2011-04-26T15:09:51-05:00 2010-06-30 DEAN DORTON ALLEN FORD PLLC 106 W VINE STREET SUITE 600 LEXINGTON KY 40507 990 2009-07-01 520795508 APPALACHIAN REGIONAL HEALTHCARE INC APPA 8592262440 2285 EXECUTIVE DRIVE No 400 LEXINGTON KY 40505 JOSEPH GROSSMAN 8592262440 2011-04-21 1 LEIGH MCKEE 8592552341 2009 2016-02-24 21:20:13Z Jerry Haynes 2285 EXECUTIVE DRIVE No 400 LEXINGTON KY 40505 567385247 0 X WWW.ARH.ORG X 1956 KY TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA. 16 16 4975 220 11307056 729737 1160171 1049317 521211445 545430866 1143061 3716893 26579318 16757854 550093995 566954930 0 0 269202292 282192194 0 253264 261753004 273512451 530955296 555704645 19138699 11250285 352013660 374684749 335950997 365423566 16062663 9261183 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 489416629 543656445 History:Appalachian Regional Healthcare (ARH) is a not-for-profit health system operating nine hospitals, physician practices, home health agencies, HomeCare Stores and retail pharmacies in Harlan, Hazard, McDowell, Middlesboro, Morgan County, Whitesburg and South Williamson, Ky. and Beckley and Summers County, W.Va. The System serves more than 16 counties and more than 350,000 residents in the two states. ARH is both the largest provider of care and one of the largest private employers in southeastern Kentucky and southern West Virginia.For the past 50 years, ARH has addressed the varied healthcare needs of the residents of Eastern Kentucky and Southern West Virginia by standing firm to its mission to improve the health and promote the well being of all the people in Central Appalachia in partnership with its communities.The UMWA's first Miners Memorial Hospital Association (MMHA) hospital opened in Middlesboro, Kentucky on November 12, 1955 - the system's other hospitals were located in Harlan, Hazard, McDowell, Whitesburg, Pikeville and South Williamson, Kentucky; Beckley and Man, West Virginia; and Wise, Virginia. The UMWA and thousands of citizens in the coal communities officially dedicated the MMHA facilities on June 2, 1956 in Beckley, West Virginia. This unique hospital system was a huge success with miners and their families and has served as a model for similar healthcare organizations. In 1962, the MMHA announced its intention to close four hospitals in Kentucky in order to save the system. The Reverend Samuel McMaster Kerr, then-pastor of the First Presbyterian Church in Harlan, realized the consequences of MMHA's decision. He asked the Board of National Missions of the United Presbyterian Church to investigate. In the meantime, the UMWA decided it would have to sell all of its facilities. Church leaders committed themselves to finding a solution.On June 28, 1963, the Board of National Missions formed a new and independent not-for-profit corporation -- Appalachian Regional Hospitals (ARH). ARH purchased the first hospitals with a $3.9 million grant from the Area Redevelopment Administration, established by President John F. Kennedy. Governor Bert T. Combs called a special session of the Kentucky legislature to approve $700,000 to support indigent care during ARH's first year.ARH continues to serve some of the most economically depressed regions in the nation that have some of the country's highest rates for heart disease, lung cancer and diabetes. Many health analysts trace these conditions to the harsh reality that these financial struggles often overshadow concerns about health risk factors or preventive care. Therefore, it is no coincidence that residents of Eastern Kentucky and Southern West Virginia statistically die younger of easily preventable disease. Most of ARH's facilities are located in areas that are at least partially classified as medically underserved areas and health professional shortage areas.A Board of Trustees provides governance to the ARH system. This dynamic group of men and women work without compensation to benefit the System and the people it serves. Among them are representatives from the area served by ARH, as well as others with an interest in the ARH service area.This Board is composed of a maximum of 21 people, including two ex-officio members. These ex-officio members include a representative from the medical staff leadership council and a representative of the regional advisory council.During Fiscal Year ending June 30, 2010, ARH provided each of the communities it serves in Eastern Kentucky and Southern West Virginia an abundance of healthcare and community-oriented services.ARH operates in an area with some of the largest uninsured and underinsured rates and provides care to all patients regardless of their ability to pay. ARH provided $120 million in uncompensated care throughout its system. ARH provides assistance in the form of charity care for those who qualify for reduced payments through a sliding fee schedule, interest-free time payments and medical assistance loans. ARH also regularly works with uninsured and underinsured patients to help them qualify for financial assistance, free or discounted medication, and referrals to physicians who provide preventive care at no charge. ARH also offers outreach programs to identify and treat uninsured patients with chronic diseases and helps them manage their conditions more effectively on their own.To further improve the health of the residents it serves, especially those without health insurance, ARH strongly promotes the importance of preventative health screenings. Throughout the year, each facility provided free health screenings such as blood pressure checks, blood glucose, body mass index, pulse and cholesterol screenings. The health system also is working to educate the region's youth about the importance of physical fitness to good health by hosting Fitness Fairs at elementary schools and keeps our seniors healthy through a senior wellness program.In recognition of its efforts in improving access to health services and information for people in rural areas through innovative, comprehensive approaches, the ARH system was selected as the 2010 Outstanding Rural Health Organization in the nation by the National Rural Health Association (NRHA).Additionally, for the fifth time in the past six years, the full-range of services offered by the ARH system were recognized as among the best in the nation by SDI Health LLC, a nationally recognized healthcare data and consulting firm. ARH was one of only two Kentucky health systems to be named to the 2010 SDI IHN 100 listing of the most highly integrated healthcare networks in the nation and the only integrated health system in West Virginia to be named.The cardiac program at Hazard ARH Regional Medical Center was also recognized during the year for its level of expertise in caring for patients who arrive in its emergency department with chest pain or other symptoms of a heart attack. Hazard ARH earned Chest Pain Center Accreditation from the Society of Chest Pain Centers (SCPC), an international organization dedicated to eliminating heart disease as the number one cause of death worldwide.ARH's hospital in McDowell, Ky, McDowell ARH, also received multiple accolades during the year including the presentation of an Excellence through Insight award for overall satisfaction in their Outpatient Lab Unit by HealthStream and the McDowell ARH auxiliary was recognized with a HANDS (Helping Accomplish Noteworthy Duties Successfully) award by the KHA Committee on Volunteer Services. McDowell's recognized program was the purchase of a refreshment cart by the auxiliary to serve refreshments and offer magazines to patients and their family members. This program has received many positive responses and has also positively impacted patient satisfaction scores for that facility.ARH also added new services and technology for residents including the expansion of bariatric services at the ARH Bariatrics Center in Hazard, which is now a full-service surgical weight loss center. In addition, the Williamson ARH Hospital joined the nationally recognized St. Mary's Regional Stroke Network enabling the hospital to now offer patients a full-spectrum of neurology services, including state-of-the-art diagnostics and the latest in treatments. At Hazard ARH Regional Medical Center, the area's first cornea transplant took place, restoring sight to a patient who had been legally blind since childhood. 489416629 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 300 0 1 4975 1 1 1 0 0 0 0 0 0 0 0 16 16 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 KY X X ORGANIZATION 8592262440 2285 EXECUTIVE DRIVE SUITE 400 LEXINGTON KY 40505 Leon Hollon 5.00 X 0 0 0 Russell Bentley 5.00 X 0 0 0 Kathleen Dalton 3.00 X 0 0 0 Deborah Harris 3.00 X 0 0 0 ida androwich 3.00 X 0 0 0 William May 3.00 X 0 0 0 Wayne Myers MD 3.00 X 0 0 0 Emmett Pugh III 5.00 X 0 0 0 Carolyn Sundy 3.00 X 0 0 0 raymond cox 3.00 X 0 0 0 ahmed faheem 3.00 X 1200 0 0 maria hortillosa 3.00 X 0 0 0 thomas hyatt 3.00 X 0 0 0 craig lenz 3.00 X 0 0 0 debra reynolds 3.00 X 0 0 0 madonna sturgill 3.00 X 0 0 0 james shoffner 3.00 X 0 0 0 larry meador 3.00 X 0 0 0 timothy mosher 3.00 X 0 0 0 john pellegrini 3.00 X 0 0 0 richard sturgill 3.00 X 0 0 0 JERRY HAYNES 40.00 X 669198 0 38352 JOSEPH GROSSMAN 40.00 X 381480 0 39042 HOLLIE P HARRIS 40.00 X 231059 0 38447 JOHN D MILLER 40.00 X 308981 0 20964 paul miles 40.00 X 276870 0 30453 bobby rick king 40.00 X 281111 0 35944 JOSE M ECHEVERRIA 40.00 X 477955 0 23197 prakash puranik 40.00 X 399807 0 51457 jameel a butt 40.00 X 651913 0 31055 jamal bazzi 40.00 X 405017 0 6549 nathan e doctry 40.00 X 421635 0 5923 4506226 0 321383 164 0 1 0 TRIANGLE ANESTHESIA GROUP PSC 3300 TATES CREEK ROAD SUITE 100 LEXINGTON KY 40502 PHYSICIAN SERVICES 6000000 MCKESSON information solutions PO BOX 9837 CHICAGO IL 60693 IT CONSULTING 3064755 esi business solutions 4144 N Central Expressway Suite 2 dallas TX 75204 revenue cycle consulting 2389221 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 55480 REFERENCE LABORATORY 2339335 executive health resources inc 15 Campus Blvd suite 200 newtown square PA 19073 consulting 1778369 56 849204 200113 1049317 PATIENT SERVICE REVENU 621110 537223045 537223045 PHARMACY/LAB/LAUNDRY 812300 8011916 4461739 3550177 RECORD TRANSCRIPT FEES 900099 195905 195905 545430866 3464929 3464929 1561353 17768 1543585 1543585 1543585 621257 43256 412549 621257 -369293 251964 251964 HOME STORES REVENUE 446199 6795866 6795866 MISCELLANEOUS REVENUE 900099 6433400 6433400 CAFETERIA REVENUE 722100 1066994 1066994 918009 49451 868558 15214269 566954930 543656445 11307056 10942112 1898504 1898504 192547754 176839193 15583474 125087 16697421 14543548 2142904 10969 57204631 51958084 5208969 37578 13843884 12905919 928871 9094 2673594 118617 2554977 22443 22443 14986966 14659391 327575 801278 235171 501132 64975 3672232 635945 3035885 402 10041292 8679066 1361096 1130 1566250 1273484 292566 200 148385 3892 144493 6530012 5537306 992706 23414029 20742777 2671252 6278951 6250794 28157 UBI Tax 962177 962177 supplies 78328137 77714298 610911 2928 bad debt 57567407 57567407 outside services 25820897 18190281 7630616 equipment rental & main 13767929 8756405 5011144 380 26930472 12805051 14124900 521 555704645 489416629 66034752 253264 35030760 33309622 18550889 24541645 68964179 75020707 15514207 5868810 8562178 8395072 3141190 2717789 434471853 284704217 157130525 149767636 34612736 67908455 481907 711158 10025089 6443855 352013660 374684749 61117425 62913778 17410877 17217822 78827784 74953835 14297630 15447992 164297281 194890139 335950997 365423566 X 16062663 9261183 16062663 9261183 352013660 374684749 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 64650 64650 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: 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. 6465343 6465343 211711314 115591894 96119420 191935714 153192882 38742832 24359482 15919441 8440041 149767636 medicare & medicaid estimated settlements 22243587 other liabilities 12712530 accrued pension cost 107453316 reserve for self-insurance 32013045 capital lease obligations 19892093 physician commitments 575568 194890139 Part X: Description of Uncertain Tax Positions Under FIN 48: The Corporation adopted the provisions of FASB ASC 740-10 relating to uncertainty in income taxes on July 1, 2009. The implementation included evaluating the tax positions taken on all income tax returns that remain open to examination by the respective taxing authorities. The Corporation does not believe that there are any uncertain positions on those returns that meet the requirements of FASB ASC 740-10 and therefore should be reflected in the financial statements. 1 1 X 1 X 1 X 150.000000000000 1 1 0 1 1 31397294 15486808 15910486 0.03190 111970262 74738253 37232009 0.07470 0 143367556 90225061 53142495 0.10660 571636 5986 565650 0.00110 571636 5986 565650 0.00110 143939192 90231047 53708145 0.10770 1 21237017 0 138245273 148827870 -10582597 X 1 1 ARH Regional Medical Center Professional Office Building Co-Owners Council Condo Owner 0.36250 Hazard ARH Imaging Center LLC dba Medical Mall Imaging Center Diagnostic Imaging Services 0.60000 Whitesburg Physician Office Building LLC Condo Owner 0.28000 Phelps Regional Health Services Inc Property Owner of Physician office building & Nursing home 0.50000 ARH Family Care Wayland

2662 King kelly Coleman Highway wayland KY 41666

primary care center or clinic Elkhorn City ARH Family Care Center

905 W Russell Street elkhorn city KY 41522

primary care center or clinic Jenkins ARH Family Care Center

9480 highway 805 jenkins KY 41514

primary care center or clinic arh family care middlesboro

1217 East Cumberland Avenue middlesboro KY 40965

Clinic Tug Valley Medical Mall

26901 US Highway 119N belfry KY 41514

primary care center or clinic Harlan ARH Hospital

81 Ball Park Road harlan KY 40831

X X X Hazard ARH Regional Medical Center

100 Medical Center Drive hazard KY 41701

X X X X McDowell ARH Hospital

Route 122 Box 247 mcdowell KY 41647

X X X X Middlesboro ARH Hospital

3600 West Cumberland Ave middlesboro KY 40965

X X X Morgan County ARH Hospital

476 Liberty Road west liberty KY 41472

X X X X Whitesburg Arh Hospital

240 Hospital Road whitesburg KY 41858

X X X Williamson ARH Hospital

260 Hospital Drive south williamson KY 41503

X X X Beckley ARH Hospital

306 Stanaford Road beckley WV 25801

X X X Summers County ARH Hospital

1500 Terrace Street hinton WV 25951

X X X X ARH HAZARD FAMILY HEALTH SERVICES

200 MEDICAL CENTER DRIVE HAZARD KY 41701

primary care center or clinic ARH MCDOWELL PROFESSIONAL CLINIC

9879 KY RT 122 MCDOWELL KY 41647

rural health clinic ARH MORGAN COUNTY CLINIC

476 LIBERTY ROAD WEST liberty KY 41472

rural health clinic ARH TRI-CITY MEDICAL CENTER

18880 NORTH US 119 CUMBERLAND KY 40823

primary care center/Rural health clinic ARH TUG VALLEY MEDICAL ASSOCIATES

306 HOSPITAL DRIVE SOUTH williamson KY 41503

rural health clinic ARH WHITESBURG CLINIC

214 HOSPITAL ROAD WHITEsburg KY 41858

rural health clinic ARH WOMEN'S AND FAMILY HEALTHCARE HARLAN

87 BALL PARK ROAD SUITE 201 HARLAN KY 40831

PHYsician Clinic NEON CLINIC

37 highway 343 NEON KY 41840

PHysician Clinic BARIATRIC CLINIC

210 BLACK GOLD BOULEVARD SUITE 102 HAZard KY 41701

PHYsician Clinic ARH MIDDLESBORO INTERNAL MEDICINE

3004 CUMBERLAND AVENUE SUITE 3 MIDDLEsboro KY 40965

Physician Clinic ARH SUMMERS COUNTY CLINIC

1500 Terrace Street HINTON WV 25951

PHysician Clinic ARH OUTPATIENT PHARMACY 37

37 BALL PARK ROAD HARLan KY 40831

PHARMACY ARH TRI-CITIES CLINIC PHARMACY

18880 NORTH US 119 CUMBERLAND KY 40823

PHARMACY ARH JUNE BUCHANAN CLINIC PHARMACY

ROUTE 550 COWTOWN ROAD HINDMAN KY 41822

PHARMACY HAZARD ARH REGNL MED CTR CLINIC PHARMACY

200 MEDICAL CENTER DRIVE HAZARD KY 41701

PHARMACY MIDDLESBORO ARH PHARMACY

3600 WEST CUMBERland Ave MIDDlesboro KY 40965

PHARMACY MORGAN COUNTY ARH PHARMACY

476 Liberty Road WEst liberty KY 41472

PHARMACY WHITESBURG ARH PHARMACY

240 HOspital Road WHItesburg KY 41858

PHARMACY ARH PRESCRIPTION DIVISION

306 HOSPITAL DRIVE SUITE 105 SOUTh williamson KY 41503

PHARMACY BECKLEY ARH PHARMACY

250 STANAFORD ROAD BEckley WV 25801

PHARMACY MATEWAN ARH PHARMACY

7 MATEWAN STREET MATEWAN WV 25678

PHARMACY HARLAN ARH HOME HEALTH AGENCY

81 BALL PARK ROAD HARLAN KY 40831

HOME HEALTH HAZARD ARH HOME HEALTH AGENCY

100 AIRPORT GARDENS ROAD HAZard KY 41701

HOME HEALTH MCDOWELL ARH HOME HEALTH AGENCY

8535 KY RT 122 MINNE KY 41651

HOME HEALTH MIDDLESBORO ARH HOME HEALTH AGENCY

1916 CUMBERLAND AVENUE MIDdlesboro KY 40965

HOME HEALTH MORGAN COUNTY ARH HOME HEALTH AGENCY

493 MAIN STREET WEst liberty KY 41472

HOME HEALTH PIKEVILLE BRANCH-ARH PIKE CO HOME HEALTH

247 SOUTH MAYO TRAIL PIKEVILLE KY 41502

HOME HEALTH WHITESBURG ARH HOME HEALTH AGENCY

240 HOSPITAL ROAD WHITEsburg KY 41858

HOME HEALTH WILLIAMSON ARH HOME HEALTH AGENCY

160 HOSPITAL DRIVE SOUTH williamson KY 41503

HOME HEALTH BECKLEY ARH HOME HEALTH AGENCY

306 STanaford Road BEckley WV 25801

HOME HEALTH MAN ARH HOME HEALTH SUB-STATION

BUFFALO CREEK ROAD/ROUTE 99 KISTLER WV 25628

HOME HEALTH ARH HARLAN HOMECARE STORE

106 RAILROAD STREET SUITE 5 HARLAN KY 40831

HOME CARE ARH HAZARD HOMECARE STORE

200 MEDICAL CENTER DRIVE HAZard KY 41701

HOME CARE ARH MCDOWELL HOMECARE STORE

8535 KY RT 122 MINNE KY 41651

HOME CARE ARH MIDDLESBORO HOMECARE STORE

1916 CUMBERLAND AVENUE MIddlesboro KY 40965

HOME CARE ARH PIKEVILLE HOMECARE STORE

247 SOUTH MAYO TRAIL PIKEVILLE KY 41501

HOME CARE ARH WEST LIBERTY HOMECARE STORE

520 PRESTONBURG STREET WEST liberty KY 41472

HOME CARE ARH WHITESBURG HOMECARE STORE

240 HOspital Road WHItesburg KY 41858

HOME CARE ARH WILLIAMSON HOMECARE STORE

306 HOSPITAL DRIVE SUITE 104A SOUTH Williamson KY 41503

HOME CARE ARH BECKLEY HOMECARE STORE

260 STANAFORD ROAD BECKLey WV 25801

HOME CARE ARH HINTON HOMECARE STORE

1500 Terrace Street HINTON WV 25951

HOME CARE ARH MAN HOMECARE STORE

ROUTE 99 BUFFALO CREEK ROAD KISTLER WV 25628

HOME CARE ARH PSYCHIATRIC CENTER- HAZARD

102 MEDICAL CENTER DRIVE HAZARD KY 41701

PHARMACY HARLAN ARH HOSPITAL PSYCHIATRIC SERVICES

81 BALL PARK ROAD HArlan KY 40831

PHARMACY BECKLEY ARH BEHAVIORAL SERVICES CENTER

306 STanaford Road BECKley WV 25801

PHARMACY ARH REFERENCE LABORATORY

100 MEDical Center Drive HAZARD KY 41701

LAB Part I, Line 3c: The discounts are based on a sliding fee schedule starting at 150% 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 I, Line 7f: $57,567,407 is the bad debt expense included in total expense on the 990. Therefore, in order to calculate the percentages as directed in the instructions, that bad debt expense has been removed from total expenses for purposes of the calcuation in column f. Part III, Line 4: 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 estimated. All patients are educated about and given every opportunity to apply for charity care and, therefore, ARH has no information for those who choose not to apply.Financial Statement Footnote related to bad debt expense: The Corporation has an established process to determine the adequacy of the allowance for uncollectible accounts that relies on a number of analytical tools and benchmarks to arrive at a reasonable allowance. No single statistic or measurement determines the adequacy of the allowance for uncollectible accounts. Some of the analytical tools that the Corporation utilizes include, but are not limited to, historical cash collection experience by payor, revenue trends by payor classification and aged accounts from date of service by payor. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. Part III, Line 8: In the fiscal year ending June 30, 2010, nearly one-half of the Corporation's patient revenues were derived from services provided to Medicare beneficiaries. In turn, payments received by the federal government fell short of the cost to provide such services by more than $10 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 $10,582,597 [or 100%] of the amount reported on Schedule H, Part III, Line 7 be treated as community benefit. Part III, Line 9b: The policy provides that charity and financial assistance applications are valid for six months, after which time the patient must reapply and present current financial documents as necessary. Part V: ARH additionally operates six support facilities and four clinics which are not required to registered or licensed with the state. Part VI, Line 2: 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. 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 in a program. Based on income and family status the patient is screened in conjunction with the federal and state poverty guidelines. At this time, all applications are completed with the assistance of ARH personnel and submitted for approval. In the event an agency requires the patient/guarantor to apply in person the individual is asked to make an appointment with that agency and file their completed documents. If the responsible party is not eligible for federal or state assistance, they are additionally screened by ARH for eligibility into our internal sliding fee schedule charity program for additional discounts up to 100% of gross charges. If the patient is held responsible, additional efforts to assist the patient are offered by offering reasonable payment plans and deferred payments. In the event the patient/guarantor does not make a reasonable effort to complete necessary documentation to apply or become eligible for a financial assistance program they are then still given the initial 40% discount and moved through the normal collection process. Part VI, Line 4: The rural service area covered by ARH in Eastern Kentucky and Southern West Virginia covers 16 counties and consists of almost 370,000 residents with 51 percent being female and 49 percent being male.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 example, in September 2010, the unemployment rate for Harlan County, Kentucky was 11.5 percent, compared to 9.8 percent for the state and 9.2 percent nationally.For more than half a century, ARH has carried a heavy load in caring for this population. Over 8 percent of ARH's inpatients in fiscal year 2010 were uninsured and during that same fiscal year more than 63 percent of ARH's inpatients were Medicare or Medicaid beneficiaries. Part VI, Line 6: 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 close to 4,700 people across Eastern Kentucky and Southern West Virginia with hospitals, clinics, home health agencies, pharmacies and home durable medical equipment stores. ARH's nine 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 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 them. 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. KY WV X X X X 0 1 0 0 0 1 0 0 0 JERRY HAYNES 613362 0 55836 0 0 0 21663 0 16689 0 707550 0 0 0 JOSEPH GROSSMAN 355440 0 26040 0 0 0 16448 0 22594 0 420522 0 0 0 HOLLIE P HARRIS 214679 0 16380 0 0 0 16500 0 21947 0 269506 0 0 0 JOHN D MILLER 288149 0 20832 0 0 0 2480 0 18484 0 329945 0 0 0 paul miles 256038 0 20832 0 0 0 7440 0 23013 0 307323 0 0 0 bobby rick king 261371 0 19740 0 0 0 21050 0 14894 0 317055 0 0 0 JOSE M ECHEVERRIA 192369 0 285586 0 0 0 1663 0 21534 0 501152 0 0 0 prakash puranik 399807 0 0 0 0 0 38154 0 13303 0 451264 0 0 0 jameel a butt 373254 0 278659 0 0 0 25132 0 5923 0 682968 0 0 0 jamal bazzi 405017 0 0 0 0 0 626 0 5923 0 411566 0 0 0 nathan e doctry 421635 0 0 0 0 0 0 0 5923 0 427558 0 0 0 Part I, Line 4a ARH provides senior executives a contribution of seven (7) percent of pay (subject to a 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 $16,500 in 2009. 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 her/his 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 to 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. Respective employer contributions into the 457(f) plan include: Jerry Haynes $2,538; Joseph Grossman $4,365; Paul Miles $192; and John Miller $192. 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 Plans. 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. city of hazard ky 616001839 2007-02-14 4600000 construction of and equipment at hazard cancer center 0 0 county of pikeville ky 616000928 2007-06-15 2400000 purchase of a building for central purchasing services 0 0 county of perry kentucky 616000810 2007-08-08 4600000 construction of and equipment at the Hazard cancer center 0 0 4600000 56500 4543500 2008 0 0 1 1 2400000 44199 2355801 2008 0 0 1 1 4600000 65525 4534475 2008 0 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 dr john pellegrini trustee of arh 210324 a clinic owned by dr. pellegrini provides physician practice management services to an arh-employed physician. 0 Form 990, Part VI, Section B, line 11 the director of accounting and cfo both review the 990. 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. Haynes and other ARH executives. The Board contracts with a consulting firm to review the market for the positions on the System Operating Council who makes recommendations on the salary ranges and assesses the competitiveness of the salaries. With that information, the Compensation and Contracts Committee set the ranges and the President's compensation. The Board reviews and finalizes compensation amounts. The consulting firm follows up with a letter attesting to the reasonableness of compensation. Form 990, Part VI, Section C, line 19 While ARH has not yet adopted a policy of sharing its financial statements with the public, it does provide financial information through the Form 990 and also provides certain financial information in other public documents, including its periodic reports to the communities it serves. Form 990, Part XI, line 2c Process for overseeing and selecting independent auditors has not changed. the arh foundation for healthier communities inc 100 airport gardens road hazard KY 41701 204840007 carrying out fundraising and charitable activities for arh KY 501(c)(3) Line 7 appalachian regional healthcare inc west virginia arh inc 2285 executive drive lexington KY 40505 550756776 HEALTH CARE WV 501(c)(3) Line 3 appalachian regional healthcare inc hazard arh imaging center llc 210 black gold blvd hazard KY 41701 270755457 medical imaging services KY N/A related -400292 430433 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 the arh foundation for healthier communities inc P 208306 hazard arh imaging center llc B 169950