TY 2024 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) GREG COUCH...................................................................... CHAIR	3.00 ................. 2.50	X	X	0	0
(2) JEFFREY B HOLLON...................................................................... VICE CHAIR	3.00 ................. 0.00	X	X	0	0
(3) JOANN ANDERSON...................................................................... SECRETARY/TREASURER	3.00 ................. 0.00	X	X	0	0
(4) MARTHA ELLIS...................................................................... TRUSTEE	3.00 ................. 0.00	X		0	0
(5) KEN ALLMAN...................................................................... TRUSTEE	3.00 ................. 0.00	X		0	0
(6) DUSTIN SCOTT CAMPBELL MD...................................................................... TRUSTEE	3.00 ................. 0.00	X		0	0
(7) SAM DUNN...................................................................... TRUSTEE	3.00 ................. 0.00	X		0	0
(8) RANDY EVANS DVM...................................................................... TRUSTEE	3.00 ................. 2.00	X		0	0
(9) JULIE AKEMON...................................................................... TRUSTEE (TERM 11/8/24)	5.00 ................. 0.00	X		0	0
(10) L BART FRANCIS...................................................................... TRUSTEE (TERM 11/8/24)	3.00 ................. 0.00	X		0	0
(11) ANDREA MASSEY...................................................................... TRUSTEE	3.00 ................. 3.00	X		0	0
(12) KAREN NEWMAN-PROFITT...................................................................... TRUSTEE	3.00 ................. 0.00	X		0	0
(13) MIKE RUST...................................................................... TRUSTEE	3.00 ................. 0.00	X		0	0
(14) ONZIE SIZEMORE...................................................................... TRUSTEE	3.00 ................. 0.00	X		0	0
(15) EDITH KELLEY...................................................................... TRUSTEE (TERM 11/8/24)	3.00 ................. 0.00	X		0	0
(16) HOLLIE P HARRIS...................................................................... PRESIDENT/CEO	25.00 ................. 15.00		X	1,503,777	118,812
(17) PAUL BETZ...................................................................... COO (TERM 11/13/24)	30.00 ................. 10.00		X	634,158	103,316

(A) Name and business address	(B) Description of services	(C) Compensation
TRIANGLE ANESTHESIA GROUP 425 LEWIS HARGETT CIRCLE LEXINGTON,KY40503	CONTRACT ANESTHESIA	20,606,194
HALLMARK HEALTH CARE SOLUTIONS PO BOX 22938 NEW YORK,NY100872938	CONTRACT NURSING	17,317,840
SODEXO OPERATIONS PO BOX 360170 PITTSBURGH,PA152516170	SUPPORT SERVICES	10,259,950
LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON,NC27216	CONTRACT LAB SERVICES	10,012,721
AHEAD INC 401 N MICHIGAN AVE CHICAGO,IL60611	SOFTWARE SUPPORT SERVICES	6,183,297
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 240

- TIN:

SCHEDULE A
(Form 990)

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.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2024

Open to Public
Inspection

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

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 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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. See section 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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2024

Page 2

Part II

Support Schedule for Organizations Described in Sections 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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2024 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2023 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2024. 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—2023. If the organization did not check a 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—2024. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2023. 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 VI 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) 2024

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 on 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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2024 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2023 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2024 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2023 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2024. 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—2023. 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) 2024

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2024

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2024

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2024

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2024 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2024	(iii) Distributable Amount for 2024
1 Distributable amount for 2024 from Section C, line 6
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2024:
a From 2019.......
b From 2020.......
c From 2021.......
d From 2022.......
e From 2023.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2024 distributable amount
i Carryover from 2019 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2024 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2024 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2025. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2020.....
b Excess from 2021.....
c Excess from 2022.....
d Excess from 2023.....
e Excess from 2024.....

Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2024

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

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, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Right Arrow

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't 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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025) Page 2

Name of organization APPALACHIAN REGIONAL HEALTHCARE

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 3

Name of organization APPALACHIAN REGIONAL HEALTHCARE		Employer identification number 52-0795508

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 4


Name of organization APPALACHIAN REGIONAL HEALTHCARE			Employer identification number 52-0795508
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c) (7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(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) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2024

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

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 in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

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

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2024

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 right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2021	(b) 2022	(c) 2023	(d) 2024	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2024

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)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(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)? ........

Yes

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? ..................

Yes

44,455

Other activities? ...................................................................................................................

Yes

48,000

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

92,455

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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

Section 162(e) nondeductible 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

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	ARH IS A MEMBER OF VARIOUS HOSPITAL ASSOCIATIONS. THE APPROPRIATE PERCENTAGE OF DUES PAID TO THE ORGANIZATIONS ALLOCABLE TO LOBBYING ACTIVITIES ARE ALSO INCLUDED. ARH HOLDS ON RETAINER CONSULTANTS TO ASSIST WITH GOVERNMENT AND PUBLIC RELATIONS IN REGARDS TO DEVELOPMENT OF LEGISLATURE, RELATED RESEARCH, AND OTHER RELEVANT ACTIVITIES.

Schedule C (Form 990) 2024

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," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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 can 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" on 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 education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

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, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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

Yes No

In Part XIII, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, 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)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) (Rev. 1-2025)

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on 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	Net investment earnings, gains, and 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 current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

The percentages on lines 2a, 2b, and 2c should equal 100%.

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

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	6,456,227		6,456,227
b	Buildings ....	331,121,254	241,067,835	90,053,419
c	Leasehold improvements	2,998,994	2,291,382	707,612
d	Equipment ....	260,083,500	187,584,774	72,498,726
e	Other .....	165,298,183	47,324,839	117,973,344
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				287,689,328

Schedule D (Form 990) (Rev. 1-2025)

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
MEDICARE & MEDICAID ESTIMATED SETTLEMENTS	38,609,457
ACCRUED PENSION COST	42,585,393
RESERVE FOR SELF-INSURANCE	83,909,958
PHYSICIAN COMMITMENTS	513,213
DUE TO PATIENTS	13,804,529
BOND INTEREST PAYABLE	2,903,777
SERP PAYABLE	255,299
ACCRUED PHYSICIAN SETTLEMENTS	2,028,338
OPERATING LEASE LIABILITY	10,151,473
DUE TO AFFILIATE	203,142,194
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	397,903,631
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) (Rev. 1-2025)

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
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 XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART X, LINE 2:

THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. HOWEVER, THE CORPORATION IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. GAAP REQUIRES THE CORPORATION TO EVALUATE ITS TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND HAS CONCLUDED THAT THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.

Schedule D (Form 990) (Rev. 1-2025)

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" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2024

Open to Public Inspection

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			41,549,646	2,741,998	38,807,648	4.300 %
b	Medicaid (from Worksheet 3, column a) . . . . .			251,449,812	310,307,118	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			0	0		0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			292,999,458	313,049,116	38,807,648	4.300 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			0	0
f	Health professions education (from Worksheet 5) . . .	1,795	1,562	3,935,411	0	3,935,411	0.440 %
g	Subsidized health services (from Worksheet 6) . . . .			0	0		0 %
h	Research (from Worksheet 7) .			0	0		0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	184	22,117	72,262	0	72,262	0.010 %
j	Total. Other Benefits . .	1,979	23,679	4,007,673		4,007,673	0.450 %
k	Total. Add lines 7d and 7j .	1,979	23,679	297,007,131	313,049,116	42,815,321	4.750 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2024

Schedule H (Form 990) 2024

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	0	0	0	0		0 %
2	Economic development	3	105	181	0	181	0 %
3	Community support	133	15,442	160,831	0	160,831	0.020 %
4	Environmental improvements	0	0	0	0
5	Leadership development and training for community members	6	310	2,103	0	2,103	0 %
6	Coalition building	80	8,244	11,495	0	11,495	0 %
7	Community health improvement advocacy	497	22,308	241,195	0	241,195	0.030 %
8	Workforce development	8	415	479	0	479	0 %
9	Other	0	0	0	0		0 %
10	Total	727	46,824	416,284		416,284	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

26,540,555

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

15,736,430

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

83,098,389

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

104,461,768

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

-21,363,379

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

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCI	CONDO OWNER	83.840 %	16.160 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2024

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?9Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)							Facility reporting group
1	HAZARD ARH REGIONAL MEDICAL CENTER 100 MEDICAL CENTER DRIVE HAZARD,KY41701 100365	X	X	X		X	A
2	BECKLEY ARH HOSPITAL 306 STANAFORD ROAD BECKLEY,WV25801 45	X	X			X	A
3	HARLAN ARH HOSPITAL 81 BALL PARK ROAD HARLAN,KY40831 100163	X	X			X	A
4	WHITESBURG ARH HOSPITAL 240 HOSPITAL ROAD WHITESBURG,KY41858 100288	X	X			X	A
5	TUG VALLEY ARH REGIONAL MEDICAL CENTER 260 HOSPITAL DRIVE SOUTH WILLIAMSON,KY41503 100368	X	X			X	A
6	MIDDLESBORO ARH HOSPITAL 3600 WEST CUMBERLAND AVENUE MIDDLESBORO,KY40965 100019	X	X			X	A
7	MCDOWELL ARH HOSPITAL ROUTE 122 BOX 247 MCDOWELL,KY41647 600082	X	X		X	X	A
8	MORGAN COUNTY ARH HOSPITAL 476 LIBERTY ROAD WEST LIBERTY,KY41472 600058	X	X		X	X	A
9	SUMMERS COUNTY ARH HOSPITAL 115 SUMMERS HOSPITAL ROAD HINTON,WV25951 88	X	X		X	X	A

Schedule H (Form 990) 2024

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 24

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://WWW.ARH.ORG/CHNA/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 24

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://WWW.ARH.ORG/CHNA/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2024

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.000000000000%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE

The FAP application form was widely available on a website (list url):

HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.ARH.ORG/FINANCIAL-ASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2024

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2024

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2024

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: HAZARD ARH REGIONAL MEDICAL CENTER, - FACILITY 3: HARLAN ARH HOSPITAL, - FACILITY 2: BECKLEY ARH HOSPITAL, - FACILITY 5: TUG VALLEY ARH REGIONAL MEDICAL CENTER, - FACILITY 4: WHITESBURG ARH HOSPITAL, - FACILITY 6: MIDDLESBORO ARH HOSPITAL, - FACILITY 8: MORGAN COUNTY ARH HOSPITAL, - FACILITY 7: MCDOWELL ARH HOSPITAL, - FACILITY 9: SUMMERS COUNTY ARH HOSPITAL
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:	A COMMUNITY STEERING COMMITTEE PROVIDED GUIDANCE OVER THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN EACH OF ARH'S COMMUNITIES. THIS STEERING COMMITTEE WAS MADE UP OF REPRESENTATIVES FROM VARIOUS ORGANIZATIONS AND AGENCIES THROUGHOUT EACH HOSPITAL'S SERVICE AREA. IN PARTICULAR, SOME OF THE COMMITTEE MEMBERS REPRESENTED THE LOCAL HEALTH DEPARTMENT, SENIOR SERVICES, SCHOOL SYSTEM, SOCIAL SERVICE ORGANIZATIONS, AND EMERGENCY MANAGEMENT. THESE INDIVIDUALS ASSISTED WITH DISTRIBUTING SURVEYS AND ORGANIZING FOCUS GROUPS THROUGHOUT THE COMMUNITY ENSURING THAT VARIED COMMUNITY INTERESTS AND EXPERTISE WERE REPRESENTED. SPECIAL ATTENTION WAS PAID TO ENSURING THAT REPRESENTATION FROM THE PUBLIC HEALTH SECTOR WAS INCLUDED IN THIS ASSESSMENT PROCESS AND THAT THE SENIOR CITIZEN AND UNDERSERVED POPULATION WERE REPRESENTED. A COMPLETE LIST OF THE COMMUNITY STEERING COMMITTEE MEMBERS FOR EACH ARH FACILITY IS INCLUDED IN EACH ASSESSMENT'S FINAL REPORT.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	APPALACHIAN REGIONAL HEALTHCARE CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT JOINTLY WITH THE OTHER FACILITIES WITHIN THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM. APPALACHIAN REGIONAL HEALTHCARE, INC. (EIN: XXX-XX-XXXX), THE PARENT ORGANIZATION, COORDINATED AND FILED THE COMBINED CHNA ON BEHALF OF ALL PARTICIPATING FACILITIES.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11:	APPALACHIAN REGIONAL HEALTHCARE CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN EACH OF ITS 10 HOSPITAL COMMUNITIES DURING 2024. RESULTS FROM COMMUNITY SURVEYS, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS ARE BEING REPORTED ALONG WITH HEALTH INFORMATION COLLECTED FROM REPUTABLE NATIONAL, STATE, AND LOCAL DATA SOURCES. ALSO BEING REPORTED FOR EACH ARH HOSPITAL IS AN IMPLEMENTATION PLAN ADDRESSING THE IDENTIFIED ISSUES FROM THIS PROCESS AND AN OUTCOMES SUMMARY FROM THE CHNA PROCESS AND IMPLEMENTATION CONDUCTED SINCE 2019. ALL OF THE INFORMATION IN THESE REPORTS PROVIDES VALUABLE INFORMATION THAT WILL BE USED IN THE FUTURE FOR PLANNING PURPOSES, SERVICE IMPROVEMENTS AND COMMUNITY OUTREACH. IT IS ARH'S HOPE THAT THIS ASSESSMENT WILL HELP OUR FACILITIES, IN PARTNERSHIP WITH OUR COMMUNITIES, TO IDENTIFY RESPECTIVE HEALTH CONCERNS, MEASURE THE IMPACT OF CURRENT PUBLIC HEALTH EFFORTS AND GUIDE THE APPROPRIATE USE OF LOCAL RESOURCES. WE ALSO HOPE THAT TOGETHER WE CAN IMPROVE THE HEALTH AND WELL-BEING OF THE RESIDENTS OF EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA.DURING THE 2022 CHNA PROCESS, THE APPOINTED COUNTY STEERING COMMITTEE IDENTIFIED THE FOLLOWING HEALTH NEEDS WITH ALL OF OUR FACILITIES: 1. MENTAL HEALTH 2. OBESITY 3. CULTURE OF HEALTH/ HEALTHY LIFESTYLE EDUCATION 4. SUBSTANCE USE DISORDER, 5. AGING IN PLACE AND OTHER SENIOR-ORIENTED SERVICES, 6. BUILD AND EXPAND CAPACITY OF HEALTH CONSORTIUM, 7. BETTER ACCESS TO CARE.MENTAL HEALTHBECKLEY ARH SET FORTH GOALS AND STRATEGIES TO ADDRESS EACH OF THE IDENTIFIED HEALTH NEEDS. SINCE 2022. BECKLEY ARH HAS EDUCATED OUR COMMUNITY ON THE IMPORTANCE OF MENTAL HEALTH AND REDUCED ASSOCIATED STIGMA BY PROVIDING 2 FREE MENTAL HEALTH FIRST AID TRAINING COURSES FOR STAFF, PROVIDING 7 MENTAL HEALTH EDUCATION AND AWARENESS EVENTS AND MANAGING AND SUPERVISING THE LOCAL STUDENTS AGAINST DESTRUCTIVE DECISIONS (SADD) GROUP. SINCE 2022, THE GROUP HAS: ATTENDED 15 EVENTS TARGETING THE K-12 POPULATION TO DISCUSS MENTAL HEALTH TOPICS AND THE NATIONAL SUICIDE CRISIS HOTLINE (988). HAZARD ON BOARDED KAITLYN WARFIELD, LCSW TO PROVIDE THERAPEUTIC SERVICES TO PATIENTS IN THE HAZARD COMMUNITY. COMPLETED RENOVATIONS AND OPENED HAZARD PSYCHIATRIC CENTER'S TREATMENT MALL IN DEC. 2023. THE ARH BEHAVIORAL HEALTH TEAM CREATED A VIDEO SERIES FOR SOCIAL MEDIA WITH 9 EDUCATIONAL VIDEOS THAT GARNERED OVER 3,000 VIEWS ON YOUTUBE. MENTAL HEALTH EDUCATION AND AWARENESS EVENTS HAVE ALSO BEEN A FOCUS OF THE COMMUNITY DEVELOPMENT AND BEHAVIORAL HEALTH TEAMS SINCE 2022.SINCE 2022, MCDOWELL ARH HAS WORKED TO IMPROVE MENTAL HEALTH IN OUR COMMUNITY BY PROVIDING 6 FREE MENTAL HEALTH FIRST AID TRAINING SESSIONS FOR STAFF FROM 2023-2024. REOPENED THE SENIOR CARE PROGRAM TO PROVIDE OLDER ADULTS WITH QUALITY BEHAVIORAL HEALTHCARE. ALONG WITH SOCIAL INTERACTION AND GROUP THERAPY, PARTICIPATING SENIORS RECEIVE TREATMENT FROM A MULTIDISCIPLINARY TEAM INCLUDING A PSYCHIATRIST, A THERAPIST, AND A REGISTERED NURSE THAT DEVELOP INDIVIDUALIZED PLANS. PRESENTED TWICE TO STUDENTS ABOUT MENTAL HEALTH ISSUES AT ADAMS MIDDLE SCHOOL AND FLOYD CENTRAL HIGH SCHOOL.MIDDLESBORO ARH HAS IMPROVED THE MENTAL HEALTH OF OUR COMMUNITY MEMBERS BY ACTIVELY PARTNERING WITH CRATER OF HOPE AND OTHER COMMUNITY ORGANIZATIONS ON IMPLEMENTATION OF A HARM REDUCTION PROGRAM (AKA A NEEDLE EXCHANGE PROGRAM) AND IN COMPLETING THE RECOVERY READY COMMUNITY APPLICATION. WORKING WITH LINCOLN MEMORIAL UNIVERSITY TO EXTEND OUR 3-YEAR HRSA MENTAL HEALTH GRANT BY ANOTHER YEAR AS WELL AS WORKING TO EXTEND THE MOSAIC GRANT TO MIDDLESBORO ARH IN ORDER TO PROVIDE 2 FULL-TIME PEER SUPPORT SPECIALISTS IN OUR EMERGENCY DEPARTMENT. IMPLEMENTED OVERDOSE SURVIVORS OUTREACH PROGRAM, PROVIDING COMMUNITY FOLLOW UPS TO OVERDOSE SURVIVORS AND EXTRA SUPPORT IN HOPES OF LINKING THOSE OVERDOSE SURVIVORS TO TREATMENT, AND OTHER COMMUNITY RESOURCES GROWN OUTPATIENT BEHAVIORAL HEALTH SERVICES THROUGH ARH CUMBERLAND VALLEY MEDICAL AND SURGICAL ASSOCIATES AND MIDDLESBORO WOMEN'S AND FAMILY HEALTH CLINIC (1,553 BEHAVIORAL HEALTH VISITS 2022-2024).MORGAN COUNTY ARH HAS INCREASED MENTAL HEALTH SERVICES AND COMMUNITY EDUCATION BY REOPENING THE SENIOR CARE PROGRAM TO PROVIDE OLDER ADULTS WITH QUALITY BEHAVIORAL HEALTHCARE. ALONG WITH SOCIAL INTERACTION AND GROUP THERAPY, PARTICIPATING SENIORS RECEIVE TREATMENT FROM A MULTIDISCIPLINARY TEAM INCLUDING A PSYCHIATRIST, A THERAPIST, AND A REGISTERED NURSE THAT DEVELOP INDIVIDUALIZED PLANS. MORGAN COUNTY HAS IMPLEMENTED TELEPSYCHIATRY CONSULTATIONS TO ENHANCE ACCESSIBILITY AND EFFICIENCY OF PSYCHIATRIC CARE. THEY HAVE CONTINUED THEIR PARTNERSHIP WITH PATHWAYS TO CONNECT INDIVIDUALS IN NEED OF MENTAL HEALTH CARE. PROVIDED 5 FREE MENTAL HEALTH FIRST AID TRAINING SESSIONS FOR STAFF FROM 2023-2024. MORGAN COUNTY ARH OFFERED THESE TRAINING COURSES WITH THE HOPE THAT THE EDUCATION WOULD ALLOW STAFF TO BETTER HELP OUR PATIENTS, BUT ALSO THEIR FAMILIES, FRIENDS, AND NEIGHBORS. PRESENTED THE HEALTHY RELATIONSHIPS PROGRAMMING TO MORGAN COUNTY HIGH SCHOOL STUDENTS, WHICH TEACHES CRITICAL THINKING AROUND QUALITIES OF HEALTHY AND UNHEALTHY RELATIONSHIPS, SIGNS OF ABUSE, AND COMMUNICATION SKILLS.IN 2023, SUMMERS COUNTY ARH PROVIDED THREE FREE MENTAL HEALTH FIRST AID TRAINING COURSES FOR STAFF. THE ARH COMMUNITY DEVELOPMENT AND BEHAVIORAL HEALTH TEAMS AT SUMMERS COUNTY HAVE PROVIDED 7 MENTAL HEALTH EDUCATIONAL OR AWARENESS EVENTS TO THE COMMUNITY SINCE 2022. IN 2020, SUMMERS COUNTY ARH LAUNCHED THE PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY. SINCE 2022 SUMMERS COUNTY ARH PEER RECOVERY COACHES HAVE COMPLETED: 3698 SBIRT SCREENINGS, 370 INITIAL BRIEF INTERVENTIONS, 62 REFERRALS TO TREATMENT, 30 LINKAGES TO TREATMENT, 300 NALOXONE DISTRIBUTED. SUMMERS COUNTY ARH ALSO EXPANDED THE MENTAL HEALTH SERVICES AVAILABLE VIA A TELEMEDICINE PARTNERSHIP WITH MARSHAL UNIVERSITY (2023).SINCE 2022, TUG VALLEY ARH HAS ADDRESSED MENTAL HEALTH IN OUR COMMUNITY BY EXPANDING OUTREACH ACTIVITIES SPECIFIC TO MENTAL HEALTH EDUCATION AND REDUCTION OF STIGMA. THEY HAVE PROVIDED TWO YEARS OF SPONSORSHIP AND STAFF PRESENTATIONS AT PIKE COUNTY STRONG, A SELF-ESTEEM, LEADERSHIP, AND MENTAL HEALTH AWARENESS EVENT FOR ALL FEMALE, JUNIOR YEAR HIGH SCHOOL STUDENTS IN THE COUNTY. PARTICIPATED IN "SAFE A LIFE" ROAD SHOW IN 2023 AND 2024, AN EVENT THAT PROVIDES MENTAL HEALTH EDUCATION, DRUG TREATMENT RESOURCES, NARCAN DISTRIBUTION, AND MORE AT LOCAL RETAIL STORES. THE ARH BEHAVIORAL HEALTH TEAM HAS ALSO CREATED A VIDEO SERIES FOR SOCIAL MEDIA WITH 9 EDUCATIONAL VIDEOS THAT GARNERED OVER 3,000 VIEWS ON YOUTUBE. THESE VIDEOS FEATURE ARH STAFF AND PROVIDERS DISCUSSING RELEVANT MENTAL HEALTH TOPICS LIKE SUICIDE PREVENTION, PTSD, SEASONAL AFFECTIVE DISORDER, AND POSTPARTUM DEPRESSION.WHITESBURG ARH HAS IMPROVED THE MENTAL HEALTH LANDSCAPE OF OUR COMMUNITY BY PROVIDING QUARTERLY FREE MENTAL HEALTH FIRST AID TRAINING FOR STAFF FROM 2023-2024. PROVIDING 3,303 BEHAVIORAL HEALTH CLINIC VISITS AND PARTICIPATED IN SEVERAL MENTAL HEALTH COMMUNITY EVENTS SUCH AS THE COUNTY'S ANNUAL CHILD ABUSE AWARENESS WALK AND THE WORLD DIABETES DAY CELEBRATION HEALTH FAIR IN 2024. WHITESBURG ARH HAS ALSO PARTNERED WITH A CERTIFIED TRAUMA INSTRUCTOR TO HOST 2 YOGA AND MINDFULNESS STRESS RELIEF CLASSES IN LETCHER COUNTY.OBESITYSINCE 2022, BECKLEY ARH HAS ADDRESSED OBESITY IN OUR COMMUNITY BY FINANCIALLY SUPPORTING WOODROW WILSON HIGH SCHOOL'S WETLAND PROJECT, MONTHLY DIABETES SUPPORT GROUPS, DEVELOPED "RETHINK YOUR DRINK" PROGRAM, PARTNERED 4 "WALK WITH A DOC" EVENTS WITH ACTIVE SOUTHERN WEST VIRGINA, REVAMPED THE HOSPITAL'S MENU, AND PROVIDED FREE GYM MEMBERSHIPS TO ALL ARH EMPLOYEES. HARLAN HAS ALSO REVAMPED THE HOSPITAL'S MENU AND PROVIDED FREE GYM MEMBERSHIPS TO ALL ARH EMPLOYEES ALONG WITH NUTRITION EDUCATION FROM AN ARH DIETITIAN. HARLAN ARH AND THE ARH FOUNDATION FUNDED THE DELIVERY OF FRESH FOODS TO 100 CLIENTS OF THE UNIVERSITY OF KENTUCKY'S KENTUCKY HOMEPLACE PROGRAM IN HARLAN COUNTY. IN 2022 AND 2023, A TOTAL OF 100 QUALIFIED HOMEPLACE CLIENTS WERE PROVIDED WITH A REDEEMABLE $25 VOUCHER TO ROPERS MARKET IN HARLAN, WHICH IS A RETAIL SOURCE OF LOCALLY- AND REGIONALLY GROWN FRESH FOODS, SPECIALIZING IN PRODUCE. THE PROGRAM WAS EXPANDED IN 2024 TO PROVIDE CLIENTS WITH MONTHLY $25 VOUCHERS TO COVER THE SPRING, SUMMER AND FALL HARVEST SEASONS. IN ADDITION TO FRESH PRODUCE, PARTICIPANTS ARE ALSO CASE MANAGED AND REFERRED TO SOCIAL ORGANIZATIONS OR HEALTHCARE WHEN NECESSARY.
PART V, SECTION B, LINE 11 CONTINUED:	SINCE 2022, MCDOWELL ARH HAS ADDRESSED OBESITY, FOOD INSECURITY, AND THE NEED FOR NUTRITION EDUCATION BY COLLABORATING WITH GOD'S PANTRY FOOD BANK TO PROVIDE NONPERISHABLE FOOD BOXES TO PATIENTS IDENTIFIED AS HAVING A NEED IN BOTH THE HOSPITAL AND CLINIC ENVIRONMENT; DISTRIBUTING ON AVERAGE 30 BOXES PER MONTH. FOOD BOXES CONTAIN ARH DIETITIAN TIPS ON HEALTHIEST USE OF FOODS INCLUDED. PARTICIPATED IN A RESEARCH STUDY WITH UNIVERSITY OF KENTUCKY FOOD AS HEALTH ALLIANCE IN WHICH MCDOWELL AMBULATORY PATIENTS WITH TYPE 2 DIABETES OR HYPERTENSION COULD RECEIVE MEDICALLY TAILORED MEALS FOR 12 WEEKS. THEY HOSTED 13 MONTHLY DIABETES SUPPORT GROUPS IN FLOYD COUNTY WITH DIABETES-RELATED TOPICS AND HEALTHY COOKING DEMONSTRATIONS EACH MONTH (2022 START). PROVIDING MEALS TO THOSE IN NEED. GAVE MONTHLY FOOD DONATIONS TO THE FLOYD COUNTY HOMELESS SHELTER AND HOSTED FOOD DRIVES AND COMMUNITY PICNICS ANNUALLY. MCDOWELL ARH ALSO WORKED TO EDUCATE AND PROVIDE HEALTHY NUTRITION TO EMPLOYEES THROUGH A REVAMPED CAFETERIA MENU, WHICH OFFERS PLANT-BASED OPTIONS.MIDDLESBORO ARH HAS ADDRESSED OBESITY AND ITS ROOT CAUSES IN OUR COMMUNITY BY HOSTING HEALTH EDUCATION AND AWARENESS EVENTS IN PARTNERSHIP WITH PINEVILLE CROSSFIT. THEY PARTNERED WITH LMU-DCOM 3RD YEAR CORE ROTATION STUDENTS TO USE THE LAND BEHIND THE HOSPITAL PROFESSIONAL OFFICE BUILDING FOR A COMMUNITY GARDEN. FRESH FRUITS AND VEGETABLES ARE BEING DISTRIBUTED TO PATIENTS AT 3 OF OUR CLINICS. UPDATED CAFETERIA MENUS WERE IMPLANTED TO REFLECT A MORE HEALTH-CONSCIOUS MENU, OFTEN WITH PLANT-BASED OPTIONS AND LEAN PROTEIN MEALS. MIDDLESBORO ARH HOSPITAL LEADERSHIP STAFF HAVE VOLUNTEERED AT THE COOPERATIVE CHRISTIAN MINISTRY (CCM) MONTHLY FOOD GIVE-A-WAY, HELPING TO FILL FOOD BOXES AND LOAD THE FOOD BOXES INTO CARS.CULTURE OF HEALTH & HEALTHY LIFESTYLE EDUCATIONBECKLEY ARH HAS ADDRESSED THE CULTURE OF HEALTH & HEALTHY LIFESTYLE EDUCATION BY PROVIDING 1,165 STROKE ASSESSMENTS AT 17 COMMUNITY EVENTS, STARTING 5 BRAIN PROTECTOR PROGRAMS AT LOCAL SCHOOLS, HAVING MONTHLY SUPPORT GROUP MEETINGS, STARTING 7 HEART HEALTH EDUCATION PROGRAMS, 8 CANCER PREVENTION PRESENTATIONS, 2 DIABETES EDUCATION SESSIONS, 3 FREE CPR TRAININGS, BEGAN A NEW PARTNERSHIP WITH COALFIELD COALITION AND RALEIGH COUNTY COMMUNITY ACTION TO HOST ANNUAL HEALTH FAIRS, AND PROVIDED 19 FREE HEALTH SCREENING EVENTS WHICH PROVIDED 1,200 FREE SCREENINGS.HARLAN ARH HAS PROVIDED HEALTH EDUCATION, PREVENTATIVE SCREENINGS, AND DISEASE AWARENESS EVENTS BROADLY THROUGHOUT THE COMMUNITY FROM 2022-2024. THEY HAVE HOSTED QUARTERLY LUNCH AND LEARN PROGRAMS COVERING TOPICS SUCH AS CHOLESTEROL AND HEART DISEASE AND STROKE AWARENESS. THEY HAVE HAD 3 "WALK AND TALK" COMMUNITY EVENTS AND 4 FITNESS FAIR EVENTS AT HARLAN ELEMENTARY. THE HOST MONTHLY "MEDICAL EXPLORERS" CLASSROOM PRESENTATIONS A TWO MIDDLE SCHOOLS IN THE HARLAN AREA. THEY PURCHASED 2 MEDICAL INFLATABLES TO USE AT 20+ COMMUNITY EVENTS SINCE PURCHASING THEM VIA GRANT FUNDS RECEIVED. SINCE 2022, HAZARD ARH HAS HOSTED 20 EVENTS THAT SPECIFICALLY PROMOTE CANCER AWARENESS, TEACH ABOUT EARLY DETECTION, AND ENCOURAGE PREVENTATIVE LIFESTYLES. HOSTING 7 COLON CANCER SCREENING EVENTS, 7 COMMUNITY PRESENTATIONS ABOUT THE EARLY DETECTION OF LUNG CANCER AND LOW DOSE CT SCREENINGS PROVIDED BY THE ARH LUNG CANCER SCREENING PROGRAM MANAGER, HELD 4 BREAST CANCER AWARENESS LUNCHEONS OR DINNERS PROVIDED FREE OF COST TO THE COMMUNITY WITH BREAST CANCER SURVIVORS. THEY HELD 1 "MAMMS DAY OUT" MAMMOGRAM SCREENING EVENT AND 1 ORAL CANCER SCREENING EVENT IN PARTNERSHIP WITH UK SCHOOL OF DENTISTRY. SINCE 2022, HAZARD HAS ALSO HOSTED SEVERAL SUPPORT GROUPS AND INFORMATIONAL EVENTS COVERING THE TOPICS OF DIABETES PREVENTION AND MANAGEMENT, STROKE AND HEART HEALTH, NUTRITION AND FOOD INSECURITY AT HEALTH FAIRS AND IN LOCAL SCHOOLS. DURING THESE EVENTS 370 VACCINES WERE ADMINISTERED, AND 907 STROKE RISK SCREENINGS AND BLOOD PRESSURE CHECKS WERE COMPLETED.SINCE 2022, MIDDLESBORO ARH HAS EDUCATED OUR COMMUNITY ABOUT PREVENTION BY PROVIDING HEALTH EDUCATION AND DISEASE PREVENTION FOR IN-SCHOOL YOUTH BY HOSTING 6 STUDENT HEALTH FAIR EVENTS, INTRODUCING THE "LOVE YOUR LUNGS" INTERACTIVE EDUCATIONAL PROGRAM, PROVIDED "STOP THE BLEED" KITS AND TRAINING TO MIDDLESBORO HIGH SCHOOL TEACHERS, AND PARTNERED WITH COSMIC CAF, A LOCAL DOWNTOWN BUSINESS, FOR A CHILDREN'S READING PROGRAM. MIDDLESBORO HAS ALSO PROVIDED EDUCATION ABOUT HEALTHY LIFESTYLES AND DISEASE PREVENTION AND PROVIDED FREE OR LOW-COST PREVENTATIVE SCREENING OPPORTUNITIES. OPPORTUNITIES SUCH AS $50 MAMMOGRAM SPECIALS AND SATURDAY LUNG SCREENING EVENTS. MIDDLESBORO PARTNERED WITH KENTUCKY CANCER LINK TO PROVIDE FREE COLON CANCER SCREENING FIT KITS (FECAL IMMUNOCHEMICAL TESTS) TO THOSE QUALIFYING AT THE A "WALK-N-TALK" WITH DR. ROBERT THOMAS. MIDDLESBORO ARH ALSO PROVIDED HUNDREDS OF FREE KINDERGARTEN READINESS PHYSICALS AND FREE SPORTS PHYSICALS FOR ALL AGES EACH YEAR IN THE COMMUNITY.MORGAN COUNTY PARTNERED WITH MANY LOCAL EMPLOYERS TO PROVIDE EDUCATION AND SCREENING OPPORTUNITIES TO THEIR EMPLOYEES. THEY PARTNERED WITH APPHARVEST TO PROVIDE SCREENINGS AND EDUCATION TO THEIR GREENHOUSE FARMING EMPLOYEES THROUGHOUT 2023, INCLUDING SESSIONS ON DIABETES WITH A1C TESTING, HYDRATION, LUNG CANCER, HEART HEALTH, AND COLON CANCER PROVIDED FREE BIOMETRIC SCREENINGS FOR EMPLOYEES OF LICKING VALEY RECC, INCLUDING LAB WORK, BMI, STROKE RISK ASSESSMENTS, AND MORE HOSTED STROKE EDUCATION AND RISK ASSESSMENTS FOR EMPLOYEES OF MORGAN COUNTY WATER DISTRICT. THE FACILITY HOSTED A HEALTH FAIR AND SCREENING EVENT FOR EMPLOYEES OF GATEWAY COMMUNITY ACTION PROGRAM. MORGAN COUNTY HAS ALSO HOSTED SEVERAL SUPPORT GROUPS AND INFORMATIONAL EVENTS COVERING THE TOPICS OF DIABETES PREVENTION AND MANAGEMENT, STROKE AND HEART HEALTH, NUTRITION AND FOOD INSECURITY AT HEALTH FAIRS AND IN LOCAL SCHOOLS. DURING THESE EVENTS, 4 FREE COOKING CLASSES WERE HELD WITH GROCERY GIFT CARD INCENTIVES IN PARTNERSHIP WITH THE MORGAN COUNTY UK EXTENSION SERVICE AND IN COLLABORATION WITH GOD'S PANTRY FOOD BANK TO PROVIDE NONPERISHABLE FOOD BOXES TO PATIENTS IDENTIFIED AS HAVING A NEED IN BOTH THE HOSPITAL AND CLINIC ENVIRONMENT ON AVERAGE 20 BOXES PER MONTH WERE DISTRIBUTED.THROUGHOUT THIS CHNA CYCLE, SUMMERS COUNTY ARH HAS IMPLEMENTED MANY PROGRAMS THAT ENCOURAGE LIFESTYLE CHANGE, HEALTHIER HABITS, AND PREVENTATIVE HEALTH. THEY HAVE PROVIDED 939 STROKE RISK ASSESSMENTS, 4 "BRAIN PROTECTOR" PROGRAM EVENTS, 7 PROGRAMS THAT HAVE CENTERED AROUND HEART HEALTH, 6 COMMUNITY CANCER PREVENTION PRESENTATIONS, AND 2 COMMUNITY DIABETES EDUCATION SESSIONS. THEY HAVE PARTNERED WITH THE SUMMERS COUNTY COMMISSION ON AGING TO HOST MONTHLY EDUCATION SESSIONS ON TOPICS SUCH AS DIABETES, HEART HEALTH, PREVENTATIVE CANCER SCREENINGS, PHYSICAL FITNESS, MENTAL HEALTH, AND NUTRITION. ANNUALLY PARTNERED WITH BOBCAT FITNESS CENTER FOR THE BIGGEST LOSER WEIGHT LOSS CHALLENGE TO ENCOURAGE COMMUNITY MEMBERS TO GET PHYSICALLY ACTIVE AND PROVIDED EMPLOYEES FREE GYM MEMBERSHIPS. SUMMERS ALSO SUPPORTED SPONSORSHIPS WITH REACHH FOR ANNUAL DAM RUN 5K AND AMERICAN HEART ASSOCIATION HEART WALKS.TUG VALLEY ARH HAS EDUCATED THE COMMUNITY ON HEALTHY CHOICES, PREVENTATIVE CARE, AND HEALTHCARE ACCESS AT COMMUNITY EVENTS SUCH AS COLON CANCER AWARENESS DAY IN 2022, IN WHICH STAFF, VISITORS, AND COMMUNITY WERE EDUCATED ON THE IMPORTANCE OF SCREENINGS, WARNING SIGNS, AND CANCER PREVENTION IN PARTNERSHIP WITH KENTUCKY CANCER PROGRAM. LUNG CANCER EDUCATION, VAPING EDUCATION, AND LOW DOSE CT INFORMATION WERE PROVIDED AT THE ANNUAL HILLBILLY DAYS FESTIVAL. FREE HEALTH SCREENINGS AND EDUCATION WERE PROVIDED AT COMMUNITY HEALTH FAIRS SUCH AS THE CHATTAROY CHURCH OF GOD HEALTH FAIR, GEARHEART ENERGY EMPLOYEE HEALTH FAIR, AND SOAR CAREER PATHWAYS FAIR. HOSTED HEART HEALTH DAY AT MINGO COUNTY SCHOOLS, IN WHICH FREE SCREENINGS AND EDUCATION WERE PROVIDED TO FACULTY AND STAFF. AN ARH HEART HEALTH FOOTBALL GAME - TUG VALLEY VS MINGO CENTRAL WAS HELD WHERE ATTENDEES WERE EDUCATED ABOUT HEART DISEASE PREVENTION.
PART V, SECTION B, LINE 11 CONTINUED:	WHITESBURG ARH HAS ADDRESSED FOOD INSECURITY AND THE NEED FOR NUTRITION EDUCATION BY COLLABORATING WITH GOD'S PANTRY FOOD BANK TO PROVIDE NONPERISHABLE FOOD BOXES TO PATIENTS IDENTIFIED AS HAVING A NEED IN BOTH THE HOSPITAL AND CLINIC ENVIRONMENT, DISTRIBUTING ON AVERAGE 20 BOXES PER MONTH. THEY HAVE IMPLEMENTED A FARMER'S MARKET SCREENING PROGRAM IN WHICH SCREENING PARTICIPANTS RECEIVED A $10 VOUCHER TO SPEND FRESH PRODUCE, MEAT, BAKED GOODS, AND DAIRY ITEMS. IMPLEMENTED A 10-WEEK FARMER'S MARKET WALKING PROGRAM IN WHICH COMMUNITY MEMBERS COULD JOIN THE SATURDAY MORNING WALKING GROUP OR COMPLETE ONE MILE ON THEIR OWN TO RECEIVE A $10 VOUCHER REDEEMABLE DURING THE MARKET SEASON. ON AVERAGE, VOUCHERS WOULD BE GIVEN TO 25 PARTICIPANTS EACH SATURDAY. WHITESBURG HAS ALSO HOSTED SEVERAL SUPPORT GROUPS AND INFORMATIONAL EVENTS COVERING THE TOPICS OF DIABETES PREVENTION AND MANAGEMENT, STROKE AND HEART HEALTH, NUTRITION AND FOOD INSECURITY AT HEALTH FAIRS AND IN LOCAL SCHOOLS.SUBSTANCE USE DISORDERBECKLEY LAUNCHED A PEER SUPPORT PROGRAM IN 2022 AND HAS ENGAGED 3,801 PATIENTS AND COMPLETED 47,451 SBIRT SCREENINGS TO DATE. THE PEER RECOVERY COACHES AND COMMUNITY DEVELOPMENT STAFF HAVE HELD SEVERAL COMMUNITY EVENTS SUCH AS "REACH THE STREETS AND "HEALING APPALACHIA". THEY HAVE ALSO COLLABORATED WITH COMMUNITY PARTNERS TO RESUME WEEKLY ALCOHOLICS ANONYMOUS MEETINGS, BEGAN THE "CATCH MY BREATH" YOUTH VAPE PREVENTION PROGRAM, AND HELD 20 COMMUNITY EDUCATIONAL SESSIONS ON THE ADMINISTRATION OF NALOXONE.HARLAN HAS ENGAGED 763 PATIENTS WITH THEIR PEER SUPPORT PROGRAMS SINCE 2022, AND THEIR COACHES HAVE ALSO WORKED WITH COMMUNITY PARTNERS TO HOST COMMUNITY EVENTS FOCUSING ON SUBSTANCE USE DISORDERS AND DRUG PREVENTION.IN 2020, HAZARD ARH LAUNCHED THE PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY. TO DATE, THEY HAVE ENGAGED 2,157 PATIENTS AND HAVE ASSISTED 54 INDIVIDUALS WITH ATTAINING HOUSING OR EMPLOYMENT. PEER RECOVERY COACHES HAVE WORKED WITH COMMUNITY PARTNERS TO HOST MANY COMMUNITY EVENTS OVER THE PAST THREE YEARS AND HAVE DISTRIBUTED NALOXONE TO LOCAL BUSINESSES AND NEIGHBORHOODS.SINCE 2022, MCDOWELL ARH HAS ADDRESSED ADDICTION IN OUR COMMUNITY BY PROVIDING EMPLOYEES FREE ACCESS TO PELAGO SMOKING CESSATION APP AND IN-PERSON CESSATION SUPPORT IN OUR PHARMACIES SPONSORED OPERATION UNITE'S "SHOOT HOOPS, NOT DRUGS" PROGRAM, WHICH PROMOTES POSITIVE ACTIVITIES FOR LOCAL YOUTH WHILE PROVIDING EDUCATION ON DRUG PREVENTION COMMUNITY DEVELOPMENT CONDUCTED ANTI-VAPING PRESENTATIONS AT FLOYD CENTRAL HIGH SCHOOL AND THE FLOYD COUNTY BOARD OF EDUCATION PARTICIPATED IN MANY COMMUNITY COALITIONS THAT ADDRESS SUD IN OUR COMMUNITY, INCLUDING COMMUNITIES AGAINST DRUG ADDICTION, UK HEALING COMMUNITIES IMITATIVE, AND ASAP/UNITE COALITION.MORGAN COUNTY ARH HAS ADDRESSED ADDICTION IN OUR COMMUNITY BY PARTNERING WITH THE KY DEPARTMENT OF PUBLIC HEALTH TO HOST NUMEROUS "SAFE A LIFE ROADSHOW" EVENTS, IN WHICH PARTICIPANTS ARE PROVIDED WITH OVERDOSE AWARENESS EDUCATION, NARCAN TRAINING AND DISTRIBUTION, AND REFERRALS TO TREATMENT. SPONSORED OPERATION UNITE'S "SHOOT HOOPS, NOT DRUGS" PROGRAM, WHICH PROMOTES POSITIVE ACTIVITIES FOR LOCAL YOUTH WHILE PROVIDING EDUCATION ON DRUG PREVENTION AND BEGAN THE "LOVE YOUR LUNGS", AN EDUCATIONAL PROGRAM ON THE DANGERS OF SMOKING AND VAPING, AT MORGAN COUNTY MIDDLE SCHOOL.SINCE 2022, WHITESBURG ARH HAS LAUNCHED THE PEER SUPPORT PROGRAM, EMPLOYING CERTIFIED PEER SUPPORT COACHES TO WORK IN OUR EMERGENCY DEPARTMENT AND THROUGHOUT THE COMMUNITY. TO DATE, THEY HAVE ENGAGED 406 PATIENTS. PEER RECOVERY COACHES HAVE WORKED WITH COMMUNITY PARTNERS TO HOST MANY SUBSTANCE USE DISORDER OR DRUG PREVENTION COMMUNITY EVENTS OVER THE PAST THREE YEARS. ARH PEER SUPPORT COACHES AND COMMUNITY DEVELOPMENT STAFF ALSO SERVE ON MANY COALITIONS, BOARDS, AND COUNCILS THAT WORK TO CREATE DRUG-FREE COMMUNITIES. THESE INCLUDE OPERATION UNITE COALITION, AGENCIES FOR SUBSTANCE ABUSE PREVENTION, HEAL COMMITTEE, AND SITUATION TABLE.AGING IN PLACE AND OTHER SENIOR-ORIENTED SERVICESHARLAN HAS ADDRESSED THIS CONCERN BY CONDUCTING A SURVEY IN PARTNERSHIP WITH THE HARLAN COUNTY COMMITTEE ON AGING TO GAUGE THE LEVEL OF INTEREST IN A VARIETY OF HEALTH TOPICS. THE RESULTS OF THE SURVEY WERE USED BY ARH TO SCHEDULE A MONTHLY ROTATION OF EDUCATIONAL PROGRAMS AT THEIR MAIN CONGREGATE CENTER IN HARLAN. FREE HEALTH SCREENINGS AND HEALTH FAIRS WERE ALSO PROVIDED WITH TRANSPORTATION BEING PROVIDED TO CLIENTS WHO ARE UNABLE TO DRIVE THEMSELVES.BUILD AND EXPAND CAPACITY OF HEALTH CONSORTIUMSINCE 2022, MCDOWELL ARH HAS INCREASED COMMUNITY, PROVIDER, AND PARTNER KNOWLEDGE OF SERVICES AVAILABLE BY CREATING SERVICE FLYERS THAT INCLUDE ALL MCDOWELL ARH CLINICS, SPECIALTIES, AND PROVIDERS. UPDATED THE OVERALL ARH WEBSITE WITH A NEW KYRUUS SYSTEM THAT ALLOWS FOR MORE ACCURACY AND DEEPER SEARCH WHEN RESEARCHING PROVIDERS AND LOCATIONS. INCREASED PRESENCE BY CONTRACTING 14 BILLBOARDS IN FLOYD COUNTY AND 3 IN THE IMMEDIATE COMMUNITY OF MCDOWELL. ON SOCIAL MEDIA, POSTED AT LEAST 1X PER WEEK ABOUT SERVICES AVAILABLE IN THE BIG SANDY REGION AND AT LEAST 2X A WEEK ABOUT HEALTH EDUCATION TOPICS (URGING ROUTINE HEALTHCARE, DISEASE PREVALENCE, ETC.). ADDED LARGE INFORMATIONAL MONITORS TO OUR CLINICS AND IN THE HOSPITAL'S MAIN LOBBY THAT PLAY ARH SERVICE COMMERCIALS AND VIDEOS ONLY. ORGANIZED 17 PROVIDER VISITS TO MCDOWELL FROM OTHER SERVICE REGIONS (VISITS COORDINATED BY PHYSICIAN LIAISONS TO INCREASE PROVIDER KNOWLEDGE) IN WHICH THE PHYSICIAN LIAISON MADE VISITS TO MCDOWELL PROVIDERS 3 TIMES PER MONTH.TUG VALLEY ARH HAS ADDRESSED COMMUNICATION BY ACTIVELY PARTICIPATING IN 10 COUNCILS, COALITIONS, AND BOARDS IN PIKE AND MINGO COUNTIES SINCE 2022. THESE GROUPS WORK TO BETTER THE HEALTH AND WELLNESS OF APPALACHIANS BUT MAY ALSO HAVE COMMUNITY BETTERMENT AND ECONOMIC DEVELOPMENT GOALS. SIMILAR TO THE OTHER FACILITIES IN THE ARH COMPANY, IN AN EFFORT TO INCREASE PROVIDER AND COMMUNITY KNOWLEDGE OF SERVICES AVAILABLE, TUG VALLEY ARH HAS CREATED SERVICE FLYERS THAT INCLUDE ALL TUG VALLEY ARH CLINICS, SPECIALTIES, AND PROVIDERS. THEY HAVE UPDATED THE OVERALL ARH WEBSITE WITH A NEW KYRUUS SYSTEM THAT ALLOWS FOR MORE ACCURACY AND DEEPER SEARCH WHEN RESEARCHING PROVIDERS AND LOCATIONS ON SOCIAL MEDIA, POSTED AT LEAST 1X PER WEEK ABOUT SERVICES AVAILABLE IN THE BIG SANDY REGION AND AT LEAST 2X A WEEK ABOUT HEALTH EDUCATION TOPICS (URGING ROUTINE HEALTHCARE, DISEASE PREVALENCE, ETC.). ADDED LARGE INFORMATIONAL MONITORS TO OUR CLINICS AND IN THE HOSPITAL'S MAIN LOBBY THAT PLAY ARH SERVICE COMMERCIALS AND VIDEOS ONLY. PHYSICIAN LIAISON MADE VISITS TO TUG VALLEY PROVIDERS 3 TIMES PER MONTH.BETTER ACCESS TO CARESINCE 2022, MCDOWELL ARH HAS INCREASED ACCESS TO CARE BY RECRUITING TWO ADDITIONAL PRIMARY CARE PROVIDERS: KIM MOSELY, DO, AND APRIL PRATER, APRN. EXTENDED HOURS OF THE AFTER-HOURS CLINIC FROM 8AM-8PM SEVEN DAYS PER WEEK. BECAME ACCREDITED AS AN ACUTE STROKE READY HOSPITAL AND INCREASED CAPACITY AND VOLUME OF THE SWING BED PROGRAM, KEEPING PATIENTS CLOSER TO HOME FOR LONGER-TERM CARE.SINCE 2022, MIDDLESBORO ARH HAS INCREASED ACCESS TO HEALTHCARE IN OUR COMMUNITY BY RECRUITING PROVIDERS, OPENING NEW SPECIALTY CLINICS, INVESTING IN FACILITIES, AND IMPROVING SERVICES. PROJECTS COMPLETED IN THIS TIME FRAME INCLUDE THE DEVELOPMENT OF PRE-ADMISSION TESTING PROGRAM TO DECREASE SURGERY NO-SHOW RATE AND PATIENT TRAVEL, OPENING OF A NEW UROLOGY SERVICE LINE IN 2022 IN PARTNERSHIP WITH DR. JOE PAZONA (VIRTUCARE) AND BRANDON WILIAMS, APRN, OFFERING BOTH TELEHEALTH AND IN-PERSON VISITS, THE OPENING OF A SPECIALTY PHARMACY, PROVIDING EASIER ACCESS FOR PATIENTS IN NEED OF SPECIALTY MEDICATIONS, SERVICES, AND COST REDUCTION PROGRAMS. MIDDLESBORO ALSO OPENED A NEW ARH WOUND CARE CENTER IN THE FACILITY, WHICH INCLUDES HYPERBARIC THERAPY IN MAY 2024. THEY IMPLEMENTED MINIMALLY INVASIVE ROBOTIC SURGERY WITH A NEW DAVINCI ROBOT. SIX PROVIDERS HAVE BEEN TRAINED ON ROBOTIC SURGERY, AND SINCE INCEPTION IN APRIL 2024 AND THROUGH FEBRUARY 2025, 156 CASES HAVE BEEN SUCCESSFULLY PERFORMED SINCE THE INCEPTION OF THIS PROGRAM. HOSTED NURSE TRAININGS IN TRAUMA AND PEDIATRIC EMERGENCIES FOR ALL ER STAFF IN AN EFFORT TO BECOME PEDIATRIC EMERGENCY READY. THEY IMPLEMENTED "QUICK DRAW" LABORATORY SITES, OR OFFSITE LABORATORY PHLEBOTOMY STATIONS PRIMARILY LOCATED IN PHYSICIAN OFFICES, SO PATIENTS CAN RECEIVE LAB DRAWS AND OTHER TESTING SERVICES WITHOUT HAVING TO TRAVEL TO A HOSPITAL FACILITY. ADDITIONALLY, THEY HAVE CONTRACTED WITH THE CUMBERLAND RIVER RHOAR CENTER (A 100- BED WOMEN'S INPATIENT DRUG TREATMENT PROGRAM) TO PROVIDE WELL WOMEN CARE ALONG WITH MOUD THERAPY.
PART V, SECTION B, LINE 11 CONTINUED:	SUMMERS COUNTY ARH HAS IMPROVED ACCESS TO HEALTHCARE BY ADDING ONE PRIMARY CARE PHYSICIAN. THEY HAVE ADDED ORTHOPEDIC SERVICES AND INCREASED MENTAL HEALTH SERVICES AVAILABLE THROUGH TELEPSYCHIATRY. SUMMERS OPENED A SENIOR CARE PROGRAM TO PROVIDE OLDER ADULTS WITH QUALITY BEHAVIORAL HEALTHCARE AND EXTENDED PRIMARY CARE CLINIC HOURS. THEY HAVE BOASTED A RETENTION RATE OF 98%, BUILDING A COMMUNITY OF TRUST BY RETAINING PROVIDERS AND EMPLOYEES.TUG VALLEY ARH HAS PROMOTED ACCESS TO CARE BY RECRUITING MANY NEW PROVIDERS SINCE 2022 IN AN EFFORT TO INCREASE ACCESS TO CARE FOR OUR PATIENTS. IN AN EFFORT TO DECREASE TRAVEL FOR PATIENTS IN NEED OF TESTING OR SPECIALTY SERVICES, TUG VALLEY ARH HAS ADDED: AN ENDOFLIP IMPEDANCE PLANIMETRY SYSTEM (TESTING FOR GASTRIC MOTILITY AND ACIDITY), SITE-RITE ULTRASOUND SYSTEM (ALLOWING FOR PICC LINE INSERTIONS), WOUND CARE/HYPERBARIC CHAMBER, DIGITAL 3D MAMMOGRAM, PFT MACHINE, MOBILE PET SERVICES, AND NEW TESTING FOR HEP C, GGT, PROCAL. THEY HAVE UPDATED THEIR LAB ANALYZERS FOR QUICKER LAB TURNAROUND TIMES FOR COVID/FLU/RSV AND ADDED MYCOPLASMA PNEUMONIA TESTING. OTHER EFFORTS TO INCREASE ACCESS TO CARE INCLUDE PROVIDING PATIENT TRANSPORTATION ASSISTANCE AND EXTENDED HOURS FOR OUR AFTER-HOURS CLINICS.WHITESBURG ARH HAS IMPROVED ACCESS TO CARE IN OUR COMMUNITY BY ADDING NEW SERVICES SINCE 2022: 3D MAMMOGRAPHY, NEW NUCLEAR SCANNER, UPGRADED THEIR CT UNIT WITH MORE TEST CAPABILITY. THEY ADDED PAIN MANAGEMENT PROGRAM WITH PAIN MANAGEMENT NP, IMPLEMENTED SWING BEDS PROGRAM FOR PATIENTS THAT NEED EXTENDED RECOVERY TIME, AND ADDED ADDITIONAL SPEECH LANGUAGE PATHOLOGIST AND OCCUPATIONAL THERAPIST. THEY HAVE EXPANDED SURGERY OFFERING TO INCLUDE PODIATRY AND HAVE EXPANDED DAYS FOR CATARACT SURGERY. WHITESBURG ARH HAS ALSO EARNED ACUTE STROKE READY CENTER CERTIFICATION AS OF FEB 2022.

Schedule H (Form 990) 2024

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?76
Name and address		Type of Facility (describe)
1	1 - HARLAN ARH HOSPITAL PSYCHIATRIC SERVICE 81 BALL PARK ROAD HARLAN,KY40831	PSYCH
2	2 - ARH PSYCHIATRIC CENTER-HAZARD 102 MEDICAL CENTER DRIVE HAZARD,KY41701	PSYCH
3	3 - ARH HAZARD FAMILY HEALTH SERVICES 200 MEDICAL CENTER DRIVE HAZARD,KY417019466	CLINIC
4	4 - ARH DANIEL BOONE CLINIC - HARLAN 37 BALL PARK ROAD HARLAN,KY408311701	RURAL HEALTH CLINIC
5	5 - ARH WHITESBURG SURGICAL CLINIC 214 HOSPITAL ROAD STE A WHITESBURG,KY418587627	CLINIC
6	6 - ARH TUG VALLEY MEDICAL ASSOCIATES 306 HOSPITAL DRIVE SOUTH WILLIAMSON,KY415034095	RURAL HEALTH CLINIC
7	7 - ARH MIDDLESBORO INTERNAL MEDICINE 3004 CUMBERLAND AVE SUITE 3 MIDDLESBORO,KY409652343	CLINIC
8	8 - ARH WHITESBURG CLINIC 214 HOSPITAL ROAD WHITESBURG,KY418587627	RURAL HEALTH CLINIC
9	9 - HAZARD ARH REGIONAL MEDICAL CENTER CLINI 200 MEDICAL CENTER DRIVE HAZARD,KY41701	PHARMACY
10	10 - HARLAN ARH OUTPATIENT PHARMACY 37 BALL PARK ROAD HARLAN,KY40831	PHARMACY
11	11 - HAZARD ARH HOME HEALTH AGENCY 100 AIRPORT GARDENS ROAD HAZARD,KY41701	HOME HEALTH
12	12 - ARH COMMUNITY PHARMACY 210 BLACK GOLD BLVD SUITE 104 HAZARD,KY41701	PHARMACY
13	13 - ARH HAZARD HOMECARE STORE 200 MEDICAL CENTER DRIVE HAZARD,KY41701	HOME HEALTH CARE
14	14 - ARH WILLIAMSON HOMECARE STORE 140 HOSPITAL DRIVE SOUTH WILLIAMSON,KY41503	HOME HEALTH CARE
15	15 - ARH HARLAN HOMECARE STORE 106 RAILROAD STREET SUITE 5 HARLAN,KY40831	HOME HEALTH CARE
16	16 - ARH PRESCRIPTION DIVISION 306 HOSPITAL DRIVE SUITE 105 SOUTH WILLIAMSON,KY41503	PHARMACY
17	17 - WHITESBURG ARH HOME HEALTH AGENCY 240 HOSPITAL ROAD WHITESBURG,KY41858	HOME HEALTH
18	18 - BECKLEY ARH HOME HEALTH AGENCY 306 STANAFORD ROAD BECKLEY,WV25801	HOME HEALTH
19	19 - MORGAN COUNTY ARH HOME HEALTH AGENCY 518 MAIN STREET STE 1 WEST LIBERTY,KY41472	HOME HEALTH
20	20 - ARH WOMEN'S AND FAMILY HEALTH CARE - TUG 26901 US HIGHWAY 119N BELFRY,KY415147520	PRIMARY CARE CLINIC
21	21 - ARH TRI-CITY MEDICAL CENTER 18880 NORTH US 119 CUMBERLAND,KY408238106	RURAL HEALTH CLINIC
22	22 - BECKLEY ARH PHARMACY 250 STANAFORD ROAD BECKLEY,WV25801	PHARMACY
23	23 - HARLAN ARH HOME HEALTH AGENCY 81 BALL PARK ROAD HARLAN,KY40831	HOME HEALTH
24	24 - ARH SUMMERS COUNTY RURAL HEALTH CLINIC 115 SUMMERS HOSPITAL ROAD HINTON,WV25951	RURAL HEALTH CLINIC
25	25 - ARH BECKLEY HOMECARE STORE 260 STANAFORD ROAD BECKLEY,WV25801	HOME HEALTH CARE
26	26 - ARH FAMILY HEALTH PHARMACY 1084 HWY 7 STE 3 WEST LIBERTY,KY41472	PHARMACY
27	27 - PIKEVILLE BRANCH-ARH PIKE CO HOME HEALTH 247 SOUTH MAYO TRAIL PIKEVILLE,KY41502	HOME HEALTH
28	28 - ARH MCDOWELL PROFESSIONAL CLINIC 9879 KY RT 122 MCDOWELL,KY416476042	RURAL HEALTH CLINIC
29	29 - WHITESBURG ARH PHARMACY 240 HOSPITAL ROAD WHITESBURG,KY41858	PHARMACY
30	30 - MIDDLESBORO ARH PHARMACY 3600 WEST CUMBERLAND AVENUE MIDDLESBORO,KY40965	PHARMACY
31	31 - MIDDLESBORO ARH HOME HEALTH AGENCY 1916 CUMBERLAND AVENUE MIDDLESBORO,KY40965	HOME HEALTH
32	32 - ARH MIDDLESBORO HOMECARE STORE 1916 CUMBERLAND AVENUE MIDDLESBORO,KY40965	HOME HEALTH CARE
33	33 - ARH SPECIALITY PHARMACY 200 MEDICAL CENTER DR HAZARD,KY41701	PHARMACY
34	34 - ARH FAMILY CARE WAYLAND 2662 KING KELLY COLEMAN HWY WAYLAND,KY416669998	PRIMARY CARE CLINIC
35	35 - ARH FAMILY CARE - WHEELWRIGHT 30 KY RT 306 BYPRO,KY416129706	PRIMARY CARE CLINIC
36	36 - JENKINS ARH FAMILY CARE 9480 HIGHWAY 805 JENKINS,KY415378182	PRIMARY CARE CLINIC
37	37 - ARH BARIATRIC CENTER 210 BLACK GOLD BOULEVARD SUITE 102 HAZARD,KY417012620	CLINIC
38	38 - ARH SYSTEM CENTER-HAZARD 100 AIRPORT GARDENS ROAD HAZARD,KY41701	SUPPORT
39	39 - ARH SYSTEM CENTER-LEXINGTON 2260 EXECUTIVE DR LEXINGTON,KY40505	SUPPORT
40	40 - ARH SYSTEM CENTER-LEXINGTON JORDAN BUIL 1218 SOUTH BROADWAY LEXINGTON,KY40504	SUPPORT
41	41 - ARH SYSTEM CENTER-SOUTH WILLIAMSON 260 HOSPITAL DRIVE SOUTH WILLIAMSON,KY41503	SUPPORT
42	42 - ARH REGIONAL DISTRIBUTION CENTER 26901 US HIGHWAY 119N BELFRY,KY41514	SUPPORT
43	43 - DME WAREHOUSE 26901 US HIGHWAY 119N BELFRY,KY41514	SUPPORT
44	44 - ARH SOUTHERN WEST VIRGINIA CLINIC 250 STANAFORD ROAD BECKLEY,WV258013140	CLINIC
45	45 - MIDDLESBORO ARH PHYSICIAN CLINIC 3602 WEST CUMBERLAND AVE MIDDLESBORO,KY409652614	CLINIC
46	46 - ARH WOMEN'S AND FAMILY HEALTH CARE - MID 2004 W CUMBERLAND AVE MIDDLESBORO,KY409652614	CLINIC
47	47 - ARH CARDIOLOGY & ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 1J HAZARD,KY417019477	CLINIC
48	48 - ARH DERMATOLOGY 210 BLACK GOLD BLVD SUITE 211 HAZARD,KY41701	CLINIC
49	49 - ARH CARDIOLOGY ASSOCIATES - BECKLEY 1256 N EISENHOWER DR BECKLEY,WV258013120	CLINIC
50	50 - BECKLEY ARH PRIMARY CARE 250 STANFORD ROAD STE 104 BECKLEY,WV258013140	CLINIC
51	51 - ARH SPECIALTY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 100 SOUTH WILLIAMSON,KY415034095	CLINIC
52	52 - ARH SPECIALTY ASSOCIATES - WHITESBURG 214 HOSPITAL DR STE B WHITESBURG,KY418587627	CLINIC
53	53 - ARH CARDIOLOGY ASSOCIATES - WHITESBURG 226 MEDICAL PLAZA LN STE C WHITESBURG,KY418587425	CLINIC
54	54 - ARH CARDIOLOGY ASSOCIATES - TUG VALLEY 306 HOSPITAL DR STE 203 SOUTH WILLIAMSON,KY415034095	CLINIC
55	55 - ARH DERMATOLOGY MIDDLESBORO 2145 US HIGHWAY 25E MIDDLESBORO,KY409651874	CLINIC
56	56 - ARH OAK HILL PRIMARY CARE CENTER 223 MAPLE AVE OAK HILL,WV259013475	CLINIC
57	57 - ARH SPECIALTY ASSOCIATES - HAZARD 200 MEDICAL CENTER DR STE 2M HAZARD,KY417019422	CLINIC
58	58 - ARH PENNINGTON GAP CLINIC 121 STACY DR PENNINGTON GAP,VA242779998	CLINIC
59	59 - BECKLEY ARH MEDICAL MALL 1256 N EISENHOWER DR BECKLEY,WV258013120	CLINIC
60	60 - SUMMERS CO ARH FAMILY CARE CLINIC 197 PLEASANT ST HINTON,WV259512540	CLINIC
61	61 - MIDDLESBORO ARH HEMATOLOGYONCOLOGY CLIN 3602 W CUMBERLAND AVE STE 104 MIDDLESBORO,KY409652614	CLINIC
62	62 - MORGAN COUNTY ARH FAMILY HEALTH 1084 HWY 7 STE 2 WEST LIBERTY,KY414727146	CLINIC
63	63 - ARH PRIMARY CARE - BECKLEY 250 STANAFORD ROAD BECKLEY,WV25801	CLINIC
64	64 - ARH BECKLEY GASTROENTEROLOGY 429 CARRIAGE DRIVE BECKLEY,WV25801	CLINIC
65	65 - ARH BECKLEY ONCOLOGY 250 STANAFORD ROAD BECKLEY,WV25801	CLINIC
66	66 - ARH HAZARD FAMILY CLINIC 181 ROY CAMPBELL DRIVE HAZARD,KY41701	CLINIC
67	67 - HAZARD MEDICAL MALL 210 BLACK GOLD BLVD STE 102 HAZARD,KY41701	MEDSPA
68	68 - ARH BECKLEY REJUVENATION CENTER 1256 N EISENHOWER DRIVE BECKLEY,WV25801	MEDSPA
69	69 - ARH MIDDLESBORO REJUVENATION CENTER 2145 HWY 25E MIDDLESBORO,KY40965	MEDSPA
70	70 - ARH HAZARD PHARMACY 181 ROY CAMPBELL DRIVE HAZARD,KY41701	PHARMACY
71	71 - ARH RETAIL PHARMACY 4845 KY RTE 321 PRESTONSBURG,KY41653	PHARMACY
72	72 - ARH MEDICAL & SPECIALTY ASSOCIATES - PRE 4851 KY ROUTE 321 PRESTONSBURG,KY41653	CLINIC
73	73 - ARH MED & SPEC ASSOC HAZARD 200 MEDICAL CENTER DRIVE HAZARD,KY41701	CLINIC
74	74 - ARH MED MALL FAMILY SPEC CLIN 210 BLACK GOLD BLVD HAZARD,KY41701	CLINIC
75	75 - ARH INTERVENTIONAL PAIN MGMT HEADACHE 200 MEDICAL CENTER DRIVE HAZARD,KY41701	CLINIC
76	76 - ARH MEDICAL & SPECIALTY ASSOCIATES - PRE 4851 KY RT 321 SUITES 101 AND 102 PRESTONBURG,KY41653	CLINIC

Schedule H (Form 990) 2024

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
PART I, LINE 3C:	THE DISCOUNTS ARE BASED ON A SLIDING FEE SCHEDULE STARTING AT 100% OF FPG QUALIFYING FOR FREE CARE, RANGING UP TO UNLIMITED INCOME LEVELS FOR A 40% DISCOUNT ON ALL UNINSURED CARE PROVIDED.
PART I, LINE 6A:	A COMBINED ANNUAL COMMUNITY BENEFIT REPORT WAS FILED FOR ALL FACILITIES WITHIN THE APPALACHIAN REGIONAL HEALTHCARE SYSTEM; FILED BY APPALACHIAN REGIONAL HEALTHCARE, INC. (EIN: 52-0795508), THE PARENT ORGANIZATION.
PART I, LINE 7:	THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2.
PART II, COMMUNITY BUILDING ACTIVITIES:	JUST AS IT HAS FOR THE PAST SEVEN DECADES, APPALACHIAN REGIONAL HEALTHCARE (ARH) REMAINED COMMITTED TO ITS MISSION TO PROVIDE THE PEOPLE OF CENTRAL APPALACHIA WITH THE HIGHEST QUALITY OF CARE IN 2025. WITH 14 HOSPITALS AS WELL CLINICS, HOME HEALTH AGENCIES, HOME MEDICAL EQUIPMENT STORES, PHARMACIES AND REHABILITATION SERVICES SPREAD ACROSS BOTH KENTUCKY AND WEST VIRGINIA, ARH AND ITS MORE THAN 6,000 EMPLOYEES AND 1,300 MEDICAL PROVIDERS IS ESSENTIAL TO THE LIVES OF THOSE WHO RESIDE IN CENTRAL APPALACHIA. ARH'S COMMITMENT TO EXCELLENCE WAS RECOGNIZED THROUGHOUT THE 2025 FISCAL YEAR WITH A VARIETY OF HONORS AND CERTIFICATIONS. THE ARH SYSTEM WAS NAMED TO FORBES' LIST OF AMERICA'S BEST-IN-STATE EMPLOYERS, SUMMERS COUNTY ARH, BARBOURVILLE ARH, MARY BRECKINRIDGE ARH, MCDOWELL ARH, AND TUG VALLEY ARH REGIONAL MEDICAL CENTER WERE ALL RECOGNIZED AS ACUTE STROKE READY CENTERS. WITH THOSE CERTIFICATIONS BESTOWED BY DNV, EACH OF ARH'S 14 HOSPITALS WERE OFFICIALLY STROKE CERTIFIED. BECKLEY AND SUMMERS COUNTY ARH RECEIVED SILVER HONORS FROM THE WEST VIRGINIA HOSPITAL ASSOCIATION AND SUMMERS COUNTY ARH RECEIVED THE WVHA GOVERNOR'S AWARD FOR OUTSTANDING SUPPORT OF TISSUE AND CORNEA DONATION. THREE ARH BIRTHING HOSPITALS: HAZARD ARH, HIGHLANDS ARH AND WHITESBURG ARH, RECEIVED THE KENTUCKY PERINATAL QUALITY COLLABORATIVE (KYPQC) AWARD FOR THE SECOND CONSECUTIVE YEAR. TWELVE ARH HOSPITALS WERE HONORED WITH AMERICAN HEART ASSOCIATION GET WITH THE GUIDELINES AWARDS FOR THEIR COMMITMENT TO THE TREATMENT OF STROKE. THE ARH SYSTEM'S HARD WORK ON THE TECHNICAL FRONT WAS AGAIN RECOGNIZED AS IT ACHIEVED A LEVEL 8 RANKING IN CHIME'S MOST WIRED HEALTH SYSTEMS FOR BOTH AMBULATORY AND ACUTE CARE FOR THE FIFTH CONSECUTIVE YEAR.ARH REMAINED COMMITTED TO WHOLE-PERSON HEALTHCARE IN 2025 FOCUSING NOT ONLY ON PROVIDING HIGH-QUALITY TRADITIONAL MEDICAL CARE, BUT ALSO MENTAL HEALTH CARE AND PREVENTATIVE CARE THROUGH SCREENINGS, VACCINATIONS, AND HEALTH EDUCATION. CENTRAL APPALACHIA IS A REGION RIDDLED WITH RESIDENTS BATTLING SUBSTANCE USE DISORDER. ARH RECOGNIZES ITS ROLE IN HELPING FIGHT THE DISEASE AND HAS PLACED PEER RECOVERY COACHES IN EACH HOSPITAL AS PART OF ITS REVERSE THE CYCLE PROGRAM. THOSE "PEERS," AS THEY ARE COMMONLY CALLED, MEET ER PATIENTS WHO SCREEN POSITIVE FOR RISKY ALCOHOL AND DRUG USE AND SHARE THEIR OWN STORIES OF SUBSTANCE USE AND RECOVERY, WHILE ALSO PROVIDING RESOURCES NEEDED TO HELP THEM AS THEY EMBARK ON THEIR RECOVERY JOURNEYS. THOSE EFFORTS WERE RECOGNIZED IN 2025 AS ARH WAS NAMED ONE OF THREE NATIONAL RECIPIENTS OF THE MOSAIC GROUP'S BEACON OF HOPE TRAILBLAZER AWARD.THE SYSTEM DEEPLY INVESTED IN THE FOOD IS MEDICINE (FIM) INITIATIVE, PARTNERING WITH BOTH THE KENTUCKY AND WEST VIRGINIA DEPARTMENTS OF AGRICULTURE. THROUGH THE PARTNERSHIPS, ARH IS WORKING WITH LEADERS IN BOTH STATES TO HELP GROW THE PROGRAM DESIGNED TO HELP THOSE IN CENTRAL APPALACHIA CHANGE THEIR HEALTH THROUGH NUTRITION. POSITIVE HEALTH CHANGES IN THOSE ARH SERVES IS THE ULTIMATE GOAL OF EVERY SERVICE THE SYSTEM PROVIDES, AND ITS EFFORTS WITH FIM WERE RECOGNIZED AS IT RECEIVED THE 2025 SHAPING OUR APPALACHIAN REGION (SOAR) HEALTH COMMUNITIES AWARD. ARH REMAINED DEEPLY COMMITTED TO HELPING ALLEVIATE FOOD INSECURITY IN 2025. THROUGH DELIVERIES OF FOOD BOXES TO PARTNERSHIPS WITH THE ORGANIZATIONS SUCH AS GOD'S PANTRY, ARH AND ITS COMMUNITY DEVELOPMENT TEAM CONTINUED ITS MISSION TO PROVIDE FOOD TO THOSE IN NEED. ARH SUPPORTED GOD'S PANTRY'S TELETHON FOR HUNGER ACTION MONTH BY PRESENTING A $100,000 MATCHING DONATION. THE DONATION WAS PART OF THE SYSTEM'S $200,000 SPONSORSHIP OF THE GOD'S PANTRY RESCUE PROGRAM. THE PARTNERSHIP PROVIDES TWO ARH AND GOD'S PANTRY CO-BRANDED VANS THAT TRAVEL TO AREA RETAILERS TO COLLECT EXCESS FOOD FOR DISTRIBUTION TO THOSE IN NEED.ARH WAS AWARDED A $500,000 PLANNING GRANT FROM THE APPALACHIAN REGIONAL COMMISSION'S (ARC) ARISE INITIATIVE. THE FUNDING IS PART OF A LARGER $33.5 MILLION PACKAGE ANNOUNCED BY ARC FEDERAL CO-CHAIR GAYLE MANCHIN IN NOVEMBER. ARISE (APPALACHIAN REGIONAL INITIATIVE FOR STRONGER ECONOMIES) WAS ESTABLISHED TO DRIVE LARGE-SCALE, REGIONAL ECONOMIC TRANSFORMATION THROUGH COLLABORATIVE PROJECTS. ARH WILL USE ARISE FUNDING TO ESTABLISH A HEALTHIER CENTRAL APPALACHIA TASK FORCE (HCAT) IN COLLABORATION WITH 15 PARTNERS IN KENTUCKY, TENNESSEE, VIRGINIA, AND WEST VIRGINIA. THE GRANT PROVIDES FUNDING FOR A COMMUNITY SCREEN TEAM THAT WILL PROVIDE CARE THROUGHOUT A 29-COUNTY AREA.THE ARH MOBILE CLINIC, DESIGNED TO EXPAND MEDICAL CARE TO THOSE WHO MIGHT STRUGGLE WITH TRAVELING TO A CLINIC OR DOCTOR'S OFFICE, WAS LAUNCHED IN 2025. THE UNIT, MADE POSSIBLE BY A $400,000 GRANT FROM THE APPALACHIAN REGIONAL COMMISSION (ARC), PROVIDES PRIMARY CARE, HEALTH SCREENINGS, PHYSICAL EXAMS, CHRONIC DISEASE MANAGEMENT AND EDUCATION IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA. ADDITIONALLY, A PARTNERSHIP WITH THE MARTIN HEALTH DEPARTMENT WILL ALLOW THE CLINIC TO PARK ON ITS CAMPUS ONE DAY EVERY MONTH AS AN ARH PROVIDER OFFERS WOMEN'S HEALTH SERVICES. A VARIETY OF EDUCATIONAL AND SCREENING EVENTS TOOK PLACE ACROSS THE SYSTEM THROUGHOUT FY2025. EACH YEAR, ARH'S COMMUNITY DEVELOPMENT DEPARTMENT AND STAFF AT EACH FACILITY, EDUCATE HUNDREDS OF WOMEN AND MEN ABOUT BREAST CANCER AND EARLY DETECTION, WHILE ALSO PROMOTING THE SYSTEM'S ANNUAL OCTOBER $50 MAMMOGRAM SPECIAL. ADDITIONALLY, EVENTS FEATURING LUNCH AND DINNER AS WELL AS CANCER EDUCATION AND SURVIVOR STORIES TOOK PLACE IN BOTH BECKLEY AND HAZARD. BREAST CANCER/PHYSICAL ACTIVITIES TOOK PLACE IN PRESTONSBURG, BARBOURVILLE AND BELL COUNTY, AND BREAST CANCER AWARENESS LUNCHEONS FOR TEACHERS TOOK PLACE AT TWO KENTUCKY ELEMENTARY SCHOOLS. ARH CONTINUED TO PROVIDE MONTHLY STROKE AND DIABETES SUPPORT GROUP THROUGHOUT THE SYSTEM AND THE COMMUNITY DEVELOPMENT TEAM STAYED ACTIVE IN THE PUBLIC, ATTENDING AND ORGANIZING HEALTH FAIRS, HOSTING WEEKLY AND MONTHLY EDUCATION EVENTS AT SENIOR CENTERS AND OTHER PUBLIC FORUMS, AND VISITING LOCAL SCHOOLS TO EDUCATE STUDENTS ON TOPICS RANGING FROM STROKE AWARENESS TO HANDS-ONLY CPR, BRAIN DISEASE AND THE IMPORTANCE OF ABSTAINING FROM NICOTINE AND ALCOHOL USE. TO HELP NOT ONLY THOSE DIAGNOSED WITH DEMENTIA BUT THEIR FAMILIES WHO ARE OFTEN THEIR DAILY CAREGIVERS, ARH LAUNCHED ITS MEMORY CARE PROGRAM IN 2025. THE PROGRAM, WHICH IS PART OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) NEW GUIDE (GUIDING AN IMPROVED DEMENTIA EXPERIENCE) MODEL, PROVIDES A DEDICATED CARE TEAM AND NURSE TO DEMENTIA PATIENTS AND THEIR FAMILIES. BECAUSE CAREGIVERS ARE OFTEN SOCIALLY ISOLATED AND ARE AT A HIGHER RISK FOR DEVELOPING THEIR OWN HEALTH ISSUES, THE PROGRAM PROVIDES THEM WITH EDUCATIONAL SUPPORT AS WELL AS RESPITE SERVICES.CONTINUED INVESTMENTS WERE MADE ACROSS THE SYSTEM INCLUDING ADDITIONAL DAVINCI ROBOTS AND THE IMPLANTATION OF AN ION ROBOT FOR RECOGNITION OF EARLY LUNG DISEASE, AS WELL AS THE RETURN OF A CARDIOTHORACIC PROGRAM AT HAZARD ARH. BECKLEY ARH BECAME THE FIRST HOSPITAL IN THE SYSTEM TO OFFER AN MRI CARING SUITE, PROVIDING A RELAXING ENVIRONMENT USEFUL TO THOSE WHO EXPERIENCE TEST ANXIETY. EMPLOYEE HEALTH WAS ALSO AT THE FOREFRONT, AS SEVERAL HOSPITALS THROUGHOUT THE SYSTEM OPENED RELAXATION ROOMS TO PROVIDE A PRIVATE SPACE FOR STAFF MEMBERS TO TAKE BREAKS DURING THEIR STRESSFUL DAYS. SUMMERS COUNTY ARH OPENED AN EXERCISE TRAIL FOR HOSPITAL STAFF AND COMMUNITY MEMBERS, AND BARBOURVILLE ARH SECURED FUNDING FOR AN AUTISM TRAIL FEATURING OUTDOOR EXERCISE EQUIPMENT.FISCAL YEAR 2025 MARKED ANOTHER TRANSFORMATIVE YEAR FOR ARH. AS THE SYSTEM ENTERS ITS 70TH YEAR OF SERVICE, IT REMAINS COMMITTED TO ITS CORE VALUES AND TO PROVIDING THE HIGHEST QUALITY OF WHOLE PATIENT CARE, TO IMPROVE THE LIVES OF THOSE IN CENTRAL APPALACHIA.
PART III, LINE 2:	COSTING METHODOLOGY: TO DETERMINE THE BAD DEBT EXPENSE ON PART III, LINE 2, THE BAD DEBT EXPENSE PER THE FINANCIAL STATEMENTS, WHICH CONSISTS OF GROSS CHARGES LESS DISCOUNTS, WAS CONVERTED TO COST USING THE GLOBAL COST-TO-CHARGE RATIO. PATIENT DISCOUNTS ARE NOT REFLECTED IN BAD DEBT. ANY PAYMENTS ON AN ACCOUNT AFTER IT IS WRITTEN OFF TO BAD DEBT RESULT IN A REVERSAL OF THE ENTIRE ACCOUNT OUT OF BAD DEBT, REINSTATEMENT OF THE PATIENT ACCOUNT RECEIVABLE, AND ANY NEGOTIATED DIFFERENCE IN THE FULL AMOUNT OF THE ACCOUNT AND THE PAYMENT MADE IS WRITTEN OFF TO CONTRACTUAL ALLOWANCE. PATIENTS WHO MAY QUALIFY FOR CHARITY CARE BUT DO NOT APPLY CANNOT BE ESTIMATED. ALL PATIENTS ARE EDUCATED ABOUT AND GIVEN EVERY OPPORTUNITY TO APPLY FOR CHARITY CARE AND, THEREFORE, ARH HAS NO INFORMATION FOR THOSE WHO CHOOSE NOT TO APPLY.
PART III, LINE 3:	MANAGEMENT CONTINUALLY MONITORS AND ADJUSTS THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ASSOCIATED WITH CREDIT RISK.THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICAL TO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE CORPORATION ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE PRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENT RECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROM INDIVIDUAL PATIENTS.THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE CORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES.
PART III, LINE 4:	THE CORPORATION HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON SEVERAL ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE CORPORATION UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES.
PART III, LINE 8:	A SIGNIFICANT PORTION OF THE CORPORATION'S PATIENT REVENUES ARE DERIVED FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES. IN TURN, PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FELL SHORT OF THE COST TO PROVIDE SUCH SERVICES BY MORE THAN $21 MILLION. MEDICARE RECIPIENTS RELY HEAVILY ON ARH FOR CARE, IN MANY OF THE COMMUNITIES IT SERVES, ARH IS THE LONE PROVIDER OF ACUTE HOSPITAL CARE. THE CORPORATION CONSIDERS ITS PARTICIPATION IN THE MEDICARE PROGRAM AND THE ASSOCIATED LOSSES RESULTING THEREOF AS AN ESSENTIAL COMPONENT OF COMMUNITY BENEFIT. ACCORDINGLY, WE DEEM THAT $21,363,379 (OR 100%) OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 7 BE TREATED AS A COMMUNITY BENEFIT.
PART III, LINE 9B:	THE PROVISIONS IN THE WRITTEN DEBT COLLECTION POLICY ARE THAT CHARITY AND FINANCIAL ASSISTANCE APPLICATIONS ARE VALID FOR 6 MONTHS. AFTER THAT TIME, THE PATIENT MUST REAPPLY AND PRESENT CURRENT FINANCIAL DOCUMENTS AS NECESSARY.
PART VI, LINE 2:	IN 2024, APPALACHIAN REGIONAL HEALTHCARE CONTRACTED UNIVERSITY OF KENTUCKY'S TEAM UP PUBLIC HEALTH COLLABORATIVE TO CONDUCT INDIVIDUAL COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR EACH OF ITS 14 FACILITIES. THESE ASSESSMENTS, CONDUCTED OVER EIGHT MONTHS, INCLUDED OVER 4,000 PUBLIC SURVEYS, 60 FOCUS GROUPS, 14 STEERING COMMITTEES, AND SECONDARY DATA COLLECTION NOT LIMITED TO: HOSPITAL UTILIZATION DATA COUNTY AND STATE HEALTH RANKINGS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA KY KIDS COUNT CENSUS DATA CANCER REGISTRY DATAIN ADDITION TO ASSESSING THE CURRENT STATE OF COMMUNITY HEALTH NEEDS, THESE CHNA REPORTS INCLUDE IMPLEMENTATION PLANS FOR THE NEXT THREE YEARS (CALENDAR YEARS 2025-2027) TO ADDRESS GREATEST PRIORITIES, AND AN OUTCOME SUMMARY FROM THE LAST CHNA CONDUCTED (2022).
PART VI, LINE 3:	UNDER ARH'S FINANCIAL ASSISTANCE PROGRAM AND POLICY, EACH PATIENT WITHOUT MEDICAL COVERAGE FOR RENDERED SERVICES IS OFFERED A 40% DISCOUNT OF GROSS CHARGES AT TIME OF SERVICE. IF THE PATIENT EXTENDS PAYMENT AT TIME OF SERVICE THEY ARE GIVEN ANOTHER 10% DISCOUNT, MAKING THEIR LIABILITY 50% OF GROSS CHARGES. ALL OF THESE DISCOUNTS ARE APPLIED AT TIME OF CHARGE AND BILLED AFTER THE DISCOUNT IS TAKEN. IF SAID PATIENT IS UNABLE TO MEET THE FINANCIAL OBLIGATIONS FOR SERVICE, THEY ARE EDUCATED AND SCREENED FOR POTENTIAL FEDERAL AND/OR STATE ASSISTANCE PROGRAMS. BY DOING THIS, THE PATIENT IS REVIEWED AND EDUCATED BY ON-SITE FINANCIAL COUNSELORS AND/OR ELIGIBILITY AGENCY TO GET THE INDIVIDUAL PLACED IN A PROGRAM. BASED ON INCOME AND FAMILY STATUS, THE PATIENT IS SCREENED IN CONJUNCTION WITH THE FEDERAL AND STATE POVERTY GUIDELINES. AT THIS TIME, ALL APPLICATIONS ARE COMPLETED WITH THE ASSISTANCE OF ARH PERSONNEL AND SUBMITTED FOR APPROVAL. IN THE EVENT AN AGENCY REQUIRES THE PATIENT/GUARANTOR TO APPLY IN PERSON, THE INDIVIDUAL IS ASKED TO MAKE AN APPOINTMENT WITH THAT AGENCY AND FILE THEIR COMPLETED DOCUMENTS. IF THE RESPONSIBLE PARTY IS NOT ELIGIBLE FOR FEDERAL OR STATE ASSISTANCE, THEY ARE ADDITIONALLY SCREENED BY ARH FOR ELIGIBILITY INTO OUR INTERNAL SLIDING FEE SCHEDULE CHARITY PROGRAM FOR ADDITIONAL DISCOUNTS UP TO 100% OF GROSS CHARGES. IF THE PATIENT IS HELD RESPONSIBLE, ADDITIONAL EFFORTS TO ASSIST THE PATIENT ARE OFFERED BY OFFERING REASONABLE PAYMENT PLANS AND DEFERRED PAYMENTS. IN THE EVENT THE PATIENT/GUARANTOR DOES NOT MAKE A REASONABLE EFFORT TO COMPLETE NECESSARY DOCUMENTATION TO APPLY OR BECOME ELIGIBLE FOR A FINANCIAL ASSISTANCE PROGRAM, THEY ARE THEN STILL GIVEN THE INITIAL 40% DISCOUNT AND MOVED THROUGH THE NORMAL COLLECTION PROCESS.
PART VI, LINE 4:	PRIMARY COUNTIES IN KENTUCKY SERVED BY APPALACHIAN REGIONAL HEALTHCARE (THOSE WITH FACILITIES IN-COUNTY) INCLUDE BELL, FLOYD, HARLAN, JOHNSON, KNOX, LESLIE, LETCHER, MORGAN, PERRY, PIKE. SECONDARY KENTUCKY COUNTIES INCLUDE BREATHITT, CLAY, KNOTT, LAWRENCE, LEE, MAGOFFIN, MARTIN, OWSLEY, AND WOLFE. PRIMARY COUNTIES IN WEST VIRGINIA SERVED BY APPALACHIAN REGIONAL HEALTHCARE INCLUDE RALEIGH AND SUMMERS, WITH SECONDARY COUNTIES OF BOONE, FAYETTE, AND GREENBRIER, MINGO, AND WYOMING. THIS SERVICE AREA LIES WITHIN THE PORTION OF THE APPALACHIAN REGIONAL COMMISSION (ARC) DESIGNATED APPALACHIAN REGION, INCLUDING MANY OF THE STEEP, FORESTED RIDGES AND NARROW VALLEYS TYPICAL OF THE APPALACHIAN MOUNTAINS IN EASTERN KENTUCKY AND SOUTHERN WEST VIRGINIA. FOR EXAMPLE, IN LETCHER COUNTY, KENTUCKY, THE LANDSCAPE IS DEFINED BY RUGGED MOUNTAINS AND DENSE FOREST, WITH THE 125-MILE RIDGELINE OF PINE MOUNTAIN RUNNING ACROSS THE COUNTY. IN HARLAN COUNTY, KENTUCKY, ANOTHER COUNTY IN THE REGION, THE HEADWATERS OF THE CUMBERLAND RIVER FLOW THROUGH VALLEYS CARVED BETWEEN HIGH RIDGES. HARLAN COUNTY CONTAINS KENTUCKY'S HIGHEST POINT, BLACK MOUNTAIN (4,145 FT), REFLECTING THE ELEVATION EXTREMES. RURAL RESIDENTS OFTEN FACE LONG TRAVEL DISTANCES TO REACH MEDICAL FACILITIES, COMPOUNDED BY LIMITED OR UNRELIABLE PUBLIC TRANSPORTATION, AND LOW VEHICLE OWNERSHIP IN SOME HOUSEHOLDS.GIVEN THE RURAL AND MOUNTAINOUS CONTEXT, MANY COMMUNITIES ARE SMALL, SCATTERED, AND ISOLATED. THAT TENDS TO YIELD LIMITED LOCAL INFRASTRUCTURE; FEWER LARGE EMPLOYERS, FEWER AND SMALLER TOWNS, AND FEWER SERVICES, WHICH ALSO AFFECTS ACCESS TO HEALTH CARE, SOCIAL SERVICES, ECONOMIC OPPORTUNITIES, AND COMMUNITY RESOURCES.THE COUNTIES SERVED, MANY OF THEM COALFIELD AND FORMER COAL-MINING COUNTIES, HAVE LONG FACED ECONOMIC DISLOCATION AS TRADITIONAL INDUSTRIES (LIKE COAL) HAVE FADED. THAT LEGACY AFFECTS INCOME, EMPLOYMENT OPPORTUNITIES, AND ECONOMIC STABILITY IN THE REGION. THIS IS COMMON ACROSS MUCH OF THE EASTERN KENTUCKY COALFIELD AREA. MOREOVER, COMPARED WITH NON-APPALACHIAN REGIONS, PEOPLE IN APPALACHIA TEND TO HAVE LOWER LEVELS OF EDUCATIONAL ATTAINMENT AND HIGHER RATES OF POVERTY, FACTORS THAT CORRELATE WITH POORER HEALTH OUTCOMES.THE TOTAL POPULATION OF ARH'S PRIMARY AND SECONDARY MARKETS IS 503,677, WITH INDIVIDUALS AGE 65 AND OLDER REPRESENTING 22% OF THE POPULATION. NOTABLY, THIS AGE GROUP IS THE ONLY DEMOGRAPHIC EXPECTED TO GROW IN SIZE. THE REGION'S POPULATION IS PREDOMINANTLY CAUCASIAN (92%), WITH AN AVERAGE HOUSEHOLD INCOME OF $63,741. APPROXIMATELY 15% OF RESIDENTS HOLD A BACHELOR'S DEGREE OR HIGHER, WHILE 27% OF HOUSEHOLDS LIVE BELOW THE POVERTY LINE.
PART VI, LINE 5:	ARH HOSPITALS FURTHER THEIR TAX-EXEMPT PURPOSE THROUGH EXPANDING ACCESS TO CARE, COMMUNITY-BASED HEALTH IMPROVEMENT ACTIVITIES AND SOCIAL DETERMINANT OF HEALTH INTERVENTIONS. IN FY25, ARH INVESTED OVER 5.2 MILLION DOLLARS IN COMMUNITY BENEFIT ACTIVITIES, INCLUDING FREE COMMUNITY-BASED CLINICAL SCREENINGS (NEARLY 4,000 PROVIDED), FOOD IS MEDICINE INITIATIVES (I.E. COOKING CLASSES, DIABETES SUPPORT GROUPS, FARMERS MARKET SUPPORT, ETC.), IN-SCHOOL HEALTH PROGRAMMING, PHYSICAL ACTIVITY PROGRAMMING, CANCER PREVENTION, AND CHRONIC DISEASE EDUCATION. ARH'S COMMUNITY BENEFIT ACTIVITIES ARE TARGETED, MEASURABLE, AND DIRECTLY RESPONSIVE TO THE NEEDS IDENTIFIED IN ITS CHNAS. BY ENSURING ACCESS TO ESSENTIAL HEALTHCARE SERVICES, IMPROVING POPULATION HEALTH, AND ADDRESSING THE UNIQUE GEOGRAPHIC AND SOCIOECONOMIC BARRIERS FACED BY CENTRAL APPALACHIAN RESIDENTS, ARH'S HOSPITALS DEMONSTRABLY ADVANCE THEIR CHARITABLE PURPOSE AND PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE.BETWEEN THESE ARH FACILITIES, NEARLY 600 EVENTS, CLASSES, AND SUPPORT GROUPS WERE HOSTED IN FY25 FOCUSED ON HEALTHY LIFESTYLE EDUCATION, FREE HEALTH SCREENING EVENTS, CHRONIC DISEASE PREVENTION, AND COMMUNITY HEALTH BETTERMENT. COMMUNITY MEMBERS HAVE BEEN EDUCATED ON SUBSTANCE ABUSE PREVENTION, THE USE OF NARCAN TO REDUCE OVERDOSE, AND THE DANGERS OF SMOKING AND VAPING. ARH HAS BEEN AT THE FOREFRONT OF FOOD IS MEDICINE IN APPALACHIA, EDUCATING PATIENTS AND COMMUNITIES ABOUT THE BENEFITS OF PROPER NUTRITION. THE FOOD IS MEDICINE MOVEMENT FURTHER INTEGRATED NUTRITION INTO HEALTHCARE, HOSTING EVENTS SUCH AS FARMER'S MARKETS, HEALTHY COOKING DEMONSTRATIONS, AND EDUCATIONAL CAMPAIGNS HIGHLIGHTING THE IMPORTANCE OF PROPER NUTRITION. FACILITIES IN ARH'S KY RIVER AND BIG SANDY REGIONS HAVE CONTINUED THEIR IN-FACILITY FOOD PANTRY PROGRAMS, DISTRIBUTING HUNDREDS OF MEALS TO PATIENTS THAT HAVE SCREENED AS FOOD INSECURE. THROUGHOUT THE COMMUNITY, ARH STAFF PARTICIPATE IN BOARDS AND COALITIONS THAT WORK TO BETTER THE HEALTH AND WELLNESS OF COMMUNITY MEMBERS; LOCAL EXTENSION ADVISORY BOARDS, DIABETES COALITIONS, COUNTY HEALTH COALITIONS, AND MORE. ARH ALSO USES LOCAL ADVISORY COUNCILS FOR EACH FACILITY, MADE OF COMMUNITY MEMBERS TO PROVIDE A PLATFORM FOR COMMUNITY INPUT AND FEEDBACK ON HEALTHCARE SERVICES AND POLICIES. THEY HELP TO ENSURE TRANSPARENCY IN HOSPITAL OPERATIONS, ENGAGE COMMUNITY MEMBERS IN PLANNING, AND SUPPORT SHARED DECISION-MAKING. THESE LOCAL ADVISORY BOARDS PLAY A KEY ROLE IN DEVELOPING INCLUSIVE HEALTH PROGRAMS AND REDUCING HEALTH DISPARITIES. BY INCLUDING A DIVERSE RANGE OF COMMUNITY MEMBERS, ARH IS PROMOTING HEALTH EQUITY AND RESPONSIVENESS TO LOCAL NEEDS.
PART VI, LINE 6:	APPALACHIAN REGIONAL HEALTHCARE (ARH) IS AN INTEGRATED, MULTI-HOSPITAL HEALTHCARE SYSTEM SERVING RURAL AND UNDERSERVED COMMUNITIES THROUGHOUT CENTRAL APPALACHIA. INDIVIDUAL ARH HOSPITALS AND OTHER HEALTH ENTITIES PROVIDE DIRECT INPATIENT, OUTPATIENT, EMERGENCY, SPECIALTY, AND COMMUNITY-BASED CARE TAILORED TO LOCAL HEALTH NEEDS.AT THE SYSTEM LEVEL, ARH SUPPORTS ITS LOCAL COMMUNITY HOSPITALS, CLINICS, PHARMACIES, HOME SERVICES AND OTHER HEALTH-RELATED OPERATIONS THROUGH COORDINATED GOVERNANCE, SHARED CLINICAL AND ADMINISTRATIVE SERVICES, AND SYSTEM-WIDE COMMUNITY BENEFIT AND POPULATION HEALTH INITIATIVES. THESE INCLUDE UNIFORM CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES, COORDINATION OF COMMUNITY HEALTH NEEDS ASSESSMENTS, AND SUPPORT FOR PROGRAMS ADDRESSING CHRONIC DISEASE, SUBSTANCE USE DISORDER, FOOD INSECURITY, PREVENTIVE CARE, AND ACCESS TO HEALTHCARE SERVICES.ARH HOSPITALS IMPLEMENT THESE INITIATIVES LOCALLY THROUGH ACTIVITIES SUCH AS PEER RECOVERY SUPPORT FOR PATIENTS WITH SUBSTANCE USE DISORDER, MOBILE AND COMMUNITY-BASED CLINICS SERVING RURAL AREAS, HEALTH SCREENINGS AND EDUCATION, AND PARTNERSHIPS WITH PUBLIC HEALTH AGENCIES AND COMMUNITY ORGANIZATIONS. TOGETHER, ARH AND ITS AFFILIATED ENTITIES WORK COLLABORATIVELY TO IMPROVE ACCESS TO CARE AND PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITIES THEY SERVE.
PART VI, LINE 7, REPORTS FILED WITH STATES	KY,WV
PART I, LINE 7F:	$26,540,555 OF BAD DEBT EXPENSE WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25; BUT WAS EXCLUDED IN CALCULATING COMMUNITY BENEFIT EXPENSE FOR SCHEDULE H, LINE 7. COMMUNITY BENEFIT EXPENSES WERE CALCULATED USING COST REPORTS FOR THE FISCAL YEAR ENDED JUNE 30, 2025.

Schedule H (Form 990) 2024

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Schedule I
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization
APPALACHIAN REGIONAL HEALTHCARE

Employer identification number
52-0795508

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) BECKLEY-RALEIGH COUNTY CHAMBER OF COMMERCE PO BOX 1798 BECKLEY,WV25802	55-0345563	501C6	5,330	SUPPORT TO THE MISSION OF CHAMBER OF COMMERCE TO CHAMPION BUSINESS SUCCESS AND ADVANCE A STRONG, RESILIENT REGIONAL ECONOMY.
(2) BLACK GOLD COMMITTEE INC 221 MEMORIAL DRIVE HAZARD,KY41701	75-3036575	501C4	5,500	TO PROMOTE COMMUNITY INVOLVEMENT, TOURISM, AND DEVELOPMENT OF SMALL BUSINESSES.
(3) KENTUCKY CHAMBER OF COMMERCE 464 CHENAULT ROAD FRANKFORT,KY40601	61-0405718	501C6	32,950	SUPPORT TO THE MISSION OF THE CHAMBER OF COMMERCE TO BUILD AND PROTECT A PROSPEROUS BUSINESS CLIMATE IN THE COMMONWEALTH OF KY.
(4) BELFRY HIGH SCHOOL ATHLETIC FACILITIES BOOSTER INC PO BOX 381 BELFRY,KY41514	83-0946179	501C3	9,050	TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUTH
(5) LETCHER COUNTY CENTRAL 435 COUGAR DRIVE WHITESBURG,KY41858	61-6001375	GOVT	6,000	TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUTH
(6) MOUNTAIN PERFORMING ARTS INC 50 HAL ROGERS DRIVE PRESTONSBURG,KY41653	83-4107663	501C3	20,000	TO SUPPORT THE MISSION OF THE ORGANIZATION THAT PROMOTES THE RICH CULTURAL HERITAGE AND ARTISTIC EXPRESSIONS OF THE APPALACHIAN REGION.
(7) CITY OF HINTON SANITARY BOARD 322 SUMMERS STREET HINTON,WV25951	55-6000185	GOVT	18,000	FITNESS CENTER SPONSORSHIP FOR EMPLOYEES TO PROMOTE AN ACTIVE, HEALTHY LIFESTYLE.
(8) JMI SPORTS KENTUCKY LLC PO BOX 645388 CINCINNATI,OH45264	36-4803508		232,691	SPONSORSHIP FOR THE UNIVERSITY OF KENTUCKY ATHLETICS PROGRAM TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUNG ADULTS
(9) SHAPING OUR APPALACHIAN REGION INC 137 MAIN STREET SUITE 300 PIKEVILLE,KY41501	37-1760428	501C3	78,958	PARTNERSHIP WITH ORGANIZATION TO EXPAND JOB CREATION, ENHANCE REGIONAL OPPORTUNITY, INNOVATION, AND QUALITY OF LIFE.
(10) COWEN COMMUNITY ACTION GROUP INC 81 STURGILL BRANCH WHITESBURG,KY41858	61-1396831	501C3	15,000	SUPPORT A SUMMER CONCERT SERIES IN OUR SERVICE AREA THAT WILL ENCOURAGE TOURISM AND COMMUNITY INVOLVEMENT THROUGH MUSIC
(11) PERRY COUNTY SCHOOL DISTRICT 315 PARK AVENUE HAZARD,KY41701	61-6001294	GOVT	10,950	TO SUPPORT AN ACTIVE, HEALTHY LIFESTYLE FOR OUR LOCAL YOUTH
(12) FAYETTE ALLIANCE FOUNDATION INC 603 WEST SHORT STREET LEXINGTON,KY40508	47-2128336	501C3	5,800	SPONSORSHIP BENEFIT TO THE FAYETTE ALLIANCE FOUNDATION AND UK MARKEY CANCER FOUNDATION, FURTHERING SUSTAINABLE GROWTH AND CANCER RESEARCH IN LEXINGTON.
(13) IHEART MEDIA 20880 SONE OAK PARKWAY SAN ANTONIO,TX78258	74-2722883		13,000	SUPPORT FOR THE CARSON GRAHAM MUSIC DEPARTMENT WHICH SUPPORTS THE SCHOOL'S MUSIC PROGRAM AND TEACHERS BY FOSTERING A COLLABORATIVE COMMUNITY FOR PARENTS AND GUARDIANS.
(14) PRO CAMPS INC 10001 ALLIANCE RD STE 1 CINCINNATI,OH45242	81-2769448		25,000	SUPPORT TO SCHOOL WHO PROVIDES A LEARNING ENVIRONMENT THAT EMPOWERS STUDENTS IN PRESCHOOL-12TH GRADE TO ACHIEVE ACADEMIC EXCELLENCE.
(15) SAYRE SCHOOL INC 194 N LIMESTONE LEXINGTON,KY40507	61-0449657	501C3	20,000	SUPPORT TO SCHOOL WHO PROVIDES A LEARNING ENVIRONMENT THAT EMPOWERS STUDENTS IN PRESCHOOL-12TH GRADE TO ACHIEVE ACADEMIC EXCELLENCE.
(16) LEXINGTON SPORTING CLUB 810 BULL LEA RUN SUITE 300 LEXINGTON,KY40511	32-0682879		139,750	TO SUPPORT THE DEVELOPMENT OF COMPLETE SOCCER PLAYERS AND TEAMS OF ALL LEVELS, FOSTERING A SAFE, WELCOMING ENVIRONMENT FOR GROWTH AND PERFORMANCE WHILE CONNECTING THE COMMUNITY THROUGH THE SPORT.
(17) HOPE IN THE HILLS INC PO BOX 9064 HUNTINGTON,WV25704	82-3221120	501C3	50,000	SPONSORSHIP FOR ANNUAL CONCERT TO RAISE FUNDS AND AWARENESS TO THE OPIOD CRISIS AS WELL AS TO CELEBRATE ACHIEVEMENTS IN RECOVERY.

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) Rev. 1-2025

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

MONITORING GRANTS AT APPALACHIAN REGIONAL HEALTHCARE (ARH) INVOLVES ADHERENCE TO FEDERAL, STATE, AND GRANTOR-SPECIFIC REGULATIONS, TYPICALLY OVERSEEN BY THE GRANTS MANAGEMENT OFFICE TO ENSURE COMPLIANCE WITH NOTICE OF AWARD (NOA) TERMS. KEY PROCEDURES INCLUDE MAINTAINING UP-TO-DATE DOCUMENTATION, QUARTERLY REPORTING VIA EHBS, FINANCIAL RECONCILIATION, AND, FOR SPECIFIC EMPLOYEE ASSISTANCE, STRICT DOCUMENTATION OF EMERGENCY NEEDS. FOR THE ARH EMPLOYEE EMERGENCY ASSISTANCE FUND (EAF), APPLICANTS MUST BE CURRENT EMPLOYEES, SUBMIT FULL DOCUMENTATION OF FINANCIAL HARDSHIP (E.G., BILLS, NOTICES), AND ADHERE TO THE $2,500 ANNUAL/$5,000 LIFETIME LIMIT. APPALACHIAN REGIONAL HEALTHCARE (ARH) MANAGES SPONSORSHIP REQUESTS BY REQUIRING ONLINE SUBMISSIONS AT LEAST TWO MONTHS IN ADVANCE, FOCUSING ON COMMUNITY HEALTH, WELL-BEING, OR ACCESS TO CARE. APPLICATIONS REQUIRE A COMPLETED FORM, FLYER/BROCHURE, AND, IF APPROVED, SPONSORSHIP FUNDS ARE TYPICALLY DELIVERED VIA CHECK WITHIN 3-4 WEEKS.

Schedule I (Form 990) Rev. 1-2025

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Schedule J
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

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 on 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 on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

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 on 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? .............

Yes

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

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

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

Yes

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) (Rev. 1-2025)

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(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)
1HOLLIE P HARRIS PRESIDENT/CEO	(i) (ii)	1,125,295 ------------- 0	377,829 ------------- 0	653 ------------- 0	93,659 ------------- 0	25,153 ------------- 0	1,622,589 ------------- 0	0 ------------- 0
2ADNAN M BHOPALWALA CARDIOLOGIST	(i) (ii)	953,557 ------------- 0	298,343 ------------- 0	0 ------------- 0	10,350 ------------- 0	43,477 ------------- 0	1,305,727 ------------- 0	0 ------------- 0
3JAYARAMAKRISHNA DEPA NEPHROLOGIST	(i) (ii)	660,776 ------------- 0	219,974 ------------- 0	103,750 ------------- 0	15,538 ------------- 0	43,477 ------------- 0	1,043,515 ------------- 0	0 ------------- 0
4TIMOTHY MICEK ORTHOPEDIC SURGEON	(i) (ii)	950,810 ------------- 0	0 ------------- 0	12,500 ------------- 0	0 ------------- 0	43,477 ------------- 0	1,006,787 ------------- 0	0 ------------- 0
5SAMUEL BAILEY ONCOLOGIST	(i) (ii)	825,283 ------------- 0	0 ------------- 0	23,669 ------------- 0	11,228 ------------- 0	43,477 ------------- 0	903,657 ------------- 0	0 ------------- 0
6CHAYAKRIT KRITTANAWONG INTERVENTIONAL CARDIOLOGIST	(i) (ii)	759,141 ------------- 0	85,467 ------------- 0	17,958 ------------- 0	0 ------------- 0	13,573 ------------- 0	876,139 ------------- 0	0 ------------- 0
7PAUL BETZ COO (TERM 11/13/24)	(i) (ii)	539,087 ------------- 0	0 ------------- 0	95,071 ------------- 0	59,839 ------------- 0	43,477 ------------- 0	737,474 ------------- 0	0 ------------- 0
8BYRON GABBARD CHIEF FINANCIAL OFFICER	(i) (ii)	512,657 ------------- 0	150,857 ------------- 0	737 ------------- 0	60,039 ------------- 0	876 ------------- 0	725,166 ------------- 0	0 ------------- 0
9MARIA BRAMAN CHIEF MEDICAL OFFICER	(i) (ii)	493,415 ------------- 0	137,143 ------------- 0	1,181 ------------- 0	45,350 ------------- 0	25,153 ------------- 0	702,242 ------------- 0	0 ------------- 0
10CHRISTI LEE CHIEF LEGAL COUNSEL	(i) (ii)	373,233 ------------- 0	109,989 ------------- 0	395 ------------- 0	44,599 ------------- 0	25,153 ------------- 0	553,369 ------------- 0	0 ------------- 0
11SONYA BERGMAN CHIEF PEOPLE OFFICER	(i) (ii)	359,047 ------------- 0	109,714 ------------- 0	1,733 ------------- 0	45,391 ------------- 0	36,338 ------------- 0	552,223 ------------- 0	0 ------------- 0

Schedule J (Form 990) (Rev. 1-2025)

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART I, LINE 4A	PAUL BETZ RECEIVED SEVERANCE OF $300,000.
SCHEDULE J, PART I, LINE 4B	ARH PROVIDES SENIOR EXECUTIVES A CONTRIBUTION 3, 5,OR 7 PERCENT OF PAY (SUBJECT TO DOLLAR CAP), DEPENDING ON JOB TITLE, INTO THE TOP HAT 457(B) RETIREMENT PLAN. THE CONTRIBUTION AND EARNINGS ARE TAX DEFERRED UNTIL ASSETS ARE DISTRIBUTED OR WITHDRAWN. THE MAXIMUM CONTRIBUTION IS SUBJECT TO THE IRS COMPENSATION CAP, WHICH ALLOWS A CONTRIBUTION OF UP TO $23,000 IN 2024. THIS CONTRIBUTION TOTAL IS AN AGGREGATE TOTAL REGARDLESS OF WHETHER ARH OR THE EXECUTIVE MAKES THE CONTRIBUTION. CONTRIBUTION TO THE 457(B) DOES NOT AFFECT THE AMOUNTS THE EXECUTIVE MIGHT CONTRIBUTE TO THE 403(B) THRIFT PLAN. THE EXECUTIVE MAY CONTRIBUTE HIS/HER OWN MONEY TO THE PLAN PRE-TAX, TO THE EXTENT THE IRS CAPS ALLOW ROOM AFTER ARH'S CONTRIBUTION. CATCH UP CONTRIBUTIONS ARE ALLOWED WITHIN IRS LIMITS IN THE LAST THREE YEARS PRIOR TO RETIREMENT (AND, IF THE 3,5 OR 7 PERCENT OF PAY EXCEEDS THE REGULAR DOLLAR CAP, ARH MAY USE THE BALANCE OF THE PERCENTAGE TO FUND UP THE CATCH UP LIMIT). BENEFITS ARE SUBJECT TO SOCIAL SECURITY AND MEDICARE TAXES AS THEY ACCRUE. THE FUNDS ARE INVESTED AS DIRECTED BY THE EXECUTIVE, BUT THE ACCOUNT REMAINS A GENERAL ASSET OF ARH. IF ARH BECOMES INSOLVENT, THE EXECUTIVE WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. IF THE FUNDING OF THE 457(B), INCLUDING ANY CATCH UP PROVISIONS, IS LESS THAN THE 3,5 OR 7 PERCENT OF BASE PAY, THEN ARH WILL CONTRIBUTE THE REMAINDER TO A 457(F) PLAN. INDIVIDUALS PARTICIPATING IN THE 457(F) PLAN AND THE RESPECTIVE EMPLOYER CONTRIBUTIONS FOR EACH INCLUDE: HOLLIE HARRIS - $53,317.50; MARIA BRAMAN - $12,000; BYRON GABBARD - $28,870; CHRISTI LEE - $5,070; SONYA BERGMAN - $5,000; PAUL BETZ- $31,552.50.
SCHEDULE J, PART I, LINE 6	THE COMPENSATION AND CONTRACTS COMMITTEE OF THE ARH BOARD OF TRUSTEES ADOPTED A SHORT-TERM INCENTIVE COMPENSATION PROGRAM FOR EXECUTIVES IN SEPTEMBER 2002. THE PROGRAM ESTABLISHED INCENTIVES FOR ACHIEVING SYSTEM AND COMMUNITY OBJECTIVES FOR EXECUTIVE LEADERSHIP BY INTEGRATING THE PERFORMANCE MANAGEMENT AND EXECUTIVE COMPENSATION SYSTEMS. THE INCENTIVE THRESHOLDS HAVE BEEN MODIFIED ACROSS TIME TO REFLECT INCREASED PERFORMANCE EXPECTATIONS AS IDENTIFIED IN THE SYSTEM'S STRATEGIC, BUDGET AND OPERATIONS PLAN. THE INCENTIVE AWARDS PROVIDE ADDITIONAL CASH COMPENSATION AS A PERCENTAGE OF BASE SALARY IN RELATION TO LEVELS OF ACHIEVEMENT. THESE ACHIEVEMENT LEVELS RANGE FROM THRESHOLD (LOWEST), TO TARGET (10% ABOVE THE THRESHOLD), AND MAXIMUM (HIGHEST AND 20% ABOVE THE THRESHOLD) AND VARY BASED UPON EXECUTIVE LEVEL. THE EXECUTIVE INCENTIVE PLAN WILL BE ADMINISTERED IN ACCORDANCE WITH THE FOLLOWING GUIDELINES: A. OBJECTIVES AND TARGETS ARE SET THROUGH THE STRATEGIC PLANNING, BUDGETING AND PERFORMANCE MANAGEMENT PROCESSES. B. SYSTEM MARGIN AND CASH BUDGET THRESHOLDS MUST BE MET BEFORE INDIVIDUAL AWARDS WILL BE CONSIDERED. C. AWARDS WILL BE CONSIDERED AS HAVING BEEN EARNED UPON AFFIRMATION BASED ON AUDITED FINANCIAL RESULTS AND ACTUAL OPERATING PERFORMANCE. D. THE PRESIDENT AND CEO WILL RECOMMEND PAYMENT OF INDIVIDUAL AWARDS, IF ANY, TO THE COMPENSATION AND CONTRACTS COMMITTEE FOR CONSIDERATION. E. THE COMPENSATION AND CONTRACTS COMMITTEE MAY ACCEPT, REJECT, OR MODIFY THE PRESIDENT AND CEO'S RECOMMENDATION.

Schedule J (Form 990) (Rev. 1-2025)

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization
APPALACHIAN REGIONAL HEALTHCARE

Employer identification number
52-0795508

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CITY OF HAZARD KY	61-6001839		07-01-2021	70,075,000	CAPITAL CONSTRUCTION OF FACILITIES IN WV, KY; REFUNDING.		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	4,915,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	70,075,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	873,823
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	58,638,837
11 Other spent proceeds .............	10,562,340
12 Other unspent proceeds .............
13 Year of substantial completion .............	2021
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

Schedule K (Form 990) (Rev. 1-2025)

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......
b Exception to rebate? ........
c No rebate due? .........
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X

Schedule K (Form 990) (Rev. 1-2025)

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) (Rev. 1-2025)

Additional Data

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Schedule L
(Form 990)
(Rev. January 2025)

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, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) 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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

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

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

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




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

Part III

Grants or Assistance Benefiting 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 assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990) (Rev. 1-2025)

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) GREG COUCH	PRINCIPAL OWNER OF MERIDIAN WEALTH	590,840	INVESTMENT COMPANY THAT MANAGES ARH RETIREMENT PORTFOLIO		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) (Rev. 1-2025)

Additional Data

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SCHEDULE O
(Form 990)
(Rev. January 2025)
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 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE DIRECTOR OF ACCOUNTING AND CFO BOTH REVIEW THE 990 PRIOR TO THE BOARD REVIEW. THE BOARD THEN REVIEWS THE 990 PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	A SECURE WEBSITE IS PROVIDED TO OFFICERS AND TRUSTEES FOR ANNUAL DISCLOSURES, AND IS MONITORED REGULARLY BY THE VICE PRESIDENT OF LEGAL AFFAIRS AND THE CORPORATE COMPLIANCE OFFICERS. POTENTIAL CONFLICTS OF INTEREST ARE REPORTED DIRECTLY TO THE CHAIRMAN OF THE BOARD. TRUSTEES IDENTIFIED AS HAVING A CONFLICT OF INTEREST IN A PARTICULAR MATTER BEFORE THE BOARD MAY NOT PARTICIPATE IN THE BOARD'S DECISION-MAKING PROCESS. FAILURE TO DISCLOSE IS SUBJECT TO DISCIPLINE, INCLUDING CENSURE, AND IN SOME CASES, REMOVAL FROM THE BOARD. EMPLOYEE OFFICERS ARE SUBJECT TO DISCIPLINE IN ACCORDANCE WITH THE CORPORATION'S HUMAN RESOURCE POLICIES AND THE ARH CODE OF BUSINESS AND PROFESSIONAL CONDUCT.
FORM 990, PART VI, SECTION B, LINE 15	APPALACHIAN REGIONAL HEALTHCARE, INC.'S (ARH) BOARD SETS COMPENSATION LEVELS FOR PRESIDENT/CEO AND OTHER ARH EXECUTIVES AND KEY EMPLOYEES THROUGH ITS COMPENSATION AND CONTRACTS COMMITTEE. THE BOARD CONTRACTS WITH A CONSULTING FIRM TO REVIEW THE MARKET FOR THE POSITIONS ON THE SYSTEM OPERATING COUNCIL WHO MAKES RECOMMENDATIONS ON THE SALARY RANGES AND ASSESSES THE COMPETITIVENESS OF THE SALARIES. WITH THAT INFORMATION, THE COMPENSATION AND CONTRACTS COMMITTEE SETS THE RANGES AND THE PRESIDENT'S COMPENSATION. THE BOARD REVIEWS AND RATIFIES COMPENSATION AMOUNTS. THE CONSULTING FIRM FOLLOWS UP WITH A LETTER ATTESTING TO THE REASONABLENESS OF COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19	WHILE ARH HAS NOT YET ADOPTED A POLICY OF SHARING ITS FINANCIAL STATEMENTS WITH THE PUBLIC, IT DOES PROVIDE FINANCIAL INFORMATION THROUGH THE FORM 990 AND ALSO PROVIDES CERTAIN FINANCIAL INFORMATION IN OTHER PUBLIC DOCUMENTS, INCLUDING ITS PERIODIC REPORTS TO THE COMMUNITIES IT SERVES.
FORM 990, PART IX, LINE 11G	OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 51,916,590. MANAGEMENT AND GENERAL EXPENSES 25,616,396. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 77,532,986. PROFESSIONAL FEES PHYSICIANS: PROGRAM SERVICE EXPENSES 44,510,853. MANAGEMENT AND GENERAL EXPENSES 449,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,960,457. PHYSICIAN STIPENDS: PROGRAM SERVICE EXPENSES 2,745. MANAGEMENT AND GENERAL EXPENSES 1,755. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,500.
FORM 990, PART XI, LINE 9:	NET PERIODIC PENSION GAIN 7,147,044. CHANGE IN PENSION PLAN ASSET AND OBLIGATION 11,412,167. NET CHANGE IN INVESTMENTS IN AFFILIATE 23,660. REVERSAL OF GRANT REVENUE RECOGNITION -115,508.
FORM 990, PART XII, LINE 2C:	THE PROCESS FOR OVERSEEING AND SELECTING INDEPENDENT AUDITORS HAS NOT CHANGED FROM THE PRIOR YEAR. PRIOR TO THE START OF THE AUDIT, THE VICE PRESIDENT OF FINANCE MEETS WITH THE INDEPENDENT AUDITORS. AT THE CONCLUSION OF THE AUDIT, THE FINANCE COMMITTEE MEETS WITH THE INDEPENDENT AUDITORS FOR PRESENTATION OF THE FINANCIAL STATEMENTS. THE INDEPENDENT AUDITORS ARE SELECTED WHEN DEEMED NECESSARY BY MANAGEMENT THROUGH A FORMAL "REQUEST FOR PROPOSAL" (RFP) PROCESS.

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

Cat. No. 51056K

Schedule O (Form 990) (Rev. 1-2025)

Additional Data

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SCHEDULE R
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

APPALACHIAN REGIONAL HEALTHCARE

Employer identification number

52-0795508

Part I

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

(a) Name, address, and EIN (if applicable) 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) HAZARD ARH IMAGING CENTER LLC 210 BLACK GOLD BLVD HAZARD,KY41701 27-0755457	MEDICAL IMAGING SERVICES	KY	0	1,876,365	APPALACHIAN REGIONAL HEALTHCARE INC
(2) CUMBERLAND VALLEY ARH CANCER CENTER LLC 2260 EXECUTIVE DRIVE LEXINGTON,KY40505	HEALTH CARE	KY	0	0	APPALACHIAN REGIONAL HEALTHCARE INC
(3) WHITESBURG PHYSICIAN OFFICE BLDG LLC 2260 EXECUTIVE DRIVE LEXINGTON,KY40505 75-3022080	PHYSICAN OFFICE BUILDING	KY	0	0	APPALACHIAN REGIONAL HEALTHCARE INC
(4) HOMETOWN FAMILY CARE PLLC 2260 EXECUTIVE DRIVE LEXINGTON,KY40505 20-2470645	MEDICAL SERVICES	KY	0	0	ARH TUG VALLEY HEALTH SERVICES INC
(5) APPALACHIAN HEALTH NETWORK 2260 EXECUTIVE DRIVE LEXINGTON,KY40505 86-3247368	MEDICAL SERVICES	KY	3,165,445	2,993,390

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 entity?
(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)THE ARH FOUNDATION FOR HEALTHIER COMMUNITIES INC 100 AIRPORT GARDENS RD HAZARD,KY41701 20-4840007	CARRYING OUT FUNDRAISING AND CHARITABLE ACTIVITIES FOR ARH	KY	501(C)(3)	LINE 7	APPALACHIAN REGIONAL HEALTHCARE INC	Yes
(2)ARH MARY BRECKINRIDGE 2260 EXECUTIVE DR LEXINGTON,KY40505 45-2696517	HEALTH CARE	KY	501(C)(3)	LINE 3	APPALACHIAN REGIONAL HEALTHCARE INC	Yes
(3)ARH TUG VALLEY HEALTH SERVICES INC 2260 EXECUTIVE DR LEXINGTON,KY40505 82-2577178	HEALTH CARE	KY	501(C)(3)	LINE 3	APPALACHIAN REGIONAL HEALTHCARE INC	Yes
(4)ARH ADVANCED CARE INC 2260 EXECUTIVE DR LEXINGTON,KY40505 82-2421892	HEALTH CARE	KY	501(C)(3)	LINE 3	APPALACHIAN REGIONAL HEALTHCARE INC	Yes
(5)HIGHLANDS HOSPITAL CORPORATION INC 2260 EXECUTIVE DR LEXINGTON,KY40505 61-0658773	HEALTH CARE	KY	501(C)(3)	LINE 3	ARH FOUNDATION FOR HEATHIER COMMUNITIES INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) (Rev. 1-2025)

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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) HIGHLANDS MEDICAL PARTNERS II 2260 EXECUTIVE DRIVE LEXINGTON,KY40505 26-3714306	MEDICAL SERVICES.	KY					No			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)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) ARH REGIONAL MEDICAL CENTER PROFESSIONAL OFFICE BUILDING CO-OWNERS COUNCIL 2260 EXECUTIVE DRIVE LEXINGTON,KY40504 20-1796044	OFFICE BUILDING MANAGEMENT	KY	APPALACHIAN REGIONAL HEALTHCARE	C			83.840 %	Yes

Schedule R (Form 990) (Rev. 1-2025)

Page 3

Part V

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

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

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, or (iv) rent from a controlled entity .....................

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

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

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

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

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

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

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

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

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

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) (Rev. 1-2025)

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

Schedule R (Form 990) (Rev. 1-2025)

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE CENTRAL APPALACHIA AN ABUNDANCE OF HEALTHCARE AND COMMUNITY-ORIENTED SERVICES THROUGH ITS HOSPITAL, CLINICS AND HOME HEALTH OPERATIONS AS WELL AS COMMUNITY OUTREACH SERVICES.
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	12
5	Total number of individuals employed in calendar year 2024 (Part V, line 2a) ......	5	5,638
6	Total number of volunteers (estimate if necessary) .............	6	112
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	37,660,306
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	3,050,783

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	620,648	1,471,544
9	Program service revenue (Part VIII, line 2g) .........	906,150,904	991,822,031
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	27,042,785	25,050,610
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	10,102,841	59,661,216
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	943,917,178	1,078,005,401
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	781,069	1,113,867
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)	438,098,268	450,843,992
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–24e)....	434,962,133	476,744,449
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	873,841,470	928,702,308
19	Revenue less expenses. Subtract line 18 from line 12.......	70,075,708	149,303,093
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,448,830,338	1,690,508,848
21	Total liabilities (Part X, line 26).............	745,614,779	770,717,777
22	Net assets or fund balances. Subtract line 21 from line 20.....	703,215,559	919,791,071

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 750,450,922 including grants of $ 1,113,867 ) (Revenue $ 993,628,124 )
	JUST AS IT HAS FOR THE PAST SEVEN DECADES, APPALACHIAN REGIONAL HEALTHCARE (ARH) REMAINED COMMITTED TO ITS MISSION TO PROVIDE THE PEOPLE OF CENTRAL APPALACHIA WITH THE HIGHEST QUALITY OF CARE IN 2025. WITH 14 HOSPITALS AS WELL CLINICS, HOME HEALTH AGENCIES, HOME MEDICAL EQUIPMENT STORES, PHARMACIES AND REHABILITATION SERVICES SPREAD ACROSS BOTH KENTUCKY AND WEST VIRGINIA, ARH AND ITS MORE THAN 6,000 TEAM MEMBERS AND 1,300 MEDICAL PROVIDERS IS ESSENTIAL TO THE LIVES OF THOSE WHO RESIDE IN CENTRAL APPALACHIA. ARH'S COMMITMENT TO EXCELLENCE WAS RECOGNIZED THROUGHOUT THE 2025 FISCAL YEAR WITH A VARIETY OF HONORS AND CERTIFICATIONS. THE ARH SYSTEM WAS NAMED TO FORBES' LIST OF AMERICA'S BEST-IN-STATE EMPLOYERS, SUMMERS COUNTY ARH, BARBOURVILLE ARH, MARY BRECKINRIDGE ARH, MCDOWELL ARH, AND TUG VALLEY ARH REGIONAL MEDICAL CENTER WERE ALL RECOGNIZED AS ACUTE STROKE READY CENTERS. WITH THOSE CERTIFICATIONS BESTOWED BY DNV, EACH OF ARH'S 14 HOSPITALS WERE OFFICIALLY STROKE CERTIFIED. BECKLEY AND SUMMERS COUNTY ARH RECEIVED SILVER HONORS FROM THE WEST VIRGINIA HOSPITAL ASSOCIATION AND SUMMERS COUNTY ARH RECEIVED THE WVHA GOVERNOR'S AWARD FOR OUTSTANDING SUPPORT OF TISSUE AND CORNEA DONATION. THREE ARH BIRTHING HOSPITALS HAZARD ARH, HIGHLANDS ARH AND WHITESBURG ARH, RECEIVED THE KENTUCKY PERINATAL QUALITY COLLABORATIVE (KYPQC) AWARD FOR THE SECOND CONSECUTIVE YEAR. TWELVE ARH HOSPITALS WERE HONORED WITH AMERICAN HEART ASSOCIATION GET WITH THE GUIDELINES AWARDS FOR THEIR COMMITMENT TO THE TREATMENT OF STROKE. THE ARH SYSTEM'S HARD WORK ON THE TECHNICAL FRONT WAS AGAIN RECOGNIZED AS IT ACHIEVED A LEVEL 8 RANKING IN CHIME'S MOST WIRED HEALTH SYSTEMS FOR BOTH AMBULATORY AND ACUTE CARE FOR THE FIFTH CONSECUTIVE YEAR.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses750,450,922

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) MARIA BRAMAN........................................................................ CHIEF MEDICAL OFFICER	30.00 .......................10.00	X		631,739	0	70,503
(19) CHRISTI LEE........................................................................ CHIEF LEGAL COUNSEL	25.00 .......................15.00	X		483,617	0	69,752
(20) SONYA BERGMAN........................................................................ CHIEF PEOPLE OFFICER	30.00 .......................0.00	X		470,494	0	81,729
(21) BYRON GABBARD........................................................................ CHIEF FINANCIAL OFFICER	25.00 .......................15.00	X		664,251	0	60,915
(22) JAYARAMAKRISHNA DEPA........................................................................ NEPHROLOGIST	40.00 .......................0.00		X	984,500	0	59,015
(23) SAMUEL BAILEY........................................................................ ONCOLOGIST	40.00 .......................0.00		X	848,952	0	54,705
(24) ADNAN M BHOPALWALA........................................................................ CARDIOLOGIST	40.00 .......................0.00		X	1,251,900	0	53,827
(25) TIMOTHY MICEK........................................................................ ORTHOPEDIC SURGEON	40.00 .......................0.00		X	963,310	0	43,477
(26) CHAYAKRIT KRITTANAWONG........................................................................ INTERVENTIONAL CARDIOLOGIST	40.00 .......................0.00		X	862,566	0	13,573

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	9,299,264	0	729,624

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	746,798

f	All other contributions, gifts, grants, and similar amounts not included above		1f	724,746

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		1,471,544

		Business Code
2a	PATIENT REVENUES	621110	718,884,721	718,884,721
b	HOSPITAL RATE IMPROVEM	900099	158,487,287	158,487,287
c	PHARMACY & LAB	812300	114,368,951	84,088,897	30,280,054
d	RECORD TRANSCRIPT FEES	900099	81,072	81,072
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		991,822,031

3 Investment income (including dividends, interest, and othersimilar amounts) ......			11,373,414			11,373,414
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	1,407,625
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	1,407,625
d	Net rental income or (loss).......			1,407,625			1,407,625
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	14,371,316
b	Less: cost or other basis and sales expenses	7b	694,120
c	Gain or (loss)	7c	13,677,196
d	Net gain or (loss).........			13,677,196			13,677,196
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	DPP REVENUE		900099	29,763,991			29,763,991
b	KMAP REVENUE		900099	14,020,729			14,020,729
c	HOME STORE SALES		900099	6,441,231		6,441,231
d	All other revenue ....			8,027,640	1,806,093	939,021	5,282,526
e	Total. Add lines 11a–11d ......			58,253,591
12	Total revenue. See instructions.....			1,078,005,401	963,348,070	37,660,306	75,525,481

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,113,867	1,113,867
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	4,998,599		4,998,599
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	339,670,931	285,321,514	54,349,417
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	7,837,538	6,795,839	1,041,699
9	Other employee benefits .......	76,659,507	63,594,047	13,065,460
10	Payroll taxes ...........	21,677,417	17,992,256	3,685,161
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	1,195,899	801,252	394,647
c	Accounting ...........	919,166	615,841	303,325
d	Lobbying ...........	92,455	92,455
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	122,497,943	96,430,188	26,067,755
12	Advertising and promotion ....	5,925,428	3,614,511	2,310,917
13	Office expenses .......	34,222,252	24,313,837	9,908,415
14	Information technology ......	23,453,995	14,306,937	9,147,058
15	Royalties ..
16	Occupancy ...........	32,699,150	21,241,616	11,457,534
17	Travel ............	2,674,361	1,631,360	1,043,001
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,122,972	685,013	437,959
20	Interest ...........	6,265,086	939,763	5,325,323
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	21,984,940	18,687,199	3,297,741
23	Insurance ...	18,839,254	11,491,945	7,347,309
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES & PHAR	179,046,384	176,745,283	2,301,101
b	PROVIDER TAX EXPENSE	35,444,854		35,444,854
c	PROVISION FOR BAD DEBT	26,540,555	26,540,555
d	340B RETAIL CONTRACT FE	5,809,448	5,809,448
e	All other expenses	-41,989,693	-28,313,804	-13,675,889
25	Total functional expenses. Add lines 1 through 24e	928,702,308	750,450,922	178,251,386	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			14,016,474	1	4,900,331
2	Savings and temporary cash investments .........			163,507,842	2	226,173,661
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			145,913,830	4	196,068,730
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			22,212,234	8	22,718,806
9	Prepaid expenses and deferred charges ......			65,818,974	9	76,957,451
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	765,958,158
b	Less: accumulated depreciation	10b	478,268,830	261,935,824	10c	287,689,328
11	Investments—publicly traded securities .			760,127,024	11	859,374,970
12	Investments—other securities. See Part IV, line 11 .....			3,986,578	12	4,388,895
13	Investments—program-related. See Part IV, line 11 ..			1,571,815	13	1,565,475
14	Intangible assets ...............			930,000	14	930,000
15	Other assets. See Part IV, line 11 ...........			8,809,743	15	9,741,201
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,448,830,338	16	1,690,508,848

17	Accounts payable and accrued expenses .....	134,983,428	17	123,886,736
18	Grants payable ...		18
19	Deferred revenue .........	4,936,547	19	19,725,843
20	Tax-exempt bond liabilities .........	66,480,000	20	65,160,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	174,770,019	23	164,041,567
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	364,444,785	25	397,903,631
26	Total liabilities. Add lines 17 through 25..	745,614,779	26	770,717,777

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	703,227,425	27	919,791,071
28	Net assets with donor restrictions ...........	-11,866	28	0
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	703,215,559	32	919,791,071
33	Total liabilities and net assets/fund balances ........	1,448,830,338	33	1,690,508,848