TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) ELIZABETH WHITE DIRECTOR	1.0	X				0	0	0
(2) MARK SNYDER DIRECTOR	1.0	X				0	0	0
(3) SAMUEL FRIEDE DIRECTOR	1.0	X				0	0	0
(4) KAY OWEN DIRECTOR	1.0	X				0	35,563	0
(5) DONALD TYLINSKI EDD DIRECTOR	1.0	X				0	0	0
(6) HAROLD ALTMAN MD DIRECTOR/CHIEF MEDICAL OFFICER	40.0	X	X			282,489	0	17,620
(7) JOHN LEWIS PRESIDENT/CEO	40.0	X	X			336,324	0	38,103
(8) MEREDITH CHRISTY CHAIRMAN	1.0	X	X			0	0	0
(9) HELEN BURNS RN PHD DIRECTOR THROUGH 11/10	1.0	X				0	0	0
(10) CHASE MCCLISTER VICE CHAIRMAN	1.0	X	X			0	0	0
(11) RODERICK GROOMES MD PRES - MEDICAL STAFF	1.0	X				0	0	0
(12) JAMES RAMAGE DVM DIRECTOR	1.0	X				0	0	0
(13) VOLKER ZAUN SECRETARY/TREASURER	1.0	X	X			0	0	0
(14) PATRICK C BURNS CFO, VP OF FINANCE	40.0		X			201,005	0	30,194
(15) JEANNE GRAFF VP OF NURSING	40.0			X		151,207	0	19,118
(16) CURT CONRY MD PHYSICIAN	40.0				X	569,034	0	16,487
(17) MAUREEN RUSSELL MD PHYSICIAN	40.0				X	487,020	0	3,422

(A) Name and business address	(B) Description of services	(C) Compensation
CHILDREN'S COMMUNITY PEDIATRIC	PEDIATRIC	462,990
N PITTSBURGH ANESTHESIA ASSOC	ANESTHESIA	213,020
OXYGEN 8 PC	OXYGEN	241,676
FRG ACMH PC	RADIOLOGY	161,531
CENTRAL KITTANNING DIALYSIS CT	DIALYSIS	215,843
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 9

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	5,000	5,000
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,076,060	470,434	605,626
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	38,940,672	31,836,462	7,104,210
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	2,007,959	1,767,408	240,551
9	Other employee benefits .......	5,514,083	4,814,108	699,975
10	Payroll taxes ...........	3,077,628	2,660,384	417,244
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	316,595		316,595
c	Accounting ...........	108,552		108,552
d	Lobbying ...........	0
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	51,926		51,926
g	Other ..........	7,638,376	6,241,197	1,397,179
12	Advertising and promotion ....	355,546	6,376	349,170
13	Office expenses .......	6,209,936	4,586,373	1,623,563
14	Information technology ......	715,276	103,386	611,890
15	Royalties ..	0
16	Occupancy ...........	1,953,930	1,587,923	366,007
17	Travel ............	96,372	55,484	40,888
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	106,219	37,422	68,797
20	Interest ...........	265,861	224,221	41,640
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	5,215,561	4,398,679	816,882
23	Insurance ..............	982,292		982,292
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	BAD DEBT	3,231,869	3,231,869
b	LICENSES, DUES & SUBSCRIPTIONS	263,601	128,278	135,323
c	RECRUITING & RETENTION	58,224		58,224
d	MEDICAL SUPPLIES & DRUGS	11,959,202	11,959,202
e	FOOD EXPENSES	699,313	699,313
f	All other expenses	143,570	43,649	99,921
25	Total functional expenses. Add lines 1 through 24f	90,993,623	74,857,168	16,136,455	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	47,219	1	3,728
2	Savings and temporary cash investments .......	15,635,667	2	14,325,582
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	7,591,185	4	7,038,873
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............	127,915	7	49,354
8	Inventories for sale or use ..............	756,551	8	975,623
9	Prepaid expenses and deferred charges ............	1,268,131	9	1,363,783
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	106,583,406
b	Less: accumulated depreciation. .....	10b	84,383,771	22,345,977	10c	22,199,635
11	Investments—publicly traded securities ..........	8,206,387	11	9,586,331
12	Investments—other securities. See Part IV, line 11 ......	1,679,311	12	1,988,747
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	2,510,471	15	3,866,521
16	Total assets. Add lines 1 through 15 (must equal line 34)...	60,168,814	16	61,398,177
	17	Accounts payable and accrued expenses .	9,307,143	17	8,084,333
18	Grants payable ..........		18
19	Deferred revenue ..........	55,631	19	109
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	5,306,820	23	4,344,265
24	Unsecured notes and loans payable to unrelated third parties ....	287,432	24	161,027
25	Other liabilities. Complete Part X of Schedule D.....	9,239,241	25	7,119,871
26	Total liabilities. Add lines 17 through 25.....	24,196,267	26	19,709,605
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	35,972,547	27	41,688,572
28	Temporarily restricted net assets .....		28
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	35,972,547	33	41,688,572
34	Total liabilities and net assets/fund balances .....	60,168,814	34	61,398,177

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization ARMSTRONG COUNTY MEMORIAL HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization ARMSTRONG COUNTY MEMORIAL HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Yes

2,100

Total. lines 1c through 1i ...................................

2,100

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
OTHER LOBBYING ACTIVITIES	SCHEDULE C, PART II-B, LINE 1(i)	THE HOSPITAL HOLDS MEMBERSHIP IN THE HOSPITAL & HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA (HAP) AND THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA (HCWP) WHICH ENGAGE IN LOBBYING AS PART OF THEIR MISSION TO REPRESENT THE INTEREST OF HOSPITALS AT BOTH THE FEDERAL AND STATE LEVELS.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back	(e)Four Years Back
1a	Beginning of year balance ....
b	Contributions ........
c	Investment earnings or losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	174,825		174,825
b	Buildings ................	35,936,713	25,445,619	10,491,094
c	Leasehold improvements ............
d	Equipment ................	67,079,044	56,412,415	10,666,629
e	Other .................	3,392,824	2,525,737	867,087
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				22,199,635

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) OTHER RECEIVABLES				3,834,886
(2) ACCRUED INTEREST				31,635







Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				3,866,521

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes		0
AMOUNT DUE TO THIRD PARTY PAYERS		2,387,177
MINIMUM PENSION LIABILITY		4,732,694







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		7,119,871
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	95,495,892
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	90,993,623
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	4,502,269
4	Net unrealized gains (losses) on investments ..........................	4	1,375,347
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8	-161,591
9	Total adjustments (net). Add lines 4 - 8 .............................	9	1,213,756
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	5,716,025

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	96,704,052
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	1,375,347
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d	-161,591
e	Add lines 2a through 2d .....................			2e	1,213,756
3	Subtract line 2e from line 1.....................			3	95,490,296
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	5,596
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................			4c	5,596
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	95,495,892

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	90,988,027
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................			2e
3	Subtract line 2e from line 1.....................			3	90,988,027
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	5,596
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................			4c	5,596
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......			5	90,993,623

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
UNCERTAIN TAX POSITIONS	SCHEDULE D, PART X, LINE 2	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
OTHER RECONCILING CHANGES IN NET ASSETS	SCHEDULE D, PART XI, LINE 8	UNREALIZED CHANGES IN DEFINED BENEFIT PLAN $1,794,431 TRANSFERS TO AFFILIATES (1,956,022) ------------- TOTAL OTHER CHANGES IN NET ASSETS $(161,591)
OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12	SCHEDULE D, PART XII, LINE 2D	UNREALIZED CHANGES IN DEFINED BENEFIT PLAN $1,794,431 TRANSFERS TO AFFILIATES (1,956,022) ------------- TOTAL OTHER $(161,591)

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

If "Yes," does the organization make it available to the public? ..............

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	1,108,316		1,108,316	1.260 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	12,754,058	10,708,003	2,046,055	2.330 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....	572,668	426,762	145,906	0.170 %
dTotal Charity Care and Means-Tested Government Programs .....	14,435,042	11,134,765	3,300,277	3.760 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	160,242	2,350	157,892	0 %
f Health professions education (from Worksheet 5) ..	280,287	65,729	214,558	0.240 %
g Subsidized health services (from Worksheet 6) ..	4,787,144	2,730,413	2,056,731	2.260 %
h Research (from Worksheet 7)	39,867		39,867	0.050 %
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	20,923		20,923	0.020 %
jTotal Other Benefits ...	5,288,463	2,798,492	2,489,971	2.570 %
kTotal. Add lines 7d and 7j. ..	19,723,505	13,933,257	5,790,248	6.330 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1	5	526	526
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	2,416	8,268	8,268	0.010 %
7	Community health improvement advocacy
8	Workforce development	2	114	6,413	6,413	0.010 %
9	Other
10	Total	4	2,535	15,207	15,207	0.020 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense (at cost).....

1,191,913

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

42,188

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

16,331,353

Enter Medicare allowable costs of care relating to payments on line 5.....

15,985,020

Subtract line 6 from line 5. This is the surplus or (shortfall)........

346,333

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	ARMSTRONG COUNTY MEMORIAL HOSPITAL ONE NOLTE DRIVE KITTANNING,PA16201	X	X	X	SNU, REHAB, & PSYCHIATRIC UNITS

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:ARMSTRONG COUNTY MEMORIAL HOSPITAL

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?10
Name and address		Type of Facility (Describe)
1	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
2	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
3	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
4	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
5	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
6	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
7	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
8	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
9	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER
10	ARMSTRONG OUTPATIENT IMAGING CENTER 87 GLADE DRIVE KITTANNING,PA16201	OUTPATIENT RADIOLOGY CENTER

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
PART I, LINE 7, COLUMN F:		THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT OF TOTAL EXPENSE IN COLUMN F WAS REDUCED BY THE AMOUNT OF BAD DEBT EXPENSE OF $3,231,869. PART I, LINE 7G: ARMSTRONG COUNTY MEMORIAL HOSPITAL REPORTS THREE RHC FACILITIES AS SUBSIDIZED HEALTH SERVICES. WHEN THESE CLINICS WERE ESTABLISHED THE AREAS IN WHICH THEY ARE LOCATED WERE IN MEDICALLY UNDERSERVED AREAS OR PHYSICIAN SHORTAGE AREAS. PART III, LINE 4: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE. THAT FOOTNOTE READS AS FOLLOWS: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PART PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENTS ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATIONS AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. LINE 2 WAS CALCULATED USING THE FACILITIES COST TO CHARGE RATIO FROM WORKSHEET C OF THE MEDICARE COST REPORT. LINE 3 WAS CALCULATED BY MULTIPLYING THE PERCENTAGE OF CHARITY CARE TO GROSS CHARGES LESS BAD DEBT BY THE TOTAL BAD DEBT EXPENSE.
PART III, LINE 8:		SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. PART III, LINE 9B: PATIENTS RECEIVE CORRESPONDENCE GIVING THEM THE OPPORTUNITY TO CONTACT THE ORGANIZATION TO QUESTIONS THEIR STATEMENTS AND/OR ESTABLISH PAYMENT ARRANGEMENTS. IF A PATIENT CONTACTS THE ORGANIZATION, IT IS FIRST DETERMINED WHETHER OR NOT THEY MAY BE ELIGIBLE FOR ASSISTANCE THROUGH MEDICAID OR FINANCIAL ASSISTANCE. IF THE PATIENT IS NOT ELIGIBLE FOR ANY OF THE ASSISTANCE LISTED, THEN THE ORGANIZATION WORKS WITH THE PATIENT TO ESTABLISH A PAYMENT PLAN, USUALLY FOR UP TO 12 MONTHS BUT EXTENSION IS ALLOWED FOR EXTENUATING CIRCUMSTANCES. IF AN ACCOUNT IS DETERMINED TO BE UNCOLLECTIBLE AND NO REQUEST FOR ASSISTANCE OR PAYMENT ARRANGEMENTS IS RECEIVED, THE ACCOUNT IS REFERRED TO AN OUTSIDE COLLECTION AGENCY.
NEEDS ASSESSMENT:		WE REGULARLY USE RELIABLE DATA AVAILABLE ON THE INTERNET TO DETERMINE THE NEEDS OF OUR COMMUNITY. COUNTY HEALTH RANKINGS PULLS FROM VARIOUS RELIABLE DATABASES TO PROVIDE INFORMATION ABOUT OUTCOMES, HEALTH FACTORS, ENVIRONMENTAL FACTORS, AND COMMUNITY HEALTH STATUS INDICATORS. WE ALSO USE INFORMATION FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH REGARDING HEALTH BEHAVIORS. WE ALSO COLLABORATE WITH THE LOCAL SCHOOL DISTRICT AND OTHER COMMUNITY ORGANIZATIONS AND EMPLOYERS TO DETERMINE OUR ROLE IN THE DEVELOPMENT OF HEALTHY FACILITIES, PROGRAMS, AND BEHAVIORS IN ARMSTRONG COUNTY. PERIODICALLY WE CONDUCT SPECIFIC SURVEYS OF KNOWLEDGABLE COMMUNITY MEMBERS.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:		EACH PATIENT IS ASKED THE QUESTION, "DO YOU NEED HELP WITH YOUR MEDICAL BILLS?" AT THE POINT OF REGISTRATION. FOR EVERY PATIENT THAT ANSWERS YES, WE SEND THE PATIENT A COVER LETTER EXPLAINING OUR FINANCIAL ASSISTANCE PROGRAM, AN APPLICATION, AND BASIC GUIDELINES IDENTIFYING INFORMATION NEEDED TO PROCESS THE APPLICATION. ONCE THE PATIENT RECEIVES THE APPLICATION AND COMPLETES THE INFORMATION, THE APPLICATION IS REVIEWED FOR ACCURACY AND POTENTIAL APPROVAL. IF THE PATIENT HAS SUPPLIED ALL THE NECESSARY INFORMATION AND A DECISION IS MADE, AN APPROVED OR DENIED LETTER IS SENT TO THE PATIENT. IF THE PATIENT HAS NOT SUPPLIED ENOUGH INFORMATION TO MAKE A PROPER DECISION, A LETTER DETAILING THE MISSING INFORMATION IS SENT TO THE PATIENT ALONG WITH A FOLLOW UP PHONE CALL. THE APPLICATION IS PRINTED ON THE BACK OF EVERY STATEMENT SENT TO PATIENTS CONCERNING THEIR OUT OF POCKET EXPENSE. WE UTILIZE AN EARLY OUT SELF PAY VENDOR THAT HAS BEEN TRAINED ON OUR FINANCIAL ASSISTANCE POLICY AND WHEN THEY HAVE CONTACT WITH OUR PATIENTS, THEY ADVISE THEM OF THE PROGRAM AND INITIATE THE APPLICATION PROCESS WHEN THE PATIENT REQUESTS THEIR ASSISTANCE. THIS VENDOR OFFERS THE FINANCIAL ASSISTANCE APPLICATION ON THEIR WEBSITE LISTED UNDER THE OPTIONS FOR RESOLUTION OF THE OUTSTANDING BALANCE(S). THE HOSPITAL HAS FINANCIAL ASSISTANCE POSTERS PLACED IN STRATEGIC LOCATIONS THROUGHOUT THE FACILITY TO INFORM THEM OF THE PROGRAM OFFERED. WE ARE PARTICIPATING IN HEALTH FAIRS THROUGHOUT BY ATTENDING AND OFFERING ASSISTANCE WITH THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE. THE HOSPITAL HAS OBTAINED THE ASSISTANCE OF A COMPANY TO WORK WITH THE INPATIENT POPULATION TO OBTAIN PENNSYLVANIA MEDICAL ASSISTANCE. THE COMPANY MEETS WITH THE PATIENT ONE ON ONE TO OBTAIN ALL THE INFORMATION NEEDED TO SUBMIT THE APPLICATION ON BEHALF OF THE PATIENT. IF INFORMATION IS NEEDED AFTER DISCHARGE, THE COMPANY GOES TO THE PATIENT'S HOME AND OBTAINS ANY INFORMATION NEEDED AND MEETS WITH THE COUNTY ASSISTANCE OFFICE WHEN NEEDED. THE HOSPITAL'S FINANCIAL COUNSELING DEPARTMENT RECEIVES PHONE CALLS DAILY AND ASSISTS PATIENTS WITH PAYMENT PLAN OPTIONS SUCH AS FINANCIAL ASSISTANCE, MEDICAID APPLICATIONS, PAYROLL DEDUCTIONS, AND PAYMENT ARRANGEMENTS/PLANS.
COMMUNITY INFORMATION:		WE CONSIDER ALL OF ARMSTRONG COUNTY TO BE INCLUDED IN OUR SERVICE AREA AS WE ARE THE ONLY HOSPITAL AND THE ONLY PROVIDER OF EMERGENCY AND URGENT CARE SERVICES. ARMSTRONG COUNTY LIES IN THE RURAL APPALACHIAN REGION AND IS MADE UP OF 45 MINOR CIVIL DIVISIONS. CURRENTLY, 33 OF THESE MUNICIPALITIES ARE DESIGNATED AS EITHER MEDICALLY UNDERSERVED AREAS OR HEALTH PROFESSIONAL SHORTAGE AREAS, OR BOTH, BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. THERE IS NO PUBLIC TRANSPORTATION SYSTEM FOR MOST OF THE AREA. SOCIOECONOMIC DATA FOR THE REGION SHOWS THAT THE PER CAPITA INCOME OF ARMSTRONG COUNTY IS LOWER THAN THE AVERAGE OF THE UNITED STATES, THE STATE OF PENNSYLVANIA AND THE OVERALL APPALACHIAN REGION. ARMSTRONG COUNTY RESIDENTS ARE OLDER THAN THE AVERAGE RESIDENT OF PENNSYLVANIA AS A WHOLE. A DISPROPORTIONATELY LARGER PERCENTAGE OF OUR POPULATION RESIDES IN RURAL AREAS (85% COMPARED TO 31.1% STATE-WIDE.) THE UNEMPLOYMENT RATE FOR NOVEMBER 2010 WAS 8.2%. THE AVERAGE WAGE IN ARMSTRONG COUNTY WAS $655 A WEEK IN THE FIRST QUARTER OF 2010 WHILE PENNSYLVANIA'S AVERAGE WAGE FOR THIS SAME PERIOD OF TIME WAS $858. WITH MORE INCOME LEVELS BELOW THE POVERTY LEVEL (12.6% VS. 10.7%), RESIDENTS ARE LESS LIKELY TO HAVE HEALTH-CARE INSURANCE.
PROMOTION OF COMMUNITY HEALTH:		ACMH IS A FOUNDING MEMBER OF THE ARMSTRONG COUNTY COALITION FOR HEALTH AND WELLNESS WHICH EXISTS TO PROMOTE PHYSICAL ACTIVITY AND HEALTHIER FAMILIES THROUGH COMMUNITY DESIGN AND SUPPORT. COALITION MEMBERS CURRENTLY INCLUDE, ELECTED ARMSTRONG COUNTY OFFICIALS, ACMH HOSPITAL PERSONNEL, AND OTHER COMMUNITY LEADERS. THE GOAL OF THE COALITION IS TO REVERSE THREATS TO THE HEALTH AND WELL-BEING OF ARMSTRONG COUNTY CITIZENS WHICH INCLUDE POOR NUTRITION, SEDENTARY LIFESTYLES, AND LIMITED PHYSICAL ACTIVITY BY PROVIDING LEADERSHIP, FUNDING AND TECHNICAL ASSISTANCE IN ORDER TO PROMOTE THE USE OF EXISTING TRAILS AND PARKS, TO OPTIMIZE COMMUNITY DESIGN, TO INCREASE ACCESS TO RECREATIONAL RESOURCES, TO ENHANCE EXISTING FITNESS FACILITIES AND TO PROMOTE EDUCATIONAL PROGRAMS THAT FOCUS ON HEALTHIER LIFESTYLES. ACMH ALSO PARTICIPATES IN HEALTHY ARMSTRONG, A COALITION OF A LARGE NUMBER OF STAKEHOLDERS THAT MEETS MONTHLY TO COMBAT CHILDHOOD OBESITY. HEALTHY ARMSTRONG HAS BEEN AWARDED SEVERAL GRANTS AND HAS ACHIEVED NATIONAL RECOGNITION THROUGH ITS PROGRAM OF USING THE SCHOOL SYSTEM TO PROMOTE INCREASED PHYSICAL ACTIVITY AND NUTRITIONAL EDUCATION. ACMH PARTICIPATES IN ECONOMIC DEVELOPMENT MEETINGS. OTHER INFORMATION: ACMH HOSPITAL HAS AN OPEN MEDICAL STAFF. THE MAJORITY OF BOARD MEMBERS ARE ARMSTRONG COUNTY RESIDENTS AND WERE SELECTED TO REPRESENT THE COMMUNITIES SERVED. ACMH MANAGERS ARE ENCOURAGED TO PARTICIPATE ON THE BOARDS OF OTHER NON-PROFIT HEALTH AND HUMAN SERVICES ORGANIZATIONS. ACMH PROVIDES STRATEGIC PLANNING LEADERSHIP AND FACILITATION TO SMALLER ORGANIZATIONS IN THE COMMUNITY. ACMH WIDELY ADVERTISES IT'S FINANCIAL ASSISTANCE/FREE CARE PROGRAMS WHICH ARE INCOME BASED. SINCE ACMH OWNS SEVERAL RURAL HEALTH CLINICS LOCATED IN MEDICALLY UNDERSERVED AREAS IT OFFERS FINANCIAL ASSISTANCE AND FREE CARE TO LOW INCOME INDIVIDUALS AND FAMILIES FOR ALL TYPES OF HEALTHCARE SERVICES.
AFFILIATED HEALTH CARE SYSTEM:		THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED GROUP, AND THE GROUP'S CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF ARMSTRONG COUNTY MEMORIAL HOSPITAL, ARMSCARE, INC., ACMH FOUNDATION, ACMH ANESTHESIA SERVICES, ACMH PHYSICIAN SERVICES, GLADE RUN MEDICAL ASSOCIATES INC., AND ARMSTRONG CENTER FOR MEDICINE AND HEALTH, INC. (ACMH, INC.), COLLECTIVELY REFERRED TO AS THE HEALTH SYSTEM. THE HOSPITAL IS A NOT-FOR-PROFIT ENTITY, WHOLLY OWNED BY ACMH, INC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES IN THE ARMSTRONG COUNTY, PENNSYLVANIA AREA. ACMH, INC. IS A NOT-FOR-PROFIT CORPORATION FORMED TO SUPPORT AND FURTHER THE CHARITABLE ACTIVITIES OF ARMSTRONG COUNTY MEMORIAL HOSPITAL AS WELL AS ANY OTHER SUBSIDIARY ORGANIZATION AND IS THE PARENT ORGANIZATION. ARMSCARE, INC. IS A 95%-OWNED, FOR-PROFIT ENTITY ENGAGED PRINCIPALLY IN THE RENTAL AND SALE OF MEDICAL EQUIPMENT AND SUPPLIES. THE FOUNDATION IS A NOT-FOR-PROFIT ENTITY WHOSE PURPOSE IS TO RAISE FUNDS FOR THE BENEFIT OF THE HOSPITAL AND WELLNESS OF THE COMMUNITY. THE HEALTH SYSTEM FORMED ACMH ANESTHESIA SERVICES AND ACMH PHYSICIAN SERVICES IN 2006. THESE ENTITIES WERE ESTABLISHED TO PROVIDE ANESTHESIA AND PHYSICIAN SERVICES TO THE HEALTH SYSTEM. THE HEALTH SYSTEM FORMED GLADE RUN MEDICAL ASSOCIATES, INC. (GLADE RUN) IN 2009, AND IT BEGAN OPERATIONS IN 2010. GLADE RUN IS A NOT-FOR-PROFIT ENTITY ESTABLISHED TO PROVIDE PHYSICIAN SERVICES TO THE HEALTH SYSTEM.

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) HAROLD ALTMAN MD	(i) (ii)	235,119 0	15,000 0	32,370 0	2,250 0	15,370 0	300,109 0	0 0
(2) JOHN LEWIS	(i) (ii)	278,447 0	30,000 0	27,877 0	18,962 0	19,141 0	374,427 0	0 0
(3) PATRICK C BURNS	(i) (ii)	163,368 0	20,000 0	17,637 0	10,580 0	19,614 0	231,199 0	0 0
(4) CURT CONRY MD	(i) (ii)	497,647 0	71,387 0	0	1,500 0	14,987 0	585,521 0	0 0
(5) MAUREEN RUSSELL MD	(i) (ii)	324,449 0	161,371 0	1,200 0	1,500 0	1,922 0	490,442 0	0 0
(6) STEVEN PATERNO MD	(i) (ii)	320,372 0	103,889 0	0 3,600	1,500 0	20,322 0	446,083 3,600	0 0
(7) JEFFREY DAVID MD	(i) (ii)	262,126 0	54,789 0	0 3,600	2,250 0	18,694 0	337,859 3,600	0 0
(8) YANOUCHKA NARCISSE	(i) (ii)	250,849 0	75,994 0	0	1,500 0	19,177 0	347,520 0	0 0
(9) JEANNE GRAFF	(i) (ii)	119,681 0	15,000 0	16,526 0	2,250 0	16,868 0	170,325 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
BONUSES FOR HIGHEST COMPENSATED EMPLOYEES	SCHEDULE J, PART II, COLUMN B(II)	MANAGEMENT USES MGMA PUBLISHED STANDARDS TO ESTABLISH A BASE SALARY FOR PROVIDERS. IN ADDITION TO THE BASE SALARY, PROVIDERS HAVE THE ABILITY TO EARN INCENTIVES BASED UPON THEIR PRODUCTIVITY AS REFLECTED IN WORK RVU MEASURES.
457(F) PLAN	SCHEDULE J, PART I, LINE 4B	JOHN I. LEWIS $16,712 PATRICK C. BURNS $ 8,330 THE 457(F) PLAN THAT ARMSTRONG COUNTY MEMORIAL HOSPITAL ESTABLISHED FOR A SELECT GROUP OF MANAGEMENT INCLUDE THE FOLLOWING TERMS: A PARTICIPANT SHALL BECOME FULLY VESTED IN HIS DEFERRED COMPENSATION ACCOUNT, AND INCOME, GAINS AND LOSSES ATTRIBUTABLE THERETO, IF HE REMAINS IN SERVICE WITH THE EMPLOYER UNTIL THE FIRST TO OCCUR OF THE FOLLOWING EVENTS: (A) THE DEATH OF THE PARTICIPANT; (B) THE DISABILITY OF THE PARTICIPANT; (C) THE DATE THE PARTICIPANT ATTAINS AGE 65; OR (D) THE DATE A PARTICIPANT IS TERMINATED FROM EMPLOYMENT WITH THE EMPLOYER DUE TO A CHANGE OF CONTROL EVENT. UPON VESTING, THE DEFERRED COMPENSATION ACCOUNT WILL BE INCLUDIBLE IN THE GROSS INCOME OF THE PARTICIPANT PURSUANT TO CODE SECTION 457(F).

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SNYDER ASSOCIATES	M SNYDER IS INDIRECT OWNR	96,370	GAS SERVICES & GAS LEASE		No
(2) SNYDER ASSOCIATES	M SNYDER IS INDIRECT OWNR	3,611	ROYALTIES FROM GAS LEASE		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation
BUSINESS TRANSACTIONS	SCHEDULE L, PART IV	ARMSTRONG COUNTY MEMORIAL HOSPITAL CONDUCTS BUSINESS TRANSACTIONS WITH SNYDER BROTHERS INC INCLUDING THE PURCHASE OF NATURAL GAS, AS WELL AS RECEIVING ROYALTIES FROM THE COMPANY FOR GAS WELLS OWNED BY ARMSTRONG COUNTY MEMORIAL HOSPITAL. MARK SNYDER IS A BOARD MEMBER OF ARMSTRONG COUNTY MEMORIAL HOSPITAL AND ARMSTRONG CENTER FOR MEDICINE AND HEALTH. WHEN THESE BUSINESS TRANSACTIONS ARE DISCUSSED AT BOARD MEETINGS, MR. SNYDER IS EXCUSED SO NO CONFLICT OF INTEREST OCCURS.

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1	THE MISSION OF ARMSTRONG COUNTY MEMORIAL HOSPITAL IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF ARMSTRONG AND NEIGHBORING COUNTIES. THE HOSPITAL WILL: FOCUS ON PATIENT AND FAMILY CENTERED SERVICES, CONTINUE TO DEVELOP THOSE SPECIALTY SERVICES THAT MEET THE CHANGING NEEDS OF THE COMMUNITY, DELIVER HIGH QUALITY, COST-EFFECTIVE CARE, AND PROMOTE HEALTH EDUCATION AND WELLNESS.
NEW SIGNIFICANT PROGRAM SERVICES	FORM 990, PART III, LINE 2	DURING FISCAL YEAR 2011, ARMSTRONG COUNTY MEMORIAL HOSPITAL (ACMH) BEGAN PERFORMING CARDIAC PROCEDURES FOR BOTH INPATIENTS AND OUTPATIENTS. SIGNIFICANT CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 DURING FISCAL YEAR 2011, ARMSTRONG COUNTY MEMORIAL HOSPITAL (ACMH) CEASED CONDUCTING PROGRAM SERVICES ASSOCIATED WITH PHYSICIAN CLINICS. ACMH STILL OWNS AND OPERATES THREE RURAL HEALTH CLINICS. THE PHYSICIAN CLINICS WHO CEASED TO DO OPERATIONS UNDER ACMH MOVED TO A SISTER CORPORATION TO ACMH CALLED GLADE RUN MEDICAL ASSOCIATES, INC.
PROGRAM SERVICES	FORM 990, PART III, LINE 4	ARMSTRONG COUNTY MEMORIAL HOSPITAL IS A 172 BED COMMUNITY HOSPITAL WHICH PROVIDES INPATIENT & OUTPATIENT MEDICAL SERVICES TO ALL COUNTY RESIDENTS WITHOUT DISCRIMINATION. THE HOSPITAL HAS CONTRACTS WITH THIRD-PARTY PAYERS TO PROVIDE CARE FOR MEDICARE, MEDICAID, BLUE CROSS PATIENTS, AND OTHER COMMERCIAL PAYERS. THE HOSPITAL PROVIDES CARE REGARDLESS OF A PATIENTS ABILITY TO PAY. PURSUANT TO THE HOSPITAL'S CHARITY CARE POLICY, CHARGES ARE FULLY OR PARTIALLY WRITTEN OFF FOR PATIENTS MEETING THE CRITERIA SPECIFIED IN THE POLICY. CHARGES EXCLUDED UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY $3,007,802 FOR THE FISCAL YEAR. PROGRAM SERVICE REVENUE AND EXPENSES UNDER LINE 4 PERTAINS TO ITEMS THAT HELP SUPPORT THE MEDICAL SERVICES THAT OUR PATIENTS RECEIVE AT ACMH. ITEMS INCLUDE CAFETERIA AND VENDING SALES, RENTAL INCOME, MEDICAL RECORDS, REBATES, AND OTHER MISCELLANEOUS INCOME. SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED ITS BYLAWS DURING THE FISCAL YEAR. SIGNIFICANT CHANGES INCLUDED: -ARMSTRONG CENTER FOR MEDICINE AND HEALTH (ACMH) WAS GIVEN AUTHORITY TO APPROVE ACTIONS TAKEN BY THE BOARD REGARDING CERTAIN MATTERS INCLUDING AMENDMENT OF THE ARTICLES OR INCORPORATION OR BYLAWS; THE SALE, LEASE, OR EXCHANGE OF SUBSTANTIALLY ALL THE PROPERTY OR ASSETS OF THE CORPORATION; MERGERS OR CONSOLIDATIONS; DISSOLUTION OF THE CORPORATION AND DISTRIBUTION OF ASSETS; APPROVAL OF THE ANNUAL BUDGET AND LONG-RANGE PLAN FOR THE CORPORATION; ANY TRANSFER OF FUNDS BY GRANT, GIFT, OR LOAN; AND ANY OTHER MATTER THAT BY LAW REQUIRES THE APPROVAL OF THE CORPORATION'S MEMBERS. THE BOARD MUST OBTAIN THE APPROVAL OF ACMH BEFORE ACTION ON THE PREVIOUSLY LISTED MATTERS BECOMES FINAL AND EFFECTIVE. -A MAJORITY OF THE BOARD OF DIRECTORS MUST BE INDEPENDENT, MEANING THEY WERE NOT COMPENSATED AS AN OFFICER OR EMPLOYEE OF ACMH OR ITS SUBSIDIARIES, THEY DID NOT RECEIVE PAYMENTS GREATER THAN $10,000 FROM ACMH OR ITS SUBSIDIARIES AS AN INDEPENDENT CONTRACTOR, AND THEY OR THEIR FAMILY MEMBERS WERE NOT A PARTY TO A TRANSACTION REPORTED ON THE MOST RECENT 990 SCHEDULE L. -THERE IS NOW NO LIMIT ON THE NUMBER OF TERMS THAT A DIRECTOR CAN SERVE. OFFICERS, HOWEVER, MAY SERVE NO MORE THAN THREE CONSECUTIVE TERMS. -DIRECTORS, OFFICERS, AND KEY EMPLOYEES MUST ABIDE BY THE CORPORATION'S CONFLICT OF INTEREST POLICY. FAILURE TO DO SO CONSTITUES GROUNDS FOR REMOVAL. -BOARD MEMBERS NO LONGER HAVE THE POWER TO REVIEW AND APPROVE INSTITUTIONAL POLICIES OR REVIEW AND APPROVE CERTIFICATE OF NEED APPLICATIONS TO ANY FEDERAL OR STATE AGENCY. THEY NOW HAVE THE POWER TO REVIEW ACMH AUXILIARY REPORTS AS REQUIRED AND APPROVE THE BYLAWS OF ACMH AUXILIARY. -THE ABILITY TO DETERMINE THE SALARY AND FRINGE BENEFITS OF THE PRESIDENT MOVED FROM THE FINANCE COMMITTEE TO THE EXECUTIVE COMMITTEE. THE FINANCE COMMITTEE NOW HAS THE POWER TO AUTHORIZE CORPORATION EXPENDITURE OF UP TO $25,000 WITHOUT PRIOR BOARD APPROVAL. -THE PRESIDENT HAS THE AUTHORITY TO EXECUTE ANY FORMS REQUIRED TO ESTABLISH BANK ACCOUNTS WITHOUT APPROVAL OF THE BOARD. -THE NEW BYLAWS PROVIDE FOR A HOSPITAL AUXILIARY THAT SHALL HAVE BYLAWS AND FUNDRAISING ACTIVITIES APPROVED BY THE BOARD OF DIRECTORS OF THE CORPORATION. IF THE AUXILIARY IS DISBANDED, ALL MONIES AND PROPERTIES OF THE AUXILIARY BELONG TO THE CORPORATION. THE BOARD OF DIRECTORS WILL DETERMINE THE APPROPRIATE SCOPE OF VOLUNTEER SERVICES AT THE CORPORATION, AND A QUALIFIED DIRECTOR WILL COORDINATE AND SUPERVISE ALL VOLUNTEER ACTIVITIES.
MEMBERS, STOCKHOLDERS, OR OTHER PERSONS	FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B	THE ORGANIZATION IS A SUBSIDIARY OF ARMSTRONG CENTER FOR MEDICINE AND HEALTH, ANOTHER TAX EXEMPT ENTITY. ACCORDING TO THE BYLAWS, ARTICLE II, ARMSTRONG CENTER FOR MEDICINE AND HEALTH ("ACMH"), A PENNSYLVANIA NONPROFIT CORPORATION, SHALL HAVE CERTAIN RIGHTS WITH RESPECT TO THE GOVERNANCE OF THIS CORPORATION AS MAY BE SPECIFIED IN THESE BYLAWS IN THE CAPACITY OF AN "OTHER BODY" AS THAT TERM IS DEFINED IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW, SPECIFICALLY 15 PA. C.S. SECTION 7103. THE BYLAWS OF ACMH DESCRIBE SEVEN SITUATIONS IN WHICH APPROVAL IS NEEDED BY THE PARENT CORPORATION. 1) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THIS CORPORATION OR OF THESE BYLAWS 2) THE SALE, LEASE, OR EXCHANGE OF ALL OF SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THIS CORPORATION 3) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION 4) DISSOLUTION OF THE CORPORATION AND DISTRIBUTION OF ASSETS PURSUANT THERETO 5) APPROVAL OF THE ANNUAL BUDGET AND LONG-RANGE PLAN FOR THIS CORPORATION 6) ANY TRANSFER OF FUND BY GRANT, GIFT OR LOAN FROM THIS CORPORATION 7) ANY OTHER MATTER THAT BYLAWS REQUIRES THE APPROVAL OF THE MEMBERS OF THE CORPORATION. ALSO, THE PARENT CORPORATION NOW HAS THE AUTHORITY TO SELECT THE BOARD MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS (ARTICLE 3, SECTION 3(b))
REVIEW OF THE FORM 990	FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CFO AND THE FINANCE DEPARTMENT PERFORM AN INITIAL REVIEW OF THE COMPLETED 990. ANY NECESSARY CHANGES ARE MADE AND THEN THE REVISED COPY IS PRESENTED TO THE CFO AND CEO FOR FINAL REVIEW. THE 990 IS PRESENTED BY THE CFO TO THE FINANCE COMMITTEE FOR THEIR CONSIDERATION. THEIR FINDINGS ARE SUBMITTED TO THE BOARD OF DIRECTORS, WHICH APPROVES THE TAX RETURN. ONCE APPROVED, THE TAX RETURN IS SIGNED BY THE CEO AND FILED WITH THE IRS. A COPY OF THE SUBMITTED TAX RETURN IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF DIRECTORS.
CONFLICTS OF INTEREST	FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY REQUESTING ON AN ANNUAL BASIS THAT MEMBERS OF THE BOARD OF DIRECTORS, ALL CORPORATE OFFICERS, AND ALL KEY EMPLOYEES COMPLETE A QUESTIONNAIRE LISTING ALL ORGANIZATIONS WITH WHICH THEY HAVE AN AFFILIATION. THE BYLAWS OF THE ORGANIZATION DESCRIBE HOW ANY CONFLICTS OF INTEREST ARE TO BE ADDRESSED. "THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH THE STATEMENTS OF ALL DIRECTORS IN ORDER TO GUIDE HIS CONDUCT SHOULD A CONFLICT ARISE. THE VICE- CHAIRMAN OF THE BOARD SHALL BE FAMILIAR WITH THE STATEMENT FILED BY THE CHAIRMAN." IF A CONFLICT OF INTEREST SHOULD ARISE, THE MEMBERS ABSTAIN FROM THE VOTE RELATING TO THAT MATTER.
COMPENSATION REVIEW	FORM 990, PART VI, SECTION B, LINES 15A & 15B	THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PAID BY ARMSTRONG COUNTY MEMORIAL HOSPITAL (ACMH HOSPITAL). THE PROCESS ACMH HOSPITAL USES TO DETERMINE IF THE OFFICERS OF THE ORGANIZATION ARE TO RECEIVE A WAGE ADJUSTMENT IS AS FOLLOWS: 1) A SALARY COMPARISON IS PREPARED BY MARC CAMMARATA ASSOCIATES, USING SURVEYS FROM YAFFE, SULLIVAN COTTER AND WATSON WYATT; 2) THE INFORMATION IS COMPILED BY THE VP OF HUMAN RESOURCES AND GIVEN TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR CONSIDERATION AND INPUT; 3) CHANGES TO EXECUTIVE COMPENSATION REQUIRE A SIGNED DOCUMENT FROM THE CHAIR OF THE HOSPITAL BOARD OF DIRECTORS. EXECUTIVE COMPENSATION IS REVIEWED AS DESCRIBED ABOVE, ON AN AS NEEDED BASIS AND WAS LAST COMPLETED IN OCTOBER, 2010.
DOCUMENT DISCLOSURE	FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION TAKES THE FOLLOWING ACTIONS RELEASING INFORMATION REGARDING THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS OF THE HOSPITAL. IF A REQUEST IS MADE TO REVIEW THE UNAUDITED FINANCIAL STATEMENTS, IT IS DISCUSSED ON A CASE BY CASE BASIS AS TO WHETHER THE INFORMATION WILL BE RELEASED. THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE ORGANIZATIONS THAT REQUEST THEM. A CODE OF CONDUCT FOR THE HOSPITAL IS AVAILABLE TO THE PUBLIC ON THE HOSPITAL'S MAIN WEBSITE AT WWW.ACMH.ORG. THE CORPORATION'S GOVERNING DOCUMENTS ARE KEPT IN THE ADMINISTRATIVE DEPARTMENT OF THE HOSPITAL. THESE DOCUMENTS CAN BE VIEWED UPON REQUEST, BUT THEY ARE NOT ALLOWED TO BE TAKEN FROM THEIR DESIGNATED AREA OR HAVE COPIES MADE WITHOUT PERMISSION.
RELATED HOURS	FORM 990, PART VII, SECTION A, COLUMN B	JOHN I. LEWIS, ACMH HOSPITAL PRESIDENT/CEO, WORKS APPROXIMATELY 40 HOURS PER WEEK BETWEEN ACMH HOSPITAL, ACMH FOUNDATION, GLADE RUN MEDICAL ASSOCIATES, ACMH PHYSICIAN SERVICES, ARMSTRONG CENTER FOR MEDICINE & HEALTH, AND ARMSCARE, INC. PATRICK BURNS, ACMH HOSPITAL CFO/VP OF FINANCE, WORKS APPROXIMATELY 40 HOURS PER WEEK BETWEEN ACMH HOSPITAL, ACMH FOUNDATION, GLADE RUN MEDICAL ASSOCIATES, ACMH PHYSICIAN SERVICES, ARMSTRONG CENTER FOR MEDICINE & HEALTH, AND ARMSCARE, INC. HAROLD ALTMAN, ACMH HOSPITAL VICE PRESIDENT OF MEDICAL AFFAIRS, WORKS APPROXIMATELY 40 HOURS PER WEEK BETWEEN ACMH HOSPITAL, GLADE RUN MEDICAL ASSOCIATES, INC, ACMH PHYSICIAN SERVICES AND ARMSTRONG CENTER FOR MEDICINE & HEALTH, INC.
RENTAL EXPENSES	FORM 990, PART VIII, LINE 6B	ACMH HOSPITAL PROVIDES RENTAL LOCATIONS TO AREA PHYSICIANS AND OTHER HEALTHCARE RELATED ENTITIES IN ORDER TO PROMOTE ACCESSIBLE HEALTHCARE OPTIONS CLOSE TO HOME FOR THE LOCAL COMMUNITY. THE RENTAL INCOME CHARGED TO EACH LOCATION IS BASED ON PREVAILING RENTAL RATES PER SQUARE FOOT, THE AMOUNT OF SPACE, THE CONDITION OF THE OFFICE SPACE AND THE AMOUNT OF TIME THE OFFICE SPACE IS USED EACH MONTH.
OTHER CHANGES IN NET ASSETS	FORM 990, PART XI, LINE 5	NET UNREALIZED GAINS ON INVESTMENTS $1,375,347 UNREALIZED CHANGE IN DEFINED BENEFIT PLAN 1,794,431 TRANSFERS TO AFFILIATES (1,956,022) ------------- TOTAL OTHER CHANGES IN NET ASSETS $1,213,756

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

ARMSTRONG COUNTY MEMORIAL HOSPITAL

Employer identification number

25-0965237

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) ARMSTRONG OUTPATIENT IMAGING LLC 87 GLADE PARK EAST KITTANNING,PA16201 03-0492975	RADIOLOGY	PA	0	903	NA

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) ACMH PHYSICIAN SERVICES ONE NOLTE DRIVE KITTANNING,PA16201 20-4648195	PRIMARY CARE	PA	501(C)(3)	3	NA
(2) ARMSTRONG HEALTH & EDUCATION FOUNDATION ONE NOLTE DRIVE KITTANNING,PA16201 25-1655867	FOUNDATION	PA	501(C)(3)	11A I	NA
(3) ARMSTRONG CENTER FOR MEDICINE AND HEALTH ONE NOLTE DRIVE KITTANNING,PA16201 20-4648477	PARENT CORP	PA	501(C)(3)	7	NA
(4) GLADE RUN MEDICAL ASSOCIATES ONE NOLTE DRIVE KITTANNING,PA16201 26-4750523	PHYS PRACTICE	PA	501(C)(3)	11A I	NA

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)
(1) ARMSCARE INC ONE NOLTE DRIVE KITTANNING,PA16201 25-1495691	DURABLE MED EQUIP	PA	NA	C CORP

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF ARMSTRONG COUNTY MEMORIAL HOSPITAL IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF ARMSTRONG AND NEIGHBORING COUNTIES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	8
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	1,109
6	Total number of volunteers (estimate if necessary) ....	6	126
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	456,558
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	36,237

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	162,537	107,783
9	Program service revenue (Part VIII, line 2g) .........	95,282,912	94,064,611
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	264,567	421,437
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	738,306	902,061
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	96,448,322	95,495,892
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	5,000
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	52,741,153	50,616,402
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	38,940,921	40,372,221
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	91,682,074	90,993,623
19	Revenue less expenses. Subtract line 18 from line 12......	4,766,248	4,502,269
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	60,168,814	61,398,177
21	Total liabilities (Part X, line 26)............	24,196,267	19,709,605
22	Net assets or fund balances. Subtract line 21 from line 20 .....	35,972,547	41,688,572

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 33,726,006 including grants of $ ) (Revenue $ 45,339,644 )
	ACMH HOSPITAL PROVIDES INPATIENT SERVICES SUCH AS MEDICAL AND SURGICAL, ACUTE REHAB, SKILLED NURSING, OB/GYN, ICU/CCU, PSYCHIATRIC, AND NURSERY. DURING THE FISCAL YEAR, TOTAL ADMISSIONS WERE 7,803 AND PATIENT DAYS WERE 37,608. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.

4b	(Code: ) (Expenses $ 37,876,672 including grants of $ ) (Revenue $ 43,251,426 )
	ACMH HOSPITAL PROVIDES OUTPATIENT SERVICES SUCH AS RADIOLOGY, LABORATORY, EMERGENCY VISITS, AMBULATORY SURGERY, AND OTHER VARIOUS SERVICES. DURING THE FISCAL YEAR, TOTAL OUTPATIENT REGISTRATIONS WERE 212,900.

4c	(Code: ) (Expenses $ 2,705,973 including grants of $ ) (Revenue $ 3,446,668 )
	ACMH HOSPITAL PROVIDES RURAL HEALTH CLINICS AT SEVERAL SURROUNDING COMMUNITY LOCATIONS INCLUDING LEECHBURG, ELDERTON, AND RURAL VALLEY. IN ADDITION THEY OPERATED A VA CLINIC IN FORD CITY. TOTAL VISITS FOR ALL PHYSICIAN CLINICS TOTALED 40,762.

4d	Other program services. (Describe in Schedule O.)
	(Expenses $ 548,517 including grants of $ 5,000 ) (Revenue $ 1,570,315 )
4e	Total program service expenses$ 74,857,168

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) STEVEN PATERNO MD PHYSICIAN	40.0	X	424,261	3,600	21,822
(19) JEFFREY DAVID MD PHYSICIAN	40.0	X	316,915	3,600	20,944
(20) YANOUCHKA NARCISSE PHYSICIAN	40.0	X	326,843	0	20,677

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,095,098	42,763	188,387

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		36,542
e	Government grants (contributions)1e		43,146

f	All other contributions, gifts, grants, and similar amounts not included above1f		28,095
g	Noncash contributions included in lines 1a-1f:$ 19,995
h	Total. Add lines 1a-1f.......			107,783
			Business Code
2a	PATIENT SERVICE		900,099	92,037,733	92,037,733
b	UNRELATED LAB SERVICES		621,500	456,558		456,558
c	CAFETERIA		722,210	621,924	621,924
d	MEDICAL RECORDS		561,000	12,800	12,800
e	OTHER REVENUE		900,099	638,056	638,056
f	All other program service revenue .			297,540	297,540
g	Total. Add lines 2a–2f........			94,064,611
3	Investment income (including dividends, interest
	and other similar amounts).....			567,907			567,907
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross Rents	477,223
b	Less: rental expenses	0
c	Rental income or (loss)	477,223
d	Net rental income or (loss).......			477,223			477,223
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	5,571,351	4,199
b	Less: cost or other basis and sales expenses	5,715,366	6,654
c	Gain or (loss)	-144,015	-2,455
d	Net gain or (loss)..........			-146,470			-146,470
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	GAIN ON INVESTMENT IN EQUITY INVESTEE		900,099	424,838			424,838
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			424,838
12	Total revenue. See Instructions....			95,495,892	93,608,053	456,558	1,323,498


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			47,219	1	3,728
2	Savings and temporary cash investments .......			15,635,667	2	14,325,582
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			7,591,185	4	7,038,873
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............			127,915	7	49,354
8	Inventories for sale or use ..............			756,551	8	975,623
9	Prepaid expenses and deferred charges ............			1,268,131	9	1,363,783
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	106,583,406
b	Less: accumulated depreciation. .....	10b	84,383,771	22,345,977	10c	22,199,635
11	Investments—publicly traded securities ..........			8,206,387	11	9,586,331
12	Investments—other securities. See Part IV, line 11 ......			1,679,311	12	1,988,747
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			2,510,471	15	3,866,521
16	Total assets. Add lines 1 through 15 (must equal line 34)...			60,168,814	16	61,398,177
17	Accounts payable and accrued expenses .			9,307,143	17	8,084,333
18	Grants payable ..........				18
19	Deferred revenue ..........			55,631	19	109
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			5,306,820	23	4,344,265
24	Unsecured notes and loans payable to unrelated third parties ....			287,432	24	161,027
25	Other liabilities. Complete Part X of Schedule D.....			9,239,241	25	7,119,871
26	Total liabilities. Add lines 17 through 25.....			24,196,267	26	19,709,605
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			35,972,547	27	41,688,572
28	Temporarily restricted net assets .....				28
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			35,972,547	33	41,688,572
34	Total liabilities and net assets/fund balances .....			60,168,814	34	61,398,177