2017-11-13T11:09:37-06:00 2016-12-31 350921680 CROWE HORWATH LLP 9600 Brownsboro Road Suite 400 Louisville KY 402411122 990 2016-01-01 610703799 Norton Hospitals Inc NORT 5026298263 Accounting 224 E Broadway 5th Floor Louisville KY 40202 Michael W Gough TREASURER & CFO 2017-11-07 true Rachel Spurlock P00520729 5023263996 2016 2017-02-10 21:41:12Z RUSSELL F COX 4967 US Highway 42 Suite 100 Louisville KY 40222 1799925999 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 HONORS OUR FAITH HERITAGE. 23 22 10685 1668 5669848 0 12790617 8807315 1713698108 1779899221 80612 -596100 3508605 10108646 1730077942 1798219082 0 0 604145209 626069126 0 0 864571485 912231135 1468716694 1538300261 261361248 259918821 1716731667 1986025406 120159373 129728663 1596572294 1856296743 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 HONORS OUR FAITH HERITAGE. false false 1509248906 1784105051 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 1,837 licensed beds, Norton Hospital - 605 beds; Norton Children's Hospital - 300; Norton Audubon Hospital - 432 beds: Norton Women's and Children's Hospital - 373 beds; and Norton Brownsboro Hospital - 127 beds. These hospitals operate twenty-four (24) hours a day, seven (7) days a week. In 2016, NHI's hospitals and diagnostic centers served 68,189 inpatients, 508,353 outpatients, and 246,963 emergency department visits. In addition, NHI's operating rooms cared for 20,391 inpatient surgical patients and 35,415 outpatient surgical patients. Additionally, 7,932 deliveries were performed at NHI birthing centers. Under its charity care program, NHI provided free care to 22,707 patients, at a cost of $9.3 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, 14,603 patients were provided care at discounted rates. Other contributions to the community were the unpaid cost of Medicaid services of $97.2 million and educational support of $35.0 million, primarily to the University of Louisville's School of Medicine. Also, community health improvement services totaled $12.6 million, contributions to community groups were $1.8 million, the Kentucky Poison Control Center was $1.0 million, and the Child Guidance and Advocacy Program was $388,000. 1509248906 true true false true false 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 false false false false false true false false false true 302 0 true 10685 true true true false false false false false false false false false X 23 22 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 Stephen A Williams CEO/Trustee 10.0 40.0 X X 0 2140771 85700 Donald H Robinson Chair 1.0 13.5 X 0 0 0 Gary L Stewart Vice Chair & Chair Elect 1.0 6.5 X 0 1600 0 Maria L Bouvette Trustee 1.0 2.5 X 0 1600 0 Brendan Canavan Trustee 1.0 2.5 X 0 1600 0 Sue Davis EdD RN Trustee 1.0 2.5 X 0 1600 0 Lee K Garlove Trustee 1.0 3.5 X 0 1600 0 Maria Gerwing Hampton Trustee 1.0 5.5 X 0 1600 0 Craig D Grant Trustee 1.0 2.5 X 0 1600 0 Louis Heuser Trustee (partial year) 1.0 2.5 X 0 0 0 Martha K Heyburn MD Trustee 1.0 4.5 X 0 1600 0 Richard R Ivey Trustee 1.0 2.5 X 0 1600 0 Ronald Lehocky MD Trustee 1.0 4.5 X 0 1600 0 Gail Lyttle Trustee 1.0 2.5 X 0 1600 0 Gregory E Mayes Trustee 1.0 6.5 X 0 1600 0 Maureen McGowan Trustee 1.0 2.5 X 0 0 0 Edie Nixon Trustee 1.0 5.5 X 0 1600 0 Barry Pennybaker Trustee 1.0 2.5 X 0 1600 0 Erwin Roberts Trustee 1.0 2.5 X 0 1600 0 G Hunt Rounsavall Jr Trustee 1.0 6.5 X 0 1600 0 Dr Rita Hudson Shourds Trustee 1.0 2.5 X 0 0 0 Rev William J Schultz Trustee 1.0 4.5 X 0 1600 0 James L Sublett MD Trustee 1.0 2.5 X 0 1600 0 Richard S Wolf MD Honorary Chair Emeritus 1.0 3.5 X 0 1600 0 Joseph J McGowan EdD Trustee (partial year) 1.0 2.5 X 0 0 0 Russell F Cox President 10.0 40.0 X 0 1332366 381368 Michael W Gough Sr VP CFO/Treasurer 10.0 40.0 X 0 1114894 317579 Robert B Azar Sys VP Chief Legal Officer/Secretary 10.0 40.0 X 0 680749 121650 Thomas Kmetz Division President Women and Children Services 50.0 1.0 X 711931 0 162491 Joseph Flynn Physician-in-Chief NCI 50.0 0 X 518932 0 114168 Kevin Wardell Hospital CAO 50.0 0 X 495598 0 20994 Charlotte Ipsan Hospital CAO 50.0 0 X 440027 0 109652 Matthew Ayers Hospital CAO 50.0 0 X 404738 0 88302 Brian Stoll MD Physician 50.0 0 X 779582 0 46186 Aaron Spalding MD Physician 50.0 0 X 776220 0 55354 Michael Hahl MD Physician 50.0 0 X 770266 0 52195 Mark Cornett MD Physician 50.0 0 X 768342 0 59314 Yong Cha MD Physician 50.0 0 X 762979 0 52223 John Harryman Former Hospital CAO 0.0 0 X 548789 0 80581 Steven MacLauchlan Former Hospital President 0.0 0 X 128375 0 159 Steven Pursell VP Medical Director NCI 50.0 0 X 222761 0 11920 7328540 5299180 1759836 365 true true false UNIVERSITY OF LOUISVILLE 323 E CHESTNUT ST LOUISVILLE KY 40202 RESIDENCY PROGRAM 10298399 Messer Construction Co 5158 Fishwick Dr Cincinnati OH 452162216 CONSTRUCTION 10042663 Morrison Management Specialist 353 NORTH CLARK ST PO Box 102289 Atlanta GA 303682289 Dietary Services 7662710 Jenner & Block LLP 353 North Clark St Chicago IL 606543456 Legal services 5558916 Wehr Constructores Inc 2517 Plantside Dr Louisville KY 40299 Construction 5415107 112 X 8807315 8807315 Net Patient Revenue 621110 1778527590 1772928309 5599281 Healthcare Education 611710 1371631 1371631 0 0 0 0 1779899221 1330295 1097327 232968 0 232968 232968 13490 609590 0 -596100 -596100 -596100 Settlement Proceeds 900099 5055365 5055365 Purchasing Co-Op Inc 561499 2111255 2040688 70567 Parking Income 812930 1219559 1219559 1489499 1489499 0 0 9875678 1798219082 1784105051 5669848 -363132 1999881 1999881 289206 289206 495095596 495095596 33261386 33261386 61568819 61568819 33854238 33854238 7700498 7700498 135287759 135287759 0 0 8469972 8469972 21189478 21189478 762121 762121 36660627 36660627 58955796 58955796 11512305 11512305 Medical Supplies 388292155 388292155 Allocated Support 152901868 123850513 29051355 Bad Debt 54916368 54916368 Provider Tax 20129732 20129732 15452456 15452456 0 0 1538300261 1509248906 29051355 0 41394 54780 218135155 218152500 0 0 0 45577954 48072804 1666250 2365268 1439580335 830246886 596166510 609333449 0 0 7445984 7445984 847698420 1100600621 1716731667 1986025406 86831831 88956693 33327542 40771970 120159373 129728663 X 1591806040 1851180344 4766254 5116399 1596572294 1856296743 1716731667 1986025406 X 259918821 -194372 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 66834 66834 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 $66,834 IS SPENT ON LOBBYING. 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 $66,834 IS SPENT ON LOBBYING. 18722595 31092 987970 898627 18843030 20430388 -86737 -772654 848402 18722595 20805488 -90195 489431 774336 20430388 17481086 1923249 1984289 583136 20805488 16388339 -79862 1540851 368242 17481086 0.0 0.9594 0.0406 false false 25560360 25560360 743414659 322129470 421285189 611510345 501313197 110197148 59094971 6804219 52290752 609333449 RECEIVABLE FROM AFFILIATE 1062948333 PHYSICIAN GUARANTEE ASSET INVESTMENT IN PREMIER PURCHASING PARTNERS LP 37191725 MISCELLANEOUS RECEIVABLES 460563 1100600621 DUE TO THIRD PARTY PAYORS 33470261 PHYSICIAN GUARANTEE LIABILITY ASSET RETIREMENT OBLIGATION 7301709 40771970 1803815454 9565984 9565984 1794249470 3969612 3969612 1798219082 1547866245 9565984 9565984 1538300261 0 0 1538300261 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 AND SERVICES AND CAPITAL PROJECTS FOR THE BENEFIT OF NORTON HOSPITALS, INC. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 Rental expenses-salaries - 181716 Rental expenses-other - 915611 Rental income-Internal - 8106924 Gain/Loss on sale of assets - 596100 Fees and Special Services - -234367 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements Contributions & Grants - 7432844 Assets Released-Programs - -3279881 Assets Released-Financial Asst - -160490 Assets Released-PP&E - -3456106 Equipment Contribution Rec'd - 3433245 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 Rental expenses-salaries - 181716 Rental expenses-other - 915611 Rental income-internal - 8106924 Gain/loss on sale of assets - 596100 Fees and special services - -234367 true true X true X 300 false true true true false true true 9330606 1829528 7501078 0.0051 416139696 318968099 97171597 0.0655 671925 4169602 0 0.0 0 0 426142227 324967229 104672675 0.0706 10564448 2281220 8283228 0.0056 40892045 4601552 36290493 0.0245 0 0 0 0.0 2624845 0 2624845 0.0018 2576244 0 2576244 0.0017 0 0 56657582 6882772 49774810 0.0336 0 0 482799809 331850001 154447485 0.1041 0 0.0 0 0.0 1458073 0 1458073 0.0010 0 0.0 0 0.0 0 0.0 185 0 185 0.0000 850 0 850 0.0000 0 0.0 0 0 1459108 0 1459108 0.0010 true 54916368 1769410 333181733 338131360 -4949627 X true true 5 1 Norton Hospital 200 E Chestnut St Louisville KY 40202 http://www.nortonhealthcare.com/nortonhospital 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 http://www.nortonhealthcare.com/pages/nwch.aspx 100255 X X X X A 4 Norton Audubon Hospital One Audubon Plaza Drive Louisville KY 40217 http://www.nortonhealthcare.com/NortonAudubonHospital 100252 X X X X A 5 Norton Brownsboro Hospital 4950 Norton Healthcare Blvd Louisville KY 40241 http://www.nortonhealthcare.com/nortonbrownsborohospital 100475 X X X A A false false true X X X X X X X X X 16 true true true true X nortonhealthcare.com/pages/communityneeds.aspx true 16 true nortonhealthcare.com/pages/communityneeds.aspx false true X 300.0 X X X true true X 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 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. THE LOUISVILLE AREA HOSPITALS COLLABORATED WITH LOUISVILLE METRO GOVERNMENT TO CONDUCT THE COMMUNITY WIDE HEALTH SURVEY AND FOCUS GROUPS. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - All Hospitals. CHANGING MARKET DEMOGRAPHICS - NORTON HOSPITALS, INC. (NHI) HAS A SMALL BUT GROWING IMMIGRANT POPULATION IN THE IN RESPONSE TO THIS, NHI HAS ENHANCED RECRUITING EFFORTS WITH A FOCUS ON INCLUSIVENESS AND ENSURING THAT THE WORKFORCE IS CONSISTENT WITH THE PATIENTS WE SERVE IN THE COMMUNITY AND REGION. NHI HAS INCORPORATED DIVERSITY AND INCLUSION TRAINING INTO THE ORIENTATION PROCESS FOR NEW HIRES, AS WELL AS UTILIZING PATIENT FAMILY ADVISORY COUNCILS TO IDENTIFY PROCESS AND SERVICE IMPROVEMENTS. NHI HAS INITIATED EMPLOYEE RESOURCE GROUPS WITHIN THE ORGANIZATION TO ENHANCE ASSIMILATION WITH NHI AND THE COMMUNITY. POVERTY LEVELS - NHI FACILITIES ACCEPT ALL PATIENTS, IRRESPECTIVE OF THEIR ABILITY TO PAY. NHI HAS A CAPITATION CONTRACT WITH PASSPORT FOR OUR COMMUNITY TO CARE FOR QUALIFIED MEDICAID PATIENTS. NHI ALSO HAS A RIGOROUS CHARITY POLICY WITH REPRESENTATIVES WHO ASSIST THOSE PATIENTS AND FAMILIES AS NEEDED TO ENSURE ALL POTENTIAL RESOURCES ARE AVAILABLE TO THEM WHEN CARE IS PROVIDED. LANGUAGE - NHI HAS MANY EMPLOYEES THAT SPEAK SPANISH AND OTHER FOREIGN LANGUAGES. WE CONTRACT WITH A SERVICE TO PROVIDE TRANSLATIONAL SERVICES TO FACILITATE CARE DELIVERY. EDUCATION - NHI PROVIDES EXTENSIVE EDUCATIONAL OFFERINGS AND LEADERSHIP DEVELOPMENT PROGRAMS, AS WELL AS EDUCATIONAL ASSISTANCE, FOR ALL EMPLOYEES AT NO ADDITIONAL COST TO THE EMPLOYEE. THESE PROGRAMS ARE PROVIDED THROUGH THE NORTON UNIVERSITY AND NORTON INSTITUTE FOR NURSING. PROGRAMS ARE EVALUATED ANNUALLY TO DETERMINE GAPS AND FUTURE PROGRAM OPPORTUNITIES IN COLLABORATION WITH NORTON UNIVERSITY LEADERSHIP. TEEN BIRTHS - THE BIRTH RATE FOR TEENAGERS IN THE LOUISVILLE METRO AREA IS ABOVE THE NATIONAL AVERAGE OF 42.5. AS A LEADING PROVIDER FOR BIRTHING SERVICES IN THE COMMUNITY AND THE PREMIER PROVIDER OF PEDIATRIC SERVICES, CONTINUING TO PROMOTE HEALTH AWARENESS AS IT RELATES TO PREGNANCY PREVENTION ALTERNATIVES IS AN AREA OF RESPONSIBILITY FOR OUR ORGANIZATION. NHI HAS EXPANDED MATERNAL FETAL MEDICINE LOCATIONS, NOW UTILIZING TELEMEDICINE TOOLS TO BROADEN ACCESS. NHI ALSO CONTINUES TO EXPAND CLINICAL AFFILIATIONS WITH RURAL PROVIDERS. NHI CONTINUES TO SUPPORT EDUCATION AND AWARENESS OF PREGNANCY PREVENTION ALTERNATIVES FOR THE COMMUNITY, INCLUDING EDUCATIONAL OFFERINGS THROUGH THE MARSHALL WOMEN'S CENTER LOCATED ON OUR ST. MATTHEWS CAMPUS. PRENATAL CARE, LOW BIRTH WEIGHT AND INFANT MORTALITY - IN KENTUCKY, LOW BIRTH WEIGHT BABIES EXCEED THE NATIONAL AVERAGE BY ONE PERCENTAGE POINT AND INFANT MORTALITY RATES ARE SLIGHTLY HIGHER THAN THE NATIONAL AVERAGE. NHI IS COMMITTED TO ESTABLISHING A MATERNAL FETAL MEDICINE CENTER OF EXCELLENCE FOR THE STATE AND REGION TO ENSURE THE FEMALE POPULATION HAS ACCESS TO CLINICAL RESOURCES FOR THE BEST POSSIBLE CARE AND OUTCOME FOR THEIR BABY. PART OF THIS INITIATIVE INVOLVES EDUCATION ON PRENATAL CARE AND THE VALUE OF THESE EFFORTS TO REDUCE LOW BIRTH WEIGHT BABIES AND OTHER COMPLICATIONS. PRENATAL CLASS OFFERINGS ARE AVAILABLE AT MULTIPLE LOCATIONS IN THE COMMUNITY. ADDITIONALLY, NHI PROVIDES CLINICAL RESOURCES TO THE SHAWNEE CHRISTIAN COMMUNITY AND PARK DUVALLE COMMUNITIES TO FURTHER PROMOTE HEALTH AND WELLNESS. DIABETES - THE DIABETES PATIENT POPULATION CONTINUES TO GROW IN KENTUCKY AND MORTALITY RATES FOR THE STATE AND LOUISVILLE METRO CONTINUE TO EXCEED NATIONAL AVERAGES. NHI HAS A FOCUSED PROGRAM AT OUR CHILDREN'S HOSPITAL TO PROMOTE EDUCATION AND AWARENESS WHILE UTILIZING PROTOCOLS FOR EARLY DETECTION OF PATIENTS WITH DIABETES. ADDITIONALLY NHI'S CLINICAL EFFECTIVENESS TEAM UTILIZES BEST PRACTICE CLINICAL PROTOCOLS TO IDENTIFY DIABETES PATIENTS AND RECOMMEND THEM TO A SPECIALIST FOR ONGOING CARE MANAGEMENT TO IMPROVE PATIENT HEALTH. OBESITY, NUTRITION & EXERCISE - OBESITY HAS BECOME A SIGNIFICANT HEALTH ISSUE FOR THE LOUISVILLE AREA AS WELL AS THE STATE. The number of served OBESE PATIENTS HAs INCREASED BY MORE THAN 350,000 OVER THE LAST 10 YEARS. FURTHER, ALMOST TWO THIRDS OF THE POPULATION IN THE AREA REPORT THEY ARE OVERWEIGHT, AND HALF OF THOSE REPORT THAT THEY ARE OBESE. NHI FEELS A RESPONSIBILITY TO THE CHILDREN OF OUR COMMUNITY TO PROMOTE HEALTHY FOOD CHOICES AND RECREATIONAL ACTIVITIES AS THE STATE'S EXPERT IN PEDIATRIC SERVICES. AS PART OF OUR ONGOING PEDIATRIC SERVICES, WE CURRENTLY PROVIDE NUTRITIONAL GUIDANCE FOR OUR PATIENTS AND FAMILIES. NHI HAS A BARIATRIC CENTER THAT PROVIDES EXERCISE AND NUTRITION PROGRAMS. BARIATRIC SURGICAL CANDIDATES PARTICIPATE IN AN EDUCATION PROGRAM PRIOR TO THE PROCEDURE TO ENSURE SUCCESS IN MAINTAINING A HEALTHY WEIGHT FOLLOWING THE PROCEDURE. NHI HAS ESTABLISHED A FOCUSED PREVENTION AND WELLNESS SERVICE LINE TO ENCOURAGE HEALTHY BEHAVIOR AND TAKE ADVANTAGE OF SCREENINGS AND OTHER PREVENTION ACTIVITIES TO FACILITATE EARLY DETECTION OF CHRONIC CONDITIONS AND RELATED RISK FACTORS. NHI WILL CONTINUE TO EXPAND OUR GEOGRAPHIC REACH FOR THESE PROGRAMS AS FEASIBLE. CANCER INCIDENCE & MORTALITY - THE INCIDENCE AND MORTALITY RATES FOR ALL CANCERS ARE WELL ABOVE THE NATIONAL AVERAGE. NHI HAS A STRONG DEPTH AND BREADTH OF SUBSPECIALISTS IN THE AREA OF ONCOLOGIC CARE WITH NORTON CANCER INSTITUTE (NCI). WE OPERATE KENTUCKY'S ONLY ACCREDITED NETWORK CANCER CENTER AND UTILIZE EVIDENCE BASED CLINICAL PROTOCOLS AND PATHWAYS TO ENHANCE THE QUALITY OF LIFE AND SURVIVORSHIP OF OUR CANCER PATIENTS. AS DEMONSTRATED BY OUR PUBLICLY AVAILABLE QUALITY REPORT, NHI'S SURVIVAL RATES ARE NEAR OR EXCEEDING NATIONAL RATES IN ALMOST EVERY CANCER CONDITION AND STAGE LEVEL. NHI HAS EXPANDED CLINIC SITES TO ADDITIONAL SERVICE AREAS OUTSIDE OUR PRIMARY SERVICE AREA TO BRING NEEDED SCREENING AND INTERVENTION SERVICES TO THEIR COMMUNITIES. IN ADDITION, NHI IS WORKING TO ASSESS COMMUNITY HEMOGLOBINOPATHY NEEDS TO PROMOTE EARLY DETECTION OF SICKLE CELL PATIENTS. LUNG CANCER - THE INCIDENCE RATES FOR LUNG CANCER ARE AMONG THE HIGHEST IN THE NATION FOR KENTUCKY. THE SURVIVAL RATE UNFORTUNATELY LAGS NATIONAL AVERAGES SIGNIFICANTLY. NHI HAS IMPLEMENTED A LUNG CT SCREENING PROGRAM TO FACILITATE EARLY DETECTION. NHI ALSO OFFERS TOBACCO AND SMOKING CESSATION CLASSES. IN ADDITION, A MULTI-DISCIPLINARY PROGRAM WAS ESTABLISHED IN PARTNERSHIP WITH PULMONARY LEADERSHIP TO ADDRESS COMPREHENSIVE PATIENT NEEDS. CHILDREN'S INJURY PREVENTION - NHI PROVIDES INJURY PREVENTION SERVICES INCLUDING CAR SEAT CHECKS, HELMET DISTRIBUTION, SAFE SLEEP EDUCATION AND SAFE KIDS COALITIONS. TO HELP REDUCE INJURIES PRESENTING TO THE EMERGENCY ROOM, NHI WORKS WITH EXTERNAL PARTNERS, INCLUDING JEFFERSON COUNTY PUBLIC SCHOOLS, TO PROVIDE EDUCATION AND ACCESS TO INJURY PREVENTION SERVICES. BREAST CANCER - NHI HAS MULTIPLE ACCESS POINTS FOR MAMMOGRAPHY SCREENINGS AND OTHER PREVENTION AND WELLNESS ACTIVITIES. NHI HAS IMPLEMENTED A BREAST HEALTH PROGRAM TO IMPROVE SERVICE OPTIONS FOR PATIENTS, TO STREAMLINE SCREENING ACTIVITIES AND PROVIDE A SINGLE ACCESS POINT TO EVALUATE CARE AND TREATMENT OPTIONS. PROSTATE CANCER - NCI PROVIDES PROSTATE SCREENINGS THROUGH VARIOUS VENUES, INCLUDING OUR MOBILE HEALTH UNIT IN UNDERSERVED AREAS, AS WELL AS OTHER ROUTINE HEALTH FAIRS WHERE SCREENINGS ARE OFFERED. NHI PROVIDES COMPREHENSIVE SERVICES, BEING THE FIRST IN THE COMMUNITY TO PROVIDE RADICAL PROSTATECTOMIES WITH THE DAVINCI ROBOT, PRESERVING TISSUE AND IMPROVING RECOVERY TIME. HEART DISEASE MORTALITY - NHI'S CARDIOVASCULAR PROGRAM HAS SPECIFIC INITIATIVES TO EXPAND ADVANCED IMAGING TO IMPROVE DIAGNOSIS RATES. FURTHER, OUR CLINICAL PROGRAMS ARE FOCUSED AROUND QUALITY INITIATIVES AND CONTINUOUS ENHANCEMENT OF BEST PRACTICES AND PROTOCOLS. NHI CONTINUES TO STRIVE FOR CLINICAL PROGRAM EXCELLENCE THROUGH ATTAINMENT OF ADVANCED ACCREDITATION LEVELS WITH NATIONAL AUTHORITIES AND WILL CONTINUE ENHANCEMENT OF OUR WORKFORCE AND PROGRAMS TO MEET COMMUNITY NEEDS. NHI HAS IMPLEMENTED A HEART FAILURE CLINIC UTILIZING ARNP'S FOR MANAGEMENT OF HIGH RISK PATIENTS. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) - AS A LEADING STATE FOR THE PROVISION OF TOBACCO AND WITH MULTIPLE INDUSTRIAL PROVIDERS IN THE COMMUNITY, KENTUCKY'S INCIDENT RATES FOR COPD ARE EXCESSIVE. 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 HOSPITALS AND AMBULATORY FACILITIES. NHI'S PREVENTION AND WELLNESS TEAM CONTINUES TO EXPAND SCREENING EFFORTS TO IDENTIFY THESE CHRONIC PATIENTS. IN ADDITION, OUR CARE MANAGEMENT TEAM HAS ESTABLISHED AND WILL CONTINUE TO IMPROVE UPON BEST PRACTICE PROTOCOLS FOR EFFECTIVE MANAGEMENT OF COPD PATIENTS. SYSTEM WIDE ICU/TCU ADMISSION CRITERIA ARE UTILIZED AND A COMPREHENSIVE CARE MODEL ENCOMPASSING HOSPITALISTS, PULMONARY SPECIALISTS AND CRITICAL CARE NP'S IS IN DEVELOPMENT TO IMPROVE CARE AND OUTCOMES FOR PATIENTS. Schedule H, Part V, Section B, Line 15 Facility A, 1 Facility A, 1 - ALL HOSPITALS. SEE RESPONSE TO PART VI, LINE 3; PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. 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. 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's parent corporation, Norton Healthcare, Inc. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH Four faith community nurses earned a new certification available through the American Nurses Credentialing Center (ANCC). Through a Norton Healthcare Foundation grant of $4,650.00, certification fees were covered. Mentored closely by FHM, all four earned the faith community nurse certification. Through Norton Faith and Health Ministries, a total of nine nurses have earned their RN-BC. Norton Heart Care Norton Heart Care provides the region's most comprehensive screening, education and prevention program and is committed to educating our community about heart health and risk factor management. In 2016: * Norton Women's Heart & Vascular Center offered its free Circle of Hearts program, a quarterly heart disease and prevention class that focuses on heart health education and other wellness issues of interest to women and also offered Yoga and Tai Chi classes. * Norton Women's Heart & Vascular Center attended heart health community events, including health fairs, presentations and speaking engagements representing businesses, churches, women's groups and health care professionals. * At Norton Women's and Norton Children's Hospital women who had experienced pregnancy-related complications were visited by a registered nurse who provided heart health education, resource referrals and a baby blanket, including a Go Red for Women message. * Norton Women's Heart & Vascular Center offers the only WomenHeart Support group in Kentucky, and Norton Heart Care is the only hospital in Kentucky to be a WomenHeart National Hospital Alliance Member. WomenHeart is the national coalition for women living with cardiovascular disease and is the only patient-centered program offering support and education for women living with cardiovascular disease. Norton Heart Care supported two women heart survivors and sent them to the Mayo Clinic to be trained at the WomenHeart Symposium to provide support and education to our Norton Heart Care patients and to the women in our community living with cardiovascular disease. In 2016, the WomenHeart program provided: * The monthly WomenHeart Support Group is offered at the Marshall Women's Health and Education Center. It is led by the WomenHeart Champions and a nurse from the Women's Heart and Vascular Center, who provide emotional support as well as education on healthy nutrition, exercise, and stress management. * The WomenHeart Champions provide support and education to women preparing to undergo cardiac surgeries or procedures and also to women who were in the recovery phase of their cardiac surgery or procedure. * The WomenHeart Champions attend community events, health fairs, and providing educational presentations to businesses, churches, women groups, and healthcare professionals. Norton Orthopaedic Care * Norton Orthopaedic Care earned The Joint Commission's Gold Seal of Approval for knee and hip replacement. This recognition confirms Norton Orthopaedic Care provides a consistently high level of quality care, expert training on best practices, a team approach to patient care and a culture of excellence throughout Norton Healthcare hospitals and doctors' offices. * Norton Orthopaedic & Hand Center near the campus of Norton Brownsboro Hospital is a state-of-the-art facility with specialists of Norton Orthopaedic Care, Norton Sports Health and Norton Healthcare to provide a multidisciplinary approach to innovative orthopaedic care. The facility supports research, training and education. It also offers patients subspecialized trained orthopaedists, a Norton Immediate Care Center with a focus on orthopaedics, rehabilitation services, advanced sports training and primary care services with an emphasis on orthopaedics. Women's services * In 2016, Norton Women's Care birthing facilities at Norton Hospital and Norton Women's and Children's Hospital provided the care and medical services for 7,932 deliveries. * Free childbirth education classes were provided at Norton Hospital and Norton Women's and Children's Hospital. Office of Child Advocacy * Norton Children's Hospital is home to the Kentucky Poison Control Center. In 2016, the center received more than 50,000 calls and made nearly 37,000 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 30,000 prevention education resources to physicians' offices, health departments and schools and more than 1,400 packets of materials to individuals who called the toll-free Poison Help Line, (800) 222-1222, available 24 hours a day, 7 days a week. * Child passenger safety technicians from Norton Children's Hospital check car and booster seats and provide car and booster seats at free checkup clinics statewide. * Norton Children's Hospital's Bike Rodeo Program saw students grades three through five throughout Kentucky and provided bike safety "rodeos." * Following interactive classroom lessons on pedestrian safety elementary school students and teachers participated in "Safe Kids Walk This Way," a program led by Norton Children's Hospital. The program is designed to reduce the number of pedestrian injuries. * Norton Children's Hospital's "Just for Kids" Transport Team transports babies and children from across the region to Norton Children's Hospital. Transportation was provided by airplane, helicopter and specially equipped ambulances (mobile intensive care units). * Kindergarten students, teachers, chaperones and nursing students participated in the 33rd annual Children & Hospitals Week event led by Norton Children's Hospital. The program was held at Louisville Slugger Field and supported by a Kohl's Cares grant. Children & Hospitals Week, held each year in March, is designed to teach safe decisions and behaviors and help lessen the fear and anxiety children may have about coming to a hospital. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH Norton Neuroscience Institute 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 allows patients to be treated for neurological disorders without having to leave the region for care. Subspecialty neurosurgeons, neurologists and other neurological-related specialists have joined the growing institute. These physicians and advanced level practitioners provide expertise in stroke care, epilepsy, Parkinson's disease, multiple sclerosis, ALS, brain tumors, headaches, concussions, spine care and many other neurological conditions. The following services also are available to our community as a result of Norton Healthcare's significant commitment to the best neurological care: * An endovascular neurosurgery team is available at two Norton Healthcare facilities, making advanced stroke, aneurysm and arteriovenous malformation (random brain hemorrhage or rupture) treatment possible for our patients. Neurosurgery teams are on call and cover all facilities for emergency situations. * A state-of-the art epilepsy center at Norton Brownsboro Hospital provides the region's most advanced epilepsy monitoring unit and is dedicated to providing accurate diagnoses and quality care for individuals living with seizures and epilepsy. As part of Norton Neuroscience Institute's multidisciplinary approach to epilepsy care, the Norton Brownsboro Hospital epilepsy monitoring unit is a specialized inpatient unit designed to evaluate and diagnose seizure disorders. Norton Neuroscience Institute has expanded the treatment options in neurosurgery treatment for patients with brain tumors, lesions and epilepsy to offer less invasive surgical options. With the use of a robotic neurosurgery technology a robotic arm assists the neurosurgeon in pinpointing a trajectory in the brain of where their treatment needs to be targeted. Taking that technology a step further, once the trajectory is set, the neurosurgeon can use image-guided laser technology to treat brain tumors and lesions in the brain. All of this is done through a small incision about the size of a spaghetti noodle. It is more comfortable for the patient and reduces the recovery time. * A centralized Norton Neuroscience Institute Resource Center is available to patients, offering free education and support services. The resource center offers support services and resources to bridge the gap between managing a neurological condition and improving the quality of life. The center offers support groups, educational, therapeutic and exercise programs. The center may also assist with access to medical care and medical equipment and referrals to community and home health services. In addition, patients have access to National Institutes of Health clinical trials through the center. * The region's first rehabilitation program focused on treating patients with orthopedic, neurological and spine disorders has the only Lokomat system and the DIERS formetric scanner. Lokomat assists with walking movements for patients receiving therapy for paralysis or movement disorders and Norton Healthcare is the only facility in Louisville to offer this treatment. DIERS formetric scanner is used for spine and posture analysis. Norton Healthcare is the only healthcare system in the region to provide this state of the art technology. Prevention and Wellness * In 2016, the Norton Healthcare Prevention & Wellness staff provided cancer screenings and/or cardiovascular screenings involving the Norton Healthcare Mobile Prevention Center. Approximately 2,400 women received mammograms and/or Pap smears aboard the Mobile Prevention Center. Of them, approximately 22 percent had not been screened in the past five years. 15 individuals were diagnosed and treated for pre-invasive and invasive breast cancer. Approximately 52% percent of these locations were in underserved communities and 64 percent of patients came from medically underserved areas. * Screenings were performed for high blood pressure, diabetes, high cholesterol and osteoporosis. In addition, our staff provided education on smoking cessation, diet and exercise. Research * Our research benefits Norton Healthcare patients and develops results 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. * Norton Healthcare Office of Research Administration partnered with Norton University to offer research education to all researchers in Metro Louisville and beyond. In 2016, programs were offered and attendees included Norton Healthcare, KentuckyOne Health, University of Louisville Hospital, Floyd Memorial Hospital, Cincinnati Children's Hospital Medical Center, St. Vincent Health, University of Kentucky, University of Louisville and various community-based practices. 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 Bad Debt Expense excluded from financial assistance calculation 54916368 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 HOSPITAL LOCATIONS UNDER ONE MEDICARE PROVIDER NUMBER). THE COST WAS DETERMINED BASED ON A SPECIFIC LOCATION COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS ADJUSTED FOR BAD DEBT EXPENSE AND OTHER COSTS. THE COST USED IN THE CALCULATION WAS REDUCED BY BAD DEBT EXPENSE, 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 AMOUNTS PRESENTED ARE BASED ON ACTUAL AMOUNTS SPENT FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE BAD DEBT EXPENSE IS BASED ON THE NET ESTIMATED AMOUNT EXPECTED TO BE DUE FROM THE PATIENT/PAYOR. BAD DEBT EXPENSE FALLS INTO THREE CATEGORIES, TRUE SELF PAY, PATIENT RESPONSIBILITY AFTER INSURANCE, AND OTHER. -TRUE SELF PAY - FOR TRUE SELF PAY PATIENTS, THE SELF PAY DISCOUNT IS APPLIED TO THE ACCOUNT ASSUMING THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. THE BAD DEBT EXPENSE WRITE-OFF IS THE DISCOUNTED AMOUNT LESS ANY PAYMENTS MADE BY THE PATIENT. -PATIENT RESPONSIBILITY AFTER INSURANCE - THE BAD DEBT EXPENSE WRITE-OFF FOR PATIENT'S RESPONSIBILITY AFTER INSURANCE IS BASED ON THE PATIENT'S LIABILITY PER THE EXPLANATION OF BENEFITS AND CONTRACT WITH THE INSURANCE COMPANY. THE BAD DEBT EXPENSE WRITE-OFF IS THE EXPECTED AMOUNT DUE LESS ANY PAYMENTS MADE BY THE PATIENT. -OTHER - THE OTHER CATEGORY IS FOR INSURANCE AMOUNTS DUE FROM PAYORS. MOST EXPECTED PAYMENTS NOT RECEIVED FROM AN INSURANCE COMPANY AFTER INVESTIGATION INTO PAYMENT DIFFERENCES ARE WRITTEN OFF TO CONTRACTUAL ALLOWANCE/DENIAL CATEGORY. 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 HOSPITAL, 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 65% 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 PROGRAM IS CALCULATED BASED ON GROSS CHARGES FOR ACCOUNTS FOR THE YEAR THAT ARE PROBABLE, BUT DON'T SUBMIT THE NECESSARY DOCUMENTATION MULTIPLIED TIMES OUR COST TO CHARGE RATIO TIMES THE 65% ESTIMATED CONVERSION FACTOR. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITEOFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. 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 THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS 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 ATTEMPTS ARE MADE TO CONTACT THE PATIENT TO GET THE NECESSARY DOCUMENTATION FOR COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AND THE PATIENT NOT RESPONDING, WILL COLLECTION EFFORTS BEGIN. THERE IS AN ONGOING EFFORT THROUGHOUT THE COLLECTION PROCESS TO SCREEN FOR MEDICAID ELIGIBILITY, DSH, 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 NORTON HOSPITALS, INC. (NHI) REGULARLY AND CONSISTENTLY EVALUATES WORKFORCE AND COMMUNITY HEALTH CARE NEEDS THROUGH PARTNERSHIPS WITH LOCAL HEALTH DEPARTMENTS, EMERGENCY MEDICAL SERVICE, 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. NHI CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR ALL HOSPITALS. THE CHNA DEFINED THE PATIENT SERVICE AREA BY PATIENT ORIGIN FOR INPATIENT STAYS. DEMOGRAPHIC, SOCIOECONOMIC, POPULATION, AND OTHER HEALTH RELATED INDICATORS WERE UTILIZED TO PROVIDE INFORMATION ON THE HEALTH STATUS OF THE COMMUNITY. COMMUNITY INPUT WAS PROVIDED THROUGH COMMUNITY FORUMS AND A COMMUNITY HEALTH SURVEY WAS WIDELY DISTRIBUTED BY THE LOUISVILLE 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 ORGANIZATION'S STRATEGIC PLANNING PROCESS AS RESOURCES ARE NECESSARY TO IMPLEMENT STRATEGIES OUTLINED FOR PRIORITIES IDENTIFIED. NORTON HEALTHCARE, INC. (NORTON) BOARD OF TRUSTEES AS WELL AS THE LEADERSHIP OF NORTON AND HOSPITAL CHIEF ADMINISTRATIVE 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. (Norton) 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 different languages and all languages are contained on the same poster. Those languages are: English, Spanish, Vietnamese, Serbo-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 Norton Eligibility vendor for assistance at no cost to the patient/guarantor. Additional questions from the patient/guarantor can be facilitated through the Norton Single Billing Office (SBO) area, Customer Service, and Norton Vendors. Norton has created a number of different options for the patient/guarantor to supply the information/application for financial assistance to Norton. 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 2016, 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 adult facilities are placed for eligibility screening with Medassist/Firstsource. They screen for: Norton Healthcare, Inc. (Norton) Financial Assistance, Medicaid , Medicaid Managed Care Organizations, Presumptive Eligibility, and DSH/KHCP. In addition, they also 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, themselves. 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 the patient's assigned 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 they are homebound as well as providing 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. NHI pays for these eligibility and enrollment services estimated to be in excess of $3,500,000 per year. NHI has a staff of 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 that are received each week. Additionally, some of those employees make out-bound calls to solicit financial assistance applications from our hospital patients, as well as requesting additional 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 that their deductibles, co-payments, and co-insurance amounts are covered under the various assistance programs. Financial Counselors/Social Workers at the adult facilities as well as Norton Children's Hospital 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 year regarding eligibility changes and additions for Norton Financial Assistance, DSH/KHCP, Medicaid, Medicaid Managed Care Organizations, Presumptive Eligibility, etc. As the Foundation Office receives inquiries in their offices, they refer these individuals to Patient Financial Services to screen for possible financial assistance. If a child's account does not qualify for Norton Financial Assistance, then those denied children's applications are referred to management of Patient Financial Services for consideration for special funding through The Children's Hospital Foundation, Inc. as well as other programs. The charity application was provided on the back of the SBO statement in 2016. NHI made a conscientious effort to ensure 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 that they will now cooperate (even if a year or more into the collection stream), then NHI would allow the patient/guarantor to apply and would approve if they met the qualifications. Financial Assistance notifications and applications were made available to the patient/guarantor via telephone, website notification, mail, electronically, etc. Collection agencies chosen by NHI print on the back of their initial placement letter or an insert is mailed with the initial placement letter, a copy of the financial assistance application for the guarantor to complete. The initial notification letter sent by the collection agencies (that is required by the fair debt collection practices act) to the guarantor is also written in Spanish that alerts guarantors to contact a specific number to speak with a Spanish-speaking representative that will also provide financial assistance: or, the customer service phone number contained on the initial notification may not be written in Spanish but the phone number allows for the patient to request to speak with a Spanish-speaking representative who could supply financial assistance information. NHI has translated a financial assistance letter in Spanish and Vietnamese. The letter and the application are made available to the collection agencies. NHI Customer Service Department routinely instructs and screens patients in the protocol regarding financial assistance through Norton Financial Assistance. Since 2007, NHI has offered at the time of final billing all true hospital self-pay patients a significant discount off of total charges that were reflected on their monthly statements. Contracted collection agencies are required to solicit charity applications when the guarantor/patient indicates "cannot pay". THE STATEMENTS PROVIDED BY NHI IN 2016: included THE LINK TO THE NORTON HEALTHCARE, INC. (NORTON) WEBSITE TO LEARN MORE ABOUT FINANCIAL ASSISTANCE; CONTAINED THE FINANCIAL ASSISTANCE APPLICATION ON THE BACK OF THE STATEMENT SO THE GUARANTOR COULD APPLY USING THE ACTUAL NORTON STATEMENT AND COULD THEN MAIL, FAX, OR EMAIL THE FORM TO NORTON; AND 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 3% BETWEEN 2016 AND 2021. 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. 89% OF NHI'S PATIENTS ARE DERIVED FROM THIS SERVICE AREA. APPROXIMATELY 29% OF THE POPULATION IS OVER 55 YEARS OLD; COMPARED TO 28% IN THE USA. THIS PORTION OF THE POPULATION TENDS TO USE ADDITIONAL HEALTHCARE SERVICES. THE PEDIATRIC POPULATION IN 2016 WAS ESTIMATED AT 342,073 AND IS EXPECTED TO DECREASE TO 341,623 WITHIN 5 YEARS AND REPRESENTS 23% OF THE POPULATION. THE NUMBER OF HOUSEHOLDS IN THE PRIMARY SERVICE AREA WAS ESTIMATED AT 600,574 IN 2016 AND IS EXPECTED TO INCREASE 2.8% BY 2021. CURRENTLY 12% OF THE ADULT POPULATION DOES NOT HAVE A HIGH SCHOOL DEGREE AND 22.7% OF THE HOUSEHOLD INCOME IS LESS THAN $25,000 A YEAR; THE AVERAGE HOUSEHOLD INCOME IS $72,459 COMPARED TO $80,853 FOR THE UNITED STATES. NHI TREATS 38% OF THE ADULT INPATIENT CASES IN THE COMMUNITY AND ITS PAYOR MIX IS 50% MEDICARE, 25% MEDICAID/PASSPORT AND 2% SELF PAY. THE LARGEST COUNTY IN THE SERVICE AREA IS JEFFERSON COUNTY AND ITS MAY 2017 PRELIMINARY NON-SEASONALLY ADJUSTED UNEMPLOYMENT RATE WAS 4.3% COMPARED TO 4.7% FOR KENTUCKY AND 4.1% FOR THE UNITED STATES. 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 418,519 IN 2016 AND IS EXPECTED TO INCREASE 2.7% BETWEEN 2016 AND 2021. THE SECONDARY SERVICE AREA SPREADS ACROSS 15 KENTUCKY COUNTIES AND 2 INDIANA COUNTIES. THE 55+ AGE COHORT REPRESENTS 29.5% OF THE SECONDARY SERVICE AREA POPULATION AND IS SLIGHTLY HIGHER THAN IN THE UNITED STATES. THE PEDIATRIC POPULATION IN 2016 WAS ESTIMATED AT 94,046 AND EXPECTED TO INCREASE TO 94,121 BY 2021. ALTHOUGH THE PEDIATRIC POPULATION IS EXPECTED TO REMAIN RELATIVELY FLAT (LESS THAN 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 164,835 IN 2016 AND IS EXPECTED TO INCREASE 2.8% BY 2021. OVER 50,000 ADULTS IN THIS SERVICE AREA DO NOT HAVE A HIGH SCHOOL EDUCATION AND THE HOUSEHOLD INCOME IS UNDER $25,000 FOR 29.5% OF THE POPULATION. THE AVERAGE HOUSEHOLD INCOME IS $56,778, LESS THAN KENTUCKY AND 22% LESS THAN THE PRIMARY SERVICE AREA. Schedule H, Part VI, Line 5 Promotion of community health NORTON HEALTHCARE, INC. (NORTON), PARENT OF NORTON HOSPITALS, INC. (NHI), IS INDEPENDENTLY OVERSEEN BY A 23 MEMBER BOARD OF TRUSTEES. WITH THE EXCEPTION OF NORTON'S CHIEF EXECUTIVE OFFICER, NONE OF THESE INDIVIDUALS ARE EMPLOYEES OF THE ORGANIZATION. ALL MEMBERS OF THE BOARD RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. IN AN EFFORT TO ENSURE THE BEST CARE FOR PATIENTS, NHI GENERALLY EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS SERVICE LINES/DEPARTMENTS. IN FACT, MORE THAN 2,000 PHYSICIANS ARE ON NHI'S MEDICAL STAFF. A THIRD OF THE ORGANIZATION'S MISSION STATEMENT SPEAKS TO THE COMMITMENT TO PROVIDE QUALITY HEALTHCARE THAT "RESPONDS TO THE NEEDS OF OUR COMMUNITIES." NHI ORGANIZATIONAL VALUES DIRECTLY ADDRESS THE NEED TO "CONTINUALLY IMPROVE CARE AND SERVICES" WHILE "DEMONSTRATING STEWARDSHIP OF RESOURCES." AS AN ORGANIZATION COMMITTED TO THE CONSTANT UNDERSTANDING AND ASSESSMENT OF THOSE SERVED, INITIATIVES AND PROGRAMS THAT ADDRESS THESE CONSTITUENTS ARE DEVELOPED AND IMPLEMENTED. IN 2016 NHI'S TOTAL COMMUNITY BENEFIT WAS $156 MILLION, ALMOST $13 MILLION A WEEK, AND INCLUDES COMMUNITY INITIATIVES AND PROGRAMS SUCH AS FINANCIAL ASSISTANCE, CHARITY CARE, EDUCATIONAL SUPPORT, UNPAID COSTS OF MEDICAID SERVICES, CORPORATE SPONSORSHIPS, HEALTH PROGRAMS FOR FAITH COMMUNITIES, KENTUCKY POISON CONTROL CENTER AND CHILD GUIDANCE AND ADVOCACY PROGRAMS. NHI EMPLOYEES VOLUNTEERED FOR OVER 200 ORGANIZATIONS. NHI PARTNERS WITH OTHER NONPROFIT ORGANIZATIONS, LOCAL GOVERNMENT AND THE CENTERS FOR DISEASE CONTROL TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITY THROUGH EVIDENCE-BASED INITIATIVES. THE ORGANIZATION'S PUBLICLY ACCESSIBLE WEBSITE OFFERS AN ONLINE ASSESSMENT GUIDE TO IDENTIFY AND UNDERSTAND SYMPTOMS OF ILLNESS AND DISEASE. GET HEALTHY VIDEOS OFFER A VISUAL RESOURCE AND AID ABOUT MANY OF THE MOST WORRISOME HEALTH PROBLEMS IN THE COMMUNITY. THROUGHOUT THE YEAR FREE SEMINARS PLACE CLINICAL EXPERTS WITH COMMUNITY AUDIENCES ON SUCH TOPICS AS DIABETES, JOINT PAIN, WEIGHT MANAGEMENT, CANCER ASSESSMENTS - ALL CONDITIONS THAT KENTUCKY, UNFORTUNATELY, LEADS THE NATION IN HAVING. THE PUBLICLY AVAILABLE QUALITY REPORT ENSURES THAT THE COMMUNITY HAS ACCESS TO INFORMATION ABOUT THE QUALITY OF CARE PROVIDED BY THE ORGANIZATION. THIS DATA NOT ONLY EMPOWERS COMMUNITY MEMBERS, BUT ALSO DRIVES THE HEALTHCARE QUALITY AGENDA IN THE COMMUNITY. Contributions to the Community Norton Healthcare employees and physicians gave more than $988,000 to the 2016 Combined Giving Campaign to help support community organizations also committed to improving the health and well-being of community residents. Supported organizations include, the WHAS Crusade for Children, Metro United Way, Fund for the Arts, The Children's Hospital Foundation and Norton Healthcare Foundation. More than 100 Norton Healthcare employees "Raised the Roof" on a Habitat for Humanity house on Brentwood Avenue in Louisville, Ky. This is the ninth Habitat home Norton Healthcare employees have built. In 2016, more than 1,000 Norton Healthcare employees donated time and funds to plan, purchase and deliver gifts, food and clothing for the Caring Tree program. The program assisted 357 employees and their 813 children by providing for their families at Christmas. More than 41,700 pounds of usable surplus medical supplies valued at more than $668,000 and $92,000 in equipment were donated for use locally and around the world. NORTON EMPLOYEES DONATED 86,552 HOURS OF COMMUNITY SERVICE, A BENEFIT VALUED AT MORE THAN $1.4 MILLION. IN ADDITION, MANY EMPLOYEES SELF-REPORTED PERSONAL VOLUNTEER ACTIVITIES WHICH TOTALED OVER 6,000 HOURS OF SERVICE. Community Education and Workforce Development As one of Kentucky's largest healthcare systems, Norton Healthcare, Inc. has established a culture of continual, lifelong learning through the departments of Workforce Development, Norton Institute for Nursing and Norton University. Workforce Development, encourages continuing education, improves job performance and provides financial assistance for designated educational programs related to the business operations of the organization. Norton Healthcare encourages and supports employees and dependents career goals by providing financial assistance and scholarships as well as other advancement opportunities. In 2016, Workforce Development financially supported more than 800 students with nearly $6 million in educational assistance programs. Workforce Development Career Center served over 1,350 students. Each program participant worked directly with a Certified Career Management Coach, offering services in resume writing; career and educational exploration; financial assistance opportunities for educational pursuit; interviewing skills and mentoring. Norton Scholars Accelerated Program, a student loan program, for employees and non-employees, provides educational funding to students interested in pursuing designated healthcare careers. It is an affiliation between Norton Healthcare and over 100 colleges and universities nationally. This program has 2,572 graduates and 2,061 of these graduates have continued their careers with Norton Healthcare. Norton Healthcare, through Workforce Development, continues to partner with the city of Louisville through a summer job and internship program known as the Mayor Summers Work Program, to give young adults an opportunity to be employed in our healthcare environment during the summer months. The Student Nurse Apprenticeship program (SNAP) is a 12-to-18-month apprenticeship in which nursing students will work and engage in hands-on learning with an experienced mentor, in addition to becoming acclimated to Norton Healthcare. Top area student nurses with good grades, good references and a desire to be the best will gain the skills and the confidence to deliver quality patient care. Norton University provides learning opportunities to enhance the professional, educational, and personal development of all employees. Norton University's Value Proposition states "Norton University nurtures learning and relations to inspire change that leads to exceptional experiences for both patients and employees." In 2016, Norton University held 300,275 learning events, an average of 20 trainings per employee. In 2016, 139,372 web-based training courses and 62,769 instructor-led courses were completed by leaders and staff of all disciplines. Elevating the First Line Employee, School at Work and College at Work programs expose entry-level staff to healthcare careers and help them obtain a higher level position, GED or college degree. Leadership development programs that support the development of leaders (Nursing, Physician Practices, Physician and System) across the continuum. Organizational development activities that assist in creating a more effective and efficient workplace with highly engaged employees. Norton Faith and Health Ministries Norton Faith and Health Ministries (FHM) works with churches and faith communities to weave health and faith together, promoting the intentional integration of faith, healing and wellness through the development of health ministries. FHM provides mentoring, educational resources and networking opportunities to assist health ministry coordinators and faith community nurses minister to their churches. In 2016, the office mentored and served nearly 200 multi-denominational faith communities with active health ministry programs, and assisted many others with health and wellness efforts. FHM nurtured relationships with faith communities through participation in events by the Mid-Kentucky Presbytery, Lutheran Church, Central District Baptist Association, African American Episcopal Church Conference and the Episcopal Diocese of Kentucky Annual Convention, and consulted with United Methodist clergy regarding the development of a mobile medical unit. In order to advance congregational health ministries, faith community nursing and other health-related programs, FHM reached more than 40,850 contacts by distributing 22 electronic informational newsletters. At 74 faith community events, 5,780 people were provided health literacy education using educational tools loaned from FHM. At 176 events, 1,375 people were screened for asthma, blood glucose, blood pressure, body mass index and/or cholesterol, and often received counseling and referrals by faith community nurses. Twelve formal educational and networking events were held reaching 331 individuals. Schedule H, Part VI, Line 6 Affiliated health care system NORTON HEALTHCARE, INC. (THE CONTROLLING COMPANY) AND ITS AFFILIATES, INCLUDING NORTON HOSPITALS, INC., NORTON ENTERPRISES, INC., NORTON PROPERTIES, INC., THE CHILDREN'S HOSPITAL FOUNDATION, INC., NORTON HEALTHCARE FOUNDATION, INC., AND COMMUNITY MEDICAL ASSOCIATES, INC. OPERATE IN THE LOUISVILLE, KENTUCKY METROPOLITAN AREA AND THE OPERATIONS OF THE AFFILIATED HEALTHCARE SYSTEM INCLUDE 1,837 LICENSED BEDS, MORE THAN 195 PHYSICIAN PRACTICE AND 13 NORTON IMMEDIATE CARE CENTER LOCATIONS, AND OTHER ANCILLARY HEALTH CARE SERVICES. X true true true true false false false false false true false Stephen A Williams CEO/Trustee 0 1100643 0 648812 0 391317 0 58375 0 27325 0 2226472 0 156533 Russell F Cox President 0 775652 0 300166 0 256549 0 350179 0 31188 0 1713734 0 105296 Michael W Gough Sr VP CFO/Treasurer 0 637892 0 253405 0 223597 0 294872 0 22707 0 1432473 0 88892 Robert B Azar Sys VP Chief Legal Officer/Secretary 0 417886 0 167415 0 95448 0 109086 0 12564 0 802399 0 55868 John Harryman Former Hospital CAO 280612 0 92898 0 175279 0 58091 0 22490 0 629371 0 429750 0 Steven MacLauchlan Former Hospital President 0 0 0 0 128375 0 159 0 0 0 128534 0 124378 0 Steven Pursell VP Medical Director NCI 153178 0 6000 0 63582 0 3825 0 8094 0 234681 0 0 0 Thomas Kmetz Division President Women and Children Services 464367 0 135834 0 111731 0 131778 0 30713 0 874422 0 67444 0 Joseph Flynn Physician-in-Chief NCI 503569 0 0 0 15363 0 86729 0 27439 0 633100 0 0 0 Kevin Wardell Hospital CAO 16798 0 167915 0 310885 0 12994 0 8001 0 516592 0 249721 0 Charlotte Ipsan Hospital CAO 281446 0 84452 0 74129 0 79992 0 29660 0 549679 0 40320 0 Matthew Ayers Hospital CAO 293987 0 62631 0 48121 0 64694 0 23608 0 493040 0 0 0 Brian Stoll MD Physician 638119 0 124888 0 16575 0 13220 0 32965 0 825767 0 0 0 Aaron Spalding MD Physician 619960 0 124888 0 31372 0 18845 0 36509 0 831574 0 0 0 Michael Hahl MD Physician 623484 0 124888 0 21894 0 19333 0 32862 0 822461 0 0 0 Mark Cornett MD Physician 621794 0 124888 0 21661 0 24002 0 35312 0 827657 0 0 0 Yong Cha MD Physician 618453 0 124888 0 19638 0 13250 0 38973 0 815202 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. (NORTON) EXECUTIVES, EFFECTIVE OCTOBER 1, 2007. NORTON 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 NORTON 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 2016: Matthew Ayers - 10,000 Kevin Wardell - 673 John Harryman - 17,500 Thomas Kmetz - 17,500 Steven MacLauchlan - 673 Charlotte Ispan - 10,000 Joseph Flynn - 10,000 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation NORTON HEALTHCARE INC (NORTON) 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 NORTON; AN INDEPENDENT COMPENSATION CONSULTANT; 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 2016 by key employee: Steven MacLauchlan in the amount of $3,996.12 other compensation included in Schedule J column B(iii). Severance payment was received during 2016 by key employee: John Harryman in the amount of $334,509.68 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-FLEX BENEFIT PLAN, THE EXECU-PLUS BENEFIT PLAN, DEFINED BENEFIT AND DEFINED CONTRIBUTION RESTORATION PLANS, AND THE PHYSICIAN DEFERRED PLAN. THE "PAY CREDIT" OULINED 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 Stephen A. Williams - $ 37,614 Russell F. Cox - 184,624 Michael W. Gough - 151,419 Robert Azar - 89,124 Matthew Ayers - 45,533 Charlotte Ipsan -52,233 John Harryman - 30,193 Thomas Kmetz - 104,340 Joseph Flynn - 73,479 THE "PAYMENT RECEIVED" OUTLINED BELOW REPRESENTS CASH PAYMENTS THAT THE EMPLOYEE RECEIVED DURING 2016 AND CAN BE COMPRISED OF CURRENT AND OR PRIOR YEARS EMPLOYEE AND EMPLOYER CONTRIBUTIONS. NAME - PAYMENT RECEIVED Stephen A. Williams -$ 269,688 Russell F. Cox - 110,639 Michael W. Gough - 91,441 Robert Azar - 56,519 Matthew Ayers - 33,926 Charlotte Ipsan - 40,615 John Harryman - 127,004 Thomas Kmetz - 67,040 Steve MacLauchlan - 124,378 Kevin Wardell - 298,448 Schedule J, Part I, Line 7 Non-fixed payments In 2016, Norton Healthcare, Inc. (Norton) 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 Norton'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 NACAZEL FAMILY MEMBER OF RONALD LEHOCKY, TRUSTEE 80749 COMPENSATION false BARBARA KMETZ FAMILY MEMBER OF THOMAS KMETZ, KEY EMPLOYEE 82874 COMPENSATION false SIBYL CAGATA FAMILY MEMBER OF STEVEN PURSELL, FORMER KEY EMPLOYEE 106378 COMPENSATION false SARAH A ROBINSON FAMILY MEMBER OF DONALD H ROBINSON, TRUSTEE 19205 COMPENSATION false Form 990, Part V, Line 2a COMMON PAYING AGENT FOR EMPLOYEES NORTON HEALTHCARE, INC. (NORTON) EIN 61-102875 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. (NHI) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY NORTON ON BEHALF OF NHI. NHI HAS APPROXIMATELY 10,685 EMPLOYEES. Form 990, Part V, Line 1a COMMON PAYING AGENT 1099S NORTON HEALTHCARE, INC. (NORTON) 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 NORTON ON BEHALF OF NHI. FOR PURPOSES OF PART V, LINE 1, THE NUMBER OF 1099S REPORTED AND FILED FOR 2016 BY NORTON FOR NHI, WAS APPROXIMATELY 302. NHI HAS APPROXIMATELY 112 INDEPENDENT CONTRACTORS EXCEEDING $100,000 FOR 2016. 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., (NORTON) 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. NORTON 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 NORTON, AND (II) PROVIDE SECURITY FOR SUCH INDEBTEDNESS. Form 990, Part VI, Line 11b Review of form 990 by governing body AT THE OCTOBER 5, 2017 NORTON HEALTHCARE, INC. (NORTON) FINANCE COMMITTEE MEETING AND AT THE OCTOBER 26, 2017 NORTON 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. NORTON IS THE PARENT OF COMMUNITY MEDICAL ASSOCIATES, INC., NORTON HOSPITALS, INC., NORTON PROPERTIES, INC., NORTON HEALTHCARE FOUNDATION, INC., AND THE CHILDREN'S HOSPITAL FOUNDATION, 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 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. (Norton) engages an outside independent compensation consultant, Integrated Healthcare Strategies (IHS), to provide comparability data for Norton'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. IHS consultants presented and discussed this comparability data in 2015 for the 2016 compensation review and met in 2016 for the 2017 compensation review with the committee of board leadership (now 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 Norton'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 FINANCIAL STATEMENTS, 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. (Norton) 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 Norton. Norton'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, Norton 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 2016. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Meaningful Use Reimbursement - Total Revenue: 1295174, Related or Exempt Function Revenue: 1295174, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Misc - Total Revenue: 194325, Related or Exempt Function Revenue: 194325, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , 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 - -194372; 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) 9 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 HEALCARE 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 ENTERPRISES INC 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 611054301 PROVIDE NURSING AND PATHOLOGY SERVICES KY NA C Corporation false false true false false false false false false false true false false false true false false true true