2025-05-14T13:02:33-05:00 2024-06-30 882730877 CHERRY BEKAERT ADVISORY LLC 101 SOUTH 5TH STREET STE 2100 LOUISVILLE KY 40202 990 2023-07-01 452696517 ARH MARY BRECKINRIDGE HEALTH SERVICE INC ARHM 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 BYRON GABBARD CFO 8592262440 2025-05-13 1 1 MELANIE MCPEAK P01346034 8885871719 2023 2025-03-06 01:10:19Z HOLLIE HARRIS 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 128273447 0 X WWW.ARH.ORG X 2011 KY TO PROVIDE LESLIE, KNOX, MARTIN, AND SURROUNDING COUNTIES AN ABUNDANCE OF HEALTHCARE AND COMMUNITY-ORIENTED SERVICES THROUGH ITS HOSPITALS, CLINICS, AND HOME HEALTH OPERATIONS AS WELL AS COMMUNITY OUTREACH SERVICES. 4 1 672 11 1027564 162401 348 0 120439911 124766411 885887 3236291 786085 268357 122112231 128271059 9228 30624 0 0 44422648 47188674 0 0 0 44453356 51778575 88885232 98997873 33226999 29273186 136035450 172520990 39410673 37969820 96624777 134551170 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. TO EARN THE CONFIDENCE AND TRUST OF THE DIVERSE COMMUNITIES WE SERVE BY OFFERING HEALTHCARE EXCELLENCE, DELIVERED WITH COMPASSION IN A TIMELY MANNER. 0 0 86211450 30624 123738847 THIS YEAR HAS BEEN AN EXCEPTIONAL ONE FOR MARY BRECKINRIDGE ARH HEALTH SERVICES, AS WE'VE EXPANDED HEALTHCARE AND COMMUNITY OUTREACH PROGRAMS ACROSS LESLIE, KNOX, MARTIN, AND SURROUNDING COUNTIES. OUR HOSPITAL PROUDLY EARNED THE 2024 KENTUCKY HOSPITAL ASSOCIATION QUALITY AWARD FOR CRITICAL ACCESS HOSPITALS, STANDING OUT AS THE ONLY CRITICAL ACCESS HOSPITAL IN THE STATE TO RECEIVE THIS PRESTIGIOUS HONOR. ADDITIONALLY, OUR STROKE CARE PROGRAM EARNED CERTIFICATION AS AN ACUTE STROKE READY HOSPITAL FROM THE ACCREDITING AGENCY DNV BASED ON STANDARDS SET FORTH BY THE BRAIN ATTACK COALITION AND THE AMERICAN STROKE ASSOCIATION, WHICH SIGNIFIES A HOSPITAL IS EQUIPPED WITH A DEDICATED STROKE-FOCUSED PROGRAM. THE HOSPITAL'S STROKE PROGRAM ALSO EARNED BRONZE RECOGNITION FROM THE AMERICAN HEART ASSOCIATION. THESE ACHIEVEMENTS HIGHLIGHT OUR COMMITMENT TO DELIVERING HIGH-QUALITY CARE AND INNOVATIVE SERVICES TAILORED TO THE NEEDS OF OUR RURAL COMMUNITY. 86211450 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 22 0 1 672 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 1 1 1 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 PRESIDENT/CEO 5.00 35.00 X X 0 1115375 112193 BYRON GABBARD TREASURER 5.00 35.00 X X 0 505151 52023 CHRISTI LEE CHIEF LEGAL COUNCIL 5.00 35.00 X 0 426815 83534 ANDREA MASSEY TRUSTEE 3.00 3.00 X 0 0 0 THOMAS MOORE MD GASTROENTEROLOGIST 40.00 0.00 X 572915 0 7253 JAMES WEST HOSPITALIST 40.00 0.00 X 470888 0 15772 LARRY E WARREN FAMILY PHYSICIAN 40.00 0.00 X 446259 0 3920 JERRY L WOOLUM FAMILY PHYSICIAN 40.00 0.00 X 396179 0 13951 PETER KUMMANT GENERAL SURGEON 40.00 0.00 X 359673 0 15390 2245914 2047341 304036 50 0 1 0 CARDIOSOLUTION LLC 4675 CORNELL ROAD CINCINNATI OH 45241 GENERAL INVASIVE SERVICES 2133919 BEAVER CREEK EMERGENCY GROUP 11203 MAIN STREET MARTIN KY 41649 PHYSICIAN SERVICES 981259 SOUTHERN MEDICAL PARTNERS 101 AIRPORT GARDENS ROAD ROOM 149 HAZARD KY 41701 PHYSICIAN SERVICES 905058 HYDEN EMERGENCY PHYSICIANS 130 KATE IRELAND DRIVE HYDEN KY 41749 PHYSICIAN SERVICES 784418 SODEXO OPERATIONS PO BOX 360170 PITTSBURGH PA 15251 DIETARY MANAGEMENT SERVICES 503205 18 LABORATORY REVENUE 621500 58083078 58069082 13996 PATIENT REVENUE 621110 27527958 27527958 HOSPITAL RATE IMPROVEMENT PROGRAM 900099 25571200 25571200 RETAIL PHARMACY REVENUE 456110 13584175 12570607 1013568 124766411 1741601 1741601 1497078 0 2388 1497078 -2388 1494690 1494690 CAFETERIA INCOME 900099 135630 135630 MISCELLANEOUS 900099 132727 132727 268357 128271059 123738847 1027564 3504648 30624 30624 35856254 35774966 81288 907225 903448 3777 8116547 8115977 570 2308648 2302904 5744 3482 3482 8701306 8220301 481005 1475 1475 3912739 3912732 7 276967 276967 4086097 4085637 460 89667 89667 148973 148973 1330416 1318891 11525 1954996 1954911 85 MEDICAL SUPPLIES & PHAR 16043278 15295541 747737 CENTRAL EXPENSES 10514130 10514130 BAD DEBT EXPENSE 3346782 3346782 PROVIDER TAXES 929790 929790 438477 428172 10305 98997873 86211450 12786423 0 554142 168616 12276206 9742044 2050530 2046731 765425 704595 26724683 10575570 15160770 16149113 105228377 143709891 136035450 172520990 2564190 1797903 263821 263473 36582662 35908444 39410673 37969820 X 96624777 134551170 96624777 134551170 136035450 172520990 29273186 8653207 0 X X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 3482 3482 0 PART II-B, LINE 1: MARY BRECKENRIDGE IS A MEMBER OF THE KENTUCKY HOSPITAL ASSOCIATION. THE AMOUNT REPORTED REPRESENTS THE PORTION OF DUES ATTRIBUTABLE TO LOBBYING EXPENSES. 237331 237331 8020281 2193222 5827059 10138963 8222122 1916841 8328108 160226 8167882 16149113 SECURITY DEPOSITS 42359 OPERATING LEASE RIGHT-OF-USE ASSETS 12817525 DUE FROM RELATED ORGANIZATIONS 126379198 HEALTH INSURANCE ACCRUAL 4470809 143709891 REFUNDS DUE PATIENTS 1528002 SELF INSURANCE RESERVE 5195064 CAPITAL LEASE OBLIGATIONS 42407 MEDICARE AND MEDICAID ESTIMATED SETTLEMENTS 12916545 OTHER LIABILITIES 68638 OPERATING LEASE LIABILITY 12817525 MISCELLANEOUS NON-PATIENT LIABILITIES 3340263 35908444 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 1561116 75500 1485616 0.01500 30185405 30185405 31746521 30260905 1485616 0.01500 206 10465 121414 121414 0.00120 202 340 93745 93745 0.00090 408 10805 215159 215159 0.00210 408 10805 31961680 30260905 1700775 0.01710 7 346 346 0.00000 48 3024 21350 21350 0.00020 1 11 20 20 0.00000 12 479 1617 1617 0.00000 60 2209 19020 19020 0.00020 2 476 514 514 0.00000 130 6199 42867 42867 0.00040 1 3346782 2182755 8483481 12246912 -3763431 X 1 1 3 1 ARH MARY BRECKINRIDGE HEALTH SERVICES INC 130 KATE IRELAND DRIVE HYDEN KY 41749 X X X X A 2 BARBOURVILLE ARH HOSPITAL 80 HOSPITAL DR BARBOURVILLE KY 40906 X X X X A 3 ARH OUR LADY OF THE WAY 11203 MAIN STREET MARTIN KY 41649 X X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.ARH.ORG/CHNA/ X 1 21 0 1 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 X 0 X 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: ARH MARY BRECKINRIDGE HEALTH SERVICES, INC, - FACILITY 2: BARBOURVILLE ARH HOSPITAL, - FACILITY 3: ARH OUR LADY OF THE WAY FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: A COMMUNITY STEERING COMMITTEE PROVIDED GUIDANCE OVER THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN EACH OF ARH'S COMMUNITIES. THIS STEERING COMMITTEE WAS MADE UP OF REPRESENTATIVES FROM VARIOUS ORGANIZATIONS AND AGENCIES THROUGHOUT EACH HOSPITAL'S SERVICE AREA. IN PARTICULAR, SOME OF THE COMMITTEE MEMBERS REPRESENTED THE LOCAL HEALTH DEPARTMENT, SENIOR SERVICES, SCHOOL SYSTEM, SOCIAL SERVICE ORGANIZATIONS, AND EMERGENCY MANAGEMENT. THESE INDIVIDUALS ASSISTED WITH DISTRIBUTING SURVEYS AND ORGANIZING FOCUS GROUPS THROUGHOUT THE COMMUNITY ENSURING THAT VARIED COMMUNITY INTERESTS AND EXPERTISE WERE REPRESENTED. SPECIAL ATTENTION WAS PAID TO ENSURING THAT REPRESENTATION FROM THE PUBLIC HEALTH SECTOR WAS INCLUDED IN THIS ASSESSMENT PROCESS AND THAT THE SENIOR CITIZEN AND UNDERSERVED POPULATION WERE REPRESENTED. A COMPLETE LIST OF THE COMMUNITY STEERING COMMITTEE MEMBERS FOR EACH ARH FACILITY IS INCLUDED IN EACH ASSESSMENT'S FINAL REPORT. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED BY ARH IN 2021-2022. THIS OFFERED A GOOD OPPORTUNITY TO EXAMINE PROGRESS MADE SINCE THE PREVIOUS CHNA PROCESS WHILE OUTLINING NEW STRATEGIES TO GUIDE ACTIVITIES, OUTREACH, AND AREAS OF IMPROVEMENT FOR RECENTLY IDENTIFIED NEEDS. ALL OF THE NEEDS IDENTIFIED DURING THIS PROCESS WERE REVIEWED AND PRIORITIZED BY EACH FACILITY. SOME NEEDS MAY NOT HAVE BEEN SELECTED AS A HIGH PRIORITY SINCE ANOTHER COMMUNITY AGENCY MAY ALREADY BE ADDRESSING THAT NEED AND REFERRALS JUST NEED TO BE MADE TO THAT PARTNER AGENCY. MEASURES WERE TAKEN TO ENSURE THAT EACH IDENTIFIED NEED WAS EITHER ADDRESSED TO SOME DEGREE BY ARH OR REFERRED TO OTHER APPROPRIATE COMMUNITY ENTITIES. BELOW ARE THE MAIN SYSTEM-WIDE NEEDS IDENTIFIED DURING ARH'S MOST RECENT CHNA. THESE AREAS ARE THE MAIN FOCUS OF THE HOSPITALS' ACTIVITIES:SUBSTANCE ABUSE (DRUGS, ALCOHOL, TOBACCO, VAPING)MENTAL HEALTH (SERVICES AND REDUCING STIGMA)OBESITY/DIABETES/PHYSICAL ACTIVITYCOMMUNICATION AND EDUCATIONTHE RESULTS FROM THE MOST RECENT CHNA IDENTIFIED THE NEED FOR ARH'S FACILITIES TO FOCUS ON PROVIDING MORE PREVENTIVE AND EDUCATIONAL SERVICES. FOR SOME COMMUNITIES, THIS ALSO MEANT FURTHER PUBLICIZING THE PREVENTIVE AND EDUCATIONAL SERVICES THAT THEY WERE ALREADY OFFERING TO FURTHER INCREASE COMMUNITY PARTNERSHIPS AND AWARENESS. CHNA RESPONDENTS ALSO REQUESTED INCREASED EDUCATIONAL TOPICS INCLUDING MORE OF A FOCUS ON TOPICS SUCH AS VAPING AND MENTAL HEALTH ALONG WITH THE CHRONIC DISEASE ISSUES OF DIABETES AND HEART DISEASE. AN INCREASE IN THE AVAILABILITY OF SERVICES AND PROVIDERS TO ADDRESS THESE IDENTIFIED HEALTH ISSUES IS ALSO A PROMINENT NEED IN THE REGION, ESPECIALLY THE NEED TO ADD MORE MENTAL HEALTH PROVIDERS. ANOTHER NEED THAT WAS ALSO APPARENT WITH THE MOST RECENT CHNA RESULTS WAS THE NEED TO IMPROVE COMMUNICATIONS. THIS NEED RANGES FROM ENSURING THAT THERE IS FASTER COMMUNICATION REGARDING TEST RESULTS, IMPROVING COMMUNICATION TO THE PUBLIC ON ARH SERVICES AND ACTIVITIES VIA SOCIAL MEDIA, AND PROVIDING MORE PATIENT NAVIGATORS/ADVOCATES TO ASSIST PATIENTS WITH NEGOTIATING THE HEALTHCARE PROCESS.- PROMOTING HEALTHY BEHAVIORS, NUTRITION, AND PHYSICAL ACTIVITY:OLW ARH, LOCATED IN FLOYD COUNTY, TACKLED FOOD INSECURITY BY PARTNERING WITH GOD'S PANTRY FOOD BANK, DISTRIBUTING AN AVERAGE OF 30 FOOD BOXES PER MONTH THAT INCLUDE DIETITIAN-APPROVED NUTRITION TIPS. ADDITIONALLY, OLW PARTICIPATED IN THE UNIVERSITY OF KENTUCKY'S FOOD AS HEALTH ALLIANCE STUDY, OFFERING MEDICALLY TAILORED MEALS TO AMBULATORY PATIENTS WITH CHRONIC CONDITIONS LIKE DIABETES AND HYPERTENSION. TO BUILD AWARENESS AND PROVIDE EDUCATION, OLW HELD MONTHLY DIABETES SUPPORT GROUPS FEATURING HEALTHY COOKING DEMOS AND CONTINUED ITS SUPPORT THROUGH INITIATIVES LIKE THE "RETHINK YOUR DRINK" CAMPAIGN AND A REVAMPED CAFETERIA MENU THAT INCLUDES PLANT-BASED OPTIONS. PHYSICAL ACTIVITY WAS ENCOURAGED THROUGH FREE GYM MEMBERSHIPS, EMPLOYEE GARDENS, AND COMMUNITY EVENT SPONSORSHIPS. EDUCATION EFFORTS INCLUDED STROKE RISK SCREENINGS, COLON CANCER AWARENESS CAMPAIGNS, LUNG AND BRAIN HEALTH PRESENTATIONS, AND DIABETES EDUCATION OFFERED IN PERSON AND VIRTUALLY AT COMMUNITY FAIRS AND SENIOR CENTERS.MARY BRECKINRIDGE ARH IN LESLIE COUNTY HAS ALSO PRIORITIZED HEALTHY NUTRITION AND DISEASE PREVENTION. THEY PARTNERED WITH THE LOCAL EXTENSION OFFICE TO PROVIDE 25 HEALTHY COOKING CLASSES WITH INCENTIVES, HOSTED 22 DIABETES SUPPORT GROUPS WITH FREE A1C SCREENINGS, AND MAINTAINED A STRONG PRESENCE AT THE LESLIE COUNTY FARMERS MARKET WITH MONTHLY STROKE, LUNG, AND DIABETES EDUCATION SESSIONS. THE HOSPITAL ALSO INTRODUCED CREATIVE STROKE EDUCATION PROGRAMMINGSUCH AS "TACO-BOUT STROKE" CLASSES AND "STRIKE OUT STROKE" EVENTSCOMPLETING 351 STROKE RISK SCREENINGS. MARY BRECKINRIDGE CONTINUED PROMOTING BREAST AND COLON CANCER AWARENESS THROUGH EVENTS, SCREENINGS, AND UNIQUE COMMUNITY ACTIVITIES SUCH AS "THE INCREDIBLE COLON" EXHIBIT AND ANNUAL LUNCHEONS. NOTABLY, THEY LAUNCHED A CHILDREN'S STORY WALK IN HYDEN TO PROMOTE LITERACY AND PHYSICAL ACTIVITY, WHILE ALSO SUPPORTING THE CARROT CASH VOUCHER PROGRAM AT THE FARMERS MARKET.BARBOURVILLE ARH SIMILARLY ADVANCED WELLNESS EFFORTS THROUGH MULTIPLE SCREENINGS, EDUCATION EVENTS, AND SUPPORT OF LOCAL FEEDING PROGRAMS. FROM 2022-2024, THE HOSPITAL HOSTED LUNG CANCER SCREENING EVENTSINCLUDING SATURDAY SESSIONS TO INCREASE ACCESSRESULTING IN A 28% INCREASE IN SCREENINGS. STROKE AND HYPERTENSION EDUCATION WERE DELIVERED AT THE KNOX COUNTY FARMERS MARKET, SCHOOLS, AND PUBLIC EVENTS. THE HOSPITAL SUPPORTED BREAST CANCER AWARENESS THROUGH ANNUAL $50 MAMMOGRAM SPECIALS AND LAUNCHED THE "THINK PINK" PROGRAM IN PARTNERSHIP WITH KNOX CROSSFIT, COMBINING PHYSICAL ACTIVITY AND HEALTH EDUCATION. COMMUNITY-WIDE WELLNESS FAIRS AND "ART FOR THE HEART" CARDIAC EVENTS WERE ALSO HELD. ADDITIONALLY, BARBOURVILLE ARH BUILT A COMMUNITY GARDEN AND PROVIDED NUTRITIOUS FOOD AND HYGIENE PRODUCTS THROUGH NATIONAL SERVE DAY AND PARTNERSHIPS WITH LOCAL CHURCHES. THE CAFETERIA NOW OFFERS PLANT-BASED OPTIONS TO PROMOTE HEALTHY NUTRITION AMONG EMPLOYEES.- ADDRESSING MENTAL HEALTH AND SUBSTANCE USE DISORDERS:AT OLW ARH, THE FOCUS WAS ON PREVENTION AND EARLY INTERVENTION. THE HOSPITAL OFFERED THREE MENTAL HEALTH FIRST AID TRAINING SESSIONS BETWEEN 2023-2024, CERTIFYING 26 EMPLOYEES. THESE SESSIONS AIMED TO EQUIP STAFF WITH THE SKILLS TO SUPPORT PATIENTS AND COMMUNITY MEMBERS FACING MENTAL HEALTH OR SUBSTANCE USE CHALLENGES. OLW ALSO COLLABORATED WITH SCHOOLS AND LOCAL AGENCIES FOR PREVENTION EDUCATION, PARTICIPATING IN THE "TRUTH AND CONSEQUENCES" SIMULATION FOR STUDENTS AND SPONSORING OPERATION UNITE'S "SHOOT HOOPS, NOT DRUGS." ANTI-VAPING EDUCATION WAS PROVIDED THROUGH FIVE SCHOOL-BASED PRESENTATIONS.MARY BRECKINRIDGE ARH IMPLEMENTED A ROBUST PEER SUPPORT PROGRAM BEGINNING IN 2022, WHERE TRAINED COACHESOFTEN IN RECOVERY THEMSELVESSUPPORTED INDIVIDUALS IN ACTIVE ADDICTION. OVER 9,600 SBIRT SCREENINGS WERE COMPLETED, AND 65 DIRECT PATIENT ENCOUNTERS WERE RECORDED. PEER COACHES DELIVERED THE "TOO GOOD FOR DRUGS" CURRICULUM IN SCHOOLS AND SERVED ON LOCAL COALITIONS. OTHER EFFORTS INCLUDED NARCAN DISTRIBUTION, TOBACCO CESSATION CLASSES, AND SPONSORSHIP OF AA/NA MEETINGS. THE HOSPITAL EXPANDED OUTPATIENT BEHAVIORAL HEALTH SERVICES BY ADDING A PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER (PMHNP), OPENING A SATELLITE CLINIC IN BIG CREEK, AND GROWING TELEHEALTH OPTIONS. A MAJOR STEP FORWARD WAS REOPENING THE ARH SENIOR CARE PROGRAM IN 2023, WHICH PROVIDES INTENSIVE BEHAVIORAL HEALTHCARE TO OLDER ADULTS USING A MULTIDISCIPLINARY TEAM APPROACH.BARBOURVILLE ARH CONTRIBUTED TO COMMUNITY RECOVERY EFFORTS BY ENGAGING IN REGIONAL COALITIONS, INCLUDING THE UNITE COALITION, CUMBERLAND VALLEY QUICK RESPONSE TEAM, AND KNOX COUNTY HEALTH COALITION. THE HOSPITAL EMPHASIZED MENTAL HEALTH AWARENESS THROUGH THE PROMOTION OF KENTUCKY'S 988 MENTAL HEALTH HOTLINE AND RECORDED OVER 2,600 BEHAVIORAL HEALTH VISITS IN THEIR AMBULATORY CLINICSAN INCREASE OF 54% FROM 2022 TO 2024.- IMPROVING COMMUNICATION AND INCREASING LOCAL ACCESS TO CARE:AT OLW ARH, STAFF ENGAGED WITH NINE DIFFERENT COUNCILS AND ADVISORY BOARDS TO FOSTER COLLABORATION AND SHARE RESOURCES. THESE INCLUDED REGIONAL CHAMBER BOARDS, SCHOOL ADVISORY GROUPS, AND PUBLIC HEALTH COUNCILS. ADDITIONALLY, FOUR NEW PROVIDERS INTRODUCED THEMSELVES TO THE COMMUNITY VIA DIRECT OUTREACH, AND THE FACILITY LAUNCHED OVER 4,000 SOCIAL MEDIA POSTS AND 14 BILLBOARDS PROMOTING SERVICES.BARBOURVILLE ARH ALSO JOINED VARIOUS COMMUNITY BOARDS SUCH AS THE KNOX COUNTY HEALTH COALITION, UNION COLLEGE NURSING ADVISORY BOARD, AND HEALING COALITION. THESE CONNECTIONS HAVE HELPED BREAK DOWN SERVICE SILOS AND RAISED AWARENESS OF AVAILABLE HEALTHCARE SERVICES THROUGHOUT THE REGION.WHEN IT COMES TO INCREASING ACCESS, OLW ARH HAS SIGNIFICANTLY EXPANDED SERVICES BY EXTENDING SLEEP LAB HOURS, REOPENING THE SENIOR CARE PROGRAM, AND ADDING SPECIALTY CLINICS SUCH AS CARDIOLOGY AND ORTHOPEDICS. TELEHEALTH ACCESS WAS BROADENED, AND TWO NEW PROVIDERS WERE ADDED IN 2023. THE MARTIN CLINIC ALSO EXTENDED HOURS TO BETTER SERVE WORKING FAMILIES.MARY BRECKINRIDGE ARH INTRODUCED MULTIPLE NEW SERVICES, INCLUDING HEPATITIS C TREATMENT, OUTPATIENT PULMONARY REHAB, AND PODIATRY SERVICES. IMPORTANTLY, THE HOSPITAL ACHIEVED CERTIFICATION AS AN ACUTE STROKE READY CENTER, WHICH AFFIRMS THEIR CAPACITY TO RESPOND QUICKLY TO STROKE CASES IN A GEOGRAPHICALLY ISOLATED AREA.BARBOURVILLE ARH ALSO MADE NOTABLE STRIDES BY REOPENING THEIR SENIOR CARE PROGRAM, ADDING PODIATRY AND GENERAL SURGERY, AND IMPLEMENTING CARDIAC AND PULMONARY REHAB. THE HOSPITAL BECAME A CERTIFIED AUTISM CENTER, WITH OVER 80% OF STAFF TRAINED TO SERVE INDIVIDUALS WITH AUTISM. A NEW PRE-ADMISSION TESTING PROGRAM WAS INTRODUCED TO IMPROVE SURGERY OUTCOMES, AND THE HOSPITAL EARNED THE AHA'S CAD RURAL ACUTE NSTE-ACS BRONZE AWARD FOR EXCELLENCE IN CARDIAC CARE. 14 1 - HYDEN ARH CLINIC 130 KATE IRELAND DRIVE HYDEN KY 41749 CLINIC 2 - MB ARH HOME HEALTH AGENCY 166 KATE IRELAND DRIVE HYDEN KY 41749 HOME HEALTH 3 - BIG CREEK ARH CLINIC 17644 SOUTH HWY 421 BIG CREEK KY 40914 CLINIC 4 - CUMBERLAND VALLEY MEDICAL SURGICAL ASSOC 80 HOSPITAL DRIVE BARBOURVILLE KY 40906 CLINIC 5 - ARH CUMBERLAND VALLEY MEDICAL & SURGICAL 3504 W CUMBERLAND AVE MIDDLESBORO KY 40965 CLINIC 6 - ARH PRIMARY CARE ASSOC NI - MARTIN 11087 MAIN STREET MARTIN KY 41649 CLINIC 7 - ARH PRIMARY CARE ASSOC NJ - BETSY LANE 12579 MAIN STREET STE 101 MARTIN KY 41649 CLINIC 8 - ARH CUMBERLAND VALLEY MEDICAL & SURGICAL 302 WALNUT ST PINEVILLE KY 40977 CLINIC 9 - OUR LADY OF THE WAY PHARMACY 12579 MAIN STREET MARTIN KY 41649 PHARMACY 10 - ARH SPECIALTY PHARMACY- BARBOURVILLE 80 HOSPITAL DRIVE BARBOURVILLE KY 40906 PHARMACY 11 - ARH MEDICAL & SPECIALTY ASSOC - HAROLD 24 LEFT PENHOOK ROAD HAROLD KY 41635 CLINIC 12 - ARH CUMBERLAND VALLEY PHARMACY 3504 W CUMBERLAND AVE MIDDLESBORO KY 40965 PHARMACY 13 - ARH PRIMARY CARE ASSOC - SETON 11088 MAIN STREET SUITE 101 MARTIN KY 41649 CLINIC 14 - ARH PRIMARY CARE ASSOC - CORBIN 1317 CUMBERLAND FALLS HWY SUITE B CORBIN KY 40701 CLINIC PART I, LINE 3C: THE DISCOUNTS ARE BASED ON A SLIDING FEE SCHEDULE STARTING AT 100% OF FPG QUALIFYING FOR FREE CARE, RANGING UP TO UNLIMITED INCOME LEVELS FOR A 40% DISCOUNT ON ALL UNINSURED CARE PROVIDED. PART I, LINE 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 II, COMMUNITY BUILDING ACTIVITIES: OUR DEDICATION TO COMMUNITY ENGAGEMENT WAS EVIDENT IN BELOVED ANNUAL EVENTS LIKE THE CHILDREN'S CHRISTMAS PARTY, WHERE EVERY CHILD RECEIVED GIFTS SUCH AS A TOBOGGAN, GLOVES, AND SWEET TREATS. WE ALSO HOSTED A SUCCESSFUL TRUNK AND TREAT EVENT AND A BACK-TO-SCHOOL BASH, OFFERING FREE SCHOOL AND SPORTS PHYSICALS ALONG WITH EAR PODS AND SCHOOL SUPPLIES FOR ATTENDEES. THE COMMUNITY-WIDE PICNIC, HELD DURING THE MARY BRECKINRIDGE FESTIVAL, WAS ANOTHER HIGHLIGHT, WITH OVER 800 MEALS SERVED TO COMMUNITY MEMBERS, THANKS TO THE SUPPORT OF THE LOCAL SHRINERS CHAPTER. IN PARTNERSHIP WITH BIG CREEK MISSIONS, WE CONTRIBUTED TO THEIR SUMMER PROGRAMS BY PROVIDING SPEAKERS WHO ADDRESSED TOPICS SUCH AS WATER SAFETY, BICYCLE SAFETY, BULLYING, AND PEER PRESSURE.WE ALSO INTRODUCED MAJOR NEW SERVICES TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THE RE-OPENING OF OUR SENIOR CARE UNIT HAS PROVIDED ESSENTIAL SUPPORT FOR OLDER ADULTS THROUGH INDIVIDUAL AND GROUP THERAPY. ADDITIONALLY, WE LAUNCHED A PULMONARY REHAB PROGRAM THAT HAS ALREADY BEEN TRANSFORMATIVE FOR MANY. ONE PARTICIPANT SHARED HOW THE PROGRAM'S ACCESSIBILITY AT MARY BRECKINRIDGE ARH WAS CRITICAL DUE TO TRAVEL EXPENSES AND TRANSPORTATION CHALLENGES GETTING TO OTHER FACILITIES. HE SPOKE ABOUT HIS GOAL OF NO LONGER NEEDING HANDICAPPED PARKING AND BEING ABLE TO WALK FROM THE PARKING LOT FOR HIS APPOINTMENTS. HEARING HIM EXPRESS HOW THE PROGRAM HELPED HIM ACHIEVE HIS GOALS UNDERSCORED THE IMPORTANCE OF PROVIDING THESE SERVICES LOCALLY AND AFFIRMED OUR MISSION TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY.OUR HEALTH INITIATIVES EXTENDED TO PROMOTING WELLNESS AND PREVENTATIVE CARE. ATTENDEES OF OUR HEALTHY COOKING CLASSES AT THE LESLIE COUNTY EXTENSION OFFICE RECEIVED $20 GIFT CARDS TO ENCOURAGE PARTICIPATION IN LEARNING ABOUT NUTRITIOUS MEAL PREPARATION. AT THE FARMER'S MARKET, WE OFFERED FREE BLOOD PRESSURE CHECKS, GLUCOSE TESTING, AND STROKE SCREENINGS, WITH KRISTEN FUGATE, BH APRN, ON-SITE TO PROVIDE ADDITIONAL SUPPORT AND EDUCATION. DURING OCTOBER, WE HIGHLIGHTED BREAST CANCER AWARENESS BY OFFERING EDUCATIONAL SESSIONS ON THE IMPORTANCE OF SCREENING MAMMOGRAMS, OFTEN SHARING THIS VITAL INFORMATION WITH SENIOR CITIZENS DURING THEIR LUNCH AT THE NIXON CENTER. THESE EFFORTS DEMONSTRATE OUR CONTINUED FOCUS ON FOSTERING HEALTH, AWARENESS, AND ENGAGEMENT THROUGHOUT THE COMMUNITY. 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: NEARLY ONE HALF OF THE CORPORATION'S PATIENT REVENUES ARE DERIVED FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES. IN TURN, PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FELL SHORT OF THE COST TO PROVIDE SUCH SERVICES BY OVER $3.5 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 $3,763,431 (OR 100%) OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 7 BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 9B: THE PROVISIONS IN THE WRITTEN DEBT COLLECTION POLICY ARE THAT CHARITY AND FINANCIAL ASSISTANCE APPLICATIONS ARE VALID FOR 6 MONTHS. AFTER THAT TIME, THE PATIENT MUST REAPPLY AND PRESENT CURRENT FINANCIAL DOCUMENTS AS NECESSARY. PART VI, LINE 2: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT IS CONDUCTED BY ARH EVERY THREE YEARS AND REPORTED ELSEWHERE IN THIS DOCUMENT, ARH ALSO CONTINUALLY ASSESSES COMMUNITY NEEDS IN OTHER FORMS AS WELL. THE NEEDS OF THE COMMUNITIES THAT MARY BRECKINRIDGE SERVES THROUGHOUT EASTERN KENTUCKY ARE ASSESSED BY FOLLOWING EMERGING MEDICAL PRACTICE NEEDS ACROSS THE NATION AND SPECIFICALLY IN THE APPALACHIAN REGION. THE HEALTH NEEDS ARE EXAMINED BY LOOKING AT HEALTH STATISTICS AND DISEASE PREVALENCE COMPARED TO SERVICE/PHYSICIAN AVAILABILITY. PATIENT AND COMMUNITY SURVEYS ARE ALSO REGULARLY CONDUCTED TO ASSESS CONSUMER PERCEIVED NEEDS. LOCAL ADVISORY COUNCILS (LACS) ALSO EXIST IN EACH OF ARH'S HOSPITAL COMMUNITIES. THE COUNCILS ARE COMPRISED OF LOCAL CITIZENS WHO VOLUNTEER TO HELP ARH IMPROVE THE HEALTH OF ITS COMMUNITIES THROUGH REGULAR MEETINGS THAT DISCUSS COMMUNITY HEALTH ISSUES AND HELP ARH IDENTIFY AND ADDRESS THEM. MEMBERS ALSO ADVISE ARH ABOUT IMPROVEMENTS NEEDED AND COMMUNITY PERCEPTIONS OF ARH FACILITIES AND THESE INDIVIDUALS SERVE AS EXCELLENT AMBASSADORS FOR ARH AND ITS SERVICES. THESE INDIVIDUALS HAVE DEMONSTRATED THEIR LEADERSHIP IN LOCAL CIVIC AFFAIRS AND REFLECT A CROSS SECTION OF THE COMMUNITY. PART VI, LINE 3: MARY BRECKINRIDGE HEALTH SERVICES, INC. OBSERVES THE FINANCIAL ASSISTANCE POLICY OF ITS SYSTEM AFFILIATE APPALACHIAN REGIONAL HEALTHCARE (ARH). 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 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 AN ASSISTANCE 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 MADE BY OFFERING REASONABLE PAYMENT PLANS AND DEFERRED PAYMENTS. IN THE EVENT THE PATIENT/GUARANTOR DOES NOT MAKE A REASONABLE EFFORT TO COMPLETE NECESSARY DOCUMENTATION TO APPLY OR BECOME ELIGIBLE FOR A FINANCIAL ASSISTANCE PROGRAM THEY ARE THEN STILL GIVEN THE INITIAL 40% DISCOUNT AND MOVED THROUGH THE NORMAL COLLECTION PROCESS. PART VI, LINE 4: THE RURAL SERVICE AREA COVERED BY ARH IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA INCLUDES MORE THAN 4 COUNTIES. THIS REGION IS FRAUGHT WITH SOME OF THE HIGHEST CHRONIC HEALTH PREVALENCE RATES IN THE COUNTRY FOR LUNG CANCER, DIABETES, AND HEART DISEASE. TO COMPOUND THESE PROBLEMS, MOST OF ARH'S FACILITIES ARE IN AREAS THAT ARE AT LEAST PARTIALLY CLASSIFIED AS MEDICALLY UNDERSERVED AREAS AND HEALTH PROFESSIONAL SHORTAGE AREAS BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. IN ADDITION, THE AREAS SERVED BY ARH ALSO FACE UNEMPLOYMENT RATES THAT ARE SUBSTANTIALLY HIGHER THAN STATE AND NATIONAL AVERAGES AND A HIGHER NUMBER OF CITIZENS IN THESE AREAS RANK BELOW THE NATIONAL POVERTY LEVEL. FOR MORE THAN 60 YEARS, ARH HAS CARRIED A HEAVY LOAD IN CARING FOR THIS POPULATION. IN FISCAL YEAR 2024 APPROXIMATELY 90.14 PERCENT OF ARH'S INPATIENTS WERE MEDICARE OR MEDICAID BENEFICIARIES. PART VI, LINE 5: MARY BRECKINRIDGE HEALTH SERVICES, INC. (MBHS) PROVIDES LESLIE, FLOYD, KNOX AND SURROUNDING COUNTIES AN ABUNDANCE OF HEALTHCARE AND COMMUNITY-ORIENTED SERVICES THROUGH ITS MEDICAL FACILITIES AS WELL AS COMMUNITY OUTREACH SERVICES. TODAY, MBHS CONTINUES ITS MISSION IN THE MOUNTAINS BY OFFERING RESIDENTS OF EASTERN KENTUCKY A LOCAL OPTION FOR QUALITY HEALTHCARE SERVICES. MBHS HOLDS STEADFAST TO THE MISSION TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL THE PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. MBHS CONSISTS OF THREE CRITICAL ACCESS HOSPITALS AND RELATED CLINIC, PHARMACY, HOME HEALTH AGENCY, AND HOME CARE STORE SERVICES. ALONG WITH THEIR SYSTEM AFFILIATE, APPALACHIAN REGIONAL HEALTHCARE (ARH), MBHS HAS EVOLVED INTO AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SERVING MORE THAN 60,000 RESIDENTS ACROSS EASTERN KENTUCKY. WHILE PROVIDING THIS REGION WITH QUALITY HEALTHCARE, MBHS 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, MBHS LEADERSHIP AND STAFF MEMBERS REALIZE THAT SERVING THIS POPULATION IS ABOUT MORE THAN JUST ADDRESSING THE HEALTH NEEDS, IT IS ALSO ABOUT PREVENTING CHRONIC DISEASES. THROUGH PARTNERSHIPS WITH AREA SCHOOLS, BUSINESSES, ORGANIZATIONS AND HEALTH DEPARTMENTS, MBHS IS ONE OF THE PRIMARY SOURCES FOR HEALTH EDUCATION AND DISEASE PREVENTION IN EACH COMMUNITY AND PARTNERS WITH ALL THESE VARIOUS COMMUNITY ENTITIES TO FURTHER THESE EFFORTS. MBHS SPONSORS MANY COMMUNITY-WIDE WELLNESS EVENTS THROUGHOUT ITS SERVICE AREAS, INCLUDING HEALTH FAIRS AND VARIOUS SUPPORT GROUPS. EACH YEAR, MBHS PROVIDES FREE OR DISCOUNTED HEALTH SCREENINGS FOR COLORECTAL, BREAST, AND PROSTATE CANCERS AS WELL AS ROUTINE BLOOD PRESSURE, CHOLESTEROL, GLUCOSE, AND BODY MASS INDEX (BMI) SCREENINGS IN EFFORTS TO PREVENT THE ONSET OF ILLNESSES OR CATCH MEDICAL CONDITIONS BEFORE THEY BECOME LIFE THREATENING. MBHS ALSO ACTIVELY UTILIZES ALL FORMS OF MEDIA TO PROMOTE WELLNESS AND EDUCATE THE PUBLIC ON THE SIGNS AND SYMPTOMS OF MANY COMMON HEALTH CONDITIONS. THIS INCLUDES HEALTH EDUCATION NEWSLETTERS THAT ARE MAILED DIRECTLY TO RESIDENTS' HOMES. PART VI, LINE 6: DURING FISCAL YEAR 2024, MARY BRECKINRIDGE HEALTH SERVICES, INC. (MBHS) EFFORTS WERE MAINLY ORGANIZED AROUND ITS THREE HOSPITAL SPECIFIC COMMUNITIES ACROSS EASTERN KENTUCKY. IN EACH OF THESE COMMUNITIES, A HOSPITAL EXISTS ALONG WITH A COMPLIMENTARY ARRANGEMENT OF OTHER MBHS SERVICES, WHICH MAY INCLUDE CLINICS, HOME HEALTH AGENCIES, PHARMACIES, AND/OR HOME DURABLE MEDICAL EQUIPMENT STORES. IN CONJUNCTION WITH OUR SYSTEM AFFILIATE APPALACHIAN REGIONAL HEALTHCARE (ARH), VARIOUS HEALTH PROMOTION ACTIVITIES ARE ORGANIZED AND PROMOTED ACROSS THE FACILITIES, INCLUDING THE INTRODUCTION OF NEW SERVICE LINES AND NEW TECHNOLOGY. IN EACH OF MBHS'S/ARH'S SERVICE AREAS, VARIOUS COMMUNITY OUTREACH PROGRAMS ARE ALSO UNDERWAY AND AGGRESSIVELY ADDRESSING THE HEALTH CONCERNS OF THAT AREA, WHILE STRONG COMMUNITY COLLABORATION IS BEING DEVELOPED. FROM SENIOR CITIZEN WELLNESS PROGRAMS TO PATIENT ASSISTANCE VIA A CANCER NAVIGATOR, ARH'S COMMUNITIES ARE REAPING THE BENEFITS OF SUCCESSFUL COMMUNITY OUTREACH. PART VI, LINE 7, REPORTS FILED WITH STATES KY,WV X X X X X 0 1 0 0 0 0 1 0 0 HOLLIE P HARRIS PRESIDENT/CEO 0 938382 0 176400 0 593 0 84230 0 27963 0 1227568 0 0 THOMAS MOORE MD GASTROENTEROLOGIST 572915 0 0 0 0 0 6813 0 440 0 580168 0 0 0 BYRON GABBARD TREASURER 0 424510 0 80000 0 641 0 52023 0 0 0 557174 0 0 CHRISTI LEE CHIEF LEGAL COUNCIL 0 354644 0 71800 0 371 0 44630 0 38904 0 510349 0 0 JAMES WEST HOSPITALIST 470888 0 0 0 0 0 14989 0 783 0 486660 0 0 0 LARRY E WARREN FAMILY PHYSICIAN 446259 0 0 0 0 0 3300 0 620 0 450179 0 0 0 JERRY L WOOLUM FAMILY PHYSICIAN 396179 0 0 0 0 0 13327 0 624 0 410130 0 0 0 PETER KUMMANT GENERAL SURGEON 359673 0 0 0 0 0 14514 0 876 0 375063 0 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 - WRITTEN EMPLOYMENT CONTRACT - 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 $22,500 IN 2023. 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 - $39,240; BYRON GABBARD - $7,022.50; CHRISTI LEE - $2,630. PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE RELATED ORGANIZATION (APPALACHIAN REGIONAL HEALTHCARE, INC. - 52-0795508) 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 A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS APPALACHIAN REGIONAL HEALTHCARE, INC. FORM 990, PART VI, SECTION A, LINE 7A APPALACHIAN REGIONAL HEALTHCARE, INC. APPOINTS THE BOARD OF DIRECTORS OF ARH MARY BRECKINRIDGE. FORM 990, PART VI, SECTION A, LINE 7B APPALACHIAN REGIONAL HEALTHCARE, INC. HAS THE POWER TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF ARH MARY BRECKINRIDGE. FORM 990, PART VI, SECTION B, LINE 11B APPALACHIAN REGIONAL HEALTHCARE'S (ARH) DIRECTOR OF ACCOUNTING AND CFO BOTH REVIEW THE 990 PRIOR TO THE ARH BOARD REVIEW. THE ARH BOARD THEN REVIEWS THE 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ARH MARY BRECKINRIDGE FOLLOWS ARH'S CONFLICT OF INTEREST POLICY AND ONGOING MONITORING. ARH'S MONITORING PROCESS IS: 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 RELATED ORGANIZATION, APPALACHIAN REGIONAL HEALTHCARE, INC.'S (ARH) BOARD SETS COMPENSATION LEVELS FOR PRESIDENT/CEO AND OTHER ARH EXECUTIVES AND KEY EMPLOYEES. 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. APPALACHIAN REGIONAL HEALTHCARE HAS DEVELOPED A PARTNERSHIP WITH MERCER GROUP TO EVALUATE EXECUTIVE COMPENSATION PLANS. FORM 990, PART VI, SECTION C, LINE 19 WHILE ARH MARY BRECKINRIDGE HAS NOT YET ADOPTED A POLICY OF SHARING ITS FINANCIAL STATEMENTS WITH THE PUBLIC, IT DOES PROVIDE FINANCIAL INFORMATION THROUGH THE FORM 990 AND PROVIDES CERTAIN FINANCIAL INFORMATION IN OTHER PUBLIC DOCUMENTS, INCLUDING ITS PERIODIC REPORTS TO THE COMMUNITIES IT SERVES. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. PRIOR TO THE START OF THE AUDIT, THE VICE PRESIDENT OF FINANCE MEETS WITH THE INDEPENDENT AUDITORS. AT THE CONCLUSION OF THE AUDIT, THE FINANCE COMMITTEE MEETS WITH THE INDEPENDENT AUDITORS FOR PRESENTATION OF THE FINANCIAL STATEMENTS. THE INDEPENDENT AUDITORS ARE SELECTED WHEN DEEMED NECESSARY BY MANAGEMENT THROUGH A FORMAL "REQUEST FOR PROPOSAL" (RFP) PROCESS. THE ARH FOUNDATION FOR HEALTHIER COMMUNITIES INC 100 AIRPORT GARDENS RD HAZARD KY 41701 204840007 CARRYING OUT FUNDRAISING AND CHARITABLE ACTIVITIES FOR ARH KY 501(C)(3) LINE 7 APPALACHIAN REGIONAL HEALTHCARE INC 0 APPALACHIAN REGIONAL HEALTHCARE INC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 520795508 HEALTH CARE KY 501(C)(3) LINE 3 N/A 0 ARH TUG VALLEY HEALTH SERVICES INC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 822577178 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 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 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0