2026-05-07T15:58:51-05:00 2025-06-30 882730877 CHERRY BEKAERT ADVISORY LLC 101 SOUTH 5TH STREET STE 2100 LOUISVILLE KY 40202 990 2024-07-01 520795508 APPALACHIAN REGIONAL HEALTHCARE APPA 8592262440 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 BYRON GABBARD CFO/VP FISCAL SERVICES 8592262440 2026-04-22 1 1 MELANIE MCPEAK P01346034 8885871719 2024 2025-03-06 01:10:19Z HOLLIE P HARRIS 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 1078699521 0 X WWW.ARH.ORG X 1963 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. 12 12 5638 112 37660306 3050783 620648 1471544 906150904 991822031 27042785 25050610 10102841 59661216 943917178 1078005401 781069 1113867 0 0 438098268 450843992 0 0 0 434962133 476744449 873841470 928702308 70075708 149303093 1448830338 1690508848 745614779 770717777 703215559 919791071 X TO IMPROVE HEALTH AND PROMOTE WELL-BEING OF ALL PEOPLE IN CENTRAL APPALACHIA IN PARTNERSHIP WITH OUR COMMUNITIES. 0 0 750450922 1113867 993628124 JUST AS IT HAS FOR THE PAST SEVEN DECADES, APPALACHIAN REGIONAL HEALTHCARE (ARH) REMAINED COMMITTED TO ITS MISSION TO PROVIDE THE PEOPLE OF CENTRAL APPALACHIA WITH THE HIGHEST QUALITY OF CARE IN 2025. WITH 14 HOSPITALS AS WELL CLINICS, HOME HEALTH AGENCIES, HOME MEDICAL EQUIPMENT STORES, PHARMACIES AND REHABILITATION SERVICES SPREAD ACROSS BOTH KENTUCKY AND WEST VIRGINIA, ARH AND ITS MORE THAN 6,000 TEAM MEMBERS AND 1,300 MEDICAL PROVIDERS IS ESSENTIAL TO THE LIVES OF THOSE WHO RESIDE IN CENTRAL APPALACHIA. ARH'S COMMITMENT TO EXCELLENCE WAS RECOGNIZED THROUGHOUT THE 2025 FISCAL YEAR WITH A VARIETY OF HONORS AND CERTIFICATIONS. THE ARH SYSTEM WAS NAMED TO FORBES' LIST OF AMERICA'S BEST-IN-STATE EMPLOYERS, SUMMERS COUNTY ARH, BARBOURVILLE ARH, MARY BRECKINRIDGE ARH, MCDOWELL ARH, AND TUG VALLEY ARH REGIONAL MEDICAL CENTER WERE ALL RECOGNIZED AS ACUTE STROKE READY CENTERS. WITH THOSE CERTIFICATIONS BESTOWED BY DNV, EACH OF ARH'S 14 HOSPITALS WERE OFFICIALLY STROKE CERTIFIED. BECKLEY AND SUMMERS COUNTY ARH RECEIVED SILVER HONORS FROM THE WEST VIRGINIA HOSPITAL ASSOCIATION AND SUMMERS COUNTY ARH RECEIVED THE WVHA GOVERNOR'S AWARD FOR OUTSTANDING SUPPORT OF TISSUE AND CORNEA DONATION. THREE ARH BIRTHING HOSPITALS HAZARD ARH, HIGHLANDS ARH AND WHITESBURG ARH, RECEIVED THE KENTUCKY PERINATAL QUALITY COLLABORATIVE (KYPQC) AWARD FOR THE SECOND CONSECUTIVE YEAR. TWELVE ARH HOSPITALS WERE HONORED WITH AMERICAN HEART ASSOCIATION GET WITH THE GUIDELINES AWARDS FOR THEIR COMMITMENT TO THE TREATMENT OF STROKE. THE ARH SYSTEM'S HARD WORK ON THE TECHNICAL FRONT WAS AGAIN RECOGNIZED AS IT ACHIEVED A LEVEL 8 RANKING IN CHIME'S MOST WIRED HEALTH SYSTEMS FOR BOTH AMBULATORY AND ACUTE CARE FOR THE FIFTH CONSECUTIVE YEAR. 750450922 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 400 0 1 5638 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 12 12 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 GREG COUCH CHAIR 3.00 2.50 X X 0 0 0 JEFFREY B HOLLON VICE CHAIR 3.00 0.00 X X 0 0 0 JOANN ANDERSON SECRETARY/TREASURER 3.00 0.00 X X 0 0 0 MARTHA ELLIS TRUSTEE 3.00 0.00 X 0 0 0 KEN ALLMAN TRUSTEE 3.00 0.00 X 0 0 0 DUSTIN SCOTT CAMPBELL MD TRUSTEE 3.00 0.00 X 0 0 0 SAM DUNN TRUSTEE 3.00 0.00 X 0 0 0 RANDY EVANS DVM TRUSTEE 3.00 2.00 X 0 0 0 JULIE AKEMON TRUSTEE (TERM 11/8/24) 5.00 0.00 X 0 0 0 L BART FRANCIS TRUSTEE (TERM 11/8/24) 3.00 0.00 X 0 0 0 ANDREA MASSEY TRUSTEE 3.00 3.00 X 0 0 0 KAREN NEWMAN-PROFITT TRUSTEE 3.00 0.00 X 0 0 0 MIKE RUST TRUSTEE 3.00 0.00 X 0 0 0 ONZIE SIZEMORE TRUSTEE 3.00 0.00 X 0 0 0 EDITH KELLEY TRUSTEE (TERM 11/8/24) 3.00 0.00 X 0 0 0 HOLLIE P HARRIS PRESIDENT/CEO 25.00 15.00 X 1503777 0 118812 PAUL BETZ COO (TERM 11/13/24) 30.00 10.00 X 634158 0 103316 MARIA BRAMAN CHIEF MEDICAL OFFICER 30.00 10.00 X 631739 0 70503 CHRISTI LEE CHIEF LEGAL COUNSEL 25.00 15.00 X 483617 0 69752 SONYA BERGMAN CHIEF PEOPLE OFFICER 30.00 0.00 X 470494 0 81729 BYRON GABBARD CHIEF FINANCIAL OFFICER 25.00 15.00 X 664251 0 60915 JAYARAMAKRISHNA DEPA NEPHROLOGIST 40.00 0.00 X 984500 0 59015 SAMUEL BAILEY ONCOLOGIST 40.00 0.00 X 848952 0 54705 ADNAN M BHOPALWALA CARDIOLOGIST 40.00 0.00 X 1251900 0 53827 TIMOTHY MICEK ORTHOPEDIC SURGEON 40.00 0.00 X 963310 0 43477 CHAYAKRIT KRITTANAWONG INTERVENTIONAL CARDIOLOGIST 40.00 0.00 X 862566 0 13573 9299264 0 729624 428 0 1 0 TRIANGLE ANESTHESIA GROUP 425 LEWIS HARGETT CIRCLE LEXINGTON KY 40503 CONTRACT ANESTHESIA 20606194 HALLMARK HEALTH CARE SOLUTIONS PO BOX 22938 NEW YORK NY 100872938 CONTRACT NURSING 17317840 SODEXO OPERATIONS PO BOX 360170 PITTSBURGH PA 152516170 SUPPORT SERVICES 10259950 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 CONTRACT LAB SERVICES 10012721 AHEAD INC 401 N MICHIGAN AVE CHICAGO IL 60611 SOFTWARE SUPPORT SERVICES 6183297 240 746798 724746 1471544 PATIENT REVENUES 621110 718884721 718884721 HOSPITAL RATE IMPROVEM 900099 158487287 158487287 PHARMACY & LAB 812300 114368951 84088897 30280054 RECORD TRANSCRIPT FEES 900099 81072 81072 991822031 11373414 11373414 1407625 0 1407625 1407625 1407625 14371316 694120 13677196 13677196 13677196 DPP REVENUE 900099 29763991 29763991 KMAP REVENUE 900099 14020729 14020729 HOME STORE SALES 900099 6441231 6441231 8027640 1806093 939021 5282526 58253591 1078005401 963348070 37660306 75525481 X 1113867 1113867 4998599 4998599 339670931 285321514 54349417 7837538 6795839 1041699 76659507 63594047 13065460 21677417 17992256 3685161 1195899 801252 394647 919166 615841 303325 92455 92455 122497943 96430188 26067755 5925428 3614511 2310917 34222252 24313837 9908415 23453995 14306937 9147058 32699150 21241616 11457534 2674361 1631360 1043001 1122972 685013 437959 6265086 939763 5325323 21984940 18687199 3297741 18839254 11491945 7347309 MEDICAL SUPPLIES & PHAR 179046384 176745283 2301101 PROVIDER TAX EXPENSE 35444854 35444854 PROVISION FOR BAD DEBT 26540555 26540555 340B RETAIL CONTRACT FE 5809448 5809448 -41989693 -28313804 -13675889 928702308 750450922 178251386 0 14016474 4900331 163507842 226173661 145913830 196068730 22212234 22718806 65818974 76957451 765958158 478268830 261935824 287689328 760127024 859374970 3986578 4388895 1571815 1565475 930000 930000 8809743 9741201 1448830338 1690508848 134983428 123886736 4936547 19725843 66480000 65160000 174770019 164041567 364444785 397903631 745614779 770717777 X 703227425 919791071 -11866 0 703215559 919791071 1448830338 1690508848 X 149303093 48793226 11830 18467363 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 1 44455 1 48000 92455 0 PART II-B, LINE 1: ARH IS A MEMBER OF VARIOUS HOSPITAL ASSOCIATIONS. THE APPROPRIATE PERCENTAGE OF DUES PAID TO THE ORGANIZATIONS ALLOCABLE TO LOBBYING ACTIVITIES ARE ALSO INCLUDED. ARH HOLDS ON RETAINER CONSULTANTS TO ASSIST WITH GOVERNMENT AND PUBLIC RELATIONS IN REGARDS TO DEVELOPMENT OF LEGISLATURE, RELATED RESEARCH, AND OTHER RELEVANT ACTIVITIES. 6456227 6456227 331121254 241067835 90053419 2998994 2291382 707612 260083500 187584774 72498726 165298183 47324839 117973344 287689328 MEDICARE & MEDICAID ESTIMATED SETTLEMENTS 38609457 ACCRUED PENSION COST 42585393 RESERVE FOR SELF-INSURANCE 83909958 PHYSICIAN COMMITMENTS 513213 DUE TO PATIENTS 13804529 BOND INTEREST PAYABLE 2903777 SERP PAYABLE 255299 ACCRUED PHYSICIAN SETTLEMENTS 2028338 OPERATING LEASE LIABILITY 10151473 DUE TO AFFILIATE 203142194 397903631 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. 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 41549646 2741998 38807648 0.04300 251449812 310307118 0 0.00000 0 0 0.00000 292999458 313049116 38807648 0.04300 0 0 1795 1562 3935411 0 3935411 0.00440 0 0 0.00000 0 0 0.00000 184 22117 72262 0 72262 0.00010 1979 23679 4007673 4007673 0.00450 1979 23679 297007131 313049116 42815321 0.04750 0 0 0 0 0.00000 3 105 181 0 181 0.00000 133 15442 160831 0 160831 0.00020 0 0 0 0 6 310 2103 0 2103 0.00000 80 8244 11495 0 11495 0.00000 497 22308 241195 0 241195 0.00030 8 415 479 0 479 0.00000 0 0 0 0 0.00000 727 46824 416284 416284 0.00050 1 26540555 15736430 83098389 104461768 -21363379 X 1 1 1 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCI CONDO OWNER 0.83840 0.16160 9 1 HAZARD ARH REGIONAL MEDICAL CENTER 100 MEDICAL CENTER DRIVE HAZARD KY 41701 100365 X X X X A 2 BECKLEY ARH HOSPITAL 306 STANAFORD ROAD BECKLEY WV 25801 45 X X X A 3 HARLAN ARH HOSPITAL 81 BALL PARK ROAD HARLAN KY 40831 100163 X X X A 4 WHITESBURG ARH HOSPITAL 240 HOSPITAL ROAD WHITESBURG KY 41858 100288 X X X A 5 TUG VALLEY ARH REGIONAL MEDICAL CENTER 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 100368 X X X A 6 MIDDLESBORO ARH HOSPITAL 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 100019 X X X A 7 MCDOWELL ARH HOSPITAL ROUTE 122 BOX 247 MCDOWELL KY 41647 600082 X X X X A 8 MORGAN COUNTY ARH HOSPITAL 476 LIBERTY ROAD WEST LIBERTY KY 41472 600058 X X X X A 9 SUMMERS COUNTY ARH HOSPITAL 115 SUMMERS HOSPITAL ROAD HINTON WV 25951 88 X 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 X 1 1 X X X X 1 X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE X X X X X 1 X 0 X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: HAZARD ARH REGIONAL MEDICAL CENTER, - FACILITY 3: HARLAN ARH HOSPITAL, - FACILITY 2: BECKLEY ARH HOSPITAL, - FACILITY 5: TUG VALLEY ARH REGIONAL MEDICAL CENTER, - FACILITY 4: WHITESBURG ARH HOSPITAL, - FACILITY 6: MIDDLESBORO ARH HOSPITAL, - FACILITY 8: MORGAN COUNTY ARH HOSPITAL, - FACILITY 7: MCDOWELL ARH HOSPITAL, - FACILITY 9: SUMMERS COUNTY 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. 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 6A: APPALACHIAN REGIONAL HEALTHCARE 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: APPALACHIAN REGIONAL HEALTHCARE CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN EACH OF ITS 10 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 2022 CHNA PROCESS, THE APPOINTED COUNTY STEERING COMMITTEE IDENTIFIED THE FOLLOWING HEALTH NEEDS WITH ALL OF OUR FACILITIES: 1. MENTAL HEALTH 2. OBESITY 3. CULTURE OF HEALTH/ HEALTHY LIFESTYLE EDUCATION 4. SUBSTANCE USE DISORDER, 5. AGING IN PLACE AND OTHER SENIOR-ORIENTED SERVICES, 6. BUILD AND EXPAND CAPACITY OF HEALTH CONSORTIUM, 7. BETTER ACCESS TO CARE.MENTAL HEALTHBECKLEY ARH SET FORTH GOALS AND STRATEGIES TO ADDRESS EACH OF THE IDENTIFIED HEALTH NEEDS. SINCE 2022. BECKLEY ARH HAS EDUCATED OUR COMMUNITY ON THE IMPORTANCE OF MENTAL HEALTH AND REDUCED ASSOCIATED STIGMA BY PROVIDING 2 FREE MENTAL HEALTH FIRST AID TRAINING COURSES FOR STAFF, PROVIDING 7 MENTAL HEALTH EDUCATION AND AWARENESS EVENTS AND MANAGING AND SUPERVISING THE LOCAL STUDENTS AGAINST DESTRUCTIVE DECISIONS (SADD) GROUP. SINCE 2022, THE GROUP HAS: ATTENDED 15 EVENTS TARGETING THE K-12 POPULATION TO DISCUSS MENTAL HEALTH TOPICS AND THE NATIONAL SUICIDE CRISIS HOTLINE (988). HAZARD ON BOARDED KAITLYN WARFIELD, LCSW TO PROVIDE THERAPEUTIC SERVICES TO PATIENTS IN THE HAZARD COMMUNITY. COMPLETED RENOVATIONS AND OPENED HAZARD PSYCHIATRIC CENTER'S TREATMENT MALL IN DEC. 2023. THE ARH BEHAVIORAL HEALTH TEAM CREATED A VIDEO SERIES FOR SOCIAL MEDIA WITH 9 EDUCATIONAL VIDEOS THAT GARNERED OVER 3,000 VIEWS ON YOUTUBE. MENTAL HEALTH EDUCATION AND AWARENESS EVENTS HAVE ALSO BEEN A FOCUS OF THE COMMUNITY DEVELOPMENT AND BEHAVIORAL HEALTH TEAMS SINCE 2022.SINCE 2022, MCDOWELL 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. REOPENED THE SENIOR CARE PROGRAM TO PROVIDE OLDER ADULTS WITH QUALITY BEHAVIORAL HEALTHCARE. ALONG WITH SOCIAL INTERACTION AND GROUP THERAPY, PARTICIPATING SENIORS RECEIVE TREATMENT FROM A MULTIDISCIPLINARY TEAM INCLUDING A PSYCHIATRIST, A THERAPIST, AND A REGISTERED NURSE THAT DEVELOP INDIVIDUALIZED PLANS. PRESENTED TWICE TO STUDENTS ABOUT MENTAL HEALTH ISSUES AT ADAMS MIDDLE SCHOOL AND FLOYD CENTRAL HIGH SCHOOL.MIDDLESBORO ARH HAS IMPROVED THE MENTAL HEALTH OF OUR COMMUNITY MEMBERS BY ACTIVELY PARTNERING WITH CRATER OF HOPE AND OTHER COMMUNITY ORGANIZATIONS ON IMPLEMENTATION OF A HARM REDUCTION PROGRAM (AKA A NEEDLE EXCHANGE PROGRAM) AND IN COMPLETING THE RECOVERY READY COMMUNITY APPLICATION. WORKING WITH LINCOLN MEMORIAL UNIVERSITY TO EXTEND OUR 3-YEAR HRSA MENTAL HEALTH GRANT BY ANOTHER YEAR AS WELL AS WORKING TO EXTEND THE MOSAIC GRANT TO MIDDLESBORO ARH IN ORDER TO PROVIDE 2 FULL-TIME PEER SUPPORT SPECIALISTS IN OUR EMERGENCY DEPARTMENT. IMPLEMENTED OVERDOSE SURVIVORS OUTREACH PROGRAM, PROVIDING COMMUNITY FOLLOW UPS TO OVERDOSE SURVIVORS AND EXTRA SUPPORT IN HOPES OF LINKING THOSE OVERDOSE SURVIVORS TO TREATMENT, AND OTHER COMMUNITY RESOURCES GROWN OUTPATIENT BEHAVIORAL HEALTH SERVICES THROUGH ARH CUMBERLAND VALLEY MEDICAL AND SURGICAL ASSOCIATES AND MIDDLESBORO WOMEN'S AND FAMILY HEALTH CLINIC (1,553 BEHAVIORAL HEALTH VISITS 2022-2024).MORGAN COUNTY ARH HAS INCREASED MENTAL HEALTH SERVICES AND COMMUNITY EDUCATION BY REOPENING THE SENIOR CARE PROGRAM TO PROVIDE OLDER ADULTS WITH QUALITY BEHAVIORAL HEALTHCARE. ALONG WITH SOCIAL INTERACTION AND GROUP THERAPY, PARTICIPATING SENIORS RECEIVE TREATMENT FROM A MULTIDISCIPLINARY TEAM INCLUDING A PSYCHIATRIST, A THERAPIST, AND A REGISTERED NURSE THAT DEVELOP INDIVIDUALIZED PLANS. MORGAN COUNTY HAS IMPLEMENTED TELEPSYCHIATRY CONSULTATIONS TO ENHANCE ACCESSIBILITY AND EFFICIENCY OF PSYCHIATRIC CARE. THEY HAVE CONTINUED THEIR PARTNERSHIP WITH PATHWAYS TO CONNECT INDIVIDUALS IN NEED OF MENTAL HEALTH CARE. PROVIDED 5 FREE MENTAL HEALTH FIRST AID TRAINING SESSIONS FOR STAFF FROM 2023-2024. MORGAN COUNTY 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. PRESENTED THE HEALTHY RELATIONSHIPS PROGRAMMING TO MORGAN COUNTY HIGH SCHOOL STUDENTS, WHICH TEACHES CRITICAL THINKING AROUND QUALITIES OF HEALTHY AND UNHEALTHY RELATIONSHIPS, SIGNS OF ABUSE, AND COMMUNICATION SKILLS.IN 2023, SUMMERS COUNTY ARH PROVIDED THREE FREE MENTAL HEALTH FIRST AID TRAINING COURSES FOR STAFF. THE ARH COMMUNITY DEVELOPMENT AND BEHAVIORAL HEALTH TEAMS AT SUMMERS COUNTY HAVE PROVIDED 7 MENTAL HEALTH EDUCATIONAL OR AWARENESS EVENTS TO THE COMMUNITY SINCE 2022. IN 2020, SUMMERS COUNTY ARH LAUNCHED THE PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY. SINCE 2022 SUMMERS COUNTY ARH PEER RECOVERY COACHES HAVE COMPLETED: 3698 SBIRT SCREENINGS, 370 INITIAL BRIEF INTERVENTIONS, 62 REFERRALS TO TREATMENT, 30 LINKAGES TO TREATMENT, 300 NALOXONE DISTRIBUTED. SUMMERS COUNTY ARH ALSO EXPANDED THE MENTAL HEALTH SERVICES AVAILABLE VIA A TELEMEDICINE PARTNERSHIP WITH MARSHAL UNIVERSITY (2023).SINCE 2022, TUG VALLEY ARH HAS ADDRESSED MENTAL HEALTH IN OUR COMMUNITY BY EXPANDING OUTREACH ACTIVITIES SPECIFIC TO MENTAL HEALTH EDUCATION AND REDUCTION OF STIGMA. THEY HAVE PROVIDED TWO YEARS OF SPONSORSHIP AND STAFF PRESENTATIONS AT PIKE COUNTY STRONG, A SELF-ESTEEM, LEADERSHIP, AND MENTAL HEALTH AWARENESS EVENT FOR ALL FEMALE, JUNIOR YEAR HIGH SCHOOL STUDENTS IN THE COUNTY. PARTICIPATED IN "SAFE A LIFE" ROAD SHOW IN 2023 AND 2024, AN EVENT THAT PROVIDES MENTAL HEALTH EDUCATION, DRUG TREATMENT RESOURCES, NARCAN DISTRIBUTION, AND MORE AT LOCAL RETAIL STORES. THE ARH BEHAVIORAL HEALTH TEAM HAS ALSO CREATED A VIDEO SERIES FOR SOCIAL MEDIA WITH 9 EDUCATIONAL VIDEOS THAT GARNERED OVER 3,000 VIEWS ON YOUTUBE. THESE VIDEOS FEATURE ARH STAFF AND PROVIDERS DISCUSSING RELEVANT MENTAL HEALTH TOPICS LIKE SUICIDE PREVENTION, PTSD, SEASONAL AFFECTIVE DISORDER, AND POSTPARTUM DEPRESSION.WHITESBURG ARH HAS IMPROVED THE MENTAL HEALTH LANDSCAPE OF OUR COMMUNITY BY PROVIDING QUARTERLY FREE MENTAL HEALTH FIRST AID TRAINING FOR STAFF FROM 2023-2024. PROVIDING 3,303 BEHAVIORAL HEALTH CLINIC VISITS AND PARTICIPATED IN SEVERAL MENTAL HEALTH COMMUNITY EVENTS SUCH AS THE COUNTY'S ANNUAL CHILD ABUSE AWARENESS WALK AND THE WORLD DIABETES DAY CELEBRATION HEALTH FAIR IN 2024. WHITESBURG ARH HAS ALSO PARTNERED WITH A CERTIFIED TRAUMA INSTRUCTOR TO HOST 2 YOGA AND MINDFULNESS STRESS RELIEF CLASSES IN LETCHER COUNTY.OBESITYSINCE 2022, BECKLEY ARH HAS ADDRESSED OBESITY IN OUR COMMUNITY BY FINANCIALLY SUPPORTING WOODROW WILSON HIGH SCHOOL'S WETLAND PROJECT, MONTHLY DIABETES SUPPORT GROUPS, DEVELOPED "RETHINK YOUR DRINK" PROGRAM, PARTNERED 4 "WALK WITH A DOC" EVENTS WITH ACTIVE SOUTHERN WEST VIRGINA, REVAMPED THE HOSPITAL'S MENU, AND PROVIDED FREE GYM MEMBERSHIPS TO ALL ARH EMPLOYEES. HARLAN HAS ALSO REVAMPED THE HOSPITAL'S MENU AND PROVIDED FREE GYM MEMBERSHIPS TO ALL ARH EMPLOYEES ALONG WITH NUTRITION EDUCATION FROM AN ARH DIETITIAN. HARLAN ARH AND THE ARH FOUNDATION FUNDED THE DELIVERY OF FRESH FOODS TO 100 CLIENTS OF THE UNIVERSITY OF KENTUCKY'S KENTUCKY HOMEPLACE PROGRAM IN HARLAN COUNTY. IN 2022 AND 2023, A TOTAL OF 100 QUALIFIED HOMEPLACE CLIENTS WERE PROVIDED WITH A REDEEMABLE $25 VOUCHER TO ROPERS MARKET IN HARLAN, WHICH IS A RETAIL SOURCE OF LOCALLY- AND REGIONALLY GROWN FRESH FOODS, SPECIALIZING IN PRODUCE. THE PROGRAM WAS EXPANDED IN 2024 TO PROVIDE CLIENTS WITH MONTHLY $25 VOUCHERS TO COVER THE SPRING, SUMMER AND FALL HARVEST SEASONS. IN ADDITION TO FRESH PRODUCE, PARTICIPANTS ARE ALSO CASE MANAGED AND REFERRED TO SOCIAL ORGANIZATIONS OR HEALTHCARE WHEN NECESSARY. PART V, SECTION B, LINE 11 CONTINUED: SINCE 2022, MCDOWELL ARH HAS ADDRESSED OBESITY, FOOD INSECURITY, AND THE NEED FOR NUTRITION EDUCATION BY 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 30 BOXES PER MONTH. FOOD BOXES CONTAIN ARH DIETITIAN TIPS ON HEALTHIEST USE OF FOODS INCLUDED. PARTICIPATED IN A RESEARCH STUDY WITH UNIVERSITY OF KENTUCKY FOOD AS HEALTH ALLIANCE IN WHICH MCDOWELL AMBULATORY PATIENTS WITH TYPE 2 DIABETES OR HYPERTENSION COULD RECEIVE MEDICALLY TAILORED MEALS FOR 12 WEEKS. THEY HOSTED 13 MONTHLY DIABETES SUPPORT GROUPS IN FLOYD COUNTY WITH DIABETES-RELATED TOPICS AND HEALTHY COOKING DEMONSTRATIONS EACH MONTH (2022 START). PROVIDING MEALS TO THOSE IN NEED. GAVE MONTHLY FOOD DONATIONS TO THE FLOYD COUNTY HOMELESS SHELTER AND HOSTED FOOD DRIVES AND COMMUNITY PICNICS ANNUALLY. MCDOWELL ARH ALSO WORKED TO EDUCATE AND PROVIDE HEALTHY NUTRITION TO EMPLOYEES THROUGH A REVAMPED CAFETERIA MENU, WHICH OFFERS PLANT-BASED OPTIONS.MIDDLESBORO ARH HAS ADDRESSED OBESITY AND ITS ROOT CAUSES IN OUR COMMUNITY BY HOSTING HEALTH EDUCATION AND AWARENESS EVENTS IN PARTNERSHIP WITH PINEVILLE CROSSFIT. THEY PARTNERED WITH LMU-DCOM 3RD YEAR CORE ROTATION STUDENTS TO USE THE LAND BEHIND THE HOSPITAL PROFESSIONAL OFFICE BUILDING FOR A COMMUNITY GARDEN. FRESH FRUITS AND VEGETABLES ARE BEING DISTRIBUTED TO PATIENTS AT 3 OF OUR CLINICS. UPDATED CAFETERIA MENUS WERE IMPLANTED TO REFLECT A MORE HEALTH-CONSCIOUS MENU, OFTEN WITH PLANT-BASED OPTIONS AND LEAN PROTEIN MEALS. MIDDLESBORO ARH HOSPITAL LEADERSHIP STAFF HAVE VOLUNTEERED AT THE COOPERATIVE CHRISTIAN MINISTRY (CCM) MONTHLY FOOD GIVE-A-WAY, HELPING TO FILL FOOD BOXES AND LOAD THE FOOD BOXES INTO CARS.CULTURE OF HEALTH & HEALTHY LIFESTYLE EDUCATIONBECKLEY ARH HAS ADDRESSED THE CULTURE OF HEALTH & HEALTHY LIFESTYLE EDUCATION BY PROVIDING 1,165 STROKE ASSESSMENTS AT 17 COMMUNITY EVENTS, STARTING 5 BRAIN PROTECTOR PROGRAMS AT LOCAL SCHOOLS, HAVING MONTHLY SUPPORT GROUP MEETINGS, STARTING 7 HEART HEALTH EDUCATION PROGRAMS, 8 CANCER PREVENTION PRESENTATIONS, 2 DIABETES EDUCATION SESSIONS, 3 FREE CPR TRAININGS, BEGAN A NEW PARTNERSHIP WITH COALFIELD COALITION AND RALEIGH COUNTY COMMUNITY ACTION TO HOST ANNUAL HEALTH FAIRS, AND PROVIDED 19 FREE HEALTH SCREENING EVENTS WHICH PROVIDED 1,200 FREE SCREENINGS.HARLAN ARH HAS PROVIDED HEALTH EDUCATION, PREVENTATIVE SCREENINGS, AND DISEASE AWARENESS EVENTS BROADLY THROUGHOUT THE COMMUNITY FROM 2022-2024. THEY HAVE HOSTED QUARTERLY LUNCH AND LEARN PROGRAMS COVERING TOPICS SUCH AS CHOLESTEROL AND HEART DISEASE AND STROKE AWARENESS. THEY HAVE HAD 3 "WALK AND TALK" COMMUNITY EVENTS AND 4 FITNESS FAIR EVENTS AT HARLAN ELEMENTARY. THE HOST MONTHLY "MEDICAL EXPLORERS" CLASSROOM PRESENTATIONS A TWO MIDDLE SCHOOLS IN THE HARLAN AREA. THEY PURCHASED 2 MEDICAL INFLATABLES TO USE AT 20+ COMMUNITY EVENTS SINCE PURCHASING THEM VIA GRANT FUNDS RECEIVED. SINCE 2022, HAZARD ARH HAS HOSTED 20 EVENTS THAT SPECIFICALLY PROMOTE CANCER AWARENESS, TEACH ABOUT EARLY DETECTION, AND ENCOURAGE PREVENTATIVE LIFESTYLES. HOSTING 7 COLON CANCER SCREENING EVENTS, 7 COMMUNITY PRESENTATIONS ABOUT THE EARLY DETECTION OF LUNG CANCER AND LOW DOSE CT SCREENINGS PROVIDED BY THE ARH LUNG CANCER SCREENING PROGRAM MANAGER, HELD 4 BREAST CANCER AWARENESS LUNCHEONS OR DINNERS PROVIDED FREE OF COST TO THE COMMUNITY WITH BREAST CANCER SURVIVORS. THEY HELD 1 "MAMMS DAY OUT" MAMMOGRAM SCREENING EVENT AND 1 ORAL CANCER SCREENING EVENT IN PARTNERSHIP WITH UK SCHOOL OF DENTISTRY. SINCE 2022, HAZARD HAS ALSO HOSTED SEVERAL SUPPORT GROUPS AND INFORMATIONAL EVENTS COVERING THE TOPICS OF DIABETES PREVENTION AND MANAGEMENT, STROKE AND HEART HEALTH, NUTRITION AND FOOD INSECURITY AT HEALTH FAIRS AND IN LOCAL SCHOOLS. DURING THESE EVENTS 370 VACCINES WERE ADMINISTERED, AND 907 STROKE RISK SCREENINGS AND BLOOD PRESSURE CHECKS WERE COMPLETED.SINCE 2022, MIDDLESBORO ARH HAS EDUCATED OUR COMMUNITY ABOUT PREVENTION BY PROVIDING HEALTH EDUCATION AND DISEASE PREVENTION FOR IN-SCHOOL YOUTH BY HOSTING 6 STUDENT HEALTH FAIR EVENTS, INTRODUCING THE "LOVE YOUR LUNGS" INTERACTIVE EDUCATIONAL PROGRAM, PROVIDED "STOP THE BLEED" KITS AND TRAINING TO MIDDLESBORO HIGH SCHOOL TEACHERS, AND PARTNERED WITH COSMIC CAF, A LOCAL DOWNTOWN BUSINESS, FOR A CHILDREN'S READING PROGRAM. MIDDLESBORO HAS ALSO PROVIDED EDUCATION ABOUT HEALTHY LIFESTYLES AND DISEASE PREVENTION AND PROVIDED FREE OR LOW-COST PREVENTATIVE SCREENING OPPORTUNITIES. OPPORTUNITIES SUCH AS $50 MAMMOGRAM SPECIALS AND SATURDAY LUNG SCREENING EVENTS. MIDDLESBORO PARTNERED WITH KENTUCKY CANCER LINK TO PROVIDE FREE COLON CANCER SCREENING FIT KITS (FECAL IMMUNOCHEMICAL TESTS) TO THOSE QUALIFYING AT THE A "WALK-N-TALK" WITH DR. ROBERT THOMAS. MIDDLESBORO ARH ALSO PROVIDED HUNDREDS OF FREE KINDERGARTEN READINESS PHYSICALS AND FREE SPORTS PHYSICALS FOR ALL AGES EACH YEAR IN THE COMMUNITY.MORGAN COUNTY PARTNERED WITH MANY LOCAL EMPLOYERS TO PROVIDE EDUCATION AND SCREENING OPPORTUNITIES TO THEIR EMPLOYEES. THEY PARTNERED WITH APPHARVEST TO PROVIDE SCREENINGS AND EDUCATION TO THEIR GREENHOUSE FARMING EMPLOYEES THROUGHOUT 2023, INCLUDING SESSIONS ON DIABETES WITH A1C TESTING, HYDRATION, LUNG CANCER, HEART HEALTH, AND COLON CANCER PROVIDED FREE BIOMETRIC SCREENINGS FOR EMPLOYEES OF LICKING VALEY RECC, INCLUDING LAB WORK, BMI, STROKE RISK ASSESSMENTS, AND MORE HOSTED STROKE EDUCATION AND RISK ASSESSMENTS FOR EMPLOYEES OF MORGAN COUNTY WATER DISTRICT. THE FACILITY HOSTED A HEALTH FAIR AND SCREENING EVENT FOR EMPLOYEES OF GATEWAY COMMUNITY ACTION PROGRAM. MORGAN COUNTY HAS ALSO HOSTED SEVERAL SUPPORT GROUPS AND INFORMATIONAL EVENTS COVERING THE TOPICS OF DIABETES PREVENTION AND MANAGEMENT, STROKE AND HEART HEALTH, NUTRITION AND FOOD INSECURITY AT HEALTH FAIRS AND IN LOCAL SCHOOLS. DURING THESE EVENTS, 4 FREE COOKING CLASSES WERE HELD WITH GROCERY GIFT CARD INCENTIVES IN PARTNERSHIP WITH THE MORGAN COUNTY UK EXTENSION SERVICE AND IN COLLABORATION 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 ON AVERAGE 20 BOXES PER MONTH WERE DISTRIBUTED.THROUGHOUT THIS CHNA CYCLE, SUMMERS COUNTY ARH HAS IMPLEMENTED MANY PROGRAMS THAT ENCOURAGE LIFESTYLE CHANGE, HEALTHIER HABITS, AND PREVENTATIVE HEALTH. THEY HAVE PROVIDED 939 STROKE RISK ASSESSMENTS, 4 "BRAIN PROTECTOR" PROGRAM EVENTS, 7 PROGRAMS THAT HAVE CENTERED AROUND HEART HEALTH, 6 COMMUNITY CANCER PREVENTION PRESENTATIONS, AND 2 COMMUNITY DIABETES EDUCATION SESSIONS. THEY HAVE PARTNERED WITH THE SUMMERS COUNTY COMMISSION ON AGING TO HOST MONTHLY EDUCATION SESSIONS ON TOPICS SUCH AS DIABETES, HEART HEALTH, PREVENTATIVE CANCER SCREENINGS, PHYSICAL FITNESS, MENTAL HEALTH, AND NUTRITION. ANNUALLY PARTNERED WITH BOBCAT FITNESS CENTER FOR THE BIGGEST LOSER WEIGHT LOSS CHALLENGE TO ENCOURAGE COMMUNITY MEMBERS TO GET PHYSICALLY ACTIVE AND PROVIDED EMPLOYEES FREE GYM MEMBERSHIPS. SUMMERS ALSO SUPPORTED SPONSORSHIPS WITH REACHH FOR ANNUAL DAM RUN 5K AND AMERICAN HEART ASSOCIATION HEART WALKS.TUG VALLEY ARH HAS EDUCATED THE COMMUNITY ON HEALTHY CHOICES, PREVENTATIVE CARE, AND HEALTHCARE ACCESS AT COMMUNITY EVENTS SUCH AS COLON CANCER AWARENESS DAY IN 2022, IN WHICH STAFF, VISITORS, AND COMMUNITY WERE EDUCATED ON THE IMPORTANCE OF SCREENINGS, WARNING SIGNS, AND CANCER PREVENTION IN PARTNERSHIP WITH KENTUCKY CANCER PROGRAM. LUNG CANCER EDUCATION, VAPING EDUCATION, AND LOW DOSE CT INFORMATION WERE PROVIDED AT THE ANNUAL HILLBILLY DAYS FESTIVAL. FREE HEALTH SCREENINGS AND EDUCATION WERE PROVIDED AT COMMUNITY HEALTH FAIRS SUCH AS THE CHATTAROY CHURCH OF GOD HEALTH FAIR, GEARHEART ENERGY EMPLOYEE HEALTH FAIR, AND SOAR CAREER PATHWAYS FAIR. HOSTED HEART HEALTH DAY AT MINGO COUNTY SCHOOLS, IN WHICH FREE SCREENINGS AND EDUCATION WERE PROVIDED TO FACULTY AND STAFF. AN ARH HEART HEALTH FOOTBALL GAME - TUG VALLEY VS MINGO CENTRAL WAS HELD WHERE ATTENDEES WERE EDUCATED ABOUT HEART DISEASE PREVENTION. PART V, SECTION B, LINE 11 CONTINUED: WHITESBURG ARH HAS ADDRESSED FOOD INSECURITY AND THE NEED FOR NUTRITION EDUCATION BY 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 20 BOXES PER MONTH. THEY HAVE IMPLEMENTED A FARMER'S MARKET SCREENING PROGRAM IN WHICH SCREENING PARTICIPANTS RECEIVED A $10 VOUCHER TO SPEND FRESH PRODUCE, MEAT, BAKED GOODS, AND DAIRY ITEMS. IMPLEMENTED A 10-WEEK FARMER'S MARKET WALKING PROGRAM IN WHICH COMMUNITY MEMBERS COULD JOIN THE SATURDAY MORNING WALKING GROUP OR COMPLETE ONE MILE ON THEIR OWN TO RECEIVE A $10 VOUCHER REDEEMABLE DURING THE MARKET SEASON. ON AVERAGE, VOUCHERS WOULD BE GIVEN TO 25 PARTICIPANTS EACH SATURDAY. WHITESBURG HAS ALSO HOSTED SEVERAL SUPPORT GROUPS AND INFORMATIONAL EVENTS COVERING THE TOPICS OF DIABETES PREVENTION AND MANAGEMENT, STROKE AND HEART HEALTH, NUTRITION AND FOOD INSECURITY AT HEALTH FAIRS AND IN LOCAL SCHOOLS.SUBSTANCE USE DISORDERBECKLEY LAUNCHED A PEER SUPPORT PROGRAM IN 2022 AND HAS ENGAGED 3,801 PATIENTS AND COMPLETED 47,451 SBIRT SCREENINGS TO DATE. THE PEER RECOVERY COACHES AND COMMUNITY DEVELOPMENT STAFF HAVE HELD SEVERAL COMMUNITY EVENTS SUCH AS "REACH THE STREETS AND "HEALING APPALACHIA". THEY HAVE ALSO COLLABORATED WITH COMMUNITY PARTNERS TO RESUME WEEKLY ALCOHOLICS ANONYMOUS MEETINGS, BEGAN THE "CATCH MY BREATH" YOUTH VAPE PREVENTION PROGRAM, AND HELD 20 COMMUNITY EDUCATIONAL SESSIONS ON THE ADMINISTRATION OF NALOXONE.HARLAN HAS ENGAGED 763 PATIENTS WITH THEIR PEER SUPPORT PROGRAMS SINCE 2022, AND THEIR COACHES HAVE ALSO WORKED WITH COMMUNITY PARTNERS TO HOST COMMUNITY EVENTS FOCUSING ON SUBSTANCE USE DISORDERS AND DRUG PREVENTION.IN 2020, HAZARD ARH LAUNCHED THE PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY. TO DATE, THEY HAVE ENGAGED 2,157 PATIENTS AND HAVE ASSISTED 54 INDIVIDUALS WITH ATTAINING HOUSING OR EMPLOYMENT. PEER RECOVERY COACHES HAVE WORKED WITH COMMUNITY PARTNERS TO HOST MANY COMMUNITY EVENTS OVER THE PAST THREE YEARS AND HAVE DISTRIBUTED NALOXONE TO LOCAL BUSINESSES AND NEIGHBORHOODS.SINCE 2022, MCDOWELL ARH HAS ADDRESSED ADDICTION IN OUR COMMUNITY BY PROVIDING EMPLOYEES FREE ACCESS TO PELAGO SMOKING CESSATION APP AND IN-PERSON CESSATION SUPPORT IN OUR PHARMACIES SPONSORED OPERATION UNITE'S "SHOOT HOOPS, NOT DRUGS" PROGRAM, WHICH PROMOTES POSITIVE ACTIVITIES FOR LOCAL YOUTH WHILE PROVIDING EDUCATION ON DRUG PREVENTION COMMUNITY DEVELOPMENT CONDUCTED ANTI-VAPING PRESENTATIONS AT FLOYD CENTRAL HIGH SCHOOL AND THE FLOYD COUNTY BOARD OF EDUCATION PARTICIPATED IN MANY COMMUNITY COALITIONS THAT ADDRESS SUD IN OUR COMMUNITY, INCLUDING COMMUNITIES AGAINST DRUG ADDICTION, UK HEALING COMMUNITIES IMITATIVE, AND ASAP/UNITE COALITION.MORGAN COUNTY ARH HAS ADDRESSED ADDICTION IN OUR COMMUNITY BY PARTNERING WITH THE KY DEPARTMENT OF PUBLIC HEALTH TO HOST NUMEROUS "SAFE A LIFE ROADSHOW" EVENTS, IN WHICH PARTICIPANTS ARE PROVIDED WITH OVERDOSE AWARENESS EDUCATION, NARCAN TRAINING AND DISTRIBUTION, AND REFERRALS TO TREATMENT. SPONSORED OPERATION UNITE'S "SHOOT HOOPS, NOT DRUGS" PROGRAM, WHICH PROMOTES POSITIVE ACTIVITIES FOR LOCAL YOUTH WHILE PROVIDING EDUCATION ON DRUG PREVENTION AND BEGAN THE "LOVE YOUR LUNGS", AN EDUCATIONAL PROGRAM ON THE DANGERS OF SMOKING AND VAPING, AT MORGAN COUNTY MIDDLE SCHOOL.SINCE 2022, WHITESBURG ARH HAS LAUNCHED THE PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY. TO DATE, THEY HAVE ENGAGED 406 PATIENTS. PEER RECOVERY COACHES HAVE WORKED WITH COMMUNITY PARTNERS TO HOST MANY SUBSTANCE USE DISORDER OR DRUG PREVENTION COMMUNITY EVENTS OVER THE PAST THREE YEARS. ARH PEER SUPPORT COACHES AND COMMUNITY DEVELOPMENT STAFF ALSO SERVE ON MANY COALITIONS, BOARDS, AND COUNCILS THAT WORK TO CREATE DRUG-FREE COMMUNITIES. THESE INCLUDE OPERATION UNITE COALITION, AGENCIES FOR SUBSTANCE ABUSE PREVENTION, HEAL COMMITTEE, AND SITUATION TABLE.AGING IN PLACE AND OTHER SENIOR-ORIENTED SERVICESHARLAN HAS ADDRESSED THIS CONCERN BY CONDUCTING A SURVEY IN PARTNERSHIP WITH THE HARLAN COUNTY COMMITTEE ON AGING TO GAUGE THE LEVEL OF INTEREST IN A VARIETY OF HEALTH TOPICS. THE RESULTS OF THE SURVEY WERE USED BY ARH TO SCHEDULE A MONTHLY ROTATION OF EDUCATIONAL PROGRAMS AT THEIR MAIN CONGREGATE CENTER IN HARLAN. FREE HEALTH SCREENINGS AND HEALTH FAIRS WERE ALSO PROVIDED WITH TRANSPORTATION BEING PROVIDED TO CLIENTS WHO ARE UNABLE TO DRIVE THEMSELVES.BUILD AND EXPAND CAPACITY OF HEALTH CONSORTIUMSINCE 2022, MCDOWELL ARH HAS INCREASED COMMUNITY, PROVIDER, AND PARTNER KNOWLEDGE OF SERVICES AVAILABLE BY CREATING SERVICE FLYERS THAT INCLUDE ALL MCDOWELL ARH CLINICS, SPECIALTIES, AND PROVIDERS. UPDATED THE OVERALL ARH WEBSITE WITH A NEW KYRUUS SYSTEM THAT ALLOWS FOR MORE ACCURACY AND DEEPER SEARCH WHEN RESEARCHING PROVIDERS AND LOCATIONS. INCREASED PRESENCE BY CONTRACTING 14 BILLBOARDS IN FLOYD COUNTY AND 3 IN THE IMMEDIATE COMMUNITY OF MCDOWELL. ON SOCIAL MEDIA, POSTED AT LEAST 1X PER WEEK ABOUT SERVICES AVAILABLE IN THE BIG SANDY REGION AND AT LEAST 2X A WEEK ABOUT HEALTH EDUCATION TOPICS (URGING ROUTINE HEALTHCARE, DISEASE PREVALENCE, ETC.). ADDED LARGE INFORMATIONAL MONITORS TO OUR CLINICS AND IN THE HOSPITAL'S MAIN LOBBY THAT PLAY ARH SERVICE COMMERCIALS AND VIDEOS ONLY. ORGANIZED 17 PROVIDER VISITS TO MCDOWELL FROM OTHER SERVICE REGIONS (VISITS COORDINATED BY PHYSICIAN LIAISONS TO INCREASE PROVIDER KNOWLEDGE) IN WHICH THE PHYSICIAN LIAISON MADE VISITS TO MCDOWELL PROVIDERS 3 TIMES PER MONTH.TUG VALLEY ARH HAS ADDRESSED COMMUNICATION BY ACTIVELY PARTICIPATING IN 10 COUNCILS, COALITIONS, AND BOARDS IN PIKE AND MINGO COUNTIES SINCE 2022. THESE GROUPS WORK TO BETTER THE HEALTH AND WELLNESS OF APPALACHIANS BUT MAY ALSO HAVE COMMUNITY BETTERMENT AND ECONOMIC DEVELOPMENT GOALS. SIMILAR TO THE OTHER FACILITIES IN THE ARH COMPANY, IN AN EFFORT TO INCREASE PROVIDER AND COMMUNITY KNOWLEDGE OF SERVICES AVAILABLE, TUG VALLEY ARH HAS CREATED SERVICE FLYERS THAT INCLUDE ALL TUG VALLEY ARH CLINICS, SPECIALTIES, AND PROVIDERS. THEY HAVE UPDATED THE OVERALL ARH WEBSITE WITH A NEW KYRUUS SYSTEM THAT ALLOWS FOR MORE ACCURACY AND DEEPER SEARCH WHEN RESEARCHING PROVIDERS AND LOCATIONS ON SOCIAL MEDIA, POSTED AT LEAST 1X PER WEEK ABOUT SERVICES AVAILABLE IN THE BIG SANDY REGION AND AT LEAST 2X A WEEK ABOUT HEALTH EDUCATION TOPICS (URGING ROUTINE HEALTHCARE, DISEASE PREVALENCE, ETC.). ADDED LARGE INFORMATIONAL MONITORS TO OUR CLINICS AND IN THE HOSPITAL'S MAIN LOBBY THAT PLAY ARH SERVICE COMMERCIALS AND VIDEOS ONLY. PHYSICIAN LIAISON MADE VISITS TO TUG VALLEY PROVIDERS 3 TIMES PER MONTH.BETTER ACCESS TO CARESINCE 2022, MCDOWELL ARH HAS INCREASED ACCESS TO CARE BY RECRUITING TWO ADDITIONAL PRIMARY CARE PROVIDERS: KIM MOSELY, DO, AND APRIL PRATER, APRN. EXTENDED HOURS OF THE AFTER-HOURS CLINIC FROM 8AM-8PM SEVEN DAYS PER WEEK. BECAME ACCREDITED AS AN ACUTE STROKE READY HOSPITAL AND INCREASED CAPACITY AND VOLUME OF THE SWING BED PROGRAM, KEEPING PATIENTS CLOSER TO HOME FOR LONGER-TERM CARE.SINCE 2022, MIDDLESBORO ARH HAS INCREASED ACCESS TO HEALTHCARE IN OUR COMMUNITY BY RECRUITING PROVIDERS, OPENING NEW SPECIALTY CLINICS, INVESTING IN FACILITIES, AND IMPROVING SERVICES. PROJECTS COMPLETED IN THIS TIME FRAME INCLUDE THE DEVELOPMENT OF PRE-ADMISSION TESTING PROGRAM TO DECREASE SURGERY NO-SHOW RATE AND PATIENT TRAVEL, OPENING OF A NEW UROLOGY SERVICE LINE IN 2022 IN PARTNERSHIP WITH DR. JOE PAZONA (VIRTUCARE) AND BRANDON WILIAMS, APRN, OFFERING BOTH TELEHEALTH AND IN-PERSON VISITS, THE OPENING OF A SPECIALTY PHARMACY, PROVIDING EASIER ACCESS FOR PATIENTS IN NEED OF SPECIALTY MEDICATIONS, SERVICES, AND COST REDUCTION PROGRAMS. MIDDLESBORO ALSO OPENED A NEW ARH WOUND CARE CENTER IN THE FACILITY, WHICH INCLUDES HYPERBARIC THERAPY IN MAY 2024. THEY IMPLEMENTED MINIMALLY INVASIVE ROBOTIC SURGERY WITH A NEW DAVINCI ROBOT. SIX PROVIDERS HAVE BEEN TRAINED ON ROBOTIC SURGERY, AND SINCE INCEPTION IN APRIL 2024 AND THROUGH FEBRUARY 2025, 156 CASES HAVE BEEN SUCCESSFULLY PERFORMED SINCE THE INCEPTION OF THIS PROGRAM. HOSTED NURSE TRAININGS IN TRAUMA AND PEDIATRIC EMERGENCIES FOR ALL ER STAFF IN AN EFFORT TO BECOME PEDIATRIC EMERGENCY READY. THEY IMPLEMENTED "QUICK DRAW" LABORATORY SITES, OR OFFSITE LABORATORY PHLEBOTOMY STATIONS PRIMARILY LOCATED IN PHYSICIAN OFFICES, SO PATIENTS CAN RECEIVE LAB DRAWS AND OTHER TESTING SERVICES WITHOUT HAVING TO TRAVEL TO A HOSPITAL FACILITY. ADDITIONALLY, THEY HAVE CONTRACTED WITH THE CUMBERLAND RIVER RHOAR CENTER (A 100- BED WOMEN'S INPATIENT DRUG TREATMENT PROGRAM) TO PROVIDE WELL WOMEN CARE ALONG WITH MOUD THERAPY. PART V, SECTION B, LINE 11 CONTINUED: SUMMERS COUNTY ARH HAS IMPROVED ACCESS TO HEALTHCARE BY ADDING ONE PRIMARY CARE PHYSICIAN. THEY HAVE ADDED ORTHOPEDIC SERVICES AND INCREASED MENTAL HEALTH SERVICES AVAILABLE THROUGH TELEPSYCHIATRY. SUMMERS OPENED A SENIOR CARE PROGRAM TO PROVIDE OLDER ADULTS WITH QUALITY BEHAVIORAL HEALTHCARE AND EXTENDED PRIMARY CARE CLINIC HOURS. THEY HAVE BOASTED A RETENTION RATE OF 98%, BUILDING A COMMUNITY OF TRUST BY RETAINING PROVIDERS AND EMPLOYEES.TUG VALLEY ARH HAS PROMOTED ACCESS TO CARE BY RECRUITING MANY NEW PROVIDERS SINCE 2022 IN AN EFFORT TO INCREASE ACCESS TO CARE FOR OUR PATIENTS. IN AN EFFORT TO DECREASE TRAVEL FOR PATIENTS IN NEED OF TESTING OR SPECIALTY SERVICES, TUG VALLEY ARH HAS ADDED: AN ENDOFLIP IMPEDANCE PLANIMETRY SYSTEM (TESTING FOR GASTRIC MOTILITY AND ACIDITY), SITE-RITE ULTRASOUND SYSTEM (ALLOWING FOR PICC LINE INSERTIONS), WOUND CARE/HYPERBARIC CHAMBER, DIGITAL 3D MAMMOGRAM, PFT MACHINE, MOBILE PET SERVICES, AND NEW TESTING FOR HEP C, GGT, PROCAL. THEY HAVE UPDATED THEIR LAB ANALYZERS FOR QUICKER LAB TURNAROUND TIMES FOR COVID/FLU/RSV AND ADDED MYCOPLASMA PNEUMONIA TESTING. OTHER EFFORTS TO INCREASE ACCESS TO CARE INCLUDE PROVIDING PATIENT TRANSPORTATION ASSISTANCE AND EXTENDED HOURS FOR OUR AFTER-HOURS CLINICS.WHITESBURG ARH HAS IMPROVED ACCESS TO CARE IN OUR COMMUNITY BY ADDING NEW SERVICES SINCE 2022: 3D MAMMOGRAPHY, NEW NUCLEAR SCANNER, UPGRADED THEIR CT UNIT WITH MORE TEST CAPABILITY. THEY ADDED PAIN MANAGEMENT PROGRAM WITH PAIN MANAGEMENT NP, IMPLEMENTED SWING BEDS PROGRAM FOR PATIENTS THAT NEED EXTENDED RECOVERY TIME, AND ADDED ADDITIONAL SPEECH LANGUAGE PATHOLOGIST AND OCCUPATIONAL THERAPIST. THEY HAVE EXPANDED SURGERY OFFERING TO INCLUDE PODIATRY AND HAVE EXPANDED DAYS FOR CATARACT SURGERY. WHITESBURG ARH HAS ALSO EARNED ACUTE STROKE READY CENTER CERTIFICATION AS OF FEB 2022. 76 1 - HARLAN ARH HOSPITAL PSYCHIATRIC SERVICE 81 BALL PARK ROAD HARLAN KY 40831 PSYCH 2 - ARH PSYCHIATRIC CENTER-HAZARD 102 MEDICAL CENTER DRIVE HAZARD KY 41701 PSYCH 3 - ARH HAZARD FAMILY HEALTH SERVICES 200 MEDICAL CENTER DRIVE HAZARD KY 417019466 CLINIC 4 - ARH DANIEL BOONE CLINIC - HARLAN 37 BALL PARK ROAD HARLAN KY 408311701 RURAL HEALTH CLINIC 5 - ARH WHITESBURG SURGICAL CLINIC 214 HOSPITAL ROAD STE A WHITESBURG KY 418587627 CLINIC 6 - ARH TUG VALLEY MEDICAL ASSOCIATES 306 HOSPITAL DRIVE SOUTH WILLIAMSON KY 415034095 RURAL HEALTH CLINIC 7 - ARH MIDDLESBORO INTERNAL MEDICINE 3004 CUMBERLAND AVE SUITE 3 MIDDLESBORO KY 409652343 CLINIC 8 - ARH WHITESBURG CLINIC 214 HOSPITAL ROAD WHITESBURG KY 418587627 RURAL HEALTH CLINIC 9 - HAZARD ARH REGIONAL MEDICAL CENTER CLINI 200 MEDICAL CENTER DRIVE HAZARD KY 41701 PHARMACY 10 - HARLAN ARH OUTPATIENT PHARMACY 37 BALL PARK ROAD HARLAN KY 40831 PHARMACY 11 - HAZARD ARH HOME HEALTH AGENCY 100 AIRPORT GARDENS ROAD HAZARD KY 41701 HOME HEALTH 12 - ARH COMMUNITY PHARMACY 210 BLACK GOLD BLVD SUITE 104 HAZARD KY 41701 PHARMACY 13 - ARH HAZARD HOMECARE STORE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 HOME HEALTH CARE 14 - ARH WILLIAMSON HOMECARE STORE 140 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 HOME HEALTH CARE 15 - ARH HARLAN HOMECARE STORE 106 RAILROAD STREET SUITE 5 HARLAN KY 40831 HOME HEALTH CARE 16 - ARH PRESCRIPTION DIVISION 306 HOSPITAL DRIVE SUITE 105 SOUTH WILLIAMSON KY 41503 PHARMACY 17 - WHITESBURG ARH HOME HEALTH AGENCY 240 HOSPITAL ROAD WHITESBURG KY 41858 HOME HEALTH 18 - BECKLEY ARH HOME HEALTH AGENCY 306 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH 19 - MORGAN COUNTY ARH HOME HEALTH AGENCY 518 MAIN STREET STE 1 WEST LIBERTY KY 41472 HOME HEALTH 20 - ARH WOMEN'S AND FAMILY HEALTH CARE - TUG 26901 US HIGHWAY 119N BELFRY KY 415147520 PRIMARY CARE CLINIC 21 - ARH TRI-CITY MEDICAL CENTER 18880 NORTH US 119 CUMBERLAND KY 408238106 RURAL HEALTH CLINIC 22 - BECKLEY ARH PHARMACY 250 STANAFORD ROAD BECKLEY WV 25801 PHARMACY 23 - HARLAN ARH HOME HEALTH AGENCY 81 BALL PARK ROAD HARLAN KY 40831 HOME HEALTH 24 - ARH SUMMERS COUNTY RURAL HEALTH CLINIC 115 SUMMERS HOSPITAL ROAD HINTON WV 25951 RURAL HEALTH CLINIC 25 - ARH BECKLEY HOMECARE STORE 260 STANAFORD ROAD BECKLEY WV 25801 HOME HEALTH CARE 26 - ARH FAMILY HEALTH PHARMACY 1084 HWY 7 STE 3 WEST LIBERTY KY 41472 PHARMACY 27 - PIKEVILLE BRANCH-ARH PIKE CO HOME HEALTH 247 SOUTH MAYO TRAIL PIKEVILLE KY 41502 HOME HEALTH 28 - ARH MCDOWELL PROFESSIONAL CLINIC 9879 KY RT 122 MCDOWELL KY 416476042 RURAL HEALTH CLINIC 29 - WHITESBURG ARH PHARMACY 240 HOSPITAL ROAD WHITESBURG KY 41858 PHARMACY 30 - MIDDLESBORO ARH PHARMACY 3600 WEST CUMBERLAND AVENUE MIDDLESBORO KY 40965 PHARMACY 31 - MIDDLESBORO ARH HOME HEALTH AGENCY 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH 32 - ARH MIDDLESBORO HOMECARE STORE 1916 CUMBERLAND AVENUE MIDDLESBORO KY 40965 HOME HEALTH CARE 33 - ARH SPECIALITY PHARMACY 200 MEDICAL CENTER DR HAZARD KY 41701 PHARMACY 34 - ARH FAMILY CARE WAYLAND 2662 KING KELLY COLEMAN HWY WAYLAND KY 416669998 PRIMARY CARE CLINIC 35 - ARH FAMILY CARE - WHEELWRIGHT 30 KY RT 306 BYPRO KY 416129706 PRIMARY CARE CLINIC 36 - JENKINS ARH FAMILY CARE 9480 HIGHWAY 805 JENKINS KY 415378182 PRIMARY CARE CLINIC 37 - ARH BARIATRIC CENTER 210 BLACK GOLD BOULEVARD SUITE 102 HAZARD KY 417012620 CLINIC 38 - ARH SYSTEM CENTER-HAZARD 100 AIRPORT GARDENS ROAD HAZARD KY 41701 SUPPORT 39 - ARH SYSTEM CENTER-LEXINGTON 2260 EXECUTIVE DR LEXINGTON KY 40505 SUPPORT 40 - ARH SYSTEM CENTER-LEXINGTON JORDAN BUIL 1218 SOUTH BROADWAY LEXINGTON KY 40504 SUPPORT 41 - ARH SYSTEM CENTER-SOUTH WILLIAMSON 260 HOSPITAL DRIVE SOUTH WILLIAMSON KY 41503 SUPPORT 42 - ARH REGIONAL DISTRIBUTION CENTER 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 43 - DME WAREHOUSE 26901 US HIGHWAY 119N BELFRY KY 41514 SUPPORT 44 - ARH SOUTHERN WEST VIRGINIA CLINIC 250 STANAFORD ROAD BECKLEY WV 258013140 CLINIC 45 - MIDDLESBORO ARH PHYSICIAN CLINIC 3602 WEST CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 46 - ARH WOMEN'S AND FAMILY HEALTH CARE - MID 2004 W CUMBERLAND AVE MIDDLESBORO KY 409652614 CLINIC 47 - ARH CARDIOLOGY & ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 1J HAZARD KY 417019477 CLINIC 48 - ARH DERMATOLOGY 210 BLACK GOLD BLVD SUITE 211 HAZARD KY 41701 CLINIC 49 - ARH CARDIOLOGY ASSOCIATES - BECKLEY 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 50 - BECKLEY ARH PRIMARY CARE 250 STANFORD ROAD STE 104 BECKLEY WV 258013140 CLINIC 51 - ARH SPECIALTY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 100 SOUTH WILLIAMSON KY 415034095 CLINIC 52 - ARH SPECIALTY ASSOCIATES - WHITESBURG 214 HOSPITAL DR STE B WHITESBURG KY 418587627 CLINIC 53 - ARH CARDIOLOGY ASSOCIATES - WHITESBURG 226 MEDICAL PLAZA LN STE C WHITESBURG KY 418587425 CLINIC 54 - ARH CARDIOLOGY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 203 SOUTH WILLIAMSON KY 415034095 CLINIC 55 - ARH DERMATOLOGY MIDDLESBORO 2145 US HIGHWAY 25E MIDDLESBORO KY 409651874 CLINIC 56 - ARH OAK HILL PRIMARY CARE CENTER 223 MAPLE AVE OAK HILL WV 259013475 CLINIC 57 - ARH SPECIALTY ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 2M HAZARD KY 417019422 CLINIC 58 - ARH PENNINGTON GAP CLINIC 121 STACY DR PENNINGTON GAP VA 242779998 CLINIC 59 - BECKLEY ARH MEDICAL MALL 1256 N EISENHOWER DR BECKLEY WV 258013120 CLINIC 60 - SUMMERS CO ARH FAMILY CARE CLINIC 197 PLEASANT ST HINTON WV 259512540 CLINIC 61 - MIDDLESBORO ARH HEMATOLOGYONCOLOGY CLIN 3602 W CUMBERLAND AVE STE 104 MIDDLESBORO KY 409652614 CLINIC 62 - MORGAN COUNTY ARH FAMILY HEALTH 1084 HWY 7 STE 2 WEST LIBERTY KY 414727146 CLINIC 63 - ARH PRIMARY CARE - BECKLEY 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 64 - ARH BECKLEY GASTROENTEROLOGY 429 CARRIAGE DRIVE BECKLEY WV 25801 CLINIC 65 - ARH BECKLEY ONCOLOGY 250 STANAFORD ROAD BECKLEY WV 25801 CLINIC 66 - ARH HAZARD FAMILY CLINIC 181 ROY CAMPBELL DRIVE HAZARD KY 41701 CLINIC 67 - HAZARD MEDICAL MALL 210 BLACK GOLD BLVD STE 102 HAZARD KY 41701 MEDSPA 68 - ARH BECKLEY REJUVENATION CENTER 1256 N EISENHOWER DRIVE BECKLEY WV 25801 MEDSPA 69 - ARH MIDDLESBORO REJUVENATION CENTER 2145 HWY 25E MIDDLESBORO KY 40965 MEDSPA 70 - ARH HAZARD PHARMACY 181 ROY CAMPBELL DRIVE HAZARD KY 41701 PHARMACY 71 - ARH RETAIL PHARMACY 4845 KY RTE 321 PRESTONSBURG KY 41653 PHARMACY 72 - ARH MEDICAL & SPECIALTY ASSOCIATES - PRE 4851 KY ROUTE 321 PRESTONSBURG KY 41653 CLINIC 73 - ARH MED & SPEC ASSOC HAZARD 200 MEDICAL CENTER DRIVE HAZARD KY 41701 CLINIC 74 - ARH MED MALL FAMILY SPEC CLIN 210 BLACK GOLD BLVD HAZARD KY 41701 CLINIC 75 - ARH INTERVENTIONAL PAIN MGMT HEADACHE 200 MEDICAL CENTER DRIVE HAZARD KY 41701 CLINIC 76 - ARH MEDICAL & SPECIALTY ASSOCIATES - PRE 4851 KY RT 321 SUITES 101 AND 102 PRESTONBURG KY 41653 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: JUST AS IT HAS FOR THE PAST SEVEN DECADES, APPALACHIAN REGIONAL HEALTHCARE (ARH) REMAINED COMMITTED TO ITS MISSION TO PROVIDE THE PEOPLE OF CENTRAL APPALACHIA WITH THE HIGHEST QUALITY OF CARE IN 2025. WITH 14 HOSPITALS AS WELL CLINICS, HOME HEALTH AGENCIES, HOME MEDICAL EQUIPMENT STORES, PHARMACIES AND REHABILITATION SERVICES SPREAD ACROSS BOTH KENTUCKY AND WEST VIRGINIA, ARH AND ITS MORE THAN 6,000 EMPLOYEES AND 1,300 MEDICAL PROVIDERS IS ESSENTIAL TO THE LIVES OF THOSE WHO RESIDE IN CENTRAL APPALACHIA. ARH'S COMMITMENT TO EXCELLENCE WAS RECOGNIZED THROUGHOUT THE 2025 FISCAL YEAR WITH A VARIETY OF HONORS AND CERTIFICATIONS. THE ARH SYSTEM WAS NAMED TO FORBES' LIST OF AMERICA'S BEST-IN-STATE EMPLOYERS, SUMMERS COUNTY ARH, BARBOURVILLE ARH, MARY BRECKINRIDGE ARH, MCDOWELL ARH, AND TUG VALLEY ARH REGIONAL MEDICAL CENTER WERE ALL RECOGNIZED AS ACUTE STROKE READY CENTERS. WITH THOSE CERTIFICATIONS BESTOWED BY DNV, EACH OF ARH'S 14 HOSPITALS WERE OFFICIALLY STROKE CERTIFIED. BECKLEY AND SUMMERS COUNTY ARH RECEIVED SILVER HONORS FROM THE WEST VIRGINIA HOSPITAL ASSOCIATION AND SUMMERS COUNTY ARH RECEIVED THE WVHA GOVERNOR'S AWARD FOR OUTSTANDING SUPPORT OF TISSUE AND CORNEA DONATION. THREE ARH BIRTHING HOSPITALS: HAZARD ARH, HIGHLANDS ARH AND WHITESBURG ARH, RECEIVED THE KENTUCKY PERINATAL QUALITY COLLABORATIVE (KYPQC) AWARD FOR THE SECOND CONSECUTIVE YEAR. TWELVE ARH HOSPITALS WERE HONORED WITH AMERICAN HEART ASSOCIATION GET WITH THE GUIDELINES AWARDS FOR THEIR COMMITMENT TO THE TREATMENT OF STROKE. THE ARH SYSTEM'S HARD WORK ON THE TECHNICAL FRONT WAS AGAIN RECOGNIZED AS IT ACHIEVED A LEVEL 8 RANKING IN CHIME'S MOST WIRED HEALTH SYSTEMS FOR BOTH AMBULATORY AND ACUTE CARE FOR THE FIFTH CONSECUTIVE YEAR.ARH REMAINED COMMITTED TO WHOLE-PERSON HEALTHCARE IN 2025 FOCUSING NOT ONLY ON PROVIDING HIGH-QUALITY TRADITIONAL MEDICAL CARE, BUT ALSO MENTAL HEALTH CARE AND PREVENTATIVE CARE THROUGH SCREENINGS, VACCINATIONS, AND HEALTH EDUCATION. CENTRAL APPALACHIA IS A REGION RIDDLED WITH RESIDENTS BATTLING SUBSTANCE USE DISORDER. ARH RECOGNIZES ITS ROLE IN HELPING FIGHT THE DISEASE AND HAS PLACED PEER RECOVERY COACHES IN EACH HOSPITAL AS PART OF ITS REVERSE THE CYCLE PROGRAM. THOSE "PEERS," AS THEY ARE COMMONLY CALLED, MEET ER PATIENTS WHO SCREEN POSITIVE FOR RISKY ALCOHOL AND DRUG USE AND SHARE THEIR OWN STORIES OF SUBSTANCE USE AND RECOVERY, WHILE ALSO PROVIDING RESOURCES NEEDED TO HELP THEM AS THEY EMBARK ON THEIR RECOVERY JOURNEYS. THOSE EFFORTS WERE RECOGNIZED IN 2025 AS ARH WAS NAMED ONE OF THREE NATIONAL RECIPIENTS OF THE MOSAIC GROUP'S BEACON OF HOPE TRAILBLAZER AWARD.THE SYSTEM DEEPLY INVESTED IN THE FOOD IS MEDICINE (FIM) INITIATIVE, PARTNERING WITH BOTH THE KENTUCKY AND WEST VIRGINIA DEPARTMENTS OF AGRICULTURE. THROUGH THE PARTNERSHIPS, ARH IS WORKING WITH LEADERS IN BOTH STATES TO HELP GROW THE PROGRAM DESIGNED TO HELP THOSE IN CENTRAL APPALACHIA CHANGE THEIR HEALTH THROUGH NUTRITION. POSITIVE HEALTH CHANGES IN THOSE ARH SERVES IS THE ULTIMATE GOAL OF EVERY SERVICE THE SYSTEM PROVIDES, AND ITS EFFORTS WITH FIM WERE RECOGNIZED AS IT RECEIVED THE 2025 SHAPING OUR APPALACHIAN REGION (SOAR) HEALTH COMMUNITIES AWARD. ARH REMAINED DEEPLY COMMITTED TO HELPING ALLEVIATE FOOD INSECURITY IN 2025. THROUGH DELIVERIES OF FOOD BOXES TO PARTNERSHIPS WITH THE ORGANIZATIONS SUCH AS GOD'S PANTRY, ARH AND ITS COMMUNITY DEVELOPMENT TEAM CONTINUED ITS MISSION TO PROVIDE FOOD TO THOSE IN NEED. ARH SUPPORTED GOD'S PANTRY'S TELETHON FOR HUNGER ACTION MONTH BY PRESENTING A $100,000 MATCHING DONATION. THE DONATION WAS PART OF THE SYSTEM'S $200,000 SPONSORSHIP OF THE GOD'S PANTRY RESCUE PROGRAM. THE PARTNERSHIP PROVIDES TWO ARH AND GOD'S PANTRY CO-BRANDED VANS THAT TRAVEL TO AREA RETAILERS TO COLLECT EXCESS FOOD FOR DISTRIBUTION TO THOSE IN NEED.ARH WAS AWARDED A $500,000 PLANNING GRANT FROM THE APPALACHIAN REGIONAL COMMISSION'S (ARC) ARISE INITIATIVE. THE FUNDING IS PART OF A LARGER $33.5 MILLION PACKAGE ANNOUNCED BY ARC FEDERAL CO-CHAIR GAYLE MANCHIN IN NOVEMBER. ARISE (APPALACHIAN REGIONAL INITIATIVE FOR STRONGER ECONOMIES) WAS ESTABLISHED TO DRIVE LARGE-SCALE, REGIONAL ECONOMIC TRANSFORMATION THROUGH COLLABORATIVE PROJECTS. ARH WILL USE ARISE FUNDING TO ESTABLISH A HEALTHIER CENTRAL APPALACHIA TASK FORCE (HCAT) IN COLLABORATION WITH 15 PARTNERS IN KENTUCKY, TENNESSEE, VIRGINIA, AND WEST VIRGINIA. THE GRANT PROVIDES FUNDING FOR A COMMUNITY SCREEN TEAM THAT WILL PROVIDE CARE THROUGHOUT A 29-COUNTY AREA.THE ARH MOBILE CLINIC, DESIGNED TO EXPAND MEDICAL CARE TO THOSE WHO MIGHT STRUGGLE WITH TRAVELING TO A CLINIC OR DOCTOR'S OFFICE, WAS LAUNCHED IN 2025. THE UNIT, MADE POSSIBLE BY A $400,000 GRANT FROM THE APPALACHIAN REGIONAL COMMISSION (ARC), PROVIDES PRIMARY CARE, HEALTH SCREENINGS, PHYSICAL EXAMS, CHRONIC DISEASE MANAGEMENT AND EDUCATION IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA. ADDITIONALLY, A PARTNERSHIP WITH THE MARTIN HEALTH DEPARTMENT WILL ALLOW THE CLINIC TO PARK ON ITS CAMPUS ONE DAY EVERY MONTH AS AN ARH PROVIDER OFFERS WOMEN'S HEALTH SERVICES. A VARIETY OF EDUCATIONAL AND SCREENING EVENTS TOOK PLACE ACROSS THE SYSTEM THROUGHOUT FY2025. EACH YEAR, ARH'S COMMUNITY DEVELOPMENT DEPARTMENT AND STAFF AT EACH FACILITY, EDUCATE HUNDREDS OF WOMEN AND MEN ABOUT BREAST CANCER AND EARLY DETECTION, WHILE ALSO PROMOTING THE SYSTEM'S ANNUAL OCTOBER $50 MAMMOGRAM SPECIAL. ADDITIONALLY, EVENTS FEATURING LUNCH AND DINNER AS WELL AS CANCER EDUCATION AND SURVIVOR STORIES TOOK PLACE IN BOTH BECKLEY AND HAZARD. BREAST CANCER/PHYSICAL ACTIVITIES TOOK PLACE IN PRESTONSBURG, BARBOURVILLE AND BELL COUNTY, AND BREAST CANCER AWARENESS LUNCHEONS FOR TEACHERS TOOK PLACE AT TWO KENTUCKY ELEMENTARY SCHOOLS. ARH CONTINUED TO PROVIDE MONTHLY STROKE AND DIABETES SUPPORT GROUP THROUGHOUT THE SYSTEM AND THE COMMUNITY DEVELOPMENT TEAM STAYED ACTIVE IN THE PUBLIC, ATTENDING AND ORGANIZING HEALTH FAIRS, HOSTING WEEKLY AND MONTHLY EDUCATION EVENTS AT SENIOR CENTERS AND OTHER PUBLIC FORUMS, AND VISITING LOCAL SCHOOLS TO EDUCATE STUDENTS ON TOPICS RANGING FROM STROKE AWARENESS TO HANDS-ONLY CPR, BRAIN DISEASE AND THE IMPORTANCE OF ABSTAINING FROM NICOTINE AND ALCOHOL USE. TO HELP NOT ONLY THOSE DIAGNOSED WITH DEMENTIA BUT THEIR FAMILIES WHO ARE OFTEN THEIR DAILY CAREGIVERS, ARH LAUNCHED ITS MEMORY CARE PROGRAM IN 2025. THE PROGRAM, WHICH IS PART OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) NEW GUIDE (GUIDING AN IMPROVED DEMENTIA EXPERIENCE) MODEL, PROVIDES A DEDICATED CARE TEAM AND NURSE TO DEMENTIA PATIENTS AND THEIR FAMILIES. BECAUSE CAREGIVERS ARE OFTEN SOCIALLY ISOLATED AND ARE AT A HIGHER RISK FOR DEVELOPING THEIR OWN HEALTH ISSUES, THE PROGRAM PROVIDES THEM WITH EDUCATIONAL SUPPORT AS WELL AS RESPITE SERVICES.CONTINUED INVESTMENTS WERE MADE ACROSS THE SYSTEM INCLUDING ADDITIONAL DAVINCI ROBOTS AND THE IMPLANTATION OF AN ION ROBOT FOR RECOGNITION OF EARLY LUNG DISEASE, AS WELL AS THE RETURN OF A CARDIOTHORACIC PROGRAM AT HAZARD ARH. BECKLEY ARH BECAME THE FIRST HOSPITAL IN THE SYSTEM TO OFFER AN MRI CARING SUITE, PROVIDING A RELAXING ENVIRONMENT USEFUL TO THOSE WHO EXPERIENCE TEST ANXIETY. EMPLOYEE HEALTH WAS ALSO AT THE FOREFRONT, AS SEVERAL HOSPITALS THROUGHOUT THE SYSTEM OPENED RELAXATION ROOMS TO PROVIDE A PRIVATE SPACE FOR STAFF MEMBERS TO TAKE BREAKS DURING THEIR STRESSFUL DAYS. SUMMERS COUNTY ARH OPENED AN EXERCISE TRAIL FOR HOSPITAL STAFF AND COMMUNITY MEMBERS, AND BARBOURVILLE ARH SECURED FUNDING FOR AN AUTISM TRAIL FEATURING OUTDOOR EXERCISE EQUIPMENT.FISCAL YEAR 2025 MARKED ANOTHER TRANSFORMATIVE YEAR FOR ARH. AS THE SYSTEM ENTERS ITS 70TH YEAR OF SERVICE, IT REMAINS COMMITTED TO ITS CORE VALUES AND TO PROVIDING THE HIGHEST QUALITY OF WHOLE PATIENT CARE, TO IMPROVE THE LIVES OF THOSE IN CENTRAL APPALACHIA. PART III, LINE 2: COSTING METHODOLOGY: 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 A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE CORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. PART III, LINE 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 $21 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 $21,363,379 (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 ARH'S FINANCIAL ASSISTANCE PROGRAM AND POLICY, EACH PATIENT WITHOUT MEDICAL COVERAGE FOR RENDERED SERVICES IS OFFERED A 40% DISCOUNT OF GROSS CHARGES AT TIME OF SERVICE. IF THE PATIENT EXTENDS PAYMENT AT TIME OF SERVICE THEY ARE GIVEN ANOTHER 10% DISCOUNT, MAKING THEIR LIABILITY 50% OF GROSS CHARGES. ALL OF THESE DISCOUNTS ARE APPLIED AT TIME OF CHARGE AND BILLED AFTER THE DISCOUNT IS TAKEN. IF SAID PATIENT IS UNABLE TO MEET THE FINANCIAL OBLIGATIONS FOR SERVICE, THEY ARE EDUCATED AND SCREENED FOR POTENTIAL FEDERAL AND/OR STATE ASSISTANCE PROGRAMS. BY DOING THIS, THE PATIENT IS REVIEWED AND EDUCATED BY ON-SITE FINANCIAL COUNSELORS AND/OR ELIGIBILITY AGENCY TO GET THE INDIVIDUAL PLACED IN A PROGRAM. BASED ON INCOME AND FAMILY STATUS, THE PATIENT IS SCREENED IN CONJUNCTION WITH THE FEDERAL AND STATE POVERTY GUIDELINES. AT THIS TIME, ALL APPLICATIONS ARE COMPLETED WITH THE ASSISTANCE OF ARH PERSONNEL AND SUBMITTED FOR APPROVAL. IN THE EVENT AN AGENCY REQUIRES THE PATIENT/GUARANTOR TO APPLY IN PERSON, THE INDIVIDUAL IS ASKED TO MAKE AN APPOINTMENT WITH THAT AGENCY AND FILE THEIR COMPLETED DOCUMENTS. IF THE RESPONSIBLE PARTY IS NOT ELIGIBLE FOR FEDERAL OR STATE ASSISTANCE, THEY ARE ADDITIONALLY SCREENED BY ARH FOR ELIGIBILITY INTO OUR INTERNAL SLIDING FEE SCHEDULE CHARITY PROGRAM FOR ADDITIONAL DISCOUNTS UP TO 100% OF GROSS CHARGES. IF THE PATIENT IS HELD RESPONSIBLE, ADDITIONAL EFFORTS TO ASSIST THE PATIENT ARE OFFERED BY OFFERING REASONABLE PAYMENT PLANS AND DEFERRED PAYMENTS. IN THE EVENT THE PATIENT/GUARANTOR DOES NOT MAKE A REASONABLE EFFORT TO COMPLETE NECESSARY DOCUMENTATION TO APPLY OR BECOME ELIGIBLE FOR A FINANCIAL ASSISTANCE PROGRAM, THEY ARE THEN STILL GIVEN THE INITIAL 40% DISCOUNT AND MOVED THROUGH THE NORMAL COLLECTION PROCESS. PART VI, LINE 4: 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 THESE ARH FACILITIES, NEARLY 600 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. FACILITIES IN ARH'S KY RIVER AND BIG SANDY REGIONS 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: $26,540,555 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 BECKLEY-RALEIGH COUNTY CHAMBER OF COMMERCE PO BOX 1798 BECKLEY WV 25802 550345563 501C6 5330 0 SUPPORT TO THE MISSION OF CHAMBER OF COMMERCE TO CHAMPION BUSINESS SUCCESS AND ADVANCE A STRONG, RESILIENT REGIONAL ECONOMY. BLACK GOLD COMMITTEE INC 221 MEMORIAL DRIVE HAZARD KY 41701 753036575 501C4 5500 0 TO PROMOTE COMMUNITY INVOLVEMENT, TOURISM, AND DEVELOPMENT OF SMALL BUSINESSES. KENTUCKY CHAMBER OF COMMERCE 464 CHENAULT ROAD FRANKFORT KY 40601 610405718 501C6 32950 0 SUPPORT TO THE MISSION OF THE CHAMBER OF COMMERCE TO BUILD AND PROTECT A PROSPEROUS BUSINESS CLIMATE IN THE COMMONWEALTH OF KY. BELFRY HIGH SCHOOL ATHLETIC FACILITIES BOOSTER INC PO BOX 381 BELFRY KY 41514 830946179 501C3 9050 0 TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUTH LETCHER COUNTY CENTRAL 435 COUGAR DRIVE WHITESBURG KY 41858 616001375 GOVT 6000 0 TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUTH MOUNTAIN PERFORMING ARTS INC 50 HAL ROGERS DRIVE PRESTONSBURG KY 41653 834107663 501C3 20000 0 TO SUPPORT THE MISSION OF THE ORGANIZATION THAT PROMOTES THE RICH CULTURAL HERITAGE AND ARTISTIC EXPRESSIONS OF THE APPALACHIAN REGION. CITY OF HINTON SANITARY BOARD 322 SUMMERS STREET HINTON WV 25951 556000185 GOVT 18000 0 FITNESS CENTER SPONSORSHIP FOR EMPLOYEES TO PROMOTE AN ACTIVE, HEALTHY LIFESTYLE. JMI SPORTS KENTUCKY LLC PO BOX 645388 CINCINNATI OH 45264 364803508 232691 0 SPONSORSHIP FOR THE UNIVERSITY OF KENTUCKY ATHLETICS PROGRAM TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUNG ADULTS SHAPING OUR APPALACHIAN REGION INC 137 MAIN STREET SUITE 300 PIKEVILLE KY 41501 371760428 501C3 78958 0 PARTNERSHIP WITH ORGANIZATION TO EXPAND JOB CREATION, ENHANCE REGIONAL OPPORTUNITY, INNOVATION, AND QUALITY OF LIFE. COWEN COMMUNITY ACTION GROUP INC 81 STURGILL BRANCH WHITESBURG KY 41858 611396831 501C3 15000 0 SUPPORT A SUMMER CONCERT SERIES IN OUR SERVICE AREA THAT WILL ENCOURAGE TOURISM AND COMMUNITY INVOLVEMENT THROUGH MUSIC PERRY COUNTY SCHOOL DISTRICT 315 PARK AVENUE HAZARD KY 41701 616001294 GOVT 10950 0 TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUTH FAYETTE ALLIANCE FOUNDATION INC 603 WEST SHORT STREET LEXINGTON KY 40508 472128336 501C3 5800 0 SPONSORSHIP BENEFIT TO THE FAYETTE ALLIANCE FOUNDATION AND UK MARKEY CANCER FOUNDATION, FURTHERING SUSTAINABLE GROWTH AND CANCER RESEARCH IN LEXINGTON. IHEART MEDIA 20880 SONE OAK PARKWAY SAN ANTONIO TX 78258 742722883 13000 0 SUPPORT FOR THE CARSON GRAHAM MUSIC DEPARTMENT WHICH SUPPORTS THE SCHOOL'S MUSIC PROGRAM AND TEACHERS BY FOSTERING A COLLABORATIVE COMMUNITY FOR PARENTS AND GUARDIANS. PRO CAMPS INC 10001 ALLIANCE RD STE 1 CINCINNATI OH 45242 812769448 25000 0 SUPPORT TO SCHOOL WHO PROVIDES A LEARNING ENVIRONMENT THAT EMPOWERS STUDENTS IN PRESCHOOL-12TH GRADE TO ACHIEVE ACADEMIC EXCELLENCE. SAYRE SCHOOL INC 194 N LIMESTONE LEXINGTON KY 40507 610449657 501C3 20000 0 SUPPORT TO SCHOOL WHO PROVIDES A LEARNING ENVIRONMENT THAT EMPOWERS STUDENTS IN PRESCHOOL-12TH GRADE TO ACHIEVE ACADEMIC EXCELLENCE. LEXINGTON SPORTING CLUB 810 BULL LEA RUN SUITE 300 LEXINGTON KY 40511 320682879 139750 0 TO SUPPORT THE DEVELOPMENT OF COMPLETE SOCCER PLAYERS AND TEAMS OF ALL LEVELS, FOSTERING A SAFE, WELCOMING ENVIRONMENT FOR GROWTH AND PERFORMANCE WHILE CONNECTING THE COMMUNITY THROUGH THE SPORT. HOPE IN THE HILLS INC PO BOX 9064 HUNTINGTON WV 25704 823221120 501C3 50000 0 SPONSORSHIP FOR ANNUAL CONCERT TO RAISE FUNDS AND AWARENESS TO THE OPIOD CRISIS AS WELL AS TO CELEBRATE ACHIEVEMENTS IN RECOVERY. 10 7 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. X X X 1 1 0 0 0 1 0 0 0 HOLLIE P HARRIS PRESIDENT/CEO 1125295 0 377829 0 653 0 93659 0 25153 0 1622589 0 0 0 ADNAN M BHOPALWALA CARDIOLOGIST 953557 0 298343 0 0 0 10350 0 43477 0 1305727 0 0 0 JAYARAMAKRISHNA DEPA NEPHROLOGIST 660776 0 219974 0 103750 0 15538 0 43477 0 1043515 0 0 0 TIMOTHY MICEK ORTHOPEDIC SURGEON 950810 0 0 0 12500 0 0 0 43477 0 1006787 0 0 0 SAMUEL BAILEY ONCOLOGIST 825283 0 0 0 23669 0 11228 0 43477 0 903657 0 0 0 CHAYAKRIT KRITTANAWONG INTERVENTIONAL CARDIOLOGIST 759141 0 85467 0 17958 0 0 0 13573 0 876139 0 0 0 PAUL BETZ COO (TERM 11/13/24) 539087 0 0 0 95071 0 59839 0 43477 0 737474 0 0 0 BYRON GABBARD CHIEF FINANCIAL OFFICER 512657 0 150857 0 737 0 60039 0 876 0 725166 0 0 0 MARIA BRAMAN CHIEF MEDICAL OFFICER 493415 0 137143 0 1181 0 45350 0 25153 0 702242 0 0 0 CHRISTI LEE CHIEF LEGAL COUNSEL 373233 0 109989 0 395 0 44599 0 25153 0 553369 0 0 0 SONYA BERGMAN CHIEF PEOPLE OFFICER 359047 0 109714 0 1733 0 45391 0 36338 0 552223 0 0 0 SCHEDULE J, PART I, LINE 4A PAUL BETZ RECEIVED SEVERANCE OF $300,000. SCHEDULE J, PART I, LINE 4B 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; MARIA BRAMAN - $12,000; BYRON GABBARD - $28,870; CHRISTI LEE - $5,070; SONYA BERGMAN - $5,000; PAUL BETZ- $31,552.50. SCHEDULE J, PART I, LINE 6 THE COMPENSATION AND CONTRACTS COMMITTEE OF THE ARH BOARD OF TRUSTEES ADOPTED A SHORT-TERM INCENTIVE COMPENSATION PROGRAM FOR EXECUTIVES IN SEPTEMBER 2002. THE PROGRAM ESTABLISHED INCENTIVES FOR ACHIEVING SYSTEM AND COMMUNITY OBJECTIVES FOR EXECUTIVE LEADERSHIP BY INTEGRATING THE PERFORMANCE MANAGEMENT AND EXECUTIVE COMPENSATION SYSTEMS. THE INCENTIVE THRESHOLDS HAVE BEEN MODIFIED ACROSS TIME TO REFLECT INCREASED PERFORMANCE EXPECTATIONS AS IDENTIFIED IN THE SYSTEM'S STRATEGIC, BUDGET AND OPERATIONS 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. A CITY OF HAZARD KY 616001839 2021-07-01 70075000 CAPITAL CONSTRUCTION OF FACILITIES IN WV, KY; REFUNDING. 0 0 0 A 4915000 70075000 873823 58638837 10562340 2021 1 0 1 1 A 0 0 0 0 0 0 1 A 1 0 0 0 0 0 A 1 GREG COUCH PRINCIPAL OWNER OF MERIDIAN WEALTH 590840 INVESTMENT COMPANY THAT MANAGES ARH RETIREMENT PORTFOLIO 0 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 OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 51,916,590. MANAGEMENT AND GENERAL EXPENSES 25,616,396. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 77,532,986. PROFESSIONAL FEES PHYSICIANS: PROGRAM SERVICE EXPENSES 44,510,853. MANAGEMENT AND GENERAL EXPENSES 449,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,960,457. PHYSICIAN STIPENDS: PROGRAM SERVICE EXPENSES 2,745. MANAGEMENT AND GENERAL EXPENSES 1,755. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,500. FORM 990, PART XI, LINE 9: NET PERIODIC PENSION GAIN 7,147,044. CHANGE IN PENSION PLAN ASSET AND OBLIGATION 11,412,167. NET CHANGE IN INVESTMENTS IN AFFILIATE 23,660. REVERSAL OF GRANT REVENUE RECOGNITION -115,508. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSEEING AND SELECTING INDEPENDENT AUDITORS HAS NOT CHANGED FROM THE 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. HAZARD ARH IMAGING CENTER LLC 210 BLACK GOLD BLVD HAZARD KY 41701 270755457 MEDICAL IMAGING SERVICES KY 0 1876365 APPALACHIAN REGIONAL HEALTHCARE INC CUMBERLAND VALLEY ARH CANCER CENTER LLC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 HEALTH CARE KY 0 0 APPALACHIAN REGIONAL HEALTHCARE INC WHITESBURG PHYSICIAN OFFICE BLDG LLC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 753022080 PHYSICAN OFFICE BUILDING KY 0 0 APPALACHIAN REGIONAL HEALTHCARE INC HOMETOWN FAMILY CARE PLLC 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 202470645 MEDICAL SERVICES KY 0 0 ARH TUG VALLEY HEALTH SERVICES INC APPALACHIAN HEALTH NETWORK 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 863247368 MEDICAL SERVICES KY 3165445 2993390 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 1 ARH MARY BRECKINRIDGE 2260 EXECUTIVE DR LEXINGTON KY 40505 452696517 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 ARH TUG VALLEY HEALTH SERVICES INC 2260 EXECUTIVE DR LEXINGTON KY 40505 822577178 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 ARH ADVANCED CARE INC 2260 EXECUTIVE DR LEXINGTON KY 40505 822421892 HEALTH CARE KY 501(C)(3) LINE 3 APPALACHIAN REGIONAL HEALTHCARE INC 1 HIGHLANDS HOSPITAL CORPORATION INC 2260 EXECUTIVE DR LEXINGTON KY 40505 610658773 HEALTH CARE KY 501(C)(3) LINE 3 ARH FOUNDATION FOR HEATHIER COMMUNITIES INC 1 HIGHLANDS MEDICAL PARTNERS II 2260 EXECUTIVE DRIVE LEXINGTON KY 40505 263714306 MEDICAL SERVICES. KY 0 0 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCIL 2260 EXECUTIVE DRIVE LEXINGTON KY 40504 201796044 OFFICE BUILDING MANAGEMENT KY APPALACHIAN REGIONAL HEALTHCARE C 0.83840 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0