2018-05-11T12:59:20-05:00 2017-06-30 271235638 MCM CPAS & ADVISORS LLP 462 S FOURTH ST SUITE 2600 LOUISVILLE KY 402023445 990 2016-07-01 520795508 APPALACHIAN REGIONAL HEALTHCARE APPA 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 405054810 DANNY HARRIS CFO/VP FISCAL SERVICES 8592262440 2018-05-09 1 BOB MORELAND CPA P00418596 5027491900 2016 2022-09-23 18:48:47Z JOSEPH GROSSMAN 2260 EXECUTIVE DRIVE LEXINGTON KY 405054810 657862920 0 X WWW.ARH.ORG X 1963 KY TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA. 18 17 5369 244 11598497 -1461666 245226 276295 646197557 631025895 7616965 11011067 16700576 14860864 670760324 657174121 249835 190508 0 0 316382148 317817216 0 0 339206 320545483 316530575 637177466 634538299 33582858 22635822 642259141 682022817 506774283 486519165 135484858 195503652 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA IN AN EVOLVING, COMMUNITY BASED SYSTEM PROVIDING HIGH QUALITY HEALTHCARE PROGRAMS AND SERVICES. 0 0 561643045 190508 626429878 DURING FISCAL YEAR ENDING JUNE 30, 2017, ARH PROVIDED EACH OF THE COMMUNITIES IT SERVES IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA AN ABUNDANCE OF HEALTHCARE AND COMMUNITY-ORIENTED SERVICES.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 ALSO 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 HEALTH SCREENINGS SUCH AS BLOOD PRESSURE CHECKS, BLOOD GLUCOSE, BODY MASS INDEX, PULSE, CHOLESTEROL AND STROKE-RISK SCREENINGS.TO ENCOURAGE WOMEN TO GET ANNUAL SCREENING MAMMOGRAMS, ARH ALSO OFFERS DISCOUNTED MAMMOGRAMS DURING OCTOBER'S BREAST CANCER AWARENESS MONTH WHICH COINCIDE WITH NUMEROUS AWARENESS EVENTS HELD THROUGHOUT THE MONTH. ARH HAS ALSO 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.BELOW IS A SUMMARY ABOUT SOME OTHER ACCOMPLISHMENTS ENCOUNTERED BY ARH DURING THE PAST FISCAL YEAR.ARH WAS AMONG 10 HEALTH CARE SYSTEMS ACROSS THE COMMONWEALTH OF KENTUCKY TO COLLECTIVELY FORM THE KENTUCKY HEALTH COLLABORATIVE, WHOSE PRIMARY OBJECTIVES ARE RAISING THE STANDARDS OF CARE ACROSS THE STATE, ADDRESSING THE COMMONWEALTH'S POOR HEALTH STATISTICS AND REDUCING THE COST OF CARE THROUGH GREATER OPERATIONAL EFFICIENCIES.ARH HOSPITALS THROUGHOUT EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA CONTINUED TO RESPOND TO THE NEEDS OF THEIR COMMUNITIES BY PUTTING INTO PLACE PLANS BASED ON INFORMATION COMPILED IN COMMUNITY NEEDS ASSESSMENT REPORTS. IN AN EFFORT TO MEASURE THE IMPACT OF CURRENT PUBLIC HEALTH EFFORTS, IDENTIFY RESPECTIVE HEALTH CONCERNS AND PRIORITIES, AND GUIDE THE APPROPRIATE USE OF LOCAL RESOURCES, ARH WITH THE ASSISTANCE OF THE COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KENTUCKY (CEDIK) AT THE UNIVERSITY OF KENTUCKY COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN EACH OF ITS HOSPITAL COMMUNITIES. THIS ASSESSMENT CONSISTED OF THE FORMATION OF A LOCAL STEERING COMMITTEE MADE UP OF MEMBERS FROM COMMUNITY ORGANIZATIONS AND BUSINESSES, DISTRIBUTION AND COMPLETION OF OVER 1,000 SURVEYS, AND COMPLETION OF SEVERAL COMMUNITY FOCUS GROUPS. THE RESULTS FROM ALL OF THESE DIFFERENT FORUMS WERE COMPILED, ANALYZED, AND PRIORITIES ESTABLISHED FOR THE NEXT THREE YEARS.THE INDEPENDENT HOSPITAL WATCHDOG, THE LEAPFROG GROUP, SHOWS HOW THE STRONG COMMITMENT TO PATIENT SAFETY HAS EARNED ARH HOSPITALS IN HARLAN, HAZARD AND WHITESBURG, KY, AND BECKLEY, WV, AN 'A' GRADE IN ITS ELITE NATIONAL RATINGS PROGRAM THAT RATES HOSPITALS ON ERRORS, INJURIES, ACCIDENTS, AND INFECTIONS. THE HOSPITAL SAFETY SCORE IS THE GOLD STANDARD RATING FOR PATIENT SAFETY, COMPILED UNDER THE GUIDANCE OF THE NATION'S LEADING PATIENT SAFETY EXPERTS AND ADMINISTERED BY THE LEAPFROG GROUP, A NATIONAL, INDEPENDENT NONPROFIT. THE FIRST AND ONLY HOSPITAL SAFETY RATING TO BE PEER-REVIEWED IN THE JOURNAL OF PATIENT SAFETY, THE HOSPITAL SAFETY SCORE IS FREE TO THE PUBLIC AND DESIGNED TO GIVE CONSUMERS INFORMATION THEY CAN USE TO PROTECT THEMSELVES AND THEIR FAMILIES WHEN FACING A HOSPITAL STAY.MCDOWELL ARH WAS NAMED ONE OF THE TOP 20 CRITICAL ACCESS HOSPITALS (CAHS) IN THE COUNTRY FOR ITS OVERALL QUALITY. THE TOP 20 CRITICAL ACCESS HOSPITALS "BEST PRACTICE RECIPIENTS-QUALITY" WHICH INCLUDED MCDOWELL ARH, SCORED BEST AMONG CRITICAL ACCESS HOSPITALS ON IVANTAGE HEALTH ANALYTICS' HOSPITAL STRENGTH INDEX FOR QUALITY. THE TOP 20 CRITICAL ACCESS HOSPITAL "WINNERS" ARE THOSE HOSPITALS WHO HAVE ACHIEVED SUCCESS IN THE OVERALL PERFORMANCE BASED ON A COMPOSITE RATING FROM NINE INDICES OF STRENGTH: INPATIENT MARKET SHARE, OUTPATIENT MARKET SHARE, POPULATION RISK, COST, CHARGE, QUALITY, OUTCOMES, PATIENT PERSPECTIVES, AND FINANCIAL STABILITY.ARH CONTINUES TO WORK TO EXPAND HEALTHCARE SERVICES IN THE COMMUNITIES IT SERVES THROUGH THE ADDITION OF STATE-OF-THE-ART TECHNOLOGY AND ADVANCED MEDICAL SERVICES. A NUMBER OF ADVANCEMENTS OCCURRED DURING FY16, WHICH INCLUDE, BUT ARE NOT LIMITED TO:ARH EXPANDED THE LEVEL OF DIAGNOSTIC SERVICES TO WOMEN WITH THE OPENING OF THE STATE-OF-THE-ART ARH BREAST CENTER LOCATED AT THE ARH MEDICAL MALL IMAGING CENTER. THE CENTER PROVIDES PATIENTS A ONE-STOP SHOP FOR ALL THEIR BREAST HEALTH AND BREAST CANCER NEEDS. THE ARH BREAST CENTER OFFERS A FULL RANGE OF SERVICES, FROM ROUTINE MAMMOGRAMS, TO SECOND OPINIONS AND TREATMENT OPTIONS FOR BREAST CANCER. THE ARH BREAST CENTER CAN BRING ABOUT A MORE TIMELY AND EFFICIENT DIAGNOSIS AND TREATMENT OF BREAST CANCER BY BRINGING TOGETHER A TEAM OF SPECIALISTS INCLUDING ONCOLOGISTS, RADIOLOGISTS, SURGEONS, PATHOLOGISTS, GENETIC COUNSELORS, AND A NURSE NAVIGATOR. THE GOAL OF THE ARH BREAST CENTER IS TO OFFER THE MOST ADVANCED BREAST CANCER CARE IN ADDITION TO EMOTIONAL SUPPORT WHILE REDUCING THE DELAYS PATIENTS MAY EXPERIENCE IN THE COURSE OF DIAGNOSTIC MAMMOGRAM TO TREATMENT. A PATIENT CAN HAVE A MAMMOGRAM, ANY FOLLOW-UP IMAGING TEST, AND A BIOPSY IF NEEDED, ALL IN ONE DAY. WITH THE ADDITION OF THE BREAST TOMOSYNTHESIS (3D MAMMOGRAPHY) IMAGING EQUIPMENT, THE ARH BREAT CENTER HAS THE LATEST TECHNOLOGY IN THE REGION.HAZARD ARH REGIONAL MEDICAL CENTER OPENED A NEW OUTPATIENT WOUND CARE CENTER WITH THE GOAL TO MAKE A DIFFERENCE IN THE LIVES OF LOCAL PATIENTS. THE NEW OUTPATIENT CENTER OFFERS THE COMMUNITY A COMPREHENSIVE QUALITY APPROACH WITH THE HOSPITAL PROVIDING STATE-OF-THE ART CLINICAL SERVICES TO OUR FASTEST-GROWING MEDICAL DEMOGRAPHIC: PATIENTS WITH DIABETES AGED 60 YEARS AND OLDER. THE CENTER ALSO TREATS OTHER TYPES OF WOUNDS INCLUDING, BUT NOT LIMITED TO VENOUS ULCERS, TRAUMATIC INJURY AND COMPROMISED FLAPS/GRAFTS TO WOUNDS RESULTING FROM RADITATION THERAPY, WHILE MAINTAINING THE GOAL OF SUCCESSFUL HEALING AND REDUCING THE RISK OF AMPUTATION AND/OR DISABILITY. THE CENTER'S HYPERBANIC CHAMBER ALLOWS PATIENTS TO RECEIVE PURE OXYGEN TO SPEED UP THE HEALING OF THEIR WOUNDS, WHICH PROVIDES A MORE ADVANCED TREATMENT OPTION FOR THOSE WHO QUALIFY FOR THE PROCEDURE.WITH THE NEED FOR CANCER TREATMENT AND INFUSION THERAPY SERVICES INCREASING, ARH ALSO HAS LAUNCHED PLANS FOR ADDITIONAL INFUSION THERAPY SUITES AS WELL AS AN EXPANSION OF THE ARH CANCER CENTER IN HAZARD. THE EXPANSION WILL PROVIDE 8,000 ADDITIONAL SQUARE FEET WHICH WILL ACCOMMODATE MORE PATIENTS AND KEEP THEM CLOSE TO HOME FOR CANCER TREATMENTS.ADDITIONALLY, ARH CONTINUED TO PROVIDE THE RESIDENTS IT SERVES A WIDE-RANGE OF PRIMARY AND SPECIALTY CARE SERVICES THROUGH ITS NETWORK OF HEALTH FACILITIES AND PARTNERSHIPS WITH OTHER HEALTH SYSTEMS SUCH AS THE RENOWNED UK HEALTHCARE, VIRTUALLY ELIMINATING RESIDENTS' NEED TO LEAVE THE AREA FOR CARE. 561643045 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 310 0 1 5369 1 1 1 0 0 0 0 0 0 1 1 0 X 18 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 405054810 JEFFREY B HOLLON TRUSTEE 3.00 X 0 0 0 THOMAS HYATT ESQ CHAIRMAN 5.00 X X 0 0 0 GREG PAULEY VICE CHAIRMANMAN 5.00 X X 0 0 0 IDA ANDROWICH PHD RN TRUSTEE 3.00 X 0 0 0 GREG COUCH TRUSTEE 3.00 X 0 0 0 RAYMOND COX TRUSTEE 3.00 X 0 0 0 RANDALL EVANS DVM TRUSTEE 5.00 X 0 0 0 AHMED FAHEEM MD TRUSTEE 3.00 X 0 0 0 J VICTOR FLANAGAN ESQ TRUSTEE 3.00 X 0 0 0 JIM HART TRUSTEE 3.00 X 0 0 0 MARIA HORTILLOSA MA TRUSTEE 3.00 X 0 0 0 BROCK LITTERAL TRUSTEE 3.00 X 0 0 0 LARRY MEADOR TRUSTEE 3.00 X 0 0 0 MADONNA STURGILL TRUSTEE 3.00 X 0 0 0 DUANNE THOMPSON SECRETARY/ TREASURER 5.00 X X 0 0 0 JULIE AKEMON TRUSTEE 3.00 X 0 0 0 ONZIE SIZEMORE TRUSTEE 3.00 X 0 0 0 ANDREA MASSEY TRUSTEE 3.00 X 0 0 0 JOSEPH L GROSSMAN PRESIDENT/CEO 40.00 X 746931 0 55609 ELLEN WRIGHT VP AND CHIEF NURSING OFFICER 40.00 X 168444 0 18813 DANNY M HARRIS CFO/VP FISCAL SERVICES 40.00 X 291237 0 23324 HOLLIE P HARRIS VP CORPORATE STRATEGY 40.00 X 244281 0 26078 PAUL V MILES COO/VP OPERATIONS 40.00 X 299934 0 31945 MARIA BRAMAN VP MEDICAL AFFAIRS & CMO 40.00 X 218630 0 16856 BOBBY RICK KING CLO/VP LEGAL AFFAIRS 40.00 X 278366 0 29012 BUTT JAMEEL A GENERAL SURGEON 40.00 X 745445 0 6559 CHANDRASHEKAR KRISHNASWAMY NEUROLOGIST 40.00 X 622922 0 5768 JYOTIN CHANDARANA FAMILY PHYSICIAN 40.00 X 511495 0 8940 FIRAS KOURA PULMONOLOGIST 40.00 X 613622 0 4797 NAGABHUSHANAM BOLLAVARAM PULMONOLOGIST 40.00 X 548557 0 4509 5289864 0 232210 245 0 1 0 MCKESSON INFORMATION SOLUTIONS 5995 WINDWARD PARKWAY ALPHARETTA GA 30005 IT CONSULTING 42037555 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA ST OMAHA NE 68154 CONTRACT NURSES 17996444 CONCORDANCE HEALTHCARE 145 HUGUENOT ST STE 108 NEW ROCHELLE NY 10801 CONTRACT HEALTHCARE 13665961 TRANSAMERICA RETIREMENT 440 MAMARONECK AVE HARRISON NY 10528 FINANCIAL SERVICES 9703410 TRIANGLE ANESTHESIA GROUP PSC 3320 TATES CREEK ROAD STE 100 LEXINGTON KY 40502 PHYSICIAN SERVICES 7230265 230 278917 -2622 276295 PATIENT REVENUES 621110 619752166 619752166 PHARMACY/LAB/LAUNDRY 812300 11024858 4794664 6230194 RECORD TRANSCRIPT FEES 900099 248421 248421 IMAGING REVENUE 900099 450 450 631025895 8444598 8444598 1505546 0 1505546 1505546 1505546 3221420 33848 0 688799 3221420 -654951 2566469 2566469 HOME STORE SALES 900099 5484291 4500854 983437 HAZARD COST TRANSFER 900099 1900452 1900452 MISC. INCOME 900099 1649410 1649410 4321165 1634177 867449 1819539 13355318 657174121 626429878 11598497 18869451 X 190508 190508 2353464 2353464 224970032 207793304 17041701 135027 14530426 13002404 1518216 9806 61728261 56053057 5634664 40540 14235033 12926687 1299237 9109 2628267 200328 2427939 213907 16304 197603 91060339 80364534 10628618 67187 929539 780184 143451 5904 10843377 9264620 1577522 1235 6564760 6330835 233690 235 14866510 13139942 1721369 5199 1682981 1322751 360022 208 392274 200507 191767 4485222 1428674 3056548 24147900 18655199 5492701 11596818 11468710 128108 MEDICAL SUPPLIES 90551932 87323635 3224975 3322 BAD DEBT 23624301 23570522 53779 TAXES & LICENSES 12415124 2567818 9831486 15820 EQUIPMENT RENTAL AND MA 8930036 5468189 3461610 237 11597288 9574333 1977578 45377 634538299 561643045 72556048 339206 21687767 17598990 26686982 54431638 61905799 64678919 1040249 1005314 13099836 13816037 11327794 8082918 522497412 352228610 178512240 170268802 322252449 346358911 1013036 927536 900000 900000 3832989 3953752 642259141 682022817 67470842 66356196 9168200 3321460 105464984 101501469 35245993 35477029 289424264 279863011 506774283 486519165 X 135486322 195505116 -1464 -1464 135484858 195503652 642259141 682022817 X 22635822 16644347 20738625 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 127642 1 21520 149162 0 PART II-B, LINE 1: RETAINED A LOBBYIST FOR MAILING TO LEGISLATORS OR THE PUBLIC AND ALSO TO HAVE DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, AND/OR A LEGISLATIVE BODY. THESE ARE DONE AT THE STATE LEVEL ONLY. ARH IS A MEMBER OF VARIOUS HOSPITAL ASSOCIATIONS. THE APPROPRIATE PERCENTAGE OF DUES PAID TO THE ORGANIZATIONS ALLOCABLE TO LOBBYING ACTIVITIES ARE ALSO INCLUDED. 17070242 15459032 4415775 4415775 140435250 90138353 50296897 149992880 86807044 63185836 216291854 172397224 43894630 11361653 2885989 8475664 170268802 MEDICARE & MEDICAID ESTIMATED SETTLEMENTS 103869721 ACCRUED PENSION COST 114019454 RESERVE FOR SELF-INSURANCE 40520146 PHYSICIAN COMMITMENTS 867226 DUE TO PATIENTS 14288229 BOND INTEREST PAYABLE 1268475 CAPITAL LEASE OBLIGATIONS 4169152 SERP PAYABLE 860608 279863011 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 17070242 15459032 1611210 0.00250 189326138 100772595 88553543 0.13960 206396380 116231627 90164753 0.14210 4252 63015 1472545 4115 1468430 0.00230 4252 63015 1472545 4115 1468430 0.00230 4252 63015 207868925 116235742 91633183 0.14440 79 12386 33220 33220 0.00010 6 129 569 569 0.00000 3 56 1272 1272 0.00000 59 1434 11327 2600 8727 0.00000 4 3103 2223 2223 0.00000 9 2953 9448 9448 0.00000 160 20061 58059 2600 55459 0.00010 1 56507591 25944384 147714604 171456385 -23741781 X 1 1 1 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCI CONDO OWNER 0.39600 0.60400 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 1500 TERRACE STREET HINTON WV 25951 X X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 15 1 0 0 1 X WWW.ARH.ORG/CHNA X 1 13 1 WWW.ARH.ORG/CHNA 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X X 1 X WWW.ARH.ORG X WWW.ARH.ORG X WWW.ARH.ORG X X X X X 1 X X 0 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 2015-2016. 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. PREVENTIVE SERVICES AND EDUCATIONAL PROGRAMSTHE 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 AND MORE VARIETY OF LOCATIONS FOR THE EVENTS. WITH THESE RESULTS IN MIND, SOME COMMUNITIES ARE FOCUSING ON OFFERING MORE COMMUNITY HEALTH EDUCATION AND SCREENING EVENTS WHILE OTHERS OFFERED MORE FOCUSED EVENTS BASED ON THEIR CHNA RESULTS TARGETING SPECIFIC DISEASES OR SEGMENTS OF THE COMMUNITY.ACCESS TO CAREAN ADDITIONAL AREA IDENTIFIED DURING THE MOST RECENT CHNA ACROSS THE SYSTEM WAS THE NEED TO INCREASE ACCESS TO CARE. RESPONDENTS WANTED INCREASED ACCESS THROUGH THE AVAILABILITY OF AFTER/EXTENDED HOURS SERVICES, ADDITIONAL SPECIALTY COVERAGE (ESPECIALLY ENT AND DERMATOLOGY), AND THROUGH THE POSSIBLE ADDITION OF TELEMEDICINE CAPABILITIES. SINCE RECEIVING THOSE CHNA RESULTS, MANY OF ARH'S FACILITIES HAVE ADDED SOME FORM OF AFTER-HOURS COVERAGE OR HAVE FURTHER PROMOTED AFTER HOURS SERVICES THAT HAD PREVIOUSLY BEEN UNDERUTILIZED. VARIOUS PHYSICIAN SPECIALTIES AND HOSPITAL SERVICES HAVE ALSO BEEN EVALUATED AND POSSIBLY ADDED ACROSS THE SYSTEM DUE TO THE IDENTIFIED NEED THROUGH THE CHNA PROCESS. TELEMEDICINE UNITS ARE ALSO BEING ADDED TO SOME OF ARH'S CLINIC LOCATIONS TO HOPEFULLY ENHANCE ACCESS TO NEEDED SPECIALTIES. COMMUNICATIONONE OTHER NEED THAT WAS ALSO APPARENT WITH THE MOST RECENT CHNA RESULTS WAS THE NEED TO IMPROVE SOME LEVEL OF COMMUNICATIONS. THIS NEED RANGED FROM ENSURING THAT THERE WAS 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. THESE VARIOUS IDENTIFIED COMMUNICATION ISSUES HAVE BEEN TACKLED INDIVIDUALLY BY EACH FACILITY AS NEEDED. ALL ARH FACILITIES NOW HAVE A SOCIAL MEDIA PRESENCE AND ARE TRYING TO UTILIZE THAT FORUM TO FURTHER PROMOTE ACTIVITIES AND EVENTS. FACILITIES ARE ALSO EXPLORING HOW TO ADD PATIENT NAVIGATION SERVICES/ADVOCATES TO ASSIST PATIENTS AS NEEDED. 89 1 - BECKLEY ARH BEHAVIORAL SCIENCES CENTER 306 STANAFORD ROAD BECKLEY WV 25801 PSYCH 2 - HARLAN ARH HOSPITAL PSYCHIATRIC SERVICE 81 BALL PARK ROAD HARLAN KY 40831 PSYCH 3 - ARH PSYCHIATRIC CENTER-HAZARD 102 MEDICAL CENTER DRIVE HAZARD KY 41701 PSYCH 4 - ARH HAZARD FAMILY HEALTH SERVICES 200 MEDICAL CENTER DRIVE HAZARD KY 417019466 CLINIC 5 - ARH HARLAN MEDICAL ASSOCIATES 37 BALL PARK ROAD HARLAN KY 408311701 RURAL HEALTH CLINIC 6 - ARH WHITESBURG SURGICAL CLINIC 214 HOSPITAL ROAD STE A WHITESBURG KY 418587627 CLINIC 7 - ARH TUG VALLEY MEDICAL ASSOCIATES 306 HOSPITAL DRIVE SOUTH WILLIAMSON KY 415034095 RURAL HEALTH CLINIC 8 - ARH MIDDLESBORO INTERNAL MEDICINE 3004 CUMBERLAND AVE SUITE 3 MIDDLESBORO KY 409652343 CLINIC 9 - ARH WHITSBURG CLINIC 222 HOSPITAL ROAD WHITESBURG KY 418587627 RURAL HEALTH CLINIC 10 - HAZARD ARH REGIONAL MEDICAL CENTER CLINI 200 MEDICAL CENTER DRIVE HAZARD KY 41701 PHARMACY 11 - HARLAN ARH OUTPATIENT PHARMACY 37 BALL PARK ROAD HARLAN KY 40831 PHARMACY 12 - HAZARD ARH HOME HEALTH AGENCY 100 AIRPORT GARDENS ROAD HAZARD KY 41701 HOME HEALTH 13 - ARH WOMEN'S AND FAMILY HEALTH CARE HARLA 37 BALL PARK ROAD SUITE 201 HARLAN KY 408311701 PRIMARY CARE CLINIC 14 - ARH COMMUNITY PHARMACY 210 BLACK GOLD BLVD SUITE 104 HAZARD KY 41701 PHARMACY 15 - ARH HAZARD HOMECARE STORE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 HOME HEALTH CARE 16 - ARH WILLIAMSON HOMECARE STORE 306 HOSPITAL DRIVE SUITE 104A SOUTH WILLIAMSON KY 41503 HOME HEALTH CARE 17 - ARH MAN HOMECARE STORE ROUTE 99 BUFFALO CREEK ROAD KISTLER WV 25628 HOME HEALTH CARE 18 - ARH HARLAN HOMECARE STORE 106 RAILROAD STREET SUITE 5 HARLAN KY 40831 HOME HEALTH CARE 19 - ARH PRESCRIPTION DIVISION 306 HOSPITAL DRIVE SUITE 105 SOUTH WILLIAMSON KY 41503 PHARMACY 20 - WHITESBURG ARH HOME HEALTH AGENCY 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH 21 - ARH MORGAN COUNTY CLINIC 476 LIBERTY ROAD WEST LIBERTY KY 414720579 RURAL HEALTH CLINIC 22 - BECKLEY ARH HOME HEALTH AGENCY 306 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH 23 - MORGAN COUNTY ARH HOME HEALTH AGENCY 493 MAIN STREET WEST LIBERTY KY 41472 HOME HEALTH 24 - ARH WOMEN'S AND FAMILY HEALTH CARE - TUG 26901 US HIGHWAY 119N BELFRY KY 415147520 PRIMARY CARE CLINIC 25 - ARH TRI-CITY MEDICAL CENTER 18880 NORTH US 119 CUMBERLAND KY 408238106 RURAL HEALTH CLINIC 26 - BECKLEY ARH PHARMACY 250 STANAFORD ROAD BECKLEY WV 25801 PHARMACY 27 - MCDOWELL ARH HOME HEALTH AGENCY 8535 KY RT 122 MINNE KY 41651 HOME HEALTH 28 - HARLAN ARH HOME HEALTH AGENCY 81 BALL PARK ROAD HARLAN KY 40831 HOME HEALTH 29 - ARH SUMMERS COUNTY RURAL HEALTH CLINIC 1500 TERRACE STREET HINTON WV 259510940 RURAL HEALTH CLINIC 30 - ARH REFERENCE LABORATORY 100 MEDICAL CENTER DRIVE HAZARD KY 41701 LAB 31 - ARH BECKLEY HOMECARE STORE 260 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH CARE 32 - MORGAN COUNTY ARH PHARMACY 476 LIBERTY ROAD WEST LIBERTY KY 41472 PHARMACY 33 - WILLIAMSON ARH HOME HEALTH AGENCY 160 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 HOME HEALTH 34 - PIKEVILLE BRANCH-ARH PIKE CO HOME HEALT 247 SOUTH MAYO TRAIL PIKEVILLE KY 41502 HOME HEALTH 35 - MAN ARH HOME HEALTH SUB-STATION BUFFALO CREEK ROAD /ROUTE 99 KISTLER WV 25628 HOME HEALTH 36 - ARH MCDOWELL PROFESSIONAL CLINIC 9879 KY RT 122 MCDOWELL KY 416476042 RURAL HEALTH CLINIC 37 - ARH WEST LIBERTY HOMECARE STORE 520 PRESTONSBURG STREET WEST LIBERTY KY 41472 HOME HEALTH CARE 38 - WHITESBURG ARH PHARMACY 240 HOSPITAL ROAD WHITESBURG KY 41858 PHARMACY 39 - ARH MAYKING HOMECARE STORE 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH CARE 40 - ARH MCDOWELL HOMECARE STORE 8535 KY RT 122 MINNE KY 41651 HOME HEALTH CARE 41 - ARH PIKEVILLE HOMECARE STORE 247 SOUTH MAYO TRAIL PIKEVILLE KY 41501 HOME HEALTH CARE 42 - MIDDLESBORO ARH PHARMACY 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 PHARMACY 43 - ARH MARY BRECKINRIDGE HOME HEALTH SERVIC 166 KATE IRELAND DR HYDEN KY 41749 HOME HEALTH 44 - MIDDLESBORO ARH HOME HEALTH AGENCY 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH 45 - ARH MIDDLESBORO HOMECARE STORE 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH CARE 46 - ARH TRI-CITIES CLINIC PHARMACY 18880 NORTH US 119 CUMBERLAND KY 40823 PHARMACY 47 - ARH HINTON HOMECARE STORE 1500 TERRACE STREET HINTON WV 25951 HOME HEALTH CARE 48 - ARH FAMILY CARE WAYLAND 2662 KING KELLY COLEMAN HWY WAYLAND KY 416669998 PRIMARY CARE CLINIC 49 - ARH FAMILY CARE - WHEELWRIGHT 30 KY RT 306 BYPRO KY 416129706 PRIMARY CARE CLINIC 50 - JENKINS ARH FAMILY CARE 9480 HIGHWAY 805 JENKINS KY 415378182 PRIMARY CARE CLINIC 51 - AH BARIATRIC CENTER 210 BLACK GOLD BOULEVARD SUITE 102 HAZARD KY 417012620 CLINIC 52 - ARH SYSTEM CENTER-HAZARD 100 AIRPORT GARDENS ROAD HAZARD KY 41701 SUPPORT 53 - ARH SYSTEM CENTER-LEXINGTON 2285 EXECUTIVE DR SUITE 400 LEXINGTON KY 40505 SUPPORT 54 - ARH SYSTEM CENTER-LEXINGTON JORDAN BUIL 1218 SOUTH BROADWAY LEXINGTON KY 40504 SUPPORT 55 - ARH SYSTEM CENTER-SOUTH WILLIAMSON 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 SUPPORT 56 - ARH REGIONAL DISTRIBUTION CENTER 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 57 - DME WAREHOUSE 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 58 - ARH SOUTHERN WEST VIRGINIA CLINIC 250 STANAFORD ROAD BECKLEY WV 258013140 CLINIC 59 - MIDDLESBORO ARH PHYSICIAN CLINIC 3600 WEST CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 60 - ARH WOMEN'S AND FAMILY HEALTH CARE - MID 3602 W CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 61 - ARH CARDIOLOGY & ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 1J HAZARD KY 417019477 CLINIC 62 - HYDEN ARH CLINIC 130 KATE IRELAND DR HYDEN KY 417499071 CLINIC 63 - BEECH FORK ARH CLINIC 805 MIDDLE FORK RD ASHER KY 408030026 CLINIC 64 - BIG CREEK ARH CLINIC 17644 S HWY 421 BIG CREEK KY 409149998 CLINIC 65 - BELL COUNTY ARH UROLOGY 2004 CUMBERLAND AVE STE 301 MIDDLESBORO KY 409651385 CLINIC 66 - MIDDLESBORO PRIMARY CARE CENTER 3602 W CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 67 - ARH DERMATOLOGY 210 BLACK GOLD BLVD SUITE 211 HAZARD KY 41701 CLINIC 68 - ARH CARDIOLOGY ASSOCIATES - BECKLEY 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 69 - BECKLEY ARH PRIMARY CARE 250 STANFORD ROAD STE 104 BECKLEY WV 258013140 CLINIC 70 - BECKLEY ARH UROLOGY CLINIC 407 CARRIAGE DR BECKLEY WV 258012805 CLINIC 71 - ARH SPECIALTY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 100 SOUTH WILLIAMSON KY 415034095 CLINIC 72 - ARH SPECIALTY ASSOCIATES - WHITESBURG 214 HOSPITAL DR STE B WHITESBURG KY 418587627 CLINIC 73 - ARH CARDIOLOGY ASSOCIATES - WHITESBURG 226 MEDICAL PLAZA LN STE C WHITESBURG KY 418587425 CLINIC 74 - ARH SPECIALTY ASSOCIATES - HARLAN 37 BALL PARK RD STE 200 HARLAN KY 408311701 CLINIC 75 - ARH CARDIOLOGY ASSOCIATES - HARLAN 37 BALL PARK RD STE 100 HARLAN KY 408311701 CLINIC 76 - ARH CARDIOLOGY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 203 SOUTH WILLIAMSON KY 415034095 CLINIC 77 - ARH DERMATOLOGY MIDDLESBORO 2145 US HIGHWAY 25E MIDDLESBORO KY 409651874 CLINIC 78 - ARH OAK HILL PRIMARY CARE CENTER 223 MAPLE AVE OAK HILL WV 259013475 CLINIC 79 - ARH SHARE PRIMARY CARE CLINIC 101 S EISENHOWER DR BECKLEY WV 258014929 CLINIC 80 - ARH SPECIALTY ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 2M HAZARD KY 417019422 CLINIC 81 - ARH PENNINGTON GAP CLINIC 121 STACY DR PENNINGTON GAP VA 242779998 CLINIC 82 - BECKLEY ARH MEDICAL MALL 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 83 - SUMMERS CO ARH FAMILY CARE CLINIC 197 PLEASANT ST HINTON WV 259512540 CLINIC 84 - ARH CARDIOLOGY ASSOCIATES MIDDLESBORO 3503 W CUMBERLAND AVE MIDDLESBORO KY 409652611 CLINIC 85 - MIDDLESBORO ARH HEMATOLOYONCOLOGY CLINI 3602 W CUMBERLAND AVE STE 104 MIDDLESBORO KY 409652614 CLINIC 86 - MORGAN COUNTY ARH FAMILY HEALTH 1084 HWY 7 STE 2 WEST LIBERTY KY 414727146 CLINIC 87 - HAZARD MEDICAL MALL 210 BLACK GOLD BLVD STE 102 HAZARD KY 41701 MEDSPA 88 - ARH BECKLEY REJUVENATION CENTER 1256 N EISENHOWER DRIVE BECKLEY WV 25801 MEDSPA 89 - ARH MIDDLESBORO REJUVENATION CENTER 3503 W CUMBERLAND AVE MIDDLESBORO KY 40965 MEDSPA 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 370,000 RESIDENTS AND EMPLOYING NEARLY 5,000 PEOPLE ACROSS EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA WITH HOSPITALS, CLINICS, HOME HEALTH AGENCIES, PHARMACIES AND HOME DURABLE MEDICAL EQUIPMENT STORES. IN FISCAL YEAR 2014, ARH'S 10 HOSPITALS RANGE IN SIZE FROM CRITICAL-ACCESS FACILITIES TO THE SYSTEM'S FLAGSHIP REGIONAL MEDICAL CENTER WITH 308-LICENSED BEDS IN HAZARD, KENTUCKY.WHILE PROVIDING THIS REGION WITH QUALITY HEALTHCARE, ARH REINVESTS ANY EARNINGS BACK INTO OPERATIONS TO FURTHER THE SYSTEMS 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 COMMUNITIES, 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: MANAGEMENT CONTINUALLY MONITORS AND ADJUSTS THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ASSOCIATED WITH CREDIT RISK.THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICAL TO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE CORPORATION ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE PRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENT RECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROM INDIVIDUAL PATIENTS.THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE CORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES.PART III, LINE 2:COSTING METHODOLOGY: TO DETERMINE THE BAD DEBT EXPENSE ON LINE 2, THE BAD DEBT EXPENSE PER THE FINANCIAL STATEMENTS, WHICH CONSISTS OF GROSS CHARGES LESS DISCOUNTS, WAS CONVERTED TO COST USING THE GLOBAL COST-TO-CHARGE RATIO DEVELOPED IN WORKSHEET 2. PATIENT DISCOUNTS ARE NOT REFLECTED IN BAD DEBT. ANY PAYMENTS ON AN ACCOUNT AFTER IT IS WRITTEN OFF TO BAD DEBT RESULT IN A REVERSAL OF THE ENTIRE ACCOUNT OUT OF BAD DEBT, REINSTATEMENT OF THE PATIENT ACCOUNT RECEIVABLE, AND ANY NEGOTIATED DIFFERENCE IN THE FULL AMOUNT OF THE ACCOUNT AND THE PAYMENT MADE IS WRITTEN OFF TO CONTRACTUAL ALLOWANCE. PATIENTS WHO MAY QUALIFY FOR CHARITY CARE BUT DO NOT APPLY CANNOT BE ESTIMATES. ALL PATIENTS ARE EDUCATED ABOUT AND GIVEN EVERY OPPORTUNITY TO APPLY FOR CHARITY CARE AND, THEREFORE, ARH HAS NO INFORMATION FOR THOSE WHO CHOOSE NOT TO APPLY. PART III, LINE 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 $8 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 $7,359,854 (OR 100%) OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 7 BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 9B: THE PROVISIONS IN THE WRITTEN DEBT COLLECTION POLICY ARE THAT CHARITY AND FINANCIAL ASSISTANCE APPLICATIONS ARE VALID FOR 6 MONTHS, AFTER THAT TIME, THE PATIENT MUST REAPPLY AND PRESENT CURRENT FINANCIAL DOCUMENTS AS NECESSARY. PART VI, LINE 2: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT IS CONDUCTED BY ARH EVERY THREE YEARS AND REPORTED ELSEWHERE IN THIS DOCUMENT, ARH ALSO CONTINUALLY ASSESSES COMMUNITY NEEDS IN OTHER FORMS AS WELL. THE NEEDS OF THE COMMUNITIES THAT ARH SERVES THROUGHOUT EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA ARE ASSESSED BY FOLLOWING EMERGING MEDICAL PRACTICE NEEDS AS A WHOLE ACROSS THE NATION AND SPECIFICALLY IN THE APPALACHIAN REGION. THE HEALTH NEEDS ARE EXAMINED BY LOOKING AT HEALTH STATISTICS AND DISEASE PREVALENCE COMPARED TO SERVICE/PHYSICIAN AVAILABILITY. PATIENT AND COMMUNITY SURVEYS ARE ALSO REGULARLY CONDUCTED TO ASSESS CONSUMER PERCEIVED NEEDS.LOCAL ADVISORY COUNCILS (LACS) ALSO EXIST IN EACH OF ARH'S HOSPITAL COMMUNITIES. THE COUNCILS ARE COMPRISED OF LOCAL CITIZENS WHO VOLUNTEER TO HELP ARH IMPROVE THE HEALTH OF ITS COMMUNITIES THROUGH REGULAR MEETINGS THAT DISCUSS COMMUNITY HEALTH ISSUES AND HELP ARH IDENTIFY AND ADDRESS THEM. MEMBERS ALSO ADVISE ARH ABOUT IMPROVEMENTS NEEDED AND COMMUNITY PERCEPTIONS OF ARH FACILITIES AND THESE INDIVIDUALS SERVE AS EXCELLENT AMBASSADORS FOR ARH AND ITS SERVICES. THESE INDIVIDUALS HAVE DEMONSTRATED THEIR LEADERSHIP IN LOCAL CIVIC AFFAIRS AND REFLECT A CROSS SECTION OF THE COMMUNITY. QUARTERLY, ONE REPRESENTATIVE FROM EACH OF THESE LACS MEETS TO DISCUSS COMMON ISSUES ACROSS THE SYSTEM AT A REGIONAL ADVISORY COUNCIL MEETING. FROM THIS GROUP OF REPRESENTATIVES, ONE MEMBER IS SELECTED TO ALSO SERVE ON THE HEALTH SYSTEM'S BOARD OF TRUSTEES. PART VI, LINE 3: UNDER ARH'S FINANCIAL ASSISTANCE PROGRAM AND POLICY EACH PATIENT WITHOUT MEDICAL COVERAGE FOR RENDERED SERVICES IS OFFERED A 40% DISCOUNT OF GROSS CHARGES AT TIME OF SERVICE. IF THE PATIENT EXTENDS PAYMENT AT TIME OF SERVICE THEY ARE GIVEN ANOTHER 10% DISCOUNT, MAKING THEIR LIABILITY 50% OF GROSS CHARGES. ALL OF THESE DISCOUNTS ARE APPLIED AT TIME OF CHARGE AND BILLED AFTER THE DISCOUNT IS TAKEN.IF SAID PATIENT IS UNABLE TO MEET THE FINANCIAL OBLIGATIONS FOR SERVICE, THEY ARE EDUCATED AND SCREENED FOR POTENTIAL FEDERAL AND/OR STATE ASSISTANCE PROGRAMS. BY DOING THIS THE PATIENT IS REVIEWED AND EDUCATED BY ON-SITE FINANCIAL COUNSELORS AND/OR ELIGIBILITY AGENCY TO GET THE INDIVIDUAL PLACED 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 COVERS 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 2017, ARH PROVIDED CLOSE TO $55 MILLION IN UNCOMPENSATED CARE AND DURING THAT SAME FISCAL YEAR APPROXIMATELY 70 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 350,000 RESIDENTS AND EMPLOYING NEARLY 5,000 PEOPLE ACROSS EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA WITH HOSPITALS, CLINICS, HOME HEALTH AGENCIES, PHARMACIES AND HOME DURABLE MEDICAL EQUIPMENT STORES. IN FISCAL YEAR 2017, ARH'S 11 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 COMMUNITIES, 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 2017, ARH'S SERVICES WERE MAINLY ORGANIZED AROUND ITS 11 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 11 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 LESLIE COUNTY FISCAL PO BOX 619 HYDEN KY 41749 610598566 GOVT 10000 SUPPORT ONGOING OPERATIONS PERRY COUNTY FAIR BOARD PO BOX 210 HAZARD KY 41702 473857010 GOVT 10000 CHRISTMAS IN A SMALL TOWN JENNY WILEY THEATER PO BOX 22 PRESTONBURG KY 41653 610667976 501(C)(3) 10000 SUPPORT ONGOING OPERATIONS FLOYD COUNTY BOARD OF EDUCATION 105 NORTH FRONT AVE PRESTONBURG KY 41653 616001347 GOVT 20000 SCOREBOARD 1 EAST KENTUCKY CORPORATION 1 BERT COMBS DRIVE PRESTONBURG KY 41653 474557366 501(C)(3) 25000 SUPPORT ONGOING OPERATIONS 5 X X X X 0 1 0 0 0 1 0 0 0 JOSEPH L GROSSMAN PRESIDENT/CEO 616526 0 127500 0 2905 0 54796 0 813 0 802540 0 0 0 ELLEN WRIGHT VP AND CHIEF NURSING OFFICER 145569 0 22875 0 0 0 18000 0 813 0 187257 0 0 0 DANNY M HARRIS CFO/VP FISCAL SERVICES 252349 0 38888 0 0 0 22511 0 813 0 314561 0 0 0 HOLLIE P HARRIS VP CORPORATE STRATEGY 211493 0 32788 0 0 0 25265 0 813 0 270359 0 0 0 PAUL V MILES COO/VP OPERATIONS 259727 0 40207 0 0 0 31132 0 813 0 331879 0 0 0 MARIA BRAMAN VP MEDICAL AFFAIRS & CMO 209005 0 9625 0 0 0 16043 0 813 0 235486 0 0 0 BOBBY RICK KING CLO/VP LEGAL AFFAIRS 241189 0 37177 0 0 0 28199 0 813 0 307378 0 0 0 BUTT JAMEEL A GENERAL SURGEON 698388 0 47057 0 0 0 5746 0 813 0 752004 0 0 0 CHANDRASHEKAR KRISHNASWAMY NEUROLOGIST 622922 0 0 0 0 0 4955 0 813 0 628690 0 0 0 JYOTIN CHANDARANA FAMILY PHYSICIAN 511495 0 0 0 0 0 8127 0 813 0 520435 0 0 0 FIRAS KOURA PULMONOLOGIST 613622 0 0 0 0 0 3984 0 813 0 618419 0 0 0 NAGABHUSHANAM BOLLAVARAM PULMONOLOGIST 548557 0 0 0 0 0 3696 0 813 0 553066 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 $18,000 IN 2015. 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 $18.000. PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE 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 16770000 40000000 3642668 735189 35622143 2013 0 1 1 1 B 4865701 10000000 10000000 0 0 1 1 C 2810866 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 16732 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 THE ARH BOARD SETS COMPENSATION LEVELS FOR MR. GROSSMAN AND OTHER ARH EXECUTIVES. THE BOARD CONTRACTS WITH MERCER CONSULTING TO REVIEW THE MARKET FOR THE POSITIONS ON THE SYSTEM OPERATING COUNCIL WHO MAKES RECOMMENDATIONS ON THE SALARY RANGES AND ASSESSES THE COMPETITIVENESS OF THE SALARIES. WITH THAT INFORMATION, THE COMPENSATION AND CONTRACTS COMMITTEE SET THE RANGES AND THE PRESIDENT'S COMPENSATION. THE REVIEW WAS COMPLETED AND SALARIES WERE SET AT THE NOVEMBER BOARD MEETING. MERCER FOLLOWED UP WITH A LETTER ATTESTING TO THE REASONABLENESS OF THE COMPENSATION. RICK KING KEEPS THE MINUTES OF THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 WHILE ARH HAS NOT YET ADOPTED A POLICY OF SHARING ITS FINANCIAL STATEMENTS WITH THE PUBLIC, IT DOES PROVIDE FINANCIAL INFORMATION THROUGH THE FORM 990 AND ALSO PROVIDES CERTAIN FINANCIAL INFORMATION IN OTHER PUBLIC DOCUMENTS, INCLUDING ITS PERIODIC REPORTS TO THE COMMUNITIES IT SERVES. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - PHYSICIANS: PROGRAM SERVICE EXPENSES 20,744,842. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,744,842. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 25,679,200. MANAGEMENT AND GENERAL EXPENSES 8,996,116. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,675,316. SECURITY SERVICES: PROGRAM SERVICE EXPENSES 2,356,485. MANAGEMENT AND GENERAL EXPENSES 14. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,356,499. LAB SERVICES: PROGRAM SERVICE EXPENSES 8,878,570. MANAGEMENT AND GENERAL EXPENSES 1,632,488. FUNDRAISING EXPENSES 67,187. TOTAL EXPENSES 10,578,245. CONTRACT LABOR FEES: PROGRAM SERVICE EXPENSES 22,705,437. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,705,437. FORM 990, PART XI, LINE 9: MINIMUM PENSION LIABILITY ADJUSTMENT 20,824,125. NET CHANGE IN AFFILIATE INVESTMENT -85,500. 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 13432314 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 2285 EXECUTIVE DRIVE LEXINGTON KY 40505 452696517 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 WHITESBURG PHYSICIAN OFFICE BLDG LLC 2285 EXECUTIVE DRIVE SUITE 400 LEXINGTON KY 40505 753022080 PHYSICIAN OFFICE BUILDING KY EXCLUDED 7361 45426 0 1 0.28130 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCIL 2285 EXECUTIVE DRIVE SUITE 400 LEXINGTON KY 40504 201796044 OFFICE BUILDING MANAGEMENT KY N/A C 0.39600 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 ARH FOUNDATION FOR HEALTHIER COMMUNITIES Q 150043 ALLOCATED COSTS