Appalachian Regional Healthcare · South Williamson, KY
2 of 5
CMS star rating
72
Beds
1,561
Inpatient discharges a year
$50.5M
Net patient revenue a year
24
In-network payers
Tug Valley Arh Regional Medical Center is a 72-bed proprietary hospital in South Williamson, KY, affiliated with Appalachian Regional Healthcare. Below you'll find publicly disclosed negotiated rates and facility details, including 24 in-network payers and 178 disclosed rate categories.
The 24 services Tug Valley Arh Regional Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Childbirth · Inpatient
MS-DRG 807
$9,459 - $9,760
from 2 insurers · median $9,610
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Childbirth · Inpatient
MS-DRG 788
$11,963 - $14,054
from 3 insurers · median $13,423
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Childbirth · Inpatient
MS-DRG 807
$9,459 - $9,760
from 2 insurers · median $9,610
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Medicine & Surgery · Inpatient
MS-DRG 743
$16,916 - $20,541
from 3 insurers · median $17,014
Hospital reports inpatient surgical services to CMS
Cardiology and vascular testing
CPT 93306
$186 - $3,891
from 4 insurers · median $1,790
Common here, based on CMS Medicare volume
CT imaging
CPT 74177
$311 - $5,943
from 4 insurers · median $510
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 66984
$4,162
negotiated rate
37 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
CT imaging
CPT 70450
$107 - $2,016
from 4 insurers · median $356
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$400 - $3,806
from 4 insurers · median $1,302
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$116 - $310
from 4 insurers · median $160
Common here, based on CMS Medicare volume
Ultrasound
CPT 76705
$80 - $1,083
from 4 insurers · median $512
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$30 - $419
from 4 insurers · median $202
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$187 - $4,524
from 4 insurers · median $417
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$1,671
negotiated rate
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93971
$110 - $1,051
from 4 insurers · median $523
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$255 - $542
from 3 insurers · median $419
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 77080
$33 - $969
from 4 insurers · median $439
Common here, based on CMS Medicare volume
Ultrasound
CPT 76830
$109 - $1,258
from 4 insurers · median $608
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$1,671
negotiated rate
Common here, based on CMS Medicare volume
MRI imaging
CPT 72197
$532 - $5,839
from 4 insurers · median $2,706
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93880
$176 - $1,266
from 4 insurers · median $667
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$1,671
negotiated rate
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93970
$173 - $1,694
from 4 insurers · median $839
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 73630
$31 - $501
from 4 insurers · median $232
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 19 | 763% | 15 | 0 |
| Insurer B* | 20 | 513% | 11 | 4 |
| Insurer C* | 22 | 135% | 0 | 15 |
| Insurer D* | 16 | 76% | 1 | 15 |
How we chose these services: 1 appear in this hospital's own Medicare claims, 19 are common here based on CMS Medicare volume, and 4 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Tug Valley Arh Regional Medical Center, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
2 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$50.5M net patient revenue
Ownership and leadership
Private (for profit)
The employer identification numbers (EINs) health plans and networks list for Tug Valley Arh Regional Medical Center in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 52-0795508(multi-state) Appalachian Regional Healthcare INC | 45Aetna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter, AmeriBen and 40 more | 1891792495 Appalachian Regional Healthcare Inc.1194723726 Appalachian Regional Healthcare Inc.1609869916 Appalachian Regional Healthcare Inc.and 120 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
260 Hospital Drive, South Williamson, KY 41503
(606) 237-1700
How Tug Valley Arh Regional Medical Center compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
2 of 5
Lower than 73% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 4 measures
0 better, 4 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
No different on 2 measures
0 better, 2 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Worse on 2 of 5 measures
0 better, 3 no different, 2 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
3 of 5
Lower than 40% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
57%
Lower than 91% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Not penalized
Not among the worst-performing 25%
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
0.95
Lower than 55% of US hospitals
US median: 0.96
Risk-adjusted composite of complications such as bedsores, falls with hip fracture and blood clots after surgery; lower is better
Time in the ER before going home
168 min
Higher than 63% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
Sepsis care
77%
Higher than 78% of US hospitals
US median: 65%
Patients with severe sepsis or septic shock who got every step of the recommended early treatment; higher is better
| Measure | Result | Period |
|---|---|---|
| Overall star ratingCMS: Overall hospital quality star rating | 2 of 5 | |
| Death rates | No different on 4 measures | |
| Safety | No different on 2 measures | |
| Readmissions | Worse on 2 of 5 measures | |
| Patient survey ratingCMS: Summary star rating | 3 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 57% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Not penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 0.95 | 2022-07-01 to 2024-06-30 |
| Time in the ER before going homeCMS: Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better | 168 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 77% | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-08-13. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
How Medicare adjusts Tug Valley Arh Regional Medical Center's inpatient payments for its readmissions, quality and cost results.
-1.88% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+1.59% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Each result CMS publishes for Tug Valley Arh Regional Medical Center, beside the US median and the average of KY hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.2 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 340 cases | 5.6 | 3.9 | 4.543 | Worse than 96% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 12.11 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.485 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 · 63 cases | 7.9 | 8.5 | 9.152 | Better than 65% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 48 cases | 10.1 | 11 | 11.98 | Better than 67% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 88 cases | 15.7 | 15.2 | 16.6 | Worse than 57% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 12.38 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 502 cases | 0.5 | 0.51 | 0.6092 | No Different Than the National Rate | Better than 51% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 185 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 788 cases | 0.2 | 0.2 | 0.2113 | No Different Than the National Rate | Better than 46% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 817 cases | 0.27 | 0.27 | 0.2787 | No Different Than the National Rate | Worse than 46% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 34 cases | 2.32 | 2.29 | 2.306 | No Different Than the National Rate | Worse than 59% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.711 | Number of Cases Too Small | ||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 10.2 | Number of Cases Too Small | ||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 35 cases | 3.47 | 3.4 | 3.435 | No Different Than the National Rate | Worse than 58% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.85 | Number of Cases Too Small | ||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 | Not Available | 1.761 | Number of Cases Too Small | ||
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 70 cases | 1.04 | 1.02 | 1.077 | No Different Than the National Rate | Worse than 57% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 13.02 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 58 cases | -14 | 1.25 | 9.521 | Better than 71% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 110 cases | 53.2 | 3.85 | 12.61 | Worse than 93% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 · 59 cases | 12.9 | 12.9 | 13.03 | No Different Than the National Rate | Better than 50% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 10.97 | Number of Cases Too Small | ||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.4 | Number of Cases Too Small | ||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 | Not Available | 1.027 | Number of cases too small | ||
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.42 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 10.55 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 131 cases | 20.7 | 19.8 | 19.89 | Worse than 82% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 129 cases | 22.3 | 21.3 | 21.36 | Worse than 78% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 6.142 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 243 cases | 20.3 | 17.2 | 17.37 | Worse than 99% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.339 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.151 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 474 | 1,370 | 2,960 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.343 | 0.9835 | 2.924 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 2.453 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.7803 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2917 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.135 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 804 | 1,799 | 3,041 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.469 | 1.377 | 3.578 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.172 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5965 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.4763 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.932 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 18 | 61 | 98 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.522 | 1.591 | 2.685 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 2 | 1 | 2.881 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.9389 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2818 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.126 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | Not Available | 73.52 | |||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.6952 | |||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.8043 | |||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.9479 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2803 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.29 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 6,987 | 14,451 | 34,235 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.184 | 0.567 | 2.406 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 2.093 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.7481 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.373 | 0.127 | 0.149 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 3.989 | 0.747 | 1.678 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 6,987 | 13,646 | 31,551 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 2.047 | 5.683 | 15.64 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 3 | 2 | 5.011 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 1.466 | 0.279 | 0.3987 | No Different than National Benchmark | Worse than 98% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 135 cases | 81 | 73 | 74.59 | Better than 78% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 135 cases | 3 | 8 | 7.987 | Better than 87% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 135 cases | 16 | 18 | 17.42 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 93 | 87 | 86.82 | Better than 92% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 135 cases | 5 | 4 | 3.533 | The top rating, shared by 12% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 135 cases | 77 | 80 | 82.24 | Worse than 65% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 89 | 91 | 92.18 | Worse than 79% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 135 cases | 9 | 4 | 3.772 | Worse than 95% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 135 cases | 2 | 3 | 3.8 | Worse than 79% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 135 cases | 14 | 16 | 13.99 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 135 cases | 86 | 79 | 81.87 | Better than 84% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 92 | 91 | 91.67 | Better than 63% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 135 cases | 6 | 5 | 4.823 | Worse than 56% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 135 cases | 4 | 3 | 3.417 | Better than 63% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 135 cases | 8 | 16 | 13.3 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 135 cases | 61 | 61 | 63.23 | Worse than 47% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 76 | 77 | 78.17 | Worse than 53% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 135 cases | 22 | 19 | 18.58 | Worse than 65% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 135 cases | 2 | 3 | 2.833 | Worse than 53% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 135 cases | 17 | 19 | 18.19 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 73 | 86 | 85.77 | Worse than 99% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 135 cases | 27 | 13 | 13.37 | Worse than 99% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 135 cases | 1 | 3 | 3.317 | The lowest rating, shared by 4% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 135 cases | 73 | 87 | 86.63 | Worse than 99% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 135 cases | 32 | 14 | 14.65 | Worse than 99% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 135 cases | 68 | 86 | 85.35 | Worse than 99% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 135 cases | 85 | 74 | 76.86 | Better than 94% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 135 cases | 6 | 7 | 6.333 | Better than 53% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 135 cases | 9 | 19 | 16.81 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 135 cases | 86 | 77 | 80.25 | Better than 90% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 135 cases | 5 | 6 | 5.278 | Better than 53% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 135 cases | 9 | 17 | 14.47 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 135 cases | 86 | 85 | 87.39 | Better than 53% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 135 cases | 6 | 3 | 3.125 | Worse than 86% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 135 cases | 8 | 11 | 9.486 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 135 cases | 16 | 8 | 7.544 | Worse than 94% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 135 cases | 20 | 20 | 19.38 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 135 cases | 64 | 72 | 73.08 | Worse than 79% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 83 | 88 | 88.38 | Worse than 90% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 135 cases | 2 | 3 | 3.333 | Worse than 78% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 135 cases | 75 | 74 | 75.21 | Better than 52% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 135 cases | 12 | 9 | 9.458 | Worse than 73% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 135 cases | 13 | 16 | 15.33 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 135 cases | 77 | 75 | 77.63 | Better than 63% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 135 cases | 10 | 5 | 5.153 | Worse than 91% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 135 cases | 13 | 20 | 17.22 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 135 cases | 72 | 77 | 79.5 | Worse than 76% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 135 cases | 10 | 4 | 4.028 | Worse than 95% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 135 cases | 18 | 19 | 16.47 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 135 cases | 83 | 86 | 88 | Worse than 72% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 135 cases | 7 | 3 | 2.556 | Worse than 96% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 135 cases | 10 | 11 | 9.444 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 135 cases | 59 | 59 | 62.39 | Worse than 49% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 135 cases | 10 | 9 | 8.089 | Worse than 54% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 135 cases | 31 | 31 | 29.52 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 82 | 82 | 83.2 | Better than 48% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 135 cases | 3 | 3 | 3.633 | Worse than 44% of US hospitals | |
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 · 135 cases | 13 | 5 | 5.19 | Worse than 95% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 135 cases | 57 | 71 | 70.95 | Worse than 91% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 135 cases | 79 | 87 | 86.8 | Worse than 93% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 135 cases | 30 | 23 | 23.86 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 135 cases | 2 | 4 | 3.6 | Worse than 85% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 135 cases | 46 | 47 | 50.82 | Worse than 53% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 135 cases | 32 | 30 | 28.18 | Worse than 57% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 135 cases | 22 | 22 | 21 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 135 cases | 3 | 3 | 3.433 | Worse than 40% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 135 cases | 22 | 12 | 11.93 | Worse than 97% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 135 cases | 78 | 88 | 88.07 | Worse than 97% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | low | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 | Not Available | 8.032 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.132 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.4286 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 446 cases | 89 | 79 | 74.25 | Better than 69% of US hospitals | |
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 479 cases | 176 | 154 | 153 | Worse than 64% of US hospitals | |
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 · 418 cases | 168 | 148 | 147 | Worse than 63% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 · 13 cases | 398 | 247 | 227 | Worse than 87% of US hospitals | |
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 52 cases | 282 | 293 | 305 | Better than 55% of US hospitals | |
| Left before being seen2024-01-01 to 2024-12-31 · 17,463 cases | 3 | 1 | 1.418 | Worse than 78% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 68.9 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 110 cases | 93 | 97 | 93.89 | Worse than 69% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | ||||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 63.27 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 478 cases | 18 | 15 | 16.73 | Worse than 73% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 161 cases | 77 | 65 | 66.02 | Better than 78% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 50 cases | 66 | 73 | 74.36 | Worse than 65% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 14 cases | 93 | 88 | 85.06 | Better than 65% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 161 cases | 89 | 82 | 81.94 | Better than 78% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 127 cases | 98 | 94 | 94.58 | Better than 77% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 96.88 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 · 0 cases | Not Available | 74 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 | Not Available | 92.33 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 76.94 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 93.3 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 6.5 | 5 | 7.251 | Worse than 66% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 8.7 | 6.6 | 6.595 | Worse than 73% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 0.81 | 0.99 | 1.007 | Better than 98% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 20 | 20 | 14.1 | Better than 48% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 5 | 5 | 3.571 | Worse than 48% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 100 | 10 | 19.82 | The best result, shared by 2% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 25 | 2.5 | 5.134 | Better than 97% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 33 | 34 | 44.76 | Worse than 52% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 8.25 | 8.75 | 11.37 | Worse than 53% of US hospitals | |
| VBP safety domain scoreFY 2026 | 55 | 40 | 46.5 | Better than 74% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 13.75 | 10 | 11.8 | Better than 73% of US hospitals | |
| VBP total performance scoreFY 2026 | 52 | 29.5 | 31.05 | Better than 95% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 45 | 43.33 | 45 | 33.33 | 36.67 | 20 |
| VBP clinical outcomes weighted domain score | 11.25 | 10.83 | 11.25 | 8.333 | 9.167 | 5 |
| VBP efficiency and cost reduction domain score | 100 | Not Available | 60 | 100 | 70 | 100 |
| VBP efficiency and cost reduction weighted domain score | 25 | Not Available | 15 | 25 | 17.5 | 25 |
| VBP person and community engagement domain score | 58 | Not Available | Not Available | 26 | 29 | 33 |
| VBP person and community engagement weighted domain score | 14.5 | Not Available | Not Available | 6.5 | 7.25 | 8.25 |
| VBP safety domain score | 65 | Not Available | Not Available | 5 | 50 | 55 |
| VBP safety weighted domain score | 16.25 | Not Available | Not Available | 1.25 | 12.5 | 13.75 |
| VBP total performance score | 67 | Not Available | Not Available | 41.08 | 46.42 | 52 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.011 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9628 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 · 99 cases | 1.05 | 0.9969 | 1.008 | Worse than 86% of US hospitals | |
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 · 71 cases | 1.043 | 0.9983 | 1.009 | Worse than 76% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 1.084 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 128 cases | 1.182 | 0.9955 | 1.006 | Worse than 99% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 1.239 | 1.193 | 1.171 | 1.113 | 1.095 | 1.05 |
| READM-30-HF-HRRP | 1.204 | 1.156 | 1.13 | 1.109 | 1.051 | 1.043 |
| READM-30-HIP-KNEE-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 1.207 | 1.173 | 1.177 | 1.143 | 1.166 | 1.182 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | This hospital | US median | KY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0.593 | 0.489 | 0.5632 | Worse than 60% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.176 | 0.346 | 0.3899 | Better than 76% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.9125 | |||
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8459 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.9509 | 0.9628 | 1.023 | Better than 55% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.8867 | |||
| Total HAC scoreFY 2026 | -0.3108 | -0.0453 | 0.1443 | Better than 68% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | No | N/A | No | No | No |
| Total HAC score | -0.2865 | -0.4962 | 0 | 0.2701 | -0.0116 | -0.3108 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
The Joint Commission (since 1999)
Accreditation
None
Medical school affiliation
Private (for profit)
Ownership type
113
Medicare-certified beds
75
Registered nurses (full-time equivalent)
1966
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Tug Valley Arh Regional Medical Center reported to Medicare in its latest cost report, covering Jul 1, 2024 to Jun 30, 2025.
1,561
Inpatient discharges
Medicare 21%, Medicaid 0%
5,493
Inpatient days
41% of available bed days used
251
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 839847). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Tug Valley Arh Regional Medical Center reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 1,454 | 3 | 4,036 | 5,493 |
| Discharges | 334 | 1 | 1,226 | 1,561 |
| Average length of stay | 4.4 days | 3.0 days | 3.3 days | 3.5 days |
| Average daily census | 4.0 | 0.0 | 11.1 | 15.0 |
1,936
Medicare Advantage days
413 discharges
1,042
Medicaid managed care days
294 discharges
1,448
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 31 | 4,328 | 1,104 | 38% |
| Intensive care unit | 6 | 1,165 | 350 | 53% |
| Skilled nursing facility | 35 | 8,153 | 371 | 64% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839847, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Tug Valley Arh Regional Medical Center treats Medicare patients for most often, in 2024. 241 Medicare discharges in 12 published DRGs; 0% surgical; 80% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 53 | $50,810 | $12,926 | $12,855 | 1.98 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 33 | $43,277 | $9,432 | $10,949 | 1.33 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 25 | $24,301 | $5,422 | $6,148 | 0.81 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 20 | $38,953 | $5,236 | $9,855 | 0.82 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 19 | $36,320 | $7,438 | $9,189 | 1.10 |
| Heart failure and shock with MCCMS-DRG 291, medical | 19 | $33,769 | $8,846 | $8,544 | 1.28 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 15 | $32,210 | $7,742 | $8,149 | 1.17 |
| Renal failure with CCMS-DRG 683, medical | 13 | $34,307 | $5,457 | $8,680 | 0.90 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 11 | $53,579 | $11,980 | $13,555 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 11 | $35,490 | $8,409 | $8,979 | 1.23 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 11 | $27,595 | $4,875 | $6,981 | 0.78 |
| Renal failure with MCCMS-DRG 682, medical | 11 | $41,293 | $11,194 | $10,447 | 1.50 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
The comprehensive outpatient service groups (APCs) Tug Valley Arh Regional Medical Center billed Medicare for most in 2024: 130 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Comprehensive Observation ServicesAPC 8011 | 93 | 82 | $22,193 | $1,809 | $2,090 |
| Level 1 Intraocular ProceduresAPC 5491 | 37 | 26 | $14,287 | $1,525 | $1,752 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.
ZIP codes with the most Medicare inpatient stays at Tug Valley Arh Regional Medical Center in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 886 in 2020 to 499 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 25661 | 178 | 36% | 929 | $8.8M | 43% | 55% |
| 25670 | 85 | 17% | 320 | $3.6M | 28% | 47% |
| 25678 | 50 | 10% | 220 | $2.3M | 49% | 45% |
| 41514 | 46 | 9% | 201 | $2.2M | 26% | 41% |
| 25674 | 31 | 6% | 109 | $1.2M | 20% | 25% |
| 25676 | 21 | 4% | 68 | $717,636 | 33% | 54% |
| 41544 | 18 | 4% | 78 | $950,511 | 25% | 42% |
| 41528 | 16 | 3% | 47 | $557,806 | 37% | |
| 41531 | 16 | 3% | 58 | $646,817 | 19% | 46% |
| 41543 | 13 | 3% | 56 | $499,383 | 48% | 53% |
| 41553 | 13 | 3% | 71 | $656,273 | 6% | 9% |
| 25672 | 12 | 2% | 51 | $566,146 | 48% | 64% |
Source: CMS Hospital Service Area file. Shares are of the 499 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units Tug Valley Arh Regional Medical Center reported at its latest Medicare certification survey (2001). Counts are people, not full-time equivalents.
15
Psychiatric unit beds
75
Registered nurses
54
Licensed practical nurses
2
Physicians
1
Pharmacists
13
Respiratory therapists
2
Physical therapists
4
Occupational therapists
1
Speech pathologists and audiologists
1
Dietitians
1
Social workers
199
Other personnel
Source: CMS Provider of Services file.
96 clinicians who bill Medicare list Tug Valley Arh Regional Medical Center as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
William Kendall, MD
Diagnostic Radiology Physician
NPI 1164530937
See commercial rates for William Kendall, MDBrian Daniels, D.O.
Family Medicine Physician
NPI 1437441953
See commercial rates for Brian Daniels, D.O.Raymon Nelson, M.D.
Cardiovascular Disease Physician
NPI 1346236452
See commercial rates for Raymon Nelson, M.D.Christopher Reynolds, M.D.
Clinical Cardiac Electrophysiology Physician
NPI 1831381755
See commercial rates for Christopher Reynolds, M.D.Rodney Handshoe, MD
Cardiovascular Disease Physician
NPI 1528070174
See commercial rates for Rodney Handshoe, MDBrandi Siggers, FNP
Family Nurse Practitioner
NPI 1184331670
See commercial rates for Brandi Siggers, FNPKevin Pugh, M.D.
Orthopaedic Surgery Physician
NPI 1477596302
See commercial rates for Kevin Pugh, M.D.Hamid Nawaz, M.D.
Cardiovascular Disease Physician
NPI 1932269503
See commercial rates for Hamid Nawaz, M.D.Subash Nepal, MD
Cardiovascular Disease Physician
NPI 1740701580
See commercial rates for Subash Nepal, MDAshok Patnaik, MD
Cardiovascular Disease Physician
NPI 1942253703
See commercial rates for Ashok Patnaik, MDAmy Bolling, NP
Nurse Practitioner
NPI 1881738169
See commercial rates for Amy Bolling, NPMariano Rivera, D.P.M
Foot & Ankle Surgery Podiatrist
NPI 1528389939
See commercial rates for Mariano Rivera, D.P.MKeith Hall, MD
Orthopaedic Surgery Physician
NPI 1932163177
See commercial rates for Keith Hall, MDThomas Ison, D.O.
Ophthalmology Physician
NPI 1548290042
See commercial rates for Thomas Ison, D.O.Ahmad Faridi, MD
Nephrology Physician
NPI 1760426068
See commercial rates for Ahmad Faridi, MDVellaiappan Somasundaram, MD
Internal Medicine Physician
NPI 1891745386
See commercial rates for Vellaiappan Somasundaram, MDKylie Rice, DO
Internal Medicine Physician
NPI 1972130540
See commercial rates for Kylie Rice, DOAlka Wells, M.D.
Diagnostic Radiology Physician
NPI 1477511160
See commercial rates for Alka Wells, M.D.Sankar Chirumamilla, MD
Physical Medicine & Rehabilitation Physician
NPI 1124346705
See commercial rates for Sankar Chirumamilla, MDNaveed Ahmed, M.D
Neurology Physician
NPI 1508946070
See commercial rates for Naveed Ahmed, M.DPallaki Ravi, M.D.
Family Medicine Physician
NPI 1053631804
See commercial rates for Pallaki Ravi, M.D.Allen Omo-Ogboi, MD
Anatomic Pathology & Clinical Pathology Physician
NPI 1366056400
See commercial rates for Allen Omo-Ogboi, MDJustin Douglas, MD
Otolaryngology Physician
NPI 1326210857
See commercial rates for Justin Douglas, MDDavid Minix, DO
Family Medicine Physician
NPI 1740383637
See commercial rates for David Minix, DOSource: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income Tug Valley Arh Regional Medical Center reported to Medicare for Jul 1, 2024 to Jun 30, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $278.3M | 550.8% |
| Inpatient | $54.2M | 107.3% |
| Outpatient | $224.1M | 443.5% |
| Contractual allowances and discounts | -$227.7M | -450.8% |
| Net patient revenue | $50.5M | 100.0% |
| Operating expenses | -$64.9M | -128.4% |
| Operating income from patient care | -$14.3M | -28.4% |
| Other income | $11.4M | 22.5% |
| Contributions and donations | $3,857 | 0.0% |
| Investment income | $1.3M | 2.7% |
| Other | $10M | 19.8% |
| Net income | -$3M | -5.9% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $33.2M | 12.3% |
| Medicaid (including managed care) | $96.1M | 35.7% |
| Other payers and self-pay | $140M | 52.0% |
| Total charges | $269.3M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839847, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from Tug Valley Arh Regional Medical Center's latest cost report.
-28.4%
Operating margin
Operating income from patient care / net patient revenue
-4.8%
Total margin
Net income / net patient revenue plus other income
-1.1%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
45% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$36.52
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-9.9%
Return on assets
Net income for a year / total assets
-5.1%
Return on equity
Net income for a year / fund balance
-0.32
Current ratio
Current assets / current liabilities
-0.30
Quick ratio
Cash, temporary investments and net receivables / current liabilities
0 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
62 days
Days in patient receivables
Net patient receivables / daily net patient revenue
-167 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
2.05
Asset turnover
Total revenue for a year / total assets
14.3 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 839847, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Tug Valley Arh Regional Medical Center owned and owed at the end of its reporting period (Jun 2025), across all fund types: $30.2M in total assets and a $58.9M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $2,047 | 0.0% |
| Patient receivables, net | $8.5M | 28.2% |
| Inventory | $679,287 | 2.3% |
| Total current assets | $9.2M | 30.5% |
| Property and equipment, net of depreciation | $21M | 69.5% |
| Total assets | $30.2M | 100.0% |
| Current liabilities | -$28.7M | -95.1% |
| Total liabilities | -$28.7M | -95.1% |
| Fund balance (net assets) | $58.9M | 195.1% |
Source: CMS cost report (HCRIS, Form 2552-10), report 839847, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Tug Valley Arh Regional Medical Center provided without full payment, as reported on Worksheet S-10 of its cost report.
$553,830
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$4.8M
Bad debt
Patient bills written off as uncollectible, at charges
$9.7M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$7.7M
Total unreimbursed and uncompensated care
11.9% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 839847, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Tug Valley Arh Regional Medical Center's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Jun 2020 | Jun 2021 | Jun 2022 | Jun 2023 | Jun 2024 | Jun 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $39.8M | $42.7M | $43.7M | $46.3M | $51.8M | $50.5M |
| Operating expenses | $47.4M | $49.8M | $62.1M | $59.9M | $62.8M | $64.9M |
| Operating margin | -19.1% | -16.5% | -42.2% | -29.2% | -21.3% | -28.4% |
| Net income | -$1.9M | $4M | -$6.8M | -$1.7M | $3.4M | -$3M |
| Total assets | $25.1M | $33.3M | $25.9M | $33.8M | $31.6M | $30.2M |
| Discharges | 1,971 | 1,912 | 1,927 | 1,727 | 1,937 | 1,561 |
| Inpatient days | 7,630 | 8,706 | 8,971 | 6,395 | 7,125 | 5,493 |
| Medicare Advantage days | 1,173 | 1,791 | 2,493 | 1,950 | 2,330 | 1,936 |
| Beds | 123 | 123 | 123 | 123 | 72 | 72 |
| Employees (FTE) | 278 | 385 | 388 | 285 | 272 | 251 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839847, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Tug Valley Arh Regional Medical Center reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Emergency | $2M | $6.8M | $41.8M | 0.16 | 6,100 |
| Rural health clinic | $2.7M | $6.2M | $5.7M | 1.09 | |
| Drugs charged to patients | $5.2M | $35.9M | 0.14 | ||
| Laboratory | $877,637 | $5M | $40.1M | 0.12 | 2,912 |
| Arh specialty associates tug valley | $3.2M | $3.5M | $2.5M | 1.42 | |
| Radiology-diagnostic | $1.2M | $3.4M | $63.9M | 0.05 | 6,966 |
| Rural health clinic ii | $1M | $3M | $1.7M | 1.73 | |
| Medical supplies charged to patient | $2.2M | $4M | 0.54 | 717 | |
| Operating room | $708,028 | $2.1M | $13.8M | 0.15 | 4,924 |
| Observation beds (non-distinct part | $1.7M | $5.9M | 0.29 | ||
| Physical therapy | $727,987 | $1.7M | $8.8M | 0.19 | 3,077 |
| Respiratory therapy | $644,965 | $1.5M | $10.8M | 0.14 | 1,661 |
| Arh cardiology associates tug valle | $1.1M | $1.1M | $803,566 | 1.42 | |
| Occupational therapy | $329,987 | $674,280 | $4.1M | 0.16 | 1,058 |
| Speech pathology | $239,198 | $504,688 | $1.1M | 0.46 | 1,050 |
| Electrocardiology | $151,836 | $389,232 | $7.7M | 0.05 | 202 |
| Impl. dev. charged to patients | $209,063 | $940,746 | 0.22 | ||
| Blood storing processing & trans. | $181,328 | $379,388 | 0.48 | ||
| Anesthesiology | $26,984 | $243,580 | 0.11 | 124 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $2.7M | $6.7M | $9.1M | 0.74 | 15,346 |
| Skilled nursing facility | $1M | $4M | $5.6M | 0.71 | 15,416 |
| Intensive care unit | $1.2M | $2.8M | $4.4M | 0.64 | 1,812 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $977,135 | $10.8M | 44,178 | $25.49 | 6,316 |
| Employee benefits department | $335,420 | $5.4M | 3,972 | $84.45 | 3,556 |
| Cap rel costs-bldg & fixt | $2.4M | 95,498 | |||
| Operation of plant | $477,374 | $2.3M | 22,996 | $20.76 | 5,297 |
| Pharmacy | $827,449 | $1.1M | 16,154 | $51.30 | 2,380 |
| Housekeeping | $571,273 | $790,469 | 40,823 | $13.99 | 1,687 |
| Cafeteria | $549,653 | 12,739 | $15.53 | 2,637 | |
| Nursing administration | $448,204 | 9,788 | $45.79 | 1,554 | |
| Dietary | $349,019 | $417,144 | 9,730 | $15.53 | 4,502 |
| Medical records & library | $228,317 | $313,418 | 11,945 | $19.11 | 2,774 |
| Laundry & linen service | $164,664 | 1,076 | |||
| Cap rel costs-mvble equip | $25,451 | ||||
| Central services & supply | $19,513 | 125 |
Source: CMS cost report (HCRIS, Form 2552-10), report 839847, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The factors Medicare uses to set what it pays Tug Valley Arh Regional Medical Center for an inpatient stay.
1.37
Case mix index
Higher than 15% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
33.0%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
298
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Rural
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 | FY 2027 |
|---|---|---|---|---|---|---|---|
| Case mix index | 1.13 | 1.13 | 1.39 | 1.39 | 1.33 | 1.33 | 1.37 |
| Wage index | 0.849 | 0.851 | 0.839 | 0.841 | 0.843 | 0.864 | 0.879 |
| Readmissions adjustment | -3.00% | -3.00% | -3.00% | -2.25% | -2.08% | -1.62% | -1.88% |
| Value-based purchasing adjustment | +1.03% | +2.30% | +2.30% | +0.40% | +1.90% | +2.15% | +1.59% |
| Medicare inpatient stays | 895 | 895 | 734 | 624 | 525 | 416 | 298 |
Source: CMS IPPS final rule Impact File (FY 2027).
The officers and board members on Tug Valley Arh Regional Medical Center's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment.
Appalachian Regional Healthcare files the Form 990 for the tax ID insurers list for Tug Valley Arh Regional Medical Center, so these people may lead the wider organization rather than Tug Valley Arh Regional Medical Center alone.
| Name | Title |
|---|---|
| Hollie P Harris | President/ceo |
| Paul Betz | COO (term 11/13/24) |
| Byron Gabbard | Chief Financial Officer |
| Maria Braman | Chief Medical Officer |
| Christi Lee | Chief Legal Counsel |
| Sonya Bergman | Chief People Officer |
| Greg Couch | Chair |
| Jeffrey B Hollon | Vice Chair |
| Joann Anderson | Secretary/treasurer |
Board members: Martha Ellis, Ken Allman, Dustin Scott Campbell MD, Sam Dunn, Randy Evans Dvm, Julie Akemon, L Bart Francis, Andrea Massey, Karen Newman-Profitt, Mike Rust, Onzie Sizemore, Edith Kelley.
Source: IRS Form 990 Part VII filed by Appalachian Regional Healthcare (EIN 52-0795508), via the IRS e-file data. A health system's return can cover several hospitals.
340B drug pricing program
Participating since 2005
340B ID DSH180069, registered as a disproportionate share hospital; 10 registered outpatient sites; 81 active contract pharmacies. Authorizing official: Maria Braman, Chief Medical Officer.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Accountable care organization (Medicare Shared Savings Program)
Main Street Rural Health Hickory ACO LLC
ACO A5334, current agreement since 2026. Public reporting page
Source: CMS Shared Savings Program participants, 2026, matched on Tug Valley Arh Regional Medical Center's legal name.
Tug valley psych
CCN 18S069, certified 1966, Medicare prospective payment
Tug valley arh snf
CCN 185172, certified 1966, Medicare prospective payment
Arh tug valley medical associates
CCN 188509, certified 2017, Medicare cost reimbursed
Arh womens and family health center
CCN 188525, certified 2019, Medicare cost reimbursed
Source: Worksheet S-2 Part I of Tug Valley Arh Regional Medical Center's latest Medicare cost report (HCRIS).
About Tug Valley Arh Regional Medical Center's rates and hospital price transparency.
For MRI of the pelvis, before and after contrast (CPT 72197), published negotiated rates at Tug Valley Arh Regional Medical Center range from $532 to $5,839 across 4 insurers. Aetna's rate is $5,839. The median at nearby comparable hospitals is $1,205. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Tug Valley Arh Regional Medical Center range from $311 to $5,943 across 4 insurers. Blue Cross Blue Shield's rate is $542. The median at nearby comparable hospitals is $1,702. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Tug Valley Arh Regional Medical Center range from $1,671 to $1,671 across 1 insurers. Cigna's rate is $1,671. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Tug Valley Arh Regional Medical Center range from $9,459 to $9,760 across 2 insurers. UnitedHealthcare's rate is $9,760. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Tug Valley Arh Regional Medical Center range from $116 to $310 across 4 insurers. UnitedHealthcare's rate is $310. The median at nearby comparable hospitals is $166. What a patient pays depends on their plan's deductible, coinsurance and network status.
Tug Valley Arh Regional Medical Center has a CMS overall hospital star rating of 2 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 73% of US hospitals.
CMS reports no Medicare-funded interns or residents at Tug Valley Arh Regional Medical Center for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Tug Valley Arh Regional Medical Center's base inpatient payments by an estimated 1.88% in fiscal year 2027 for more readmissions than expected.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (53 discharges), simple pneumonia and pleurisy with mcc (33 discharges), kidney and urinary tract infections without mcc (25 discharges).
Tug Valley Arh Regional Medical Center's Medicare case mix index is 1.37 for fiscal year 2027, higher than 15% of hospitals paid under the inpatient prospective payment system.
Tug Valley Arh Regional Medical Center reported 1,561 inpatient discharges and 5,493 inpatient days from Jul 1, 2024 to Jun 30, 2025.
Tug Valley Arh Regional Medical Center reported 251 full-time-equivalent employees on payroll from Jul 1, 2024 to Jun 30, 2025.
Tug Valley Arh Regional Medical Center reported $50.5M in net patient revenue on $278.3M of gross charges for Jul 1, 2024 to Jun 30, 2025, an operating margin of -28.4%, and net income of -$3M.
Tug Valley Arh Regional Medical Center reported $7.7M of unreimbursed and uncompensated care for Jul 1, 2024 to Jun 30, 2025, including $553,830 of charity care at cost.
Tug Valley Arh Regional Medical Center's Medicare enrollment lists Hollie Harris as CEO & President since 2021.
Insurers' price transparency files list Tug Valley Arh Regional Medical Center under employer identification number 52-0795508 ((multi-state) Appalachian Regional Healthcare INC). 45 health plans and networks list 52-0795508 for it.
Yes. HRSA's 340B database lists Tug Valley Arh Regional Medical Center (340B ID DSH180069) as a participating disproportionate share hospital since 2005, with 81 active contract pharmacies.
96 clinicians who bill Medicare list Tug Valley Arh Regional Medical Center as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family nurse practitioner (24), family medicine physician (12), cardiovascular disease physician (8).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Tug Valley Arh Regional Medical Center, effective 1999.
CMS lists 22 services at Tug Valley Arh Regional Medical Center, including Adult Inpatient Psychiatric Care, Anesthesia, Clinical Laboratory, Coronary Care Unit, Diagnostic Radiology, Dietary Care.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Tug Valley Arh Regional Medical Center came from ZIP codes 25661 (178), 25670 (85), 25678 (50).
Tug Valley Arh Regional Medical Center has 72 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 113 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Tug Valley Arh Regional Medical Center is located at 260 Hospital Drive, South Williamson, KY 41503. Its main phone number is (606) 237-1700.
Tug Valley Arh Regional Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 180069.
The National Provider Identifier (NPI) on file for Tug Valley Arh Regional Medical Center is 1649270257.
Tug Valley Arh Regional Medical Center is affiliated with Appalachian Regional Healthcare.
Tug Valley Arh Regional Medical Center lists 24 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
178 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers