2025-11-17T11:48:32-06:00 2024-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 101 WASHINGTON STREET EAST CHARLESTON WV 25301 990 2024-01-01 812817266 ADAMS COUNTY REGIONAL MEDICAL CENTER ADAM 8778295500 230 MEDICAL CENTER DR SEAMAN OH 45679 PETE R DAGENBACH CFO 9373863001 2025-11-14 1 1 DOLORES ROSE P01286262 3043460441 2025-11-14 2024 2025-03-06 01:10:19Z PETE R DAGENBACH 230 MEDICAL CENTER DR SEAMAN OH 45679 49934516 0 X ACRMC.COM X 2016 OH TO PROVIDE QUALITY HEALTH CARE CLOSE TO HOME AND TO MEET COMMUNITY'S NEEDS, EXCEL AT CUSTOMER SERVICE AND BE THE FIRST CHOICE FOR HEALTHCARE NEEDS. 7 7 453 8 0 0 1192649 24526 40690899 47542241 656374 860858 1281735 1506891 43821657 49934516 0 0 0 0 19842977 23297582 0 0 0 24000516 26969125 43843493 50266707 -21836 -332191 47233754 48742786 28786153 31800410 18447601 16942376 TO PROVIDE QUALITY HEALTH CARE CLOSE TO HOME. TO MEET THE COMMUNITY'S NEEDS, TO EXCEL AT CUSTOMER SERVICE AND TO BE YOUR FIRST CHOICE FOR HEALTHCARE NEEDS. 0 0 34157514 49049132 ACRMC HAS SIX LOCATIONS AND PROVIDES A WIDE RANGE OF SERVICES TO MEET THE HEALTHCARE NEEDS OF ADAMS COUNTY AND ITS SURROUNDING COMMUNITIES. HEALTH CARE SERVICES PROVIDED INCLUDE, BUT ARE NOT LIMITED TO: SURGICAL, ORTHOPEDIC, WOMEN'S HEALTH, REHABILITATION, SENIOR LIFE SOLUTIONS, SLEEP LAB, ADVANCED IMAGING AND CARDIO/PULMONARY. IT IS A CRITICAL ACCESS HOSPITAL WITH 25 BEDS AND 24/7/365 EMERGENCY DEPARTMENT AND ONLINE CARE. THE COST OF CHARITY CARE WAS APPROXIMATELY $183,000 FOR THE YEAR. AN ANNUAL HEALTH FAIR PROVIDES AFFORDABLE HEALTH SCREENINGS AND AN OPPORTUNITY FOR COMMUNITY MEMBERS TO SHARE FEEDBACK ON THEIR THOUGHTS AND DESIRES REGARDING THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES, THROUGH A SURVEY. 34157514 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 44 0 453 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 OH X PETE DAGENBACH CFO 9373863007 230 MEDICAL CENTER DR SEAMAN OH 45679 JACK MCCOY CHAIRMAN 1.50 X X 0 0 0 ROY SPUD GUSTIN VICE-CHAIR 1.50 X X 0 0 0 CHAD WILSON SECRETARY 1.50 X X 0 0 0 DANE CLARK MEMBER 1.50 X 0 0 0 MATTHEW ARMSTRONG MD MEMBER 1.50 X 0 0 0 PEGGY CHALKER PHD MEMBER 1.50 X 0 0 0 DARRIN SCHNEIDER MEMBER 1.50 X 0 0 0 ALAN BIRD CEO 40.00 X 103703 0 6811 PETE DAGENBACH CFO 40.00 X 200833 0 57272 ALI ALALWAN MD PHYSICIAN 40.00 X 305400 0 38006 JON MOORE MD PODIATRIST 40.00 X 277381 0 17104 HANNAH HOPKINS MD DOCTOR 40.00 X 386648 0 5254 KRISHNA REDDY MD ORTHOPEDIC SURGEON 40.00 X 365623 0 5662 JOHN DEBANTO MD GASTROENTEROLOGIST 40.00 X 429357 0 31851 2068945 0 161960 30 0 1 1 EMERGENCY PROFESSIONAL SERVICES INC PO BOX 634850 CINCINNATI OH 452634850 STAFFING ER PHYSICIANS 797648 CPS REHABILITATION SERVICES LLC 655 METRO PLACE SOUTH DUBLIN OH 43017 CONTRACTED THERPAY SERVICES 713705 RDI 4350 GLANDALE-MILFORD RD SUITE 250 CINCINNATI OH 45242 IT SUPPORT 679108 RHG CONSOLIDATED LLC 4770 N BELLVIEW AVE SUITE 205 KANSAS CITY MO 64116 HOSPITAL MANAGEMENT COMPANY 618263 PSYCHIATRIC MEDICAL CARE INC PO BOX 734606 DALLAS TX 75373 PSYCHIATRIC SERVICES 419576 11 24526 24526 PATIENT SERVICES 900099 47542241 47542241 47542241 823592 823592 37266 0 37266 37266 37266 DRUGS SOLD 900099 852484 852484 OTHER REVENUE 900099 355474 355474 CAFETERIA AND VENDING REVENUE 900099 298933 298933 1506891 49934516 49049132 0 860858 X 368619 217301 151318 19317951 11387932 7930019 2036762 1200671 836091 1574250 928020 646230 64230 64230 108999 108999 8391656 5779837 2611819 140935 140935 2643375 1557456 1085919 641327 378062 263265 101786 60003 41783 1703209 1004042 699167 1613953 951425 662528 448756 264542 184214 BAD DEBT 6536496 6536496 MEDICAL SUPPLIES 2911365 2911365 MEDICAID ASSISTANCE 1055621 622289 433332 REPAIRS AND MAINTENANCE 250672 147771 102901 356745 210302 146443 50266707 34157514 16109193 0 7554856 6245742 7864412 10324951 5429279 5335755 365096 362443 359753 460001 31053093 8048029 22584707 23005064 61275 1027305 2642972 1499812 41082 6565 330322 475148 47233754 48742786 4594402 4989447 23531681 24740255 660070 2070708 28786153 31800410 X 18435223 16929907 12378 12469 18447601 16942376 47233754 48742786 X -332191 -1173034 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21952987 3484658 18468329 7251819 4304071 2947748 1848287 259300 1588987 23005064 CAPITAL LEASE OBLIGATIONS 2070708 2070708 X 43398020 0 43398020 6536496 6536496 49934516 43730211 0 43730211 6536496 6536496 50266707 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND HAS BEEN RECOGNIZED AS TAX EXEMPT UNDER SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. THE CENTER FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2021, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 6,536,496. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 6,536,496. 1 1 X 1 X 1 X 1 0 0 177143 177143 0.00410 648794 648794 825937 648794 177143 0.00410 825937 648794 177143 0.00410 6536496 2973718 2562899 410819 X 1 1 1 1 ADAMS COUNTY REGIONAL MEDICAL CENTER INC 230 MEDICAL CENTER DRIVE SEAMAN OH 45679 HTTPS://ACRMC.COM/ X X X X ADAMS COUNTY REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X 24 1 1 1 1 X SEE PART V FOR LINK X 1 24 1 SEE PART V FOR LINK 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTPS://ACRMC.COM/PATIENT-FINANCIAL-SERVICES/ X HTTPS://ACRMC.COM/PATIENT-FINANCIAL-SERVICES/ X X X X X X 1 X 0 X X X 1 X 0 0 ADAMS COUNTY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: EVERY THREE YEARS, THE GREATER CINCINNATI TRI-STATE REGION CONDUCTS A REGIONAL CHNA TO EVALUATE THE HEALTH AND WELL-BEING OF ITS 18-COUNTIES AND IDENTIFY OPPORTUNITIES FOR COLLECTIVE ACTION. THE REGIONAL CHNA IS A RESOURCE THAT CAN BE USED BY PARTNERS ACROSS SECTORS, INCLUDING POLICYMAKERS, TO INCREASE ACCESS TO DATA, GUIDE HEALTH IMPROVEMENT, AND ADVANCE EQUITY. THE REGIONAL CHNA INFORMS THE 2025-2027 COLLECTIVE HEALTH AGENDA, A REGIONAL COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND ROADMAP TO ADVANCE HEALTH AND EQUITY IN THE REGION. IT BUILDS UPON PROGRESS AND LESSONS LEARNED FROM THE 2021 REGIONAL CHNA AND THE 2022-2024 REGIONAL CHIP.COMPILED 49 SECONDARY, QUANTITATIVE DATA METRICS FROM 34 DIFFERENT SOURCES ANALYZED 18 OHIO HOSPITAL ASSOCIATION DATA METRICS REVIEWED SEVEN OTHER PRIMARY AND SECONDARY REGIONAL DATA SOURCES SUCH AS COMMUNITY SURVEYS, DATA FROM 2-1-1 CALLS, AND RECENT COMMUNITY REPORTS DISAGGREGATED 32 METRICS BY CHARACTERISTICS SUCH AS RACE, ETHNICITY, AGE, AND INCOME HOSTED 12 ADVISORY COMMITTEE MEETINGS AND SIX TASK FORCE MEETINGS, WHICH INCLUDED 45 TOTAL PARTNER ORGANIZATIONS.THE HEALTH COLLABORATIVE LAUNCHED THE COMMUNITY PARTNERSHIP NETWORK (CPN) IN JULY 2024 TO CENTER EQUITY AND COMMUNITY VOICE IN THE ASSESSMENT AND PLANNING PROCESS, INCREASE BIDIRECTIONAL COMMUNICATION ON PROGRESS, AND MINIMIZE THE BURDEN OF "NEW" DATA COLLECTION. THE CPN LEVERAGES EXISTING COMMUNITY MEETINGS, MOMENTUM, AND ASSETS TO STRENGTHEN CONNECTIVE TISSUE AND PARTNERSHIP TO ADVANCE SHARED GOALS FOR COMMUNITY HEALTH. CURRENTLY IN AN INITIAL PILOT PHASE, EXISTING COMMUNITY PARTNERSHIPS ARE CO-DESIGNING A FRAMEWORK FOR ACTIONABILITY AND SUSTAINABILITY OF THE CPN. ADAMS COUNTY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6A: CHRIST HOSPITALCINCINNATI CHILDRENLINDNER CENTER OF HOPEMARGARET MARY HEALTHMERCY HEALTH CINCINNATITRIHEALTHUC HEALTH ADAMS COUNTY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: BUTLER COUNTY GENERAL HEALTH DISTRICT AND SOUTHWEST ASSOCIATION OF OHIO HEALTH COMMISSIONERSCINCINNATI HEALTH DEPARTMENTCLERMONT COUNTY PUBLIC HEALTHHAMILTON COUNTY PUBLIC HEALTHCENTER FOR CLOSING THE HEALTH GAPHAMILTON COUNTY HUMAN SERVICES CHAMBERUNITED WAY OF GREATER CINCINNATIURBAN LEAGUE OF GREATER SOUTHWESTERM OHIOBI3INTERACT FOR HEALTHTHE HEALTHCARE CONNECTIONHEALTHSOURCE OF OHIOCARESOURCE ADAMS COUNTY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE PLAN FOCUSES ON TWO PRIORITY AREAS: MENTAL HEALTH TREATMENT AND PREVENTION AND HEART DISEASE AND STROKE PREVENTION AND TREATMENT. THESE ISSUES WERE SELECTED BASED ON THEIR SIGNIFICANT IMPACT ON COMMUNITY HEALTH, AS WELL AS ACRMC'S CAPACITY TO EFFECTIVELY ADDRESS THEM THROUGH TARGETED PROGRAMS AND SERVICES. WHILE OTHER HEALTH CONCERNS REMAIN IMPORTANT, RESOURCE LIMITATIONS AND SERVICE AVAILABILITY GUIDED OUR DECISION TO CONCENTRATE ON THESE CRITICAL AREAS WHERE WE CAN MAKE THE GREATEST DIFFERENCE.MENTAL HEALTH IS A CRITICAL COMPONENT OF OVERALL WELL-BEING, YET NEARLY 1 IN 5 ADULTS IN ADAMS COUNTY REPORT FREQUENT MENTAL DISTRESS.STRATEGY #1: PARTNER WITH OUR SENIOR LIFE SOLUTIONS TEAM TO IMPLEMENT A MENTAL HEALTH LITERACY CAMPAIGN, INCLUDING WORKSHOPS AND DIGITAL RESOURCES, TO EDUCATE THE PUBLIC ON STRESS MANAGEMENT, COPING MECHANISMS, AND LOCAL MENTAL HEALTH SERVICES. STRATEGIC MEASURE: TRACK THE NUMBER OF VIEWS/CLICKS ON SOCIAL MEDIA AND ALSO ATTENDANCE AT IN-PERSON EVENTS WHERE INFORMATION IS TAUGHT/PASSED OUT. STRATEGY #2: ACRMC SOCIAL WORKERS AND CASE MANAGERS WILL PROVIDE RESOURCES AND REFERRALS FOR MENTAL HEALTH CARE COORDINATION, AND RESOURCE NAVIGATION TO ENSURE PATIENTS RECEIVE APPROPRIATE FOLLOW-UP CARE AND COMMUNITY SUPPORT.STRATEGIC MEASURE: TRACK THE NUMBER OF MENTAL HEALTH REFERRALS COMPLETED TO BEHAVIORAL HEALTH SERVICES TO MEASURE IMPACT AND IMPROVE CARE CONTINUITY.HEART DISEASE AND STROKE REMAIN LEADING CAUSES OF DEATH IN THE COUNTIES ACRMC SERVES.STRATEGY #1: LAUNCH A COMMUNITY-WIDE HEART HEALTH INITIATIVE, INCLUDING CPR TRAINING, HYPERTENSION AWARENESS PROGRAMS, AND EDUCATIONAL MATERIALS ON STROKE PREVENTION. STRATEGIC MEASURE: ISSUE AT LEAST 3,000 CPR CERTIFICATION CARDS TO COMMUNITY MEMBERS THROUGH THE ACRMC CPR TRAINING CENTER ANNUALLY AND TRACK KNOWLEDGE THROUGH COMPLETED CERTIFICATIONS. STRATEGY #2: HOST THE JUNE HEALTH FAIR, OFFERING THE AFFORDABLE COMPREHENSIVE BLOOD PANEL TO ENCOURAGE SCREENINGS FOR HEART DISEASE RISK FACTORS, AIMING TO EXCEED 1,000 PARTICIPANTS. STRATEGIC MEASURE: TRACK THE NUMBER OF HEALTH FAIR PARTICIPANTS, AIMING FOR A 5% ANNUAL INCREASE IN ATTENDANCE. MEASURE ENGAGEMENT AND FOLLOW-UP SCREENINGS TO ASSESS ANY CHANGES IN HEART DISEASE RISK FACTORS AND MANAGEMENT. STRATEGY #3: STRENGTHEN THE PARTNERSHIP WITH ADAMS COUNTY EMERGENCY MEDICAL SERVICES THROUGH HISPEED STUDY AND STROKE PREVENTION EDUCATION. STRATEGIC MEASURE: TRACK THE NUMBER OF EMS EDUCATION SESSIONS AND THE NUMBER OF TIMES ADAMS COUNTY EMS TRANSPORT PATIENTS PER REQUESTS.NEEDS NOT ADDRESSING:WHILE OTHER HEALTH CONCERNS ARE IMPORTANT, WE ARE UNABLE TO ADDRESS THEM FULLY DUE TO FINANCIAL CONSTRAINTS AND SERVICE LIMITATIONS AS A CRITICAL ACCESS HOSPITAL. CANCER: WE DO NOT HAVE AN ONCOLOGY PROGRAM AND REFER PATIENTS TO REGIONAL CANCER CENTERS. SUBSTANCE ABUSE & ADDICTION: WE PROVIDE EMERGENCY CARE AND REFERRALS BUT LACK INPATIENT REHAB AND ADDICTION TREATMENT SERVICES. LUNG DISEASE: WE OFFER BASIC RESPIRATORY CARE BUT DO NOT HAVE SPECIALIZED PULMONARY TREATMENT. POVERTY: WHILE POVERTY AFFECTS HEALTH, WE RELY ON COMMUNITY ORGANIZATIONS FOR FINANCIAL AND SOCIAL SUPPORT SERVICES. SMOKING & TOBACCO USE: WE PROVIDE EDUCATION AND REFERRALS BUT DO NOT HAVE A DEDICATED SMOKING CESSATION PROGRAM. ADDITIONALLY, WE ARE UNABLE TO FOCUS ON HOMELESSNESS PREVENTION AND HOUSING STABILITY AS WE DO NOT HAVE HOUSING PROGRAMS, BUT WORK WITH LOCAL AGENCIES TO SUPPORT THOSE IN NEED. SCHEDULE H, PART V, SECTION B, LINE 7A AND LINE 10A LINK FOR CHNA LINE 7A:HTTPS://ACRMC.COM/WP-CONTENT/UPLOADS/2021/01/2024-REGIONAL-CHNA_FINAL_03052025.PDFLINK FOR IMPLEMENTATION PLAN LINE 10A:HTTPS://ACRMC.COM/WP-CONTENT/UPLOADS/2025/04/2024-ACRMC-COMM.-HEALTH-IMPLEMENTATION-PLAN.PDF 5 1 - FAMILY MEDICINE - GEORGETOWN 900 MT ORAB PIKE GEORGETOWN OH 45131 CLINIC 2 - FAMILY MEDICINE - WEST UNION 211 NORTH WILSON DRIVE WEST UNION OH 45693 CLINIC 3 - FAMILY MEDICINE - WINCHESTER 19262 STATE ROUTE 136 WINCHESTER OH 45697 CLINIC 4 - FAMILY MEDICINE - MT ORAB 217 HUGHES BLVD MT ORAB OH 45154 CLINIC 5 - FAMILY MEDICINE - PEEBLES 154 ELLIOT AVENUE PEEBLES OH 45660 CLINIC PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6,536,496. PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COSTS AND REIMBURSEMENTS. PART VI, LINE 2: THE CENTER PROVIDES AN ANNUAL HEALTH FAIR SCREENING AND ASKS THE PARTICIPANTS TO COMPLETE A SURVEY. PART VI, LINE 3: ALL PATIENTS ARE INFORMED OF APPLICATION PROCESS, PRIOR TO SERVICE. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE. PART VI, LINE 4: ADAMS COUNTY IS A RURAL, MEDICALLY UNDERSERVED AREA, LOCATED APPROXIMATELY FIFTY MILES EAST OF CINCINNATI ALONG THE OHIO RIVER. ADAMS COUNTY HAS A POPULATION OF APPROXIMATELY 28,550. IN THE COUNTY, THE POPULATION IS SPREAD OUT, WITH 26.40% UNDER THE AGE OF 18, 8.70% FROM 18 TO 24, 28.20% FROM 25 TO 44, 23.40% FROM 45 TO 64, AND 13.30% WHO WERE 65 YEARS OF AGE OR OLDER. THE MEDIAN AGE WAS 36 YEARS. THE MEDIAN HOUSEHOLD INCOME IS $36,894. APPROXIMATELY 20% OF THE POPULATION IS IN POVERTY. PART VI, LINE 5: THE COMMUNITY HEALTH FAIR AND A RURAL HEALTH CLINIC WITH WALK-IN APPOINTMENTS. X X 1 0 0 0 0 0 0 0 0 JOHN DEBANTO MD GASTROENTEROLOGIST 429357 0 0 0 0 0 0 0 31851 0 461208 0 0 0 HANNAH HOPKINS MD DOCTOR 260000 0 126648 0 0 0 0 0 5254 0 391902 0 0 0 KRISHNA REDDY MD ORTHOPEDIC SURGEON 365623 0 0 0 0 0 5662 0 0 0 371285 0 0 0 ALI ALALWAN MD PHYSICIAN 305000 0 400 0 0 0 10056 0 27950 0 343406 0 0 0 JON MOORE MD PODIATRIST 200000 0 77381 0 0 0 17104 0 0 0 294485 0 0 0 PETE DAGENBACH CFO 200833 0 0 0 0 0 29155 0 28117 0 258105 0 0 0 PART I, LINE 4A ALAN BIRD RECEIVED A PAYMENT IN THE AMOUNT OF $25,000. FORM 990, PART VII, SECTION A, LINE 5 UNRELATED ORGANIZATION OFFICER COMPENSATION: THE CENTER HAD A MANAGEMENT SERVICES AGREEMENT WITH RURAL HOSPITAL GROUP. FOR THE FIRST NINE MONTHS OF 2024, RURAL HOSPITAL GROUP SUPPLIED A FULL-TIME CHIEF EXECUTIVE OFFICER (CEO) TO THE HOSPITAL, MR. ALAN BIRD. EFFECTIVE OCTOBER 1, 2024, MR. BIRD TRANSITIONED TO BECOME AN EMPLOYEE OF THE HOSPITAL AND CONTINUES TO SERVE AS CEO. A COUNTY OF ADAMS OH SERIES 2019 BONDS 00610PAH9 2019-09-27 25400000 TO FINANCE ACQUISITION OF EXISTING HOSPITAL FACILITIES IN ADAMS COUNTY, OH 0 0 0 A 1025000 24892000 2075280 508000 1 0 0 1 A 0 0 0 0 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE DISTRIBUTED TO ALL BOARD MEMBERS. IT WILL BE PRESENTED AND DISCUSSED AT A BOARD OF TRUSTEES MEETING AFTER THE COMPLETION OF FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ACRMC CONFLICT OF INTEREST POLICY REQUIRES THAT ALL PERSONNEL SHALL UPON HIRE AND ANNUALLY THEREAFTER SIGN A STATEMENT WHICH AFFIRMS THE PERSON'S UNDERSTANDING AND ADHERENCE TO THE POLICY. THE COMPLIANCE COMMITTEE MEETS EACH QUARTER AND THE HIM DIRECTOR PERFORMS HIPAA AUDITS. FORM 990, PART VI, SECTION B, LINE 15 SALARY SURVEYS AND RECOMMENDATIONS FROM THE CEO ARE USED TO DETERMINE THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES SALARIES. THE SALARY RECOMMENDATIONS ARE REVIEWED AND APPROVED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 866,801. MANAGEMENT AND GENERAL EXPENSES 603,599. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,470,400. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,883,911. MANAGEMENT AND GENERAL EXPENSES 2,008,220. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,892,131. CONTRACTED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 2,029,125. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,029,125. FORM 990, PART XI, LINE 9: CHANGE IN EQUITY OF NON-CONTROLLING INTEREST IN SUB 0. INCREASE IN TEMP RESTRICTED ASSETS 91. LOSS ON REFINANCING OF DEBT -1,173,125. ADAMS COUNTY REGIONAL MEDICAL PAIN MANAGEMENT LLC 230 MEDICAL CENTER DR SEAMAN OH 45679 853030741 HEALTHCARE OH ADAMS COUNTY REGIONAL MEDICAL CENTER RELATED -16410 172687 0 0 0.51000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0