Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 2a · Program service revenue: PATIENT SERVICE REVENUE

  total $873,164 · related or exempt $873,164

• 2b · Program service revenue: OTHER REVENUE

  total $248 · related or exempt $248

• 3 · Investment income

  total $0

• 4 · Income from investment of tax-exempt bond proceeds

  total $0

• 5 · Royalties

  total $0

• 6c · Rental income or loss

  real property $0 · personal property $0

• 6d · Net rental income or loss

  total $0

• 7d · Net gain or loss

  total $0

• 8a · Fundraising events: gross income

  $0

• 8b · Fundraising events: direct expenses

  $0

• 8c · Net income from fundraising events

  total $0

• 9a · Gaming: gross income

  $0

• 9b · Gaming: direct expenses

  $0

• 9c · Net income from gaming

  total $0

• 10a · Gross sales of inventory

  $0

• 10b · Cost of goods sold

  $0

• 10c · Net income from sales of inventory

  total $0

• 11e · Other revenue, total

  $0

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $0

• 2 · Grants to domestic individuals

  total $0

• 3 · Grants to foreign organizations and individuals

  total $0

• 4 · Benefits paid to or for members

  total $0

• 5 · Compensation of officers, directors and key employees

  total $0

• 6 · Compensation of disqualified persons

  total $0

• 7 · Other salaries and wages

  total $2,136,980 · program services $2,136,980

• 8 · Pension plan contributions

  total $57,978 · program services $57,978

• 9 · Other employee benefits

  total $114,597 · program services $114,597

• 10 · Payroll taxes

  total $0

• 11a · Fees: management

  total $0

• 11b · Fees: legal

  total $0

• 11c · Fees: accounting

  total $900 · management and general $900

• 11d · Fees: lobbying

  total $0

• 11e · Fees: professional fundraising services

  total $0

• 11f · Fees: investment management

  total $0

• 11g · Fees: other

  total $0

• 12 · Advertising and promotion

  total $0

• 13 · Office expenses

  total $142 · program services $142

• 14 · Information technology

  total $0

• 15 · Royalties

  total $0

• 16 · Occupancy

  total $0

• 17 · Travel

  total $0

• 18 · Travel or entertainment for public officials

  total $0

• 19 · Conferences, conventions and meetings

  total $0

• 20 · Interest

  total $0

• 21 · Payments to affiliates

  total $0

• 22 · Depreciation, depletion and amortization

  total $0

• 23 · Insurance

  total $0

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  beginning of year $213,791 · end of year $68,125

• 2 · Savings and temporary cash investments

  beginning of year $0 · end of year $0

• 3 · Pledges and grants receivable

  beginning of year $0 · end of year $0

• 4 · Accounts receivable

  beginning of year $73,646 · end of year $92,619

• 5 · Loans and receivables from officers and key people

  beginning of year $0 · end of year $0

• 6 · Loans and receivables from disqualified persons

  beginning of year $0 · end of year $0

• 7 · Other notes and loans receivable

  beginning of year $0 · end of year $0

• 8 · Inventories for sale or use

  beginning of year $0 · end of year $0

• 9 · Prepaid expenses and deferred charges

  beginning of year $0 · end of year $0

• 10c · Land, buildings and equipment, net

  beginning of year $0 · end of year $0

• 11 · Investments: publicly traded securities

  beginning of year $0 · end of year $0

• 12 · Investments: other securities

  beginning of year $0 · end of year $0

• 13 · Investments: program-related

  beginning of year $0 · end of year $0

• 14 · Intangible assets

  beginning of year $0 · end of year $0

• 15 · Other assets

  beginning of year $0 · end of year $0

• 17 · Accounts payable and accrued expenses

  beginning of year $5,012 · end of year $4,784

• 18 · Grants payable

  beginning of year $0 · end of year $0

• 19 · Deferred revenue

  beginning of year $0 · end of year $0

• 20 · Tax-exempt bond liabilities

  beginning of year $0 · end of year $0

• 21 · Escrow or custodial account liability

  beginning of year $0 · end of year $0

• 22 · Loans and payables to officers and key people

  beginning of year $0 · end of year $0

• 23 · Secured mortgages and notes payable

  beginning of year $0 · end of year $0

• 24 · Unsecured notes and loans payable

  beginning of year $0 · end of year $0

• 25 · Other liabilities

  beginning of year $282,426 · end of year $155,961

• 27 · Net assets without donor restrictions

  beginning of year -$1 · end of year -$1

• 28 · Net assets with donor restrictions

  beginning of year $0 · end of year $0

The filer's explanations (Part III)

SCHEDULE J, PART I, LINE 3

COMPENSATION: ARMSTRONG COUNTY MEMORIAL HOSPITAL, A RELATED ORGANIZATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

SCHEDULE J, PART I, LINE 4B

SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUAL PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND RECEIVED THE FOLLOWING 457(F) CONTRIBUTIONS OR DISTRIBUTIONS: $ 55,000 JOHN I. LEWIS - DISTRIBUTIONS $ 29,954.34 MATTHEW KOCIOLA - CONTRIBUTIONS THE 457(F) CONTRIBUTION PLAN THAT ARMSTRONG COUNTY MEMORIAL HOSPITAL ESTABLISHED FOR A SELECT GROUP OF MANAGEMENT INCLUDES THE FOLLOWING TERMS: A PARTICIPANT SHALL BECOME FULLY VESTED IN HIS DEFERRED COMPENSATION ACCOUNT, AND INCOME, GAINS AND LOSSES ATTRIBUTABLE THERETO, IF HE REMAINS IN SERVICE WITH THE EMPLOYER UNTIL THE FIRST OF THE FOLLOWING EVENTS OCCUR: (A) THE DEATH OF THE PARTICIPANT; (B) THE DISABILITY OF THE PARTICIPANT; (C) THE DATE THE PARTICIPANT ATTAINS AGE 65; OR (D) THE DATE A PARTICIPANT IS TERMINATED FROM EMPLOYMENT WITH THE EMPLOYER DUE TO A CHANGE OF CONTROL EVENT. (E) THE PARTICIPANT WILL BE VESTED AT 5 YEARS, AT WHICH TIME PAYMENTS WILL BEGIN. UPON VESTING, THE DEFERRED COMPENSATION ACCOUNT WILL BE INCLUDIBLE IN THE GROSS INCOME OF THE PARTICIPANT PURSUANT TO CODE SECTION 457(F).

SCHEDULE J, PART I, LINES 5A & 6A

CONTINGENT COMPENSATION: MANAGEMENT USES MGMA PUBLISHED STANDARDS TO ESTABLISH A BASE SALARY FOR PROVIDERS. IN ADDITION TO THE BASE SALARY, PROVIDERS HAVE THE ABILITY TO EARN INCENTIVES BASED UPON THEIR PRODUCTIVITY AS REFLECTED IN WORK RVU MEASURES. IN ADDITION, THE CEO PRESENTS GOALS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF WHAT THE ORGANIZATION HOPES TO ACHIEVE DURING EACH FISCAL YEAR. THESE GOALS ARE BASED ON REVENUES, NET EARNINGS, AND OTHER MEASURES. DEPENDING ON THE RESULTS, THE EXECUTIVE COMMITTEE OF THE BOARD, WITH INPUT FROM THE CEO, DETERMINES WHAT AMOUNT OF BONUSES (IF ANY) WILL BE PAID. IF APPROVED, BONUSES ARE PAID BY ARMSTRONG COUNTY MEMORIAL HOSPITAL.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

• ACMH ANESTHESIA SERVICES LLC

  ANESTHESIA SV · PA · income $873,412 · assets $160,744

  Directly controlled by ACMH