AND EDUCATIONTHE RESULTS FROM THE MOST RECENT CHNA IDENTIFIED THE NEED FOR ARH'S FACILITIES TO FOCUS ON PROVIDING MORE PREVENTIVE AND EDUCATIONAL SERVICES. FOR SOME COMMUNITIES, THIS ALSO MEANT FURTHER PUBLICIZING THE PREVENTIVE AND EDUCATIONAL SERVICES THAT THEY WERE ALREADY OFFERING TO FURTHER INCREASE COMMUNITY PARTNERSHIPS AND AWARENESS. CHNA RESPONDENTS ALSO REQUESTED INCREASED EDUCATIONAL TOPICS INCLUDING MORE OF A FOCUS ON TOPICS SUCH AS VAPING AND MENTAL HEALTH ALONG WITH THE CHRONIC DISEASE ISSUES OF DIABETES AND HEART DISEASE. AN INCREASE IN THE AVAILABILITY OF SERVICES AND PROVIDERS TO ADDRESS THESE IDENTIFIED HEALTH ISSUES IS ALSO A PROMINENT NEED IN THE REGION, ESPECIALLY THE NEED TO ADD MORE MENTAL HEALTH PROVIDERS. ANOTHER NEED THAT WAS ALSO APPARENT WITH THE MOST RECENT CHNA RESULTS WAS THE NEED TO IMPROVE COMMUNICATIONS. THIS NEED RANGES FROM ENSURING THAT THERE IS FASTER COMMUNICATION REGARDING TEST RESULTS, IMPROVING COMMUNICATION TO THE PUBLIC ON ARH SERVICES AND ACTIVITIES VIA SOCIAL MEDIA, AND PROVIDING MORE PATIENT NAVIGATORS/ADVOCATES TO ASSIST PATIENTS WITH NEGOTIATING THE HEALTHCARE PROCESS. 84 1 - HARLAN ARH HOSPITAL PSYCHIATRIC SERVICE 81 BALL PARK ROAD HARLAN KY 40831 PSYCH 2 - ARH PSYCHIATRIC CENTER-HAZARD 102 MEDICAL CENTER DRIVE HAZARD KY 41701 PSYCH 3 - ARH HAZARD FAMILY HEALTH SERVICES 200 MEDICAL CENTER DRIVE HAZARD KY 417019466 CLINIC 4 - ARH HARLAN MEDICAL ASSOCIATES 37 BALL PARK ROAD HARLAN KY 408311701 RURAL HEALTH CLINIC 5 - ARH WHITESBURG SURGICAL CLINIC 214 HOSPITAL ROAD STE A WHITESBURG KY 418587627 CLINIC 6 - ARH TUG VALLEY MEDICAL ASSOCIATES 306 HOSPITAL DRIVE SOUTH WILLIAMSON KY 415034095 RURAL HEALTH CLINIC 7 - ARH MIDDLESBORO INTERNAL MEDICINE 3004 CUMBERLAND AVE SUITE 3 MIDDLESBORO KY 409652343 CLINIC 8 - ARH WHITSBURG CLINIC 214 HOSPITAL ROAD WHITESBURG KY 418587627 RURAL HEALTH CLINIC 9 - HAZARD ARH REGIONAL MEDICAL CENTER CLINI 200 MEDICAL CENTER DRIVE HAZARD KY 41701 PHARMACY 10 - HARLAN ARH OUTPATIENT PHARMACY 37 BALL PARK ROAD HARLAN KY 40831 PHARMACY 11 - HAZARD ARH HOME HEALTH AGENCY 100 AIRPORT GARDENS ROAD HAZARD KY 41701 HOME HEALTH 12 - ARH WOMEN'S AND FAMILY HEALTH CARE HARLA 37 BALL PARK ROAD SUITE 201 HARLAN KY 408311701 CLINIC 13 - ARH COMMUNITY PHARMACY 210 BLACK GOLD BLVD SUITE 104 HAZARD KY 41701 PHARMACY 14 - ARH HAZARD HOMECARE STORE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 HOME HEALTH CARE 15 - ARH WILLIAMSON HOMECARE STORE 306 HOSPITAL DRIVE SUITE 104A SOUTH WILLIAMSON KY 41503 HOME HEALTH CARE 16 - ARH MAN HOMECARE STORE ROUTE 99 BUFFALO CREEK ROAD KISTLER WV 25628 HOME HEALTH CARE 17 - ARH HARLAN HOMECARE STORE 106 RAILROAD STREET SUITE 5 HARLAN KY 40831 HOME HEALTH CARE 18 - ARH PRESCRIPTION DIVISION 306 HOSPITAL DRIVE SUITE 105 SOUTH WILLIAMSON KY 41503 PHARMACY 19 - WHITESBURG ARH HOME HEALTH AGENCY 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH 20 - BECKLEY ARH HOME HEALTH AGENCY 306 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH 21 - MORGAN COUNTY ARH HOME HEALTH AGENCY 493 MAIN STREET WEST LIBERTY KY 41472 HOME HEALTH 22 - ARH WOMEN'S AND FAMILY HEALTH CARE - TUG 26901 US HIGHWAY 119N BELFRY KY 415147520 RURAL HEALTH CLINIC 23 - ARH TRI-CITY MEDICAL CENTER 18880 NORTH US 119 CUMBERLAND KY 408238106 RURAL HEALTH CLINIC 24 - BECKLEY ARH PHARMACY 250 STANAFORD ROAD BECKLEY WV 25801 PHARMACY 25 - MCDOWELL ARH HOME HEALTH AGENCY 8535 KY RT 122 MINNE KY 41651 HOME HEALTH 26 - HARLAN ARH HOME HEALTH AGENCY 81 BALL PARK ROAD HARLAN KY 40831 HOME HEALTH 27 - ARH SUMMERS COUNTY RURAL HEALTH CLINIC 115 SUMMERS HOSPITAL RD HINTON WV 259510940 RURAL HEALTH CLINIC 28 - ARH REFERENCE LABORATORY 100 MEDICAL CENTER DRIVE HAZARD KY 41701 LAB 29 - ARH BECKLEY HOMECARE STORE 260 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH CARE 30 - MORGAN COUNTY ARH PHARMACY 476 LIBERTY ROAD WEST LIBERTY KY 41472 PHARMACY 31 - WILLIAMSON ARH HOME HEALTH AGENCY 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 HOME HEALTH 32 - PIKEVILLE BRANCH-ARH PIKE CO HOME HEALT 247 SOUTH MAYO TRAIL PIKEVILLE KY 41502 HOME HEALTH 33 - MAN ARH HOME HEALTH SUB-STATION BUFFALO CREEK ROAD /ROUTE 99 KISTLER WV 25628 HOME HEALTH 34 - ARH MCDOWELL PROFESSIONAL CLINIC 9879 KY RT 122 MCDOWELL KY 416476042 RURAL HEALTH CLINIC 35 - ARH WEST LIBERTY HOMECARE STORE 520 PRESTONSBURG STREET WEST LIBERTY KY 41472 HOME HEALTH CARE 36 - WHITESBURG ARH PHARMACY 240 HOSPITAL ROAD WHITESBURG KY 41858 PHARMACY 37 - ARH WHITESBURG HOMECARE STORE 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH CARE 38 - ARH MCDOWELL HOMECARE STORE 8535 KY RT 122 MINNE KY 41651 HOME HEALTH CARE 39 - ARH PIKEVILLE HOMECARE STORE 247 SOUTH MAYO TRAIL PIKEVILLE KY 41501 HOME HEALTH CARE 40 - MIDDLESBORO ARH PHARMACY 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 PHARMACY 41 - MIDDLESBORO ARH HOME HEALTH AGENCY 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH 42 - ARH MIDDLESBORO HOMECARE STORE 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH CARE 43 - ARH HINTON HOMECARE STORE 1500 TERRACE STREET HINTON WV 25951 HOME HEALTH CARE 44 - ARH FAMILY CARE WAYLAND 2662 KING COLEMAN HWY WAYLAND KY 416669998 PRIMARY CARE CLINIC 45 - ARH FAMILY CARE - WHEELWRIGHT 30 KY RT 306 BYPRO KY 416129706 PRIMARY CARE CLINIC 46 - JENKINS ARH FAMILY CARE 9480 HIGHWAY 805 JENKINS KY 415378182 PRIMARY CARE CLINIC 47 - ARH BARIATRIC CENTER 210 BLACK GOLD BOULEVARD SUITE 102 HAZARD KY 417012620 CLINIC 48 - ARH SYSTEM CENTER-HAZARD 100 AIRPORT GARDENS ROAD HAZARD KY 41701 SUPPORT 49 - ARH SYSTEM CENTER-LEXINGTON 2285 EXECUTIVE DR SUITE 400 LEXINGTON KY 40505 SUPPORT 50 - ARH SYSTEM CENTER-LEXINGTON JORDAN BUIL 1218 SOUTH BROADWAY LEXINGTON KY 40504 SUPPORT 51 - ARH SYSTEM CENTER-SOUTH WILLIAMSON 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 SUPPORT 52 - ARH REGIONAL DISTRIBUTION CENTER 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 53 - DME WAREHOUSE 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 54 - ARH SOUTHERN WEST VIRGINIA CLINIC 250 STANAFORD ROAD BECKLEY WV 258013140 CLINIC 55 - MIDDLESBORO ARH PHYSICIAN CLINIC 3602 WEST CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 56 - ARH WOMEN'S AND FAMILY HEALTH CARE - MID 2004 CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 57 - ARH CARDIOVASCULAR & THORACIC ASSOC 210 BLACK GOLD PLAZA SUITE 201 HAZARD KY 417019477 CLINIC 58 - ARH DERMATOLOGY 210 BLACK GOLD BLVD SUITE 211 HAZARD KY 41701 CLINIC 59 - ARH CARDIOLOGY ASSOCIATES - BECKLEY 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 60 - BECKLEY ARH PRIMARY CARE 250 STANFORD ROAD STE 104 BECKLEY WV 258013140 CLINIC 61 - ARH SPECIALTY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 100 SOUTH WILLIAMSON KY 415034095 CLINIC 62 - ARH SPECIALTY ASSOCIATES - WHITESBURG 214 HOSPITAL DR STE B WHITESBURG KY 418587627 CLINIC 63 - ARH CARDIOLOGY ASSOCIATES - WHITESBURG 226 MEDICAL PLAZA LN STE C WHITESBURG KY 418587425 CLINIC 64 - ARH CARDIOLOGY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 202 SOUTH WILLIAMSON KY 415034095 CLINIC 65 - ARH DERMATOLOGY MIDDLESBORO 2145 US HIGHWAY 25E MIDDLESBORO KY 409651874 CLINIC 66 - ARH OAK HILL PRIMARY CARE CENTER 223 MAPLE AVE OAK HILL WV 259013475 CLINIC 67 - ARH SPECIALTY ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE MULTIPLE SUIT HAZARD KY 417019422 CLINIC 68 - ARH PENNINGTON GAP CLINIC 121 STACY DR PENNINGTON GAP VA 242779998 CLINIC 69 - BECKLEY ARH MEDICAL MALL 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 70 - SUMMERS CO ARH FAMILY CARE CLINIC 197 PLEASANT ST HINTON WV 259512540 CLINIC 71 - MIDDLESBORO ARH HEMATOLOYONCOLOGY CLINI 3602 W CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 72 - MORGAN COUNTY ARH FAMILY HEALTH 1084 HWY 7 WEST LIBERTY KY 414727146 CLINIC 73 - HAZARD MEDICAL MALL 210 BLACK GOLD BLVD STE 102 HAZARD KY 41701 MEDSPA 74 - ARH BECKLEY REJUVENATION CENTER 1256 N EISENHOWER DRIVE BECKLEY WV 25801 MEDSPA 75 - ARH MIDDLESBORO REJUVENATION CENTER 3503 W CUMBERLAND AVE MIDDLESBORO KY 40965 MEDSPA 76 - ARH BECKLEY FAMILY CARE 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 77 - ARH BECKLEY GASTROENTEROLOGY 429 CARRIAGE DRIVE BECKLEY WV 25801 CLINIC 78 - ARH BECKLEY ONCOLOGY 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 79 - ARH BEAVER FAMILY CLINIC 703 RITTER DRIVE BEAVER WV 25813 CLINIC 80 - ARH HAZARD FAMILY CLINIC 181 ROY CAMPBELL DRIVE HAZARD KY 41701 CLINIC 81 - ARH FAMILY HEALTH LACKEY 77 MILLARD ALLEN DR LACKEY KY 41643 CLINIC 82 - ARH FAMILY HEALTH PHARMACY 1084 HWY 7 SUITE 3 WEST LIBERTY KY 41472 PHARMACY 83 - ARH HAZARD CLINIC PHARMACY 181 ROY CAMPBELL DRIVE HAZARD KY 41701 PHARMACY 84 - ARH PAIN AND HEADACHE MEDICINE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 CLINIC PART I, LINE 3C: THE DISCOUNTS ARE BASED ON A SLIDING FEE SCHEDULE STARTING AT 100% OF FPG QUALIFYING FOR FREE CARE, RANGING UP TO UNLIMITED INCOME LEVELS FOR A 40% DISCOUNT ON ALL UNINSURED CARE PROVIDED. PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART II, COMMUNITY BUILDING ACTIVITIES: TODAY APPALACHIAN REGIONAL HEALTHCARE CONTINUES ITS MISSION IN THE MOUNTAINS BY OFFERING RESIDENTS OF EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA A LOCAL OPTION FOR QUALITY HEALTHCARE SERVICES. ARH HOLDS STEADFAST TO THE MISSION TO, ""IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES."" ARH HAS EVOLVED INTO AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SERVING MORE THAN 320,000 RESIDENTS AND EMPLOYING OVER 6,000 PEOPLE ACROSS EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA WITH HOSPITALS, CLINICS, HOME HEALTH AGENCIES, PHARMACIES AND HOME DURABLE MEDICAL EQUIPMENT STORES. IN FISCAL YEAR 2020, ARH'S NINE HOSPITALS RANGE IN SIZE FROM CRITICAL-ACCESS FACILITIES TO THE SYSTEM'S FLAGSHIP REGIONAL MEDICAL CENTER WITH 358-LICENSED BEDS IN HAZARD, KENTUCKY. ARH IS THE LARGEST PROVIDER OF CARE AND SINGLE LARGEST EMPLOYER IN SOUTHEASTERN KENTUCKY AND THE THIRD LARGEST PRIVATE EMPLOYER IN SOUTHERN WEST VIRGINIA, AND IS CONSISTENTLY RECOGNIZED FOR ITS MEDICAL EXCELLENCE. WHILE PROVIDING THIS REGION WITH QUALITY HEALTHCARE, ARH REINVESTS ANY EARNINGS BACK INTO OPERATIONS TO FURTHER THE SYSTEM'S EFFORTS IN IMPROVING AND ACCESSING HEALTHCARE SERVICES FOR THE REGION. CREATED TO ADDRESS THE UNMET HEALTH NEEDS OF AN UNDERSERVED REGION, ARH LEADERSHIP AND STAFF MEMBERS REALIZE THAT SERVING THIS POPULATION IS ABOUT MORE THAN JUST ADDRESSING THE HEALTH NEEDS, IT IS ALSO ABOUT PREVENTING CHRONIC DISEASES. THROUGH PARTNERSHIPS WITH AREA SCHOOLS, BUSINESSES, ORGANIZATIONS AND HEALTH DEPARTMENTS, ARH IS ONE OF THE PRIMARY SOURCES FOR HEALTH EDUCATION AND DISEASE PREVENTION IN EACH COMMUNITY AND PARTNERS WITH ALL OF THESE VARIOUS COMMUNITY ENTITIES TO FURTHER THESE EFFORTS. ARH SPONSORS MANY COMMUNITY-WIDE WELLNESS EVENTS THROUGHOUT ITS SERVICE AREAS, INCLUDING HEALTH FAIRS AND VARIOUS SUPPORT GROUPS. EACH YEAR, ARH PROVIDES FREE OR DISCOUNTED HEALTH SCREENINGS FOR COLORECTAL, BREAST, AND PROSTATE CANCERS AS WELL AS ROUTINE BLOOD PRESSURE, CHOLESTEROL, GLUCOSE, AND BODY MASS INDEX (BMI) SCREENINGS IN EFFORTS TO PREVENT THE ONSET OF ILLNESSES OR CATCH MEDICAL CONDITIONS BEFORE THEY BECOME LIFE THREATENING. ARH ALSO ACTIVELY UTILIZES ALL FORMS OF MEDIA TO PROMOTE WELLNESS AND EDUCATE THE PUBLIC ON THE SIGNS AND SYMPTOMS OF MANY COMMON HEALTH CONDITIONS. THIS INCLUDES HEALTH EDUCATION NEWSLETTERS THAT ARE MAILED DIRECTLY TO RESIDENTS' HOMES. PART III, LINE 2: COSTING METHODOLOGY: TO DETERMINE THE BAD DEBT EXPENSE ON LINE 2, THE BADDEBT EXPENSE PER THE FINANCIAL STATEMENTS, WHICH CONSISTS OF GROSS CHARGESLESS DISCOUNTS, WAS CONVERTED TO COST USING THE GLOBAL COST-TO-CHARGERATIO DEVELOPED IN WORKSHEET 2. PATIENT DISCOUNTS ARE NOT REFLECTED INBAD DEBT. ANY PAYMENTS ON AN ACCOUNT AFTER IT IS WRITTEN OFF TO BAD DEBTRESULT IN A REVERSAL OF THE ENTIRE ACCOUNT OUT OF BAD DEBT, REINSTATEMENTOF THE PATIENT ACCOUNT RECEIVABLE, AND ANY NEGOTIATED DIFFERENCE IN THEFULL AMOUNT OF THE ACCOUNT AND THE PAYMENT MADE IS WRITTEN OFF TOCONTRACTUAL ALLOWANCE. PATIENTS WHO MAY QUALIFY FOR CHARITY CARE BUT DONOT APPLY CANNOT BE ESTIMATES. ALL PATIENTS ARE EDUCATED ABOUT AND GIVENEVERY OPPORTUNITY TO APPLY FOR CHARITY CARE AND, THEREFORE, ARH HAS NOINFORMATION FOR THOSE WHO CHOOSE NOT TO APPLY. PART III, LINE 3: EXPLANATION: MANAGEMENT CONTINUALLY MONITORS AND ADJUSTS THEALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ASSOCIATED WITH CREDIT RISK.THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICALTO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTSRECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE CORPORATIONESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYINGVALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THEPRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENTRECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROMINDIVIDUAL PATIENTS.THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OFTHE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OFANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NOSINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCEFOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THECORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASHCOLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION ANDAGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE AREWRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITHTHE CORPORATION'S POLICIES. PART III, LINE 4: THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE CORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. PART III, LINE 8: NEARLY ONE HALF OF THE CORPORATION'S PATIENT REVENUES ARE DERIVED FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES. IN TURN, PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FELL SHORT OF THE COST TO PROVIDE SUCH SERVICES BY MORE THAN $17 MILLION. MEDICARE RECIPIENTS RELY HEAVILY ON ARH FOR CARE, IN MANY OF THE COMMUNITIES IT SERVES, ARH IS THE LONE PROVIDER OF ACUTE HOSPITAL CARE. THE CORPORATION CONSIDERS ITS PARTICIPATION IN THE MEDICARE PROGRAM AND THE ASSOCIATED LOSSES RESULTING THEREOF AS AN ESSENTIAL COMPONENT OF COMMUNITY BENEFIT. ACCORDINGLY, WE DEEM THAT $17,815,138(OR 100%) OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 7 BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 9B: THE PROVISIONS IN THE WRITTEN DEBT COLLECTION POLICY ARE THAT CHARITY AND FINANCIAL ASSISTANCE APPLICATIONS ARE VALID FOR 6 MONTHS. AFTER THAT TIME, THE PATIENT MUST REAPPLY AND PRESENT CURRENT FINANCIAL DOCUMENTS AS NECESSARY. PART VI, LINE 2: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT IS CONDUCTED BY ARH EVERY THREE YEARS AND REPORTED ELSEWHERE IN THIS DOCUMENT, ARH ALSO CONTINUALLY ASSESSES COMMUNITY NEEDS IN OTHER FORMS AS WELL. THE NEEDS OF THE COMMUNITIES THAT ARH SERVES THROUGHOUT EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA ARE ASSESSED BY FOLLOWING EMERGING MEDICAL PRACTICE NEEDS AS A WHOLE ACROSS THE NATION AND SPECIFICALLY IN THE APPALACHIAN REGION. THE HEALTH NEEDS ARE EXAMINED BY LOOKING AT HEALTH STATISTICS AND DISEASE PREVALENCE COMPARED TO SERVICE/PHYSICIAN AVAILABILITY. PATIENT AND COMMUNITY SURVEYS ARE ALSO REGULARLY CONDUCTED TO ASSESS CONSUMER PERCEIVED NEEDS. LOCAL ADVISORY COUNCILS (LACS) ALSO EXIST IN EACH OF ARH'S HOSPITAL COMMUNITIES. THE COUNCILS ARE COMPRISED OF LOCAL CITIZENS WHO VOLUNTEER TO HELP ARH IMPROVE THE HEALTH OF ITS COMMUNITIES THROUGH REGULAR MEETINGS THAT DISCUSS COMMUNITY HEALTH ISSUES AND HELP ARH IDENTIFY AND ADDRESS THEM. MEMBERS ALSO ADVISE ARH ABOUT IMPROVEMENTS NEEDED AND COMMUNITY PERCEPTIONS OF ARH FACILITIES AND THESE INDIVIDUALS SERVE AS EXCELLENT AMBASSADORS FOR ARH AND ITS SERVICES. THESE INDIVIDUALS HAVE DEMONSTRATED THEIR LEADERSHIP IN LOCAL CIVIC AFFAIRS AND REFLECT A CROSS SECTION OF THE COMMUNITY. QUARTERLY, ONE REPRESENTATIVE FROM EACH OF THESE LACS MEETS TO DISCUSS COMMON ISSUES ACROSS THE SYSTEM AT A REGIONAL ADVISORY COUNCIL MEETING. FROM THIS GROUP OF REPRESENTATIVES, ONE MEMBER IS SELECTED TO ALSO SERVE ON THE HEALTH SYSTEM'S BOARD OF TRUSTEES. PART VI, LINE 3: UNDER ARHS FINANCIAL ASSISTANCE PROGRAM AND POLICY, EACH PATIENT WITHOUT MEDICAL COVERAGE FOR RENDERED SERVICES IS OFFERED A 40% DISCOUNT OF GROSS CHARGES AT TIME OF SERVICE. IF THE PATIENT EXTENDS PAYMENT AT TIME OF SERVICE THEY ARE GIVEN ANOTHER 10% DISCOUNT, MAKING THEIR LIABILITY 50% OF GROSS CHARGES. ALL OF THESE DISCOUNTS ARE APPLIED AT TIME OF CHARGE AND BILLED AFTER THE DISCOUNT IS TAKEN. IF SAID PATIENT IS UNABLE TO MEET THE FINANCIAL OBLIGATIONS FOR SERVICE, THEY ARE EDUCATED AND SCREENED FOR POTENTIAL FEDERAL AND/OR STATE ASSISTANCE PROGRAMS. BY DOING THIS, THE PATIENT IS REVIEWED AND EDUCATED BY ON-SITE FINANCIAL COUNSELORS AND/OR ELIGIBILITY AGENCY TO GET THE INDIVIDUAL PLACED IN A PROGRAM. BASED ON INCOME AND FAMILY STATUS, THE PATIENT IS SCREENED IN CONJUNCTION WITH THE FEDERAL AND STATE POVERTY GUIDELINES. AT THIS TIME, ALL APPLICATIONS ARE COMPLETED WITH THE ASSISTANCE OF ARH PERSONNEL AND SUBMITTED FOR APPROVAL. IN THE EVENT AN AGENCY REQUIRES THE PATIENT/GUARANTOR TO APPLY IN PERSON, THE INDIVIDUAL IS ASKED TO MAKE AN APPOINTMENT WITH THAT AGENCY AND FILE THEIR COMPLETED DOCUMENTS. IF THE RESPONSIBLE PARTY IS NOT ELIGIBLE FOR FEDERAL OR STATE ASSISTANCE, THEY ARE ADDITIONALLY SCREENED BY ARH FOR ELIGIBILITY INTO OUR INTERNAL SLIDING FEE SCHEDULE CHARITY PROGRAM FOR ADDITIONAL DISCOUNTS UP TO 100%OF GROSS CHARGES. IF THE PATIENT IS HELD RESPONSIBLE, ADDITIONAL EFFORTS TO ASSIST THE PATIENT ARE OFFERED BY OFFERING REASONABLE PAYMENT PLANS AND DEFERRED PAYMENTS. IN THE EVENT THE PATIENT/GUARANTOR DOES NOT MAKE A REASONABLE EFFORT TO COMPLETE NECESSARY DOCUMENTATION TO APPLY OR BECOME ELIGIBLE FOR A FINANCIAL ASSISTANCE PROGRAM, THEY ARE THEN STILL GIVEN THE INITIAL 40% DISCOUNT AND MOVED THROUGH THE NORMAL COLLECTION PROCESS. PART VI, LINE 4: THE RURAL SERVICE AREA COVERED BY ARH IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA INCLUDES MORE THAN 20 COUNTIES. THIS REGION IS FRAUGHT WITH SOME OF THE HIGHEST CHRONIC HEALTH PREVALENCE RATES IN THE COUNTRY FOR LUNG CANCER, DIABETES, AND HEART DISEASE. TO COMPOUND THESE PROBLEMS, MOST OF ARH'S FACILITIES ARE LOCATED IN AREAS THAT ARE AT LEAST PARTIALLY CLASSIFIED AS MEDICALLY UNDERSERVED AREAS AND HEALTH PROFESSIONAL SHORTAGE AREAS BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. IN ADDITION, THE AREAS SERVED BY ARH ALSO FACE UNEMPLOYMENT RATES THAT ARE SUBSTANTIALLY HIGHER THAN STATE AND NATIONAL AVERAGES AND A HIGHER NUMBER OF CITIZENS IN THESE AREAS RANK BELOW THE NATIONAL POVERTY LEVEL. FOR MORE THAN 60 YEARS, ARH HAS CARRIED A HEAVY LOAD IN CARING FOR THIS POPULATION. IN FISCAL YEAR 2020, ARH PROVIDED CLOSE TO $77 MILLION IN UNCOMPENSATED CARE AND DURING THAT SAME FISCAL YEAR, APPROXIMATELY 80 PERCENT OF ARH'S INPATIENTS WERE MEDICARE OR MEDICAID BENEFICIARIES. PART VI, LINE 5: TODAY APPALACHIAN REGIONAL HEALTHCARE CONTINUES ITS MISSION IN THE MOUNTAINS BY OFFERING RESIDENTS OF EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA A LOCAL OPTION FOR QUALITY HEALTHCARE SERVICES. ARH HOLDS STEADFAST TO THE MISSION TO, ""IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES."" ARH HAS EVOLVED INTO AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SERVING MORE THAN 320,000 RESIDENTS AND EMPLOYING OVER 6,000 PEOPLE ACROSS EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA WITH HOSPITALS, CLINICS, HOME HEALTH AGENCIES, PHARMACIES AND HOME DURABLE MEDICAL EQUIPMENT STORES. IN FISCAL YEAR 2020, ARH'S NINE HOSPITALS RANGE IN SIZE FROM CRITICAL-ACCESS FACILITIES TO THE SYSTEM'S FLAGSHIP REGIONAL MEDICAL CENTER WITH 358-LICENSED BEDS IN HAZARD, KENTUCKY. ARH IS THE LARGEST PROVIDER OF CARE AND SINGLE LARGEST EMPLOYER IN SOUTHEASTERN KENTUCKY AND THE THIRD LARGEST PRIVATE EMPLOYER IN SOUTHERN WEST VIRGINIA, AND IS CONSISTENTLY RECOGNIZED FOR ITS MEDICAL EXCELLENCE. WHILE PROVIDING THIS REGION WITH QUALITY HEALTHCARE, ARH REINVESTS ANY EARNINGS BACK INTO OPERATIONS TO FURTHER THE SYSTEM'S EFFORTS IN IMPROVING AND ACCESSING HEALTHCARE SERVICES FOR THE REGION. CREATED TO ADDRESS THE UNMET HEALTH NEEDS OF AN UNDERSERVED REGION, ARH LEADERSHIP AND STAFF MEMBERS REALIZE THAT SERVING THIS POPULATION IS ABOUT MORE THAN JUST ADDRESSING THE HEALTH NEEDS, IT IS ALSO ABOUT PREVENTING CHRONIC DISEASES. THROUGH PARTNERSHIPS WITH AREA SCHOOLS, BUSINESSES, ORGANIZATIONS AND HEALTH DEPARTMENTS, ARH IS ONE OF THE PRIMARY SOURCES FOR HEALTH EDUCATION AND DISEASE PREVENTION IN EACH COMMUNITY AND PARTNERS WITH ALL OF THESE VARIOUS COMMUNITY ENTITIES TO FURTHER THESE EFFORTS. ARH SPONSORS MANY COMMUNITY-WIDE WELLNESS EVENTS THROUGHOUT ITS SERVICE AREAS, INCLUDING HEALTH FAIRS AND VARIOUS SUPPORT GROUPS. EACH YEAR, ARH PROVIDES FREE OR DISCOUNTED HEALTH SCREENINGS FOR COLORECTAL, BREAST, AND PROSTATE CANCERS AS WELL AS ROUTINE BLOOD PRESSURE, CHOLESTEROL, GLUCOSE, AND BODY MASS INDEX (BMI) SCREENINGS IN EFFORTS TO PREVENT THE ONSET OF ILLNESSES OR CATCH MEDICAL CONDITIONS BEFORE THEY BECOME LIFE THREATENING. ARH ALSO ACTIVELY UTILIZES ALL FORMS OF MEDIA TO PROMOTE WELLNESS AND EDUCATE THE PUBLIC ON THE SIGNS AND SYMPTOMS OF MANY COMMON HEALTH CONDITIONS. THIS INCLUDES HEALTH EDUCATION NEWSLETTERS THAT ARE MAILED DIRECTLY TO RESIDENTS' HOMES. PART VI, LINE 6: DURING FISCAL YEAR 2020, ARH'S SERVICES WERE MAINLY ORGANIZED AROUND ITS 9 HOSPITAL SPECIFIC COMMUNITIES ACROSS EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA. IN EACH OF THESE COMMUNITIES A HOSPITAL EXISTS ALONG WITH A COMPLIMENTARY ARRANGEMENT OF OTHER ARH SERVICES WHICH MAY INCLUDE CLINICS, HOME HEALTH AGENCIES, PHARMACIES, AND/OR HOME DURABLE MEDICAL EQUIPMENT STORES. AT THE SYSTEM-LEVEL VARIOUS HEALTH PROMOTION ACTIVITIES ARE ORGANIZED AND PROMOTED ACROSS THE FACILITIES, INCLUDING THE INTRODUCTION OF NEW SERVICE LINES AND NEW TECHNOLOGY. HOWEVER, IN EACH OF ARH'S 9 COMMUNITIES, VARIOUS COMMUNITY OUTREACH PROGRAMS ARE ALSO UNDERWAY AND AGGRESSIVELY ADDRESSING THE HEALTH CONCERNS OF THAT PARTICULAR AREA WHILE STRONG COMMUNITY COLLABORATION IS BEING DEVELOPED. FROM SENIOR CITIZEN WELLNESS PROGRAMS TO PATIENT ASSISTANCE VIA A CANCER NAVIGATOR, ARH'S COMMUNITIES ARE REAPING THE BENEFITS OF SUCCESSFUL COMMUNITY OUTREACH. 0 PERRY CO ECONOMIC DEVELOPMENT PO BOX 1059 HAZARD KY 41702 473338245 GOVT 20000 SUPPORT ONGOING OPERATIONS ONE HARLAN COUNTY 81 BALL PARK RD HARLAN KY 40831 811027395 GOVT 20000 SUPPORT ONGOING OPERATIONS PERRY CO FAIR BOARD 318 MORTON BLVD HAZARD KY 41701 473857010 501(C)(3) 15000 CHRISTMAS IN A SMALL TOWN JENNY WILEY FESTIVALCITY OF PRESTONSBURG 200 NORTH LAKE DRIVE PRESTONSBURG KY 41653 616001899 GOVT 5000 SUPPORT ONGOING OPERATIONS SOUTHEAST EDUCATION FOUNDATIONSOUTHEAST COMMUNITY & TECHNICAL COLLEGE 700 COLLEGE ROAD CUMBERLAND KY 40823 311021118 501(C)(3) 20000 BUILDSMART: MIDDLESBORO EDUCATIONAL ALLICANCE CENTER UNIVERSITY OF KENTUCKY STURGILL PHILANTHROPY BUILDING LEXINGTON KY 40506 616001218 501(C)(3) 43529 ARH ENDOCRINOLOGY FELLOWSHIP FUND LETCHER COUNTY PARKS & RECREATION 156 MAIN STREET SUITE 107 WHITESBURG KY 41858 610865570 GOVT 20000 SUPPORT ONGOING OPERATIONS HARLAN COUNTY BOYS & GIRLS CLUB 1 POSITIVE PLACE HARLAN KY 40831 311793599 501(C)(3) 5000 SUPPORT ONGOING OPERATIONS THE MOUNTAIN ARTS CENTER 50 HAL ROGERS DRIVE PRESTONSBURG KY 41653 311490755 501(C)(3) 5000 SUPPORT ONGOING OPERATIONS 5 4 X X X X 0 1 0 0 0 1 0 0 0 JAMEEL A BUTT GENERAL SURGEON 1009709 0 0 0 0 0 0 0 7456 0 1017165 0 0 0 JOSEPH L GROSSMAN PRESIDENT/CEO 620318 0 169800 0 2215 0 42000 0 23652 0 857985 0 0 0 DONNIE R STACY RADIATION ONCOLOGIST 786008 0 0 0 0 0 0 0 23652 0 809660 0 0 0 JAMES H SHOPTAW CARDIOVASCULAR SURGEON 686506 0 0 0 0 0 19000 0 23652 0 729158 0 0 0 ZOUHAIR KABBARA FAMILY PHYSICIAN 693161 0 0 0 0 0 10445 0 4349 0 707955 0 0 0 ASHOK PATNAIK CARDIOLOGIST 665108 0 0 0 0 0 0 0 23652 0 688760 0 0 0 PAUL V MILES COO/VP OPERATIONS 267397 0 55956 0 3260 0 41732 0 23652 0 391997 0 0 0 MARIA BRAMAN CMO/VP MEDICAL AFFAIRS 279416 0 58365 0 894 0 19000 0 23652 0 381327 0 0 0 BOBBY RICK KING SECRETARY 245448 0 51740 0 3853 0 42320 0 15677 0 359038 0 0 0 DANNY M HARRIS TREASURER 259955 0 54141 0 2163 0 18116 0 15677 0 350052 0 0 0 HOLLIE P HARRIS VP CORPORATE STRATEGY 218102 0 45631 0 530 0 33151 0 15677 0 313091 0 0 0 BESSIE ELLEN WRIGHT VP AND CHIEF NURSING OFFIC 148422 0 31835 0 1534 0 16840 0 15677 0 214308 0 0 0 PART I, LINE 4B ARH PROVIDES SENIOR EXECUTIVES A CONTRIBUTION OF SEVEN (7) PERCENT OF PAY (SUBJECT TO DOLLAR CAP) INTO THE TOP HAT 457(B) RETIREMENT PLAN, IF THE EXECUTIVE SIGNS A NON-COMPETE AGREEMENT. THE CONTRIBUTION AND EARNINGS ARE TAX DEFERRED UNTIL ASSETS ARE DISTRIBUTED OR WITHDRAWN. THE MAXIMUM CONTRIBUTION IS SUBJECT TO THE IRS COMPENSATION CAP, WHICH ALLOWS A CONTRIBUTION OF UP TO $19,000 IN 2019. THIS CONTRIBUTION TOTAL IS AN AGGREGATE TOTAL REGARDLESS OF WHETHER ARH OR THE EXECUTIVE MAKES THE CONTRIBUTION. CONTRIBUTION TO THE 457(B) DOES NOT AFFECT THE AMOUNTS THE EXECUTIVE MIGHT CONTRIBUTE TO THE 403(B) THRIFT PLAN. THE EXECUTIVE MAY CONTRIBUTE HIS/HER OWN MONEY TO THE PLAN PRE-TAX, TO THE EXTENT THE IRS CAPS ALLOW ROOM AFTER ARH'S CONTRIBUTION. CATCH UP CONTRIBUTIONS ARE ALLOWED WITHIN IRS LIMITS IN THE LAST THREE YEARS PRIOR TO RETIREMENT (AND, IF 7% OF PAY EXCEEDS THE REGULAR DOLLAR CAP, ARH MAY USE THE BALANCE OF THE 7% TO FUND UP THE CATCH UP LIMIT). BENEFITS ARE SUBJECT TO SOCIAL SECURITY AND MEDICARE TAXES AS THEY ACCRUE. THE FUNDS ARE INVESTED AS DIRECTED BY THE EXECUTIVE, BUT THE ACCOUNT REMAINS A GENERAL ASSET OF ARH. IF ARH BECOMES INSOLVENT, THE EXECUTIVE WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. TO RECEIVE THE ARH CREDIT TO THE 457(B) PLAN, THE EXECUTIVE MUST SIGN A NON-COMPETE, CONFIDENTIALITY, ETC. AGREEMENT RESTRICTING WORK FOR A COMPETING ORGANIZATION FOR TWO (2) YEARS POST TERMINATION. IF THE FUNDING OF THE 457(B), INCLUDING ANY CATCH UP PROVISIONS, IS LESS THAN 7% OF BASE PAY, THEN ARH WILL CONTRIBUTE THE REMAINDER TO A 457(F) PLAN. INDIVIDUALS PARTICIPATING IN THE 457(F) PLAN AND THE RESPECTIVE EMPLOYER CONTRIBUTIONS FOR EACH INCLUDE: JOE GROSSMAN $23,000 AND MARIA BRAMAN $539. PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE RELATED ORGANIZATION (ARH) BOARD OF TRUSTEES ADOPTED A SHORT-TERM INCENTIVE COMPENSATION PROGRAM FOR EXECUTIVES IN SEPTEMBER 2002. THE PROGRAM ESTABLISHED INCENTIVES FOR ACHIEVING SYSTEM AND COMMUNITY OBJECTIVES FOR EXECUTIVE LEADERSHIP BY INTEGRATING THE PERFORMANCE MANAGEMENT AND EXECUTIVE COMPENSATION SYSTEMS. THE INCENTIVE THRESHOLDS HAVE BEEN MODIFIED ACROSS TIME TO REFLECT INCREASED PERFORMANCE EXPECTATIONS AS IDENTIFIED IN THE SYSTEM'S STRATEGIC, BUDGET AND OPERATIONS PLAN. THE INCENTIVE AWARDS PROVIDE ADDITIONAL CASH COMPENSATION AS A PERCENTAGE OF BASE SALARY IN RELATION TO LEVELS OF ACHIEVEMENT. THESE ACHIEVEMENT LEVELS RANGE FROM THRESHOLD (LOWEST), TO TARGET (10% ABOVE THE THRESHOLD), AND MAXIMUM (HIGHEST AND 20% ABOVE THE THRESHOLD) AND VARY BASED UPON EXECUTIVE LEVEL. THE EXECUTIVE INCENTIVE PLAN WILL BE ADMINISTERED IN ACCORDANCE WITH THE FOLLOWING GUIDELINES: A. OBJECTIVES AND TARGETS ARE SET THROUGH THE STRATEGIC PLANNING, BUDGETING AND PERFORMANCE MANAGEMENT PROCESSES. B. SYSTEM MARGIN AND CASH BUDGET THRESHOLDS MUST BE MET BEFORE INDIVIDUAL AWARDS WILL BE CONSIDERED. C. AWARDS WILL BE CONSIDERED AS HAVING BEEN EARNED UPON AFFIRMATION BASED ON AUDITED FINANCIAL RESULTS AND ACTUAL OPERATING PERFORMANCE. D. THE PRESIDENT AND CEO WILL RECOMMEND PAYMENT OF INDIVIDUAL AWARDS, IF ANY, TO THE COMPENSATION AND CONTRACTS COMMITTEE FOR CONSIDERATION. E. THE COMPENSATION AND CONTRACTS COMMITTEE MAY ACCEPT, REJECT, OR MODIFY THE PRESIDENT AND CEO'S RECOMMENDATION. A CITY OF HAZARD KY 616001839 2012-12-19 40000000 REFUNDING CURRENT BONDS 0 0 0 B CITY OF WHITESBURG 2014-11-20 10000000 HEALTHCARE REVENUE BOND 0 0 0 C CITY OF HAZARD KY 616001839 2015-12-20 9750000 HEALTHCARE REVENUE BOND 0 0 0 A 29530000 40000000 3642668 735189 35622143 2013 0 1 1 1 B 10000000 10000000 10000000 0 0 1 1 C 8747443 9750000 9750000 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 1 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 C 0 0 0 1 0 0 0 0 0 A 0 B 0 C 0 GREG COUCH PRINCIPAL OWNER OF MERIDIAN WEALTH 225340 INVESTMENT COMPANY THAT MANAGES ARH RETIREMENT PORTFOLIO 0 FORM 990, PART VI, SECTION B, LINE 11B THE DIRECTOR OF ACCOUNTING AND CFO BOTH REVIEW THE 990 PRIOR TO THE BOARD REVIEW. THE BOARD THEN REVIEWS THE 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A SECURE WEBSITE IS PROVIDED TO OFFICERS AND TRUSTEES FOR ANNUAL DISCLOSURES, AND IS MONITORED REGULARLY BY THE VICE PRESIDENT OF LEGAL AFFAIRS AND THE CORPORATE COMPLIANCE OFFICERS. POTENTIAL CONFLICTS OF INTEREST ARE REPORTED DIRECTLY TO THE CHAIRMAN OF THE BOARD. TRUSTEES IDENTIFIED AS HAVING A CONFLICT OF INTEREST IN A PARTICULAR MATTER BEFORE THE BOARD MAY NOT PARTICIPATE IN THE BOARD'S DECISION-MAKING PROCESS. FAILURE TO DISCLOSE IS SUBJECT TO DISCIPLINE, INCLUDING CENSURE, AND IN SOME CASES, REMOVAL FROM THE BOARD. EMPLOYEE OFFICERS ARE SUBJECT TO DISCIPLINE IN ACCORDANCE WITH THE CORPORATION'S HUMAN RESOURCE POLICIES AND THE ARH CODE OF BUSINESS AND PROFESSIONAL CONDUCT. FORM 990, PART VI, SECTION B, LINE 15 APPALACHIAN REGIONAL HEALTHCARE, INC.'S (ARH) BOARD SETS COMPENSATION LEVELS FOR PRESIDENT/CEO AND OTHER ARH EXECUTIVES AND KEY EMPLOYEES THROUGH ITS COMPENSATION AND CONTRACTS COMMITTEE. THE BOARD CONTRACTS WITH A CONSULTING FIRM TO REVIEW THE MARKET FOR THE POSITIONS ON THE SYSTEM OPERATING COUNCIL WHO MAKES RECOMMENDATIONS ON THE SALARY RANGES AND ASSESSES THE COMPETITIVENESS OF THE SALARIES. WITH THAT INFORMATION, THE COMPENSATION AND CONTRACTS COMMITTEE SETS THE RANGES AND THE PRESIDENT'S COMPENSATION. THE BOARD REVIEWS AND RATIFIES COMPENSATION AMOUNTS. THE CONSULTING FIRM FOLLOWS UP WITH A LETTER ATTESTING TO THE REASONABLENESS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 WHILE ARH HAS NOT YET ADOPTED A POLICY OF SHARING ITS FINANCIAL STATEMENTS WITH THE PUBLIC, IT DOES PROVIDE FINANCIAL INFORMATION THROUGH THE FORM 990 AND ALSO PROVIDES CERTAIN FINANCIAL INFORMATION IN OTHER PUBLIC DOCUMENTS, INCLUDING ITS PERIODIC REPORTS TO THE COMMUNITIES IT SERVES. FORM 990, PART XI, LINE 9: NET PERIODIC PENSION GAIN 1,509,270. HIGHLANDS ACQUISITION -5,422,433. CHANGE IN PENSION PLAN ASSET AND OBLIGATION -54,108,022. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSEEING AND SELECTING INDEPENDENT AUDITORS HAS NOT CHANGED FROM THE PRIOR YEAR. PRIOR TO THE START OF THE AUDIT, THE VICE PRESIDENT OF FINANCE MEETS WITH THE INDEPENDENT AUDITORS. AT THE CONCLUSION OF THE AUDIT, THE FINANCE COMMITTEE MEETS WITH THE INDEPENDENT AUDITORS FOR PRESENTATION OF THE FINANCIAL STATEMENTS. THE INDEPENDENT AUDITORS ARE SELECTED WHEN DEEM NECESSARY BY MANAGEMENT THROUGH A FORMAL "REQUEST FOR PROPOSAL" (RFP) PROCESS. HAZARD ARH IMAGING CENTER LLC 210 BLACK GOLD BLVD HAZARD KY 41701 270755457 MEDICAL IMAGING SERVICES KY 9538239 APPALACHIAN REGIONAL HEALTHCARE INC ARH REAL ESTATE LLC 101 AIRPORT GARDENS ROAD HAZARD KY 41701 REAL ESTATE HOLDING KY APPALACHIAN REGIONAL HEALTHCARE INC THE ARH FOUNDATION FOR HEALTHIER COMMUNITIES INC 100 AIRPORT GARDENS RD HAZARD KY 41701 204840007 CARRYING OUT FUNDRAISING AND CHARITABLE ACTIVITIES FOR ARH KY 501(C)(3) LINE 7 APPALACHIAN REGIONAL HEALTHCARE INC 1 ARH MARY BRECKINRIDGE 2260 EXECUTIVE DR LEXINGTON KY 40505 452696517 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 ARH TUG VALLEY HEALTH SERVICES INC 2260 EXECUTIVE DR LEXINGTON KY 40505 822577178 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 WHITESBURG PHYSICIAN OFFICE BLDG LLC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 753022080 PHYSICIAN OFFICE BUILDING KY EXCLUDED 66189 477190 0 1 0.28130 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCIL 2260 EXECUTIVE DRIVE LEXINGTON KY 40504 201796044 OFFICE BUILDING MANAGEMENT KY N/A C 0.61490 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 ARH FOUNDATION FOR HEALTHIER COMMUNITIES Q 484478 ALLOCATED COSTS