2021-11-12T13:34:42-06:00 2020-12-31 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402413902 990 2020-01-01 610703799 Norton Hospitals Inc NORT 5026298263 Accounting 224 E Broadway 5th Floor Louisville KY 40202 Adam Kempf CFO 2021-11-12 true Adam Kempf 999009999 Kim Scifres P01316095 5023263996 2020 2022-09-23 18:48:47Z RUSSELL F COX 4967 US Highway 42 Suite 100 Louisville KY 40222 2123767350 false X www.nortonhealthcare.com X 1969 KY Norton Hospitals, Inc.'s purpose is to provide quality health care to all those we serve, in a manner that responds to the needs of our communities and faith heritage. 22 21 12237 659 7491189 110980 10439382 71255894 2051207997 2046868775 0 2000 2686374 4583579 2064333753 2122710248 0 0 0 666284004 703130837 0 0 0 1147632663 1207280791 1813916667 1910411628 250417086 212298620 2777133873 3193313774 132535974 336544733 2644597899 2856769041 Norton Hospitals, Inc.'s purpose is to provide quality health care to all those we serve, in a manner that responds to the needs of our communities and faith heritage. false false 1861252939 2042671304 Norton Hospitals, Inc. (NHI) was formed to: I) provide on a nonprofit basis, hospital or health care facilities and services for the care and treatment of ill and injured persons and those who otherwise require medical care and related services of the kind customarily furnished most effectively by hospitals or health care facilities; II) conduct educational activities related to rendering care to the sick and injured; III) promote and conduct scientific research related to the care of the sick and injured. NHI has a total of 1,907 licensed beds, Norton Hospital - 605 beds; Norton Children's Hospital - 300 beds; Norton Audubon Hospital - 432 beds; Norton Women's and Children's Hospital - 373 beds; and Norton Brownsboro Hospital - 197 beds. These hospitals operate twenty-four (24) hours a day, seven (7) days a week. In 2020, NHI's hospitals and diagnostic centers served 67,225 inpatients, 543,384 outpatients, 205,571 emergency department visits, and 25,467 observation cases. In addition, NHI's operating rooms cared for 17,440 inpatient surgical patients and 34,160 outpatient surgical patients. Additionally, 7,986 deliveries were performed at NHI birthing centers. Under its charity care program, NHI provided free care to 8,497 patients, at a cost of $12.8 million. Also, NHI grants patients a discount from billed charges to any individuals that have no access to private health insurance or do not qualify for government assistance or charity care. Under this program, 9,796 patients were provided care at discounted rates. Other contributions to the community were the unpaid cost of Medicaid services of $51.5 million and educational support of $75.0 million, primarily to the University of Louisville's School of Medicine. Also, community health improvement services totaled $15.6 million, and contributions to community groups were $1.6 million. 1861252939 true true false true false false false false true true false false true true false false true false false false false false false false false true true false false true false false false false false false true false true false false false false true false false false true X 264 0 true 12237 true true true false false false false false false false false false false false X 22 21 false false false false true true true true true false false true true true true true true true true true false X Helena Schulz 5026298263 Accounting 224 E BROADWAY 5th Fl Louisville KY 40202 Russell F Cox President & CEO/Trustee 10.0 40.0 X X 0 2512441 200831 Barry Pennybaker Trustee 1.0 2.5 X 0 0 0 Brendan Canavan Trustee 1.0 2.5 X 0 0 0 Craig D Grant Trustee 1.0 4.5 X 0 0 0 Donald H Robinson Trustee 1.0 6.5 X 0 0 0 Edie Nixon Vice Chair 1.0 7.5 X 0 0 0 Erwin Roberts Trustee 1.0 2.5 X 0 1600 0 G Hunt Rounsavall Sr Trustee 1.0 5.5 X 0 0 0 Gail Lyttle Trustee 1.0 2.5 X 0 0 0 Gary L Stewart Chair 1.0 11.5 X 0 0 0 Gregory E Mayes Trustee 1.0 6.5 X 0 0 0 James L Sublett MD Trustee 1.0 2.5 X 0 0 0 Lee K Garlove Trustee 1.0 3.5 X 0 0 0 Maria L Bouvette Trustee 1.0 2.5 X 0 0 0 Marshall Farrer Trustee (partial year) 1.0 2.5 X 0 0 0 Martha K Heyburn MD Trustee 1.0 2.5 X 0 0 0 Rev William J Schultz Trustee 1.0 4.5 X 0 0 0 Richard R Ivey Trustee 1.0 2.5 X 0 0 0 Richard S Wolf MD Chair Emeritus 1.0 2.5 X 0 0 0 Rick Guillaume Chair Emeritus 1.0 3.5 X 0 0 0 Rita Hudson Shourds EdD Trustee 1.0 2.5 X 0 1600 0 Ronald Lehocky MD Trustee 1.0 4.5 X 0 0 0 Sue Davis EdD RN Trustee 1.0 2.5 X 0 0 0 Adam Kempf Sr VP, CFO/Treasurer 10.0 40.0 X 0 860845 154149 Michael W Gough Exec VP and COO 10.0 40.0 X 0 1545025 142238 Robert B Azar Sr VP Chief Legal Officer/Secretary 10.0 40.0 X 0 822706 129978 Andrew Strausbaugh Hospital CAO 50.0 0 X 461129 0 90137 Charlotte Ipsan Hospital CAO 50.0 0 X 502727 0 99971 Emmett Ramser Hospital CAO 49.0 1.0 X 453759 0 96782 Joseph Flynn DO CAO NMG - Physician -in-Chief NCI 50.0 0 X 882142 0 144504 Matthew Ayers Hospital CAO 50.0 0 X 523493 0 96576 Aaron Spalding MD Physician 50.0 0 X 1483232 0 68902 Don Stevens MD Physician 50.0 0 X 1184067 0 51886 Joseph Maly MD Physician 50.0 0 X 1286583 0 48708 Shawn Glisson MD Physician 50.0 0 X 1295072 0 50264 Yong Cha MD Physician 50.0 0 X 1207439 0 61420 Thomas Kmetz Former Division President Women and Children Services 0.0 0.0 X 844306 0 5571 10123951 5744216 1441918 494 true true false Messer Construction Co 11001 Plantside Dr LOUISVILLE KY 40299 Construction 45426076 Wehr Constructors Inc 2517 Plantside Dr Louisville KY 40299 Construction 10131191 Northstar Anesthesia of KY II PLLC 6225 N State Hwy 161 Suite 200 Irving TX 75038 Anesthesia Services 9531239 Morrison Management Specialist 400 Northridge Rd Suite 600 Sandy Springs GA 30350 Food Service 7911889 AMN Healthcare Inc 2735 Collection Center Dr Chicago IL 60693 Nurse Staffing Services 7192567 141 10464673 60791221 597733 71255894 Net Patient Revenue 621110 2046532968 2039061826 7471142 Healthcare Education 624190 335807 335807 0 0 0 0 2046868775 1056065 1057102 -1037 0 -1037 -1037 2000 0 0 2000 2000 2000 PURCHASING CO-OP INC 561499 2187513 2167466 20047 PARKING INCOME 812930 1290897 1290897 AFFILIATION AGREEMENT 621990 515303 515303 590903 590903 0 0 4584616 2122710248 2042671305 7491189 1291860 2310259 2310259 354601 354601 565130761 565130761 30718488 30718488 65839784 65839784 38776944 38776944 167436242 167436242 0 0 8358171 8358171 23723770 23723770 2513391 2513391 45128392 45128392 76348125 76348125 14800033 14800033 Medical Supplies 547773021 547773021 Allocated Support 277106476 227947787 49158689 Provider Tax 24554370 24554370 Repairs & Maintenance 15213225 15213225 4325575 4325575 0 0 1910411628 1861252939 49158689 0 9000 9000 226547434 223213275 0 0 0 0 56299747 59958395 2403879 1440301 2003063979 1093051181 836368295 910012798 0 2545313 8340110 7445984 1644620095 1991234021 2777133873 3193313774 99860608 154961988 0 0 32675366 181582745 132535974 336544733 X 2634171147 2850901241 10426752 5867800 2644597899 2856769041 2777133873 3193313774 X 212298620 -127478 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 65685 65685 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Norton Hospitals, Inc. pays dues to the Kentucky Hospital Association. A portion of those dues in the amount of $65,685 was spent by the Kentucky Hospital Association on lobbying. 24411014 898799 2852846 1106318 27056341 18881092 2971598 3518035 959711 24411014 20691046 127680 -1053047 884587 18881092 18843030 30621 2617227 799832 20691046 18722595 31092 987970 898627 18843030 0.0 0.8486 0.1514 false true true 25560360 25560360 1033442843 456709846 576732997 758353952 627533752 130820200 185706824 8807583 176899241 910012798 RECEIVABLE FROM AFFILIATE 1990303387 MISCELLANEOUS RECEIVABLES 722422 RIGHT OF USE ASSETS 208212 1991234021 DUE TO THIRD PARTY PAYORS 23963765 PHYSICIAN GUARANTEE LIABILITY ASSET RETIREMENT OBLIGATION 8586353 LEASE LIABILITIES 208213 CONTRACT LIABILITIES 148824414 181582745 Schedule D, Part V, Line 4 Intended uses of endowment funds The Children's Hospital Foundation, Inc. and Norton Healthcare Foundation, Inc. utilize income generated from endowment funds to support various programs, services and capital projects for the benefit of Norton Hospitals, Inc. true true X true X 300 false false true false true true 12236287 830381 11405906 0.0060 460425261 408969689 51455572 0.0269 582610 0 582610 0.0003 0 0 473244158 409800070 63444088 0.0332 12523178 1953138 10570040 0.0055 81427778 5686952 75740826 0.0396 0 0.0 2408549 2408549 0.0013 3037124 3037124 0.0016 0 0 99396629 7640090 91756539 0.0480 0 0 572640787 417440160 155200627 0.0812 0 0.0 0 0.0 610592 610592 0.0003 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 610592 0 610592 0.0003 true 0 1752929 378585808 414558819 -35973011 X true true 5 1 Norton Hospital 200 E Chestnut St Louisville KY 40202 https://nortonhealthcare.com/location/hospitals/norton-hospital/ 100234 X X X X A 2 Norton Children's Hospital 231 E Chestnut St Louisville KY 40202 http://www.nortonchildrens.com/ 100234 X X X X X A 3 Norton Women's and Children's Hospital 4001 Dutchmans Lane Louisville KY 40207 https://nortonhealthcare.com/location/hospitals/norton-womens-and-childrens-hospital/ 100255 X X X X A 4 Norton Audubon Hospital One Audubon Plaza Drive Louisville KY 40217 https://nortonhealthcare.com/location/hospitals/norton-audubon-hospital/ 100252 X X X X A 5 Norton Brownsboro Hospital 4950 Norton Healthcare Blvd Louisville KY 40241 https://nortonhealthcare.com/location/hospitals/norton-brownsboro-hospital/ 100475 X X X A A false false true X X X X X X X X X 19 true true true true X https://nortonhealthcare.com/about-us/community-health-needs-assessment/ X true 19 true https://nortonhealthcare.com/about-us/community-health-needs-assessment/ false true X 300.0 X X X X X true true X X X true X WWW.NORTONHEALTHCARE.COM/FAP X WWW.NORTONHEALTHCARE.COM/FAP X WWW.NORTONHEALTHCARE.COM/FAP X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - ALL HOSPITALS. NORTON HOSPITALS, INC. OWNS AND OPERATES FIVE HOSPITALS LOCATED IN LOUISVILLE, JEFFERSON COUNTY, KENTUCKY. THE HOSPITALS ARE: - NORTON HOSPITAL - NORTON CHILDREN'S HOSPITAL - NORTON WOMEN'S AND CHILDREN'S HOSPITAL - NORTON AUDUBON HOSPITAL - NORTON BROWNSBORO HOSPITAL Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - OTHER ORGANIZATIONS. Norton collaborated with the Louisville Metro Department of Public Health and Wellness (LMDPHW) and a variety of partners ranging from other local health systems to the Jefferson County Public School system and other community organizations. All of these organizations worked together to ensure a coordinated approach to gathering initial primary data. Through this collaboration, a community health survey was conducted using both online and paper survey methodologies. After the conclusion of the survey, a few specific under-represented populations in the survey results were found. To ensure that the opinions and perspectives of these groups were adequately represented, eight targeted focus groups were held. Community input also was obtained through key stakeholder interviews of 43 community leaders and health care providers. To ensure the medically underserved were represented in this CHNA, interviews were conducted with representatives from LMDPHW, Jefferson County Public Schools and health care organizations serving neighborhoods where median household incomes are very low, as well as agencies providing services related to mental health, domestic violence and recent immigration to the United States. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - All Hospitals. DRUG USE IN 2019 THE KENTUCKY POISON CONTROL CENTER OF NORTON CHILDREN'S HOSPITAL LAUNCHED A 24/7 SUPPORT HOTLINE FOR HEALTH CARE PROVIDERS, PATIENTS AND FIRST RESPONDERS ON OPIOID-RELATED ISSUES. THE KENTUCKY OPIOID ASSISTANCE & RESOURCE HOTLINE - (800) 854-6813 - IS STAFFED BY TOXICOLOGY-CERTIFIED NURSES AND PHARMACISTS. FOR THE COMMUNITY, THE HOTLINE OFFERS ADVICE ON SAFE MEDICATION DISPOSAL, WHERE TO GET NALOXONE AND HOW TO USE IT. STAFF ALSO CAN DIRECTLY CONNECT USERS AND THEIR FAMILIES TO OPERATION UNITE FOR SUBSTANCE USE DISORDER TREATMENT AND ASSIST DISPLACED PATIENTS OF PAIN CLINICS THAT SUDDENLY CLOSE. THE NORTON MATERNAL OPIATE AND SUBSTANCE TREATMENT (MOST) PROGRAM WAS CREATED TO HELP PREGNANT WOMEN BREAK THE CYCLE OF ADDICTION. THE MOST PROGRAM OFFERS KNOWLEDGEABLE, SUPPORTIVE STAFF MEMBERS WHO ARE SKILLED IN CARING FOR PREGNANT WOMEN WITH SUBSTANCE USE DISORDERS AND FOR THEIR BABIES. IN 2020, 112 WOMEN ENROLLED IN THE PROGRAM AND 78% DELIVERED THEIR BABIES FULL TERM. Norton Hospitals, Inc. (NHI) IS WORKING TO EXPAND THIS ADDICTION RECOVERY PROGRAM THROUGH USE OF NURSE PRACTITIONERS/NAVIGATORS. HEALTH EDUCATORS FROM NORTON CHILDREN'S PREVENTION & WELLNESS TEAM OFFER WELLNESS WORKSHOPS IN HEALTH AND PHYSICAL EDUCATION CLASSROOMS, AFTER-SCHOOL EVENTS AND SUMMER PROGRAMS. THIS PEER-TO-PEER EDUCATION SUPPORTS YOUNG PEOPLE IN DEVELOPING POSITIVE GROUP NORMS AND IN MAKING HEALTHY DECISIONS. WORKSHOPS ARE OFFERED AS A FOUR-PART SERIES AND EMPOWER STUDENTS TO BECOME VOICES IN THEIR SCHOOL TO ENCOURAGE HEALTHY BEHAVIORS AND DECISION-MAKING. IN 2018 NHI CREATED AN OPIOID STEWARDSHIP PROGRAM TO DEVELOP PROTOCOLS FOR OPIOID USE AND DISPOSAL IN BOTH THE HOSPITAL AND AMBULATORY SETTING, AND TO PROMOTE ALTERNATIVE PAIN MANAGEMENT METHODS TO REDUCE THE NUMBER OF OPIOIDS IN THE COMMUNITY. THE PROGRAM FOCUSES ON CHANGING PRESCRIPTION PRACTICES BASED ON RECOMMENDATIONS MADE BY THE JOINT COMMISSION, A HEALTH CARE ACCREDITATION ORGANIZATION. OBESITY NHI OFFERS FREE HEALTHY LIVING WELLNESS GROUP VIRTUAL CLASSES LED BY CERTIFIED HEALTH COACHES, FOR PARENTS OF CHILDREN AGES 8 TO 17. THIS CLASS SERIES IS AIMED AT SUPPORTING FAMILIES ON THEIR WELLNESS JOURNEYS THROUGH HELPING THEM REACH THEIR WELLNESS GOALS IN AN ENGAGING AND SUPPORTIVE VIRTUAL GROUP SETTING. NORTON CHILDREN'S PREVENTION & WELLNESS TEAM ALSO OFFERS GROWING COOKS, A THREE-WEEK VIRTUAL COOKING CLASS THEY CAN TAKE FROM HOME. EACH FAMILY IS RECEIVES A GIFT CARD TO OFFSET GROCERY COSTS. THE NORTON HEALTH & WELLNESS CENTER OFFERS FREE WEIGHT MANAGEMENT SEMINARS TO THE COMMUNITY IN EITHER AN IN-PERSON OR ONLINE SETTING. SERVICES INCLUDE EDUCATIONAL SEMINARS, SUPPORT GROUPS, A DEMONSTRATION KITCHEN AND MORE. NHI CONTINUES TO OFFER FREE HEALTH SCREENINGS AND EDUCATION TO THE COMMUNITY THROUGH USE OF OUR MOBILE PREVENTION UNIT, AS WELL AS THROUGH VARIOUS COMMUNITY EVENTS AND HEALTH FAIRS. IN 2020, THERE WERE OVER 1,794 FREE SCREENINGS PERFORMED IN THE COMMUNITY.. THROUGH A PARTNERSHIP WITH MORE THAN 200 COMMUNITY ORGANIZATIONS, THE NORTON HEALTHCARE MOBILE PREVENTION CENTER CONNECTS PEOPLE TO WELLNESS AT MULTIPLE STOPS EVERY WEEK. MANY OF THE SCREENINGS ARE PROVIDED AT LOW COST OR NO COST, AND OTHERS TYPICALLY ARE COVERED BY INSURANCE. SMOKING/TOBACCO USE NORTON HEALTHCARE PREVENTION & WELLNESS OFFERS A COMPREHENSIVE TOBACCO CESSATION PROGRAM TO HELP THOSE IN THE COMMUNITY STRUGGLING WITH TOBACCO ADDICTION. CLASSES MEET FOR EIGHT 60- TO 90-MINUTE SESSIONS OVER SEVEN WEEKS. CLASSES FOLLOW THE AMERICAN LUNG ASSOCIATION FREEDOM FROM SMOKING PROGRAM, PROVEN TO BE EFFECTIVE FOR MILLIONS OF SMOKERS. THE COMPREHENSIVE LUNG CENTER AT NORTON CANCER INSTITUTE IS A SCREENING CENTER OF EXCELLENCE, AS DESIGNATED BY THE LUNG CANCER ALLIANCE. LED BY A TEAM OF LUNG SPECIALISTS, THE CENTER COMBINES FOUR COMPREHENSIVE COMPONENTS - PREVENTION, SCREENING, DIAGNOSIS AND TREATMENT - TO ENSURE EACH PATIENT HAS ACCESS TO STATE-OF-THE-ART LUNG CANCER SCREENING, SAME-DAY FOLLOW-UP APPOINTMENTS AND FAST-TRACK TREATMENT AND SUPPORT SERVICES. THE COMPREHENSIVE LUNG CENTER ALLOWS PATIENTS TO SEE AN ONCOLOGIST, SURGEON, RADIATION ONCOLOGIST, COUNSELOR, NUTRITIONIST AND OTHER MEMBERS OF THE CARE TEAM ALL IN ONE VISIT. NHI HAS ESTABLISHED A NO SMOKING POLICY ON ALL CAMPUSES TO ELIMINATE EXPOSURE TO TOBACCO SMOKE FOR OUR PATIENTS AND FAMILIES. NHI HAS MULTIPLE PULMONOLOGISTS ON STAFF AND OFFERS A BROAD RANGE OF ACUTE CARE SERVICES AS WELL AS RESPIRATORY THERAPY AT ALL NHI AND AMBULATORY FACILITIES. MENTAL HEALTH NHI IMPLEMENTED THE COLUMBIA-SUICIDE SEVERITY RATING SCALE IN APRIL 2019. THIS IS A QUESTIONNAIRE WHICH IS USED TO ASSESS SUICIDE RISKS FOR PATIENTS AT ALL ACCESS POINTS, INCLUDING THE EMERGENCY ROOM AND AMBULATORY SETTING. THE TOOL IS USED TO ASSESS PATIENT RISK AND ENSURE REFERRAL TO APPROPRIATE RESOURCES FOR TREATMENT. FROM 2019 TO 2020 THE NUMBEROF SUICIDE SCREENINGS COMPLETED AT NORTON HEALTHCARE INCREASED BY 40%. HEALTH EDUCATORS FROM NORTON CHILDREN'S PREVENTION & WELLNESS TEAM PARTNER WITH LOCAL MIDDLE/HIGH SCHOOLS TO OFFER PEER-TO-PEER EDUCATION AND AWARENESS ABOUT MENTAL HEALTH CONCERNS. WORKSHOPS ARE OFFERED IN SCHOOL HEALTH AND PHYSICAL EDUCATION CLASSROOMS, AT AFTER-SCHOOL EVENTS AND SUMMER PROGRAMS. WORKSHOPS PROVIDE PEER EDUCATION TO SUPPORT YOUNG PEOPLE IN DEVELOPING POSITIVE GROUP NORMS AND MAKING HEALTHY DECISIONS. THIS SERIES TEACHES STUDENTS HOW TO REDUCE STRESS AND EMPOWERS STUDENTS TO BECOME VOICES IN THEIR SCHOOLS AND TO ENCOURAGE HEALTHY BEHAVIORS AND DECISION-MAKING. FREE CLASSES ARE HELD ONLINE AS PART OF A SERIES CALLED LET'S TALK THAT IS A PARENT TEEN LED DISCUSSION LED BY A NORTON HEALTHCARE SPECIALIST. CURRENTLY CLASSES OFFERED INCLUDE A CLASS LED BY A PEDIATRIC UROLOGIST AND GYNECOLOGIST TO DISCUSS PUBERTY. THERE IS ALSO CLASSES LED BY A CHILD PSYCHOLOGIST FOR PARENTS AND THEIR PRETEENS AND TEENS TO LEARN ABOUT MENTAL HEALTH, GET TOOLS TO RELIEVE STRESS AND HEAR ABOUT AVAILABLE RESOURCES. NORTON CHILDREN'S HOSPITAL OFFERS INPATIENT PSYCHIATRIC CARE FOR CHILDREN AGES 2 TO 17 THROUGH THE ACKERLY CHILD PSYCHIATRIC UNIT. THEIR MISSION IS TO HELP CHILDREN AND FAMILIES REACH THEIR FULLEST POTENTIAL IN A NURTURING AND SAFE ENVIRONMENT. THEY ARE EQUIPPED TO SERVE PATIENTS WITH DEVELOPMENTAL DISABILITIES AND AUTISM, AND EXTEND CARE REGARDLESS OF A FAMILY'S BACKGROUND OR ABILITY TO PAY. IN THE AMBULATORY SETTING, NORTON CHILDREN'S MEDICAL GROUP PSYCHIATRY & PSYCHOLOGY OFFERS CHILD AND ADOLESCENT PSYCHIATRY SERVICES. IN 2019, NHI ESTABLISHED THE NORTON BEHAVIORAL HEALTH PRACTICE, WITH THE GOAL OF PROVIDING CLINICALLY INTEGRATED FAMILY AND PATIENT-CENTERED MENTAL HEALTH CARE. THE PRACTICE OFFERS TELEMEDICINE VISITS IN PRIMARY CARE LOCATIONS TO IMPROVE ACCESS AND HELP OVERCOME THE STIGMA OFTEN ASSOCIATED WITH MENTAL HEALTH FACILITIES. THE PRACTICE CARED FOR ALMOST 6,500 PATIENTS IN 2020 WHICH IS AN INCREASE OF OVER 300% FROM THE 2019. NORTON WOMEN'S MENTAL HEALTH SERVICES PROVIDES OUTPATIENT WOMEN'S MENTAL HEALTH SERVICES ON THE NORTON - ST. MATTHEWS CAMPUS. THEY ARE COMMITTED TO PROVIDING QUALITY MENTAL HEALTH CARE TO WOMEN ACROSS THEIR LIFESPAN. CARE COORDINATION NHI, IN PARTNERSHIP WITH THE UNITED WAY, IS PARTICIPATING IN THE UNITED COMMUNITY INITIATIVE. UNITED COMMUNITY SEEKS TO LINK HEALTH CARE SERVICES AND SOCIAL SERVICES VIA A DATABASE PLATFORM CALLED UNITE US. NHI CAN REFER PATIENTS WITH SOCIOECONOMIC NEEDS TO APPROPRIATE RESOURCES USING THIS DATABASE PLATFORM. THE DATABASE IS INTEGRATED INTO THE PATIENT'S ELECTRONIC MEDICAL RECORD SO THAT PROVIDERS CAN SEE PATIENT REFERRALS TO SOCIAL SERVICES AS WELL AS THE OUTCOME OF THOSE REFERRALS. NHI HAS ESTABLISHED A SOCIAL SERVICES ASSESSMENT TOOL TO STREAMLINE THE SCREENING AND DOCUMENTATION OF SOCIAL NEEDS FOR PATIENTS. THE ASSESSMENT IS INTEGRATED IN THE ELECTRONIC MEDICAL RECORD AND UTILIZED BY SOCIAL WORKERS TO IDENTIFY AND DOCUMENT SOCIAL NEEDS AND TO REFER PATIENTS TO APPROPRIATE SOCIAL SERVICES RESOURCES USING THE UNITE US DATABASE PLATFORM. IN 2019, NHI LAUNCHED THE NORTON BABY APP TO STREAMLINE CARE FOR OBSTETRICS PATIENTS FROM PREGNANCY PLANNING, TO EXPECTING A NEW BABY, TO THE NEW PARENT STAGE. THE APP IS A ONE-STOP-SHOP FOR EXPECTANT MOTHERS AND PROVIDES HEALTH METRICS MONITORING, APPOINTMENT TRACKING, CHECKLISTS, HEALTH TIPS, AND MORE. IN 2020, 1,238 PATIENTS UTILIZED THE APP. NORTON WOMEN'S CARE LAUNCHED A NEW DOULA PROGRAM THAT AIMS TO IMPROVE THE LONG-TERM HEALTH OF NEW MOTHERS IN 2021. THIS NEW PROGRAM WILL INCLUDE SEVERAL HOME VISITS THROUGHOUT THE PATIENT'S PREGNANCY AND THE PERIOD AFTER DELIVERY. PATIENTS MUST LIVE IN SPECIFIC UNDERSERVED NEIGHBORHOODS TO BE ELIGIBLE, AND WILL RECEIVE ADDITIONAL PRENATAL CARE THROUGH NORTON OB/GYN PRACTICES. Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - All Hospitals. ACCESS TO CARE IN 2020, NORTON HEALTHCARE CREATED THE INSTITUTE FOR HEALTH EQUITY AS ONE OF FIVE INITIATIVES TO ADDRESS INEQUALITIES WITHIN THE COMMUNITY. THE PRIMARY FOCUS OF THE INSTITUTE WILL BE TO IDENTIFY AND REMOVE OBSTACLES THAT PREVENT PEOPLE IN UNDERSERVED AREAS FROM RECEIVING THE HEALTH CARE THEY DESERVE, AS WELL AS TO ELIMINATE DISPARITIES IN CARE. NORTON IS INVESTING $20 MILLION TOWARD THE ESTABLISHMENT OF PERMANENT FACILITIES AND EQUIPMENT LOUISVILLE'S UNDERSERVED NEIGHBORHOODS. IN 2019, THE LOUISVILLE URBAN LEAGUE AND NORTON HEALTHCARE ANNOUNCED NORTON'S SUPPORT OF THE WEST END MULTI-USE SPORTS AND LEARNING COMPLEX. NORTON HEALTHCARE CONTRIBUTED $5 MILLION TO THE PROJECT THROUGH A $3 MILLION GRANT AND AN ADDITIONAL CHALLENGE GRANT OF $2 MILLION IN MATCHING FUNDS. THE FACILITY IS NAMED THE NORTON SPORTS HEALTH ATHLETICS & LEARNING COMPLEX AND OFFICIALLY OPENED IN FEBRUARY 2021. THE KEY TO ENSURING HEALTH EQUITY IS INCREASING ACCESS TO CARE IN LOUISVILLE'S UNDERSERVED AREAS. NORTON EXPANDED ACCESS IN UNDERSERVED AREAS THROUGH THE OPENING OF A NEW PRIMARY CARE PRACTICE IN THE WEST END, INCLUDING A COVID-19 TESTING AND VACCINATION CENTER AT THAT LOCATION. NORTON ALSO PURCHASED A SECOND MOBILE UNIT, MAKING IT EASIER FOR THE COMMUNITY TO ACCESS PREVENTIVE SERVICES SUCH AS MAMMOGRAMS, WELL-WOMAN EXAMS AND COLON CANCER SCREENINGS. ADDITIONAL SITE OPENINGS ARE PLANNED IN WEST AND SOUTH LOUISVILLE TO FURTHER EXPAND ACCESS TO CARE. NEEDS NOT ADDRESSED NHI'S COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED A PRIORITIZATION PROCESS TO RANK IDENTIFIED NEEDS AND ISSUES BASED ON PERCEPTION OF THE COMMUNITY, SECONDARY RESEARCH AND HOW THE ISSUES ALIGN WITH NORTON HEALTHCARE'S MISSION, VISION, VALUES AND STRATEGIC PRIORITIES. IDENTIFIED NEEDS WERE CATEGORIZED INTO FOUR CATEGORIES: HEALTH CONDITIONS, ACCESS TO CARE, BEHAVIORAL CONDITIONS AND SOCIOECONOMIC/DEMOGRAPHIC NEEDS. NHI EXECUTIVE LEADERSHIP AND THE COMMUNITY BENEFIT COMMITTEE OF THE BOARD OF TRUSTEES IDENTIFIED AREAS IN THE BEHAVIORAL AND SOCIOECONOMIC CATEGORIES WHERE NORTON CAN MOST EFFECTIVELY FOCUS ITS RESOURCES TO HAVE SIGNIFICANT IMPACT. THOSE AREAS OF FOCUS ARE: DRUG USE, OBESITY, SMOKING/TOBACCO USE, MENTAL HEALTH, POOR NUTRITION AND COORDINATED CARE ACROSS THE CONTINUUM. NEEDS THAT WERE IDENTIFIED BUT ARE CURRENTLY NOT AN AREA OF FOCUS FOR NHI ARE HOME SAFETY CONCERNS, CRIME/SAFETY, POOR OR LACK OF DENTAL CARE, AND POVERTY LEVELS. THESE FALL OUTSIDE OF THE CURRENT CORE COMPETENCIES OF THE ORGANIZATION AND THEREFORE ARE NOT ADDRESSED DIRECTLY IN OUR COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGIES. NHI HAS A DESIRE TO CONTINUE PROVIDING CLINICAL PROGRAMS AND SERVICES TO MEET COMMUNITY NEEDS WHILE ALSO PURSUING CONTINUOUS IMPROVEMENT IN EXISTING AND FUTURE PROGRAMS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY WE SERVE. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - All Hospitals. Other eligibility criteria in addition to the criteria answered above would include as described in the Financial Assistance Policy: * The patient does not qualify for subsidized coverage of government assistance such as Disproportionate Share Hospital, Children's Health Insurance Program, Medicaid, Medicaid Managed Care Organization, or Hoosier Healthcare. * To be eligible for assistance for non-emergent Medically Necessary Care, a patient (or that patient's guarantor) must be a resident of Kentucky, Indiana, Tennessee, Ohio, or Illinois. This residency requirement does not apply to emergency care. Schedule H, Part V, Section B, Line 16 Facility A, 1 Facility A, 1 - ALL HOSPITALS. SEE RESPONSE TO PART VI, LINE 3; PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. 0 Schedule H, Line 7, Input 7 STATE FILING OF COMMUNITY BENEFIT REPORT Not required at this time by Commonwealth of Kentucky. Schedule H, Part I, Line 6b Community Benefit Report The annual community benefit initiative report is for all five hospitals in Norton Hospitals, Inc. (NHI) and is contained in the report prepared by NHI' parent corporation, Norton Healthcare, Inc. Schedule H, Part VI, Line 5 Promotion of community health Norton Healthcare Inc. is a not-for-profit corporation based in Louisville, Kentucky, In 2020, Norton Healthcare, through its affiliate, Norton Hospitals Inc., had a total of 1,907 licensed beds: Norton Audubon Hospital - 432 beds; Norton Brownsboro Hospital - 197 beds; Norton Children's Hospital - 300 beds; Norton Hospital - 605 beds; and Norton Women's & Children's Hospital - 373 beds. These five hospitals operate 24 hours a day, seven days a week. In 2020, Norton Healthcare, through its affiliate, Community Medical Associates Inc., had approximately 2.5 million patient encounters. Norton Healthcare's hospitals, diagnostic centers and Norton Cancer Institute served 67,225 inpatients and 543,384 outpatients, and saw 205,571 emergency room visits. In addition, Norton Healthcare hospitals' operating rooms cared for 17,440 inpatient surgical patients and 34,160 outpatient surgical patients. Additionally, 7,986 babies were delivered at Norton Healthcare birthing facilities. As part of our commitment to improving the health of our community, Norton Healthcare provides funding for a wide array of lifesaving and life-enhancing services that benefit the communities we serve. In 2020, under its charity care program, Norton Healthcare provided free care to 8,497 patients, at a cost of $12.8 million. Also, Norton Healthcare grants a discount from billed charges to any patients who have no access to private health insurance or do not qualify for government assistance or charity care. Under this program, 9,796 patients were provided care at discounted rates. Other contributions to the community were the unpaid cost of Medicaid services of $51.5 million and educational support of $75.0 million, primarily to the University of Louisville (UofL) School of Medicine. Community health improvement services totaled $15.6 million and contributions to community groups were $1.6 million. Norton Healthcare employees donated 55,000 hours of community service, a benefit valued at more than $600,000. In addition, many employees self-reported personal volunteer activities. Norton Healthcare provides programmatic support to the UofL School of Medicine through funding and facilities. During the 2020 calendar year, 198 residents completed clinical rotations in 43 specialties at Norton Healthcare facilities. Residency programs are part of the $75.0 million in educational support and clinical funding provided to the medical school. Norton Healthcare's Board of Trustees includes representatives from the community and largest employers in the region that live and work in the NHI's primary service area. Members are neither employees of nor independent contractors with the organization, nor family members thereof. Community Improvement Funding Norton Healthcare invests in the community to improve the quality of patient care, facilities and equipment. * In 2020 the expansion of Norton Brownsboro Hospital was completed, with 70 new patient beds - a 55% increase - advancements in stroke and aneurysm care capabilities and a larger emergency department. The new emergency department has 42 patient care areas, including two triage rooms, 33 exam rooms and a dedicated space for performing rapid electrocardiograms (EKGs). Six fast-track bays are a fresh innovation designed for treating minor conditions, freeing exam rooms for patients with more serious conditions. The expansion builds on the facility's neurosciences services with the addition of epilepsy monitoring units (EMUs). The expansion also includes two new neurointerventional operating rooms. These new operating rooms are equipped with state-of the-art biplane angiography machines for neurological emergencies such as a stroke or an aneurysm. A bigger and more prominent ambulance bay will allow for easier access to the emergency department. A new parking structure helps accommodate the hospital's larger capacity. * In March 2021, Norton Children's Hospital pediatric intensive care unit (PICU), completed a $78 million expansion and renovation project to improve critical care services for children and expand a family-centered approach to treating the region's sickest kids. * In 2021, Norton Hospital celebrated the opening of more than 60 patient beds in the Giles Units at Norton Healthcare Pavilion. Renovations made available 36 additional medical/surgical beds on the third floor and 31 beds on the fourth floor. These areas serve patients in intensive care, surgical and medical oncology, and the Norton Cancer Institute Head and Neck Tumor Program. Norton Healthcare continues to invest in medical training, education, and research programs. * Norton Healthcare was the first in the world to enroll COVID-19 patients in two new clinical trials after becoming the first to participate in a randomized Phase 2 clinical study in 2020 using low-dose selinexor, a cancer drug, for treating COVID-19. Norton Healthcare has been an international leader in the fight against the coronavirus, which causes COVID-19. The established history of scientific excellence has allowed Norton Healthcare physician scientists to bring important new treatments and diagnostic tools to the region. Researchers with expertise in experimental therapeutics and drug development have worked with industry leaders to ensure patients have access to the latest discoveries to battle COVID-19. * Norton Healthcare's clinical trials program is one of the most robust programs in the region and has been instrumental in the development of many drugs and medical devices in a variety of areas. * Norton Healthcare offers many medical training and education opportunities through a variety of different programs to reach the community. Norton Healthcare's Respiratory Therapy Apprenticeship Program, Student Nurse Apprenticeship Program (SNAP), and a Surgical technologist program are all ways Norton Healthcare continues to further healthcare knowledge in the community. Investment in Extending Medical Staff Privileges The Norton Healthcare Center for Continuing Medical, Provider and Nursing Education strives to provide high-quality continuing medical education (CME) opportunities for physicians and other health care providers. These activities are intended to improve competence, performance and/or overall patient outcomes. It is Norton's goal to meet needs and improve the health status of people in the communities Norton Healthcare serves. By working with the comprehensive medical staff and with Norton's long commitment to quality, strategic partnerships and affiliations, Norton Healthcare is dedicated to serving as a regional leader in providing quality, certified continuing education opportunities. The activities are built on a platform of scientifically sound, evidence-based medicine, enhancing the provision of patient care. Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education activities for physicians. Norton Healthcare strictly adheres to the Accreditation Council for Continuing Medical Education (ACCME) policies, accreditation criteria and standards for commercial support. Norton received accreditation with commendation (the highest level) for a six-year term. Participation in continuing medical education helps providers meet requirements for maintenance of licensure, maintenance of certification, credentialing, membership in professional societies, and other professional privileges. Contributions to the community * Norton Healthcare employees and physicians gave nearly $917,980 to our 2020 - 2021 Combined Giving Campaign to help support community organizations that also are committed to improving the health and well-being of community residents. Supported organizations include WHAS Crusade for Children, Metro United Way, Fund for the Arts, and our own Norton Children's Hospital Foundation and Norton Healthcare Foundation. * Due to the COVID-19 pandemic, the number of volunteers in 2020 was limited to 42 employees who helped "raise the roof" on Norton Healthcare's 13th Habitat for Humanity home. * In 2020, more than 1,400 Norton Healthcare employees donated time and funds to plan, purchase and deliver gifts, food and clothing for the Caring Tree program. The program assisted 512 employees and their 1,168 children and dependents by providing for their families at Christmas. * More than 31,000 pounds of usable surplus medical supplies valued at more than $456,000, and over $146,000 in equipment, were donated for use locally and around the world. Of the donated equipment, ventilators valued at $98,000 were returned to Norton Healthcare in April 2020 due to the COVID-19 pandemic. Schedule H, Part VI, Line 5 Promotion of community health Community education and workforce development As one of Kentucky's largest health care systems, Norton Healthcare has established a culture of continual, lifelong learning. Opportunities are available through our Human Resources Department's Workforce Development team and our Norton Healthcare Institute for Education & Development. Workforce Development encourages continuing education, improves job performance and provides financial assistance for educational programs aimed toward key areas of workforce need within the organization. Norton Healthcare encourages and supports the career goals of employees and their dependents by providing financial assistance and scholarships as well as other advancement opportunities. Established in the early 2000s, Workforce Development has assisted more than 6,000 students with tuition assistance. In 2020, Workforce Development financially supported more than 700 students with over $3.5 million in educational assistance programs. * In 2020, Workforce Development provided nearly 1,100 career coaching sessions to employees and students. Each program participant worked directly with a career management coach. Coaches offer services in resume writing, career and educational exploration, financial assistance opportunities and interviewing skills. * The accelerated Norton Healthcare Scholars Program, a student loan program for employees and nonemployees, provides educational funding to students interested in pursuing health care-related degrees in areas of workforce need. It is an affiliation between Norton Healthcare and over 100 colleges and universities nationally. Since 2014, this program has assisted more than 1,000 graduates continue their careers with Norton Healthcare. * In 2018, Norton Healthcare was one of the founding partners in Jefferson County Public Schools' Academies of Louisville, a strategic pipeline development program in conjunction with the local public school system. Jefferson County Public Schools created an academy model in which students have the opportunity to select career-focused education and earn industry-recognized credentials while in high school. Norton Healthcare transformed its summer program and previous high school scholarship offerings into a comprehensive internship program for students on the health care academy track. Beginning in a student's junior year, health care academy students explore career pathways in one of four key areas: patient care, medical office, allied health and pharmacy technician. Each phase offers a rigorous curriculum, business acumen and professional development, as well as hands-on learning opportunities in the students' chosen career fields. The goal is to transition graduating students into staff positions with our organization after completion of the program. Tuition assistance is offered for these new employees to continue their academic and career pursuits while working at Norton Healthcare in the field of their choice. * In 2019, Norton Healthcare announced a strategic partnership program with UPS and Metro College. Norton Healthcare - UPS Health Care Career Tracks provides a two-plus-two method, splitting a four-year bachelor's degree into two parts. Typically, the first two years are spent working with UPS in a general or preclinical designation, and then the student begins their clinical program in the last two years. This transition allows students to explore employment with Norton Healthcare as well as become a Norton Healthcare Scholar. This program helps to support career readiness in a health care-related field. The combined tuition assistance offers students a debt-free way to get a college education while working with two of the leading companies in the region. * The Student Nurse Apprenticeship Program (SNAP) is a 12- to 18-month apprenticeship through the Norton Healthcare Center for Nursing Practice in which nursing students work and engage in hands-on learning with an experienced mentor while becoming integrated with Norton Healthcare. * In 2019, Norton Healthcare launched new apprenticeship programs. The surgical tech apprenticeship program and the respiratory therapy apprenticeship program allow students to work and learn with tuition assistance as they grow their careers with Norton Healthcare. Development of the medical assistant program launched in 2020 with a goal of internal training programs to produce quality prepared medical assistants to introduce into the Norton Healthcare workforce. There are several cohorts for apprenticeships throughout each year. The Norton Healthcare Institute for Education and Development provides learning opportunities to enhance the professional, educational and personal development of all employees. It consists of seven centers: the Center for Professional Growth; Center for Nursing Practice; Center for Continuing Medical, Nursing & Provider Education; Center for eLearning & Clinical Documentation Support; Center for Allied Health; and Center for System Nursing & Ancillary Education. The Center for Professional Growth provides learning and growth opportunities that meet the needs of Norton Healthcare employees. * Norton Healthcare's leadership development program is composed of three programs that address the needs of new, aspiring and current leaders: - N the Know: This is our new leader orientation program. Newly hired and promoted leaders are automatically enrolled. The program has four required courses and six elective courses. - Learning the Norton Way: This six-week program is focused on preparing employees for leadership. Leadership approval is required for all employees who wish to attend. - Leading the Norton Way: This program is for current Norton Healthcare leaders. It is a six-week program focused on best practices for effective leadership. Additional leadership development is provided through quarterly Norton Healthcare leadership conferences. * Staff development programs include general enrichment courses and personal and professional development opportunities that honor Norton Healthcare's commitment to life-long learning. A variety of online and instructor-led courses focus on learning topics such as communication, diversity, interpersonal relationship building, accountability, and proficiency in Microsoft Office tools. * Norton Healthcare uses a comprehensive learning management system to provide a variety of online programs that enable staff in any specialty as well as other employees to expand their knowledge and skills. These programs were designed to meet the needs of Norton Healthcare, as well as our community, and to ensure the highest quality of patient care. Norton Faith & Health Ministries Norton Faith & Health Ministries works with faith communities to weave health and faith together, promoting the intentional integration of faith, healing and wellness through the development of health ministries. Norton Faith & Health Ministries provides mentoring, educational resources and networking opportunities to assist health ministry coordinators and faith community nurses in ministering to their members. In 2020, the department served more than 200 faith communities with active health ministry programs and communicated best practices for COVID-19, including mitigation, reopening and other health and safety practices. By maximizing long-standing relationships, the department provided a trusted voice for timely pandemic information relevant to faith communities. Efforts included: * Distribution of 12 issues of the "Coordinators' Connection" email to 220 health ministry volunteer leaders, advising on vital COVID-19 announcements and resources * Hosting five networking sessions with health experts and spiritual support, providing a regular space for questions and answers; 119 individuals attended these sessions * Providing a COVID-19-focused bimonthly newsletter, distributed electronically to an average of 1,400 subscribers per issue * Russell F. Cox, president and CEO, wrote an article informing faith leaders and the larger community of Norton Healthcare's mission-driven response to the pandemic in a midyear issue of "Health Ministries Connection" newsletter, delivered to 5,000 individuals. While the COVID-19 pandemic presented unique challenges, Norton Faith & Health Ministries continued to nurture relationships with faith communities and build bridges to whole-person health and wellness information and services. Schedule H, Part I, Line 7f Bad debt In accordance with accounting guidance, bad debt is not presented as an expense, but is included as a reduction in net patient service revenue. Schedule H, Part III, Line 3 Bad Debt Expense under the organization's financial assistance policy FOR FINANCIAL STATEMENT PURPOSES, NORTON Healthcare HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). Implicit price concessions includes BAD DEBTS. Therefore, Bad debts ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 and bad debt expense is not separately reported as an expense. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED COST OF BAD DEBT attributable to patients eligible under Norton Hospital's financial assistance policy ON A GROSS BASIS. Schedule H, Part VI, Line 5 Promotion of community health Pastoral Care Department Norton Healthcare's Pastoral Care Department provides spiritual, religious and emotional care and support for patients, families and staff throughout the system, 24 hours a day, 7 days a week. The COVID-19 pandemic presented many new challenges and opportunities for the department. As visitation restrictions were implemented and patient numbers decreased in the spring of 2020, chaplains put additional focus on supporting staff. With so many changes, uncertainties and anxieties, chaplains listened, prayed with and encouraged staff of all disciplines. The leadership of Norton Healthcare routinely reminded all 17,000+ employees that chaplains were available 24/7 to help them. Together, chaplains and caregivers learned how to use iPads and Zoom videoconferencing technology to help patients communicate with family members. More than three dozen initiatives were undertaken to support staff during 2020, including: * Videotaping worship services for employees unable to attend services in person * Providing small cards with inspirational messages to hand out to staff and patients * Creating "Flat Henry," a paper photo version of a facility dog who is handled by a chaplain, to use when the dog could not be in the hospital * Meeting with family members in the parking lots when they could not come into the hospital * Assigning chaplains individual groups or communities to support. One chaplain focused on the Hispanic community by visiting families at funeral homes and providing ongoing support. Another became the chaplain for staff who were on extended furlough due to long-term COVID-19 symptoms. Even with the total number of patients down for several months during 2020, chaplains made more than 29,000 patient contacts, plus the thousands of family members they also cared for during those visits. Pastoral care conversations were made over the phone with patients and family members alike. As supplies of personal protective equipment (PPE) became more stable, chaplains spent more time in rooms with patients and welcomed visitors back during the summer. The assistance included, but was not limited to: * Grief support and facilitation of decision-making at death * End of-life and goals-of-care conversations * Education about and enacting advance directives * Offering religious rituals and literature * Discussing ethical dilemmas * Providing comfort and conversation with patients who were lonely, afraid, conflicted or struggling Chaplains care for people, regardless of their religious or spiritual backgrounds and beliefs, to help them use and strengthen their spiritual, emotional and relational resources to better cope and to thrive. Through formal and informal staff support efforts, teaching, committee involvement, ethics consultations and many other ways, chaplains are fully integrated into the life of the Norton Healthcare system. Norton Heart & Vascular Institute Norton Heart & Vascular Institute is Louisville's leading cardiovascular disease prevention and treatment program. Each year, it provides diagnostic, medical, interventional and surgical care for thousands of patients from Kentucky and Southern Indiana. Norton Heart & Vascular Institute specialists treat patients at Norton Healthcare's four adult-service hospitals and more than 28 outpatient clinics, diagnostic centers and specialty locations throughout Greater Louisville and Southern Indiana. Norton Heart & Vascular Institute is a progressive group of practices that maintains more than 52% of the total cardiovascular market share, more than any other health care provider in our service area. It offers comprehensive cardiovascular care, including specialized programs for electrophysiology, structural heart defects, advanced cardiac imaging, advanced heart failure and cardiac rehabilitation. * Kentucky has one of the highest occurrences of heart disease in the country. As a result, Norton Heart & Vascular Institute has committed to being a leader in acute chest pain care. All four of Norton Healthcare's adult-service hospitals are recognized by the American College of Cardiology as Acute Chest Pain Centers. Optimal care for heart attack patients takes coordination at the hospital, emergency medical services and system levels. For excellence in coordinating this care and creating a regional network of care, Norton Healthcare received the Mission: Lifeline Regional STEMI Trailblazer Achievement Award from the American Heart Association and was the only health care organization in Kentucky to receive this award. * Comorbidities found in many in our region, as well as advancing heart disease, are leading to increased occurrences of heart failure. The Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program provides comprehensive care to manage heart failure, and in some cases, recover individuals out of heart failure. In 2020, the program expanded its advanced treatment offerings as Norton Audubon Hospital received ventricular assist device (VAD) accreditation from DNV GL Healthcare USA and the U.S. Centers for Medicare & Medicaid Services. This advanced level of care, partnered with navigation, patient education and support of those with heart failure, is key to impacting heart failure care in Kentucky. * In 2020, Norton Healthcare achieved systemwide noninvasive cardiology accreditation from the Intersocietal Accreditation Commission. Departments that perform noninvasive cardiology procedures are many times the first touchpoint for Norton Healthcare patients for heart and vascular care. This recognition signifies the highest level of diagnostic capabilities at all Norton Healthcare locations through the use of noninvasive echocardiography, noninvasive vascular ultrasound, nuclear cardiology and positron emission tomography (PET) cardiology. Norton Orthopedic Institute Norton Orthopedic Institute, a part of Norton Healthcare, provides advanced orthopedic care for all bones and joints, and for people of all ages. Norton Orthopedic Institute is made up of board-certified physicians - many of whom are fellowship trained - who work together with therapists, physical rehabilitation specialists, primary care physicians, neurologists, certified athletic trainers and other care providers to offer a full range of multidisciplinary orthopedic services. Utilizing a team approach, these specialists focus on the diagnosis, treatment and rehabilitation of bone and joint conditions and injuries. Norton Orthopedic Institute's hip and knee replacement program has been certified as a Center of Excellence by DNV GL Healthcare USA, as meeting guidelines of the American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons. With locations throughout Greater Louisville, including Southern Indiana, Norton Orthopedic Institute offers several specialty centers focused on providing expertise in general orthopedics, joint replacement, injuries, trauma, pediatrics, oncology, spinal conditions and sports health. Norton Women's Care * In 2020, Norton Women's Care birthing facilities at Norton Hospital and Norton Women's & Children's Hospital provided care and medical services for 7,986 deliveries. * Norton Hospital and Norton Women's & Children's Hospital offered free childbirth education classes, hosting a total of 235 in 2020. In response to the COVID-19 pandemic, the expectant parent curriculum was adjusted to offer classes online. Class offerings were significantly reduced due to the lack of resources available for virtual instruction. Schedule H, Part VI, Line 5 Promotion of community health Norton Children's Prevention & Wellness * Child passenger safety technicians check car and booster seats and also provide car and booster seats at free checkup clinics statewide. In 2020, 97 car seats were given to families in need through the community events and hospital admissions. Additionally, 34 special needs car seats were loaned to children with body casts and premature infants who would not safely fit in a conventional car seat. Certified car seat technicians completed 273 car seat inspections. 41 new car seat technicians were trained and certified locally and throughout the state. * The Norton Children's Bike Safety Rodeo program held 19 rodeo events to teach bicycle safety to 2,010 students from grades 3 through 5 throughout Kentucky. * The "Just for Kids" Transport Team transports babies and children from across the region to Norton Children's Hospital. Transportation is provided by airplane, helicopter and specially equipped ambulances (mobile intensive care units). In 2020, 1,643 transportation trips were completed. * In early February, more than 3,600 kindergarten students, teachers, chaperones and nursing students participated in the 37th annual Children and Hospitals Week event. The program was held at Louisville Slugger Field and supported by a Kohl's Cares grant. Children and Hospitals Week is designed to teach safe decisions and behaviors to help lessen the fear and anxiety children may have about coming to a hospital. * Norton Children's food pantries in 19 of our pediatric and family medicine primary care practices served over 10,000 individuals with food insecurity needs. * In response to the COVID-19 pandemic, Norton Children's Prevention & Wellness moved all of its in-person programming to a virtual platform in March of 2020, serving over 5,187 individuals with prevention and wellness programming, including cooking workshops, Teen Wellness Workshops, Healthy Living Wellness Group, and Teen Talk, Open Airways, Power Up and Play, Safe Baby Essentials, Safe Kids and Safe Grandparenting classes. Kentucky Poison Control Center of Norton Children's Hospital Norton Children's Hospital is home to the Kentucky Poison Control Center. In 2020, the center received almost 50,000 calls and made more than 16,000 follow-up calls to concerned families from all 120 counties in Kentucky. The center provided treatment consultation and education about how to correctly handle exposures to poisons. In addition, the center distributed more than 12,000 prevention education resources to physicians' offices, health departments and schools, and almost 1,000 packets of materials to individuals who called the poison hotline at (800) 222-1222, available 24 hours a day, 7 days a week. In addition to answering the poison control hotline, this year the staff of the poison control center also answered the Kentucky COVID-19 hotline. In 2020 the hotline received more than 200,000 calls, including those who called to listen to the recorded information line. Norton Neuroscience Institute Founded in 2009, Norton Neuroscience Institute is continuing its quest to be the regional and national leader in treatment, research and academic training for adult and pediatric neuroscience disciplines. Norton Neuroscience Institute ensures patients will be treated for neurological disorders without having to leave the region for care. Subspecialty neurosurgeons, neurologists and other neurology-related specialists have joined the growing institute. These physicians and advanced practice providers offer expertise in stroke care, epilepsy, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), brain tumors, headaches, concussions, spine care, endovascular and cerebrovascular neurosurgery, and many other neurological conditions. * Kentucky is considered to be part of the "stroke belt," a region of the United States that sees a high number of incidents of stroke cases. As a result, Norton Neuroscience Institute has committed to being a leader in stroke care. Norton Brownsboro Hospital is a designated Comprehensive Stroke Center. Norton Audubon Hospital and Norton Hospital are certified Primary Stroke Centers, and Norton Women's & Children's Hospital is an Acute Stroke Ready certified center. * Neurosurgeons with Norton Neuroscience Institute were the first in Kentucky to use minimally invasive surgery techniques, including robotic surgery, laser ablation and stereoelectroencephalography (SEEG) in the treatment of brain tumors and epilepsy for children and adults. * Norton Neuroscience Institute offers treatment for all neurological disorders. Providers work together for the patient, providing multidisciplinary programs in areas of brain tumor, ALS, movement disorders, epilepsy, trigeminal neuralgia (face pain) and stroke. * In 2019, Norton Neuroscience Institute's pediatric neurosurgeons came together with the UofL School of Medicine Department of Neurology, Division of Child Neurology, to create Norton Children's Neuroscience Institute, affiliated with the UofL School of Medicine. While both groups having been working together for decades, the creation of the new institute allows for leading experts to work more seamlessly together to treat the full spectrum of spine and brain conditions in children. Norton Healthcare Prevention & Wellness * Norton Healthcare Prevention and Wellness played a key role in supporting the community throughout the COVID-19 pandemic. In 2020, this department supported the first COVID-19 testing site and provided testing throughout the city at various locations. In December 2020, it began administering COVID-19 vaccinations. * In 2020, Norton Healthcare Prevention & Wellness staff provided preventive screenings aboard the Norton Healthcare Mobile Prevention Center in collaboration with various community partners. Over 800 women received mammograms and/or wellness exams, including cervical cancer screenings, aboard the mobile unit. Of those, approximately 9% had not been screened in the past five years and 13% had never had a mammogram. Of the almost 90 Norton Healthcare Mobile Prevention Center events, over half took place in underserved communities and over 60% of patients came from medically underserved areas. * Education on cardiovascular health, effects of smoking, prostate health, breast and women's health, colon health and more was provided to almost 1,200 community members at various events, such as health fairs and presentations. If eligible and interested, participants were offered referrals for a colonoscopy or given an at-home testing kit that they could mail to the lab and later receive their results. Colonoscopy referrals were made for 29 people and 95 people received at-home testing kits. To help eliminate barriers to care, Norton Healthcare Prevention & Wellness implemented a dedicated phone number, (502) 446-WELL, that links eligible patients to colonoscopy scheduling or requesting in-home tests. * In collaboration with many community partners, staff provided almost 2,000 cardiovascular screenings (blood pressure, BMI, glucose and cholesterol) for approximately 700 participants in multiple locations throughout Jefferson and surrounding counties, including in Southern Indiana. Each participant received education on healthy lifestyle choices, such as diet and exercise. Group education on various health and wellness topics was provided throughout the year. * Norton Healthcare Prevention & Wellness conducted nine American Lung Association Freedom From Smoking classes in 2020, with over 20 people attending. Half reported they were tobacco-free. One class was taught in Spanish. * The Get Healthy Walking Club has almost 5,000 members. 2020 brought 1,081 new members to the free club to improve their overall health. Get Healthy Walking Club members have free access to walk each day at the Louisville Zoo from March through October, 8 to 9:30 a.m. Schedule H, Part VI, Line 5 Promotion of community health Research * Norton Healthcare guides one of the largest portfolios of clinical research of any community health care system in the United States. At any point in time, more than 750 clinical studies are active or pending at Norton Healthcare. These studies engage more than 300 Norton Healthcare staff and significantly impact our patients and their families. * Areas of clinical research focus include pediatrics, oncology, cardiology, orthopedics and spine, neurology, neurosurgery, maternal-fetal medicine and pulmonology. * Norton Healthcare invests significantly in clinical research to benefit our community/patients and to support clinical science by participating in the development of new clinical interventions (drugs/device/procedures) that will become generalizable to and shared with a wide number of patient populations and medical professionals. These new, innovative treatments expand the medical community's knowledge and potentially improve the quality of medical care now and in the future. * In 2020, Norton Healthcare responded to the COVID-19 pandemic by opening and guiding more than 10 COVID-19 treatment studies. As a clinical study site, Norton Healthcare enrolled the first patient in the world for three of those clinical trials. * Norton Healthcare guided a Phase 3 study of the one-dose Johnson & Johnson/Janssen COVID-19 vaccine that gained FDA Emergency Use Authorization early in 2021. Norton Healthcare, in partnership with UK HealthCare and Baptist Health Lexington, gained visibility as the largest enrolling site in the world for this important study. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care Norton Hospitals, Inc. has a policy where we discount charges for all self-pay patients with no insurance coverage regardless of income qualifications. Because of this policy, we responded "No" to line 3b in that we do not utilize federal poverty guidelines for providing discounted care. Schedule H, Part I, Line 6a Community benefit report prepared by related organization Norton Healthcare, Inc. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The costing methodology used to calculate the community benefit expenses was to calculate the cost by hospital location (five separate locations under one Medicare provider number). The cost was determined based on a specific location cost to charge ratio. The cost used in the calculator was reduced by provider taxes, Graduate Medical Education expenses, and other costs. The adjusted cost to charge ratio was then multiplied times the gross charges for qualified financial assistance charges, Medicaid, and the state Disproportionate Program (other means tested government program) to obtain the specific community benefit expense. Schedule H, Part II Community Building Activities NORTON HOSPITALS INC.'S (NHI) SUPPORTED OVER 250 COMMUNITY ORGANIZATIONS WITH LEADERSHIP SUPPORT WHICH INCLUDED OVER 55,000 HOURS AND OVER $600,000 IN SALARIES. NHI REPRESENTATIVES SERVED ON A VARIETY OF NONPROFITS AND GOVERNMENT AGENCIES THAT HELPED IMPROVE ACCESS TO HEALTH SERVICES, ENHANCED THE HEALTH OF THE COMMUNITY, ADVANCED MEDICAL AND HEALTH CARE KNOWLEDGE, AND RELIEVED OR REDUCED THE BURDEN OF GOVERNMENT OR COMMUNITY EFFORT. NHI'S PURPOSE IS TO PROVIDE QUALITY HEALTH CARE TO ALL THOSE WE SERVE, IN A MANNER THAT RESPONDS TO THE NEEDS OF OUR COMMUNITIES AND HONORS OUR FAITH HERITAGE. OUR COMMUNITY BENEFIT INITIATIVE ALIGNS WITH OUR MISSION TO PROMOTE THE HEALTH OF THE COMMUNITY THROUGH SERVICE ON LOCAL BOARDS, ADVISORY COUNCILS AND VOLUNTEERING. NHI EMPLOYEES REPRESENT NHI ON MANY COMMUNITY BOARD POSITIONS THAT HELP TO ENHANCE THE COMMUNITY INCLUDING THE AMERICAN RED CROSS, GREATER LOUISVILLE INC. BOARD, KENTUCKY NURSES ASSOCIATION, HABITAT FOR HUMANITY, METRO UNITED WAY, THE AMERICAN HEART ASSOCIATION, THE RONALD MCDONALD HOUSE, AND MANY MORE. NHI HAS A RICH CULTURAL HISTORY OF PROVIDING COMMUNITY SUPPORT AND NHI EMPLOYEES ARE PASSIONATE ABOUT SERVING OTHERS AND PROMOTING THE HEALTH OF OUR COMMUNITY. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount In accordance with accounting guidance, bad debt is not presented as an expense, but is included as a reduction in net patient revenue. Schedule H, Part III, Line 3 Bad Debt Expense Methodology The method used to determine the amount that reasonably could be attributable to patients who likely would qualify for financial assistance under our financial assistance policy is based on our outside eligibility vendor's experience with qualifying accounts as financial assistance. Medassist Firstsource, our outside vendor, screens all self-pay accounts and based on an initial screening, will classify the account as probable financial assistance. If the accounts appear to meet Norton Hospitals, Inc.'s (NHI) financial assistance program guidelines, these accounts are then required to submit the necessary documentation to ultimately be classified as a financial assistance account. Based on all accounts that are classified as probable financial assistance by Medassist Firstsource and their experience with getting accounts qualified as financial assistance, it is estimated that 55% of those accounts classified as probable financial assistance and which do not submit the required documentation would qualify as a NHI financial assistance account. The estimated cost of accounts that are estimated to qualify for our financial assistance programs is calculated based on gross charges for accounts for the year that are probable but do not submit the necessary documentation multiplied times our cost to charge ratio times the 55% estimated conversion factor. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote In accordance with accounting guidance, bad debt is no longer an expense, but is included as a reduction in net patient service revenue. The following paragraph per the audited financial statements (page 19, second paragraph) discusses the handling of patient deductible and coinsurance not paid by patients; "Generally, patients who are covered by third-party payors are responsible for patient responsibility balances, including deductibles and coinsurance, which vary in amount. The Corporation estimates the transaction price for patients with deductibles and coinsurance based on historical experience and current market conditions. The initial estimate of the transaction price is determined by reducing the standard charge by any explicit price concessions, discounts, and /or implicit price concessions. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to net patient service revenue in the period of change. Adjustments arising from a change in the transaction price were not significant in 2020 and 2019." Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The costing methodology used to determine the Medicare allowable cost was based on the Medicare principles used in completing the Medicare cost report. All cost reported came from the Medicare cost report. Norton Hospitals, Inc. (NHI) accepts all Medicare patients with the knowledge that there may be shortfalls and operates to promote the Health of the community. NHI believes that any Medicare shortfall should be treated as a Community Benefit because Medicare does not typically fully compensate NHI for the cost of providing hospital care to Medicare beneficiaries. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance After the patient's initial screening for financial assistance, if it is believed that the patient qualifies for financial assistance; Norton Hospitals Inc. will not start collection efforts pending the patient submitting the necessary information to document meeting the financial assistance qualifications. If the patient submits the necessary documentation within a reasonable time period, then there will not be any collection efforts made to collect any amount from the patient. The patient will receive a statement/bill reflecting the amount due through the financial assistance application process pending the patient's financial assistance application, but there will be no collection efforts. Only after an attempt is made to contact the patient to obtain the necessary documentation for completing the financial assistance application and the patient not responding will collection efforts begin. There is ongoing effort throughout the collection process to screen for Medicaid eligibility, Disproportionate Share Hospital, and the need for providing financial assistance applications to patients. When a patient is approved for financial assistance, their account balance is written off. Schedule H, Part V, Section B, Line 16a FAP website A - Norton Hospital: Line 16a URL: WWW.NORTONHEALTHCARE.COM/FAP; Schedule H, Part V, Section B, Line 16b FAP Application website A - Norton Hospital: Line 16b URL: WWW.NORTONHEALTHCARE.COM/FAP; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Norton Hospital: Line 16c URL: WWW.NORTONHEALTHCARE.COM/FAP; Schedule H, Part VI, Line 2 Needs assessment NEEDS ASSESSMENT NORTON HOSPITALS, INC (NHI) REGULARLY AND CONSISTENTLY EVALUATES WORKFORCE AND COMMUNITY HEALTH CARE NEEDS THROUGHT PARTNERSHIPS WITH LOCAL HEALTH DEPARTMENTS, EMERGENCY MEDICAL SERVICES, LOCAL AND STATE UNIVERSITIES, AND KENTUCKIANA WORKS, THE WORKFORCE INVESTMENT BOARD FOR THE SEVEN COUNTY REGION SURROUNDING LOUISVILLE. PARTNERSHIPS WITH THESE ORGANIZATIONS, ALONG WITH NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION AND OTHERS, ALSO PROVIDE NHI IMPORTANT STATISTICS AND DATA TO USE IN EVALUATING COMMUNITY ACCESS TO HEALTH CARE SERVICES AND HEALTH CARE DISPARITIES. ADDITIONALLY, NHI ACCESSES DATA FROM ORGANIZATIONS SUCH AS THE CENTER FOR DISEASE CONTROL AND THE UNITED STATES CENSUS BUREAU TO ASSESS AREAS OF GREATEST ANTICIPATED POPULATION GROWTH AND LOW-INCOME AREAS, BOTH OF WHICH MAY BE IN GREATEST NEED FOR PREVENTION EDUCATION, FREE SCREENINGS AND ACCESS TO HEALTH CARE. Norton Healthcare, Inc. (NHC), the parent company of NHI, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR ALL five HOSPITALS. THE CHNA DEFINED THE PATIENT SERVICE AREA BY PATIENT ORIGIN FOR INPATIENT STAYS, DEMOGRAPHIC, SOCIOECONOMIC, POPULATION, AND OTHER HEALTH RELATED INDICATORS UTILIZED TO PROVIDE INFORMATION ON THE HEALTH STATUS OF THE COMMUNITY. COMMUNITY INPUT WAS PROVIDED THROUGH PROVIDER AND COMMUNITY INTERVIEWS, TARGETED FOCUS GROUPS AND A COMMUNITY HEALTH SURVEY IN PARTNERSHIP WITH THE LOUSIVILLE METRO DEPARTMENT OF PUBLIC HEALTH AND WELLNESS. HEALTH NEEDS WERE PRIORITIZED AND ADDRESSED BASED ON HEALTH STATUS FINDINGS AND THE COMMUNITY INPUT. THE CHNA IS A COMPONENT OF THE ORGANIZATIONS STRATEGIC PLANNING PROCESS AS RESOURCES ARE NECESSARY TO IMPLEMENT STRATEGIES OUTLINED FOR PRIORITIES IDENTIFIED. THE NHC BOARD OF TRUSTEES AS WELL AS THE LEADERSHIP OF NHC AND HOSPITAL CHIEF ADMINSTRATIVE OFFICERS HAVE APPROVED THE ASSESSMENT AND IMPLEMENTATION PLAN Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Signage is posted in all Norton Healthcare, Inc. (NHC) hospital facilities, including the admission area and emergency room, providing information on the ability to apply for financial assistance and to seek help in paying your bill. The signage is translated in five languages and all languages are contained on the same poster. The languages are: English, Spanish, Vietnamese, Croatian, and Arabic. At the time of registration, the Patient Access/Registration department discusses with the patient the financial assistance/charity options, guidelines, and provides assistance as needed in filling out a financial assistance application and answering questions. The patient may also be referred to the NHC eligibility vendor for assistance at no cost to the patient/guarantor. Additional questions from the patient/guarantor can be facilitated through the NHC Single Billing Office (SBO) area, Customer Service, and NHC vendors. NHC has created a number of different options for the patient/guarantor to supply the information/application for financial assistance to NHC. Those various methods of delivery include: in person, by mail, by fax, on-line application submission via the website, and by specific email address. These various options are publicized and made known to the patient. In 2020 statements mailed to the guarantors by Norton Hospitals, Inc. (NHI) contained information to start the financial assistance application process. NHI employs an outside eligibility vendor, Medassist Firstsource. All self-pay accounts for the facilities are placed for eligibility screening with Medassist Firstsource. They screen for NHC financial assistance, Medicaid, Medicaid Managed Care organizations, presumptive eligibility, and Disproportionate Share Hospital/Kentucky Children's Health Insurance Program (DSH/KCHIP). In addition, they may provide education and referral assistance to the appropriate county/state departments for food stamps, rent assistance, heating assistance, etc. The process of completing the application is often performed by Medassist Firstsource. They protect filing deadlines by submitting the appropriate forms to the state/county. They follow up to secure proof of income documents for Norton financial assistance and follow up with a state caseworker as needed. Medassist Firstsource also makes outside field calls or home visits to the patients to secure the needed information for eligibility assistance if the patient is homebound. Additionally, Medassist Firstsource may provide assistance with patient transportation needs so that the patient can make their scheduled appointments with their caseworker. All of the services provided by Medassist Firstsource eligibility are at no cost to the patient. Cost to the hospitals for these eligibility and enrollment services was in excess of $6,600,000 in 2020. NHI has a staff of over 11 full-time employees including a supervisor that are dedicated to performing the following functions: processing, reviewing, and approving the hundreds of financial assistance applications received each week. Additionally, some of those employees make out-bound calls to solicit financial assistance information needed to process the patient's application. Financial assistance for Norton financial assistance is not limited to the self-pay population. Even patients with insurance coverage are encouraged to apply for assistance so their deductible, co-payments, and co-insurance amounts are covered under the various assistance programs. Financial counselors/social workers at the facilities are educated and trained to assist with counseling patients to determine and explain our financial assistance programs. They continue to receive on-going education throughout the entire year regarding eligibility changes and additions for Norton financial assistance, DSH/KCHIP, Medicaid, Medicaid Managed Care organization, presumptive eligibility, etc. As the foundation office receives inquiries directed to their offices, they refer these individuals to Patient Financial Services (PFS) to screen for possible Norton financial assistance or The Norton Children's Hospital Foundation, Inc. (NCHF) funding. If a child's account does not qualify for Norton financial assistance, then those not qualifying for children's applications are referred to management of PFS for consideration for special funding through NCHF as well as other programs. The charity application was provided on the back of the SBO statement. NHI ensures that all patients were made aware of financial assistance regardless of where the patient's account may have been in the collection cycle. Even if the patient/guarantor had not previously availed themselves of the opportunity to apply for financial assistance and decided they will now cooperate, then allowed the patient/guarantor to apply and approved if they met the qualifications. Financial assistance notifications and applications were made available to the patient/guarantor via telephone, face to face meetings, website, mail, electronically, etc. Primary collection agencies chosen by NHI include with their initial placement letter an insert of a copy of a financial assistance application for the guarantor to complete. Calls resulting from notification correspondence sent by the collection agencies may be routed to Spanish-speaking Customer Service representatives or patient/guarantors may also request an interpreter service to assist in facilitating information regarding financial assistance. NHI has translated the full financial assistance policy, financial assistance applications, and the plain language summary into four languages: Spanish, Vietnamese, Croatian, and Arabic. NHI's Customer Service department routinely instructs and screens patients in the protocol regarding financial assistance through the Norton financial assistance program. Since 2007, NHI has offered at the time of final billing all true hospital self-pay patients a significant discount off of the total charges that were reflected on their monthly statements and the amount due. Contracted collection agencies are required to solicit financial assistance applications when the patient/guarantor indicates "cannot pay". The statement provided by NHI in 2020 included the link to the NHC website to allow the patient/guarantor to learn more about financial assistance. The statement contained the financial assistance application on the back of the statement so the guarantor could apply using the actual NHI statement and could then mail, fax, bring the application directly to the facilities, or email the form to PFS. The statement included a phone number to call to learn more about the application process and discuss financial assistance options. Schedule H, Part VI, Line 4 Community information PRIMARY SERVICE AREA NORTON HOSPITALS INC.'S (NHI) PRIMARY SERVICE AREA POPULATION IS OVER 1.5 MILLION AND EXPECTED TO INCREASE 2% BETWEEN 2021 AND 2026. IN 2016, THE PRIMARY SERVICE AREA INCREASED FROM A 7 COUNTY AREA TO AN AREA INCLUSIVE OF 16 COUNTIES, 5 OF WHICH ARE LOCATED ALONG THE OHIO RIVER BORDER IN KENTUCKY, 4 BORDER THE RIVER IN INDIANA, AND INCLUDES 5 ADDITIONAL KENTUCKY COUNTIES AND 2 ADDITIONAL INDIANA COUNTIES THAT DO NOT BORDER THE OHIO RIVER. 94% OF NHI'S PATIENTS ARE DERIVED FROM THIS SERVICE AREA. APPROXIMATELY 30% OF THE POPULATION IS OVER 55 YEARS OLD; COMPARED TO 29% IN THE USA. THIS PORTION OF THE POPULATION TENDS TO USE ADDITIONAL HEALTHCARE SERVICES. THE PEDIATRIC POPULATION IN 2021 WAS ESTIMATED AT 340,722 AND IS EXPECTED TO INCREASE TO 339,920 WITHIN 5 YEARS AND REPRESENTS 22% OF THE POPULATION. THE NUMBER OF HOUSEHOLDS IN THE PRIMARY SERVICE AREA WAS ESTIMATED AT 612,307 IN 2021 AND IS EXPECTED TO INCREASE 2.2% BY 2026. CURRENTLY 10% OF THE ADULT POPULATION DOES NOT HAVE A HIGH SCHOOL DEGREE AND 18.3% OF THE HOUSEHOLD INCOME IS LESS THAN $25,000 A YEAR; THE MEDIAN HOUSEHOLD INCOME IS $66,313 COMPARED TO $68,703 FOR THE UNITED STATES. NHI TREATS 43% OF THE ADULT INPATIENT CASES IN THE COMMUNITY AND ITS PAYOR MIX IS 50% MEDICARE, 26% MEDICAID/PASSPORT AND 2% SELF PAY. THE LARGEST COUNTY IN THE SERVICE AREA IS JEFFERSON COUNTY AND ITS MAY 2021 PRELIMINARY NON-SEASONALLY ADJUSTED UNEMPLOYMENT RATE WAS 3.8% COMPARED TO 4.4% FOR KENTUCKY AND 5.5% FOR THE UNITED STATES. NORTON'S PRIMARY SERVICE AREA HAS ADEQUATE ACCESS TO HOSPITAL CARE, WITH OVER 3,400 INPATIENT SHORT-TERM ACUTE CARE BEDS IN JEFFERSON COUNTY ALONE, 1,861 (54%) OF WHICH ARE PART OF THE NORTON HEALTHCARE SYSTEM. REVIEW OF OCCUPANCY RATES FOR EACH HOSPITAL INDICATES THAT THE INPATIENT NEED IS CURRENTLY BEING MET. THROUGH A CERTIFICATE OF NEED (CON) PROCESS, KENTUCKY HAS A STATE HEALTH PLAN THAT REGULATES HEALTH SERVICES PROVIDED. THE CON PROCESS ESTABLISHES CRITERIA BASED ON COMMUNITY NEED IN AN ATTEMPT TO ENSURE THAT UNNECESSARY DUPLICATION OF SERVICES DOES NOT OCCUR. IN JEFFERSON COUNTY 14.2% OF THE COMMUNITY IS BELOW THE FEDERAL POVERTY GUIDELINES AS COMPARED TO 16% OF THE POPULATION BELOW THE FEDERAL POVERTY IN KENTUCKY. POVERTY IS A KEY DRIVER OF HEALTH STATUS AND CREATES BARRIERS TO ACCESS, INCLUDING HEALTH SERVICES, HEALTHY FOOD CHOICES AND OTHER FACTORS THAT CONTRIBUTE TO POOR HEALTH. CERTAIN SEGMENTS OF THE COMMUNITIES SERVED BY NORTON HAVE EXTREME POVERTY. THE CENTRAL AND WEST SEGMENTS OF JEFFERSON COUNTY HAVE POVERTY RATES TWICE THAT OF THE KENTUCKY AND NATIONAL RATES. FOUR AREAS WITHIN JEFFERSON COUNTY HAVE BEEN DESIGNATED AS MEDICALLY UNDERSERVED AREAS BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). THE HRSA IS THE PRIMARY FEDERAL AGENCY FOR IMPROVING HEALTH CARE FOR PEOPLE WHO ARE ECONOMICALLY AND MEDICALLY VULNERABLE. IT WORKS WITH STATE PARTNERS TO DETERMINE AREAS WITH TOO FEW PRIMARY CARE, DENTAL AND MENTAL HEALTH PROVIDERS AND SERVICES. THERE ARE LIMITED FEDERAL RESOURCES, SO THE DESIGNATION HELPS TO PRIORITIZE AND FOCUS RESOURCES TO AREAS WITH THIS DESIGNATION. THE TABLE BELOW LISTS FEDERALLY QUALIFIED HEALTH CENTERS LOCATED IN JEFFERSON COUNTY THAT HAVE BEEN ESTABLISHED TO SERVE UNDERSERVED AREAS OR POPULATIONS. SECONDARY SERVICE AREA NHI's SECONDARY SERVICE AREA DECREASED FROM 26 COUNTIES TO 17 COUNTIES IN 2016 AS MANY COUNTIES ARE NOW INCLUDED IN THE PRIMARY SERVICE AREA. NHI's SECONDARY SERVICE AREA POPULATION WAS 432,542 IN 2021 AND IS EXPECTED TO INCREASE 2% BETWEEN 2021 AND 2026. THE SECONDARY SERVICE AREA SPREADS ACROSS 15 KENTUCKY COUNTIES AND 2 INDIANA COUNTIES. THE 55+ AGE COHORT REPRESENTS 30% OF THE SECONDARY SERVICE AREA POPULATION AND IS SLIGHTLY HIGHER THAN IN THE UNITED STATES. THE PEDIATRIC POPULATION IN 2021 WAS ESTIMATED AT 97,728 AND EXPECTED TO INCREASE TO 98,628 BY 2026. ALTHOUGH THE PEDIATRIC POPULATION IS EXPECTED TO REMAIN RELATIVELY FLAT (1% GROWTH), THERE IS A NEED FOR CHILDREN TO HAVE APPROPRIATE ACCESS TO CARE IN THE RURAL AREAS OF KENTUCKY. THE NUMBER OF HOUSEHOLDS IN THE SECONDARY SERVICE AREA WAS ESTIMATED AT 169,940 IN 2021 AND IS EXPECTED TO INCREASE 2.7% BY 2026. OVER 45,000 ADULTS IN THIS SERVICE AREA DO NOT HAVE A HIGH SCHOOL EDUCATION AND THE AVERAGE HOUSEHOLD INCOME IS UNDER $25,000 FOR 25.8% OF THE POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $50,208, 4% LESS THAN KENTUCKY AND 24% LESS THAN THE PRIMARY SERVICE AREA AVERAGE HOUSEHOLD INCOME. Schedule H, Part VI, Line 6 Affiliated health care system Norton Healthcare, Inc. (the controlling company) and its affiliates, including Norton Hospitals, Inc., Norton Properties, Inc., Community Medical Associates, Inc., The Children's Hospital Foundation, Inc., Norton Healthcare Foundation, Inc., and Norton Enterprises, Inc. operate in the Louisville, Kentucky metropolitan area and the operations of the affiliated healthcare system include 1,907 licensed beds, over 260 physician practice locations, and 16 Norton Immediate Care Center locations, and other ancillary health care services. X true true true true false false false false false true false Russell F Cox President & CEO/Trustee 0 1278434 0 697191 0 536817 0 167797 0 33034 0 2713272 0 44485 Michael W Gough Exec VP and COO 0 873998 0 407253 0 263773 0 112157 0 30080 0 1687263 0 30710 Adam Kempf Sr VP, CFO/Treasurer 0 529306 0 228445 0 103094 0 123967 0 30182 0 1014993 0 57152 Robert B Azar Sr VP Chief Legal Officer/Secretary 0 493335 0 213253 0 116118 0 115748 0 14230 0 952684 0 69368 Thomas Kmetz Former Division President Women and Children Services 0 0 0 0 844306 0 3093 0 2478 0 849878 0 567886 0 Joseph Flynn DO CAO NMG - Physician -in-Chief NCI 602040 0 190868 0 89234 0 113165 0 31339 0 1026646 0 67364 0 Matthew Ayers Hospital CAO 348506 0 113932 0 61056 0 70248 0 26329 0 620070 0 38872 0 Charlotte Ipsan Hospital CAO 306167 0 108729 0 87832 0 75320 0 24652 0 602698 0 37396 0 Andrew Strausbaugh Hospital CAO 301578 0 101411 0 58140 0 61231 0 28906 0 551266 0 34376 0 Emmett Ramser Hospital CAO 301861 0 99202 0 52697 0 67783 0 28999 0 550541 0 32448 0 Aaron Spalding MD Physician 798735 0 540729 0 143768 0 16656 0 52246 0 1552135 0 0 0 Shawn Glisson MD Physician 914594 0 375765 0 4713 0 17100 0 33164 0 1345336 0 0 0 Joseph Maly MD Physician 705298 0 580636 0 650 0 12649 0 36060 0 1335291 0 0 0 Yong Cha MD Physician 634812 0 539161 0 33466 0 12560 0 48860 0 1268860 0 0 0 Don Stevens MD Physician 740340 0 408250 0 35478 0 25015 0 26870 0 1235953 0 0 0 Schedule J, Part I, Line 1a Discretionary spending account DISCRETIONARY SPENDING ACCOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE ORGANIZATION PROVIDES A DISCRETIONARY SPENDING ACCOUNT FOR ELIGIBLE NORTON HEALTHCARE, INC. (NHC) EXECUTIVES, EFFECTIVE OCTOBER 1, 2007. NHC PROVIDES BENEFITS TO ITS IDENTIFIED EXECUTIVE STAFF TO PROVIDE A TOTAL COMPENSATION PACKAGE THAT IS COMPETITIVE WITH THE MARKET AND WHICH CONFORMS TO THE PHILOSOPHY AND GUIDELINES SET OUT BY THE BOARD OF TRUSTEES, THROUGH THE EXECUTIVE COMPENSATION PHILOSOPHY AND PROGRAMS. THROUGH THE DISCRETIONARY SPENDING ACCOUNT POLICY, EXECUTIVES ARE FREE TO CHOOSE WHATEVER BENEFITS THEY FIND MOST USEFUL OR IMPORTANT TO THEM AND NHC DOES NOT REIMBURSE FOR THE COST OF THOSE BENEFITS, AS THEY ARE PART OF THE DISCRETIONARY SPENDING ACCOUNT. THE INTERESTED PERSONS LISTED BELOW RECEIVED THE BENEFIT OF A DISCRETIONARY SPENDING ACCOUNT IN 2020: Matthew Ayers - $10,000 Thomas Kmetz - $1,346 Charlotte Ipsan - $10,000 Joseph Flynn - $10,000 Andrew Strausbaugh - $10,000 Emmett Ramser - $10,000 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation NORTON HEALTHCARE INC (NHC) EIN 61-1028725 IS THE PARENT ORGANIZATION FOR NORTON HOSPITALS, INC. AND THEREFORE ESTABLISHES COMPENSATION FOR THE CEO, OFFICERS AND KEY EMPLOYEES THROUGH ENGAGING WITH THE EXECUTIVE COMMITTEE OF NHC; AN INDEPENDENT COMPENSATION CONSULTANT; REVIEW OF OTHER ORGANIZATION'S FORM 990; WRITTEN EMPLOYMENT AGREEMENTS; THIRD PARTY COMPENSATION SURVEYS AND APPROVAL BY THE EXECUTIVE COMMITTEE AND BOARD. SEE NARRATIVE IN SCHEDULE O, REFERENCING PART VI, LINE 15 WHICH FURTHER DESCRIBES THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION. Schedule J, Part I, Line 4a Severance or change-of-control payment Severance payment was received during 2020 by former key employee: Thomas Kmetz in the amount of $59,601 other compensation included in Schedule J column B(iii). Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INTERESTED PERSONS PARTICIPATED IN OR RECEIVED PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AS DESCRIBED IN IRC SECTION 457(F). THE INTERESTED PERSONS BELOW MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS: THE EXECU-PLUS BENEFIT PLAN, DEFINED BENEFIT AND DEFINED CONTRIBUTION RESTORATION PLANS, AND THE PHYSICIAN DEFERRED PLAN. THE "PAY CREDIT" OUTLINED BELOW REPRESENTS A REASONABLE ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE OF THE PLANS; AND THEREFORE, REPRESENTS THE ORGANIZATION'S CONTRIBUTION TO THE VALUE OF THE BENEFITS. NAME - PAY CREDIT Russell F. Cox - $149,210 Michael W. Gough - $94,136 Robert Azar - $98,798 Adam Kempf - $108,162 Matthew Ayers - $54,116 Charlotte Ipsan - $52,937 Joseph Flynn - $98,915 Andrew Strausbaugh - $45,039 Emmett Ramser - $47,595 THE "PAYMENT RECEIVED" OUTLINED BELOW REPRESENTS CASH PAYMENTS THAT THE EMPLOYEE RECEIVED DURING 2020 AND CAN BE COMPRISED OF CURRENT AND OR PRIOR YEARS EMPLOYEE AND EMPLOYER CONTRIBUTIONS. NAME - PAYMENT RECEIVED Russell F. Cox - $181,945 Michael W. Gough - $126,527 Robert Azar - $71,360 Adam Kempf - $63,686 Matthew Ayers - $45,476 Charlotte Ipsan - $41,545 Thomas Kmetz - $784,502 Joseph Flynn - $69,298 Andrew Strausbaugh - $38,883 Emmett Ramser - $38,190 Schedule J, Part I, Line 7 Non-fixed payments In 2020, Norton Healthcare, Inc. (NHC) had in place a Variable Compensation Plan for Executives, eligibility under which extended to employees holding a full-time position as Senior Officer, Officer, System Director or other designated Director level position. Under the plan, a variable compensation pool amount is approved by the Board of Trustees. Each participant's performance is evaluated relative to the goals and objectives documented as part of the participant's plan; and an award is determined for the participant, based on achievement of the goals and objectives, subject to the funding of the variable compensation pool. At the end of each year, the Committee on Executive Compensation and Benefits determines an appropriate award for the NHC's President & Chief Executive Officer, and the President & Chief Executive Officer recommends appropriate awards for other senior executives to the Committee on Executive Compensation and Benefits for its review and approval. JASON NACHAZEL FAMILY MEMBER OF RONALD LEHOCKY, TRUSTEE 86318 COMPENSATION false BARBARA KMETZ FAMILY MEMBER OF THOMAS KMETZ, FORMER KEY EMPLOYEE 92054 COMPENSATION false SARAH A ROBINSON FAMILY MEMBER OF DONALD H ROBINSON, TRUSTEE 56829 COMPENSATION false Lorraine Bouvette Family member of Maria Bouvette, Trustee 74869 COMPENSATION false Laura Hortert FAMILY MEMBER OF EMMETT RAMSER, KEY EMPLOYEE 44531 COMPENSATION false X 6000 Market value X 144822 Market value X 14 194123 Market value X Hospital equipment 3 52187 Market value X Donated meals 17 200601 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Books and publications - Number of Contributions Clothing and household goods - Number of contributions Drugs and medical supplies - Number of contributions Other - Hospital equipment Number of contributions Other - Donated meals Number of contributions Form 990, Part V, Line 2a COMMON PAYING AGENT FOR EMPLOYEES NORTON HEALTHCARE, INC. (NHC) EIN 61-102875 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. (NHI) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY NHC ON BEHALF OF NHI. NHI HAS APPROXIMATELY 12,237 EMPLOYEES. Form 990, Part V, Line 1a COMMON PAYING AGENT 1099S NORTON HEALTHCARE, INC. (NHC) EIN 61-1028725 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. (NHI) AND THEREFORE, ALL VENDORS, INCLUDING INDEPENDENT CONTRACTORS, ARE PAID AND REPORTED BY NHC ON BEHALF OF NHI. FOR PURPOSES OF PART V, LINE 1, THE NUMBER OF 1099S REPORTED AND FILED FOR 2020 BY NHC FOR NHI, WAS APPROXIMATELY 264. NHI HAS 141 INDEPENDENT CONTRACTORS EXCEEDING $100,000 FOR 2020. Form 990, Part VI, Line 1a Delegate broad authority to a committee THE EXECUTIVE COMMITTEE SHALL POSSESS AND MAY EXERCISE ALL THE POWERS AND AUTHORITY OF THE BOARD OF TRUSTEES IN THE MANAGEMENT AND DIRECTION OF THE BUSINESS AND AFFAIRS OF THE CORPORATION. HOWEVER, THE EXECUTIVE COMMITTEE DOES NOT POSSESS THE AUTHORITY TO DO THE FOLLOWING: A) FILL VACANCIES ON THE BOARD; B) CHANGE THE MEMBERSHIP OF THE EXECUTIVE COMMITTEE; C) MAKE DECISIONS TO MERGE, LIQUIDATE, OR OTHERWISE MAKE DECISIONS OUTSIDE OF THE NORMAL COURSE OF BUSINESS, D) MAKE FINAL DETERMINATIONS OF LONG-TERM POLICY; E) HIRE OF FIRE THE CHIEF EXECUTIVE OFFICER; AND F) AMEND THE ARTICLES OF INCORPORATION OR BYLAWS. Form 990, Part VI, Line 6 Classes of members or stockholders Norton Healthcare, Inc. (EIN 61-1028725) is the sole member of Norton Hospitals, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The Board of Trustees of Norton Healthcare, Inc. appoints the trustees of the organization. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders According to the Articles of Incorporation of the organization, Norton Healthcare, Inc. (NHC) the sole member, possesses all of the rights granted to a member pursuant to law, including the right to elect trustees or directors and approve amendments to the Articles of Incorporation of the organization. NHC also possesses the right to require the organization to (I) provide contributions of funds of the organization to pay all to a portion of the principle of , interest on, and all other payments to become due and owing with respect to any and all indebtedness incurred by NHC, and (II) provide security for such indebtedness. Form 990, Part VI, Line 11b Review of form 990 by governing body AT THE October 7, 2021 NORTON HEALTHCARE, INC. (NHC) FINANCE COMMITTEE MEETING AND AT THE OCTOBER 14, 2021 NHC BOARD OF TRUSTEES MEETING, THE 990S WERE DISCUSSED AND COMMITTEE MEMBERS AND TRUSTEES HAD AN OPPORTUNITY TO ASK QUESTIONS. COINCIDING WITH THE FINANCE COMMITTEE MEETING, ELECTRONIC COPIES OF THE 990S WERE MADE AVAILABLE TO ALL MEMBERS OF THE FINANCE COMMITTEE AND BOARD OF TRUSTEES THROUGH THE DIRECTORS PORTAL SITE, PRIOR TO THE FILING WITH THE IRS. NHC IS THE PARENT OF COMMUNITY MEDICAL ASSOCIATES, INC., NORTON HOSPITALS, INC., NORTON PROPERTIES, INC., NORTON HEALTHCARE FOUNDATION, INC., THE CHILDREN'S HOSPITAL FOUNDATION, INC., and Norton Healthcare-Indiana, Inc. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY ANNUALLY DISTRIBUTING A QUESTIONNAIRE THAT REQUIRES OFFICERS, TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE INTERESTS THAT MAY GIVE RISE TO CONFLICTS. IF A CONFLICT ARISES, THE POLICY PROVIDES PROCEDURES FOR ADDRESSING CONFLICTS TO ENSURE DECISIONS ARE MADE IN THE BEST INTERST OF THE ORGANIZATION. Form 990, Part VI, Line 15a Process to establish compensation of top management official The top management official is paid by a related organization. Please see explanation provided for Form 990, Part VI, Line 15b. Form 990, Part VI, Line 15b Process to establish compensation of other employees The organization takes all necessary steps to ensure that compensation for all officers, directors and key employees is reasonable and appropriate for the services provided to the organization. The organization provides a total compensation package that is on par with compensation provided by similar organizations and which conforms to the policies and guidelines set out by the Board of Trustees. Norton Healthcare, Inc. (NHC) engages an outside independent compensation consultant, Gallagher, to provide comparability data, including review of other health systems and hospital organizations filed Form 990s, for NHC's officers and key employees on total compensation for similar positions at health systems and hospital organizations similar in size, scope of services, and circumstances. In addition, the organization participates in third party surveys which provide aggregate, comparative compensation data for officers and key employees in similar positions at similar organizations. Gallagher consultants presented and discussed this comparability data in 2019 for the 2020 compensation review and met in 2020 for the 2021 compensation review with the Executive Committee of the Board of Trustees (Board). The Committee reviewed the executive compensation and benefits program, determined total compensation for the CEO, and approved compensation for other officers and key employees. The Committee reviewed NHC's variable compensation program and determined appropriate awards for performance relative to goals set for the year. After the Committee determined appropriate compensation and benefits for officers and key employees, the Board approved their total compensation. Form 990, Part VI, Line 19 Required documents available to the public CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE HERE: HTTPS://NORTONHEALTHCARE.COM/ABOUT-US/FINANCIAL-INFORMATION/. GOVERNING DOCUMENTS, AND CONFLICTS OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. Form 990, Part VII, Section A, Line 1a, Column (E) Board Member Stipend Payments Norton Healthcare, Inc. (NHC) and affiliates (Norton Hospitals, Inc., Community Medical Associates, Inc., Norton Properties, Inc., Norton Healthcare Foundation, Inc., and The Children's Hospital Foundation, Inc.) encourages and facilitates board member attendance at educational programs and conferences on subjects relevant to NHC. NHC's travel policy for Board of Trustees provides that for each trustee that attends at least one out of town educational conference, a lump sum stipend will be paid to cover unreimbursed travel expense and other miscellaneous expenses associated with conference preparation, attendance or follow up. In compliance with IRS regulations, NHC provides a form 1099 to any trustee that receives a stipend. These amounts have been reported in Part VII or the form 990 as reportable compensation to the trustee receiving stipends in 2020. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS - Total Revenue: 590903, Related or Exempt Function Revenue: 590903, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances AFFILIATE TRANSFER - -127478; NORTON HEALTHCARE INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 611028725 PROVIDE ADMINISTRATIVE AND SUPPORT SERVICES KY 501(c)(3) Type II NA false COMMUNITY MEDICAL ASSOCIATES INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 611276316 OPERATES A NETWORK OF PHYSICIAN PRACTICES KY 501(c)(3) 10 NORTON HEALTHCARE INC false NORTON PROPERTIES INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 611028724 MAINTAIN OFFICE AND PARKING FACILITIES KY 501(c)(3) Type I NORTON HEALTHCARE INC false THE CHILDREN'S HOSPITAL FOUNDATION INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 616027530 GENERATE FUNDS TO SUPPORT PROGRAMS AND SERVICES KY 501(c)(3) 7 NORTON HEALTHCARE INC false NORTON HEALTHCARE FOUNDATION INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 310914919 GENERATE FUNDS TO SUPPORT PROGRAMS AND SERVICES KY 501(c)(3) 7 NORTON HEALTHCAREINC false NORTON HEALTHCARE - INDIANA INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 850513259 OPERATE HOSPITAL AND OTHER HEALTHCARE FACILITIES IN 501(c)(3) 10 Norton Healthcare Inc false NORTON ENTERPRISES INC 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 402022025 611054301 PROVIDE PATHOLOGY SERVICES KY Norton Healthcare Inc C Corporation false false false true false false false false false false true false false false true false false true true