2014-11-12T20:55:33-06:00 2013-12-31 CROWE HORWATH LLP 9600 BROWNSBORO ROAD SUITE 400 LOUISVILLE KY 402411122 990 2013-01-01 610703799 NORTON HOSPITALS INC NORT 5026298263 Accounting 224 E Broadway 5th Floor Louisville KY 40202 MICHAEL W GOUGH TREASURER 2014-11-10 true Rachel Spurlock P00520729 5023263996 2013 2015-11-30 17:44:51Z X STEPHEN A WILLIAMS 4967 US Highway 42 Suite 100 Louisville KY 40222 1508872926 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. 21 18 9279 1360 4774871 -125302 16909581 10915802 1464215618 1473153426 -1181382 13693517 6358578 9275001 1486302395 1507037746 0 0 0 0 538583528 546805416 0 0 0 822692692 823675843 1361276220 1370481259 125026175 136556487 1090945217 1238589907 85442814 96551521 1005502403 1142038386 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 1342163833 1476393376 NORTON HOSPITALS, INC. (NORTON) 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. NORTON HAS A TOTAL OF 1,837 LICENSED BEDS, NORTON HOSPITAL - 640 BEDS; KOSAIR CHILDREN'S HOSPITAL - 265 BEDS; NORTON AUDUBON HOSPITAL - 432 BEDS; NORTON SUBURBAN HOSPITAL - 373 BEDS; AND NORTON BROWNSBORO HOSPITAL - 127 BEDS. THESE HOSPITALS OPERATE TWENTY-FOUR (24) HOURS A DAY, SEVEN (7) DAYS A WEEK. IN 2013, NORTON'S HOSPITALS AND DIAGNOSTIC CENTERS SERVED 61,281 INPATIENTS, 419,595 OUTPATIENTS, AND 208,008 EMERGENCY ROOM VISITS. IN ADDITION, NORTON'S OPERATING ROOMS CARED FOR 18,110 INPATIENT SURGICAL PATIENTS AND 30,773 OUTPATIENT SURGICAL PATIENTS. ADDITIONALLY, 8,173 DELIVERIES WERE PERFORMED AT NORTON BIRTHING CENTERS. UNDER ITS CHARITY CARE PROGRAM, NORTON PROVIDED FREE CARE TO 789 PATIENTS, AT A COST OF $12.1 MILLION. ALSO, NORTON 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, 39,157 PATIENTS CARE AT DISCOUNTED RATES. OTHER CONTRIBUTIONS TO THE COMMUNITY WERE THE UNPAID COST OF MEDICAID AND THE KENTUCKY DISPROPORTIONATE SHARE PROGRAM SERVICES TOTALING $90.6 MILLION AND EDUCATIONAL SUPPORT OF $29.8 MILLION, PRIMARILY TO THE UNIVERSITY OF LOUISVILLE'S SCHOOL OF MEDICINE. ALSO, COMMUNITY HEALTH IMPROVEMENT SERVICES TOTALED $11.6 MILLION, CONTRIBUTIONS TO COMMUNITY GROUPS WERE $1.2 MILLION, PASTORAL CARE AND COUNSELING PROGRAMS WERE $1.7 MILLION, THE KENTUCKY POISON CONTROL CENTER WAS $2.1 MILLION, AND THE CHILD GUIDANCE AND ADVOCACY PROGRAM WAS $1.0 MILLION. 1342163833 true true false true false false false false false true false false true true true 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 false true X 312 0 true 9279 true true true false false false false false false false false false X 21 18 true false false false true true true true true false false true true true true true true true true true false X Helena Schulz 5026298263 224 E Broadway louisville KY 40202 STEPHEN A WILLIAMS CEO/Trustee 10.00 40.00 X X 0 2426731 213713 CAROLYN GATZ Chair Emeritus 1.00 2.50 X 0 1500 0 CRAIG D GRANT Trustee 1.00 2.50 X 0 1500 0 DONALD H ROBINSON Trustee (partial year) 1.00 4.50 X 0 0 0 EDIE NIXON Trustee 1.00 3.50 X 0 1500 0 ERWIN ROBERTS Trustee 1.00 2.50 X 0 1500 0 G H NIXON Chair Emeritus 1.00 2.50 X 0 0 0 G HUNT ROUSAVALL Trustee (partial year) 1.00 5.50 X 0 1500 0 GAIL LYTTLE Trustee 1.00 2.50 X 0 0 0 GARY L STEWART Trustee 1.00 4.50 X 0 1500 0 GREGORY E MAYES Trustee 1.00 6.50 X 0 1500 0 JAMES L SUBLETT MD Trustee 1.00 2.50 X 0 1500 0 JOSEPH J MCGOWAN EDD Trustee 1.00 2.50 X 0 1500 0 JOSEPH PARADIS III Trustee 1.00 5.50 X 0 0 0 KEVIN J HABLE Trustee 1.00 2.50 X 0 0 0 LOUIS S HEUSER MD Trustee 1.00 2.50 X 0 1500 0 MARIA GERWING HAMPTON Chair 1.00 12.50 X 0 1500 0 MARIA L BOUVETTE Trustee 1.00 2.50 X 0 1500 0 MARTHA K HEYBURN MD Trustee 1.00 4.50 X 0 1500 0 MITCH NICHOLS Trustee 1.00 2.50 X 0 0 0 R K GUILLAUME Vice Chair 1.00 5.50 X 0 1500 0 REV WILLIAM J SCHULTZ Trustee (partial year) 1.00 4.50 X 0 1500 0 RICHARD R IVEY Trustee 1.00 2.50 X 0 1500 0 RICHARD S WOLF MD Honorary Chair Emeritus 1.00 3.50 X 0 1500 0 ROBERT R GOODIN MD Chair Emeritus 1.00 2.50 X 0 1500 0 RONALD LEHOCKY MD Trustee 1.00 4.50 X 0 0 0 WENDELL P WRIGHT Trustee 1.00 2.50 X 0 1500 0 MICHAEL W GOUGH Sys Sr VP CFO/Treasurer 10.00 40.00 X 0 1050457 484459 ROBERT B AZAR Sys VP Chief Legal Officer/Secretary 10.00 40.00 X 0 536159 95391 RUSSELL F COX President and COO 10.00 40.00 X 0 1287478 635804 CHARLOTTE IPSAN Hospital CAO 50.00 0 X 470396 0 101977 JOHN HARRYMAN Hospital CAO 50.00 1.00 X 673976 0 137874 KEVIN WARDELL Hospital CAO 50.00 0 X 703966 0 133511 ROBERT SHAW Hospital President 50.00 0 X 604803 0 253369 STEVEN MACLAUCHLAN Hospital President 50.00 0 X 708997 0 1013914 THOMAS KMETZ Division President Women and Children Services 50.00 1.00 X 719114 0 145191 JEFFREY HARGIS Physician 50.00 0 X 780780 0 32872 JOHN HAMM Physician 50.00 0 X 744872 0 44698 MIAN MUSHTAQ Physician 50.00 0 X 722316 0 32516 RENATO LAROCCA Physician 50.00 0 X 938343 0 24629 STEVEN PURSELL Physician 50.00 0 X 738961 0 28444 7806523 5329326 3378362 321 false true false WEHR CONSTRUCTORS INC 2517 PLANTSIDE DR LOUISVILLE KY 40299 CONSTRUCTION 17979443 MESSER TMG INC 11001 PLANTSIDE DR LOUISVILLE KY 40299 CONSTRUCTION 9751551 UNIVERSITY OF LOUISVILLE 323 E CHESTNUT LOUISVILLE KY 40202 RESIDENCY PROGRAM 9142043 BRASCH BARRY GENERAL CONTRACTOR 901 LAMPTON ST LOUISVILLE KY 40204 CONSTRUCTION 8089856 MORRISON MANAGEMENT SPECIALIST P O BOX 102289 ATLANTA GA 303682289 DIETARY SERVICES 6959313 141 10246653 669149 10915802 NET PATIENT REVENUE 621110 1471412006 1466925521 4486485 HEALTHCARE EDUCATION 611710 1741420 1741420 0 0 0 0 0 0 0 1473153426 14286580 14286580 0 0 1178684 1019780 158904 0 158904 158904 222337 815400 0 -593063 -593063 -593063 0 0 0 PURCHASING CO-OP INC 561499 3250135 2961749 288386 PARKING INCOME 812930 1101276 1101276 MEANINGFUL USE REIMBURSEMENT 621990 4669083 4669083 95603 95603 0 0 9116097 1507037746 1476393376 4774871 14953697 0 0 0 0 4286188 4286188 175465 175465 425386162 425386162 25555326 25555326 62078987 62078987 29323288 29323288 0 0 0 56094 56094 0 0 110906213 110906213 0 0 0 10451998 10451998 0 0 19179930 19179930 1120158 1120158 0 0 33820353 33820353 0 57847670 57847670 19859187 19859187 MEDICAL SUPPLIES 309225444 309225444 ALLOCATED SUPPORT 152901868 124584442 28317426 BAD DEBT 74656731 74656731 PROVIDER TAX 20129732 20129732 13520465 13520465 0 0 1370481259 1342163833 28317426 0 0 12609 34414 178119023 170565296 0 0 0 0 44352563 44616845 1578601 1279795 1264921065 669190670 550494412 595730395 0 0 0 0 7715022 7605735 308672987 418757427 1090945217 1238589907 67006157 64908729 0 0 18436657 31642792 85442814 96551521 X 996745075 1133385369 8757328 8653017 1005502403 1142038386 1090945217 1238589907 X 136556487 -20504 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 56094 56094 false Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i NHI PAYS DUES TO THE KENTUCKY HOSPITAL ASSOCIATION. A PORTION OF THOSE DUES IN THE AMOUNT OF $56,094 IS SPENT ON LOBBYING. 23867064 23867064 592559349 243623094 348936255 0 0 0 539681153 419696932 119984221 108813499 5870644 102942856 595730395 RECEIVABLE FROM AFFILIATE 404579326 PHYSICIAN GUARANTEE ASSET 7588859 INVESTMENT IN PREMIER PURCHASING PARTNERS LP 5943972 MISCELLANEOUS RECEIVABLES 645270 418757427 0 DUE TO THIRD PARTY PAYORS 17632043 PHYSICIAN GUARANTEE LIABILITY 7588859 ASSET RETIREMENT OBLIGATION 6421890 31642792 X 1496938662 8952191 8952191 1487986471 19051275 19051275 1507037746 1379001699 8952192 8952192 1370049507 431752 431752 1370481259 Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote NORTON HEALTHCARE, INC. AND AFFILIATES (NORTON HOSPITALS, INC., COMMUNITY MEDICAL ASSOCIATES, NORTON ENTERPRISES, INC., NORTON HEALTHCARE FOUNDATION, INC., NORTON PROPERTIES, INC., AND THE CHILDREN'S HOSPITAL FOUNDATION, INC.) COMPLETED AN ANALYSIS OF ITS TAX POSITIONS AT DECEMBER 31, 2013 AND 2012, AND DETERMINED THAT NO UNCERTAIN TAX PROVISIONS WERE REQUIRED TO BE RECOGNIZED UNDER ACCOUNTING STANDARDS CODIFICATION 740, INCOME TAXES, IN THE COMBINED FINANCIAL STATEMENTS. Schedule D, Part XI, Line 2d, Other revenues in audited financial statements not in form 990 RENTAL INCOME INTERNAL - 8952191; Schedule D, Part XI, Line 4b, Other revenues in form 990 not in audited financial statements CONTRIBUTIONS AND GRANTS - 5357758; PREMIER INITIAL PUBLIC OFFERING PROCEEDS - 14286580; GAIN/LOSS ON SALE OF ASSETS - -593063; Schedule D, Part XII, Line 2d, Other expenses in audited financial statements not in form 990 RENTAL INCOME - 7932412; REIMBURSEMENT OF UTILITY EXPENSE - 213885; PHYSICIAN PRACTICE SUBSIDY - 805895; Schedule D, Part XII, Line 4b, Other expenses in form 990 not in audited financial statements CONTRIBUTIONS AND GRANTS - 431752; true true X true X 3 false true true true false true true 12068256 0 12068256 0.00930 286367503 195742479 90625024 0.06990 10971907 3872354 7099553 0.00550 0 0 309407666 199614833 109792833 0.08470 10857834 0 10857834 0.00840 33386151 3589417 29796734 0.02300 0 0 0 0.00000 2845762 0 2845762 0.00220 2631025 0 2631025 0.00200 0 0 49720772 3589417 46131355 0.03560 0 0 359128438 203204250 155924188 0.12030 0 0.00000 0 0.00000 1320852 0 1320852 0.00100 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 1320852 0 1320852 0.00100 true 74656731 7411365 312831922 315697343 -2865421 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 KOSAIR CHILDREN'S HOSPITAL 231 E Chestnut St LOUISVILLE KY 40202 HTTP://WWW.KOSAIRCHILDRENSHOSPITAL.COM/ 100234 X X X X X A 3 NORTON AUDUBON HOSPITAL One Audubon Plaza Drive LOUISVILLE KY 40217 HTTP://WWW.NORTONHEALTHCARE.COM/NORTONAUDUBONHOSPITAL 100252 X X X X A 4 NORTON SUBURBAN HOSPITAL 4001 Dutchmans Lane LOUISVILLE KY 40207 HTTP://WWW.NORTONHEALTHCARE.COM/NORTONSUBURBANHOSPITAL 100255 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 1 true X X X X X X X X X 13 true true true X nortonhealthcare.com (about us; community health needs) X X X X X X X X X true false true true 300 false true X true true X X X X true false X X true X false false Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment (1) A - NORTON HOSPITAL: COMMUNITY INPUT WAS PROVIDED THROUGH FIVE COMMUNITY FORUMS AND A COMMUNITY HEALTH SURVEY WAS WIDELY DISTRIBUTED BY THE LOUISVILLE METRO DEPARTMENT OF PUBLIC HEALTH AND WELLNESS. THE COMMUNITY HEALTH SURVEY WAS COMPLETED BY 45 INDIVIDUALS THAT ATTENDED THE PUBLIC FORUMS ALONG WITH 1,826 ONLINE SURVEY RESPONDENTS; IN ADDITION TO ANOTHER FORUM WHERE 40 BUSINESS LEADERS AND PHYSICIANS ATTENDED. FINDINGS ARE DESCRIBED IN THE COMMUNITY HEALTH SURVEY SECTION OF THIS SCHEDULE.; Schedule H, Part V Sec B, Line 4, Other Hospital Facilities included in Needs Assessment (1) A - NORTON HOSPITAL: NORTON HOSPITALS, INC. OWES AND OPERATES FIVE HOSPITALS LOCATED IN LOUISVILLE AND JEFFERSON COUNTY, KENTUCKY. THE HOSPITALS ARE: - NORTON HOSPITAL - KOSAIR CHILDREN'S HOSPITAL - NORTON AUDUBON HOSPITAL - NORTON SUBURBAN HOSPITAL - NORTON BROWNSBORO HOSPITAL; Schedule H, Part V Sec B, Line 11, Eligibility for Discounted Care (1) A - NORTON HOSPITAL: NORTON HOSPITALS, INC. (NHI) DOES NOT HAVE A SLIDING SCALE FOR FINANCIAL ASSISTANCE. NHI PROVIDES TOTAL FREE CARE THAT IS DISCOUNTED 100% FOR INDIVIDUALS THAT MET THE FEDERAL POVERTY GUIDELINES (FPG) UP TO 300% OF THE FPG AND COMPLETE THE APPLICATION PROCESS. ALL SELF PAY FINANCIAL CLASS PATIENTS RECEIVE A SELF PAY DISCOUNT.; (1) A - KOSAIR CHILDREN'S HOSPITAL: NORTON HOSPITALS, INC. (NHI) DOES NOT HAVE A SLIDING SCALE FOR FINANCIAL ASSISTANCE. NHI PROVIDES TOTAL FREE CARE THAT IS DISCOUNTED 100% FOR INDIVIDUALS THAT MET THE FEDERAL POVERTY GUIDELINES (FPG) UP TO 300% OF THE FPG. ALL SELF PAY FINANCIAL CLASS PATIENTS RECEIVE A SELF PAY DISCOUNT.; (1) A - NORTON AUDUBON HOSPITAL: NORTON HOSPITALS, INC. (NHI) DOES NOT HAVE A SLIDING SCALE FOR FINANCIAL ASSISTANCE. NHI PROVIDES TOTAL FREE CARE THAT IS DISCOUNTED 100% FOR INDIVIDUALS THAT MET THE FEDERAL POVERTY GUIDELINES (FPG) UP TO 300% OF THE FPG. ALL SELF PAY FINANCIAL CLASS PATIENTS RECEIVE A SELF PAY DISCOUNT.; (1) A - NORTON SUBURBAN HOSPITAL: NORTON HOSPITALS, INC. (NHI) DOES NOT HAVE A SLIDING SCALE FOR FINANCIAL ASSISTANCE. NHI PROVIDES TOTAL FREE CARE THAT IS DISCOUNTED 100% FOR INDIVIDUALS THAT MET THE FEDERAL POVERTY GUIDELINES (FPG) UP TO 300% OF THE FPG. ALL SELF PAY FINANCIAL CLASS PATIENTS RECEIVE A SELF PAY DISCOUNT.; (1) A - NORTON BROWNSBORO HOSPITAL: NORTON HOSPITALS, INC. (NHI) DOES NOT HAVE A SLIDING SCALE FOR FINANCIAL ASSISTANCE. NHI PROVIDES TOTAL FREE CARE THAT IS DISCOUNTED 100% FOR INDIVIDUALS THAT MET THE FEDERAL POVERTY GUIDELINES (FPG) UP TO 300% OF THE FPG. ALL SELF PAY FINANCIAL CLASS PATIENTS RECEIVE A SELF PAY DISCOUNT.; Schedule H, Part V Sec B, Line 14g, Other ways hospital publicized Financial Assistance Policy (1) A - NORTON HOSPITAL: SEE RESPONSE TO PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE.; Schedule H, Part V Sec B, Line 18e, Efforts made before initiating collection actions (1) A - KOSAIR CHILDREN'S HOSPITAL: NORTON HOSPITALS, INC. (NHI) ATTEMPTS TO GET SELF PAY PATIENTS TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. ALSO, MEDASSIST, THE OUTSIDE VENDOR CONTRACTED BY NHI ATTEMPTS TO GET PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE. OUR EARLY OUT VENDOR HIRED BY NHI IS REQUIRED TO GIVE PATIENTS A COPY OF THE FINANCIAL ASSISTANCE APPLICATION TO COMPLETE WITH THE INITIAL BILLING STATEMENT. THE BAD DEBT AGENCY CONTRACTED WITH NHI WILL SEND THE INITIAL NOTICE AS REQUIRED BY THE FAIR DEBT COLLECTION PRACTICES ACT FIRST, AND THEN AFTER THE LETTER IS SENT, WILL SEND TO THE PATIENT A FINANCIAL ASSISTANCE APPLICATION WITH A LETTER OF INSTRUCTIONS.; (1) A - NORTON AUDUBON HOSPITAL: NORTON HOSPITALS, INC. (NHI) ATTEMPTS TO GET SELF PAY PATIENTS TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. ALSO, MEDASSIST, THE OUTSIDE VENDOR CONTRACTED BY NHI ATTEMPTS TO GET PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE. OUR EARLY OUT VENDOR HIRED BY NHI IS REQUIRED TO GIVE PATIENTS A COPY OF THE FINANCIAL ASSISTANCE APPLICATION TO COMPLETE WITH THE INITIAL BILLING STATEMENT. THE BAD DEBT AGENCY CONTRACTED WITH NHI WILL SEND THE INITIAL NOTICE AS REQUIRED BY THE FAIR DEBT COLLECTION PRACTICES ACT FIRST, AND THEN AFTER THE LETTER IS SENT, WILL SEND TO THE PATIENT A FINANCIAL ASSISTANCE APPLICATION WITH A LETTER OF INSTRUCTIONS.; (1) A - NORTON SUBURBAN HOSPITAL: NORTON HOSPITALS, INC. (NHI) ATTEMPTS TO GET SELF PAY PATIENTS TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. ALSO, MEDASSIST, THE OUTSIDE VENDOR CONTRACTED BY NHI ATTEMPTS TO GET PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE. OUR EARLY OUT VENDOR HIRED BY NHI IS REQUIRED TO GIVE PATIENTS A COPY OF THE FINANCIAL ASSISTANCE APPLICATION TO COMPLETE WITH THE INITIAL BILLING STATEMENT. THE BAD DEBT AGENCY CONTRACTED WITH NHI WILL SEND THE INITIAL NOTICE AS REQUIRED BY THE FAIR DEBT COLLECTION PRACTICES ACT FIRST, AND THEN AFTER THE LETTER IS SENT, WILL SEND TO THE PATIENT A FINANCIAL ASSISTANCE APPLICATION WITH A LETTER OF INSTRUCTIONS.; (1) A - NORTON BROWNSBORO HOSPITAL: NORTON HOSPITALS, INC. (NHI) ATTEMPTS TO GET SELF PAY PATIENTS TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. ALSO, MEDASSIST, THE OUTSIDE VENDOR CONTRACTED BY NHI ATTEMPTS TO GET PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE. OUR EARLY OUT VENDOR HIRED BY NHI IS REQUIRED TO GIVE PATIENTS A COPY OF THE FINANCIAL ASSISTANCE APPLICATION TO COMPLETE WITH THE INITIAL BILLING STATEMENT. THE BAD DEBT AGENCY CONTRACTED WITH NHI WILL SEND THE INITIAL NOTICE AS REQUIRED BY THE FAIR DEBT COLLECTION PRACTICES ACT FIRST, AND THEN AFTER THE LETTER IS SENT, WILL SEND TO THE PATIENT A FINANCIAL ASSISTANCE APPLICATION WITH A LETTER OF INSTRUCTIONS.; Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined (1) A - NORTON HOSPITAL: NORTON HOSPITALS, INC. PROVIDES FREE CARE TO INDIVIDUALS THAT QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. NO AMOUNTS ARE CHARGED TO ELIGIBLE PATIENTS AND THEREFORE NO BASIS FOR CALCULATING THOSE AMOUNTS ARE NECESSARY. ; 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 COMMUNITY BENEFIT IS REPORTED UNDER NORTONHEALTHCARE.COM, PARENT OF NORTON HOSPITALS, 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 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 I, LINE 7E, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AMOUNTS PRESENTED ARE BASED ON ACTUAL SPENT FOR THOSE SERVICES AND BENEFITS PROVIDED DEEMED TO IMPROVE THE HEALTH OF THE COMMUNITIES IN WHICH WE SERVE AND CONFORM TO THE MISSION OF OUR EXEMPT PURPOSE. Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation 74,656,731 SCHEDULE H, PART I, LINE 7F, HEALTH PROFESSIONS EDUCATION AMOUNTS PRESENTED ARE BASED UPON ACTUAL SPEND AND ARE IN CONFORMITY WITH AGREED UPON COMMITMENTS WITH VARIOUS EDUCATIONAL PROGRAMS. SCHEDULE H, PART I, LINE 7H, RESEARCH AMOUNTS PRESENTED REPRESENT ACTUAL SPEND TO SUPPORT COMMUNITY HEALTH RESEARCH REGARDING OUTCOMES AND EFFECTIVENESS OF TREATMENTS. SCHEDULE H, PART I, LINE 7I, CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFITS IN KEEPING WITH OUR MISSION AND COMMITMENT TO THE COMMUNITIES WE SERVE, NORTON HOSPITALS, INC. CONTINUES ITS TRADITION OF CONTRIBUTING MONIES TO NUMEROUS ORGANIZATIONS. AMOUNTS PRESENTED REPRESENT ACTUAL MONIES CONTRIBUTED TO ORGANIZATIONS THROUGHOUT OUR COMMUNITIES. 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 CATAGORIES, 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. MEDASSIT, 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'S 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 AND THEIR EXPERIENCE WITH GETTING ACCOUNTS QUALIFIED AS FINANCIAL ASSISTANCE, IT IS ESTIMATED THAT 80% 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 80% 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 WRITE-OFF 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. NHI EXPERIENCED LOSSES ($2.9 MILLION FOR THE FISCAL YEAR ENDING 2013) DUE TO UNDERPAYMENT FOR THE TREATMENT OF MEDICARE PATIENTS. UNREIMBURSED MEDICARE COSTS REPRESENT A SIGNIFICANT VALUE THAT NONPROFIT HOSPITALS PROVIDE TO THE COMMUNITY AS THE HOSPITAL RELIEVES THE FEDERAL GOVERNMENT OF A FINANCIAL BURDEN WHEN IT PROVIDES ESSENTIAL HEALTHCARE SERVICES TO MEDICARE COVERED PATIENTS. 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 APPLICATIONS, BUT THERE WILL BE NO COLLECTION EFFORTS. ONLY AFTER SEVERAL ATTEMPTS 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 IS WRITTEN OFF. 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 PRESIDENTS HAVE APPROVED THE ASSESSMENT AND IMPLEMENTATION PLAN. Schedule H, Part VI, Line 3, Patient education of eligibility for assistance. NORTON HOSPITALS, INC. (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 FINANCIAL ASSISTANCE, MEDICAID, MEDICAID MANAGED CARE ORGANIZATIONS, 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., WITH 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 AT WELL OVER $1,000,000 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 HOSPITAL PATIENTS. FINANCIAL ASSISTANCE FOR NORTON FINANCIAL ASSISTANCE OR KOSAIR CHARITIES 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 KOSAIR CHILDREN'S HOSPITAL ARE EDUCATED AND TRAINED TO ASSIST WITH COUNSELING PATIENTS AND DETERMINING AND EXPLAINING OUR FINANCIAL ASSISTANCE PROGRAMS. THEY CONTINUE TO RECEIVE ON-GOING EDUCATION THROUGHOUT THE YEAR REGARDING ELIGIBILITY CHANGES AND ADDITIONS FOR NORTON FINANCIAL ASSISTANCE, KOSAIR CHARITIES, DSH/KHCP, MEDICAID, ETC. AS THE FOUNDATION OFFICE RECEIVES INQUIRES IN THEIR OFFICE, THEY SEND POTENTIAL REFERRALS TO PATIENT FINANCIAL SERVICES TO SCREEN FOR POSSIBLE FINANCIAL ASSISTANCE. IF A PATIENT DOES NOT QUALIFY FOR KOSAIR CHARITY, THEN THOSE DENIED APPLICATIONS ARE REFERRED TO THE DIRECTOR OF PATIENT FINANCIAL SERVICES FOR CONSIDERATION FOR SPECIAL FUNDING THROUGH THE CHILDREN'S FOUNDATION AS WELL AS OTHER PROGRAMS. THE CHARITY APPLICATION WAS PROVIDED ON THE BACK OF THE HOSPITAL STATEMENT AND STATEMENTS SUPPLIED BY OUR VENDORS IN 2013 TO MOST OF OUR HOSPITAL PATIENTS. AS A RESULT OF NHI'S SYSTEM CONVERSION TO EPIC, IN 2013 A SMALL PORTION OF THE HOSPTIAL PATIENTS FOR ONE VENDOR DID NOT RECEIVE THE CHARITY APPLICATION ON THEIR SPECIFIC STATEMENT FOR SOME OF THE MONTHS IN 2013. ONCE THIS SYSTEM ISSUE WAS IDENTIFIED IT WAS IMMEDIATELY CORRECTED AND THE CHARITY APPLICATION WAS PROVIDED ON THE BACK OF THAT ONE VENDOR'S STATEMENTS. HOWEVER, THE CHARITY BACKER BEING ON THE INITIAL STATEMENTS BEING SENT FROM NHI AND THE STATEMENTS AND NOTIFICATIONS BEING SENT FROM THE OTHER VENDORS, AND WITH THE OTHER CHARITY NOTIFICATIONS SUCH AS SIGNAGE, TELEPHONE NOTIFICATION, WEBSITE INFORMATION, THE APPLICATIONS BEING MADE AVAILABLE VIA TELEPHONE, MAIL ELECTRONICALLY, ETC., NHI MADE A CONSCIENTIOUS EFFORT TO ENSURE THAT ALL HOSPITAL PATIENTS WERE MADE AWARE OF FINANCIAL ASSISTANCE. REGARDLESS OF WHERE THE PATIENT'S ACCOUNT MAY BE IN THE COLLECTION CYCLE, EVEN IF THE PATIENT/GUARANTOR HAS 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 WILL ALLOW THE PATIENT/GUARANTOR TO APPLY AND WILL APPROVE IF THEY MEET THE QUALIFICATIONS. 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. CONTAINED ON THE INITIAL NOTIFICATION LETTER THAT IS REQUIRED BY THE FAIR DEBT COLLECTION PRACTICE ACT THAT THE AGENCIES SEND TO THE GUARANTOR IS A PHRASE WRITTEN IN SPANISH THAT ALERTS SPANISH SPEAKING GUARANTORS TO CONTACT A SPECIFIC NUMBER TO SPEAK WITH A SPANISH SPEAKING COLLECTOR. THAT SPANISH SPEAKING COLLECTOR WILL ALSO PROVIDE FINANCIAL ASSISTANCE INFORMATION. NHI HAS TRANSLATED A SERIES OF FINANCIAL ASSISTANCE LETTERS IN SPANISH AND VIETNAMESE. THESE LETTERS AND THE APPLICATION ARE MADE AVAILABLE TO THE COLLECTION AGENCIES TO USE WITH THOSE GUARANTORS TO APPLY FOR FINANCIAL ASSISTANCE. NHI CUSTOMER SERVICE DEPARTMENT ROUTINELY INSTRUCTS AND SCREENS PATIENTS IN THE PROTOCOL REGARDING FINANCIAL ASSISTANCE THRU KOSAIR CHARITIES OR NORTON FINANCIAL ASSISTANCE. BEGINNING IN 2007, NHI OFFERED AT THE TIME OF FINAL BILLING ALL TRUE SELF PAY PATIENTS A SIGNIFICANT DISCOUNT OFF OF TOTAL CHARGES THAT WERE REFLECTED ON THEIR MONTHLY STATEMENTS. AN ADDITIONAL PROMPT PAY DISCOUNT IS ALSO PROVIDED IF THE REMAINING BALANCE IS PAID WITHIN 30 DAYS FROM DATE OF FIRST BILL. CONTRACTED COLLECTION AGENCIES ARE REQUIRED TO SOLICIT CHARITY APPLICATIONS WHEN THE GUARANTOR/PATIENT INDICATES "CANNOT PAY". NHI PAYS A COMMISSION TO OUR CONTRACTED COLLECTION AGENCIES FOR EVERY APPROVED CHARITY APPLICATION THAT IS FINALIZED. THIS COMMISSION IS AN INCENTIVE FOR THE REPRESENTATIVES TO OBTAIN CHARITY APPLICATIONS AND NOT JUST COLLECT MONEY OWED ON THE ACCOUNT. IN 2013, NHI HAD SOME EVENING HOURS FOR THEIR INTERNAL STAFF TO MAKE OUTBOUND PHONE CALLS AND TAKE INBOUND PHONE CALLS FROM GUARANTORS IN ORDER TO PROVIDE EVENING HOURS TO NOTIFY THEM AND ALLOW THEM TO APPLY FOR FINANCIAL ASSISTANCE. NHI MANAGEMENT MONITORS THE NUMBER OF APPROVED FINANCIAL ASSISTANCE APPLICATIONS THAT ARE PROVIDED AS A DIRECT RESULT OF THE COLLECTION AGENCIES EFFORTS. TRENDING IS REVIEWED AND INQUIRES ARE MADE BY NHI MANAGEMENT TO THE AGENCIES' MANAGEMENT WHEN THE MONTHLY NUMBERS SHOW A VARIANCE SHORT OF THE AVERAGE NUMBER APPROVED. Schedule H, Part VI, Line 4, Community information. PRIMARY SERVICE AREA NORTON HOSPITALS INC.'S (NHI) PRIMARY SERVICE AREA POPULATION IS OVER ONE MILLION AND EXPECTED TO INCREASE 2.4% BETWEEN 2014 AND 2019. THE PRIMARY SERVICE AREA INCLUDES SEVEN COUNTIES, THREE OF WHICH ARE LOCATED ALONG THE OHIO RIVER BORDER IN KENTUCKY AND THE OTHER FOUR ARE BORDERING THE RIVER IN INDIANA. SEVENTY-NINE PERCENT OF NHI'S PATIENTS ARE DERIVED FROM THIS SERVICE AREA. APPROXIMATELY 28% OF THE POPULATION IS OVER 55 YEARS OLD; COMPARED TO 27% IN THE USA. THIS PORTION OF THE POPULATION TENDS TO USE ADDITIONAL HEALTHCARE SERVICES. THE PEDIATRIC POPULATION IN 2013 WAS ESTIMATED AT 265,633 AND IS EXPECTED TO INCREASE TO 266,183 WITHIN FIVE YEARS AND REPRESENTS 23% OF THE POPULATION. THE NUMBER OF HOUSEHOLDS IN THE PRIMARY SERVICE AREA WAS ESTIMATED AT 465,381 IN 2013 AND IS EXPECTED TO INCREASE 2.6% BY 2019. CURRENTLY 12% OF THE ADULT POPULATION DOES NOT HAVE A HIGH SCHOOL DEGREE AND 26% OF THE HOUSEHOLD INCOME IS LESS THAN $25,000 A YEAR; THE AVERAGE HOUSEHOLD INCOME IS $66,470 COMPARED TO $71,320 FOR THE UNITED STATES. NHI TREATS 35% OF THE ADULT INPATIENT CASES IN THE COMMUNITY AND ITS PAYOR MIX IS 45% MEDICARE, 10% MEDICAID/PASSPORT AND 6% SELF PAY. THE LARGEST COUNTY IN THE SERVICE AREA IS JEFFERSON COUNTY AND ITS MAY 2014 PRELIMINARY NON-SEASONALLY ADJUSTED UNEMPLOYMENT RATE WAS 7.4% COMPARED TO 7.5% FOR KENTUCKY AND 6.1% FOR THE UNITED STATES. SECONDARY SERVICE AREA NHI'S SECONDARY SERVICE AREA POPULATION WAS 740,670 IN 2013 AND IS EXPECTED TO INCREASE 2.1% BETWEEN 2014 AND 2019. THE SECONDARY SERVICE AREA SPREADS ACROSS 22 KENTUCKY COUNTIES AND 4 INDIANA COUNTIES. THE 55+ AGE COHORT REPRESENTS 27% OF THE SECONDARY SERVICE AREA POPULATION AND IS SLIGHTLY HIGHER THAN IN THE UNITED STATES. THE PEDIATRIC POPULATION IN 2013 WAS ESTIMATED AT 174,536 AND EXPECTED TO DECREASE TO 172,650 BY 2019. ALTHOUGH THE PEDIATRIC POPULATION IS EXPECTED TO BE CONSISTENT, 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 285,799 IN 2013 AND IS EXPECTED TO INCREASE BY 6,503 BY 2019. ALMOST 88,000 ADULTS IN THIS SERVICE AREA DO NOT HAVE A HIGH SCHOOL EDUCATION AND THE HOUSEHOLD INCOME IS UNDER $25,000 FOR 29% OF THE POPULATION. THE AVERAGE HOUSEHOLD INCOME IS $55,627, LESS THAN KENTUCKY AND 16% LESS THAN THE PRIMARY SERVICE AREA. Schedule H, Part VI, Line 5, Promotion of community health NORTON HEALTHCARE, INC. (NHC), PARENT OF NORTON HOSPITALS, INC. (NHI), IS INDEPENDENTLY OVERSEEN BY A 24 MEMBER BOARD OF TRUSTEES. WITH THE EXCEPTION OFNHC'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 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 2013 NHI'S TOTAL COMMUNITY BENEFIT WAS $157.2 MILLION, OVER $3.0 MILLION A WEEK, AND INCLUDES COMMUNITY INITIATIVES AND PROGRAMS SUCH AS FINANCIAL ASSISTANCE, EDUCATIONAL SUPPORT, UNPAID COSTS OF MEDICAID SERVICES, CORPORATE SPONSORSHIPS, PASTORAL CARE AND COUNSELING PROGRAMS, KENTUCKY POISON CONTROL CENTER AND CHILD GUIDANCE AND ADVOCACY PROGRAMS. NHI EMPLOYEES VOLUNTEERED FOR OVER 200 ORGANIZATIONS. NHI PARTNERS WITH OTHER NON-PROFIT 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. THE OFFICE OF CHURCH AND HEALTH MINISTRIES (OFFICE) PROVIDES EDUCATIONAL PROGRAMS FOR CHURCH LEADERS AND MEMBERS TO LEARN ABOUT FAITH COMMUNITY NURSING, ETHICS, WHOLE-PERSON CARE AND OTHER TOPICS RELATED TO HEALTH MINISTRIES. IN 2013, A FREE SEMINAR ABOUT UNDERSTANDING ADDICTION AND CARING FOR CONGREGANTS AND FAMILIES AFFECTED BY SUBSTANCE ABUSE WAS ATTENDED BY 71 MEMBERS OF CLERGY AND STAFF. WITH THE MID-KENTUCKY PRESBYTERY AND LOUISVILLE PRESBYTERIAN SEMINARY, THE OFFICE COORDINATED A CHURCH SAFETY WORKSHOP AT WHICH 38 CHURCHES WERE REPRESENTED BY 72 ATTENDEES. NEARLY 300 INDIVIDUALS ATTENDED EDUCATIONAL PROGRAMS SPONSORED BY THE OFFICE. TOPICS INCLUDED DIABETES, THE AFFORDABLE CARE ACT, COMMUNICATION SKILLS IN MINISTRY AND SPIRITUAL CARE. THE OFFICE HAD AN ESTIMATED ONE MILLION CONTACTS OR EXPOSURES DURING THE YEAR, INCLUDING HEALTH FAIR AND HEALTH SCREENING ATTENDEES, EDUCATIONAL CLASSES PROVIDED, EDUCATIONAL TOOLS BORROWED, PHONE AND EMAIL CONTACTS, NURSE EDUCATOR MENTORING AND CONSULTATIONS, BIMONTHLY ELECTRONIC BULLETINS OF REGIONAL HEALTH AND WELLNESS INFORMATION, NEWSLETTER AND WEBSITE VISITS. THE OFFICE HAS CREATED A NETWORK OF MORE THAN 180 FAITH COMMUNITIES THAT PROMOTE HEALTH AND WELLNESS AMONG THEIR MEMBERS AND THE LARGER COMMUNITY. STAFF MEMBERS, INCLUDING FOUR REGISTERED NURSES, TEACH THE CONCEPTS OF THE FAITH COMMUNITY NURSING SPECIALTY AND MENTOR CHURCH LEADERS AS THEY DEVELOP HEALTH AND WELLNESS INITIATIVES. RESOURCES PROVIDED TO FAITH COMMUNITIES IN 2013 ALSO INCLUDED SCHEDULING SPEAKERS ON HEALTH RELATED TOPICS, LOANING EDUCATIONAL DISPLAYS, COORDINATING RESOURCES FOR HEALTH SCREENING AND CONNECTING HEALTH MINISTRIES VOLUNTEERS WITH RESOURCES WITHIN THE ORGANIZATION AND THROUGHOUT THE COMMUNITY. FAITH COMMUNITIES IN THE LOUISVILLE, KENTUCKY REGION AND NORTON HEALTHCARE, INC. (NHC) EMPLOYEES RECEIVED REGULAR COMMUNICATIONS FROM THE OFFICE ABOUT WHOLE-PERSON HEALTH AND THE INTENTIONAL CARE OF THE SPIRIT THROUGH AN ELECTRONIC BULLETIN, A NEWSLETTER, AND THE ORGANIZATION'S WEBSITE. NORTON HEALTHCARE PREVENTION & WELLNESS SERVES AS AN UMBRELLA FOR PREVENTION, OUTREACH, AND WELLNESS ACTIVITIES FOR NHC. THE DEPARTMENT PROVIDES EDUCATION, CARDIOVASCULAR, AND CANCER SCREENING AND HEALTH PROMOTION TO OUR COMMUNITY. APPROXIMATELY 50% OF THESE ACTIVITIES FOCUS ON MEDICALLY UNDERSERVED COMMUNITIES AND POPULATIONS. THE PREVENTION PROGRAM USES EVIDENCED-BASED APPROACHES TO POPULATION HEALTH AND PROVIDES NO COST OR LOW-COST SCREENINGS FOR MAMMOGRAM, PAP SMEAR, PROSTATE-SPECIFIC ANTIGEN OR PSA TESTING, BLOOD PRESSURE, BODY MASS INDEX, GLUCOSE, CHOLESTEROL, COLON CANCER TESTING AND TOBACCO CESSATION RESOURECES. MANY OF OUR SERVICES ARE PROVIDED ABOARD OUR MOBILE PREVENTION CENTER (MPC), A 40 FOOT MOBILE UNIT EQUIPPED WITH DIGITAL MAMMOGRAPHY, AN EXAM ROOM, A SMALL LABORATORY, AND INDIVIDUAL EDUCATION SPACE. IN 2013 OUR MPC TRAVELED TO 139 UNIQUE LOCATIONS IN COLLABORATION WITH MORE THAN 400 COMMUNITY PARTNERS. IN 2013, THE PREVENTION AND WELLNESS TEAM SCREENED 4,437 PEOPLE FOR HIGH BLOOD PRESSURE, DIABETES, HIGH CHOLESTEROL AND OSTEOPOROSIS AND PROVIDED INFORMATION ABOUT SMOKING CESSATION, DIET AND EXERCISE. IN AUGUST 2013, CARDIOVASCULAR DISEASE NAVIGATION WAS PROVIDED TO AT-RISK PATIENTS IN THE COMMUNITY. MORE THAN 450 PATIENTS WERE CONTACTED FOR FOLLOW-UP. ADDITIONALLY IN 2013, 2,348 PEOPLE WERE SCREENED FOR CANCER. OF THESE, APPROXIMATELY 22% EITHER HAD NEVER BEEN SCREENED FOR CANCER OR HAD NOT BEEN SCREENED IN THE PAST FIVE YEARS. IN 2013, 15 INDIVIDUALS WERE DIAGNOSED AND TREATED FOR PRE-INVASIVE AND INVASIVE CANCER. SINCE THE INCEPTION OF THE PROGRAM, 110 INDIVIDUALS HAVE BEEN DIAGNOSED AND TREATED FOR PRE-INVASIVE AND INVASIVE CANCER. WE HOLD SEVERAL SPECIAL EVENTS THROUGHOUT THE YEAR. ONE EVENT, THE GET HEALTHY WALKING EXPO IS HELD AT THE LOUISVILLE ZOO IN JULY. WE PROVIDE HEALTH SCREENINGS, EDUCATION, AND EXERCISE. IN 2013, A TOTAL OF 249 PEOPLE PARTICIPATED IN THIS FREE EVENT. ANOTHER EVENT, MEN'S HEALTH EVENT: A FAMILY AFFAIR, WAS HELD AT THE KENTUCKY CENTER FOR AFRICAN AMERICAN HERITAGE (KCAAH) IN SEPTEMBER 2013. WE COLLABORATED WITH 27 PARTNERS INCLUDING COMMUNITY ORGANIZATIONS AND NHC DEPARTMENTS TO ADDRESS THE PHYSICAL, SPIRITUAL, FINANCIAL, AND MENTAL NEEDS OF THE MEN IN OUR COMMUNITY (FOCUSING ON AFRICAN AMERICAN MEN). A TOTAL OF 364 SCREENINGS WERE PROVIDED TO EVENT PARTICIPANTS. IN MAY 2013, THE NORTON HEALTHCARE CENTERS FOR PREVENTION & WELLNESS PUBLISHED "MOBILE MAMMOGRAPHY IN UNDERSERVED POPULATIONS: ANALYSIS OF OUTCOMES OF 3,923 WOMEN". THE ARTICLE WAS PUBLISHED IN THE JOURNAL OF COMMUNITY HEALTH. IT WAS ONE OF THE FIRST ARTICLES OF ITS KIND EXAMING OUTCOMES OF WOMEN SCREENED ON A MOBILE UNIT. NHI IS COMMITTED TO INVESTING IN THE COMMUNITY IT SERVES AND "DEMONSTRATING STEWARDSHIP OF RESOURCES" IS ONE OF OUR ORGANIZATIONAL VALUES. WE DO THIS IN A VARIETY OF WAYS, SUCH AS: WORKFORCE DEVELOPMENT EFFORTS; SUPPORTING LOCAL EDUCATIONAL INSTITUTIONS - INCLUDING THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE; OFFERING SCHOLARSHIPS TO STUDENTS; PROVIDING STUDENTS WITH FORGIVABLE LOANS FOR THEIR EDUCATION; PLACING MEDICAL PROFESSIONALS IN MEDICALLY-UNDERSERVED AREAS; PROVIDING FREE HEALTH SCREENINGS AND EDUCATION; CONTRIBUTING FUNDS TO OTHER NON-PROFIT HEALTH CARE ORGANIZATIONS; AND BUILDING A NEW HOSPITAL THAT FOLLOWS THE GREEN GUIDE TO HEALTH CARE, A BEST PRACTICES TOOL KIT FOR PLANNING, DESIGN, CONSTRUCTION, OPERATIONS AND MAINTENANCE OF NEW HOSPITALS. NHI OPERATES SIX (6) FULL-TIME EMERGENCY ROOMS WHERE NO ONE REQUIRING EMERGENCY CARE IS DENIED TREATMENT. NHI INVESTS IN ITS COMMUNITY BY APPLYING SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE - INCLUDING MANY FREE HEALTH CARE SCREENINGS AND EDUCATION PROGRAMS, MEDICAL EDUCATION AND RESEARCH. NHI UTILIZES EXCESS FUNDS BY INVESTING IN THE EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT. NHI PROVIDED $29.8 MILLION IN EDUCATIONAL SUPPORT, PRIMARILY TO THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE. SCHEDULE H, PART VI, LINE 5, PROMOTION OF COMMUNITY HEALTH BY ESTABLISHING PARTNERSHIPS, NHI HELPS TO BUILD A STRONGER AND MORE COHESIVE COMMUNITY THAT WORKS TOGETHER FOR THE GOOD OF ITS CITIZENS. BY INVESTING IN EDUCATION, NHI IS - IN ESSENCE - INVESTING IN OUR COMMUNITY'S FUTURE BY MAKING SURE THAT WELL-PREPARED GRADUATES ARE EXITING LOCAL COLLEGES AND UNIVERSITIES, ULTIMATELY TO WORK IN A VARIETY OF LOCAL BUSINESSES - INCLUDING HEALTH CARE. BY PROVIDING FREE EDUCATION AND SCREENINGS AND PLACING MEDICAL PROFESSIONALS IN UNDERSERVED AREAS, NHI IS POSSIBLY PREVENTING MORE TRAGIC AND COSTLY MEDICAL EMERGENCIES AND DISEASES THAT MIGHT NOT HAVE OTHERWISE BEEN PREVENTED. BY INVESTING IN ENVIRONMENTALLY-FRIENDLY AND PATIENT-FRIENDLY FACILITIES, NHI HELPS TO ENSURE THAT PATIENTS WILL FEEL COMFORTABLE SEEKING HEALTH CARE WHEN THEY NEED IT MOST, RATHER THAN WAITING UNTIL A MEDICAL SITUATION EXACERBATES. THIS COMMITMENT ALSO ENSURES THAT WE DO OUR PART TO PRESERVE THE WORLD AND THE ENVIRONMENT IN WHICH WE LIVE. KOSAIR CHILDREN'S HOSPITAL IS HOME TO THE KENTUCKY REGIONAL POISON CONTROL CENTER. THE CENTER PROVIDES POISON CONTROL SERVICES THROUGH THE POISON HELPLINE TO ALL 120 COUNTIES IN KENTUCKY. IN 2013, THE CENTER RECEIVED MORE THAN 59,000 CALLS. THESE CALLERS INCLUDED THE GENERAL PUBLIC, HEALTHCARE PROVIDERS, EMERGENCY MEDICAL SERVICES, AND LAW ENFORCEMENT SEEKING TREATMENT ADVICE FOR POTENTIAL POISONINGS. ADDITIONALLY, THE CENTER HAS CONTINUED TO WORK WITH STATE AND LOCAL HEALTH DEPARTMENTS TO PROVIDE STATEWIDE SURVEILLANCE AND DATA ON POISONINGS AND DRUG OVERDOSE IN KENTUCKY. 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 120 PHYSICIAN PRACTICE AND NORTON IMMEDIATE CARE CENTER LOCATIONS, AND OTHER ANCILLARY HEALTH CARE SERVICES. SCHEDULE H, PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT STATE FILING OF COMMUNITY BENEFIT REPORT; NOT REQUIRED AT THIS TIME. X X true true false true false false false false false true false STEPHEN A WILLIAMS CEO/TRUSTEE 0 957232 0 594080 0 875419 0 193323 0 20390 0 2640445 0 127109 ROBERT B AZAR SYS VP CHIEF LEGAL OFFICER/SECRETARY 0 369824 0 128247 0 38089 0 86464 0 8927 0 631551 0 0 RUSSELL F COX PRESIDENT AND COO 0 736492 0 301538 0 249448 0 610658 0 25147 0 1923283 0 99540 MICHAEL W GOUGH SYS SR VP CFO/TREASURER 0 586472 0 254035 0 209950 0 459560 0 24898 0 1534916 0 83860 JOHN HARRYMAN HOSPITAL CAO 393531 0 172549 0 107895 0 113186 0 24689 0 811850 0 58520 0 CHARLOTTE IPSAN HOSPITAL CAO 273242 0 84903 0 112251 0 82392 0 19585 0 572373 0 0 0 THOMAS KMETZ DIVISION PRESIDENT WOMEN AND CHILDREN SERVICES 456438 0 159272 0 103404 0 122392 0 22799 0 864305 0 58520 0 STEVEN MACLAUCHLAN HOSPITAL PRESIDENT 382824 0 127819 0 198355 0 1002067 0 11847 0 1722911 0 151552 0 ROBERT SHAW HOSPITAL PRESIDENT 344280 0 126598 0 133925 0 241220 0 12149 0 858172 0 47096 0 KEVIN WARDELL HOSPITAL CAO 420564 0 127712 0 155690 0 112521 0 20991 0 837477 0 58520 0 JOHN HAMM PHYSICIAN 422803 0 320000 0 2068 0 22233 0 22465 0 789570 0 0 0 JEFFREY HARGIS PHYSICIAN 777426 0 0 0 3354 0 12750 0 20122 0 813651 0 0 0 RENATO LAROCCA PHYSICIAN 934489 0 0 0 3854 0 12750 0 11879 0 962973 0 0 0 MIAN MUSHTAQ PHYSICIAN 384274 0 320000 0 18042 0 12750 0 19766 0 754831 0 0 0 STEVEN PURSELL PHYSICIAN 398768 0 320000 0 20193 0 19511 0 8932 0 767405 0 0 0 Schedule J, Part I, Line 1a, Tax indemnification and gross-up payments TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE TREATED AS TAXABLE COMPENSATION TO THE INTERESTED PERSONS LISTED BELOW AT TIME OF PAYMENT. PAYMENTS ARE IN ACCORDANCE WITH EXISTING COMPENSATION POLICY. GROSS-UP PAYMENTS SHALL BE MADE ONLY WHEN SPECIFIED IN AN EMPLOYEE'S EMPLOYMENT CONTRACT, OR AS APPROVED IN WRITING BY THE PRESIDENT AND CEO OF NORTON HEALTHCARE, EXECUTIVE VICE PRESIDENT OR CFO. DURING 2013, GROSS-UP PAYMENTS WERE PROCESSED AS OUTLINED IN THE EMPLOYMENT CONTRACT FOR THE CEO. SEE NARRATIVE PROVIDED IN SCHEDULE O, REFERENCING PART VI, LINE 15, WHICH DESCRIBES THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. ANNUITY - THE ANNUITY REPRESENT ACCULUATED RETIREMENT BENEFITS EARNED RELATED TO A NON-QUALIFIED DEFINED BENEFIT PENSION RESTORATION PLAN IN EFFECT SINCE 1990. CONTRIBUTIONS TO THIS PLAN HAVE BEEN MADE EACH YEAR, BEGINNING IN 2005. THE TOTAL VALUE OF THIS YEAR'S BENEFIT IS $503,879, OF WHICH $225,367 WAS A GROSS-UP PAYMENT TO COVER THE APPLICABLE TAXES AND $278,512 WAS USED TO PURCHASE THE ANNUITY. THE FULL VALUE OF THIS YEAR'S BENEFIT WAS INCLUDED IN 2013 TAXABLE COMPENSATION OF MR. WILLIAMS. DISABILITY COVERAGE (AND ASSOCIATED GROSS-UP) FOR MR. WILLIAMS - DURING 2013 NET DISABILITY COVERAGE PREMIUMS TOTALED $30,921, AND THE ASSOCIATED GROSS-UP OF SUCH PREMIUMS TOTALED $25,095. THUS, THE TOTAL OF THESE AMOUNTS - $56,016 - WAS INCLUDED IN THE TAXABLE COMPENSATION OF MR. WILLIAMS IN 2013. 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 EXECUTIVES, EFFECTIVE OCTOBER 1, 2007. NORTON HEALTHCARE 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 HEALTHCARE 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 2013: STEPHEN A. WILLIAMS - $58,120 RUSSELL F. COX - 59,434 MICHAEL G. GOUGH - 52,208 ROBERT B. AZAR - 17,500 KEVIN WARDELL - 17,500 JOHN HARRYMAN - 17,500 THOMAS KMETZ - 17,500 STEVEN MACLAUCHLAN - 17,500 ROBERT SHAW - 20,000 CHARLOTTE ISPAN - 10,000 Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation NORTON HEALTHCARE INC (NHI) 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 NHI; 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 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 - $ 134,851 RUSSELL F. COX - 593,016 MICHAEL W. GOUGH - 441,391 ROBERT AZAR - 71,313 WILLIAM RICHIE - 36,439 CHARLOTTE IPSAN -56,309 JOHN HARRYMAN - 92,098 THOMAS KMETZ - 103,037 STEVE MACLAUCHLAN - 87,776 ROBERT SHAW - 68,523 KEVIN WARDELL -92,216 THE "PAYMENT RECEIVED" OUTLINED BELOW REPRESENTS CASH PAYMENTS THAT THE EMPLOYEE RECEIVED DURING 2013 AND CAN BE COMPRISED OF PRIOR YEARS EMPLOYEE AND EMPLOYER CONTRIBUTIONS. NAME - PAYMENT RECEIVED STEPHEN A. WILLIAMS -$ 232,232 RUSSELL F. COX - 110,669 MICHAEL W. GOUGH - 92,970 ROBERT AZAR - 0 WILLIAM RICHIE - 29,616 CHARLOTTE IPSAN - 100,265 JOHN HARRYMAN - 66,683 THOMAS KMETZ - 64,130 STEVE MACLAUCHLAN - 174,045 ROBERT SHAW - 98,165 KEVIN WARDELL - 110,230 Schedule J, Part I, Line 7, Non-fixed payments IN 2013, NHI 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 NHI'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 72491 COMPENSATION false ANNE ROBINSON FAMILY MEMBER OF DONALD H ROBINSON, TRUSTEE 11938 COMPENSATION false AMY TONN FAMILY MEMBER OF RUSSELL F. COX, OFFICER 44049 COMPENSATION false BARBARA KMETZ FAMILY MEMBER OF THOMAS KMETZ, KEY EMPLOYEE 46987 COMPENSATION false FORM 990, PART V, LINE 1A, COMMON PAYING AGENT 1099S NORTON HEALTHCARE, INC., EIN 61-1028725 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. AND THEREFORE, ALL VENDORS, INCLUDING INDEPENDENT CONTRACTORS, ARE PAID AND REPORTED BY NORTON HEALTHCARE, INC. ON BEHALF OF NORTON HOSPITALS, INC. FOR PURPOSES OF PART V, LINE 1, THE NUMBER OF 1099S REPORTED AND FILED FOR 2013 BY NORTON HEALTHCARE, INC. FOR NORTON HOSPITALS, INC., WAS APPROXIMATELY 312. NORTON HOSPITALS, INC., HAS APPROXIMATELY 141 INDEPENDENT CONTRACTORS EXCEEDING $100,000 FOR 2013. FORM 990, PART V, LINE 2A, COMMON PAYING AGENT FOR EMPLOYEES NORTON HEALTHCARE, INC. EIN 61-102875 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY NORTON HEALTHCARE, INC. ON BEHALF OF NORTON HOSPITALS, INC. NORTON HOSPITALS, INC AS APPROXIMATELY 9,279 EMPLOYEES. Form 990, Part VI, Sec A, 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 OR FIRE THE CHIEF EXECUTIVE OFFICER; AND F)AMEND THE ARTICLES OF INCORPORATION OR BYLAWS. Form 990, Part VI, Sec A, Line 2, Family/business relationships amongst interested persons MR. STEPHEN A. WILLIAMS, PRESIDENT AND CEO OF NORTON HEALTHCARE, INC., IS ALSO AN OFFICER FOR NORTON HEALTHCARE, INC., NORTON HOSPITALS, INC., COMMUNITY MEDICAL ASSOCIATES, INC., AND NORTON PROPERTIES, INC. MARIA L. BOUVETTE, PRESIDENT AND CEO (THROUGH JULY 31, 2013) OF PORTER BANCORP, INC. IS A TRUSTEE FOR NORTON HEALTHCARE, INC., NORTON HOSPITALS, INC., COMMUNITY MEDICAL ASSOCIATES, INC. AND NORTON PROPERTIES, INC. MR. WILLIAMS IS A BOARD MEMBER OF PORTER BANCORP, INC. - BUSINESS RELATIONSHIP Form 990, Part VI, Sec A, 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, Sec A, 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, Sec A, Line 7b, Decisions requiring approval by members or stockholders ACCORDING TO THE ARTICLES OF INCORPORATION OF THE ORGANIZATION, NORTON HEALTHCARE, INC., 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 HEALTHCARE, INC., ALSO POSSESSES THE RIGHT TO REQUIRE THE ORGANIZATION TO (I) PROVIDE CONTRIBUTIONS OF FUNDS OF THE ORGANIZATION TO PAY ALL OR A PORTION OF THE PRINCIPAL OF, INTEREST ON, AND ALL OTHER PAYMENTS TO BECOME DUE AND OWING WITH RESPECT TO ANY AND ALL INDEBTEDNESS INCURRED BY NORTON HEALTHCARE, INC., AND (II) PROVIDE SECURITY FOR SUCH INDEBTEDNESS. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body AT THE OCTOBER 9, 2014 FINANCE COMMITTEE MEETING OF NORTON HEALTHCARE, INC. (NORTON), THE 990S WERE DISCUSSED AND COMMITTEE MEMBERS 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 DIRECTOR'S PORTAL SITE. 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, Sec B, 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 INTEREST OF THE ORGANIZATION. Form 990, Part VI, Sec B, 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, Sec B, 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. (NHI) ENGAGES AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT, INTEGRATED HEALTHCARE STRATEGIES (IHS), TO PROVIDE COMPARABILITY DATA FOR NHI'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 2012 FOR THE 2013 COMPENSATION REVIEW AND MET IN 2013 FOR THE 2014 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 NHI'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. EMPLOYMENT CONTRACTS FOR THE CEO, COO, AND CFO AND KEY EMPLOYEES ARE SIGNED, AND REVIEWED AS NECESSARY. Form 990, Part VI, Sec C, 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. (NHI) 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 NHI. NHI'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, NHI 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 2013. Form 990 , Part XI, Line 9, Other changes in net assets or fund balances AFFILIATE TRANSFER - -20504; FORM 990, PART XII, LINE 3A, A-133 AUDITS PART XII LINE 3A AND 3B AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFITS ORGANIZATIONS, IN 2011 NORTON HEALTHCARE, INC. AND AFFILIATES (NORTON HOSPITALS, INC. COMMUNITY MEDICAL ASSOCIATES, INC., NORTON ENTERPRISES, INC., NORTON HEALTHCARE FOUNDATION, INC., NORTON PROPERTIES, INC., AND THE CHILDREN'S HOSPITAL FOUNDATION) RECEIVED AN AUDIT IN ACCORDANCE WITH SINGLE AUDIT ACT. NORTON HEALTHCARE INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE KY 40202 611028725 PROVIDE ADMINISTRATIVE AND SUPPORT SERVICES KY 501(C)(3) 11 - 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) 11 - 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 false false true false false false false false false false false false false false true false false true true