2026-05-07T15:57:53-05:00 2025-06-30 882730877 CHERRY BEKAERT ADVISORY LLC 101 SOUTH 5TH STREET STE 2100 LOUISVILLE KY 40202 990 2024-07-01 822577178 ARH TUG VALLEY HEALTH SERVICES INC ARHT 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 BYRON GABBARD CFO 8592262440 2026-04-22 1 1 MELANIE MCPEAK P01346034 8885871719 2024 2025-03-06 01:10:19Z HOLLIE HARRIS 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 238140026 0 X WWW.ARH.ORG X 2013 KY TO PROVIDE CENTRAL APPALACHIA AN ABUNDANCE OF HEALTHCARE AND COMMUNITY-ORIENTED SERVICES THROUGH ITS HOSPITAL, CLINICS AND HOME HEALTH OPERATIONS AS WELL AS COMMUNITY OUTREACH SERVICES. 4 0 1067 24 2125973 0 2038 18170 207875198 230284710 6732338 6295883 3250577 1541263 217860151 238140026 48033 96170 0 0 82170547 84357627 0 0 0 120512061 131872568 202730641 216326365 15129510 21813661 116507614 149900805 29321424 28874166 87186190 121026639 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. 0 0 171154174 96170 230284710 DURING THE PAST FISCAL YEAR, HIGHLANDS ARH REGIONAL MEDICAL CENTER CONTINUED TO STRENGTHEN ITS ROLE AS THE HEALTHCARE HUB FOR THE ARH BIG SANDY REGION, SERVING FLOYD, JOHNSON, MARTIN, AND MAGOFFIN COUNTIES. SINCE JOINING THE ARH SYSTEM IN 2019, HIGHLANDS ARH HAS REMAINED FOCUSED ON EXPANDING ACCESS, IMPROVING QUALITY, AND ADDRESSING THE UNIQUE HEALTHCARE NEEDS OF CENTRAL APPALACHIA.HIGHLANDS ARH SUPPORTS A DIVERSE MEDICAL STAFF REPRESENTING NUMEROUS SPECIALTIES, INCLUDING FAMILY MEDICINE, CARDIOLOGY, OBSTETRICS AND GYNECOLOGY, GENERAL SURGERY, INTERNAL MEDICINE, ORTHOPEDICS, UROLOGY, ONCOLOGY, NEPHROLOGY, NEUROLOGY, AND MORE. WITH MORE THAN 700 EMPLOYEES, THE MEDICAL CENTER IS COMMITTED TO DELIVERING COMPASSIONATE, HIGH-QUALITY CARE TO THE COMMUNITIES IT SERVES.KEY SERVICE EXPANSIONS DURING THE FISCAL YEAR INCLUDED THE OPENING OF AN EIGHT-BED PROGRESSIVE CARE UNIT AND THE ADDITION OF IP UROLOGY SERVICES. THESE INITIATIVES CONTRIBUTED TO AN ALMOST 20 PERCENT YEAR-OVER-YEAR INCREASE IN ADMISSIONS AND ENHANCED HIGHLANDS ARH'S ABILITY TO PROVIDE ADVANCED CARE CLOSE TO HOME. 171154174 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 102 0 1 1067 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X BYRON GABBARD 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 HOLLIE P HARRIS CHAIRMAN 5.00 35.00 X X 0 1503777 118812 BYRON GABBARD TREASURER 5.00 35.00 X X 0 664251 60915 JONATHAN COLLINS SECRETARY 7.00 33.00 X X 0 121676 30694 ROCCO K MASSEY DIRECTOR 5.00 35.00 X 0 374529 67288 ROBERT N ROYALTY ORTHOPEDIC SURGEON 40.00 0.00 X 1997033 0 58914 AHMED MALIK CARDIOLOGIST 40.00 0.00 X 710268 0 4136 JASON T RICE FAMILY MEDICINE PHYSICIAN 40.00 0.00 X 750275 0 53594 ANDREW R BURCHETT CARDIOLOGIST 40.00 0.00 X 693951 0 59356 BAHRAM FOROUZANDEH GASTROENTEROLOGIST 40.00 0.00 X 682001 0 0 4833528 2664233 453709 80 0 1 0 HALLMARK HEALTH CARE SOLUTIONS PO BOX 22938 NEW YORK NY 100872938 CONTRACT NURSES 8306324 SODEXO OPERATIONS LLC PO BOX 360170 PITTSBURGH PA 152516170 SERVICE MANAGEMENT 2241859 CARDIOLOLUTIONS LLC 4675 CORNELL RD SUITE 100 CINCINNATI OH 45241 EMERGENCY MEDICAL SERVICES 1756725 JACKSON & COKER 2655 NORTHWINDS PARKWAY ALPHARETTA GA 30009 SURGERY LOCUM TENENS 1479717 GUARDLOGIC 710 E MAIN ST LEXINGTON KY 40502 SECURITY SERVICES 957690 61 18170 18170 PATIENT REVENUE 621110 161061475 161061475 HOSPITAL RATE IMPROVEMENT PROGRAM 621110 43381029 43381029 PHARMACY 456110 25838710 23716347 2122363 TRANSCRIPT FEES 621110 3496 3496 230284710 2700236 2700236 485228 0 485228 485228 485228 3595647 0 3595647 3595647 3595647 KMAP REVENUE 900099 691291 691291 MEDITECH REVENUE 900099 229098 229098 VENDOR REBATE INCOME 900099 106491 106491 29155 3610 25545 1056035 238140026 228162347 2125973 7833536 X 96170 96170 65415314 54720525 10694789 885674 735109 150565 14029193 11624293 2404900 4027446 3342780 684666 13142 13142 29017330 23226939 5790391 156852 95680 61172 19331517 18070707 1260810 448922 273842 175080 5230299 3320716 1909583 112696 68745 43951 137691 83992 53699 374508 56176 318332 3866376 3286420 579956 4145701 2528878 1616823 MEDICAL SUPPLIES & PHAR 30047229 29465400 581829 PROVIDER TAXES 9463118 60926 9402192 BAD DEBT 5409374 5409374 24117813 14674360 9443453 216326365 171154174 45172191 0 362407 937686 1037499 21412596 23959456 4143187 4102975 13270773 186443 143247276 98024662 39395022 45222614 1293972 1465264 178249 330229 330229 35183493 73596325 116507614 149900805 9398737 15353793 7598414 7328845 12324273 6191528 29321424 28874166 X 87186190 121026639 87186190 121026639 116507614 149900805 X 21813661 12035542 -8754 X X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 13142 13142 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF THE KENTUCKY HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THE AMOUNT REPORTED REPRESENTS THE PORTION OF DUES ATTRIBUTABLE TO LOBBYING EXPENSES. 3029249 3029249 68241005 45869008 22371997 827056 827056 0 48698387 41524041 7174346 22451579 9804557 12647022 45222614 INTERCOMPANY RECEIVABLES 73596325 73596325 INTEREST RATE SWAP 21846 THIRD PARTY SETTLEMENTS 6169682 6191528 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. U.S. 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 0 1 1 0 1 1 10936623 10936623 0.05190 61309047 61143605 165442 0.00080 72245670 61143605 11102065 0.05270 86 85 419393 419393 0.00200 19 15850 15850 0.00010 105 85 435243 435243 0.00210 105 85 72680913 61143605 11537308 0.05480 14 50 7317 7317 0.00000 20 1014 3243 3243 0.00000 15 651 651 0.00000 105 4099 33600 33600 0.00020 154 5163 44811 44811 0.00020 1 5409374 3188951 14734909 20725849 -5990940 X 1 1 2 1 HIGHLANDS ARH REGIONAL MEDICAL CENTER 5000 KY RT 321 PRESTONSBURG KY 41653 WWW.ARH.ORG 100124 X X X X A 2 PAINTSVILLE ARH HOSPITAL 625 JAMES S TRIMBLE BLVD PAINTSVILLE KY 41240 100263 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 24 1 1 0 1 X HTTPS://WWW.ARH.ORG/CHNA/ X 1 24 1 HTTPS://WWW.ARH.ORG/CHNA/ 0 1 X 100.000000000000 200.000000000000 X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X 1 X 0 X 1 X 0 0 PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ PART V, LINE 16C, FAP SUMMARY WEBSITE: HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE/ PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: HIGHLANDS ARH REGIONAL MEDICAL CENTER, - FACILITY 2: PAINTSVILLE 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. 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 6A: ARH TUG VALLEY HEALTH SERVICES INC CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT JOINTLY WITH THE OTHER FACILITIES WITHIN THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM. APPALACHIAN REGIONAL HEALTHCARE, INC. (EIN: XXX-XX-XXXX), THE PARENT ORGANIZATION, COORDINATED AND FILED THE COMBINED CHNA ON BEHALF OF ALL PARTICIPATING FACILITIES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: ARH TUG VALLEY HEALTH SERVICES, INC. CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN EACH OF ITS 2 HOSPITAL COMMUNITIES DURING 2024. RESULTS FROM COMMUNITY SURVEYS, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS ARE BEING REPORTED ALONG WITH HEALTH INFORMATION COLLECTED FROM REPUTABLE NATIONAL, STATE, AND LOCAL DATA SOURCES. ALSO BEING REPORTED FOR EACH ARH HOSPITAL IS AN IMPLEMENTATION PLAN ADDRESSING THE IDENTIFIED ISSUES FROM THIS PROCESS AND AN OUTCOMES SUMMARY FROM THE CHNA PROCESS AND IMPLEMENTATION CONDUCTED SINCE 2019. ALL OF THE INFORMATION IN THESE REPORTS PROVIDES VALUABLE INFORMATION THAT WILL BE USED IN THE FUTURE FOR PLANNING PURPOSES, SERVICE IMPROVEMENTS AND COMMUNITY OUTREACH. IT IS ARH'S HOPE THAT THIS ASSESSMENT WILL HELP OUR FACILITIES, IN PARTNERSHIP WITH OUR COMMUNITIES, TO IDENTIFY RESPECTIVE HEALTH CONCERNS, MEASURE THE IMPACT OF CURRENT PUBLIC HEALTH EFFORTS AND GUIDE THE APPROPRIATE USE OF LOCAL RESOURCES. WE ALSO HOPE THAT TOGETHER WE CAN IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA.DURING THE 2024 CHNA PROCESS, THE APPOINTED COUNTY STEERING COMMITTEE IDENTIFIED THE FOLLOWING HEALTH NEEDS: 1. OBESITY, 2. ADDICTION SUPPORT, 3. MENTAL HEALTH, 4. INCREASING KNOWLEDGE OF SERVICES, 5. ACCESS TO CAREOBESITYHIGHLANDS ARH HAS ADDRESSED FOOD INSECURITY, PHYSICAL INACTIVITY, AND THE NEED FOR NUTRITION EDUCATION BY PROVIDING 7 FREE COOKING CLASSES WITH GROCERY GIFT CARD INCENTIVES IN PARTNERSHIP WITH THE FLOYD COUNTY UK EXTENSION SERVICE. COLLABORATING WITH GOD'S PANTRY FOOD BANK TO PROVIDE NONPERISHABLE FOOD BOXES TO PATIENTS IDENTIFIED AS HAVING A NEED IN BOTH THE HOSPITAL AND CLINIC ENVIRONMENT. DISTRIBUTING ON AVERAGE 40 BOXES PER MONTH. HOSTING 11 MONTHLY DIABETES SUPPORT GROUPS IN FLOYD COUNTY WITH DIABETES-RELATED TOPICS AND HEALTHY COOKING DEMONSTRATIONS EACH MONTH (2022 START). PARTICIPATING IN A RESEARCH STUDY WITH UNIVERSITY OF KENTUCKY FOOD AS HEALTH ALLIANCE IN WHICH HIGHLANDS' AMBULATORY PATIENTS WITH TYPE 2 DIABETES OR HYPERTENSION COULD RECEIVE MEDICALLY TAILORED MEALS FOR 12 WEEKS. ANNUAL SPONSORSHIP OF COMMUNITY FEEDING PROGRAMS LIKE THE BRIGHT BEGINNINGS COMMUNITY THANKSGIVING DINNER, WHICH FEEDS 1000+ PEOPLE IN FLOYD COUNTY. CREATING A NEW PROGRAM, RETHINK YOUR DRINK, WHICH EDUCATES STUDENTS ON THE HARMFUL EFFECTS OF SUGARY, OVERLY CAFFEINATED DRINKS (SUCH AS ENERGY DRINKS). COMMUNITY DEVELOPMENT STAFF HAVE PRESENTED THIS PROGRAM 2 TIMES IN THE COMMUNITY. IN 2023, AN EMPLOYEE GARDEN WAS CREATED ON-SITE, ALLOWING SPACE FOR EMPLOYEES TO GROW PRODUCE. GROWN FRUIT AND VEGETABLES ARE AVAILABLE FOR EMPLOYEES TO TAKE HOME AND ARE OFTEN GIVEN TO PATIENTS. HIGHLANDS ARH ALSO WORKED TO EDUCATE AND PROVIDE HEALTHY NUTRITION TO EMPLOYEES THROUGH A REVAMPED CAFETERIA MENU, WHICH OFFERS PLANT-BASED OPTIONS PROVIDED ACCESS TO PHYSICAL ACTIVITY OPPORTUNITIES IN OUR COMMUNITY BY SPONSORING MOMMY AND ME FITNESS CLASSES AND THINK PINK EVENTS ANNUALLY WITH FOXY FITNESS IN PRESTONSBURG. AS OF 2022, FREE GYM MEMBERSHIPS TO NO LIMITS FITNESS ARE AVAILABLE TO ALL ARH EMPLOYEES. SPONSORED NUMEROUS 5K RACES IN THE COMMUNITY, INCLUDING THOSE THAT BENEFIT THE LOCAL HOMELESS SHELTER AND ANIMAL SHELTER.SINCE 2022, PAINTSVILLE ARH HAS ADDRESSED FOOD INSECURITY AND THE NEED FOR NUTRITION EDUCATION BY PROVIDING 5 FREE COOKING CLASSES WITH GROCERY GIFT CARD INCENTIVES IN PARTNERSHIP WITH THE JOHNSON COUNTY UK EXTENSION SERVICE. COLLABORATED WITH GOD'S PANTRY FOOD BANK TO PROVIDE NONPERISHABLE FOOD BOXES TO PATIENTS IDENTIFIED AS HAVING A NEED IN BOTH THE HOSPITAL AND CLINIC ENVIRONMENT. DISTRIBUTING ON AVERAGE 20 BOXES PER MONTH. HOSTED 11 MONTHLY DIABETES SUPPORT GROUPS IN JOHNSON COUNTY WITH DIABETES RELATED TOPICS AND HEALTHY COOKING DEMONSTRATIONS EACH MONTH (2022 START). HOSTING A FALL FESTIVAL FARMERS MARKET ON-SITE AT THE FACILITY IN 2022. KITCHENSHIFT PROVIDED COOKING DEMONSTRATIONS AT THE EVENT. PARTNERED WITH THE JOHNSON COUNTY FARMER'S MARKET TO PROVIDE HEART HEALTH EDUCATION AND HEALTHY RECIPES AT 5 MARKET EVENTS. PAINTSVILLE ARH ALSO WORKED TO EDUCATE AND PROVIDE HEALTHY NUTRITION TO EMPLOYEES THROUGH A REVAMPED CAFETERIA MENU, WHICH OFFERS PLANT-BASED OPTIONS PROVIDED VOUCHERS FOR CHILDREN TO PURCHASE FRUITS AND VEGETABLES FROM GRIFFITH'S FARM AT 2023 FARM AND FIELD DAY. CREATED A NEW PROGRAM, RETHINK YOUR DRINK, WHICH EDUCATES STUDENTS ON THE HARMFUL EFFECTS OF SUGARY, OVERLY CAFFEINATED DRINKS (SUCH AS ENERGY DRINKS). COMMUNITY DEVELOPMENT STAFF HAVE PRESENTED THIS PROGRAM TO 300 STUDENTS AT HIGHLAND ELEMENTARY IN PAINTSVILLE.ADDICTION SUPPORTIN 2022, HIGHLANDS ARH LAUNCHED THE PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY, ENGAGING 1,873 PATIENTS AND ASSISTING 90 INDIVIDUALS WITH ATTAINING HOUSING OR EMPLOYMENT. ARH PEER RECOVERY COACHES AND COMMUNITY DEVELOPMENT MANAGERS HAVE WORKED WITH COMMUNITY PARTNERS TO HOST MANY COMMUNITY EVENTS OVER THE PAST THREE YEARS THAT HAVE WORKED TO REDUCE SUBSTANCE USE. PARTNERED WITH THE KY DEPARTMENT OF PUBLIC HEALTH HOSTING NUMEROUS SAFE A LIFE ROADSHOW EVENTS, IN WHICH PARTICIPANTS ARE PROVIDED WITH OVERDOSE AWARENESS EDUCATION, NARCAN TRAINING AND DISTRIBUTION, AND REFERRALS TO TREATMENT. LOVE YOUR LUNGS, AN EDUCATIONAL PROGRAM ON THE DANGERS OF SMOKING AND VAPING, WAS PRESENTED TO FLOYD COUNTY SCHOOLS 8 TIMES SINCE 2022. SPONSORED OPERATION UNITE'S "SHOOT HOOPS, NOT DRUGS" PROGRAM, WHICH PROMOTES POSITIVE ACTIVITIES FOR LOCAL YOUTH WHILE PROVIDING EDUCATION ON DRUG PREVENTION BEGINNING IN 2023, THE HIGHLANDS ARH PHARMACY BEGAN IN-PERSON SMOKING CESSATION CLASSES FOR EMPLOYEES, AND ONLINE COUNSELING IS ALSO AVAILABLE TO ALL EMPLOYEES. ARH STAFF PARTICIPATED ANNUALLY IN TRUTH AND CONSEQUENCES, A PROGRAM FOR ALL HIGH SCHOOL FRESHMEN AND SOPHOMORES IN THE COUNTY. THIS PROGRAM ALLOWS HIGH SCHOOL STUDENTS TO "EXPERIENCE" THE HARSH REALITIES OF SUBSTANCE ABUSE FROM DANGERS TO THEIR HEALTH TO INCARCERATIONBY WALKING THROUGH A SCENARIO PROVIDED TO EACH OF THEM.PAINTSVILLE ARH HAS ADDRESSED ADDICTION IN OUR COMMUNITY BY LAUNCHING PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY, ENGAGING 615 PATIENTS AND ASSISTING 20 INDIVIDUALS WITH ATTAINING HOUSING OR EMPLOYMENT. PEER RECOVERY COACHES AND COMMUNITY DEVELOPMENT STAFF HAVE WORKED WITH COMMUNITY PARTNERS TO HOST SEVERAL COMMUNITY EVENTS WITH A SUBSTANCE USE DISORDER/ DRUG PREVENTION FOCUS, EVENTS SUCH AS "SAFE A LIFE ROADSHOW". "KICK THE HABIT AND ORAL CANCER PROGRAMS, BOTH OF WHICH TEACH ABOUT THE DANGERS OF SMOKING & VAPING, WERE TAUGHT IN JOHNSON COUNTY SCHOOLS 5 TIMES SINCE 2022. SPONSORED OPERATION UNITE'S "SHOOT HOOPS, NOT DRUGS" PROGRAM, WHICH PROMOTES POSITIVE ACTIVITIES FOR LOCAL YOUTH WHILE PROVIDING EDUCATION ON DRUG PREVENTION. EDUCATION ABOUT ADDICTION AND RECOVERY RESOURCES SHARED ANNUALLY AT THE KENTUCKY APPLE FESTIVAL THROUGH PEER SUPPORT PROGRAM. PAINTSVILLE ARH IS ALSO AN ACTIVE MEMBER OF GROWING UP SAFE JOHNSON COUNTY, AREA AGENCIES ON SUBSTANCE ABUSE PREVENTION (ASAP), AND JOHNSON COUNTY HEALTH COALITION. THESE ARE COALITIONS AND COUNCILS THAT ADDRESS COMMUNITY SUBSTANCE USE ISSUES.MENTAL HEALTHSINCE 2022, HIGHLANDS ARH HAS WORKED TO IMPROVE MENTAL HEALTH IN OUR COMMUNITY BY PROVIDING 6 FREE MENTAL HEALTH FIRST AID TRAINING SESSIONS FOR STAFF FROM 2023-2024. HIGHLANDS ARH OFFERED THESE TRAINING COURSES WITH THE HOPE THAT THE EDUCATION WOULD ALLOW STAFF TO BETTER HELP OUR PATIENTS, BUT ALSO THEIR FAMILIES, FRIENDS, AND NEIGHBORS. 72 HIGHLANDS EMPLOYEES HAVE BEEN CERTIFIED. PRESENTING HEALTHY RELATIONSHIPS PROGRAMMING TO FLOYD CENTRAL, PRESTONSBURG HIGH SCHOOL, AND BETSY LAYNE HIGH SCHOOL STUDENTS. THIS PROGRAM TEACHES CRITICAL THINKING AROUND QUALITIES OF HEALTHY AND UNHEALTHY RELATIONSHIPS, SIGNS OF ABUSE, AND COMMUNICATION SKILLS. THROUGH A PARTNERSHIP WITH KENTUCKY EDUCATION DEVELOPMENT CORPORATION, ARH SPONSORED ART THERAPY "TRAIN THE TRAINER" SESSIONS FOR SIX AREA TEACHERS. THE THRIVING THROUGH ART PROGRAM TEACHES EDUCATORS HOW TO OFFER MENTAL HEALTH ART SESSIONS IN CLASSROOMS.PAINTSVILLE ARH HAS IMPROVED MENTAL HEALTH IN OUR COMMUNITY BY PROVIDING 8 FREE MENTAL HEALTH FIRST AID TRAINING SESSIONS FOR STAFF AND THE COMMUNITY FROM 2023-2024. HIGHLANDS ARH OFFERED THESE TRAINING COURSES WITH THE HOPE THAT THE EDUCATION WOULD ALLOW STAFF TO BETTER HELP OUR PATIENTS, BUT ALSO THEIR FAMILIES, FRIENDS, AND NEIGHBORS. 65 PAINTSVILLE ARH EMPLOYEES AND 9 COMMUNITY MEMBERS HAVE BEEN CERTIFIED. PRESENTED REAL TALK, A PROGRAM THAT TEACHES DEPRESSION, SUICIDE PREVENTION, CYBER BULLYING, AND HEALTHY RELATIONSHIPS, TO STUDENTS AT PAINTSVILLE HIGH SCHOOL. PROVIDED INFORMATION AND RESOURCES ABOUT YOUTH MENTAL HEALTH TO STUDENTS AND PARENTS AT EMPOWER ACADEMY AT JOHNSON COUNTY MIDDLE SCHOOL, JOHNSON COUNTY READYFEST, AND MULTIPLE OPEN HOUSE EVENTS. PART V, SECTION B, LINE 11 CONTINUED: PAINTSVILLE ARH ALSO ADDED MENTAL HEALTH SERVICES WITH THE RECRUITMENT OF GREG HORN, APRN, PMHNP-BC. SINCE 2022, PAINTSVILLE ARH HAS TRACKED 2,868 BEHAVIORAL HEALTH CLINIC VISITS.INCREASING KNOWLEDGE OF SERVICESHIGHLANDS ARH HAS INCREASED COMMUNITY, PROVIDER, AND PARTNER KNOWLEDGE OF SERVICES AVAILABLE BY BREAKING DOWN SILOS, MEETING COMMUNITY HEALTH NEEDS, AND FOSTERING PARTNERSHIPS BETWEEN HEALTH CARE ORGANIZATIONS, ARH HAS ACTIVELY PARTICIPATED IN 14 COUNCILS, COALITIONS, AND BOARDS SINCE 2022. THESE GROUPS WORK TO BETTER THE HEALTH AND WELLNESS OF APPALACHIANS BUT MAY ALSO HAVE COMMUNITY BETTERMENT AND ECONOMIC DEVELOPMENT GOALS. HIGHLANDS ARH HAS ALSO MADE 4,368 SOCIAL MEDIA POSTS FROM 2022-2023 PROMOTING OUR SERVICES AND EDUCATING THE COMMUNITY IMPORTANT HEALTH TOPICS.ACCESS TO CARESINCE 2022, HIGHLANDS ARH HAS INCREASED COMMUNITY, PROVIDER, AND PARTNER KNOWLEDGE OF SERVICES AVAILABLE BY IMPROVING ACCESS TO CARE BY INCREASING SPECIALTY SERVICES IN NEPHROLOGY RECRUITMENT OF DR. KHAN, ENDOCRINOLOGY RECRUITMENT OF DR. UY AND BONNIE FERGUSON, APRN FOR ENDO CLINIC, GENERAL SURGERY RECRUITMENT OF DR. KASSUM, INTERVENTIONAL CARDIOLOGY RECRUITMENT OF DR. TALEY. RADIOLOGY HAS A NEW 3D MAMMOGRAM UNIT. NEONATAL CARE OPENED A 6 BED NICU IN 2024. ROBOTIC SURGERY ADDED THE DAVINCI XI ROBOT WHICH IS USED BY 4 GENERAL SURGEONS. MED/SURG ADDED 12 ADDITIONAL BEDS AND RENOVATED THE UNIT. HIGHLANDS ARH ALSO LAUNCHED AN INTERNAL MEDICINE RESIDENCY PROGRAM IN AN EFFORT TO RECRUIT MORE PROVIDERS TO THE AREA. THE PROGRAM OPENED WITH 4 RESIDENTS IN YEAR ONE.SINCE 2022, PAINTSVILLE ARH HAS INCREASED ACCESS TO CARE IN OUR COMMUNITY BY EMPLOYING NURSES AND AN APRN TO PROVIDE SERVICES TO STUDENTS AND STAFF OF JOHNSON COUNTY SCHOOLS. PAINTSVILLE ARH OPENED A NEW CLINIC, ARH SPECIALTY ASSOCIATES, AND A NEW RETAIL PHARMACY IN 2024. PAINTSVILLE ARH PROVIDED FREE HEALTH SCREENINGS AND COMMUNITY-BASED CLINICAL SERVICES BROADLY THROUGHOUT THE SERVICE AREA SINCE 2022. OVER 900 FREE SCREENINGS HAVE BEEN ADMINISTERED AT LOCAL RETAIL STORES, SENIOR CENTERS, LOW-INCOME HOUSING, COMMUNITY HEALTH FAIRS, AND MORE. SINCE 2022, PAINTSVILLE ARH HAS HOSTED MANY EVENTS THAT PROVIDE PREVENTATIVE SCREENINGS AT A DISCOUNT, ON WEEKENDS, OR AFTER TRADITIONAL WORK HOURS. ADDED SPEECH LANGUAGE PATHOLOGY AS A NEW SERVICE AND EXPANDED MULTIPLE SERVICE LINES. PAINTSVILLE ARH WAS ALSO RECOGNIZED DURING THIS TIME AS AN ACUTE STROKE READY FACILITY AND A LUNG CANCER SCREENING CENTER OF EXCELLENCE. IN AN EFFORT TO PROVIDE BETTER CARE, WE ALSO INVESTED IN NEW EQUIPMENT (3-D MAMMOGRAPHY, DEXA SCANNER, TILT TABLE TESTING FOR CARDIOLOGY) AND EXTENDED AFTER-HOURS CARE HOURS OF OPERATION FROM 9AM-9PM. PART V, SECTION B, LINE 13A: FPG FAMILY INCOME IS UNLIMITED FOR ELIGIBILITY FOR FREE CARE. 14 1 - ARH MEDICAL AND SURGICAL ASSOC HIGHLANDS 5000 KY ROUTE 321 PRESTONSBURG KY 41653 CLINIC 2 - ARH MEDICAL & SPECIALTY ASSOC PAINTSVILL 604 JAMES S TRIMBLE BLVD PAINTSVILLE KY 41240 CLINIC 3 - ARH FAMILY HEALTH & SPECIALTY CLINIC PNT 520 NORTH MAYO TRAIL PAINTSVILLE KY 41240 CLINIC 4 - ARH WOUND HEALING CENTER 228 CHURCH STREET PAINTSVILLE KY 41240 CLINIC 5 - ARH FAMILY CARE - PAINTSVILLE 607 SOUTH MAYO TRAIL SUITE B PAINTSVILLE KY 41240 CLINIC 6 - ARH PRIMARY CARE - PAINTSVILLE 826 SOUTH MAYO TRAIL PAINTSVILLE KY 41240 CLINIC 7 - ARH OPTOMETRY CARE 341 COURT STREET PAINTSVILLE KY 41240 CLINIC 8 - ARH MEDICAL & SPECIALTY ASSOC HIGHLANDS 5000 KY ROUTE 321 PRESTONSBURG KY 41653 CLINIC 9 - CUMBERLAND VALLEY PHARMACY 3504 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 PHARMACY 10 - HIGHLANDS ARH MEDICAL OFFICE PHARMACY 5000 KY ROUTE 321 PRESTONSBURG KY 41653 PHARMACY 11 - HIGHLANDS ARH CLINIC PHARMACY 713 BROADWAY ST SUITE 101 PAINTSVILLE KY 41240 PHARMACY 12 - HIGHLANDS HOME HEALTH 93 DEWEY STREET PRESTONSBURG KY 41653 HOME HEALTH 13 - PSYCHIATRIC CENTER - HIGHLANDS 5000 KY ROUTE 321 PRESTONSBURG KY 41653 PSYCH 14 - HIGHLANDS WELLNESS CENTER 5000 KY ROUTE 321 SUITE 104 PRESTONSBURG KY 41653 MED SPA 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 6A: A COMBINED ANNUAL COMMUNITY BENEFIT REPORT WAS FILED FOR ALL FACILITIES WITHIN THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM; FILED BY APPALACHIAN REGIONAL HEALTHCARE, INC. (EIN: 52-0795508), THE PARENT ORGANIZATION. PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART I, LINE 3B: FPG FAMILY INCOME IS UNLIMITED FOR ELIGIBILITY FOR FREE CARE. PART II, COMMUNITY BUILDING ACTIVITIES: DURING THE PAST FISCAL YEAR, HIGHLANDS ARH REGIONAL MEDICAL CENTER CONTINUED TO STRENGTHEN ITS ROLE AS THE HEALTHCARE HUB FOR THE ARH BIG SANDY REGION, SERVING FLOYD, JOHNSON, MARTIN, AND MAGOFFIN COUNTIES. SINCE JOINING THE ARH SYSTEM IN 2019, HIGHLANDS ARH HAS REMAINED FOCUSED ON EXPANDING ACCESS, IMPROVING QUALITY, AND ADDRESSING THE UNIQUE HEALTHCARE NEEDS OF CENTRAL APPALACHIA.HIGHLANDS ARH SUPPORTS A DIVERSE MEDICAL STAFF REPRESENTING NUMEROUS SPECIALTIES, INCLUDING FAMILY MEDICINE, CARDIOLOGY, OBSTETRICS AND GYNECOLOGY, GENERAL SURGERY, INTERNAL MEDICINE, ORTHOPEDICS, UROLOGY, ONCOLOGY, NEPHROLOGY, NEUROLOGY, AND MORE. WITH MORE THAN 700 EMPLOYEES, THE MEDICAL CENTER IS COMMITTED TO DELIVERING COMPASSIONATE, HIGH-QUALITY CARE TO THE COMMUNITIES IT SERVES.KEY SERVICE EXPANSIONS DURING THE FISCAL YEAR INCLUDED THE OPENING OF AN EIGHT-BED PROGRESSIVE CARE UNIT AND THE ADDITION OF IP UROLOGY SERVICES. THESE INITIATIVES CONTRIBUTED TO AN ALMOST 20 PERCENT YEAR-OVER-YEAR INCREASE IN ADMISSIONS AND ENHANCED HIGHLANDS ARH'S ABILITY TO PROVIDE ADVANCED CARE CLOSE TO HOME.THE ARH BIG SANDY REGION WAS SELECTED TO LAUNCH ARH MEMORY CARE, A NEW DEMENTIA CARE SERVICE FOR MEDICARE PATIENTS AS PART OF CMS'S GUIDE (GUIDING AN IMPROVED DEMENTIA EXPERIENCE) MODEL. THIS INNOVATIVE PROGRAM PROVIDES 24/7 SUPPORT, PERSONALIZED CARE PLANNING, CAREGIVER EDUCATION, CARE COORDINATION, AND RESPITE SERVICES, HELPING PATIENTS WITH DEMENTIA SAFELY REMAIN IN THEIR HOMES WHILE SUPPORTING UNPAID CAREGIVERS. PLANS ARE IN PLACE TO EXPAND THE PROGRAM SYSTEMWIDE.HIGHLANDS ARH ALSO RECEIVED STATEWIDE RECOGNITION FOR MATERNAL AND INFANT HEALTH INITIATIVES. IN ADDITION TO OPENING OF ITS SIX-BED LEVEL II NICU LAST SUMMER, HIGHLANDS WAS AMONG ARH BIRTHING HOSPITALS AWARDED RECOGNITION FROM THE KENTUCKY PERINATAL QUALITY COLLABORATIVE FOR EXCELLENCE IN QUALITY IMPROVEMENT AND DATA REPORTING, WITH A FOCUS ON IMPROVING OUTCOMES FOR MOTHERS AND INFANTS AFFECTED BY SUBSTANCE USE DISORDER.ACCESS TO CARE WAS FURTHER ENHANCED THROUGH THE LAUNCH OF THE ARH MOBILE HEALTH CLINIC, WHICH DELIVERS SCREENINGS AND ROUTINE CARE DIRECTLY TO RESIDENTS IN REMOTE AND UNDERSERVED AREAS. BY BRINGING SERVICES TO COMMUNITY LOCATIONS, THE MOBILE CLINIC REDUCES BARRIERS TO CARE, SUPPORTS AGING POPULATIONS, AND HELPS PATIENTS MAINTAIN INDEPENDENCE.COMMUNITY OUTREACH REMAINED A PRIORITY, WITH EDUCATION EFFORTS FOCUSED ON NUTRITION, CANCER PREVENTION, HEART AND STROKE HEALTH, DIABETES MANAGEMENT, MENTAL HEALTH, AND SUBSTANCE USE DISORDER. ARH ALSO EXPANDED EFFORTS TO ADDRESS FOOD INSECURITY, A CRITICAL SOCIAL DETERMINANT OF HEALTH IN THE REGION.ADDRESSING FOOD INSECURITY REMAINED A CRITICAL PRIORITY FOR ARH DURING THE FISCAL YEAR, AS LIMITED ACCESS TO NUTRITIOUS FOOD CONTINUES TO SIGNIFICANTLY AFFECT HEALTH OUTCOMES IN CENTRAL APPALACHIA. IN PARTNERSHIP WITH GOD'S PANTRY FOOD BANK, ARH EXPANDED IN-FACILITY FOOD PANTRIES ACROSS HOSPITALS AND AMBULATORY CLINICS IN THE BIG SANDY AND KENTUCKY RIVER REGIONS. PATIENTS IDENTIFIED THROUGH CLINICAL SCREENING AS FOOD INSECURE RECEIVED FOOD BOXES AT THE POINT OF CARE, HELPING TO ADDRESS AN IMMEDIATE BASIC NEED WHILE SUPPORTING IMPROVED MANAGEMENT OF CHRONIC CONDITIONS SUCH AS DIABETES AND HEART DISEASE.THIS WORK IS PART OF ARH'S BROADER FOOD IS MEDICINE INITIATIVE, WHICH INTEGRATES NUTRITION SUPPORT INTO CLINICAL CARE FOR VULNERABLE POPULATIONS. THROUGH THIS INITIATIVE, ARH PROVIDES ACCESS TO NUTRITIOUS FOOD, NUTRITION EDUCATION, AND COMMUNITY-BASED RESOURCES FOR PATIENTS AT INCREASED RISK DUE TO ECONOMIC HARDSHIP, CHRONIC ILLNESS, OR GEOGRAPHIC ISOLATION. BY ADDRESSING FOOD INSECURITY AS A SOCIAL DETERMINANT OF HEALTH, ARH AIMS TO REDUCE PREVENTABLE ILLNESS, IMPROVE HEALTH OUTCOMES, AND SUPPORT LONG-TERM WELLNESS FOR PATIENTS AND FAMILIES ACROSS ITS SERVICE REGION.ARH'S LEADERSHIP AND MEASURABLE IMPACT IN ADDRESSING FOOD INSECURITY WERE RECOGNIZED WITH THE SHAPING OUR APPALACHIAN REGION (SOAR) HEALTHY COMMUNITIES AWARD. THE AWARD ACKNOWLEDGES ARH'S FOOD IS MEDICINE INITIATIVE FOR ITS EFFECTIVENESS IN IMPROVING ACCESS TO NUTRITIOUS FOOD AND ADVANCING COMMUNITY HEALTH ACROSS APPALACHIAN KENTUCKY.FINALLY, WITH SUPPORT FROM THE ARH FOUNDATION FOR HEALTHIER COMMUNITIES, HIGHLANDS ARH REINFORCED ITS COMMITMENT TO COMMUNITY WELL-BEING BY PRESENTING A $5,000 DONATION ON THE FOUNDATION'S BEHALF TO HAND IN HAND, SUPPORTING HOUSING, EDUCATION, AND HEALTHCARE NEEDS FOR ECONOMICALLY VULNERABLE FAMILIES ACROSS THE BIG SANDY REGION.COLLECTIVELY, THESE EFFORTS REFLECT HIGHLANDS ARH REGIONAL MEDICAL CENTER'S CONTINUED COMMITMENT TO ADVANCING ITS MISSION BY EXPANDING ACCESS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, AND IMPROVING THE OVERALL WELL-BEING OF THE COMMUNITIES IT SERVES. PART III, LINE 2: TO DETERMINE THE BAD DEBT EXPENSE ON PART III, 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. 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. PART III, LINE 3: 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 SEVERAL 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 RECEIVABLES ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. PART III, LINE 4: THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON SEVERAL 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 RECEIVABLES ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. PART III, LINE 8: A SIGNIFICANT PORTION 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 $5 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 $5,990,940 (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 2024, APPALACHIAN REGIONAL HEALTHCARE CONTRACTED UNIVERSITY OF KENTUCKY'S TEAM UP PUBLIC HEALTH COLLABORATIVE TO CONDUCT INDIVIDUAL COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR EACH OF ITS 14 FACILITIES. THESE ASSESSMENTS, CONDUCTED OVER EIGHT MONTHS, INCLUDED OVER 4,000 PUBLIC SURVEYS, 60 FOCUS GROUPS, 14 STEERING COMMITTEES, AND SECONDARY DATA COLLECTION NOT LIMITED TO: HOSPITAL UTILIZATION DATA COUNTY AND STATE HEALTH RANKINGS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA KY KIDS COUNT CENSUS DATA CANCER REGISTRY DATAIN ADDITION TO ASSESSING THE CURRENT STATE OF COMMUNITY HEALTH NEEDS, THESE CHNA REPORTS INCLUDE IMPLEMENTATION PLANS FOR THE NEXT THREE YEARS (CALENDAR YEARS 2025-2027) TO ADDRESS GREATEST PRIORITIES, AND AN OUTCOME SUMMARY FROM THE LAST CHNA CONDUCTED (2022). PART VI, LINE 3: UNDER ARHS FINANCIAL ASSISTANCE PROGRAM AND POLICY, EACH PATIENT WITHOUT MEDICAL COVERAGE FOR RENDERED SERVICES IS OFFERED A 40% DISCOUNT OF GROSS CHARGES AT TIME OF SERVICE. IF THE PATIENT EXTENDS PAYMENT AT TIME OF SERVICE THEY ARE GIVEN ANOTHER 10% DISCOUNT, MAKING THEIR LIABILITY 50% OF GROSS CHARGES. ALL OF THESE DISCOUNTS ARE APPLIED AT TIME OF CHARGE AND BILLED AFTER THE DISCOUNT IS TAKEN. IF SAID PATIENT IS UNABLE TO MEET THE FINANCIAL OBLIGATIONS FOR SERVICE, THEY ARE EDUCATED AND SCREENED FOR POTENTIAL FEDERAL AND/OR STATE ASSISTANCE PROGRAMS. BY DOING THIS, THE PATIENT IS REVIEWED AND EDUCATED BY ON-SITE FINANCIAL COUNSELORS AND/OR ELIGIBILITY AGENCY TO GET THE INDIVIDUAL PLACED IN A PROGRAM. BASED ON INCOME AND FAMILY STATUS, THE PATIENT IS SCREENED IN CONJUNCTION WITH THE FEDERAL AND STATE POVERTY GUIDELINES. AT THIS TIME, ALL APPLICATIONS ARE COMPLETED WITH THE ASSISTANCE OF ARH PERSONNEL AND SUBMITTED FOR APPROVAL. IN THE EVENT AN AGENCY REQUIRES THE PATIENT/GUARANTOR TO APPLY IN PERSON, THE INDIVIDUAL IS ASKED TO MAKE AN APPOINTMENT WITH THAT AGENCY AND FILE THEIR COMPLETED DOCUMENTS. IF THE RESPONSIBLE PARTY IS NOT ELIGIBLE FOR FEDERAL OR STATE ASSISTANCE, THEY ARE ADDITIONALLY SCREENED BY ARH FOR ELIGIBILITY INTO OUR INTERNAL SLIDING FEE SCHEDULE CHARITY PROGRAM FOR ADDITIONAL DISCOUNTS UP TO 100% OF GROSS CHARGES. IF THE PATIENT IS HELD RESPONSIBLE, ADDITIONAL EFFORTS TO ASSIST THE PATIENT ARE OFFERED BY OFFERING REASONABLE PAYMENT PLANS AND DEFERRED PAYMENTS. IN THE EVENT THE PATIENT/GUARANTOR DOES NOT MAKE A REASONABLE EFFORT TO COMPLETE NECESSARY DOCUMENTATION TO APPLY OR BECOME ELIGIBLE FOR A FINANCIAL ASSISTANCE PROGRAM, THEY ARE THEN STILL GIVEN THE INITIAL 40% DISCOUNT AND MOVED THROUGH THE NORMAL COLLECTION PROCESS. PART VI, LINE 4: PRIMARY COUNTIES IN KENTUCKY SERVED BY APPALACHIAN REGIONAL HEALTHCARE (THOSE WITH FACILITIES IN-COUNTY) INCLUDE BELL, FLOYD, HARLAN, JOHNSON, KNOX, LESLIE, LETCHER, MORGAN, PERRY, PIKE. SECONDARY KENTUCKY COUNTIES INCLUDE BREATHITT, CLAY, KNOTT, LAWRENCE, LEE, MAGOFFIN, MARTIN, OWSLEY, AND WOLFE. PRIMARY COUNTIES IN WEST VIRGINIA SERVED BY APPALACHIAN REGIONAL HEALTHCARE INCLUDE RALEIGH AND SUMMERS, WITH SECONDARY COUNTIES OF BOONE, FAYETTE, AND GREENBRIER, MINGO, AND WYOMING. THIS SERVICE AREA LIES WITHIN THE PORTION OF THE APPALACHIAN REGIONAL COMMISSION (ARC) DESIGNATED APPALACHIAN REGION, INCLUDING MANY OF THE STEEP, FORESTED RIDGES AND NARROW VALLEYS TYPICAL OF THE APPALACHIAN MOUNTAINS IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA. FOR EXAMPLE, IN LETCHER COUNTY, KENTUCKY, THE LANDSCAPE IS DEFINED BY RUGGED MOUNTAINS AND DENSE FOREST, WITH THE 125-MILE RIDGELINE OF PINE MOUNTAIN RUNNING ACROSS THE COUNTY. IN HARLAN COUNTY, KENTUCKY, ANOTHER COUNTY IN THE REGION, THE HEADWATERS OF THE CUMBERLAND RIVER FLOW THROUGH VALLEYS CARVED BETWEEN HIGH RIDGES. HARLAN COUNTY CONTAINS KENTUCKY'S HIGHEST POINT, BLACK MOUNTAIN (4,145 FT), REFLECTING THE ELEVATION EXTREMES. RURAL RESIDENTS OFTEN FACE LONG TRAVEL DISTANCES TO REACH MEDICAL FACILITIES, COMPOUNDED BY LIMITED OR UNRELIABLE PUBLIC TRANSPORTATION, AND LOW VEHICLE OWNERSHIP IN SOME HOUSEHOLDS. GIVEN THE RURAL AND MOUNTAINOUS CONTEXT, MANY COMMUNITIES ARE SMALL, SCATTERED, AND ISOLATED. THAT TENDS TO YIELD LIMITED LOCAL INFRASTRUCTURE; FEWER LARGE EMPLOYERS, FEWER AND SMALLER TOWNS, AND FEWER SERVICES, WHICH ALSO AFFECTS ACCESS TO HEALTH CARE, SOCIAL SERVICES, ECONOMIC OPPORTUNITIES, AND COMMUNITY RESOURCES.THE COUNTIES SERVED, MANY OF THEM COALFIELD AND FORMER COAL-MINING COUNTIES, HAVE LONG FACED ECONOMIC DISLOCATION AS TRADITIONAL INDUSTRIES (LIKE COAL) HAVE FADED. THAT LEGACY AFFECTS INCOME, EMPLOYMENT OPPORTUNITIES, AND ECONOMIC STABILITY IN THE REGION. THIS IS COMMON ACROSS MUCH OF THE EASTERN KENTUCKY COALFIELD AREA. MOREOVER, COMPARED WITH NON-APPALACHIAN REGIONS, PEOPLE IN APPALACHIA TEND TO HAVE LOWER LEVELS OF EDUCATIONAL ATTAINMENT AND HIGHER RATES OF POVERTY, FACTORS THAT CORRELATE WITH POORER HEALTH OUTCOMES.THE TOTAL POPULATION OF ARH'S PRIMARY AND SECONDARY MARKETS IS 503,677, WITH INDIVIDUALS AGE 65 AND OLDER REPRESENTING 22% OF THE POPULATION. NOTABLY, THIS AGE GROUP IS THE ONLY DEMOGRAPHIC EXPECTED TO GROW IN SIZE. THE REGION'S POPULATION IS PREDOMINANTLY CAUCASIAN (92%), WITH AN AVERAGE HOUSEHOLD INCOME OF $63,741. APPROXIMATELY 15% OF RESIDENTS HOLD A BACHELOR'S DEGREE OR HIGHER, WHILE 27% OF HOUSEHOLDS LIVE BELOW THE POVERTY LINE. PART VI, LINE 5: ARH HOSPITALS FURTHER THEIR TAX-EXEMPT PURPOSE THROUGH EXPANDING ACCESS TO CARE, COMMUNITY-BASED HEALTH IMPROVEMENT ACTIVITIES AND SOCIAL DETERMINANT OF HEALTH INTERVENTIONS. IN FY25, ARH INVESTED OVER 5.2 MILLION DOLLARS IN COMMUNITY BENEFIT ACTIVITIES, INCLUDING FREE COMMUNITY-BASED CLINICAL SCREENINGS (NEARLY 4,000 PROVIDED), FOOD IS MEDICINE INITIATIVES (I.E. COOKING CLASSES, DIABETES SUPPORT GROUPS, FARMERS MARKET SUPPORT, ETC.), IN-SCHOOL HEALTH PROGRAMMING, PHYSICAL ACTIVITY PROGRAMMING, CANCER PREVENTION, AND CHRONIC DISEASE EDUCATION. ARH'S COMMUNITY BENEFIT ACTIVITIES ARE TARGETED, MEASURABLE, AND DIRECTLY RESPONSIVE TO THE NEEDS IDENTIFIED IN ITS CHNAS. BY ENSURING ACCESS TO ESSENTIAL HEALTHCARE SERVICES, IMPROVING POPULATION HEALTH, AND ADDRESSING THE UNIQUE GEOGRAPHIC AND SOCIOECONOMIC BARRIERS FACED BY CENTRAL APPALACHIAN RESIDENTS, ARH'S HOSPITALS DEMONSTRABLY ADVANCE THEIR CHARITABLE PURPOSE AND PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE.BETWEEN PAINTSVILLE ARH AND HIGHLANDS ARH REGIONAL MEDICAL CENTER, NEARLY 70 EVENTS, CLASSES, AND SUPPORT GROUPS WERE HOSTED IN FY25 FOCUSED ON HEALTHY LIFESTYLE EDUCATION, FREE HEALTH SCREENING EVENTS, CHRONIC DISEASE PREVENTION, AND COMMUNITY HEALTH BETTERMENT. COMMUNITY MEMBERS HAVE BEEN EDUCATED ON SUBSTANCE ABUSE PREVENTION, THE USE OF NARCAN TO REDUCE OVERDOSE, AND THE DANGERS OF SMOKING AND VAPING. ARH HAS BEEN AT THE FOREFRONT OF FOOD IS MEDICINE IN APPALACHIA, EDUCATING PATIENTS AND COMMUNITIES ABOUT THE BENEFITS OF PROPER NUTRITION. THE FOOD IS MEDICINE MOVEMENT FURTHER INTEGRATED NUTRITION INTO HEALTHCARE, HOSTING EVENTS SUCH AS FARMER'S MARKETS, HEALTHY COOKING DEMONSTRATIONS, AND EDUCATIONAL CAMPAIGNS HIGHLIGHTING THE IMPORTANCE OF PROPER NUTRITION. BOTH FACILITIES HAVE CONTINUED THEIR IN-FACILITY FOOD PANTRY PROGRAMS, DISTRIBUTING HUNDREDS OF MEALS TO PATIENTS THAT HAVE SCREENED AS FOOD INSECURE. THROUGHOUT THE COMMUNITY, ARH STAFF PARTICIPATE IN BOARDS AND COALITIONS THAT WORK TO BETTER THE HEALTH AND WELLNESS OF COMMUNITY MEMBERS; LOCAL EXTENSION ADVISORY BOARDS, DIABETES COALITIONS, COUNTY HEALTH COALITIONS, AND MORE. ARH ALSO USES LOCAL ADVISORY COUNCILS FOR EACH FACILITY, MADE OF COMMUNITY MEMBERS TO PROVIDE A PLATFORM FOR COMMUNITY INPUT AND FEEDBACK ON HEALTHCARE SERVICES AND POLICIES. THEY HELP TO ENSURE TRANSPARENCY IN HOSPITAL OPERATIONS, ENGAGE COMMUNITY MEMBERS IN PLANNING, AND SUPPORT SHARED DECISION-MAKING. THESE LOCAL ADVISORY BOARDS PLAY A KEY ROLE IN DEVELOPING INCLUSIVE HEALTH PROGRAMS AND REDUCING HEALTH DISPARITIES. BY INCLUDING A DIVERSE RANGE OF COMMUNITY MEMBERS, ARH IS PROMOTING HEALTH EQUITY AND RESPONSIVENESS TO LOCAL NEEDS. PART VI, LINE 6: APPALACHIAN REGIONAL HEALTHCARE (ARH) IS AN INTEGRATED, MULTI-HOSPITAL HEALTHCARE SYSTEM SERVING RURAL AND UNDERSERVED COMMUNITIES THROUGHOUT CENTRAL APPALACHIA. INDIVIDUAL ARH HOSPITALS AND OTHER HEALTH ENTITIES PROVIDE DIRECT INPATIENT, OUTPATIENT, EMERGENCY, SPECIALTY, AND COMMUNITY-BASED CARE TAILORED TO LOCAL HEALTH NEEDS.AT THE SYSTEM LEVEL, ARH SUPPORTS ITS LOCAL COMMUNITY HOSPITALS, CLINICS, PHARMACIES, HOME SERVICES AND OTHER HEALTH-RELATED OPERATIONS THROUGH COORDINATED GOVERNANCE, SHARED CLINICAL AND ADMINISTRATIVE SERVICES, AND SYSTEM-WIDE COMMUNITY BENEFIT AND POPULATION HEALTH INITIATIVES. THESE INCLUDE UNIFORM CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES, COORDINATION OF COMMUNITY HEALTH NEEDS ASSESSMENTS, AND SUPPORT FOR PROGRAMS ADDRESSING CHRONIC DISEASE, SUBSTANCE USE DISORDER, FOOD INSECURITY, PREVENTIVE CARE, AND ACCESS TO HEALTHCARE SERVICES.ARH HOSPITALS IMPLEMENT THESE INITIATIVES LOCALLY THROUGH ACTIVITIES SUCH AS PEER RECOVERY SUPPORT FOR PATIENTS WITH SUBSTANCE USE DISORDER, MOBILE AND COMMUNITY-BASED CLINICS SERVING RURAL AREAS, HEALTH SCREENINGS AND EDUCATION, AND PARTNERSHIPS WITH PUBLIC HEALTH AGENCIES AND COMMUNITY ORGANIZATIONS. TOGETHER, ARH AND ITS AFFILIATED ENTITIES WORK COLLABORATIVELY TO IMPROVE ACCESS TO CARE AND PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITIES THEY SERVE. PART VI, LINE 7, REPORTS FILED WITH STATES KY,WV PART I, LINE 7F: $5,409,374 OF BAD DEBT EXPENSE WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25; BUT WAS EXCLUDED IN CALCULATING COMMUNITY BENEFIT EXPENSE FOR SCHEDULE H, LINE 7. COMMUNITY BENEFIT EXPENSES WERE CALCULATED USING COST REPORTS FOR THE FISCAL YEAR ENDED JUNE 30, 2025. 1 MOUNTAIN PERFORMING ARTS INC 50 HAL ROGERS DRIVE PRESTONSBURG KY 41653 834107663 501C3 40000 0 TO SUPPORT THE MISSION OF THE ORGANIZATION THAT PROMOTES THE RICH CULTURAL HERITAGE AND ARTISTIXC EXPRESSIONS OF THE APPALACHIAN REGION. CITY OF PRESTONSBURG 200 NORTH LAKE DRIVE PRESTONSBURG KY 41653 616001899 GOVT 8947 0 TO SPONSOR THE LOCAL YOUTH IN THE AREA WITH EDUCATIONAL SUPPLIES SUCH AS SPONSORING A REGIONAL BASEBALL TOURNAMENT AND PROVIDING BACK PACKS FILLED WITH SCHOOL SUPPLIES FOR A "BACK TO SCHOOL BASH". FLOYD COUNTY HOMELESS SHELTER INC PO BOX 1446 MARTIN KY 41649 811936272 501C3 10000 0 SPONSORSHIP FOR AN ANNUAL FUNDRAISING EVENTS SUCH AS A DANCE OR 4K RUN TO SUPPORT THE MISSION OF THE ORGANIZATION IN PROVIDING TEMPORARY, EMERGENCY SHELTER, AND NOURISHMENT TO INDIVIDUALS IN NEED. IT SERVES AS A SAFE REFUGE FOR THOSE EXPERIENCING HOMELESSNESS WHILE AIMING TO EMPOWER THEM TO REBUILD THEIR LIVES AND REINTEGRATE INTO SOCIETY. JOHNSON CENTRAL HIGH SCHOOL 257 NORTH MAYO TRAIL PAINTSVILLE KY 41240 454313357 501C3 9375 0 TO SUPPORT AN ACTIVE, HEALTHLY LIFESTYLE FOR OUR LOCAL YOUTH 4 0 PART I, LINE 2: MONITORING GRANTS AT APPALACHIAN REGIONAL HEALTHCARE (ARH) INVOLVES ADHERENCE TO FEDERAL, STATE, AND GRANTOR-SPECIFIC REGULATIONS, TYPICALLY OVERSEEN BY THE GRANTS MANAGEMENT OFFICE TO ENSURE COMPLIANCE WITH NOTICE OF AWARD (NOA) TERMS. KEY PROCEDURES INCLUDE MAINTAINING UP-TO-DATE DOCUMENTATION, QUARTERLY REPORTING VIA EHBS, FINANCIAL RECONCILIATION, AND, FOR SPECIFIC EMPLOYEE ASSISTANCE, STRICT DOCUMENTATION OF EMERGENCY NEEDS. FOR THE ARH EMPLOYEE EMERGENCY ASSISTANCE FUND (EAF), APPLICANTS MUST BE CURRENT EMPLOYEES, SUBMIT FULL DOCUMENTATION OF FINANCIAL HARDSHIP (E.G., BILLS, NOTICES), AND ADHERE TO THE $2,500 ANNUAL/$5,000 LIFETIME LIMIT. APPALACHIAN REGIONAL HEALTHCARE (ARH) MANAGES SPONSORSHIP REQUESTS BY REQUIRING ONLINE SUBMISSIONS AT LEAST TWO MONTHS IN ADVANCE, FOCUSING ON COMMUNITY HEALTH, WELL-BEING, OR ACCESS TO CARE. APPLICATIONS REQUIRE A COMPLETED FORM, FLYER/BROCHURE, AND, IF APPROVED, SPONSORSHIP FUNDS ARE TYPICALLY DELIVERED VIA CHECK WITHIN 3-4 WEEKS. 0 1 0 0 0 1 0 0 0 ROBERT N ROYALTY ORTHOPEDIC SURGEON 1485018 0 512015 0 0 0 15437 0 43477 0 2055947 0 0 0 HOLLIE P HARRIS CHAIRMAN 0 1125295 0 377829 0 653 0 93659 0 25153 0 1622589 0 0 JASON T RICE FAMILY MEDICINE PHYSICIAN 385902 0 358748 0 5625 0 10117 0 43477 0 803869 0 0 0 ANDREW R BURCHETT CARDIOLOGIST 662472 0 31479 0 0 0 15879 0 43477 0 753307 0 0 0 BYRON GABBARD TREASURER 0 512657 0 150857 0 737 0 60039 0 876 0 725166 0 0 AHMED MALIK CARDIOLOGIST 697768 0 12500 0 0 0 3897 0 239 0 714404 0 0 0 BAHRAM FOROUZANDEH GASTROENTEROLOGIST 669501 0 12500 0 0 0 0 0 0 0 682001 0 0 0 ROCCO K MASSEY DIRECTOR 0 289538 0 82286 0 2705 0 36048 0 31240 0 441817 0 0 JONATHAN COLLINS SECRETARY 0 96126 0 25179 0 371 0 5541 0 25153 0 152370 0 0 PART I, LINE 3 THE RELATED ORGANIZATION (APPALACHIAN REGIONAL HEALTHCARE, INC. - 52-0795508) USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION FOR ITS CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE RELATED ORGANIZATION, APPALACHIAN REGIONAL HEALTHCARE, INC. (52-0795508) ("ARH"), PROVIDES SENIOR EXECUTIVES A CONTRIBUTION 3, 5, OR 7 PERCENT OF PAY (SUBJECT TO DOLLAR CAP), DEPENDING ON JOB TITLE, INTO THE TOP HAT 457(B) RETIREMENT PLAN. 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 $23,000 IN 2024. 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 THE 3,5 OR 7 PERCENT OF PAY EXCEEDS THE REGULAR DOLLAR CAP, ARH MAY USE THE BALANCE OF THE PERCENTAGE 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. IF THE FUNDING OF THE 457(B), INCLUDING ANY CATCH UP PROVISIONS, IS LESS THAN THE 3,5 OR 7 PERCENT 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: HOLLIE HARRIS -$53,317.50; BYRON GABBARD - $28,870. PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE RELATED ORGANIZATION (APPALACHIAN REGIONAL HEALTHCARE, INC. - 52-0795508) ("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. FORM 990, PART VI, SECTION B, LINE 11B THE DIRECTOR OF ACCOUNTING AND CFO BOTH REVIEW THE 990 PRIOR TO THE BOARD REVIEW. THE BOARD THEN REVIEWS THE 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A SECURE WEBSITE IS PROVIDED TO OFFICERS AND TRUSTEES FOR ANNUAL DISCLOSURES, AND IS MONITORED REGULARLY BY THE VICE PRESIDENT OF LEGAL AFFAIRS AND THE CORPORATE COMPLIANCE OFFICERS. POTENTIAL CONFLICTS OF INTEREST ARE REPORTED DIRECTLY TO THE CHAIRMAN OF THE BOARD. TRUSTEES IDENTIFIED AS HAVING A CONFLICT OF INTEREST IN A PARTICULAR MATTER BEFORE THE BOARD MAY NOT PARTICIPATE IN THE BOARD'S DECISION-MAKING PROCESS. FAILURE TO DISCLOSE IS SUBJECT TO DISCIPLINE, INCLUDING CENSURE, AND IN SOME CASES, REMOVAL FROM THE BOARD. EMPLOYEE OFFICERS ARE SUBJECT TO DISCIPLINE IN ACCORDANCE WITH THE CORPORATION'S HUMAN RESOURCE POLICIES AND THE ARH CODE OF BUSINESS AND PROFESSIONAL CONDUCT. FORM 990, PART VI, SECTION B, LINE 15 APPALACHIAN REGIONAL HEALTHCARE, INC.'S (ARH) BOARD SETS COMPENSATION LEVELS FOR PRESIDENT/CEO AND OTHER ARH EXECUTIVES AND KEY EMPLOYEES THROUGH ITS COMPENSATION AND CONTRACTS COMMITTEE. THE BOARD CONTRACTS WITH A CONSULTING FIRM TO REVIEW THE MARKET FOR THE POSITIONS ON THE SYSTEM OPERATING COUNCIL WHO MAKES RECOMMENDATIONS ON THE SALARY RANGES AND ASSESSES THE COMPETITIVENESS OF THE SALARIES. WITH THAT INFORMATION, THE COMPENSATION AND CONTRACTS COMMITTEE SETS THE RANGES AND THE PRESIDENT'S COMPENSATION. THE BOARD REVIEWS AND RATIFIES COMPENSATION AMOUNTS. THE CONSULTING FIRM FOLLOWS UP WITH A LETTER ATTESTING TO THE REASONABLENESS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 WHILE ARH HAS NOT YET ADOPTED A POLICY OF SHARING ITS FINANCIAL STATEMENTS WITH THE PUBLIC, IT DOES PROVIDE FINANCIAL INFORMATION THROUGH THE FORM 990 AND ALSO PROVIDES CERTAIN FINANCIAL INFORMATION IN OTHER PUBLIC DOCUMENTS, INCLUDING ITS PERIODIC REPORTS TO THE COMMUNITIES IT SERVES. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES - PHYSICIANS: PROGRAM SERVICE EXPENSES 11,724,274. MANAGEMENT AND GENERAL EXPENSES 118,427. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,842,701. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 11,502,665. MANAGEMENT AND GENERAL EXPENSES 5,671,964. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,174,629. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -8,754. FORM 990, PART XII, LINE 2C: THERE IS A COMMITTEE OF THE BOARD OF DIRECTORS THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HOMETOWN FAMILY CARE PLLC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 202470645 MEDICAL SERVICES KY 0 0 ARH TUG VALLEY HEALTH SERVICES INC THE ARH FOUNDATION FOR HEALTHIER COMMUNITIES INC 101 AIRPORT GARDENS ROAD HAZARD KY 41701 204840007 FUNDRAISING AND CHARITABLE ACTIVITIES FOR ARH KY 501(C)(3) LINE 7 APPALACHIAN REGIONAL HEALTHCARE INC 0 ARH MARY BRECKINRIDGE 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 452696517 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 0 APPALACHIAN REGIONAL HEALTHCARE INC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 520795508 HEALTH CARE KY 501(C)(3) LINE 3 N/A 0 ARH ADVANCED CARE INC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 872421892 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 0 HIGHLANDS MEDICAL PARTNERS II 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 263714306 MEDICAL SERVICES KY ARH TUG VALLEY HEALTH SERVICES INC 219795 0 0 0.51000 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0