2024-08-23T09:33:09-05:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 101 WASHINGTON STREET EAST CHARLESTON WV 25301 990 2023-01-01 812817266 ADAMS COUNTY REGIONAL MEDICAL CENTER ADAM 8778295500 230 MEDICAL CENTER DR SEAMAN OH 45679 PETE R DAGENBACH CFO 9373863001 2024-08-23 1 1 DOLORES ROSE P01286262 3043460441 2024-08-16 2023 2024-08-08 14:25:15Z PETE R DAGENBACH 230 MEDICAL CENTER DR SEAMAN OH 45679 43821657 0 X ACRMC.COM X 2016 OH TO PROVIDE QUALITY HEALTH CARE CLOSE TO HOME AND TO MEET COMMUNITY'S NEEDS, EXCEL AT CUSTOMER SERVICE AND BE THE FIRST CHOICE FOR HEALTHCARE NEEDS. 7 7 413 25 0 0 4169863 1192649 41464820 40690899 56101 656374 1023287 1281735 46714071 43821657 0 0 0 0 17784219 19842977 0 0 0 24874605 24000516 42658824 43843493 4055247 -21836 47297565 47233754 28828216 28786153 18469349 18447601 TO PROVIDE QUALITY HEALTH CARE CLOSE TO HOME. TO MEET THE COMMUNITY'S NEEDS, TO EXCEL AT CUSTOMER SERVICE AND TO BE YOUR FIRST CHOICE FOR HEALTHCARE NEEDS. 0 0 29427131 41972634 ACRMC HAS SIX LOCATIONS AND PROVIDES A WIDE RANGE OF SERVICES TO MEET THE HEALTHCARE NEEDS OF ADAMS COUNTY AND ITS SURROUNDING COMMUNITIES. HEALTH CARE SERVICES PROVIDED INCLUDE, BUT ARE NOT LIMITED TO: SURGICAL, ORTHOPEDIC, WOMEN'S HEALTH, REHABILITATION, SENIOR LIFE SOLUTIONS, SLEEP LAB, ADVANCED IMAGING AND CARDIO/PULMONARY. IT IS A CRITICAL ACCESS HOSPITAL WITH 25 BEDS AND 24/7/365 EMERGENCY DEPARTMENT AND ONLINE CARE. THE COST OF CHARITY CARE WAS APPROXIMATELY $156,000 FOR THE YEAR. AN ANNUAL HEALTH FAIR PROVIDES AFFORDABLE HEALTH SCREENINGS AND AN OPPORTUNITY FOR COMMUNITY MEMBERS TO SHARE FEEDBACK ON THEIR THOUGHTS AND DESIRES REGARDING THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES, THROUGH A SURVEY. 29427131 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 49 0 413 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 OH X PETE DAGENBACH CFO 9373863007 230 MEDICAL CENTER DR SEAMAN OH 45679 JACK MCCOY CHAIRMAN 1.50 X X 0 0 0 ROY SPUD GUSTIN VICE-CHAIR 1.50 X X 0 0 0 CHAD WILSON SECRETARY 1.50 X X 0 0 0 DANE CLARK MEMBER 1.50 X 0 0 0 MATTHEW ARMSTRONG MD MEMBER 1.50 X 0 0 0 PEGGY CHALKER PHD MEMBER 1.50 X 0 0 0 DARRIN SCHNEIDER MEMBER 1.50 X 0 0 0 ALAN BIRD CEO 40.00 X 0 0 0 PETE DAGENBACH CFO 40.00 X 194631 0 51631 RACHEL D CUMMINGS CNO 40.00 X 192277 0 4359 AMBER THIEL NP 40.00 X 133606 0 17177 HANNAH HOPKINS MD DOCTOR 40.00 X 392013 0 19218 KRISHNA REDDY MD ORTHOPEDIC SURGEON 40.00 X 171554 0 0 JOHN DEBANTO MD GASTROENTEROLOGIST 40.00 X 189238 0 6362 1273319 0 98747 12 0 1 0 EMERGENCY PROFESSIONAL SERVICES INC PO BOX 634850 CINCINNATI OH 452634850 STAFFING ER PHYSICIANS 793777 RHG CONSOLIDATED LLC 4770 N BELLVIEW AVE SUITE 205 KANSAS CITY MO 64116 HOSPITAL MANAGEMENT COMPANY 723978 CPS REHABILITATION SERVICES LLC 655 METRO PLACE SOUTH DUBLIN OH 43017 CONTRACTED THERPAY SERVICES 722504 RDI 4350 GLANDALE-MILFORD RD SUITE 250 CINCINNATI OH 45242 IT SUPPORT 556943 PSYCHIATRIC MEDICAL CARE INC PO BOX 734606 DALLAS TX 75373 PSYCHIATRIC SERVICES 411037 5 1150783 41866 1192649 PATIENT SERVICES 900099 40690899 40690899 40690899 639524 639524 16850 0 16850 16850 16850 DRUGS SOLD 900099 737105 737105 OTHER REVENUE 900099 294584 294584 CAFETERIA AND VENDING REVENUE 900099 250046 250046 1281735 43821657 41972634 0 656374 X 246262 145319 100943 15897438 9381078 6516360 2260849 1334127 926722 1438428 848816 589612 70955 70955 119388 119388 8022197 5419038 2603159 125676 125676 1770614 1043320 727294 595187 351220 243967 118682 70034 48648 1810973 1068655 742318 1612635 951616 661019 407899 240701 167198 BAD DEBT 4477318 4477318 MEDICAL SUPPLIES 2982918 2982918 MEDICAID ASSISTANCE 1069211 630941 438270 REPAIRS AND MAINTENANCE 458826 270753 188073 358037 211277 146760 43843493 29427131 14416362 0 6682900 7554856 7599513 7864412 4233946 5429279 299608 365096 273962 359753 29065121 6480414 23745583 22584707 60557 61275 2614917 2642972 74249 41082 1712330 330322 47297565 47233754 4125221 4594402 23824756 23531681 878239 660070 28828216 28786153 X 18457059 18435223 12290 12378 18469349 18447601 47297565 47233754 X -21836 88 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21868547 2760923 19107624 5597418 3514055 2083363 1599156 205436 1393720 22584707 BOND INDENTURE 2642972 C 2642972 CAPITAL LEASE OBLIGATIONS 660070 660070 X 39344339 0 39344339 4477318 4477318 43821657 39366175 0 39366175 4477318 4477318 43843493 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND HAS BEEN RECOGNIZED AS TAX EXEMPT UNDER SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. THE CENTER FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2020, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 4,477,318. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 4,477,318. 1 1 X 1 X 1 X 1 0 0 145413 145413 9747177 6050543 3696634 0.09390 9892590 6195956 3696634 0.09390 9892590 6195956 3696634 0.09390 4477318 3172199 2385642 786557 X 1 1 1 1 ADAMS COUNTY REGIONAL MEDICAL CENTER INC 230 MEDICAL CENTER DRIVE SEAMAN OH 45679 HTTPS://ACRMC.COM/ X X X X ADAMS COUNTY REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X 21 1 1 1 1 X HTTPS://ACRMC.COM/WP-CONTENT/UPLOADS/2022/02/CHNA-FINAL-FULL-12-14-21.PDF X 1 21 1 HTTPS://ACRMC.COM/WP-CONTENT/UPLOADS/2022/09/ACRMC-CHNA-ACTIONS-110822.PDF 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTPS://ACRMC.COM/PATIENT-FINANCIAL-SERVICES/ X HTTPS://ACRMC.COM/PATIENT-FINANCIAL-SERVICES/ X X X X X X 1 X 0 X X X 1 X 0 0 ADAMS COUNTY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: THE HEALTH COLLABORATIVE (THC), IN PARTNERSHIP WITH THE GREATER DAYTON AREA HOSPITAL ASSOCIATION (GDAHA), FACILITATED THE 2021 REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THIS REGIONAL CHNA INCLUDES 36 HOSPITALS, 22 HEALTH DEPARTMENTS, ACROSS 26 COUNTIES IN SOUTHWEST OHIO AND THE GREATER DAYTON AREA, SOUTHEAST INDIANA, AND NORTHERN KENTUCKY. THE REGIONAL CHNA WAS GUIDED BY THE ADVISORY COMMITTEE. A TOTAL OF 42 INDIVIDUALS ARE PART OF THE ADVISORY COMMITTEE REPRESENTING HOSPITALS, HEALTH DEPARTMENTS, AND COMMUNITY PARTNERS IN SOUTHWEST OHIO AND THE GREATER DAYTON AREA, SOUTHEAST INDIANA, AND NORTHERN KENTUCKY. ADAMS COUNTY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6A: MERCY HEALTH URBANA HOSPITALMERCY HEALTH SPRINGFIELD REGIONAL MEDICAL CENTERWAYNE HEALTHCAREWILSON MEMORIAL HOSPITALPREMIER VALLEY HOSPITALSGREATER DAYTON AREA HOSPITAL ASSOCIATIONBON SECOURS MERCY HOSPITALCINCINNATI CHILDREN'S HOSPITALTHE CHRIST HOSPITAL, MT. AUBURNTRIHEALTH HOSPITALSUC HEALTH UNIVERSITY OF CINCINNATI MEDICAL CENTER ADAMS COUNTY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: GREATER DAYTON AREA HOSPITAL ASSOCIATION 5 1 - FAMILY MEDICINE - GEORGETOWN 900 MT ORAB PIKE GEORGETOWN OH 45131 CLINIC 2 - FAMILY MEDICINE - WEST UNION 211 NORTH WILSON DRIVE WEST UNION OH 45693 CLINIC 3 - FAMILY MEDICINE - WINCHESTER 19262 STATE ROUTE 136 WINCHESTER OH 45697 CLINIC 4 - FAMILY MEDICINE - MT ORAB 217 HUGHES BLVD MT ORAB OH 45154 CLINIC 5 - FAMILY MEDICINE - PEEBLES 154 ELLIOT AVENUE PEEBLES OH 45660 CLINIC PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4,477,318. PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COSTS AND REIMBURSEMENTS. PART VI, LINE 2: THE CENTER PROVIDES AN ANNUAL HEALTH FAIR SCREENING AND ASKS THE PARTICIPANTS TO COMPLETE A SURVEY. PART VI, LINE 3: ALL PATIENTS ARE INFORMED OF APPLICATION PROCESS, PRIOR TO SERVICE. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE. PART VI, LINE 4: ADAMS COUNTY IS A RURAL, MEDICALLY UNDERSERVED AREA, LOCATED APPROXIMATELY FIFTY MILES EAST OF CINCINNATI ALONG THE OHIO RIVER. ADAMS COUNTY HAS A POPULATION OF APPROXIMATELY 28,550. IN THE COUNTY, THE POPULATION IS SPREAD OUT, WITH 26.40% UNDER THE AGE OF 18, 8.70% FROM 18 TO 24, 28.20% FROM 25 TO 44, 23.40% FROM 45 TO 64, AND 13.30% WHO WERE 65 YEARS OF AGE OR OLDER. THE MEDIAN AGE WAS 36 YEARS. THE MEDIAN HOUSEHOLD INCOME IS $36,894. APPROXIMATELY 20% OF THE POPULATION IS IN POVERTY. PART VI, LINE 5: THE COMMUNITY HEALTH FAIR AND A RURAL HEALTH CLINIC WITH WALK-IN APPOINTMENTS. X 0 0 0 0 0 0 0 0 0 HANNAH HOPKINS MD DOCTOR 392013 0 0 0 0 0 3788 0 15430 0 411231 0 0 0 PETE DAGENBACH CFO 194631 0 0 0 0 0 27248 0 24383 0 246262 0 0 0 RACHEL D CUMMINGS CNO 192277 0 0 0 0 0 0 0 4359 0 196636 0 0 0 JOHN DEBANTO MD GASTROENTEROLOGIST 189238 0 0 0 0 0 0 0 6362 0 195600 0 0 0 KRISHNA REDDY MD ORTHOPEDIC SURGEON 171554 0 0 0 0 0 0 0 0 0 171554 0 0 0 AMBER THIEL NP 133606 0 0 0 0 0 4960 0 12217 0 150783 0 0 0 FORM 990, PART VII, SECTION A, LINE 5 UNRELATED ORGANIZATION OFFICER COMPENSATION: THE CENTER HAS A MANAGEMENT SERVICES AGREEMENT WITH RURAL HOSPITAL GROUP. THE RURAL HOSPITAL GROUP PROVIDES A FULL-TIME CHIEF EXECUTIVE OFFICER (CEO) TO THE HOSPITAL. AS OF THE FILING DATE OF THE 990, ALAN BIRD IS THE CEO. THE CEO'S COMPENSATION FOR THE PERIOD OF 1/1/23 TO 12/31/23 WAS $315,000. A COUNTY OF ADAMS OH SERIES 2019 BONDS 00610PAH9 2019-09-27 25400000 TO FINANCE ACQUISITION OF EXISTING HOSPITAL FACILITIES IN ADAMS COUNTY, OH 0 0 0 A 660000 24892000 2075280 508000 1 0 0 1 A 0 0 0 0 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE DISTRIBUTED TO ALL BOARD MEMBERS. IT WILL BE PRESENTED AND DISCUSSED AT A BOARD OF TRUSTEES MEETING AFTER THE COMPLETION OF FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ACRMC CONFLICT OF INTEREST POLICY REQUIRES THAT ALL PERSONNEL SHALL UPON HIRE AND ANNUALLY THEREAFTER SIGN A STATEMENT WHICH AFFIRMS THE PERSON'S UNDERSTANDING AND ADHERENCE TO THE POLICY. THE COMPLIANCE COMMITTEE MEETS EACH QUARTER AND THE HIM DIRECTOR PERFORMS HIPAA AUDITS. FORM 990, PART VI, SECTION B, LINE 15 SALARY SURVEYS AND RECOMMENDATIONS FROM THE CEO ARE USED TO DETERMINE THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES SALARIES. THE SALARY RECOMMENDATIONS ARE REVIEWED AND APPROVED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 847,140. MANAGEMENT AND GENERAL EXPENSES 588,448. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,435,588. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,900,416. MANAGEMENT AND GENERAL EXPENSES 2,014,711. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,915,127. CONTRACTED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,671,482. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,671,482. FORM 990, PART XI, LINE 9: CHANGE IN EQUITY OF NON-CONTROLLING INTEREST IN SUB 0. INCREASE IN TEMP RESTRICTED ASSETS 88. ADAMS COUNTY REGIONAL MEDICAL PAIN MANAGEMENT LLC 230 MEDICAL CENTER DR SEAMAN OH 45679 853030741 HEALTHCARE OH ADAMS COUNTY REGIONAL MEDICAL CENTER RELATED 9325 151779 0 0 0.51000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0