2025-11-14T17:39:41+00:00 2024-12-31 331498605 Plante & Moran PLLC 250 SOUTH HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-01-01 311072406 PIKE HEALTH SERVICES INC PIKE 7409472186 100 DAWN LANE WAVERLY OH 45690 JEFF GRAHAM AHS CEO 7409472186 2025-11-14 true true AMY CIMINELLO CPA P00796388 6148493000 2025-11-14 2024 2025-03-06 01:10:19Z ADENA PIKE MEDICAL CENTER DAVE ZANNI 100 DAWN LANE WAVERLY OH 45690 35114677 false X WWW.ADENA.ORG X 1983 OH ADENA PIKE MEDICAL CENTER IS A CRITICAL ACCESS HOSPITAL AND A MEMBER OF THE ADENA HEALTH SYSTEM THAT PROVIDES HEALTHCARE TO CITIZENS IN PIKE COUNTY. 10 10 290 15 0 349663 0 33951951 35036341 907 309 100670 78027 34403191 35114677 0 0 0 0 13330654 13920398 0 0 0 15349312 18645366 28679966 32565764 5723225 2548913 13326257 13666492 1617700 1793132 11708557 11873360 CALLED TO SERVE OUR COMMUNITIES false false 26740176 0 35040749 PIKE HEALTH SERVICES, INC. IS A 25- BED CRITICAL ACCESS HOSPITAL LOCATED IN PIKE COUNTY IN THE STATE OF OHIO. IN 2024, PIKE HEALTH SERVICES, INC. HAD 857 INPATIENT DISCHARGES AND 11,354 EMERGENCY ROOM PATIENTS. DURING THE YEAR, PIKE HEALTH SERVICES, INC PARTICIPATED IN HEALTH FAIRS OFFERING SCREENING AND EDUCATION FOR DIABETES, CHOLESTEROL AND ARTHRITIS FOR BOTH ADULTS AND CHILDREN. PIKE HEALTH SERVICES MAINTAINS CLINIC OFFICE SPACE FOR PHYSICIAN SPECIALISTS FROM ADENA HEALTH SYSTEM TO SEE PATIENTS AT A DESTINATION CLOSER TO THEIR HOMES. THESE INCLUDE GENERAL SURGEONS, UROLOGISTS, AND GYNECOLOGISTS. 26740176 true false false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false false false true false false false false true X 0 0 290 true false false false false false false false false false false false false X 10 10 false false false false true true true true true false false false true true true true true true true false false false X JEFF CRAFT 7407794481 272 HOSPITAL ROAD CHILLICOTHE OH 456019031 ANTHONY FISH TRUSTEE/CHAIR 2.0 2.0 X X 0 0 0 VAL FRANCIS TRUSTEE/VICE CHAIR 2.0 0 X X 0 0 0 CONNIE SHELLEY TRUSTEE 2.0 0 X 0 0 0 JOSH REMY TRUSTEE 2.0 0 X 0 0 0 JUDY SCHMITT TRUSTEE 2.0 0 X 0 0 0 JUSTIN SMITH COS/PHYSICIAN 1.0 50.0 X 0 530434 20635 KIM ROE TRUSTEE 2.0 0 X 0 0 0 RENEA GREGORY TRUSTEE 2.0 0 X 0 0 0 SARA RAMSEY TRUSTEE 2.0 0 X 0 0 0 TONY DIXON TRUSTEE 2.0 0 X 0 0 0 DAVE ZANNI SENIOR OPERATIONS EXECUTIVE OFFICER 50.0 0 X 211755 0 62067 JAMES MCMANUS AHS CFO 1.0 54.0 X 0 738566 253395 JEFF GRAHAM AHS CEO 1.0 54.0 X 0 1180581 368169 KATHERINE EDRINGTON AHS COO 1.0 54.0 X 0 441728 191286 ANITA KOHN STAFF NURSE RN BSN 50.0 0 X 153198 0 12798 CHERYL SMITH PHARMACIST 50.0 0 X 193460 0 10282 JASON LOUTSENHIZER TL PHARMACIST 50.0 0 X 178554 0 20643 LADOSKA EVANS STAFF NURSE RN BSN 50.0 0 X 158203 0 7652 RANDALL RATLIFF REG NUC MED TECH 50.0 0 X 136214 0 30650 1031384 2891309 977577 20 false true false ENSEMBLE HEALTH PARTNERS HOLDINGS LLC 11511 REED HARTMAN HWY CINCINNATI OH 45241 REVENUE CYCLE MANAGEMENT 1807708 Premier Physician Services Inc 332 CONGRESS PARK DRIVE dayton OH 45459 PHYSICIAN SERVICES 1188423 Apogee Medical Managementap SCOTTSDALE RD 600 SCOTTSDALE AZ 85254 PHYSICIAN SERVICES 759978 Captive Radiology LLC 6273 FRANK AVENUE NW NORTH CANTON OH 44720 MRI SERVICES 609917 MeDefis Inc 2121 N 117th Ave Ste 200 Omaha NE 68164 MANAGEMENT SOLUTIONS 499374 6 0 NET PATIENT SERVICE REVENUE 621110 35036341 35036341 0 0 0 0 35036341 309 309 4408 0 4408 0 4408 4408 0 0 CAFETERIA REVENUE 722514 73619 73619 0 0 0 0 73619 35114677 35040749 0 73928 X 273822 236436 37386 10761921 9292564 1469357 2326858 2041952 284906 557797 489499 68298 3344627 465970 2878657 0 452796 357934 94862 3597 2158 1439 937810 688025 249785 92295 69981 22314 MEDICAL SUPPLIES 5969781 5693456 276325 CORPORATE OVERHEAD ALLOCATION 3530256 3530256 BAD DEBT EXPENSE 2583318 2583318 FRANCHISE FEES 1106767 1106767 624119 181860 442259 0 32565764 26740176 5825588 0 578724 689883 3443339 3738266 0 0 289831 343434 701626 777198 0 -4947 18449411 11887753 6709737 6561658 0 0 1603000 1561000 13326257 13666492 988403 1256358 282617 0 0 346680 536774 1617700 1793132 X 11705484 11870287 3073 3073 11708557 11873360 13326257 13666492 X 2548913 -2384110 X false true true false X false false false false false false false false true 671 671 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE OHIO HOSPITAL ASSOCIATION DOES LOBBYING ON BEHALF OF HOSPITAL RELATED CAUSES. THIS ACTIVITY IS PAID FOR THROUGH DUES PAID TO THE OHIO HOSPITAL ASSOCIATION. 350000 350000 8454167 4517598 3936569 8496645 6988525 1508120 1148599 381630 766969 6561658 GROUND LEASE 1561000 1561000 Federal Income Taxes COST REPORT SETTLEMENTS PAYABLE 445006 CAPITAL LEASE OBLIGATION 91768 536774 true true X true X true X 621464 1181905 0 0.0 7721375 4739410 2981965 0.09157 0 0 0 0.0 0 0 8342839 5921315 2981965 0.09157 9980 0 9980 0.00031 0 0.0 0 0.0 0 0.0 0 0.0 0 0 9980 0 9980 0.00031 0 0 8352819 5921315 2991945 0.09187 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 2583318 17686915 17598291 88624 X true true 1 1 PIKE HEALTH SERVICES INC 100 DAWN LANE WAVERLY OH 45690 WWW.ADENA.ORG 1299 X X X X PIKE HEALTH SERVICES INC 1 false false true X X X X X X X X X 22 true true true true X HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW X X true 22 true HTTPS://WWW.ADENA.ORG/COMMUNITY-HEALTH/OVERVIEW false true X 200.0 400.0 X X X X true true X X X X true X HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/ X HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/ X HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - PIKE HEALTH SERVICES, INC.. The Adena Pike Medical Center captured the broad interests of the community for the CHNA through three primary methods: public surveys, focus groups and key stakeholder interviews. A health needs survey was widely distributed in both electronic and paper form across the Pike County Community and received more than 300 responses. In addition to the surveys, interviews with local community leaders, including civic, public health and emergency response were requested and/or conducted to gain further knowledge of survey topics. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - PIKE HEALTH SERVICES, INC.. THE CHNA FOR ADENA PIKE MEDICAL CENTER WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING HOSPITALS: ADENA HEALTH SYSTEM. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - PIKE HEALTH SERVICES, INC.. The CHNA for Adena Pike Medical Center was conducted in collaboration with the following organizations: Pike County General Health District, Adena Health, Valley View Health Center, Community Action Committee of Pike County, OSU Extension-Pike County, Pike Healthy Lifestyle Initiative (PHLI), Pike County Job and Family Services, Pike County Senior Center, Pike County Children's Services, the Recovery Council, Southern Ohio Medical Center, Paint Valley ADAMH, Pike County YMCA, Pike County Sherriff's Department, Pike County Partnership Against Domestic Violence, Ross-Pike Educational Services District. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - PIKE HEALTH SERVICES, INC. THE CHNA WAS MADE AVAILABLE IN ELECTRONIC FORM THROUGH SOCIAL MEDIA, NEWSPAPER, AND PARTICIPATING AGENCY WEBSITES. PRESENTATIONS OF ITS CONTENT WERE MADE TO GOVERNMENT, COMMUNITY AND CIVIC ORGANIZATIONS. HARD COPIES OF THE CHNA REPORT WERE ALSO PRINTED AND SENT TO COMMUNITY LEADERS AND AGENCIES. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - PIKE HEALTH SERVICES, INC.. The following details the specific implementation strategies used for health priorities identified for the Adena Pike Medical Center during the 2022 Community Health Needs Assessment. Substance Use Disorder Community Development Adena Health assisted in the development of a HRSA Rural Communities Opioid Response Program (RCORP) implementation grant in 2019. In 2022, Adena Health awarded $1.6 million over three years. Adena Health is the fiscal agent for the grant, oversees all of the grants management and provides 0.5 FTE project coordinator to oversee the project. The grant is focused on increasing medication assisted treatment access for those who are being treated for opioid use disorder in Pike, Ross and Fayette counties. This grant continues through August 2025. Adena works with Bright View Treatment to provide priority appointments to patients identified with substance use disorder to facilitate more immediate access to treatment. Advocacy Adena Health share a weekly communication to community partners where substance use topics and education opportunities are shared. An Adena employee devotes 4-6 hours/week on this education to community partners. Adena Health has one who each dedicated a minimum of one hour a month to participating in Pike County Drug Coalition meetings and coordinating projects for the group in 2024. Programming and Initiatives The Baby Centered Recovery Program provided a total of 12 women (from multiple counties including Ross) with pregnancy education and addiction counseling in 2024. In addition, participants were provided resource referrals, as well as food and baby supplies at no charge to participants. More than 300 mothers have been supported by the program since 2014. The program has been recognized for exceptional care provided at the local, state and national level. Financial Support and Clinical Alignment Adena Health works to align its service lines and clinics with community resources that will address the social factors and barriers faced by many of its rural patients. This often involves community partnering and monetary support from Adena Community Health and Development. These two strategies are connected and reported together. - Adena Health provided $35,000 in support during 2024 for the Buck Fifty which coordinates the Drug Free Clubs of America/MADE program deployed in area school districts which incentivizes student participation in drug testing. Adena caregivers provide more than 50 hours per year supporting this program by working with area students to collect samples for testing to support their participation in the program. - Adena Health also provided an additional support for harm reduction kits deployed in the ARMC, AFMC, APMC and AGMC emergency departments and risk reduction supply distribution with community partners using funds from the HRSA RCORP grant. - Adena Health contributed $1,000 to support the Paint Valley Alcohol, Drug Addiction and Mental Health (ADAMH) Board's annual Recovery Celebration dinner, honoring those who work to prevent, treat and support recovery for those in Ross, Highland, Fayette, Pike and Pickaway counties. Obesity and Diabetes Advocacy Adena Health has one employee who dedicates 10 hours a year to participate in the Pike County Local Foods Group and programming activities related to this. This group works to address healthy food access in Pike County and provide nutrition education to residents. Representatives on this group include area dietitians from Valley View Health Center, OSU Extension (local and state offices), Adena Health, Pike Outreach, and Pike Health District. The group also engages with Pike County 3rd graders to educate about fresh produce and the local farmers market at the annual Pike Ag Day. Vouchers for students to use fresh produce from Pike Ag Day were sponsored in part by Adena Health. Adena Health share a weekly communication to community partners where health topics and education opportunities are shared. An Adena employee devotes 4-6 hours/week on this education to community partners. Programming and Initiatives, Financial Support and Clinical Alignment Adena Health partnered with the Chillicothe Farmers; Market, Fayette County Farmers' Market and Way Farms to fund the "Fresh Food Rx Fruit & Veggie Perks programing. This program provides Adena patients referred by their provider an opportunity for fresh fruits and vegetables from area produce markets (a benefit for the patient and the local farmer). In 2024, Adena provided $9,439 in support to area markets for this programming. Adena Health partnered with the Ohio State University Extension - Pike County to provide cooking classes and education to area residents. The program provides nutrition education, food preparation and education on shopping healthy on a budget and label reading. Adena Health also supports the incentives given to participant which includes the cooking utensils (cutting board, measuring spoons, measuring cup, etc.). Respiratory Issues Advocacy Adena Health had 1 employee participating in the Pike Health Coalition meetings and activities for approximately 20 hours/year. Programming, Initiatives and Clinical Alignment Adena Health continued its coordination of the Adena Quit Clinic in 2024. The clinic provided a total of 19 patients served in 5 locations: Chillicothe (Ross County); Waverly (Pike County); Washington Court House (Fayette County); Greenfield (Highland County) and Jackson (Jackson County). Adena pharmacists completed 35 visits with patient with tobacco cessation counseling services including cessation planning, support and nicotine replacement education is provided by Adena pharmacists. Adena provided free lung cancer screenings to 2,200 patients from the region including Pike, Fayette, Highland and Ross counties. The screenings resulted in 188 patients being referred for additional work up secondary to the screening findings. By providing cancer screenings Adena Health is helping to decrease rates of death as early detection and treatment result in saving lives. Mental Health Community Development Adena Health participates in the education and support of the Paint Valley ADAMH events where topics such as mental health access, stigma reduction and other mental health related issues are discussed. Advocacy Adena Health had 1 employee participating in the Pike Health Coalition meetings and activities for approximately 20 hours/year. Adena Health share a weekly communication to community partners where mental health topics and education opportunities are shared. An Adena employee devotes 4-6 hours/week on this education to community partners. Mental health topics were also shared through Adena Health's social media channels. Programming & Initiatives Adena Health showcased mental health topics throughout the year as part of the Just Walk/Walk with a Doc programming. There were 4 such events throughout the year in 2024 in the region. As part of the event, participants are able to speak with a provider to have questions answered pertinent to the topic in a general format. Financial Support & Clinical Alignment Adena Health supported mental health events throughout the region through participation and/or financial support. A contribution was also made of $1000 to support a community education night for suicide awareness prevention. Adena's sponsorship helped support the speaker costs for this free community event. Child Safety & Wellness Advocacy Adena Health compiles a weekly communication to community partners where mental health topics and education opportunities are shared. An Adena employee devotes 4-6 hours/week on this education to community partners. Mental health topics were also shared through Adena Health's social media channels. Programming & Initiatives Adena Health provided athletic trainer services to 12 local public high schools within a six county (Ross, Pike, Fayette, Highland, Jackson, Pickaway) service region in 2024. A total of 13 athletic trainers worked within the school's athletic departments and focused on educating students, parents and coaches on sports medicine topics, including concussion identification and treatment. The value of this community support was greater than $650,000. The staff is also readily available at athletic events and provides yearly sports physicals to more than 1200 students in Highland, Fayette, and Jackson, Pickaway, Pike, and Ross counties. Sponsoring 4-H project books is another way Adena Health supports youth wellness. The cost of the projects books is prohibitive in some cases for area youth. Adena Health provided more than $4,000 in 2024 to support Pike County 4-H participants in this enrichment program. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - PIKE HEALTH SERVICES, INC.. In 2021, Adena Health partnered with Nationwide Children's Hospital to develop the Appalachian Whole Child Initiative. In 2023, Adena Health expanded the program and provided a coordinator (1.0 FTE) valued at $101,608 to work with partnered school district to complete school needs assessments, develop school wellness plans, and improve healthcare access to students and staff. In addition, the coordinator is assisting the districts in developing primary care and telehealth resources for the district, as well as bring in additional community partners to address mental health and social needs of students. Also in September 2023, Adena launched a mobile health clinic to provide medical care to area students and staff. In 2024, there were 714 patient encounters on the mobile unit. Adena Health partnered with the Garnet A. Wilson Public Library to coordinate the Healthy Kids Summer Fun Challenge, part of the Bookworm Summer Reading program. Pike County residents - children and adults- were engaged in the program that rewarded them for completing weekly health challenges. Participants are offered the opportunity to earn prizes as they complete challenges and those who complete all challenges are entered into a drawing for a new bicycle and adults got the opportunity for a Fitbit. A total of $2500 was spent on reward prizes for participants in Ross, Fayette, Highland and Pike counties. Financial Support and clinical alignment Adena Health works to align its service lines and clinics with community resources that will address the social factors and barriers faced by many of its rural patients. This often involves community partnering and monetary support from Adena Community Health and Development. - Adena Women's & Children's Center: Adena Health provided sleep sacks for the babies born at the Adena Women's and Children's Center in 2024 valued at $10,000. Patients come from a number of counties including Fayette, Ross, Pike and Highland. - School Districts: A total of 2 Pike County school districts - Waverly City Schools and Scioto Valley Local Schools - each received $25,000 or a total of $50,000 to support the health and wellness of their district's athletes, aligned with the support of athletic trainers provided by Adena Health. Community Health Outcomes and Health Factors Summary - Pike County Health Outcomes stayed at 87 in 2022 (County Health Rankings). - Pike County Health Factors moved from 84 to 79 in 2022 (County Health Rankings). Additional Initiatives and Resources The Adena Family Medicine - Residency Clinic and the Adena Residency Clinic - Internal Medicine continued operations of its clinic in 2023 providing affordable, quality health care. The clinics paired accessible primary care medical services provided by physician interns and residents of Adena's Graduate Medical Education program, family and internal medicine preceptors providing services to patients in the clinic. Combined the clinics had 10,084 visits from patients mostly from seven counties (Ross, Pickaway, Pike, Jackson, Highland, Fayette, Vinton). Approximately 5% of patients served by the clinics are uninsured. Community Engagement: Adena also provides support to the Pike County community through a variety of engagement activities, including financial support and participation in local community events and initiatives. A total of 17 caregivers from APMC provided more than 51 hours of community service and volunteer time participating in community service, non-profit board participation and leadership, and other initiatives. - Over $5,000 in coordinated transportation services for patients in Fayette, Ross, Highland and Pike Counties without transport to medical appoints and no insurance coverage. - Supported Pike County Community Action Coalition with $2,500 to support the Gus Macker tournament. - Contributed $500 to Waverly City Schools COPE program. - Donated $500 to the Pike County Color Run, an event to raise awareness to suicide prevention. - $300 sponsorship to the Pike County Chamber of Commerce golf outing. - Provided $500 for Pike County Outreach Council's Christmas in Canal Park event. - Supported the Pike County FFA with a $450 donation. - Adena Health supported Pike County Agricultural Association with a donation of $15,000 to support the 2024 Pike County Fair, its market program and junior fair market projects. Additional Community Collaborations Ross County Child Protection Center: Adena Health continued it's more than 25-year relationship with and support of the Ross County Child Protection Center in 2024 which provides resources and counseling to young victims of interpersonal violence and sexual assault in a nine-county service region that includes Fayette, Ross, Pike and Highland Counties. Adena provided a total of $61,374 in financial support for the CPC's facility costs and information technology needs. Medical and nursing staff also provide support to the center. An additional $2,000 in support was provided to support the fundraising efforts of the organization. Hope Clinic: Adena Health continued support of Hope Clinic in 2024. Support was both with Adena caregivers volunteering and financial support. Hope Clinic provides free medical care to those without health insurance coverage, including medical, dental and vision care. Located in Chillicothe, Ohio, the clinic serves patients from around the region including Ross, Pike Fayette, and Highland counties. It is open one day per week. In 2024, Hope Clinic had more than 3,000 medical, dental and pharmacy patients and provided more $1.7 million in free medical care. In addition to the clinical service, Hope Clinic operates a mobile food market where more than 4,100 families (10,000 were served in 2024). Ten providers from Adena Health volunteered 68 hours of care at Hope Clinic in 2024. Adena Health provided $25,000 in monetary support for the clinic's community charitable pharmacy, operations and medical resource system Elsevier. For more information, go to http://www.hopeclinicfree.org/. Pike County Health Coalition: In 2017, Adena Health collaborated with the Pike County Health Department to reconvene a community steering committee focused on completing regular community health assessments (CHA) and a community health improvement plan (CHIP) for Ross County. A total of 21 local government, civic and business leaders participate to identify strategic health priorities for the community and assist in allocating resources to support initiatives built around these strategic priorities. Adena Health had one employee who volunteered over 20 hours in 2024 to contributing to the Pike County Health Coalition's work. 1 ADENA FAMILY MEDICINE - PIKETON 100 INDIAN RIDGE DRIVE piketon OH 45661 PHYSICIAN OFFICES Schedule H, Part I, Line 7f BAD DEBT EXPENSE OF $2,583,318 WAS DEDUCTED FROM TOTAL OPERATING EXPENSES WHEN CALCULATING THE PERCENTAGES IN THIS COLUMN. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CONVERT CHARGES TO COSTS IN LINE 7A AND 7B. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE BAD DEBT EXPENSE LISTED ON PART III, LINE 2 IS DERIVED FROM THE FINANCIAL STATEMENTS. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote WE DO NOT HAVE SEPARATE FINANCIAL STATEMENTS FOR ADENA PIKE MEDICAL CENTER. IT IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF ADENA HEALTH SYSTEM. THE FOOTNOTE IN OUR FINANCIAL STATEMENTS INCLUDES THE FOLLOWING ABOUT OUR BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLES. "ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE SYSTEM'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE, ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE SYSTEM'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs MEDICARE SURPLUS, WHICH IS THE EXCESS OF REMIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT OVER COST TO TREAT MEDICARE PATIENTS. PIKE HEALTH SERVICES USED THE MEDICARE ALLOWABLE COSTS PER ITS 2024 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IF THE RESPONSIBLE INDIVIDUAL HAS NOT SUBMITTED A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE OR HAS NOT PAID-IN-FULL, FOUR SEPARATE STATEMENTS ARE SENT OUT FOR THE COLLECTION OF SELF-PAY ACCOUNTS. THE FINAL STATEMENT SENT WILL INFORM THE INDIVIDUAL OF POSSIBLE EXTRAORDINARY COLLECTION ACTIONS (ECA) TO BE TAKEN IF FINANCIAL ASSISTANCE IS NOT APPLIED FOR OR THE ACCOUNT IS NOT PAID IN FULL. AFTER THE FINAL STATEMENT AND BEFORE ECAS ARE TAKEN, REASONABLE EFFORTS ARE MADE TO ORALLY CONTACT THE INDIVIDUAL AS A FINAL NOTICE. PATIENTS WHO CANNOT PAY CHARGES IN FULL MAY ALSO BE OFFERED A PAYMENT PLAN THAT IS CONSISTENT WITH PIKE HEALTH SERVICES INC.'S CUSTOMER SERVICE PROCEDURES. Schedule H, Part V, Section B, Line 16a FAP website - PIKE HEALTH SERVICES, INC.: Line 16a URL: HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/; Schedule H, Part V, Section B, Line 16b FAP Application website - PIKE HEALTH SERVICES, INC.: Line 16b URL: HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - PIKE HEALTH SERVICES, INC.: Line 16c URL: HTTPS://WWW.ADENA.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-SERVICES/; Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE AVAILABILITY OF FINANCIAL ASSISTANCE IS COMMUNICATED IN THE FOLLOWING MANNER: 1. STATEMENTS FROM ADENA AS WELL AS COLLECTION VENDORS EXPLAIN AND LIST THE 100% AND 60% ASSISTANCE GUIDELINES ON THE BACKSIDE OF THE STATEMENT. 2. THERE IS SIGNAGE EXPLAINING THE PROGRAM AT ALL THE REGISTRATION AREAS. 3. A CONTRACTED VENDOR SUPPLIES STAFF AT THE CASHIER AREA TO EXPLAIN OPTIONS AVAILABLE TO THE PATIENT. 4. WE SEND AN APPLICATION WITH THE SELF-PAY DISCOUNT LETTERS IN CASE THE PATIENT/GUARANTOR CAN'T SET UP A PAYMENT PLAN. 5. THE CUSTOMER SERVICE STAFF IS EDUCATED ON ALL THE OPTIONS AND CAN EXPLAIN THE PROGRAMS WHEN PATIENTS CALL. 6. OUR PHYSICIAN OFFICES, AS WELL AS COLLECTION VENDORS HAVE FINANCIAL AID APPLICATIONS AVAILABLE. 7. LASTLY, WE UTILIZE A "HINDSIGHT" VENDOR THAT SCREENS ALL BAD DEBT ACCOUNTS, AFTER THE YEAR-END, AGAINST THE STATE MEDICAID ELIGIBILITY AND FEDERAL POVERTY GUIDELINES TO ATTEMPT ONE LAST EFFORT TO OBTAIN FINANCIAL ASSISTANCE FOR INDIVIDUALS. Schedule H, Part VI, Line 4 Community information PIKE COUNTY, HOME OF THE ADENA PIKE MEDICAL CENTER (APMC), IS LOCATED IN SOUTH CENTRAL OHIO. IT IS PART OF THE 2ND CONGRESSIONAL DISTRICT AND IS ONE OF OHIO'S 32 APPALACHIAN COUNTIES. IT CONTAINS THE POPULATION PATTERNS AND DISTINCT ECONOMIC CONDITIONS INHERENT OF THIS REGION OF THE U.S AND FACES SIMILAR CHALLENGES IN DIVERSIFYING ITS ECONOMY TO IMPROVE THE LIVES OF ITS 28,160 RESIDENTS. THERE ARE 10,816 HOUSEHOLDS IN PIKE COUNTY. THE AVERAGE HOUSEHOLD SIZE IS 2.61 PEOPLE, COMPARABLE WITH THE REST OF THE 12 COUNTY SERVICE REGION AND OHIO. THE AVERAGE FAMILY SIZE IS AS WELL WITH 3.11 PEOPLE. MORE THAN 22% OF THE ADULTS IN PIKE COUNTY HAVE NOT GRADUATED FROM HIGH SCHOOL. THIS PERCENTAGE IS HIGHER THAN THE AVERAGES FOR THE REGION (18.9%), OHIO (12.2%) AND THE NATION (14.6%). LESS THAN 12% HAVE A COLLEGE DEGREE. MORE THAN 12% OF THE POPULATION OF PIKE COUNTY IS ESTIMATED TO BE FUNCTIONALLY ILLITERATE OR LACKING THE READING AND WRITING SKILLS SUFFICIENT FOR ORDINARY PRACTICAL NEEDS. THE UNEMPLOYMENT RATE IN PIKE COUNTY (10.7%) IS CONSIDERABLY HIGHER THAN PIKE HEALTH SERVICES, INC. 31-1072406 THE REGIONAL (6.8%), STATE (6%) AND U.S. (7.7%) AVERAGES. IN ADDITION, MORE THAN 44.5% OF THE POPULATION IS NOT IN THE WORKFORCE. THIS IS HIGHER THAN THE STATE (35.4%) AND NATIONAL AVERAGES (35.2%). THE TOP FIVE EMPLOYMENT INDUSTRIES IN PIKE COUNTY ARE MANAGEMENT/BUSINESS/SCIENCE (28.9%), SERVICE (21.5%) SALES (23%), PRODUCTION/TRANSPORTATION SERVICES (19.2%), SALES (18.2%), AND NATURAL RESOURCES/CONSTRUCTION/MAINTENANCE. PIKE COUNTY HAS A GREATER PERCENTAGE OF PEOPLE EMPLOYED IN PRODUCTION, TRANSPORTATION AND MATERIAL MOVING OCCUPATIONS (19.2%) THAN THE REGIONAL, STATE AND NATIONAL AVERAGES. THE PER CAPITA MEDIAN AND MEAN HOUSEHOLD INCOMES IN PIKE COUNTY OHIO ARE MUCH LOWER THAN THE STATE AND U.S. AVERAGES. POVERTY RATES ARE ALSO HIGHER THAN REGIONAL, STATE AND NATIONAL AVERAGES. ACCESS TO EMPLOYMENT IN PIKE COUNTY IS ALSO LOWER THAN OTHER COUNTIES IN THE REGION. PIKE COUNTY AND ITS ENTIRE SURROUNDING SERVICE REGION HAVE A HIGHER PREVALENCE OF DISABILITY THAN THE REST OF OHIO. SEVEN OF THE 12 COUNTIES IN THE SERVICE REGION, INCLUDING PIKE COUNTY, HAVE DISABILITY PREVALENCE RATES OF 16.7% - 22%. Schedule H, Part VI, Line 5 Promotion of community health The Adena Pike Medical Center captured the broad interests of the community for the CHNA through three primary methods: public surveys, focus groups and key stakeholder interviews. A health needs survey was widely distributed in both electronic and paper form across the Pike County Community and received more than 300 responses. In addition to the surveys, interviews with local community leaders, including civic, public health and emergency response were requested and/or conducted to gain further knowledge of survey topics. Schedule H, Part VI, Line 6 Affiliated health care system FOUNDED IN 1895, ADENA HEALTH SYSTEM IS AN INDEPENDENT, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN CHILLICOTHE, OH. THE HEALTH SYSTEM INCLUDES THREE HOSPITALS AND SIX REGIONAL CLINICS, WITH A TOTAL OF 311 BEDS. ADENA SERVES THE NEEDS OF NEARLY 500,000 PEOPLE IN 13 COUNTIES, LIVING IN OHIO'S APPALACHIAN REGION. OUR FACILITIES INCLUDE: ADENA REGIONAL MEDICAL CENTER: A 261-BED INPATIENT HOSPITAL IN CHILLICOTHE, OH FEATURING AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND TREATMENT SERVICES, ADVANCED SURGICAL SUITES, INTENSIVE/CARDIAC CARE, MEDICAL OFFICE BUILDING AND THE ADENA HEALTH PAVILION, WHICH INCLUDES OUTPATIENT SURGERY, PHYSICIAN OFFICES AND THE ADENA SLEEP CENTER. IN 2011, ADENA INVESTED $21 MILLION IN THE CONSTRUCTION OF A 35,000 SQUARE-FOOT CANCER CENTER TO PROVIDE PATIENTS WITH ACCESS TO CANCER DIAGNOSIS AND TREATMENT AT A FACILITY NEAR THEIR HOMES. THE CANCER CENTER OPENED IN JANUARY 2012. GREENFIELD AREA MEDICAL CENTER AND PIKE HEALTH SERVICES, INC.: BOTH ARE CRITICAL ACCESS HOSPITALS, EACH WITH A 25-BED INPATIENT FACILITY IN GREENFIELD, OH AND WAVERLY, OH, RESPECTIVELY. EACH FEATURES AN EMERGENCY DEPARTMENT, INPATIENT CARE INCLUDING REHABILITATION AND MEDICAL/SURGICAL, DIAGNOSTIC AND TREATMENT SERVICES, AS WELL AS FAMILY PRACTICE AND SPECIALTY PHYSICIANS. THESE TWO HOSPITALS DIRECTLY BENEFIT HIGHLAND COUNTY (GREENFIELD AREA MEDICAL CENTER) AND PIKE COUNTY (PIKE HEALTH SERVICES, INC.) AS WELL AS SURROUNDING COMMUNITIES. ADENA HEALTH CENTERS: LOCATED IN CHILLICOTHE AND WITH REGIONAL SITES IN CIRCLEVILLE, JACKSON, OAK HILL, WELLSTON, HILLSBORO, WASHINGTON COURT HOUSE AND WAVERLY, OH. OUR HEALTH CENTERS INCLUDE PHYSICIAN OFFICES, DIAGNOSTIC AND TREATMENT SERVICES, PHYSICAL, OCCUPATION AND SPEECH THERAPIES. URGENT CARE SERVICES ARE OFFERED IN CHILLICOTHE, HILLSBORO, AND WAVERLY. ADENA HOME CARE AND HOSPICE: PROVIDES HIGHLY PERSONALIZED, QUALITY CARE TO PATIENTS OF FOUR SERVICE LINES -- HOME HEALTH, HOSPICE, HOME RESPIRATORY AND HOME INFUSION. ADENA REHABILITATION AND WELLNESS CENTER: PROVIDES PHYSICAL, OCCUPATIONAL, MASSAGE AND INDUSTRIAL REHABILITATION, AS WELL AS ORTHOPEDICS, SPORTS MEDICINE, WOMEN'S HEALTH, VESTIBULAR, FIBROMYALGIA AND CHRONIC PAIN PROGRAMS, AS WELL AS INDUSTRIAL AND SPECIALIZED HAND PROGRAMS. ADENA COUNSELING CENTER: PROVIDES A WIDE RANGE OF OUTPATIENT COUNSELING SERVICES, INCLUDING GROUP, INDIVIDUAL AND FAMILY COUNSELING. A VARIETY OF SUPPORT GROUPS ALSO MEET AT THE CENTER. OFF-CAMPUS PHYSICIAN OFFICES: A NUMBER OF PHYSICIAN OFFICES ARE LOCATED THROUGHOUT THE REGION SERVED BY ADENA. THESE INCLUDE OFFICES FOR FAMILY PHYSICIANS, ENDOCRINOLOGISTS, GERONTOLOGISTS AND UROLOGISTS. TELEMEDICINE: IN 2011, THE HEALTH SYSTEM CONTINUED ITS AFFILIATION WITH THE SOUTHERN OHIO HEALTH CARE NETWORK (SOHCN). THIS PARTNERSHIP HAS RESULTED IN THE CONSTRUCTION OF AN EXPANSIVE FIBER OPTIC BROADBAND TELECOMMUNICATIONS NETWORK TO SERVE THE HEALTHCARE AND EDUCATIONAL NEEDS OF PEOPLE LIVING IN OHIO'S APPALACHIAN REGION. THROUGH THIS TECHNOLOGY, TELEMEDICINE IS ENABLING PATIENTS TO BE ON ADENA'S CAMPUS, BUT TREATED BY PHYSICIANS OUTSIDE THE REGION. ADENA HAS TELEMEDICINE RELATIONSHIPS WITH OHIO STATE UNIVERSITY MEDICAL CENTER, RIVERSIDE METHODIST HOSPITAL, AND NATIONWIDE CHILDREN'S HOSPITAL IN COLUMBUS. X true true X X X X false true false false false false false true false JUSTIN SMITH COS/PHYSICIAN 0 263934 0 205026 0 61474 0 12871 0 7764 0 551069 0 0 JAMES MCMANUS AHS CFO 0 560539 0 112972 0 65055 0 225932 0 27463 0 991961 0 56375 JEFF GRAHAM AHS CEO 0 977033 0 187011 0 16537 0 319845 0 48324 0 1548750 0 0 KATHERINE EDRINGTON AHS COO 0 306628 0 126256 0 8844 0 171687 0 19599 0 633014 0 0 DAVE ZANNI SENIOR OPERATIONS EXECUTIVE OFFICER 203977 0 0 0 7778 0 51716 0 10351 0 273822 0 0 0 ANITA KOHN STAFF NURSE RN BSN 97269 0 1851 0 54078 0 5266 0 7532 0 165996 0 0 0 CHERYL SMITH PHARMACIST 166405 0 0 0 27055 0 7930 0 2352 0 203742 0 0 0 JASON LOUTSENHIZER TL PHARMACIST 163026 0 100 0 15428 0 7474 0 13169 0 199197 0 0 0 LADOSKA EVANS STAFF NURSE RN BSN 131025 0 750 0 26428 0 5981 0 1671 0 165855 0 0 0 RANDALL RATLIFF REG NUC MED TECH 107792 0 18892 0 9530 0 5174 0 25476 0 166864 0 0 0 Schedule J, Part I, Line 1a Health or social club dues or initiation fees DAVE ZANNI HAS MEMBERSHIP IN ROTARY. PURPOSE IS TO ENHANCE PIKE'S ENGAGEMENT IN THE ACTIVITES OF WAVERLY AND SURROUNDING COMMUNITIES. DAVE ZANNI IS REIMBURSED FOR HIS ROTARY CLUB DUES. THIS IS NOT TREATED AS TAXABLE COMPENSATION. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation EXECUTIVE LEADERSHIP AT PIKE HEALTH SERVICES HAS THEIR COMPENSATION REVIEWED EVERY YEAR BY ADENA HEALTH SYSTEM, A RELATED PARTY. THE SYSTEM UTILIZES A SEPARATE COMPENSATION CONSULTING FIRM THAT USES SEVERAL AVAILABLE MARKET STUDIES FOR APPLICABLE POSITIONS IN COMPARABLE MARKETS. OTHER PIKE HEALTH SERVICES MANAGEMENT WAGES ARE REVIEWED INTERNALLY USING MARKET DATA. THIS PROCESS WAS LAST UNDERTAKEN IN 2024. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE ORGANIZATION HAS A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENT FROM THE SERP IN 2024: JAMES MCMANUS $56,375 SERP EARNINGS THE SERP ACCRUALS, INCLUDED IN PART II, COLUMN (C), ARE AMOUNTS CREDITED TO THE EXECUTIVE UNDER THE SECTION 457(F) DEFERRED COMPENSATION PLAN. JAMES MCMANUS $62,812 SERP ACCRUALS Schedule J, Part I, Line 7 Non-fixed payments MANAGEMENT OF ADENA HEALTH SYSTEM HAVE A PORTION OF THEIR ANNUAL SALARY AT RISK UNDER A VARIABLE COMPENSATION PLAN. IF THE OPERATING RESULTS OF AHS MEET A MARGIN TARGET IN ANY FISCAL YEAR, ADDITIONAL COMPENSATION IS PAID THAT IS CALCULATED USING THE OPERATING MARGIN ALONG WITH RESULTS IN EMPLOYEE ENGAGEMENT, PATIENT QUALITY, AND SATISFACTION USING A BALANCED SCORECARD FORMULA. Form 990, Part V, Line 1a A RELATED ORGANIZATION, ADENA HEALTH SYSTEM, ISSUES THE 1099S. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE MEMBER OF PIKE HEALTH SERVICES IS ADENA HEALTH SYSTEM. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE BOARD OF THE ORGANIZATION NOMINATES TRUSTEES, AND ADENA HEALTH SYSTEM, AS THE SOLE MEMBER OF THE ORGANIZATION, ELECTS THE TRUSTEES. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CERTAIN GOVERNANCE DECISIONS ARE RESERVED FOR ADENA HEALTH SYSTEM AS THE SOLE MEMBER OF THE ORGANIZATION, SUCH AS THE ELECTION OF MEMBERS OF THE BOARD OF TRUSTEES OF THE ORGANIZATION, APPROVAL OF STRATEGIC PLANS OF THE ORGANIZATION, AND APPROVAL OF AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND CODE OF REGULATIONS. ADENA HEALTH SYSTEM CAN ACT ON THESE RIGHTS BY A VOTE AT ANY MEETING, AN ACTION WITHOUT A MEETING, OR THROUGH OTHER AUTHORIZED MEANS. Form 990, Part VI, Line 11b Review of form 990 by governing body COPIES OF ALL FORMS 990 ARE MADE AVAILABLE TO THE PARENT GOVERNING BOARD PRIOR TO FILING. Form 990, Part VI, Line 12c Conflict of interest policy MANAGEMENT OF ADENA HEALTH SYSTEM HAVE A PORTION OF THEIR ANNUAL SALARY AT RISK UNDER A VARIABLE COMPENSATION PLAN. IF THE OPERATING RESULTS OF AHS MEET A MARGIN TARGET IN ANY FISCAL YEAR, ADDITIONAL COMPENSATION IS PAID THAT IS CALCULATED USING THE OPERATING MARGIN ALONG WITH RESULTS IN EMPLOYEE ENGAGEMENT, PATIENT QUALITY, AND SATISFACTION USING A BALANCED SCORECARD FORMULA. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE TOP MANAGEMENT OFFICIAL AT ADENA PIKE MEDICAL CENTER HAS HIS COMPENSATION REVIEWED EVERY OTHER YEAR BY ADENA HEALTH SYSTEM TOTAL REWARDS TEAM. THE LAST REVIEW WAS COMPLETED IN 2023. Form 990, Part VI, Line 19 Required documents available to the public THE SYSTEM DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. SOME ORGANIZING DOCUMENTS MAY BE AVAILABLE THROUGH STATE OF OHIO WEBSITES. THE ANNUAL AUDITED FINANCIAL STATEMENTS ARE POSTED TO THE ELECTRONIC MUNICIPAL MARKET ACCESS SYSTEM WITHIN 150 DAYS AFTER FISCAL YEAR END. THE PUBLIC MAY ACCESS THIS SYSTEM FREE OF CHARGE. Form 990, Part IX, Line 11g Other Fees CONTRACT STAFFING - Total Expense: 1353249, Program Service Expense: 465970, Management and General Expenses: 887279, Fundraising Expenses: ; REVENUE CYCLE MANAGEMENT - Total Expense: 1991378, Program Service Expense: , Management and General Expenses: 1991378, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER (TO) FROM RELATED ORGANIZATION - -2384110; Total - -2384110; Form 990, Part XII, Line 2c THE ADENA HEALTH SYSTEM'S AUDIT COMMITTEE ENGAGES THE INDEPENDENT AUDIT FIRM FOR THE AUDIT, REVIEWS RESULTS, AND REPORTS TO THE BOARD. ADENA HEALTH SYSTEM'S BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. PIKE HEALTH SERVICES IS PART OF ADENA HEALTH SYSTEM'S CONSOLIDATED AUDIT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. GREENFIELD AREA MEDICAL CENTER 550 MIRABEAU ST GREENFIELD OH 45123 310993422 HOSPITAL OH 501(c)(3) 3 ADENA HEALTH SYSTEM true ADENA HEALTH FOUNDATION 272 HOSPITAL ROAD CHILLICOTHE OH 45601 753008742 FUNDRAISING OH 501(c)(3) Type I ADENA HEALTH SYSTEM true SOUTHERN OHIO HEALTHCARE NETWORK 272 HOSPITAL ROAD CHILLICOTHE OH 45601 261566590 FIBEROPTIC NETWORK GRANTS OH 501(c)(3) Type I ADENA HEALTH SYSTEM true ADENA HEALTH SYSTEM 272 HOSPITAL ROAD CHILLICOTHE OH 45601 314379443 HOSPITAL OH 501(c)(3) 3 NA false ADENA FAYETTE MEDICAL CENTER 1430 COLUMBUS AVE WASHINGTON COURT HOUSE OH 43160 852985806 HOSPITAL OH 501(c)(3) 3 ADENA HEALTH SYSTEM true adena care 272 HOSPITAL ROAD CHILLICOTHE OH 45601 453980850 SEE SCHEDULE R, PART VII OH NA C Corporation -1324 true false false false false false false false false false false false false false false true true true true true Schedule R, Part IV, Column (b) THE PRIMARY ACTIVITY OF ADENA CARE IS TO DEVELOP STRATEGIC RELATIONSHIPS TO THE SERVICE AREAS MAJOR EMPLOYERS THROUGH HEALTH MANAGEMENT AND WELLNESS SERVICES.