Appalachian Regional Healthcare

Legal name: Arh Tug Valley Health Services Inc

Nonprofit profile at a glance

EIN
822577178
IRS 990 coverage
2019–2024
Official website data refreshed
Sep 2026
Forms available
Form 990 2024, Form 990-T 2024
Location
Lexington, KY, US
Phone
(866) 940-4572
Rating
61
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Hospital, General

Official website

Reported finances

Revenue
$238,140,026
Expenses
$216,326,365
Assets
$149,900,805
Liabilities
$28,874,166

Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.

Leadership & pay

9 people listed

Highest reported compensation

  • ROBERT N ROYALTY (ORTHOPEDIC SURGEON): $2,055,947 total reported compensation
  • HOLLIE P HARRIS (CHAIRMAN): $1,622,589 total reported compensation
  • JASON T RICE (FAMILY MEDICINE PHYSICIAN): $803,869 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.

Overview

Mission

To improve the health and well-being of the people of Central Appalachia.

What it reported doing in 2024

During the past fiscal year, highlands arh regional medical center continued to strengthen its role as the healthcare hub for the arh big sandy region, serving floyd, johnson, martin, and magoffin counties. Since joining the arh system in 2019, highlands arh has remained focused on expanding access, improving quality, and addressing the unique healthcare needs of central appalachia.highlands arh supports a diverse medical staff representing numerous specialties, including family medicine, cardiology, obstetrics and gynecology, general surgery, internal medicine, orthopedics, urology, oncology, nephrology, neurology, and more. With more than 700 employees, the medical center is committed to delivering compassionate, high-quality care to the communities it serves.key service expansions during the fiscal year included the opening of an eight-bed progressive care unit and the addition of ip urology services. These initiatives contributed to an almost 20 percent year-over-year increase in admissions and enhanced highlands arh's ability to provide advanced care close to home.

Operating model

Revenue model
Earned-program. 98% of the money available for current operations came from fees and other program revenue.
Distribution model
Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.

The verdict

SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. A relatively small share of voting board members are independent and few specific pay-setting methods are documented in the filing; unanswered boxes are not proof of absence.

Rating breakdown

  • Financial Efficiency: 66
  • Transparency & Controls: 62
  • Accountability: 42
  • Sustainability: 55
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 72.1%; rating input score 72
  • Program expense ratio: 79.1%; rating input score 79
  • Fundraising efficiency: Limited

Transparency & Controls

  • Consistency checks: 91.7%; rating input score 92; 8th percentile among comparable filings
  • Pay-setting controls: 0 of 6 controls in place; rating input score 0
    • Compensation committee: Missing
    • Independent consultant: Missing
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Missing
    • Board or committee approval: Missing
  • Foreign activity oversight: Limited
  • Grant itemization coverage: 71%; rating input score 71; 15th percentile among comparable filings
  • Major donor itemization: Limited
  • Related-party transparency: Limited

Accountability

  • Independent voting board: 0%; rating input score 0; 4th percentile among comparable filings
  • Governance controls: 9 of 9 controls in place; rating input score 100
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Pass
    • Other executive compensation review process: Pass
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: 9.2%; rating input score 70; 70th percentile among comparable filings
  • Total-asset coverage ratio: 0.69; rating input score 27; 27th percentile among comparable filings
  • Liabilities to assets ratio: 0.19; rating input score 70; 70th percentile among comparable filings
  • Officer compensation ratio: 2.4%; rating input score 47; 47th percentile among comparable filings

Growth

  • Program expense growth: 11.6% per year; rating input score 100; 80th percentile among comparable filings
  • Revenue growth: 13.1% per year; rating input score 100; 85th percentile among comparable filings
  • Asset growth: 21.8% per year; rating input score 100; 94th percentile among comparable filings

Details

  • What they do: 4 programs and campaigns described on the official site · 3 operating locations identified
  • Where the money goes: 72.1% of revenue deployed · 79.1% of spending went to programs
  • Governance: 0 of 4 board members independent · 9 of 9 filing controls reported
  • Programs: 1 filed program accomplishment · $171.2M in reported program spending
  • Leadership: top reported pay $2.1M · 9 people listed · 0 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $14.7M reported
  • Consistency: 30 of 31 current checks pass · 1 finding to review
  • Schedules: 8 filed schedules · includes grants and executive pay
  • Filing history: 6 filing years from 2019 to 2024
  • Contacts: How to reach this organization
  • Money network: 9 filed money-flow records
  • Related organizations: 10 filed related-organization links
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

  • High — Accountability: Independent voting board scored 0/100.
  • High — Transparency & Controls: Pay-setting controls scored 0/100.
  • High — Sustainability: Total-asset coverage ratio scored 27/100.
  • Review — Transparency & Controls: Domestic grant itemization did not reconcile in the filed values.
  • Moderate — Sustainability: Officer compensation ratio scored 47/100.